Skeletal benefits after long-term retirement in former elite female gymnasts

Bone strength benefits after long-term retirement from elite gymnastics in terms of bone geometry and volumetric BMD were studied by comparing retired female gymnasts to moderately active age-matched women. In a cross-sectional study, 30 retired female gymnasts were compared with 30 age-matched moderately active controls. Bone geometric and densitometric parameters were measured by pQCT at the distal epiphyses and shafts of the tibia, femur, radius, and humerus. Muscle cross-sectional areas were assessed from the shaft scans. Independent t-tests were conducted on bone and muscle variables to detect differences between the two groups. The gymnasts had retired for a mean of 6.1 +/- 0.4 yr and were engaged in distal radius (22-25%, p

[Avascular necrosis of the hamate--case report]

Avascular necrosis of the hamate is a very rare condition. After repetitive stress a young male developed left wrist pain which was found to be an avascular necrosis of the hamate. After progression of the necrosis with cyst formation on follow-up magnetic resonance imaging (MRI) and persisting pain, the patient underwent successful revascularisation with a vascular bone graft of the distal radius.

Quantitative contrast echocardiographic assessment of collateral derived myocardial perfusion during elective coronary angioplasty

OBJECTIVE To determine whether myocardial contrast echocardiography can be used to quantify collateral derived myocardial flow in humans. METHODS In 25 patients undergoing coronary angioplasty, a collateral flow index (CFI) was determined using intracoronary wedge pressure distal to the stenosis to be dilated, with simultaneous mean aortic pressure measurements. During balloon occlusion, echo contrast was injected into both main coronary arteries simultaneously. Echocardiography of the collateral receiving myocardial area was performed. The time course of myocardial contrast enhancement in images acquired at end diastole was quantified by measuring pixel intensities (256 grey units) within a region of interest. Perfusion variables, such as background subtracted peak pixel intensity and contrast transit rate, were obtained from a fitted gamma variate curve. RESULTS 16 patients had a left anterior descending coronary artery stenosis, four had a left circumflex coronary artery stenosis, and five had a right coronary artery stenosis. The mean (SD) CFI was 19 (12)% (range 0-47%). Mean contrast transit rate was 11 (8) seconds. In 17 patients, a significant collateral contrast effect was observed (defined as peak pixel intensity more than the mean + 2 SD of background). Peak pixel intensity was linearly related to CFI in patients with a significant contrast effect (p = 0.002, r = 0.69) as well as in all patients (p = 0.0003, r = 0.66). CONCLUSIONS Collateral derived perfusion of myocardial areas at risk can be demonstrated using intracoronary echo contrast injections. The peak echo contrast effect is directly related to the magnitude of collateral flow.

Clinical parameters associated with collateral development in patients with chronic total coronary occlusion

OBJECTIVE Well-developed collaterals provide survival benefit in patients with obstructive coronary artery disease (CAD). Therefore, in this study we sought to determine which clinical variables are associated with arteriogenesis. DESIGN Clinical and laboratory variables were collected before percutaneous coronary intervention. Multivariate analysis was performed to determine which variables are associated with the collateral flow index (CFI). PATIENTS Data from 295 chronic total occlusion (CTO) patients (Bern, Switzerland, Amsterdam, the Netherlands and Jena, Germany) were pooled. In earlier studies, patients had varying degrees of stenosis. Therefore, different stages of development of the collaterals were used. In our study, a unique group of patients with CTO was analysed. INTERVENTIONS Instead of angiography used earlier, we used a more accurate method to determine CFI using intracoronary pressure measurements. CFI was calculated from the occlusive pressure distal of the coronary lesion, the aortic pressure and central venous pressure. RESULTS The mean CFI was 0.39 ± 0.14. After multivariate analysis, β blockers, hypertension and angina pectoris duration were positively associated with CFI (B: correlation coefficient β=0.07, SE=0.03, p=0.02, B=0.040, SE=0.02, p=0.042 and B=0.001, SE=0.000, p=0.02). Furthermore also after multivariate analysis, high serum leucocytes, prior myocardial infarction and high diastolic blood pressure were negatively associated with CFI (B=-0.01, SE=0.005, p=0.03, B=-0.04, SE=0.02, p=0.03 and B=-0.002, SE=0.001, p=0.011). CONCLUSIONS In this unique cohort, high serum leucocytes and high diastolic blood pressure are associated with poorly developed collaterals. Interestingly, the use of β blockers is associated with well-developed collaterals, shedding new light on the potential action mode of this drug in patients with CAD.

