Study on the structure and behaviour of cavitation bubbles generated in a high-intensity focused ultrasound (HIFU) field.

In this study, structures and behaviours of acoustic cavitation bubbles induced by a high-intensity focused ultrasound (HIFU) transducer, operating at its resonance frequency of 250kHz, are experimentally explored with corresponding observations captured by a high-speed video camera system. The experiments were conducted in an open-top Perspex water tank with deionized water, and illumination was provided by a LED spotlight which is placed beside the water tank throughout the whole experiment. Experimental results show that the structure of ultrasonically generated bubbles forms in a conical shape with several concentric bubble rings above the transducer. The distance between the adjacent rings with equal spacing as determined by the driving frequency of the HIFU transducer is experimentally measured and compared with the theoretical value. Then, the distribution of acoustic pressure in the acoustically driven liquid is further studied to investigate the behaviours of cavitation bubbles generated in a HIFU field. Additionally, the analysis of Bjerknes forces on the bubble surface which are induced by the gradient of acoustic pressure and the adjacent oscillating bubbles is quantitatively carried out, and the radius and velocity of a typical larger bubble are measured to characterize the behaviours of ultrasonically induced bubbles. Particularly, the physical phenomena of large bubbles including the coalescence, attraction or repulsion between adjacent bubbles, as well as the jumping of an acoustic bubble from the lower concentric ring level to the higher level, are analysed. The moving trajectory of the bubble is next obtained, and some conclusions are summarized to provide a greater understanding of the complex behaviours of the ultrasonically generated bubbles.

Ageing Effects on 3-Dimensional Femoral Neck Cross-Sectional Asymmetry: Implications for Age-Related Bone Fragility in Falling.

This paper explores the effects of aging on femoral neck (FN) anatomy in a study of women aged 20-90years in relation to implications for FN fracture propensity in buckling. Five hundred and four participants were scanned by Quantitative Computed Tomography and analyzed using Quantitative Computed Tomography Pro BIT (Mindways). FN cross-section was split through geometric center into superior and inferior sectors. Bone mass, structural measurements, and bone mineral density were analyzed. Buckling ratio was calculated as ratio of buckling radius to cortical thickness. Between 2nd decade and 8th decade, age-related integral bone mass reduction in superior sector was substantially larger than in inferior sector (33% compared to 21%), especially in cortical bone superiorly compared to inferiorly (53% vs 21%; p < 0.001), principally due to reduction in cortical thickness, averaged cortical thickness (56%) with little difference in density. Superior and inferior sector trabecular bone mineral density reduction was similar at 41% and 43% respectively. Differential cortical bone loss in superior sector resulted in a 59% inferior displacement (δ) of center-of-mass from geometric center. Differences in δ and averaged cortical thickness with age accounted for a 151% increase in mean superior buckling ratio from 9 to 23. Analysis confirms significant progressive age-related superior cortical bone loss as the major age effect on FN structure with relative preservation of inferior cortex probably related to maintenance of inferior sector by regular loading as a result of standing and walking. Computation of buckling ratio may allow prediction of fracture propensity in a sideways fall.

Evaluation of a simplified hip structure analysis method for the prediction of incident hip fracture events.

UNLABELLED: Many attempts have been made to improve the predictive ability of areal bone mineral density (aBMD) which integrates bone mass and area. The addition of an extra variable derived from the hip dual-energy X-ray (DXA) image TR_σ, which describes distribution of mass within the scanned area of the trochanter, improved prediction of 15-year hip fracture probability in elderly women. INTRODUCTION: Two-dimensional DXA imaging of the proximal femur to produce an aBMD is a clinically useful predictor of future fracture risk. Further analysis of the DXA image to produce an eight-variable hip structure analysis (Beck HSA) has been developed to improve understanding of structural factors determining hip bone strength at each of three proximal femur sites, the narrow femoral neck (NN), intertrochanter (TR) and shaft (S). Recently, data on four measurements derived from the currently used eight Beck HSA variables were used to capture population variation in bone structure at each site. These include two previously used variables, the localised aBMD and the sub-periosteal width (W) applying to 5-mm sections (at each sites), and two new variables, standard deviation of normalised mineral-mass projection profile distribution (σ), and displacement between centre-of-mineral mass and geometric centre-of-mineral mass of projection profile (δ). METHODS: Using a cohort of 1159 women, mean baseline age 75, who sustained 139 hip fractures over 15 years, we determined whether these measures significantly improved 15-year hip fracture prediction compared to current approach utilising age and total hip aBMD. To describe the most parsimonious model for hip fracture risk prediction, the 12 base measures (4 from each site), total hip aBMD and age were evaluated in stepwise logistic regression models. RESULTS: The final model included TR_σ, total hip aBMD and age and provided improved utility for hip fracture prediction compared to total hip aBMD and age alone (C-statistic 0.73 vs. 0.69, P = 0.009 and net reclassification improvement 0.164, P < 0.001, respectively). CONCLUSIONS: Addition of TR_σ to total hip aBMD and age substantially improved prediction of 15-year hip fracture risk in this cohort of elderly women.

