The vacuolated morphology of chordoma cells is dependent on cytokeratin intermediate filaments.

Notochordal cells (NCs), characterized by their vacuolated morphology and coexpression of cytokeratin and vimentin intermediate filaments (IFs), form the immature nucleus pulposus (NP) of the intervertebral disc. As humans age, NCs give way to mature NP cells, which do not possess a vacuolated morphology and typically only express vimentin IFs. In light of their concomitant loss, we investigated the relationship between cytosolic vacuoles and cytokeratin IFs, specifically those containing cytokeratin-8 proteins, using a human chordoma cell line as a model for NCs. We demonstrate that the chemical disruption of IFs with acrylamide, F-actin with cytochalasin-D, and microtubules with nocodazole all result in a significant (p < 0.001) decrease in vacuolation. However, vacuole loss was the greatest in acrylamide-treated cells. Examination of the individual roles of vimentin and cytokeratin-8 IFs in the existence of vacuoles was accomplished using small interfering RNA-mediated RNA interference to knock down either vimentin or cytokeratin-8 expression. Reduction of cytokeratin-8 expression was associated with a less-vacuolated cell morphology. These data demonstrate that cytokeratin-8 IFs are involved in stabilizing vacuoles and that their diminished expression could play a role in the loss of vacuolation in NCs during aging. A better understanding of the NCs may assist in preservation of this cell type for NP maintenance and regeneration.

Correction to: Deformability of Human Mesenchymal Stem Cells Is Dependent on Vimentin Intermediate Filaments.

This erratum is to correct the following: (1) in the Western Blotting subsection under the Materials and Methods section, the concentration of protein from each sample loaded into Criterion Tris-HCl gels was incorrectly stated as 155 µg of protein. The correct value is 9.7 µg; (2) in Fig. 1b, the bar graph showed incorrect values for semi-quantitation of Western blots. Figure 1 has been updated with a corrected graph in Fig. 1b only.

A Biomechanical Comparison of Allograft Tendons for Ligament Reconstruction.

BACKGROUND: Allograft tendons are frequently used for ligament reconstruction about the knee, but they entail availability and cost challenges. The identification of other tissues that demonstrate equivalent performance to preferred tendons would improve limitations. Hypothesis/Purpose: We compared the biomechanical properties of 4 soft tissue allograft tendons: tibialis anterior (TA), tibialis posterior (TP), peroneus longus (PL), and semitendinosus (ST). We hypothesized that allograft properties would be similar when standardized by the looped diameter. STUDY DESIGN: Controlled laboratory study. METHODS: This study consisted of 2 arms evaluating large and small looped-diameter grafts: experiment A consisted of TA, TP, and PL tendons (n = 47 each) with larger looped diameters of 9.0 to 9.5 mm, and experiment B consisted of TA, TP, PL, and ST tendons (n = 53 each) with smaller looped diameters of 7.0 to 7.5 mm. Each specimen underwent mechanical testing to measure the modulus of elasticity (E), ultimate tensile force (UTF), maximal elongation at failure, ultimate tensile stress (UTS), and ultimate tensile strain (UTε). RESULTS: Experiment A: No significant differences were noted among tendons for UTF, maximal elongation at failure, and UTϵ. UTS was significantly higher for the PL (54 MPa) compared with the TA (44 MPa) and TP (43 MPa) tendons. E was significantly higher for the PL (501 MPa) compared with the TP (416 MPa) tendons. Equivalence testing showed that the TP and PL tendon properties were equivalent or superior to those of the TA tendons for all outcomes. Experiment B: All groups exhibited a similar E. UTF was again highest in the PL tendons (2294 N) but was significantly different from only the ST tendons (1915 N). UTϵ was significantly higher for the ST (0.22) compared with the TA (0.19) and TP (0.19) tendons. Equivalence testing showed that the TA, TP, and PL tendon properties were equivalent or superior to those of the ST tendons. CONCLUSION: Compared with TA tendons, TP and PL tendons of a given looped diameter exhibited noninferior initial biomechanical strength and stiffness characteristics. ST tendons were mostly similar to TA tendons but exhibited a significantly higher elongation/UTϵ and smaller cross-sectional area. For smaller looped-diameter grafts, all tissues were noninferior to ST tendons. In contrast to previous findings, PL tendons proved to be equally strong. CLINICAL RELEVANCE: The results of this study should encourage surgeons to use these soft tissue allografts interchangeably, which is important as the number of ligament reconstructions performed with allografts continues to rise.

