Volume 58, Issue 4

The high failure rate of traditional procedures of repairing pelvic organ prolapse by using sutures pushes multiple transvaginal mesh delivery systems into the marketplace; however, these are currently without optimal clinical results. We observed the short-term histological changes and the effects of Th1/Th2 cytokines after the implantation in rabbit abdominal walls of five materials, i.e., porcine urinary bladder matrix (UBM), cross-linked UBM, polypropylene mesh, composite cross-linked UBM, and composite UBM, and explored the feasibility of their application to pelvic reconstructive surgery. Grafts were harvested at 1, 2, 4, 8, and 12 weeks after surgery and were processed for histology in order to evaluate the host inflammatory response and the degree of tissue incorporation. Additionally, graft site cytokine levels were determined by reverse transcriptase polymerase chain reaction. The results demonstrate that the two composite groups were associated with an erosion response, whereas the other groups induced a milder response than the composite groups. The Th1/Th2 cytokine mRNA expression levels of the cross-linked UBM group at each time point were similar to that of the sham group, whereas the other groups elicited a more variable expression. The cross-linked UBM showed slow degradation, mild inflammatory response, and low immunogenicity. This suggests that cross-linked UBM is a better material of choice for pelvic reconstructive surgery.

The aim of this prospective study was to analyze the migration pattern of the Lubinus SP II hip stem and to evaluate the clinical results. Fifty-nine patients were followed for 2 years. Translational and rotational micromotion of the implant was measured by radiostereometric analysis (RSA) and the Harris hip score (HHS), and the Charnley classification was used to assess the clinical outcome. Although there was a very small, but statistically significant, distal migration of 0.04±0.83 mm, the prosthesis was found stable at 2 years of follow-up. The main migration in this direction took place between 6 months and 1 year. Maximum total point motion (MTPM) showed a mean of 0.99±0.69 mm. Good clinical outcome with HHS results of 42±11 before and 79±16 at 2 years after surgery was observed. The Charnley classification showed increasing additional impairments in the 2-year interval, which is likely to influence the HHS results of future follow-ups. The migration values measured in the present study are far below the thresholds considered clinically relevant in literature. Thus, the conclusion can be drawn that the implant is not at risk for early aseptic loosening. Long-term RSA is required to assess possible late migration.

Based on computed tomography scanning images of human cervical spine, this paper develops a detailed and anatomically accurate finite element model for C4–C6 motion segment to investigate its biomechanical responses. The model includes vertebrae, intervertebral disc, and various ligaments. The annulus fibrosus is characterized by using a previously developed nonlinear, anisotropic, hyperelastic fiber-reinforced model with fiber-matrix shear interaction considered. Other materials are simplified as linear or nonlinear elastic. The proposed cervical model is first validated by comparing numerical force-displacement relationship and intradiscal pressure under axial compression with experimental data available in the literature. The biomechanical responses of the spine segment under axial compression and rotation are then investigated. It is found that the fiber matrix-shear interaction of the annulus fibrosis plays an important role on appropriately predicting the biomechanical behavior of the cervical spine segment.

The use of active prostheses for the lower extremity is limited by the amount of electric energy stored in batteries. A promising way to extend their usage time is to convert motions generated by the human body during walking to electrical energy. A first functioning prototype was designed to transfer kinetic energy from heel contact and forefoot contact to a generator by using a fluidic system. Experimental results show that walking with the system generates an average electrical power of 0.8 W. The design of the energy scavenging system (ESS) is presented and results are discussed.

Novel surface coatings of percutaneous implants need to be tested in biocompatibility studies. The use of animal models for testing usually involves numerous lethal biopsies for the analysis of the implant-tissue interface. In this study, optical coherence tomography (OCT) was used to monitor the reaction of the skin to a percutaneous implant in an animal model of hairless but immunocompetent mice. In vivo optical biopsies with OCT were taken at days 7 and 21 after implantation and post mortem on the day of noticeable inflammation. A Fourier-domain OCT was programmed for spoke pattern scanning schemes centered at the implant midpoint to reduce motion artifacts during in vivo imaging. Image segmentation allowed the automatic detection and morphometric analysis of the skin contour and the subcutaneous implant anchor. On the basis of the segmentation, the overall refractive index of the tissue within one OCT data set was estimated as a free parameter of a fitting algorithm, which corrects for the curved distortion of the planar implant base in the OCT images. OCT in combination with the spoke scanning scheme and image processing provided time-resolved three-dimensional optical biopsies around the implants to assess tissue morphology.

With the aging but still active population, research on total joint replacements relies increasingly on numerical methods, such as finite element analysis, to improve wear resistance of components. However, the validity of finite element models largely depends on the accuracy of their material behavior and geometrical representation. In particular, material properties are often based on manufacturer data or literature reports, but can alternatively be estimated by matching experimental measurements and structural predictions through modal analyses and identification of eigenfrequencies. The aim of the present study was to compare the accuracy of common setups used for estimating the eigenfrequencies of typical components often used in prosthetized joints. Eigenfrequencies of cobalt-chrome and ultra-high-molecular weight polyethylene components were therefore measured with four different setups, and used in modal analyses of corresponding finite element models for an iterative adjustment of their material properties. Results show that for the low-damped cobalt chromium endoprosthesis components, all common measuring setups provided accurate measurements. In the case of high-damped structures, measurements were only possible with setups including a continuously excitation system such as electrodynamic shakers. This study demonstrates that the iterative back-calculation of eigenfrequencies can be a reliable method to estimate the elastic properties for finite element models.

The computation of neural firing rates based on spike sequences has been introduced as a useful tool for extraction of an animal’s behavior. Different estimating methods of such neural firing rates have been developed by neuroscientists, and among these methods, time histogram and kernel estimators have been used more than other approaches. In this paper, the problem in the estimation of firing rates using wavelet density estimators has been considered. The results of simulation study in estimation of underlying rates based on spike sequences sampled from two different variable firing rates show that the proposed wavelet density method provides better and more accurate estimation of firing rates with smooth results compared to two other classical approaches. Furthermore, the performance of a different family of wavelet density estimators in the estimation of the underlying firing rate of biological data have been compared with results of both time histogram and kernel estimators. All in all, the results show that the proposed method can be useful in the estimation of firing rate of neural spike trains.