An experimentally validated finite element method for augmented vertebral bodies

Background Finite element models of augmented vertebral bodies require a realistic modelling of the cement infiltrated region. Most methods published so far used idealized cement shapes or oversimplified material models for the augmented region. In this study, an improved, anatomy-specific, homogenized finite element method was developed and validated to predict the apparent as well as the local mechanical behavior of augmented vertebral bodies. Methods Forty-nine human vertebral body sections were prepared by removing the cortical endplates and scanned with high-resolution peripheral quantitative CT before and after injection of a standard and a low-modulus bone cement. Forty-one specimens were tested in compression to measure stiffness, strength and contact pressure distributions between specimens and loading-plates. From the remaining eight, fourteen cylindrical specimens were extracted from the augmented region and tested in compression to obtain material properties. Anatomy-specific finite element models were generated from the CT data. The models featured element-specific, density-fabric-based material properties, damage accumulation, real cement distributions and experimentally determined material properties for the augmented region. Apparent stiffness and strength as well as contact pressure distributions at the loading plates were compared between simulations and experiments. Findings The finite element models were able to predict apparent stiffness (R2 > 0.86) and apparent strength (R2 > 0.92) very well. Also, the numerically obtained pressure distributions were in reasonable quantitative (R2 > 0.48) and qualitative agreement with the experiments. Interpretation The proposed finite element models have proven to be an accurate tool for studying the apparent as well as the local mechanical behavior of augmented vertebral bodies.

Intraoperative Mechanical Measurement of Bone Quality With the DensiProbe.

Reduced bone stock can result in fractures that mostly occur in the spine, distal radius, and proximal femur. In case of operative treatment, osteoporosis is associated with an increased failure rate. To estimate implant anchorage, mechanical methods seem to be promising to measure bone strength intraoperatively. It has been shown that the mechanical peak torque correlates with the local bone mineral density and screw failure load in hip, hindfoot, humerus, and spine in vitro. One device to measure mechanical peak torque is the DensiProbe (AO Research Institute, Davos, Switzerland). The device has shown its effectiveness in mechanical peak torque measurement in mechanical testing setups for the use in hip, hindfoot, and spine. In all studies, the correlation of mechanical torque measurement and local bone mineral density and screw failure load could be shown. It allows the surgeon to judge local bone strength intraoperatively directly at the region of interest and gives valuable information if additional augmentation is needed. We summarize methods of this new technique, its advantages and limitations, and give an overview of actual and possible future applications.

Magnet resonance imaging in common injuries of the wrist

Falling on the outstretched hand is a common trauma mechanism. In contrast to fractures of the distal radius, which usually are diagnosed on plain film radiographs, identifying wrist injuries requires further diagnostic methods, e.g., MRI or CT. This article provides a review of the use of MRI in the most common traumatic wrist injuries, including scaphoid fractures, TFCC lesions, and tears of the scapholunate ligament. Early and selective use of MRI as a further diagnostic method in cases of adequate clinical suspicion helps to initiate the correct treatment and, thus, prevents long-term arthrotic injuries and reduces unnecessary absence due to illness. MRI shows a high reliability in the diagnosis of scaphoid fractures and the America College of Radiology recommends MRI as method of choice after X-ray images have been made. In the diagnosis of ligament and discoid lesions, MR arthrography (MRA) using intraarticular contrast agent has considerably higher accuracy than i.v.-enhanced and especially unenhanced MRI.