When Should We Change Drill Bits? A Mechanical Comparison of New, Reprocessed, and Damaged Bits.

OBJECTIVES: We assessed how reprocessed and damaged drill bits perform relative-to-new drill bits in terms of drilling force required, heat generated at near and far cortices, and number of usable passes. METHODS: Nine pairs of nonosteoporotic human cadaveric femora were tested using 3 types of 3.2-mm drill bits (new, reprocessed, and damaged) in 3 investigations (force, temperature, and multiple usable passes). Operating room conditions were simulated. Force and temperature data were collected for each type. The multiple pass investigation measured only force. RESULTS: New and reprocessed drill bits performed similarly regarding force required and heat generated; both outperformed damaged bits. New and reprocessed bits had a similar number of usable passes in ideal conditions. Damaged bits required nearly 2.6 times as much force to maintain drilling rate. CONCLUSIONS: Reprocessed drill bits seem to be a viable alternative to new drill bits for fracture treatment surgery in terms of force required, heat generated, and number of usable passes. Drill bits that are damaged intraoperatively should be replaced. In ideal conditions, new and reprocessed drill bits can be used for multiple consecutive cases. CLINICAL RELEVANCE: Reprocessed drill bits may be as effective as new drill bits, representing potential cost savings for institutions. Both types can be considered for reuse.

Deformability of Human Mesenchymal Stem Cells Is Dependent on Vimentin Intermediate Filaments.

Mesenchymal stem cells (MSCs) are being studied extensively due to their potential as a therapeutic cell source for many load-bearing tissues. Compression of tissues and the subsequent deformation of cells are just one type physical strain MSCs will need to withstand in vivo. Mechanotransduction by MSCs and their mechanical properties are partially controlled by the cytoskeleton, including vimentin intermediate filaments (IFs). Vimentin IF deficiency has been tied to changes in mechanosensing and mechanical properties of cells in some cell types. However, how vimentin IFs contribute to MSC deformability has not been comprehensively studied. Investigating the role of vimentin IFs in MSC mechanosensing and mechanical properties will assist in functional understanding and development of MSC therapies. In this study, we examined vimentin IFs' contribution to MSCs' ability to deform under external deformation using RNA interference. Our results indicate that a deficient vimentin IF network decreases the deformability of MSCs, and that this may be caused by the remaining cytoskeletal network compensating for the vimentin IF network alteration. Our observations introduce another piece of information regarding how vimentin IFs are involved in the complex role the cytoskeleton plays in the mechanical properties of cells.

Biomechanical Comparison of Cadaveric and Commercially Available Synthetic Osteoporotic Bone Analogues in a Locked Plate Fracture Model Under Torsional Loading.