Jitter reduction using native fiducials in rotating mirror ultra-fast microphotography.

Rotating mirror cameras represent a workhorse technology for high speed imaging in the MHz framing regime. The technique requires that the target image be swept across a series of juxtaposed CCD sensors, via reflection from a rapidly rotating mirror. Employing multiple sensors in this fashion can lead to spatial jitter in the resultant video file, due to component misalignments along the individual optical paths to each CCD. Here, we highlight that static and dynamic fiducials can be exploited as an effective software-borne countermeasure to jitter, suppressing the standard deviation of the corrected file relative to the raw data by up to 88.5% maximally, and 66.5% on average over the available range of framing rates. Direct comparison with industry-standard algorithms demonstrated that our fiducial-based strategy is as effective at jitter reduction, but typically also leads to an aesthetically superior final form in the post-processed video files.

Differences in structural geometrical outcomes at the neck of the proximal femur using two-dimensional DXA-derived projection (APEX) and three-dimensional QCT-derived (BIT QCT) techniques.

UNLABELLED: Structural geometric parameters at neck of the proximal femur were obtained using DXA-derived hip structural analysis (APEX 3) and quantitative computed tomography-derived (BIT QCT) techniques in 237 elderly females. Linear correlations for parameters ranged from 0.45 to 0.90. The average value of the subperiosteal width, as determined by the two techniques, was the same; variables dependent on mass measurements were different. INTRODUCTION: There has been increasing interest in using bone structural geometry to assess bone fragility to complement bone mineral mass. The objective of this study is to compare structural geometrical differences between "2D" DXA-derived and "3D" QCT-derived techniques in unselected clinical cases. METHODS: All 237 females had both DXA and QCT assessments of femoral neck structural geometry. Variables compared were areal bone mineral density, cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), section modulus (Z), averaged cortical thickness (Ct), endosteal width (ESW), subperiosteal width (W), and buckling ratio (BR). RESULTS: Correlation of femoral neck variables ranged from 0.45 for ESW to 0.90 for CSA. APEX 3 and BIT QCT-derived femoral neck W values were numerically similar. However CSA, CSMI, Z and Ct values measured by APEX 3 were higher and ESW and BR values were lower than corresponding BIT QCT. CONCLUSIONS: 2D DXA structural analysis of neck of femur is related to but different from same parameters calculated from true 3D images obtained by CT. Femoral neck size values are similar for DXA and QCT, but structural geometrical variables dependent on mass calibration standards, location of neck ROI and mathematical derivation techniques are different.

Characterizing bubble dynamics created by high-intensity focused ultrasound for the delivery of antibacterial nanoparticles into a dental hard tissue.

Hig hintensity focused ultrasound (HIFU) has been applied for drug delivery in various disease conditions. Delivery of antibacterial-nanoparticles into dental hard tissues may open up new avenues in the treatment of dental infections. However, the basic mechanism of bubble dynamics, its characterization, and working parameters for effective delivery of nanoparticles, warrants further understanding. This study was conducted to highlight the basic concept of HIFU and the associated bubble dynamics for the delivery of nanoparticles. Characterization experiments to deliver micro-scale particles into simulated tubular channels, activity of ultrasonic bubbles, and pressure measurement inside the HIFU system were conducted. Subsequently, experiments were carried out to test the ability of HIFU to deliver nanoparticles into human dentine using field emission scanning electron micrographs (FESEM) and elemental dispersive X-ray analysis (EDX). The characterization experiments showed that the bubbles collapsing at the opening of tubular channels were able to propel particles along their whole length. The pressure measured showed sufficient negative and positive pressure suggesting that the bubble grew to a certain size before collapsing, thus enabling the particles to be pushed. The FESEM and EDX analysis highlighted the ability of HIFU to deliver nanoparticles deep within the dentinal tubules. This study highlighted the characteristics and the mechanism involved of the bubbles generated by the HIFU and their capability to deliver nanoparticles.

