In vitro comparison of mechanical and degradation properties of equivalent absorbable suture materials from two different manufacturers.

OBJECTIVE: To compare the mechanical, knotting, and absorption properties of 3 synthetic absorbable suture materials (polyglactin 910, polydioxanone, poliglecaprone 25) from 2 different manufacturers (Huaiyin Medical Instruments Co. Ltd. and Ethicon Inc.). SAMPLE POPULATION: Suture material samples from the same manufacturing lot for each suture type and manufacturer. METHODS: Part 1: 10 samples of each suture were incubated in bovine serum and tested for ultimate load and stiffness at days 0, 1, 7, 14, 21, and 28. Part 2: 10 knotted samples were similarly evaluated, without incubation. RESULTS: Huaiyin polydioxanone had a greater (P<.001) ultimate load on days 0, 1, and 7; and a consistently greater stiffness for the duration of the study, compared with the Ethicon polydioxanone. Ethicon poliglecaprone 25 had a greater ultimate load on days 0, 1, 7 (P<.001); on day 21 Huaiyin had a greater ultimate load. Ethicon poliglecaprone had greater stiffness on days 0, 1, 7 (P<.001). Ethicon polyglactin 910 had a greater (P<.001) ultimate load at all times and a greater stiffness (P<.001) at days 0, 1, 7, and 14 compared with Huaiyin polyglactin 910. Huaiyin polydioxanone and polyglactin 910 had greater knot breaking strengths than Ethicon equivalents (P<.001). CONCLUSION: Differences in mechanical properties exist between nominally identical suture materials from different manufacturers.

Aging enhances a mechanically-induced reduction in tendon strength by an active process involving matrix metalloproteinase activity.

Age-associated and degenerative loss of functional integrity in soft tissues develops from effects of cumulative and subtle changes in their extracellular matrix (ECM). The highly ordered tendon ECM provides the tissue with its tensile strength during loading. As age and exercise collide in the high incidence of tendinopathies, we hypothesized that aged tendons fail due to cumulative damage resulting from a combination of diminished matrix repair and fragmentation of ECM proteins induced by prolonged cyclical loading, and that this is an active cell-mediated process. We developed an equine tendon explant model to examine the effect of age on the influence of prolonged cyclical loading at physiologically relevant strain rates (5% strain, 1 Hz for 24 h) on tissue mechanical properties, loss of ECM protein and matrix metalloproteinase (MMP) expression. We show significantly diminished mechanical strength of cyclically loaded tissue compared to controls (39.7 +/- 12%, P

Regional load bearing of the canine acetabulum.

OBJECTIVE: To determine the load bearing areas of the canine acetabulum. MATERIALS AND METHODS: A kinematic study of four healthy dogs was used to determine the orientation of the femur to the pelvis at mid-stance. Femora and pelves from 10 canine cadavers were loaded with the physiological canine hip reaction force and angle being replicated. Impression material placed within the acetabulum was extruded from areas of load bearing. Digital images before and after loading were used to assess if six different regions of the acetabulum were fully, partially or non-load bearing. RESULTS: All areas of the acetabulum were partially or fully load bearing. The cranial and caudal thirds of the acetabulum were 7.9 and 13.1 times more likely to be fully load bearing than the central third, respectively. There was a significant difference in load bearing between the axial, middle and abaxial thirds of the acetabulum in all tests, with the middle and abaxial thirds 72.4 and 351 times more likely to be fully load bearing than the axial third, respectively. CONCLUSION: The cranial and caudal thirds and the middle and abaxial thirds of the canine acetabulum are fully load bearing. CLINICAL RELEVANCE: The caudal third of the canine acetabulum is loaded and therefore recommendations that fractures in this area be managed conservatively need to be reconsidered.

Noninvasive Raman spectroscopy of human tissue in vivo.

We report the first transcutaneous Raman spectrum of human bone in vivo obtained at skin-safe laser illumination levels. The spectrum of thumb distal phalanx was obtained using spatially offset Raman spectroscopy (SORS), which provides chemically specific information on deep layers of human tissue, well beyond the reach of existing comparative approaches. The spectroscopy is based on collecting Raman spectra away from the point of laser illumination using concentric rings of optical fibers. As a generic analytical tool this approach paves the way for a range of uses including disease diagnosis, noninvasive probing of pharmaceutical products, biofilms, catalysts, paints, and in dermatological applications.

Novel assessment of bone using time-resolved transcutaneous Raman spectroscopy.