OBJECTIVES: Biomechanical studies of osteoporotic bone have used synthetic models rather than cadaveric samples because of decreased variability, increased availability, and overall ease of the use of synthetic models. We compared the torsional mechanical properties of cadaveric osteoporotic bone with those of currently available synthetic osteoporotic bone analogues. METHODS: We tested 12 osteoporotic cadaveric humeri and 6 specimens each of 6 types of synthetic analogues. A 5-mm fracture gap model and posterior plating technique with 4.5-mm narrow 10-hole locking compression plate were used. Torque was applied to a peak of ±10 N·m for 1000 cycles at 0.3 Hz. Data were continuously collected during cyclical and ramped loading with a servohydraulic materials testing system. RESULTS: Cadaveric bone had a 17% failure rate before completing 1000 cycles. Three osteoporotic bone models had 100% failure (P < 0.05), 2 had 17% failure, and 1 had 0% failure before 1000 cycles. Significant differences in the stiffness of the 3 types of synthetic bone models that survived cyclic loading were noted compared with the cadaveric bone model (P < 0.05). Osteoporotic bone analogues had torsional mechanical properties different from those of osteoporotic cadaveric specimens. CONCLUSIONS: The differences between osteoporotic cadaveric humeri and synthetic osteoporotic bone analogues ranged from profound with complete catastrophic failure after a few cycles to subtler differences in stiffness and strain hardening. These findings suggest that different bone analogue models vary substantially in their torsional mechanical properties and might not be appropriate substitutes for cadaveric bone in biomechanical studies of osteoporotic bone.

Biomechanical and Cost Comparisons of Near-Far and Pin-Bar Constructs.

Orthopedic dogma states that external fixator stiffness is improved by placing 1 pin close to the fracture and 1 as distant as possible ("near-far"). This fixator construct is thought to be less expensive than placing pins a shorter distance apart and using "pin-bar" clamps that attach pins to outriggers. The authors therefore hypothesized that the near-far construct is stiffer and less expensive. They compared mechanical stiffness and costs of near-far and pin-bar constructs commonly used for temporary external fixation of femoral shaft fractures. Their testing model simulated femoral shaft fractures in damage control situations. Fourth-generation synthetic femora (n=18) were used. The near-far construct had 2 pins that were 106 mm apart, placed 25 mm from the gap on each side of the fracture. The pin-bar construct pins were 55 mm apart, placed 40 mm from the gap. Mechanical testing was performed on a material test system machine. Stiffness was determined in the linear portion of the load-displacement curve for both constructs in 4 modes: axial compression, torsional loading, frontal plane 3-point bending, and sagittal plane 3-point bending. Costs were determined from a 2012 price guide. Compared with the near-far construct, the pin-bar construct had stiffness increased by 58% in axial compression (P<.05) and by 52% in torsional loading (P<.05). The pin-bar construct increased cost by 11%. In contrast to the authors' hypothesis and existing orthopedic dogma, the near-far construct was less stiff than the pin-bar construct and was similarly priced. Use of the pin-bar construct is mechanically and economically reasonable. [Orthopedics. 2017; 40(2):e238-e241.].

Ultrasonic Structural Health Monitoring to Assess the Integrity of Spinal Growing Rods In Vitro.

BACKGROUND: Rod fracture is a common complication of growing rods and can result in loss of correction, patient discomfort, and unplanned revision surgery. The ability to quantitate rod integrity at each lengthening would be advantageous to avoid this complication. We investigate the feasibility of applying structural health monitoring to evaluate the integrity of growing rods in vitro. METHODS: Single-rod titanium 4.5-mm growing rod constructs (n = 9), one screw proximally and one distally connected by in-line connectors, were assembled with pedicle screws fixed in polyethylene blocks. Proximal and distal ends were loaded and constructs subjected to cyclic axial compression (0-100 N at 1 Hz), with incrementally increasing maximum compressive loads of 10 N every 9k cycles until failure. Four piezoceramic transducers (PZTs) were mounted along the length the constructs to interrogate the integrity of the rods with an ultrasonic, guided lamb wave approach. Every 9k cycles, an 80 V excitatory voltage was applied to a PZT to generate high-frequency vibrations, which, after propagating through the construct, was detected by the remaining PZTs. Amplitude differences between pre- and postload waveform signals were calculated until rod failure. RESULTS: Average construct lifetime was 88,991 ± 13,398 cycles. All constructs failed due to rod fracture within 21 mm (mean = 15 ± 4.5 mm) of a screw or connector. Amplitude differences between pre- and postload increased in a stepwise fashion as constructs were cycled. Compared to baseline, we found a 1.8 ± 0.6-fold increase in amplitude 18k cycles before failure, a 2.2 ± 1.0-fold increase in amplitude 9k cycles before failure, and a 2.75 ± 1.5-fold increase in amplitude immediately before rod fracture. CONCLUSION: We describe a potential method for assessing the structural integrity of growing rods using ultrasonic structural health monitoring. These preliminary data demonstrate the ability of periodic rod assessment to detect structural changes in cycled growing rods, which appear to correspond to subclinical rod fatigue before rod fracture.

