Anesthetic management for cesarean section in two parturient with ascending aortic aneurysm: a case-based discussion.

BACKGROUND: The anesthetic management of parturients with ascending aortic aneurysm for cesarean section can be particularly challenging, primarily because of increased risk for aortic dissection or aneurysm rupture. CASE PRESENTATION: We present some aspects of the anesthetic management of two parturients with ascending aortic aneurysm for cesarean sections; amongst, the use of remifentanil with its effects on patient and newborn. We emphasize the importance of a cardio-obstetric team in the context of preoperative planning of such patients. Also, we reviewed some literature on the anesthetic management with its effect on peri-operative hemodynamic stability. CONCLUSION: Maintaining hemodynamic stability is paramount in the prevention of the rupture or dissection of ascending aortic aneurysm during labor of parturient.

A Novel Approach to Measuring Muscle Mechanics in Vehicle Collision Conditions.

The aim of the study was to evaluate a novel approach to measuring neck muscle load and activity in vehicle collision conditions. A series of sled tests were performed on 10 healthy volunteers at three severity levels to simulate low-severity frontal impacts. Electrical activity-electromyography (EMG)-and muscle mechanical tension was measured bilaterally on the upper trapezius. A novel mechanical contraction (MC) sensor was used to measure the tension on the muscle surface. The neck extensor loads were estimated based on the inverse dynamics approach. The results showed strong linear correlation (Pearson's coefficient = 0.821) between the estimated neck muscle load and the muscle tension measured with the MC sensor. The peak of the estimated neck muscle force delayed 0.2 ± 30.6 ms on average vs. the peak MC sensor signal compared to the average delay of 61.8 ± 37.4 ms vs. the peak EMG signal. The observed differences in EMG and MC sensor collected signals indicate that the MC sensor offers an additional insight into the analysis of the neck muscle load and activity in impact conditions. This approach enables a more detailed assessment of the muscle-tendon complex load of a vehicle occupant in pre-impact and impact conditions.

Failure properties and damage of cervical spine ligaments, experiments and modeling.

Cervical spine ligaments have an important role in providing spinal cord stability and restricting excessive movements. Therefore, it is of great importance to study the mechanical properties and model the response of these ligaments. The aim of this study is to characterize the aging effects on the failure properties and model the damage of three cervical spine ligaments: the anterior and the posterior longitudinal ligament and the ligamentum flavum. A total of 46 samples of human cadaveric ligaments removed within 24-48 h after death have been tested. Uniaxial tension tests along the fiber direction were performed in physiological conditions. The results showed that aging decreased the failure properties of all three ligaments (failure load, failure elongation). Furthermore, the reported nonlinear response of cervical ligaments has been modeled with a combination of the previously reported hyperelastic and damage model. The model predicted a nonlinear response and damage region. The model fittings are in agreement with the experimental data and the quality of agreement is represented with the values of the coefficient of determination close to 1.

Comparison of hydraulic, pneumatic and electric linear actuation systems.

Different applications or industries use different systems for linear actuation, such as hydraulic, pneumatic or electric. Electric systems are becoming increasingly popular and are already replacing hydraulic systems in various applications. These are known to be potentially harmful to the environment, as large amounts of fluid can be released into the environment in the event of a pipe burst or other accident. This paper presents the results of a comparison between hydraulic, pneumatic and electric systems under variable conditions but with similar loads in all three systems. The common feature of all three systems is the input power, which was limited to 1.1 kW. There was no hydraulic accumulator in the hydraulic system and no pressure vessel in the pneumatic system, so no stored energy could influence the system behaviour or results. The main difference between the systems studied was the profile of displacement and power consumption. The most consistent response and lowest power consumption were obtained with the electric system, although both hydraulic and pneumatic systems can achieve consistent response with some modifications.

Analysis of the mechanical response of damaged human cervical spine ligaments.

BACKGROUND: Cervical spine ligaments that protect the spinal cord and stabilize the spine are frequently injured in motor vehicle collisions and other traumatic situations. These injuries are usually incomplete, and often difficult to notice. The focus of the presented study is placed on analysis of the effect of subfailure load on the mechanical response of the three main cervical spine ligaments: the anterior and the posterior longitudinal ligament and the ligamentum flavum. METHODS: A total of 115 samples of human cadaveric ligaments removed within 24-48 h after death have been tested. Uniaxial tension tests along the fiber direction were performed in physiological conditions on a custom designed test equipment. The ligaments were loaded into an expected damage zone at two different subfailure values (based on previously reported reference group of 46 samples), and then reloaded to failure. FINDINGS: The main effect of a high subfailure load has proven to be the toe elongation change. The toe elongation increase is affected by the subfailure load value. While anterior and posterior longitudinal ligament showed similar changes, the smallest subfailure effect was found in ligamentum flavum. INTERPRETATIONS: The normal physiological region of the cervical spine ligaments mechanical response is modified by a high subfailure load. The observed ligament injury significantly compromises ligament ability to give tensile support within physiological spinal motion.

Material properties of human patellar-ligament grafts from the elderly population.

The aim of the presented study was to estimate the material properties of human patellar ligaments from the elderly population by means of tensile tests. The experimental part was conducted on a custom tensile-testing device, with a built-in enclosure to simulate in-vivo conditions, using 25 (15 female, 10 male) bone-ligament-bone samples from elderly (age 83 (8)) human donors. During the tensile tests, the resultant force and displacement of the sample attachments were recorded. With this data and the values of the initial length and the initial cross-sectional area of the samples, the engineering stress and strain, the Young's modulus and the toughness at rupture were calculated for each sample. The results were then averaged and presented for all the samples together and for the female and male populations separately. The measured Young's modulus and the failure stress values were found to be significantly higher for the female samples compared to the male (p < 0.05). All the other measured properties did not show a significant difference. The toe region's material properties for the patellar ligament were also presented as valuable information for the anterior cruciate ligament reconstruction. The tensile-test results were compared to other research carried on human patellar ligaments using samples from younger donors. The comparison showed that the samples from the elderly population exhibit lower values of strain at the end of the toe region and have a lower failure strain for the patellar ligament. The Young's modulus and the failure stress of the samples in this study were in the range of other research conducted on patellar ligaments.

Loading rate effect on mechanical properties of cervical spine ligaments.

Mechanical properties of cervical spine ligaments are of great importance for an accurate finite element model when analyzing the injury mechanism. However, there is still little experimental data in literature regarding fresh human cervical spine ligaments under physiological conditions. The focus of the present study is placed on three cervical spine ligaments that stabilize the spine and protect the spinal cord: the anterior longitudinal ligament, the posterior longitudinal ligament and the ligamentum flavum. The ligaments were tested within 24-48 hours after death, under two different loading rates. An increase trend in failure load, failure stress, stiffness and modulus was observed, but proved not to be significant for all ligament types. The loading rate had the highest impact on failure forces for all three ligaments (a 39.1% average increase was found). The observed increase trend, compared to the existing increase trends reported in literature, indicates the importance of carefully applying the existing experimental data, especially when creating scaling factors. A better understanding of the loading rate effect on ligaments properties would enable better case-specific human modelling.