J Biomech Eng. 1993;115(2):131-136. doi:10.1115/1.2894112.

Six major mechanical design variables characterizing single-upright lateral prophylactic knee braces were studied experimentally, using a generic modular brace (GMB). Impulsive valgus loading tests were conducted with the GMB applied to a surrogate leg model. The surrogate involved anatomically realistic aluminum-reinforced acrylic components to model bone, and expendable polymeric blanks to mimic the major knee ligaments. Behavior of the surrogate system reasonably reproduced that of human cadaveric knees under similar loading conditions. Load at failure of the medial collateral ligament (MCL) analog, gross knee stiffness, and MCL relative strain relief were measured for each of twelve parametric brace design permutations. Compared to the unbraced condition, bracing provided statistically significant increases in valgus load uptake at failure and in MCL strain relief. Increasing the dimensions of individual brace components (hinge length and offset; upright length, breadth, and thickness; cuff area), relative to those of a GMB baseline configuration deemed representative of current commerical products, failed to achieve statistically significant improvements in brace performance. However, most below-baseline dimensioning of individual components did significantly compromise GMB performance. These surrogate test data indicate that geometric modifications of current single-upright lateral brace designs are unlikely to substantially improve upon the fairly modest valgus load protection afforded by this class of devices.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 1993;115(2):137-143. doi:10.1115/1.2894113.

Almost a decade ago, three-dimensional formulation for the dynamic modeling of an articulating human joint was introduced. Two-dimensional version of this fomulation was subsequently applied to the knee joint. However, because of the iterative nature of the solution technique, this model cannot handle impact conditions. In this paper, alternative solution methods are introduced which enable investigation of the response of the human knee to impact loading on the lower leg via an anatomically based model. In addition, the classical impact theory is applied to the same model and a closed-form solution is obtained. The shortcomings of the classical impact theory as applied to the impact problem of the knee joint are delineated.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 1993;115(2):144-148. doi:10.1115/1.2894114.

A dynamic knee simulator has been developed to allow in-vitro investigation of the mechanical response of the joint corresponding to dynamic functional activities, e.g., walking. In the simulator, the controlled inputs are the time-histories of three parameters of a given dynamic activity: the flexion angle, and the flexion/extension moment and tibial axial force components of the foot-to-floor reaction. A combination of stepping motors and electro-hydraulic actuators is used to apply to a knee specimen, simultaneously and independently, the specified load and/or displacement inputs while allowing unconstrained relative motion between the joint members. Satisfactory performance of the simulator has been established for walking gait conditions based on measurements on three fresh-frozen specimens.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 1993;115(2):149-159. doi:10.1115/1.2894115.

Hotani has filmed morphological transformations in unilamellar liposomes, starting from a spherical shape, when the interior volume decreases steadily. Hotani’s liposomes showed no evidence of general thermal fluctuations. We use a finite-deformation theory of axisymmetric, quasi-static thin shells to analyze theoretically bifurcations and changes of shape in liposomes under decreasing volume. The main structural action in a lipid bilayer is generally agreed to be its elastic resistance to bending, and it is usual to regard surface deformation as being like that of a two-dimensional liquid. We find, however, that some in-plane shear elasticity is also needed in order to produce the observed post-bifurcation behavior. Such an elasticity would be difficult to measure directly.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 1993;115(2):160-168. doi:10.1115/1.2894116.

When bovine pulmonary artery endothelial cells in culture are subjected to mechanical strain, their physiology is altered. Experimentally, this mechanical strain is generated by increased tension in the substrate to which the cells are attached and results in altered levels of fibronectin. Studies of the structural response of the endothelial cell suggest that this stimulus is transmitted to the cell membrane, organelles, and cytoskeleton by natural cell attachments in a quantifiable and predictable manner. This report examines altered intracellular calcium homeostasis as a possible messenger for the observed strain-induced physiologic response. In particular, using the intracellularly trapped calcium indicator dyes, Quin2 and Fura2, we observed changes in cytosolic free calcium ion concentration in response to biaxial strain of bovine pulmonary artery endothelial cells in culture. The magnitude and time course of this calcium transient resemble that produced by treatment with the calcium ionophore, Ionomycin, indicating that mechanical stimulation may alter cell membrane permeability to calcium. Additional experiments in the presence of EDTA indicated that calcium was also released from intracellular stores in response to strain. In order to explain the stretch-induced calcium transients, a first-order species conservation model is presented that takes into account both the cell’s structural response and the calcium homeostatic mechanisms of the cell. It is hypothesized that the cell’s calcium sequestering and pumping capabilities balanced with its mechanically induced changes in calcium ion permeability will determine the level and time course of calcium accumulation in the cytosol.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 1993;115(2):169-174. doi:10.1115/1.2894117.

Successful protocols for cryopreservation of living cells can be designed if the physicochemical conditions to preclude intracellular ice formation (IIF) can be defined. Unfortunately, all attempts to predict the probability of IIF have met with very limited success. In this study, an analytical model is developed to predict ice formation inside mouse oocytes subjected to a freezing stress. According to the model, IIF is catalyzed heterogeneously by the plasma membrane (i.e., surface catalyzed nucleation, SCN). A local site on the plasma membrane is assumed to become an ice nucleator in the presence of the extracellular ice via its effects on the membrane. This interaction is characterized by the contact angle between the plasma membrane and the ice cluster. In addition, IIF is assumed to be catalyzed at temperatures below -30° C by intracellular particles distributed throughout the cell volume (i.e., volume catalyzed nucleation, VCN). In the present study, these two distinctly coupled modes of IIF, especially SCN, are applied to various experimental protocols from mouse oocytes. Excellent agreement between predictions and observations suggests that the proposed model of IIF is adequate.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 1993;115(2):175-179. doi:10.1115/1.2894118.