Layered Alginate Constructs: A Platform for Co-culture of Heterogeneous Cell Populations.

Many load bearing tissues possess structurally and functionally distinct regions, typically accompanied by different cell phenotypes with differential mechanosensing characteristics. Engineering and analysis of these tissue types remain a challenge. Layered hydrogel constructs provide an opportunity for investigating the interactions among multiple cell populations within single constructs. Alginate hydrogels are both biocompatible and allow for easy isolation of cells after experimentation. Here, we describe a method for the development of small sized dual layered alginate hydrogel discs. This process maintains high cell viability of human mesenchymal stem cells during the formation process and these layered discs can withstand unconfined cyclic compression, commonly used for stimulation of hMSCs undergoing chondrogenesis. These layered constructs can potentially be scaled up to include additional levels, and also be used to segregate cell populations initially after layering. This dual layer alginate hydrogel culture platform can be used for many different applications including engineering and analysis of cells of load bearing tissues and co-cultures of other cell types.

Optical Coherence Tomographic Elastography Reveals Mesoscale Shear Strain Inhomogeneities in the Annulus Fibrosus.

STUDY DESIGN: Basic science study using in vitro tissue testing and imaging to characterize local strains in annulus fibrosus (AF) tissue. OBJECTIVE: To characterize mesoscale strain inhomogeneities between lamellar and inter-/translamellar (ITL) matrix compartments during tissue shear loading. SUMMARY OF BACKGROUND DATA: The intervertebral disc is characterized by significant heterogeneities in tissue structure and plays a critical role in load distribution and force transmission in the spine. In particular, the AF possesses a lamellar architecture interdigitated by a complex network of extracellular matrix components that form a distinct ITL compartment. Currently, there is not a firm understanding of how the lamellar and ITL matrix coordinately support tissue loading. METHODS: AF tissue samples were prepared from frozen porcine lumbar spines and mounted onto custom fixtures of a materials testing system that incorporates optical coherence tomography (OCT) imaging to perform tissue elastography. Tissues were subjected to 20 and 40% nominal shear strain, and OCT images were captured and segmented to identify regions of interest corresponding to lamellar and ITL compartments. Images were analyzed using an optical flow algorithm to quantify local shear strains within each compartment. RESULTS: Using histology and OCT, we first verified our ability to visualize and discriminate the ITL matrix from the lamellar matrix in porcine AF tissues. Local AF strains in the ITL compartment (22.0 ±â€Š13.8, 31.1 ±â€Š16.9 at 20% and 40% applied shear, respectively) were significantly higher than corresponding strains in the surrounding lamellar compartment (12.1 ±â€Š5.6, 15.3 ±â€Š5.2) for all tissue samples (P < 0.05). CONCLUSION: Results from this study demonstrate that the lamellar and ITL compartments of the AF distribute strain unevenly during tissue loading. Specifically, shear strain is significantly higher in the ITL matrix, suggesting that these regions may be more susceptible to tissue damage and more mechanobiologically active. LEVEL OF EVIDENCE: N/A.

Effect of Dynamic Culture and Periodic Compression on Human Mesenchymal Stem Cell Proliferation and Chondrogenesis.

