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  • 1
    ISSN: 1432-0932
    Keywords: Spine ; Spinal fusion ; Biomechanics ; Pedicle screw ; Stress shielding
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The rigidity of a pedicle screw implant is a critical biomechanical variable in lumbar spinal fusions. Sufficient rigidity is required for integration of bone grafts and to promote healing. Osteopenia, stress shielding, and compensatory hypermobility have been described as consequences of excessive rigidity. Little is known about the biomechanical characteristics of “semirigid” compared to “rigid” implants. A new implant, whose rigidity can be varied by selection of different implant components, was tested in vitro under well-defined loading conditions. The three-dimensional load-displacement behavior of all lumbar vertebrae involved in or adjacent to the two-level fusion was evaluated for two fusion modifications: bilateral rigid and bilateral semirigid. Cyclic fatigue loading was subsequently carried out under realistic conditions and motion testing repeated. The rigid device reduced the motion of the L3–4 transfixed segment in the primary movement planes by 87.3% with respect to the intact spine value in flexion/extension (FE), 86.3% in lateral bending (LB), and 76.8% in axial rotation (AR). The semirigid device achieved a reduction in motion of 79.6% (FE), 82.7% (LB), and 51.7% (AR). The semirigid implant was particularly easy to insert, because no bending of rods or plates was necessary. The implants showed no loosening or breakage after the fatigue testing. The results are compared to other available systems and the underlying biomechanics discussed.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0932
    Keywords: Low back pain ; von Willebrand factor antigen ; Vibration ; Vascular damage ; Endothelium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The von Willebrand factor (vWf) is a complex protein whose release is a marker for endothelial damage; serum levels of its antigen (vWFAg) can be used as a marker for such changes. We measured the levels of back discomfort and vWFAg in 11 subjects following 25-min periods of (1) lying down, (2) sitting upright, (3) vibrating whilst sitting and (4) sitting upright. Back discomfort appeared and vWf levels were significantly increased following sitting upright, compared with lying flat, and increased further following vibration. They fell thereafter with a period of sitting still upright. These results demonstrate that vibration has a significant effect in increasing back discomfort and the serum levels of vWFAg, and it is possible that vibration may induce vascular damage within the spine.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-0932
    Keywords: Muscle response ; Sudden load ; Posture ; Low back pain ; Rehabilitation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Unexpected loads, which often occur in the working environment, can lead to high forces in the spine and, thus, may be a cause of low back injury. This paper discusses the effect of “sudden load” on the erector spine reaction and amplitude. Muscle responses were mediated by several factors, including fatigue, posture, expectation and rehabilitation, in chronic low back pain patients. The subjects were fatigued by holding a 20% maximum voluntary contraction for 1 min. A functional restoration program was tested for its efficacy in reducing reaction time and EMG amplitude in chronic low back pain patients. Reaction time was longer and EMG amplitude lower in patients than in their matched controls. EMG reaction time and magnitude decreased in patients after a 2-week rehabilitation program, including specific training of coordination and posture control. The results of the modelling showed higher spinal compressive load and lower shear forces when the load was expected than when the load was unexpected. The effect of sudden loads can be exacerbated if a worker is not standing on a flat surface or is fatigued. Chronic low back pain patients have less ability to protect themselves from sudden loads, but they can be trained to improve their response by means of an appropriate rehabilitation program.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1749-6632
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Natural Sciences in General
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1432-1424
    Keywords: membrane proteins ; membrane biosynthesis ; membrane potential ; surface potential ; surface charge ; dipole potential ; amino acid sequence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Chemistry and Pharmacology
    Notes: Summary Although hydrophobic forces probably dominate in determining whether or not a protein will insert into a membrane, recent studies in our laboratory suggest that electrostatic forces may influence the final orientation of the inserted protein. A negatively charged hepatic receptor protein was found to respond totrans-positive membrane potentials as though “electrophoresing” into the bilayer. In the presence of ligand, the protein appeared to cross the membrane and expose binding sites on the opposite side. Similarly, a positively charged portion of the peptide melittin crosses a lipid membrane reversibly in response to atrans-negative potential. These findings, and others by Date and co-workers, have led us to postulate that transmembrane proteins would have hydrophobic transmembrane segments bracketed by positively charged residues on the cytoplasmic side and negatively charged residues on the extra-cytoplasmic side. In the thermodynamic sense, these asymmetrically placed charge clusters would create a compelling preference for correct orientation of the protein, given the inside-negative potential of most or all cells. This prediction is borne out by examination of the few transmembrane proteins (glycophorin, M13 coat protein, H-2Kb, HLA-A2, HLA-B7, and mouse Ig μ heavy chain) for which we have sufficient information on both sequence and orientation. In addition to the usual diffusion and pump potentials measurable with electrodes, the “microscopic” membrane potential reflects surface charge effects. Asymmetries in surface charge arising from either ionic or lipid asymmetries would be expected to enhance the bias for correct protein orientation, at least with respect to plasma membranes. We introduce a generalized form of Stern equation to assess surface charge and binding effects quantitatively. In the kinetic sense, dipole potentials within the membrane would tend to prevent positively charged residues from crossing the membrane to leave the cytoplasm. These considerations are consistent with the observed protein orientations. Finally, the electrostatic and hydrophobic factors noted here are combined in two hypothetical models of translocation, the first involving initial interaction of the presumptive transmembrane segment with the membrane; the second assuming initial interaction of a leader sequence.
