Добірка наукової літератури з теми "Multi-layered soft tissues"

Background and Objectives: Profound knowledge on the load-dependent behavior of human soft tissues is required for the development of suitable replacements as well as for realistic computer simulations. Regarding the former, e.g., the anisotropy of a particular biological tissue has to be represented with site- and direction-dependent particular mechanical values. Contrary to this concept of consistent mechanical properties of a defined soft tissue, mechanical parameters of soft tissues scatter considerably when being determined in tensile tests. In spite of numerous measures taken to standardize the mechanical testing of soft tissues, several setup- and tissue-related factors remain to influence the mechanical parameters of human soft tissues to a yet unknown extent. It is to date unclear if measurement extremes should be considered a variation or whether these data have to be deemed incorrect measurement outliers. This given study aimed to determine mechanical parameters of the human cranial dura mater as a model for human soft tissues using a highly standardized protocol and based on this, critically evaluate the definition for the term mechanical “variation” of human soft tissue. Materials and Methods: A total of 124 human dura mater samples with an age range of 3 weeks to 94 years were uniformly retrieved, osmotically adapted and mechanically tested using customized 3D-printed equipment in a quasi-static tensile testing setup. Scanning electron microscopy of 14 samples was conducted to relate the mechanical parameters to morphological features of the dura mater. Results: The here obtained mechanical parameters were scattered (elastic modulus = 46.06 MPa, interquartile range = 33.78 MPa; ultimate tensile strength = 5.56 MPa, interquartile range = 4.09 MPa; strain at maximum force = 16.58%, interquartile range = 4.81%). Scanning electron microscopy revealed a multi-layered nature of the dura mater with varying fiber directions between its outer and inner surface. Conclusions: It is concluded that mechanical parameters of soft tissues such as human dura mater are highly variable even if a highly standardized testing setup is involved. The tissue structure and composition appeared to be the main contributor to the scatter of the mechanical parameters. In consequence, mechanical variation of soft tissues can be defined as the extremes of a biomechanical parameter due to an uncontrollable change in tissue structure and/or the respective testing setup.

Medication-related osteonecrosis of the jaw (MRONJ) is a side effect of bisphosphonate therapy, characterised by exposed necrotic bone. The soft tissues of the oral mucosa no longer provide a protective barrier and MRONJ patients experience pain, infections and difficulties eating. We hypothesised that hydroxyapatite (Ca5(PO4)3(OH)) could reduce bisphosphonate concentrations and protect the oral mucosa by exploiting bisphosphonate’s calcium binding affinity. The effect of zoledronic acid (ZA) and pamidronic acid (PA) on the metabolism of oral fibroblasts, oral keratinocytes and three-dimensional oral mucosa models was investigated and then repeated in the presence of hydroxyapatite granules. Without hydroxyapatite, ZA and PA significantly reduced the metabolic activity of oral cells in a dose-dependent manner. Both drugs reduced epithelial thickness and 30 µM ZA resulted in loss of the epithelium. Hydroxyapatite granules had a protective effect on oral cells, with metabolic activity retained. Oral mucosa models retained their multi-layered epithelium when treated with ZA in the presence of hydroxyapatite granules and metabolic activity was comparable to controls. These results demonstrate hydroxyapatite granules protected oral soft tissues from damage caused by bisphosphonate exposure. Porous hydroxyapatite granules are currently used for socket preservation and this data suggests their potential to prevent MRONJ in at-risk patients.

Prolonged exposure to mechanical vibration has been associated with many musculoskeletal, vascular and sensorineural disorders of the foot from simple Plantar fasciitis and Achilles Tendonitis to complex ones as Tarsal tunnel syndrome (TTS) and Vibration white feet/toes. Foot-transmitted vibrations (FTV) are exposed to the occupants using vibrating equipment’s or standing on vibrating platforms. Prolonged exposure to foot-transmitted vibrations (FTV) can lead to syndromes like vibration white feet/toes may result in tingling sensation, blanching of the toes and even numbness in the feet and toes. A multi-layered two dimensional, plane strain finite element model is developed from the actual cross-section of the human foot to study the stresses and strains developed in the skin and soft tissues. The foot is assumed to be in contact with a steel plate, mimicking the interaction between the foot and the work platform. The skin and the subcutaneous tissue are considered as hyperelastic and viscoelastic. The effects of loading in the form of displacements and the frequency of sinusoidal vibration on a time-dependent stress/strain distribution at various depths in the subcutaneous tissue of the foot are investigated. The simulations indicate that lower frequency vibrations penetrate deep into the subcutaneous tissue while higher frequencies are concentrated in the outer skin layer. The present biomechanical model may serve as a valuable tool to study the response of foot of those who work on a vibrating platform.

