Thoracic surgery may alter body static balance via diaphragm dysfunction.

Many diseases and conditions can alter an ability to maintain body balance. The aim of the present study was to investigate whether thoracic surgery may elicit diaphragm dysfunction thereby impairing postural stability. 40 patients qualified to video-assisted thoracoscopy (VATS) lobectomy or lobectomy via thoracotomy due to pulmonary carcinoma were examined two times: a day before lung resection and 3-5 days after surgical procedure. Diaphragm assessment was performed using ultrasonography, while postural sways were evaluated by Zebris FDM-S stabilometric platform. Thoracic surgery was associated with decrease of diaphragm thickness and movement, as well as, with deterioration of static body balance maintenance. Upper lobe resection was linked with greater diaphragm excursion restriction and worse body sway parameters than middle and lower lobe resection. VATS lobectomy was associated with better postoperative diaphragm function and better postural sway parameters than lobectomy via thoracotomy. Patients after lobectomy via thoracotomy had significantly more load on lower limb on the operated side than patients after VATS lobectomy. Impairment of diaphragm function is closely associated with equilibrium impairment after pulmonary resection. VATS lobectomy was less invasive than lobectomy via thoracotomy in terms of primary respiratory muscle function and body balance maintenance parameters.

The influence of isometric rotation of the lower limb on the functioning of the knee joint stabilizers and rotator muscles.

PURPOSE: This paper presents an assessment of the influence of isometric rotation of the lower limb in a standing position on the functioning of the muscles stabilizing the knee joint in the frontal plane with the use of modeling the loads on the musculoskeletal system. METHODS: The research was carried out in the AnyBody Modeling System software, performing multi-variant simulations of the musculoskeletal system during isometric rotation of the lower limbs. The simulations were carried out using as input data the values of rotating moments and the ground reaction forces acting on foot segments, which were measured using the proprietary Rotenso device and the position of the body segments. RESULTS: The result is the muscular activity of the lower limbs of the selected muscle groups during isometric rotation. Muscle activity was recorded for Sartorius, Tensor fasciae latae, Iliopsoas, Gluteus minimus, Gluteus medius, Gluteus maximus, Piriformis, Quadratus femoris, Obturator internus, Obturator externus, Gemellus inferior, Gemellus superior. CONCLUSIONS: Performing isometric rotation allowed for the activation of most of the knee joint stabilizing muscles and rotators of the lower limb. The results indicate that lower limb rotation exercises can be used in physiotherapy in patients with valgus knee.

Lower Leg Injury Mechanism Investigation During an IED Blast Under a Vehicle Using an Anatomic Leg Model.

Attacks with improvised explosive device (IED) constituted the main threat to, for example, Polish soldiers in Iraq and Afghanistan. Improving safety during transport in an armored vehicle has become an important issue. The main purpose of the presented research is to investigate the mechanism of lower leg injuries during explosion under an armored vehicle. Using a numerical anatomic model of the lower leg, the analysis of the leg position was carried out. In all presented positions, the stress limit of 160 (MPa) was reached, which indicates bone damage. There is a difference in stress distribution in anatomic elements pointing to different injury mechanisms.

Assessment of the Impact of Decellularization Methods on Mechanical Properties of Biocomposites Used as Skin Substitute.

This work aimed to assess the impact of acellularization and sterilization methods on the mechanical properties of biocomposites used as a skin substitute. On the basis of the statistical analysis, it was ascertained that the values of the Young modulus for the samples before the sterilization process-only in the cases of substances such as: trypsin, 15% glycerol and dispase-changed in a statistically significant way. In the case of dispase, the Young modulus value before the sterilization process amounted to 66.6 MPa, for trypsin this value equalled 33.9 MPa, whereas for 15% glycerol it was 11 MPa. In the case of samples after the completion of the sterilization process, the analysis did not show any statistically significant differences between the obtained results of Young's modulus depending on the respective reagents applied. It was confirmed that different methods of acellularization and the process of sterilization effect the alteration of mechanical properties of allogeneic skins. In the case of the decellularization method using SDS (Sodium Dodecyl Sulfate), liquid nitrogen and 85% glycerol the highest values of strain were observed. In the authors' opinion, it is the above-mentioned methods that should be recommended in the process of preparation of skin substitutes.

Finite element head model for the crew injury assessment in a light armoured vehicle.