The influence of a large blood vessel (larger than 500 μm in diameter) on the local tissue temperature decay following a point source heating pulse was determined numerically using a sink/source method. It was assumed that the vessel was large enough so that the temperature of blood flowing within it remained essentially constant and was unaffected by any local tissue temperature transients. After the insertion of a point source heating pulse, the vessel influence on the local tissue transient temperature field was estimated by representing the vessel as a set of negative fictitious instantaneous heat sources with strength just sufficient to maintain the vessel at a constant temperature. In the surrounding tissue, the Pennes’ tissue heat transfer equation was used to describe the temperature field. Computations have been performed for a range of vessel sizes, probe-vessel spacings and local blood perfusion rates. It was found that the influence of a large vessel on the local tissue temperature decay is more sensitive to its size and location rather than to the local blood perfusion rate. For a heating pulse of 3s duration and 5 mW of power, there is a critical probe-vessel center distance 7R (R, vessel radius) beyond which the larger vessel influence on tissue temperature at the probe can be neglected.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 1993;115(2):180-186. doi:10.1115/1.2894119.

A microvascular network with random dimensions of vessels is built on the basis of statistical analysis of conjuctival beds reported in the literature. Our objective is to develop a direct method of evaluating the statistics of the pulsatile hydrodynamic field starting from a priori statistics which mimic the large-scale heterogeneity of the network. The model consists of a symmetric diverging-converging dentritic network of ten levels of vessels, each level described by a truncated Gaussian distribution of vessel diameters and lengths. In each vascular segment, the pressure distribution is given by a diffusion equation with random parameters, while the blood flow rate depends linearly on the pressure gradient. The results are presented in terms of the mean value and standard deviation of the pressure and flow rate waveforms at two positions along the network. It is shown that the assumed statistical variation of vessel lengths results in flow rate deviations as high as 50 percent of the mean, while the corresponding effect of vessel diameter variation is much smaller. For a given pressure drop, the statistical variation of lengths increases the mean flow while the effect on the mean pressure distribution is negligible.

Commentary by Dr. Valentin Fuster
J Biomech Eng. 1993;115(2):187-194. doi:10.1115/1.2894120.

An adaptive technique for the estimation of the time history of aortic pressure (from applied voltage and position feedback) has been designed, implemented, and bench tested using the Penn State Electric Ventricular Assist Device (EVAD). This method, known in the field of automatic control as a dynamic observer, utilizes gains which were determined using experimental data collected while the EVAD was running on a mock circulatory system. An adaptive scheme provides the observer with a method of changing its initial conditions on a stroke-by-stroke basis which improves observer performance. In both determining the feedback gains and developing the adaptation scheme, a range of beat rates and pressure loads was taken into account to yield satisfactory observer performance over a range of operating conditions. The observer was implemented, its performance was verified in vitro and results are reported. In the six experimental operating conditions, the beat rate ranged from 56-104 beats per minute (bpm) and the span of the mean systolic aortic pressure was 10.7-18.7 kPa (80–140 mmHg). For these cases, the mean deviation between the actual and estimated aortic pressure during the latter two-thirds of systole was 0.41 kPa (3.1 mmHg).

Commentary by Dr. Valentin Fuster
J Biomech Eng. 1993;115(2):195-201. doi:10.1115/1.2894121.

A viscoelastic model is presented to describe the dynamic response of the human chest to cyclic loading during manual cardiopulmonary resuscitation (CPR). Sternal force and displacement were measured during 16 clinical resuscitation attempts and during compressions on five CPR training manikins. The model was developed to describe the clinical data and consists of the parallel combination of a spring and dashpot. The human chests’ elastic and damping properties were both augmented with increasing displacement. The manikins’ elastic properties were stiffer and both elastic and damping properties were less dependent on displacement than the humans’.

Commentary by Dr. Valentin Fuster


J Biomech Eng. 1993;115(2):202-205. doi:10.1115/1.2894122.

The biaxial mechanical properties of right ventricular free wall (RVFW) myocardium were studied. Tissue specimens were obtained from the sub-epicardium of potassium-arrested hearts and different stretch protocols were used to characterize the myocardium’s mechanical response. To assess regional differences, we excised tissue specimens from the conus and sinus regions. The RVFW myocardium was found to be consistently anisotropic, with a greater stiffness along the preferred (or averaged) fiber direction. The anisotropy in the conus region was more pronounced than in the sinus region. A comparison with studies of left ventricle (LV) midwall myocardium revealed that, 1) the fiber direction stiffnesses are greater in the RVFW than in the LV, 2) the degree of anisotropy is greater in the RVFW than in the LV.

Commentary by Dr. Valentin Fuster
Commentary by Dr. Valentin Fuster
J Biomech Eng. 1993;115(2):206-207. doi:10.1115/1.2894124.

An analytical expression for the characteristic recovery time of an erythrocyte subject to an extensional deformation is derived using a previous nonlinear Kelvin-Voigt model. The recovery time thus obtained depends on the initial deformation in agreement with experimental observations, as a result of the nonlinearity of the model. The validity of the analytical results is confirmed using previous experimental data.

Commentary by Dr. Valentin Fuster

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