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  • 7
    ISSN: 1045-4861
    Keywords: Chemistry ; Polymer and Materials Science
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine , Technology
    Notes: In this paper we have reviewed the feasibility of using a shock wave lithotripter to loosen the interface between the bone and acrylic bone cement for revision arthroplasty. We have reviewed the physics of shock wave and its applications in medicine, especially its interaction with tissues. The calculations show that the energy is greatly reduced at the interface both in the soft tissue-bone interface and cement-bone interface. On the other hand, a tensile and compressive pressure can be operated at the cement-bone interface that can cause the interface to break if the pressure exceeds the tensile strength of the cement-bone interface.Subsequent papers will deal with in vitro and in vivo application of the shock wave in the treatment of the cement-bone interface in order to weaken it and consequently for easier extraction of bone cement from the intramedullary canal.
    Additional Material: 5 Ill.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1045-4861
    Keywords: Chemistry ; Polymer and Materials Science
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine , Technology
    Notes: In order to apply the extracorporeal shock wave lithotripter (ECWSL) technique to the loosening of the bone-cement interface for the extraction of the cement during revision arthroplasty it is essential to know the dose-response characteristics. The present study shows that the number of shocks needed to break the interface between a 2- and 6-mm-thick bovine femoral bone and bone cement is similar to the fatigue behavior of a material, that is, Log(N) = C(kV) + D, where N is the number of shock impulses, kV is the power setting of the lithotripter machine in kilovolts, and C and D are constants. Iso-pressure distribution of the traveling shock wave front through a simulated bone in a Plexiglass® tube using Fuji® pressure film showed quantitative pressure contours from which one can understand the effective area of shock wave and its distribution. The most effective area of the shock wave was about 1.5 cm in diameter at 23 and 25 kV with pressure at least 7.0 MPa which is more than sufficient to break the bone-cement interface in tension.
    Additional Material: 16 Ill.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1045-4861
    Keywords: Chemistry ; Polymer and Materials Science
    Source: Wiley InterScience Backfile Collection 1832-2000
    Topics: Medicine , Technology
    Notes: The present study was conducted to compare the push-out strength of the treated and control samples obtained after implantation of intramedullary rod in canine femurs with bone cement to simulate the femoral stem implantation for 2 weeks, 3 and 6 months. Contralateral femur served as control. The result showed a significant decrease in push-out interfacial strength after shock wave treatment (average 48.4% decrease compared with control, p 〈 0.0001) which is similar to the in vitro results. There was no significant difference if the shock treatment was applied and left for 2 weeks or 4 weeks compared to the ones tested immediately after sacrifice. There were some soft tissue damage immediately following shock treatment in the focal area but this returned to normal in 2 weeks. Human cadaveric femoral bones and the canine bone (the dosage level was higher for the human bone than canine). The number of impacts used to extract the bone cement plug out of a human femur segment (5-cm long) decreased about 68% at 23 and 25 kV treatment power level. These preliminary studies indicate that the shock wave can be utilized to reduce the interfacial strength of the bone and bone cement although more studies are needed to assess its efficacy in terms of cost, long-term effect on patients and the exact mechanism of the loosening before this technique can be used clinically.
    Additional Material: 18 Ill.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Palo Alto, Calif. : Annual Reviews
    ISSN: 0084-6589
    Source: Annual Reviews Electronic Back Volume Collection 1932-2001ff
    Topics: Biology , Physics
    Type of Medium: Electronic Resource
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