The human head is a complex multi-layered structure of hard and soft tissues, governed by complex materials laws and interactions. Computational models of the human head have been developed over the years, reaching high levels of detail, complexity, and precision. However, most of the attention has been devoted to the brain and other intracranial structures. The skull, despite playing a major role in direct head impacts, is often overlooked and simplified. In this work, a new skull model is developed for the authors’ head model, the YEAHM, based on the original outer geometry, but segmenting it with sutures, diploë, and cortical bone, having variable thickness across different head sections and based on medical craniometric data. These structures are modeled with constitutive models that consider the non-linear behavior of skull bones and also the nature of their failure. Several validations are performed, comparing the simulation results with experimental results available in the literature at several levels: (i) local material validation; (ii) blunt trauma from direct impact against stationary skull; (iii) three impacts at different velocities simulating falls; (iv) blunt ballistic temporoparietal head impacts. Accelerations, impact forces, and fracture patterns are used to validate the skull model.

Decellularized extracellular matrix (dECM)–based biomaterials are of great clinical utility in soft tissue repair applications due to their regenerative properties. Multi-layered dECM devices have been developed for clinical indications where additional thickness and biomechanical performance are required. However, traditional approaches to the fabrication of multi-layered dECM devices introduce additional laminating materials or chemical modifications of the dECM that may impair the biological functionality of the material. Using an established dECM biomaterial, ovine forestomach matrix, a novel method for the fabrication of multi-layered dECM constructs has been developed, where layers are bonded via a physical interlocking process without the need for additional bonding materials or detrimental chemical modification of the dECM. The versatility of the interlocking process has been demonstrated by incorporating a layer of hyaluronic acid to create a composite material with additional biological functionality. Interlocked composite devices including hyaluronic acid showed improved in vitro bioactivity and moisture retention properties.

The aim of this article is to provide some insights on the osmo-inelastic response under stretching of annulus fibrosus of the intervertebral disc. Circumferentially oriented specimens of square cross section, extracted from different regions of bovine cervical discs (ventral-lateral and dorsal-lateral), are tested under different strain-rates and saline concentrations within normal range of strains. An accurate optical strain measuring technique, based upon digital image correlation, is used in order to determine the full-field displacements in the lamellae and fibers planes of the layered soft tissue. Annulus stress–stretch relationships are measured along with full-field transversal strains in the two planes. The mechanical response is found hysteretic, rate-dependent and osmolarity-dependent with a Poisson’s ratio higher than 0.5 in the fibers plane and negative (auxeticity) in the lamellae plane. While the stiffness presents a regional-dependency due to variations in collagen fibers content/orientation, the strain-rate sensitivity of the response is found independent on the region. A significant osmotic effect is found on both the auxetic response in the lamellae plane and the stiffness rate-sensitivity. These local experimental observations will result in more accurate chemo-mechanical modeling of the disc annulus and a clearer multi-scale understanding of the disc intervertebral function.

Hydrogel-based bio-inks have recently attracted more attention for 3D printing applications in tissue engineering due to their remarkable intrinsic properties, such as a cell supporting environment. However, their usually weak mechanical properties lead to poor printability and low stability of the obtained structures. To obtain good shape fidelity, current approaches based on extrusion printing use high viscosity solutions, which can compromise cell viability. This paper presents a novel bio-printing methodology based on a dual-syringe system with a static mixing tool that allows in situ crosslinking of a two-component hydrogel-based ink in the presence of living cells. The reactive hydrogel system consists of carboxymethyl chitosan (CMCh) and partially oxidized hyaluronic acid (HAox) that undergo fast self-covalent crosslinking via Schiff base formation. This new approach allows us to use low viscosity solutions since in situ gelation provides the appropriate structural integrity to maintain the printed shape. The proposed bio-ink formulation was optimized to match crosslinking kinetics with the printing process and multi-layered 3D bio-printed scaffolds were successfully obtained. Printed scaffolds showed moderate swelling, good biocompatibility with embedded cells, and were mechanically stable after 14 days of the cell culture. We envision that this straightforward, powerful, and generalizable printing approach can be used for a wide range of materials, growth factors, or cell types, to be employed for soft tissue regeneration.