We have recently developed a bioreactor that can apply both shear and compressive forces to engineered tissues in dynamic culture. In our system, alginate hydrogel beads with encapsulated human mesenchymal stem cells (hMSCs) were cultured under different dynamic conditions while subjected to periodic, compressive force. A customized pressure sensor was developed to track the pressure fluctuations when shear forces and compressive forces were applied. Compared to static culture, dynamic culture can maintain a higher cell population throughout the study. With the application of only shear stress, qRT-PCR and immunohistochemistry revealed that hMSCs experienced less chondrogenic differentiation than the static group. The second study showed that chondrogenic differentiation was enhanced by additional mechanical compression. After 14 days, alcian blue staining showed more extracellular matrix formed in the compression group. The upregulation of the positive chondrogenic markers such as Sox 9, aggrecan, and type II collagen were demonstrated by qPCR. Our bioreactor provides a novel approach to apply mechanical forces to engineered cartilage. Results suggest that a combination of dynamic culture with proper mechanical stimulation may promote efficient progenitor cell expansion in vitro, thereby allowing the culture of clinically relevant articular chondrocytes for the treatment of articular cartilage defects.

Axial strain enhances osteotomy repair with a concomitant increase in connexin43 expression.

The mechanical environment is known to influence fracture healing. We speculated that connexin43 (Cx43) gap junctions, which impact skeletal homeostasis, fracture healing and the osteogenic response to mechanical load, may play a role in mediating the response of the healing bone to mechanical strain. Here, we used an established rat fracture model, which uses a 2 mm osteotomy gap stabilized by an external fixator, to examine the impact of various cyclical axial loading protocols (2%, 10%, and 30% strain) on osteotomy healing. We examined the presence of Cx43 in the osteotomy-healing environment and assessed how mechanical strain modulates Cx43 expression patterns in the callus. We demonstrated that increased cyclical axial strain results in increased radiographic and histologic bone formation. In addition, we show by immunohistochemistry that Cx43 is abundantly expressed in the healing callus, with the expression most robust in samples exposed to increased cyclical axial strain. These data are consistent with the concept that an increase in Cx43 expression by mechanical load may be part of the mechanisms by which mechanical forces enhances fracture healing.

Transient solid-fluid interactions in rat brain tissue under combined translational shear and fixed compression.

An external mechanical insult to the brain may create internal deformation waves, which have shear and longitudinal components that induce combined shear and compression of the brain tissue. To isolate such interactions and to investigate the role of the extracellular fluid (ECF) in the transient mechanical response, translational shear stretch up to 1.25 under either 0 or 33% fixed normal compression is applied without preconditioning to heterogeneous sagittal slices which are nearly the full length of the rat brain cerebrum. The normal stress contribution is estimated by separate unconfined compression stress-stretch curves at 0.0667/s and 1/s engineering strain rates to 33% strain. Unconfined compression deformation causes lateral dimension expansion less than that predicted for an incompressible material under large deformation and often a visible loss of internal fluid from the specimen so that the bulk brain tissue is not incompressible in vitro, as sometimes assumed for mathematical modeling. The response to both slow 0.001/s and moderate 1/s shear translational stretch rates is deformation rate dependent and hardening under no compression but under 33% compression is nearly linear perhaps because of increased solid-solid friction. Both shear and normal stress relaxation are faster after the fast rate deformation possibly because higher deformation rates produce higher ECF hydrostatic pressure that primarily drives stress relaxation. The experimental results on ECF behavior guide the form of our nonlinear viscoelastic mathematical model. Our data are closely fit by non-equilibrium evolution equations that involve at most three specimen-specific empirical parameters and that are based on the idea that stretch of axons and glial processes resists load-induced ECF pressure.

Effects of proinflammatory cytokines on axonal outgrowth from adult rat lumbar dorsal root ganglia using a novel three-dimensional culture system.