PURPOSE: The aim of this paper was the development of a finite element model of the soldier's head to assess injuries suffered by soldiers during blast under a light armoured vehicle. METHODS: The application of a multibody wheeled armoured vehicle model, including the crew and their equipment, aenabled the researchers to analyse the most dangerous scenarios of the head injury. These scenarios have been selected for a detailed analysis using the finite element head model which allowed for the examination of dynamic effects on individual head structures. In this paper, the authors described stages of the development of the anatomical finite element head model. RESULTS: The results of the simulations made it possible to assess parameters determining the head injury of the soldier during the IED explosion. The developed model allows the determination of the parameters of stress, strain and pressure acting on the structures of the human head. CONCLUSION: In future studies, the model will be used to carry out simulations which will improve the construction of the headgear in order to minimize the possibility of the head injury.

Evaluation of the impact of decellularization and sterilization on tensile strength transgenic porcinedermal dressings.

PURPOSE: The aim of this paper was to evaluate which method of acellularization and sterilization is optimal, in the meaning of which processes have the least impact on the deterioration of mechanical properties of porcine tissues used for xenogeneic applications. METHODS: The static tensile probe was conducted for 80 skin specimens obtained from transgenic swine, which are used as a wound dressing for skin recipient. Obtained data were subsequently analyzed with the use of statistical methods. RESULTS: It was found that Young's modulus for the samples after the sterilization process for the dispase substance and the mixed method (SDS + trypsin) were statistically significantly changed. In the case of dispase, Young's modulus value before the sterilization process was 12.4 MPa and after the value increased to 28.0 MPa. For the mixed method (SDS + trypsin) before the sterilization process Young's modulus value was 5.6 MPa and after it was increased to 6.3 MPa. The mixed method (SDS + trypsin) had the slightest effect on changing the mechanical properties of the samples before and after the sterilization process. CONCLUSIONS: It was confirmed that different methods of acellularization and the process of sterilization have an influence on the change of mechanical properties of the skin of transgenic swine. In the authors' opinion, the mixed method (SDS + trypsin) should be recommended as the best one for the preparation of transgenic porcine dermal dressings because it ensures a smaller probability of dressing's damage during a surgical procedure.

Impact of diaphragm function parameters on balance maintenance.

The diaphragm is well known for its role as the principal muscle of respiration. However, according to previous studies, its role is multifactorial, from breathing through pain perception, regulation of emotional sphere, collaborating in gastroesophageal functions, facilitating the venous and lymphatic return, to an essential role in the maintenance of lumbar spine stability. The purpose of the study was to examine whether diaphragm function parameters (thickness and range of motion) are associated with static balance maintenance. A total of 142 participants were examined and divided into three groups: G1-patients qualified for lung resection due to cancer; G2 -patients after lobe resection; G3 -healthy subjects. Diaphragm thickness and excursion was measured using ultrasonography. Stabilometric parameters of balance were assessed by Zebris FDM-S platform. Greater diaphragm thickening during active breathing and diaphragm thickness fraction were associated with better static balance parameters. Limitation of diaphragm motion during quiet breathing and deep breathing was linked to balance disorders. There was no correlation between diaphragm muscle excursion during sniff maneuvers and balance parameters. Deterioration of diaphragm function observed after thoracic surgery was closely related with deterioration of balance maintenance. Impairment of diaphragm function manifested by decrease of muscle thickness and movement restriction is strongly associated with balance disorders in a clinical sample and among healthy subjects.

Biomechanical analysis of injuries of rally driver with head supporting device.

PURPOSE: The aim of the study was to develop and verify a model of rally driver with a safety system HANS (head supporting device), which will enable biomechanical analysis of injuries in rally accident. METHODS: Simulations were carried out in Madymo® software, the results of which were verified based on sled test performed in the Automotive Industry Institute (PIMOT) in Warsaw. The model being verified allowed us to perform a multivariate simulation of rally accident in terms of assessing effectiveness of protection and usefulness of HANS system. RESULTS: Acceleration waveforms of the head and chest were obtained from numerical experiment and also forces and moments occurring in the upper cervical spine. The results obtained allowed driver injuries to be analyzed based on injury criteria of the head and neck: HIC15, NTE, NTF, NCE and NCF. CONCLUSIONS: The analysis enabled assessment of the driver safety while using 4 and 5 point harness with HANS system. In further studies the model developed was used to identify factors affecting the safety of a rally driver.