Correlation of computed finite element stresses to bone density after remodeling around cementless femoral implants

Fundamental to the development of a durable, uncemented femoral component is an understanding of the remodeling process that goes on after implantation. Predicting the bone remodeling that results from the use of a given hip implant would facilitate the design of a prosthesis that would optimize bone adaptation. This report combines the results of finite element stress analysis of the AML prosthesis implanted in vitro into a proximal femur with quantitative bone mineral density measured in vivo in the medial and lateral aspects of human femora at periods after implantation. Unimplanted femora were also analyzed for comparison purposes. Bone density measurements were obtained using dual energy x-ray absorptiometry. Absolute values of the maximum principal stress and maximum shear stress calculated in the femur at the time of implantation accurately predict bone density resulting from remodeling caused by the prosthesis. The calculated initial strain was not found to correlate with resultant bone density. These findings suggest that the results of stress analyses using three dimensional models of femora implanted in vitro can predict bone remodeling around prostheses and may be used to quantitate appropriate design criteria for total hip replacements.     

A phase I/II study of multicyclic dose-intensive chemotherapy supported with G-CSF, or G-CSF and haematopoietic progenitor cells in whole blood, in two consecutive cohorts of patients

We investigated the reconstitutive potential of haematopoietic progenitor cells collected in autologous whole blood during multicycle dose-intensified chemotherapy. Forty patients with metastatic solid tumours were treated with up to six cycles of cisplatin and escalating doses of ifosfamide every 14 days. Cisplatin was administered in 3% sodium chloride over 3 h, followed by ifosfamide over 24 h and mesna over 36 h. The first cohort of patients received granulocyte colony-stimulating factor (G-CSF) days 4-14. Once dose-limiting toxicity was reached in cohort 1, the study continued with a second cohort of patients, in whom, in addition to G-CSF on days 4-14, 500 ml of G-CSF and chemotherapy-'primed' whole blood was collected on day 15, i.e. on day 1 of treatment cycles two to six, before cisplatin administration. This volume of blood was kept unprocessed at 4 degrees C and reinfused 20-24 h after the completion of ifosfamide. In cohort 1, dose-limiting toxicity (DLT) was reached at ifosfamide 6.0 g m(-2) with two out of six of the patients developing neutropenic fever. Although in cohort 2 no neutropenic fever was encountered, neither the frequency nor the duration of grade 4 neutropenia and thrombocytopenia were reduced. Cumulative asthenia resulted in DLT at 7.0 g m(-2). The median number of CD34+ cells in 500 ml of whole blood after the first cycle (i.e. at start of cycle 2) was 1.15 x 10(6) kg(-1). This number was significantly greater after the second cycle (2.06 x 10(6) kg(-1), P = 0.01) and then gradually decreased after cycles three to six. After storing whole blood, the number of CD34+ cells had not decreased (median + 10%). We conclude that the method of combined bone marrow support by G-CSF and haematopoietic progenitor cells in autologous whole blood collected before each cycle of a 2-weekly regimen of cisplatin-ifosfamide does not result in clinically measurable reduced bone marrow toxicity compared with what can be expected by the use of G-CSF alone.     

Resistant Starch in Foods: Modified Method for Dietary Fiber Residues

In a modified method for measuring Resistant Starch (RS) in dietary fiber residues all operations for obtaining fiber residues and determination of RS were performed in a 50 mL centrifugation tube. This minimized error sources and simplified previous methodology.     

Novel ventricular apical cannula: in vitro evaluation using transparent, compliant ventricular casts

The geometric configuration of the cannula connection to the left ventricular (LV) apex was studied with respect to several characteristics defining functionality and compatibility. The authors had previously determined, through in vivo studies in sheep, that the design of the cannula used with a dynamic blood pump for LV circulatory support can significantly affect the hemodynamics by improving both the bypass flow rate and the fluid dynamics within the ventricle. The tip of the cannula can aid in preventing wall to wall ventricular collapse, as well as septal shift, due to reduced LV pressure. Proper surgical placement of the cannula with respect to the endocardial surface of the LV can also be simplified by the tip geometry. To investigate the anatomic interaction and fluid dynamics of apical cannulation, transparent compliant casts of bovine LVs were fabricated for in vitro flow visualization. Two different heart geometries were cast, end systolic and end diastolic. The latter was fitted with a pericardial mitral valve and pressurized in a pulsatile fashion to simulate the wall movement of a beating heart. The internal flow and anatomy were visualized with fluorescent particle tracking velocimetry. These studies were performed with conventional cannula tips, as well as a novel, trumpet mouth cannula. The visualization clearly shows the dramatic differences in flow between the geometries tested, and strongly advocates a trumpet mouth design. This novel tip demonstrated excellent placement, beneficial stenting, and improved blood flow by reducing apical stasis and recirculation. Ongoing evaluation of these and future geometries include the application of in vitro endoscopy, quantitative velocimetry, and extension to dilated human ventricles.     