Comparison of QCT-derived and DXA-derived areal bone mineral density and T scores.

UNLABELLED: Two-dimensional areal bone mineral density (aBMD) of the proximal femur measured by three-dimensional quantitative computed tomography (QCT) in 91 elderly women was compared to dual-energy X-ray absorptiometry (DXA) aBMD results measured in the same patients. The measurements were highly correlated, though QCT aBMD values were marginally lower in absolute units. Transformation of the QCT aBMD values to T score values using National Health and Nutrition Examination Survey (NHANES) DXA-derived reference data improved agreement and clinical utility. INTRODUCTION: World Health Organization guidelines promulgate aBMD (g cm(-2)) measurement of the proximal femur for the diagnosis of bone fragility. In recent years, there has been increasing interest in QCT to facilitate understanding of three-dimensional bone structure and strength. OBJECTIVE: To assist in comparison of QCT-derived data with DXA aBMD results, a technique for deriving aBMD from QCT measurements has been developed. METHODS: To test the validity of the QCT method, 91 elderly females were scanned on both DXA and CT scanners. QCT-derived DXA equivalent aBMD (QCT(DXA) aBMD) was calculated using CTXA Hip software (Mindways Software Inc., Austin, TX, USA) and compared to DXA-derived aBMD results. RESULTS: Test retest analysis indicated lower root mean square (RMS) errors for CTXA; F test between CTXA and DXA was significantly different at femoral neck (FN) and trochanter (TR) (p < 0.05). QCT underestimates DXA values by 0.02 +/- 0.05 g cm(-2) (total hip, TH), 0.01 +/- 0.04 g cm(-2) (FN), 0.03 +/- 0.07 g cm(-2) (inter-trochanter, IT), and 0.02 +/- 0.05 g cm(-2) (TR). The RMS errors (standard error of estimate) between QCT and DXA T scores for TH, FN, IT, and TR were 0.36, 0.40, 0.39, and 0.49, respectively. CONCLUSIONS: This study shows that results from QCT aBMD appropriately adjusted can be evaluated against NHANES reference data to diagnose osteoporosis.

Differential regulation of RNA polymerases I, II, and III by the TBP-binding repressor Dr1.

RNA polymerases I, II, and III each use the TATA-binding protein (TBP). Regulators that target this shared factor may therefore provide a means to coordinate the activities of the three nuclear RNA polymerases. The repressor Dr1 binds to TBP and blocks the interaction of TBP with polymerase II- and polymerase III-specific factors. This enables Dr1 to coordinately regulate transcription by RNA polymerases II and III. Under the same conditions, Dr1 does not inhibit polymerase I transcription. By selectively repressing polymerases II and III, Dr1 may shift the physiological balance of transcriptional output in favor of polymerase I.

A cortical-bone structural geometry phantom: dental plaster as a convenient and radiologically similar fabrication material.

Areal bone mineral density (aBMD), derived from dual-energy X-ray absorptiometry (DXA) scanners is used routinely to infer bone strength. With DXA hip scans there is growing acceptance of the advantages of also measuring bone structural geometric variables, that complement conventional aBMD to improve understanding of bone modelling, remodelling and processes of metabolic bone disease. However, phantoms for assessing structural geometric variables from DXA scans are not widely available, unlike those for aBMD. This study describes the development of such a phantom, simulating the cortical shell of the human femoral neck, using dental plaster as a material radiologically similar to cortical bone. The mass attenuation coefficient of the dental plaster differed by < 1% from cortical bone, over the relevant energy range. Performance testing was carried out with DXA, to determine accuracy and precision of the phantom structural geometry, using its dimensions and composition as 'gold standards'. Accuracy and precision of cortical structural geometry were poor when measured in a simulated 1 mm-thick osteoporotic cortex (5.5% precision and 50% accuracy errors), but improved with increasing cortical thickness. This study demonstrates the limitations of DXA-based Hip Structure Analysis when applied to femora with thin cortices, and indicates improvements in the design of a phantom to better simulate such cortical structures.