BACKGROUND CONTEXT: Degeneration of the intervertebral disc is often associated with low back pain and increased infiltration of nerve fibers originating from dorsal root ganglia (DRG). The degenerated disc is also characterized by the presence of proinflammatory cytokines, which may influence axonal outgrowth. Toward an improved understanding of the growth of DRG neurons into compliant extracellular matrices, we developed a novel experimental system to measure axonal outgrowth of adult rat lumbar DRG neurons within three-dimensional (3D) collagen hydrogels and used this system to examine the effects of interleukin 1ß (IL-1ß) and tumor necrosis factor (TNF)-α treatment. PURPOSE: The aim was to investigate the effects of proinflammatory cytokines on 3D neuronal growth into collagen matrices. STUDY DESIGN: This was an in vitro study of neurite outgrowth from adult rat lumbar DRG into collagen gels in response to IL-1ß and TNF-α. METHODS: Lumbar DRG were obtained from adult Sprague Dawley rats, bisected to expose cell bodies and placed onto collagen gel constructs prepared in 24-well Transwell inserts. Dorsal root ganglia were then treated with nerve growth factor (NGF)-free Neurobasal media (negative control) or NGF-supplemented media containing 0, 1, and 10 ng/mL of IL-1ß and TNF-α. After 7 days, collagen gel-DRG constructs were immunostained for phosphorylated neurofilament, an axonal marker. Simple Neurite Tracer (Fiji/ImageJ) was used to quantify 3D axonal outgrowth from confocal image stacks. Data were analyzed using one-way analysis of variance, with Tukey HSD post hoc correction at a level of p<.05. RESULTS: Immunostaining showed robust axonal outgrowth into collagen gels from all NGF-treated DRG. The negative control demonstrated very few and short neurites. Tumor necrosis factor-α (1 and 10 ng/mL) significantly inhibited axonal outgrowth compared with NGF-only media (p<.026 and p<.02, respectively). After IL-1ß treatment, average axon length was 10% lower at 1 ng/mL and 7.5% higher at 10 ng/mL, but these differences were not statistically significant. Among cytokine treatments, however, average axon length in the IL-1ß (10 ng/mL) group was significantly higher than that in the other groups (p<.05). CONCLUSIONS: A novel 3D collagen gel culture system was used to investigate factors modulating neuronal ingrowth. Our results showed that NGF was necessary to promote neurite growth into collagen gels. In the presence of proinflammatory cytokines, high concentrations of IL-1ß induced significantly higher axonal outgrowth than TNF-α and low levels of IL-1ß.

Internal anterior fixators for pelvic ring injuries: Do monaxial pedicle screws provide more stiffness than polyaxial pedicle screws?

OBJECTIVES: Little is known about the mechanical properties of internal anterior fixators (known as INFIX), which have been proposed as subcutaneous alternatives to traditional anterior external fixators for pelvic ring disruptions. We hypothesised that INFIX has superior biomechanical performance compared with traditional external fixators because the distance from the bar to the bone is reduced. METHODS: Using a commercially available synthetic bone model, 15 unstable pelvic ring injuries were simulated by excising the pubic bone through the bilateral superior and inferior rami anteriorly and the sacrum through the bilateral sacral foramen posteriorly. Three test groups were established: (1) traditional supra-acetabular external fixation, (2) INFIX with polyaxial screws, (3) INFIX with monaxial screws. Load was applied, simulating lateral compression force. Outcome measure was construct stiffness. RESULTS: The traditional external fixator constructs had an average stiffness of 6.21 N/mm ± 0.40 standard deviation (SD). INFIX with monaxial screws was 23% stiffer than the traditional external fixator (mean stiffness, 7.66 N/mm ± 0.86 SD; p = .01). INFIX with polyaxial screws was 26% less stiff than INFIX with monaxial screws (mean stiffness, 5.69 N/mm ± 1.24 SD; p = .05). No significant difference was noted between polyaxial INFIX and external fixators (mean stiffness, 6.21 N/mm ± 0.40 SD; p=.65). CONCLUSIONS: The performance of INFIX depends on the type of screw used, with monaxial screws providing significantly more stiffness than polyaxial screws. Despite the mechanical advantage of being closer to the bone, polyaxial INFIX was not stiffer than traditional external fixation.