Category: Trauma Introduction/Purpose: Displaced intraarticular calcaneus fractures comprise the majority of all calcaneus fractures. Many are indicated for open reduction and internal fixation (ORIF) through an extensile lateral approach (ELA). Unfortunately, this approach has reported complication rates of up to 32%. Improved edema management may reduce the incidence of complications. While compression wrapping has been shown to reduce wound complications in ankle arthroplasty, it has not been well studied in lower extremity trauma. This study aimed to evaluate the benefit of compression wrapping in calcaneus fractures treated surgically with an ELA. Methods: This study included 19 patients from 2015-2018 who underwent ORIF of closed intra-articular calcaneal fractures via an ELA by two surgeons. Demographics, comorbidities, fracture characteristics, and time to surgery were recorded. Following surgery, the extremity was initially immobilized in a short leg splint with transition to serial compression wrappings on postoperative day two. Wrappings involved application of multi-layered cotton cast padding and short stretch elastic bandages to the extremity in a distal to proximal fashion. Wraps were replaced every three days by trained physiotherapists until the two- week postoperative visit. The primary outcome was development of a wound complication. A minor complication was defined as wound appearance prompting initiation of oral or IV antibiotics or local wound care. A major complication was defined as development of flap necrosis or return to the OR for debridement. Results: Mean age was 47.7 years. 3 patients (15.7%) were diabetic, and 7 patients (36.8%) were smokers. Mean BMI was 26.9 kg/m2 (SD 4.4). Mean time to surgery was 11.4 days from injury (SD 6.93). The rate of minor soft tissue complication was 4/19 (26.3%); 2 patients required oral antibiotics only, 1 local wound care only, and 1 both antibiotics and local wound care. The rate of major complication was 2/19 (10.5%), with 1 patient requiring a return to OR and another requiring both a return to the OR and IV antibiotics. Of those patients, 1 was noncompliant with the protocol. All patients progressed to eventual soft tissue healing. Statistical analysis identified diabetes as a risk factor for any complication (p=0.02, relative risk 5.3). Conclusion: Compression wrapping resulted in a low incidence of major soft tissue complications in calcaneus fractures treated with an extensile lateral approach. Compression wrapping is an effective method of post-operative soft tissue management for calcaneal fractures, and may have further applications for similar high energy foot and ankle fractures. Further studies are warranted to determine whether this novel wound care technique is superior to standard post-operative wound care.

Background Surgery in the lesser pelvis is associated with a high complication rate as surgeons are spatially limited by solid anatomic structures and soft tissue borders. So far, only two-dimensional (2D) parameters have been used for risk stratification. Purpose To precisely measure the inner pelvic volume a computed tomography (CT)-based three-dimensional (3D) approach was established and compared to approximations by 2D parameter combinations. Material and Methods Thin-layered multi-slice CT datasets were used retrospectively for slice by slice depiction of the inner pelvic surface. The inner pelvic volume was then automatically compounded. Combinations of two to four 2D dimensions determined in 3D volume rendered reconstructions were correlated with the inner pelvic volume. Pearson’s correlation coefficient and Chi square test were used for statistical calculations. Significance level was set at P < 0.05. Results In total 142 patients (91 men, 51 women) aged 64.8 ± 10.6 years at surgery were included in the study. Mean calculated pelvic volume was 1031.13 ± 180.06 cm3 (men, 996.57 ± 172.43 cm3; women, 1093.34 ± 178.39 cm3). Best approximations were obtained by combination of the 2D measurements transverse inlet and pelvic height for men (r = 0.799, P < 0.05) as well as transverse inlet, obstetric conjugate, interspinous distance and pelvic depth for women (r = 0.855, P < 0.05). Conclusion We describe a precise and reproducible CT-based method for pelvic volumetry. A less time consuming but still reliable approximation can be achieved by combination of two to four 2D dimensions.