UNLABELLED: With fragility fractures increasing as the population ages, there is a need for improved means to estimate risk of fracture. We recorded Raman spectra of both the mineral and organic phases of bone transcutaneously, a technology with potential to enhance bone quality and fracture risk assessment. INTRODUCTION: The current "gold standard" assessment of bone quality is BMD determined by DXA. However, this accounts for only 60-70% of bone strength. X-rays are absorbed by the mineral phase of bone, whereas the organic phase remains essentially invisible; however, bone strength is critically dependent on both phases. We report, for the first time, a Raman spectroscopic technique that analyses both phases of bone beneath unbroken skin by eliminating spectral components of overlying tissues. MATERIALS AND METHODS: We used an 800-nm laser (1-kHz, 1-ps pulses) with a synchronized 4-ps Kerr gate with variable picosecond delay that effectively shuttered out photons from overlying tissues. We measured bone Raman spectra at a point 2 mm above the carpus from two mouse genotypes with extreme differences in bone matrix quality: wildtype and oim/oim (matched for age, sex, and weight). Typical depth was 1.1 mm. We repeated the measurements with overlying tissues removed down to bone. Oim/oim mice produce only homotrimeric collagen, which results in poorly mineralized bone tissue. RESULTS: The main spectral features were present from both bone phases. The spectral bands were in similar ratios when measured through the skin or directly from bone (in both genotypes). The band of the mineral phase (phosphate nu1) was smaller in oim/oim mice when measured directly from bone and through skin. The band associated with a particular vibrational mode of organic phase collagen (CH2 wag) showed a frequency shift between the genotypes. CONCLUSIONS: This novel technique allowed us, for the first time, to make objective transcutaneous spectral measurements of both the mineral and the organic phases of bones and distinguish between normal and unhealthy bone tissue. After further optimization, this technology may help improve fracture risk assessments and open opportunities for screening in anticipation of the predicted increase in fragility fractures.

Kerr-gated time-resolved Raman spectroscopy of equine cortical bone tissue.

Picosecond time-resolved Raman spectroscopy in equine cortical bone tissue is demonstrated. Using 400-nm pulsed laser excitation (1 ps at 1 kHz) it is shown that Kerr cell gating with a 4-ps window provides simultaneously time-resolved rejection of fluorescence and time-resolved Raman scatter enabling depth profiling through tissue. The Raman shifts are the same as those observed by conventional cw Raman spectroscopy using deep-red or near-infrared lasers. The time decay of Raman photons is shown to fit an inverse square root of time function, suggesting propagation by a diffusive mechanism. Using polystyrene behind a bone specimen, it is shown that the 400-nm laser light penetrates at least 0.31 mm below the surface of a fully mineralized bone tissue specimen and generates observable bone Raman scatter (approximately 415 to 430 nm) through most of this depth. These novel results demonstrate great promise for in vivo applications for studying diseased bone tissue, and ways to optimize the setup are discussed.

A novel technique for four-point bending of small bone samples with semi-automatic analysis.

The design of this system takes into account the following parameters: the effects of excessive strain; specimen depth and width; span-depth ratio; overhang; rate of loading; measuring displacement from the crosshead position; radius of contact points; and the distance between the contacts. The contacts are radius edges rather than cylinders, although this is not to be recommended for multiple cycles because of wear problems, it does make the system as stiff as possible (allowance is made for this compliance). Equations are presented that allow the surface stress and strain to be calculated for each time point semi-automatically. The combination of stiff contacts and strain equations based on crosshead position not mid-span displacement is novel, this allows rapid analysis with minimum intervention from the user and gives results that are in agreement with those in the literature.

Mechanical testing of human cardiac tissue: some implications for MRI safety.

PURPOSE: The effects of aging on tissue strength and its ability to withstand forces associated with MRI have not been investigated. This study aimed to determine the forces required to cause partial or total detachment of a heart valve prosthesis in patients with age-related degenerative diseases exposed to MRI. METHODS: Eighteen tissue samples excised during routine heart valve replacement surgery were subjected to a suture pull-out test using a tensile materials testing machine. Five preconditioning cycles were applied before commencing the final destructive test. The test was complete when the sample ruptured and the suture was pulled completely free from the tissue. Results were compared with previously calculated magnetically induced forces at 4.7 T. RESULTS: All tissue samples displayed a basic failure pattern. Mean forces required to cause initial yield and total rupture were 4.0 N (+/- 3.3 N) and 4.9 N (+/- 3.6 N), respectively. Significant factors determining initial yield were stenosed calcific tissue (p < .01), calcific degeneration (single pathology) (p < .04) and tissue stiffness (p < .01). Calcific degeneration (p < .03) and tissue stiffness (p < .03) were also significant in determining maximum force required to cause total rupture. CONCLUSION: Specific age-related degenerative cardiac diseases stiffen and strengthen tissue resulting in significant forces being required to pull a suture through valve annulus tissue. These forces are significantly greater than magnetically induced < 4.7 T. Therefore, patients with degenerative valvular diseases are unlikely to be at risk of valve dehiscence during exposure to static magnetic field < or = 4.7 T.

Early experience with a new technique and technology designed for the study of pulsatile cardiopulmonary bypass in the rat.

The benefits of pulsatile flow during the period of cardiopulmonary bypass (CPB) applied during open-heart surgery remains controversial. We have developed a rodent (rat) model of CBP that has been designed to functionally mimic the clinical setting, principally, but not solely, for the study of pulsatile CPB. The successful development of this model centres on the design of the bypass circuitry and the surgical approach employed. The entire circuit is similar to clinical equipment in terms of its construction, configuration, performance, material surface area to blood volume ratio, and priming volume to blood volume ratio. The overall priming volume of the perfusion circuitry is less than 12 ml. Early studies confirm that the pumping technology functions well, gas exchange was adequate at all times, and blood pressure exhibited a normal CPB profile and haemodynanmic response to pulsatile blood flow. We conclude that this is an effective tool for investigating the pathophysiology of pulsatile blood flow during CPB.