Three dimensional mesoscale analysis of translamellar cross-bridge morphologies in the annulus fibrosus using optical coherence tomography.

The defining characteristic of the annulus fibrosus (AF) of the intervertebral disc (IVD) has long been the lamellar structures that consist of highly ordered collagen fibers arranged in alternating oblique angles from one layer to the next. However, a series of recent histologic studies have demonstrated that AF lamellae contain elastin- and type VI collagen-rich secondary "cross-bridge" structures across lamellae. In this study, we use optical coherence tomography (OCT) to elucidate the three-dimensional (3-D) morphologies of these translamellar cross-bridges in AF tissues. Mesoscale volumetric images by OCT revealed a 3-D network of heterogeneously distributed cross-bridges. The results of this study confirm the translamellar cross-bridge is identifiable as a distinguishable structure, which lies in the interbundle space of adjacent lamellae and crisscrosses multiple lamellae in the radial direction. In contrast to previously proposed models extrapolated from 2-D sections, results from this current study show that translamellar cross-bridges exist as a complex, interconnected network. We also found much greater variation in lengths of cross-bridges within the interbundle space of lamellae (0.8-1.4 mm from the current study versus 0.3-0.6 mm from 2-D sections). OCT-based 3-D morphology of translamellar cross-bridge provides novel insight into the AF structure.

Rib Fracture Fixation Restores Inspiratory Volume and Peak Flow in a Full Thorax Human Cadaveric Breathing Model.

BACKGROUND: Multiple rib fractures cause significant pain and potential for chest wall instability. Despite an emerging trend of surgical management of flail chest injuries, there are no studies examining the effect of rib fracture fixation on respiratory function. OBJECTIVES: Using a novel full thorax human cadaveric breathing model, we sought to explore the effect of flail chest injury and subsequent rib fracture fixation on respiratory outcomes. PATIENTS AND METHODS: We used five fresh human cadavers to generate negative breathing models in the left thorax to mimic physiologic respiration. Inspiratory volumes and peak flows were measured using a flow meter for all three chest wall states: intact chest, left-sided flail chest (segmental fractures of ribs 3 - 7), and post-fracture open reduction and internal fixation (ORIF) of the chest wall with a pre-contoured rib specific plate fixation system. RESULTS: A wide variation in the mean inspiratory volumes and peak flows were measured between specimens; however, the effect of a flail chest wall and the subsequent internal fixation of the unstable rib fractures was consistent across all samples. Compared to the intact chest wall, the inspiratory volume decreased by 40 ± 19% in the flail chest model (P = 0.04). Open reduction and internal fixation of the flail chest returned the inspiratory volume to 130 ± 71% of the intact chest volumes (P = 0.68). A similar 35 ± 19% decrease in peak flows was seen in the flail chest (P = 0.007) and this returned to 125 ± 71% of the intact chest following ORIF (P = 0.62). CONCLUSIONS: Negative pressure inspiration is significantly impaired by an unstable chest wall. Restoring mechanical stability of the fractured ribs improves respiratory outcomes similar to baseline values.

Effects of angular frequency during clinorotation on mesenchymal stem cell morphology and migration.