Evaluation of HA-fibrin-based hydrogel for restoration of degenerated intervertebral disc

Introduction: Intervertebral disc degeneration is associated with loss of nucleus pulposus (NP) tissue and reduced disc height[1]. A number of therapies, including synthetic and natural biomaterials, have been developed to restore full disc function and to minimize the pain and disability caused by this disease. Fibrin-based biomaterials are used as a replacement for NP or as a cell carrier for tissue engineering approaches[2]. While the behavior of such gels is well-characterized from a material point of view, little is known about their contribution to intervertebral disc (IVD) restoration under dynamic loads. The aim of the present study is the evaluation of a hyaluronic acid fibrin-based hydrogel (ProCore) used to repair an in vitro model of disc degeneration under dynamic loading. Methods: In vitro model of disc degeneration was induced in intact coccygeal bovine IVD by papain digestion of the NP as previously described[3]. In order to characterize fibrin hydrogels, four experimental groups were considered: 1) intact IVD (control), 2) IVD injected with PBS, 3) injection of hydrogels in degenerative IVD and 4) injection of hydrogels in combination with human bone marrow-derived mesenchymal stem cells (MSC) in degenerative IVD. All of the groups were subjected to dynamic loading protocols consisting of 0.2MPa static compression superimposed with ±2° torsion at 0.2Hz for 8h per day and maintained for 7 days. Additionally, one group consisted of degenerative IVD injected with hydrogel and subjected to static compression. Disc heights were monitored after the duration of the loading and compared to the initial disc height. The macrostructure of the formed tissue and the cellular distribution was evaluated by histological means. Results: After one week of loading, the degenerative IVD filled with hydrogel in combination with MSC (dynamic load), hydrogels (dynamic load) and hydrogels (static load) showed a reduction in height by 30%, 15% and 20%, respectively, as compared to their initial disc height. Histological sections showed that the HA-fibrin gel fully occupied the nucleotomized region of the disc and that fibrin was effective in filling the discontinuities of the cavity region. Furthermore, the cells were homogenously distributed along the fibrin hydrogels after 7 days of loading. Discussion: In this study, we showed that fibrin hydrogels showed a good integration within the papain-induced model of disc degeneration and can withstand the applied loads. Fibrin hydrogels can contribute to disc restoration by possibly maintaining adequate stiffness of the tissue and thus preventing disorganization of the surrounding IVD. References: 1. Jarman, J.P., Arpinar, V.E., Baruah, D., Klein, A.P., Maiman, D.J., and Tugan Muftuler, L. (2014). Intervertebral disc height loss demonstrates the threshold of major pathological changes during degeneration. Eur Spine J . 2. Colombini, A., Ceriani, C., Banfi, G., Brayda-Bruno, M., and Moretti, M. (2014). Fibrin in intervertebral disc tissue engineering. Tissue Eng Part B Rev . 3. Chan, S.C., Bürki, A., Bonél, H.M., Benneker, L.M., and Gantenbein-Ritter, B. (2013). Papain-induced in vitro disc degeneration model for the study of injectable nucleus pulposus therapy. Spine J 13, 273-283. Acknowledgement We thank the Swiss National Science Foundation SNF #310030_153411 for funding.

Estudio de estabilidad de barreras de contención hidráulicas mediante tomografia eléctrica y placa de carga en Zaragoza

El objetivo del presente proyecto es definir las actuaciones encaminadas a restaurar el sistema actual de defensa del río Ebro en el tramo Pradilla de Ebro- Boquiñeni (Zaragoza), con el propósito de reducir el riesgo por inundaciones en los núcleos de población del mismo nombre, para lo que se ha realizado una campaña de reconocimiento del Terreno mediante técnicas geofísicas. La campaña de prospección ha consistido en la realización de perfiles de tomografía eléctrica para determinar la distribución de los niveles geoeléctricos en la zona obteniéndose la profundidad y variabilidad del nivel freático y la distribución aparente de los niveles biológicos. En base a las anomalías detectadas en las secciones de resistividad se han llevado a cabo ensayos in situ con placa de carga dinámica con el fin de determinar las características portantes de las barreras. La correlación de ambos estudios permite localizar las zonas de debilidad estructural para así poder establecer las recomendaciones oportunas de cara a restaurar los diques de protección, de forma que puedan cumplir con su función de contención frente a los caudales de crecida. ABSTRACT The aim of this project is so define the interventions required to restore the current defense system of Ebro River in the stretch between Pradilla de Ebro and Boquiñeni (Zaragoza), in order to reduce flood risk in the population centers of the same name, for what a soil survey has been done using geophysical techniques. The geophysical prospecting campaign has consisted on the realization of electrical tomography profiles to determine the distribution of due geoelectric levels in the area, the depth and variability of the water table and the distribution of apparent lithology level. Based on anomalies detected in resistivity sections, dynamic loading plate test were carried out in situ in order to determine the load bearing characteristics of the safety barriers. The correlation o f both studies makes possible to locate die areas o f structural weakness, with the objective of establishing appropriate recommendations to restore the embankments so that they can meet their retaining functions against flood flows.