This article provides the review of the medical use of pH- and temperature-sensitive polymer hydrogels. Such polymers are characterised by their thermal and pH sensitivity in aqueous solutions at the functioning temperature of living organisms and can react to the slightest changes in environmental conditions. Due to these properties, they are called stimuli-sensitive polymers. This response to an external stimulus occurs due to the amphiphilicity (diphilicity) of these (co)polymers. The term hydrogels includes several concepts of macrogels and microgels. Microgels, unlike macrogels, are polymer particles dispersed in a liquid and are nano- or micro-objects. The review presents studies reflecting the main methods of obtainingsuch polymeric materials, including precipitation polymerisation, as the main, simplest, and most accessible method for mini-emulsion polymerisation, microfluidics, and layer-by-layer adsorption of polyelectrolytes. 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L’endommagement dans les tissus souples de l'annulus fibrosus est un phénomène multi-échelle complexe dû à un arrangement structural complexe du réseau de collagène à différentes échelles d'organisation hiérarchique. Une représentation constitutive entièrement tridimensionnelle, considérant la variation régionale de la complexité structurale, n'a pas encore été développée, pour estimer la mécanique multiaxiale de l'annulus jusqu'à la rupture. Dans la présente thèse de doctorat, un modèle, formulé dans le cadre de la mécanique non linéaire des milieux continues, est développé pour prédire l’endommagement et la rupture de l'annulus induits par la déformation sous des histoires de chargements multiaxiaux en considérant comme processus physique dépendant du temps à la fois les effets volumétriques induits chimiquement et l'accumulation de l’endommagement.Dans une première partie, un modèle basé sur la microstructure est proposé pour relier les caractéristiques structurales aux propriétés mécaniques intrinsèques et électrochimiques des tissus souples de l'annulus. Le modèle lamellaire/interlamellaire multicouche est construit en considérant les interactions effectives entre les couches adjacentes et la contrainte volumétrique induite chimiquement. La comparaison modèle/expériences démontre que l'évaluation de la réponse globale dépendante du temps implique de considérer simultanément la contrainte, le changement volumétrique et la caractéristique auxétique en relation avec les caractéristiques structurales.Dans une deuxième partie, le modèle est enrichi en considérant la structure hiérarchique des tissus souples depuis les fibrilles de collagène de taille nanométrique jusqu'aux fibres de collagène orientées de taille microscopique. Le processus stochastique d'événements progressifs d’endommagement, opérant à différentes échelles de la phase solide, est introduit pour la matrice extracellulaire, les fibres microscopiques et le réseau de fibrilles nanométriques. Les effets directionnels sur la réponse mécanique et la rupture de l’annulus sont mis en évidence en relation avec le mode de chargement externe, les caractéristiques de la structure, les événements d'endommagement et l'hydratation.Dans une troisième partie, le modèle est développé en considérant la variation régionale de l'organisation structurale complexe du réseau de collagène à différentes échelles pour prédire l’endommagement multiaxial anisotrope régional du disque intervertébral. Après identification du modèle à l'aide de lamelles simples extraites de différentes régions du disque, le caractère prédictif du modèle est vérifié pour divers modes de chargement élémentaires multiaxiaux représentatifs du mouvement de la colonne vertébrale. Les étirements dans les directions circonférentielle et radiale jusqu'à la rupture ont servi à vérifier les capacités prédictives du modèle pour les différentes régions. Les résultats du modèle sous cisaillement simple, étirement biaxial et compression en déformation plane sont également présentés et discutés.Dans une quatrième partie, un modèle de disque humain complet est construit afin d’examiner la mécanique hétérogène dans le cœur du disque. Les champs d'endommagement au sein du disque sont analysés, sous compression axiale, torsion axiale et chargements combinés, afin d’évaluer les zones où le risque de rupture est le plus élevé
The damage in annulus fibrosus soft tissues is a complex multiscale phenomenon due to a complex structural arrangement of collagen network at different scales of hierarchical organization. A fully three-dimensional constitutive representation that considers the regional variation of the structural complexity to estimate annulus multiaxial mechanics till failure has not yet been developed. In the present PhD dissertation, a model, formulated within the framework of nonlinear continuum mechanics, is developed to predict deformation-induced damage and failure of annulus under multiaxial loading histories considering as time-dependent physical process both chemical-induced volumetric effects and damage accumulation.In a first part, a microstructure-based model is proposed to connect structural features, intrinsic mechanics and electro-chemical properties of annulus soft tissues. The multi-layered lamellar/inter-lamellar annulus model is constructed by considering the effective interactions between adjacent layers and the chemical-induced volumetric strain. The model/experiments comparison demonstrates that the evaluation of the overall time-dependent response involves considering stress, volumetric change and auxetic feature simultaneously in relation to structural features.In a second part, the model is enriched by considering the hierarchical structure of the soft tissue from the nano-sized collagen fibrils to the micro-sized oriented collagen fibers. The stochastic process of progressive damage events operating at different scales of the solid phase is introduced for the extracellular matrix and the network of nano-sized fibrils/micro-sized fibers. The directional effects on annulus mechanics and failure are highlighted in relation to external loading mode, structure features, damage events and hydration.In a third part, the model is further developed by considering the regional variation of the complex structural organization of collagen network at different scales to predict the regional anisotropic multiaxial damage of the intervertebral disc. After model identification using single lamellae extracted from different disc regions, the model predictability is verified for various multiaxial elementary loading modes representative of the spine movement. The stretching along the circumferential and radial directions till failure serves to check the predictive capacities of the annulus model for the different regions. Model results under simple shear, biaxial stretching and plane-strain compression are further presented and discussed.In a fourth part, a full human disc model is constructed using the regional annulus model to examine the heterogeneous mechanics in the disc core. Damage fields in the disc are analyzed under axial compression, axial twist and combined loadings to assess the areas where the risk of failure is the highest