Differences in femoral neck structure between elderly Caucasian and Chinese populations: a cross-sectional study of Perth-Beijing cohorts.

Structural skeletal differences of the femoral neck of older Beijing-Chinese and Perth-Caucasian women were compared; adjusting for frame size-related differences, Beijing-Chinese have lower periosteal width; however, indices of internal bone distribution suggest that Beijing-Chinese may exhibit increased resistance to fracture that may relate to the reduced hip fracture incidence. INTRODUCTION: Ethnic differences in skeletal structure may relate to differences in hip fracture risk in Chinese and Caucasian populations. 2D mass, size, and structural biomechanics were compared in the two populations. METHODS: Quantitative computed tomography-derived geometric variables were compared in age-matched community-derived female populations, 196 Beijing-Chinese 76.5 ± 4.8 (mean ± SD) years and 237 Perth-Caucasians 77.1 ± 5.0 years. These included scanned area (A), periosteal width (W), bone mineral content (BMC), aBMD, bone cross-sectional area (bCSA), section modulus (Z) and buckling ratio (BR). Assumption-free measures included sigma (σ), related to the distribution of bone in the scanned image previously identified as a predictor of hip fracture, and delta (δ), the center-of-mass displacement from the geometric center. RESULTS: Compared to Beijing-Chinese, Perth-Caucasians were heavier (Beijing-Chinese 58.7 ± 11.8; Perth-Caucasians 66.1 ± 11.0 kg), taller (154.9 ± 16.7 vs 158.9 ± 6.0 cm), and had higher BMC, A, and W. After adjustment for frame size, BMC was not significantly different but W remained higher in Perth-Caucasians. Differences in variables aBMD, Z, BR, and σ favored higher resistance to failure with Beijing-Chinese before and after adjustment for frame size. δ was similar in both populations; bCSA was higher in Beijing-Chinese before adjustment for frame size but not after. CONCLUSIONS: Bone mass differences in two populations were related to frame size differences. However, femoral neck width remained smaller in Beijing-Chinese suggesting effects of local genetic and environmental factors. In Beijing-Chinese participants compared to Perth-Caucasians, internal bone distribution suggests increased resistance to deformation if exposed to same force that may, in-part, relate to reduced incidence of hip fracture in Beijing-Chinese.

Reconsideration of the Effects of Age on Proximal Femur Structure: Implications for Joint Replacement and Hip Fracture.

OBJECTIVES: In recent years quantitative computed tomography (QCT) has allowed precise non-invasive, three dimensional, in vivo measurement of hip structure in large numbers of individuals. The effects of ageing on proximal femur structure are reported and implications for the prevention of hip prosthesis loosening and hip fracture considered. DESIGN, SETTING AND PARTICIPANTS: An observational cross-sectional study of proximal femur QCT in 719 unselected female European descent aged 20 to 89 years recruited from US and Australian populations. MAIN OUTCOMES MEASURES: QCT scans were obtained using software that separates cortical and cancellous bone by a thresholding technique. Voxel based mineral volume and mass was computed for the integral (external), cancellous and cortical compartments of 1 mm wide sections through the femoral neck (FN), trochanter (TR) and intertrochanter (IT) regions. RESULTS: Over the adult life span total integral volumes at the FN, TR and IT sites expand linearly by between 18 and 37% at the same time as bone mass decreased by 22 to 25% resulting in massive reductions in true volumetric BMD (vBMD) of 40 to 50%. Cancellous volume expansion was larger at 65 to 79% at the three sites. Between the ages of 65 and 75 the average increase in cancellous volume at the IT site was 3.74 cm3 (12.1%). Voxel determined FN cortical volume decreased linearly by 43%, as did cortical bone mass so that vBMD did not change substantially. TR and IT cortical volumes decreased 54 and 28% respectively, small reductions in TR and IT cortical vBMD also occurred. CONCLUSIONS: Large endosteal expansion in the area in which hip replacement stem placement occurs may contribute to loosening. Regarding the propensity to hip fracture, periosteal expansion contributes to increased resistance to bending but cortical thinning contributes to loss of bone to resistance to bending forces. Understanding individual hip structure may contribute to individualisation of risk and subsequent targeting of management using pharmaceutical agents.