AIMS: To determine the short-term effects of simulated microgravity on mesenchymal stem cell behaviors-as a function of clinorotation speed-using time-lapse microscopy. BACKGROUND: Ground-based microgravity simulation can reproduce the apparent effects of weightlessness in spaceflight using clinostats that continuously reorient the gravity vector on a specimen, creating a time-averaged nullification of gravity. In this work, we investigated the effects of clinorotation speed on the morphology, cytoarchitecture, and migration behavior of human mesenchymal stem cells (hMSCs). METHODS: We compared cell responses at clinorotation speeds of 0, 30, 60, and 75 rpm over 8 h in a recently developed lab-on-chip-based clinostat system. Time-lapse light microscopy was used to visualize changes in cell morphology during and after cessation of clinorotation. Cytoarchitecture was assessed by actin and vinculin staining, and chemotaxis was examined using time-lapse light microscopy of cells in NGF (100 ng/ml) gradients. RESULTS: Among clinorotated groups, cell area distributions indicated a greater inhibition of cell spreading with higher angular frequency (P<0.005), though average cell area at 30 rpm after 8 h became statistically similar to control (P=0.794). Cells at 75 rpm clinorotation remained viable and were able to re-spread after clinorotation. In chemotaxis chambers, clinorotation did not alter migration patterns in elongated cells, but most clinorotated cells exhibited cell retraction, which strongly compromised motility. CONCLUSIONS: These results indicate that hMSCs respond to clinorotation by adopting more rounded, less-spread morphologies. The angular frequency-dependence suggests that a cell's ability to sense the changing gravity vector is governed by the rate of perturbation. For migration studies, cells cultured in clinorotated chemotaxis chambers were generally less motile and exhibited retraction instead of migration.

Bar diameter is an important component of knee-spanning external fixator stiffness and cost.

The authors' objective was to determine the effects of bar diameter on the stiffness and cost of a knee-spanning external fixator. The authors studied 2 versions of an external fixator with a difference in bar diameter (small bars, 8-mm diameter; large bars, 11-mm diameter). Fixators were tested using frame dimensions and a synthetic fracture model appropriate for a tibial plateau fracture. Five configurations of each fixator were tested: standard, cross-link, oblique pin, double stack, and super construct. The construct stiffness of each configuration (n=60) was measured in anterior-posterior bending, medial-lateral bending, axial torsion, and axial compression. Cost analysis allowed for calculation of the stiffness per unit cost. In the large bar group, an increase in construct stiffness was noted for all constructs and testing modes. Magnitude of stiffness increase ranged from 24% to 224% (P<.05 in all cases), depending on the configuration and loading mode. Increase in stiffness was so large that double-stack small bars performed similarly to standard construct large bars. Considering that the frame components have similar costs, the double-stack small bar fixator results in a 66% increase in cost for the same stiffness provided by the standard large bar. Bar diameter seems to have a large effect on knee-spanning external fixators. The authors observed an increase in stiffness of up to 191% under anterior-posterior bending despite an increase in bar size of only 37.5%. This finding might allow clinicians to use less expensive frames constructed of larger bars without sacrificing construct stiffness.

A computational model to describe the regional interlamellar shear of the annulus fibrosus.

Interlamellar shear may play an important role in the homeostasis and degeneration of the intervertebral disk. Accurately modeling the shear behavior of the interlamellar compartment would enhance the study of its mechanobiology. In this study, physical experiments were utilized to describe interlamellar shear and define a constitutive model, which was implemented into a finite element analysis. Ovine annulus fibrosus (AF) specimens from three locations within the intervertebral disk (lateral, outer anterior, and inner anterior) were subjected to in vitro mechanical shear testing. The local shear stress-stretch relationship was described for the lamellae and across the interlamellar layer of the AF. A hyperelastic constitutive model was defined for interlamellar and lamellar materials at each location tested. The constitutive models were incorporated into a finite element model of a block of AF, which modeled the interlamellar and lamellar layers using a continuum description. The global shear behavior of the AF was compared between the finite element model and physical experiments. The shear moduli at the initial and final regions of the stress-strain curve were greater within the lamellae than across the interlamellar layer. The difference between interlamellar and lamellar shear was greater at the outer anterior AF than at the inner anterior region. The finite element model was shown to accurately predict the global shear behavior or the AF. Future studies incorporating finite element analysis of the interlamellar compartment may be useful for predicting its physiological mechanical behavior to inform the study of its mechanobiology.