Two-temperature model of the coronal irradiated pellets

A two electron-temperature, quasi-steady model of the corona of a laser-ablated pellet is considered. Ablation pressure, critical radius and mass flow rate are determined. Results are close to those obtained with heat flux saturation well below the free-streaming limit.

A review of load models for the prediction of footfall-induced vibration in structures

Crowd induced dynamic loading in large structures, such as gymnasiums or stadium, is usually modelled as a series of harmonic loads which are defined in terms of their Fourier coefficients. Different values of these coefficients that were obtained from full scale measurements can be found in codes. Recently, an alternative has been proposed, based on random generation of load time histories that take into account phase lag among individuals inside the crowd. This paper presents the testing done on a structure designed to be a gymnasium. Two series of dynamic test were performed on the gym slab. For the first test an electrodynamic shaker was placed at several locations and during the second one people located inside a marked area bounced and jumped guided by different metronome rates. A finite element model (FEM) is presented and a comparison of numerically predicted and experimentally observed vibration modes and frequencies has been used to assess its validity. The second group of measurements will be compared with predictions made using the FEM model and three alternatives for crowd induced load modelling.

Model of human rhythmic activities on structures

Crowd induced dynamic loading in large structures, such as gymnasiums or stadiums, is usually modelled as a series of harmonic loads which are defined in terms of their Fourier coefficients. Different values of these Fourier coefficients that were obtained from full scale measurements can be found in codes. Recently, an alternative has been proposed, based on random generation of load time histories that take into account phase lags among individuals inside the crowd. Generally the testing is performed on platforms or structures that can be considered rigid because their natural frequencies are higher than the excitation frequencies associated with crowd loading. In this paper we shall present the testing done on a structure designed to be a gymnasium, which has natural frequencies within that range. In this test the gym slab was instrumented with acceleration sensors and different people jumped on a force plate installed on the floor. Test results have been compared with predictions based on the two abovementioned load modelling alternatives and a new methodology for modelling jumping loads has been proposed in order to reduce the difference between experimental and numerical results at high frequency range.

Modified Gutenberg-Richter coefficient for damage evaluation in reinforced concrete structures subjected to seismic simulations on a shaking table

This paper presents analysis and discussion of the b- and ib-values calculated from the acoustic emission (AE) signals recorded during dynamic shake-table tests conducted on a reinforced concrete (RC) frame subjected to several uniaxial seismic simulations of increasing intensity until collapse. The intensity of shaking was controlled by the peak acceleration applied to the shake-table in each seismic simulation, and it ranged from 0.08 to 0.47 times the acceleration of gravity. The numerous spurious signals not related to concrete damage that inevitably contaminate AE measurements obtained from complex dynamic shake-table tests were properly filtered with an RMS filter and the use of guard sensors. Comparing the b- and ib-values calculated through the tests with the actual level of macro-cracking and damage observed during testing, it was concluded that the limit value of 0.05 proposed in previous research to determine the onset of macro-cracks should be revised in the case of earthquake-type dynamic loading. Finally, the b- and ibvalues were compared with the damage endured by the RC frame evaluated both visually and quantitatively in terms of the inter-story drift index.

Analysis and forecast of truck traffic loads and the relative damage to pavement systems as a function of axle configurations. Final report.

Texas State Department of Highways and Public Transportation, Transportation Planning Division, Austin

Seismically-Induced Rock-Slope Failure: Numerical Investigation using the Bonded Particle Model

Thesis (Ph.D.)--University of Washington, 2016-06