Lithotripter shock wave interaction with a bubble near various biomaterials.

Following previous work on the dynamics of an oscillating bubble near a bio-material (Ohl et al 2009 Phys. Med. Biol. 54 6313-36) and the interaction of a bubble with a shockwave (Klaseboer et al 2007 J. Fluid Mech. 593 33-56), the present work concerns the interaction of a gas bubble with a traveling shock wave (such as from a lithotripter) in the vicinity of bio-materials such as fat, skin, muscle, cornea, cartilage, and bone. The bubble is situated in water (to represent a water-like biofluid). The bubble collapses are not spherically symmetric, but tend to feature a high speed jet. A few simulations are performed and compared with available experimental observations from Sankin and Zhong (2006 Phys. Rev. E 74 046304). The collapses of cavitation bubbles (created by laser in the experiment) near an elastic membrane when hit by a lithotripter shock wave are correctly captured by the simulation. This is followed by a more systematic study of the effects involved concerning shockwave bubble biomaterial interactions. If a subsequent rarefaction wave hits the collapsed bubble, it will re-expand to a very large size straining the bio-materials nearby before collapsing once again. It is noted that, for hard bio-material like bone, reflection of the shock wave at the bone-water interface can affect the bubble dynamics. Also the initial size of the bubble has a significant effect. Large bubbles (∼1 mm) will split into smaller bubbles, while small bubbles collapse with a high speed jet in the travel direction of the shock wave. The numerical model offers a computationally efficient way of understanding the complex phenomena involving the interplay of a bubble, a shock wave, and a nearby bio-material.

A numerical study of muco-ciliary transport under the condition of diseased cilia.

Structural and functional disorders of pulmonary cilia may result from genetic disorders and acquired insults. A two-dimensional numerical model based on the immersed boundary method coupled with the projection method is used to study the flow physics of muco-ciliary transport of the human respiratory tract under various abnormalities of cilia. The effects of the cilia beat pattern (CBP), ciliary length, immotile cilia, beating amplitude and uncoordinated beating of cilia are investigated. As expected, the mucus velocity decreases as the beating amplitude reduces. The windscreen wiper motion and rigid planar motion, which are two abnormal CBPs owing to genetic disorders, greatly reduce or almost stop the mucus transport. If the ciliary length varies from its standard length, the mucus velocity would decrease. The mucus velocity decreases rather linearly if the number of uniformly distributed immotile cilia increases. The numerical results show that the mucus velocity would be further reduced marginally when the uniformly distributed immotile cilia are rearranged as a cluster of immotile cilia. Furthermore, if half of the cilia are immotile and uniformly distributed and motile cilia beat at reduced amplitude, the incoordination between the active motile cilia would not significantly affect the mucus velocity.

The pixie earlobe: a method of correction.

A simple method for the correction of the pixie earlobe is documented. This technique preserves the natural free border of the earlobe.

The proboscis lateralis--a 14-year follow-up.

A short historical review of proboscis lateralis is given and some of the important contributions highlighted. Forster was the first to mention this abnormality. I collected 34 cases from the literature (including one of my own) and have divided them clinically into four groups. The proboscis is most commonly associated with deformities of the ipsilateral half nose, the eye, and its adnexa. The various lines of management of this problem are discussed. I recommend dilating the canal of the proboscis as a useful step when it is used for reconstructing the absent heminose. A case of a left proboscis lateralis associated with an ipsilateral heminasal aplasia, a bilateral cleft of the lip and palate, a congenital cleft ala, and microphthalmia with a coloboma of the lower eyelid is documented.

A biomechanical model to determine lumbosacral loads during single stance phase in normal gait.