Hydrophobic and Electrostatic Interactions on Extrusion of Protein Isolates

Lung protein isolates previously defatted by solvents of increasing polarity were extruded. Water monolayer values of these isolates, calculated from water vapor isotherms, showed a maximum when solvents of intermediate polarity were used. Shear resistance of the extruded products presented a similar behavior, with maximum values attained when the same solvents were employed to defat the isolates prior to extrusion. Phospholipid percentage in lipid fraction of the solvent extracts showed that minimum phospholipids were removed from the isolates when these solvents were used. The results suggested that the presence of phospholipid in the isolates after defatting could be important in improving the extrusion of these systems. Hydrophobic and electrostatic interactions between the macromolecules involved seemed therefore, to be relevant for the final texture obtained by extrusion.     

Aspirative lipectomy in patients with alimentary-constitutional obesity

The results of aspirative lipectomy in patients with 2nd and 3rd stage of alimentary-constitutional obesity are analysed. The effectiveness of lipectomy with surgical creation of a small ventricle and without previous surgery, has been demonstrated. The criteria of patients selection, based on their somatic and psychic features, are formulated. Aspirative lipectomy has certain advantages over other types of plastic surgery as it has the minimal rate of postoperative complications.     

Influence of pH on the uptake of 5-fluorouracil into isolated tumour cells

To investigate the possible dependence of 5-fluorouracil (5FU) uptake in tumours on the intra- (pHi) and extracellular (pHe) pH, a pH gradient (deltapH) was imposed across the plasma membrane of ascites tumour cells in vitro, similar to that known to occur in some solid tumours in vivo, by incubation in media of PHe 5-8. A > or = 2:1 (intracellular/extracellular) accumulation of radiolabelled 5FU occurred after 5 min incubation of the cells with 0.5 mM 5FU at pHe of 5.0, 5.5 or 6.0. 5FU metabolism is slow under these conditions, and 5FU uptake was not affected by longer incubations up to 20 min, nor by the absence of a sodium gradient. pHi was estimated from the distribution of the weak acid, 5.5-dimethyl-2,4-oxazolidione ([14C]DMO) across the cell membrane. There was significant correlation between the intracellular/extracellular 5FU ratio and pHe (from pHe 6-8), deltapH and pHi (P < 0.02). Similar results were obtained with HT29 cells. Incubation with a drug that made plasma membranes permeable to H+ significantly decreased 5FU uptake in Lettre cells. The co-transport of 5FU may occur on a proton symport using the proton motive force of the deltapH.     

Glutathione S-transferase of goat lens: evidence for expression of only class mu isoenzymes

Misbisection of lines is thought to represent an attentional bias. When radial lines (intersection of the midsagittal and transverse planes) are presented below eye level, normal subjects are biased toward far peripersonal space in the visual modality and to near peripersonal space in the tactile modality. These errors may be related to a body centered, a retinotopic, or an object centered attentional bias. The purpose of this study was to contrast the body centered and retinotopic-objective centered hypotheses by having 12 normal subjects perform visual and tactile bisections of radial lines that are above and below eye level. The top of the page, which may be defined by retinotopic or object centered coordinates, contains the portion of the line that is most distant from our bodies when the page is below eye level. However, above eye level, the top of a radial line would be the portion of the page that is most proximal to our bodies. We observed that when stimuli are presented below eye level, normal subjects have a visual bias toward far peripersonal space or the top of the page or both, and have a tactile bias in the opposite direction. In the above eye position we found no overall bias in either modality. Because above eye level the body centered bias should have remained the same but the retinotopic or object centered bias should have reversed, our results suggest that the body and object centered or retinotopic biases, which are oriented in opposite directions, nullified each other.