A dynamic biomechanical model to determine loads (joint forces) attained at the lumbosacral joint-centre during the stance phase of normal level walking was developed. The biomechanical model was based on rigid free body-segments; namely, the foot, shank, thigh, pelvis and head, arms and trunk (HAT) segments. In this biomechanical model, the forces and moments acting on the lumbar spine are derived from body-segment mass and movements of the trunk. These external forces and their moments must be equilibrated by internal forces, that is, contributions from the erector spinae or rectus abdominus muscle group, and abdominal pressures from within the trunk together with spine forces. Three-dimensional co-ordinate and ground-reaction force data were captured from five healthy young male subjects performing normal level walking in the motion analysis laboratory of the Department of Orthopaedic Surgery, National University of Singapore. These data were captured using the VICON motion analysis system. Both of these data sets were pre-processed, and together with relevant anthropometric parameters and physical measurements of the subject, were passed into the biomechanical model to compute the resultant loads at the lumbosacral joint-centre. The results of this study showed that the peak resultant loads at the lumbosacral joint-centre were between 1.45 and 2.07 times body-weight.

A comparison of lumbosacral loads during static and dynamic activities.

A biomechanical model to determine the loads at the lumbosacral joint was developed. This model was used to determine the lumbosacral loads during two specific activities--a stable standing posture representing a static activity, and a normal level walk representing a dynamic activity. This study involved ten healthy and young male subjects. The results obtained indicated that the lumbosacral loads during a stable standing posture was in the range of 0.82 to 1.18 times body-weight, with a mean of 1.03 (+/- 0.11) times body-weight. In comparison, during a normal level walk the lumbosacral loads were in the range between 1.41 and 2.07 times body-weight, with a mean of 1.61 (+/- 0.24) times body-weight. The walking speed of these subjects varied between 0.96 and 1.48 ms-1, with a mean of 1.25 (+ 0.18) ms-1. Results in this study indicated that there was a significant difference (p < 0.005) between the means of the lumbosacral loads of these two specified activities. An increase of 56.3% between means of the static to the dynamic case was observed.

Pupillary irradiance distributions for light backscattered in the human eye.

An investigation of linear knife-edge photoscreening devices for detecting focusing errors, refractive defects and other optical artifacts in the human eye is described. Pupillary irradiance distributions calculated for a model eye are shown to agree qualitatively with distributions recorded experimentally using video frame grabbing equipment. The form of the pupillary irradiance distribution from a cyclopleged human eye supports a diffuse-like characterization for the reflection/scattering processes at the retina. The extreme sensitivity of the instruments enables real-time detection of refractive effects from tear films on the cornea and real-time tracking of floaters.

Evaluating accuracy of structural geometry by DXA methods with an anthropometric proximal femur phantom.

DXA-derived bone structural geometry has been reported extensively but lacks an accuracy standard. In this study, we describe a novel anthropometric structural geometry phantom that simulates the proximal femur for use in assessing accuracy of geometry measurements by DXA or other X-ray methods. The phantom consists of seven different interchangeable neck modules with geometries that span the range of dimensions in an adult human proximal femur, including those representing osteoporosis. Ten repeated hip scans of each neck module using two current DXA scanner models were performed without repositioning. After scanner specific calibration, hip structure analysis was used to derive structural geometry. Scanner performance was similar for the two manufacturers. DXA-derived HSA geometric measurements were highly correlated with values derived directly from phantom geometry and position; R² between DXA and phantom measures were greater than 94% for all parameters, while precision error ranged between 0.3 and 3.9%. Despite high R² there were some systematic geometry errors for both scanners that were small for outer diameter, but increasing with complexity of geometrical parameter; e.g. buckling ratio. In summary, the anthropometric phantom and its fabrication concept were shown to be appropriate for evaluating proximal femoral structural geometry in two different DXA systems.

A low-voltage spark-discharge method for generation of consistent oscillating bubbles.

Underwater spark-discharge methods have been widely utilized for experimental studies in many fields such as material processing, water treatment, and cavitation bubble dynamics. However, the precise control of bubble size using this method has been difficult. This poses challenges to better understand the complex interactions of non-spherical cavitation bubble growth and collapse, which require fine and careful control of bubble size. A novel low-voltage (60.0 V) underwater spark-discharge method using a metal-oxide-semiconductor field effect transistor is presented here. We are able to repeatedly generate oscillating bubbles of consistent maximum radius, a. The dependency of the total circuit resistance to spark-generated bubble size in this method is discussed.