Non-invasive biomechanical characterization of intervertebral discs by shear wave ultrasound elastography: a feasibility study.

PublishedJournal ArticleThe final publication is available at Springer via http://dx.doi.org/10.1007/s00330-014-3382-8OBJECTIVES: Although magnetic resonance is widely spread to assess qualitatively disc morphology, a simple method to determine reliably intervertebral disc status is still lacking. Shear wave elastography is a novel technique that allows quantitative evaluation of soft-tissues' mechanical properties. The aim of this study was to assess preliminary the feasibility and reliability of mechanical characterization of cervical intervertebral discs by elastography and to provide first reference values for asymptomatic subjects. METHODS: Elastographic measurements were performed to determine shear wave speed (SWS) in C6-C7 or C7-T1 disc of 47 subjects; repeatability and inter-operator reproducibility were assessed. RESULTS: Global average shear wave speed (SWS) was 3.0 ± 0.4 m/s; measurement repeatability and inter-user reproducibility were 7 and 10%, respectively. SWS was correlated with both subject's age (p = 1.3 × 10(-5)) and body mass index (p = 0.008). CONCLUSIONS: Shear wave elastography in intervertebral discs proved reliable and allowed stratification of subjects according to age and BMI. Applications could be relevant, for instance, in early detection of disc degeneration or in follow-up after trauma; these results open the way to larger cohort studies to define the place of this technique in routine intervertebral disc assessment. KEY POINTS: A simple method to obtain objectively intervertebral disc status is still lacking. Shear wave elastography was applied in vivo to assess intervertebral discs. Elastography showed promising results in biomechanical disc evaluation. Elastography could be relevant in clinical routine for intervertebral disc assessment.ParisTech BiomecAM chair programParisTechYves Cotrel FoundationsSociété GénéraleProteorCove

In vivo cervical intervertebral disc characterisation by elastography.

PublishedJournal ArticleThis is an Accepted Manuscript of an article published by Taylor & Francis in Computer Methods in Biomechanics and Biomedical Engineering on 30/07/2014, available online: http://www.tandfonline.com/10.1080/10255842.2014.931515Not availableParisTech BiomecAM chair programProteorSociété GénéraleCoveaParisTechYves Cotrel Foundation

Intervertebral disc characterization by shear wave elastography: An in vitro preliminary study.

Published onlineJOURNAL ARTICLEAuthor's accepted (post-print) manuscriptThe final version of record is available at http://dx.doi.org/10.1177/0954411914540279Patient-specific numerical simulation of the spine is a useful tool both in clinic and research. While geometrical personalization of the spine is no more an issue, thanks to recent technological advances, non-invasive personalization of soft tissue's mechanical properties remains a challenge. Ultrasound elastography is a relatively recent measurement technique allowing the evaluation of soft tissue's elastic modulus through the measurement of shear wave speed. The aim of this study was to determine the feasibility of elastographic measurements in intervertebral disc. An in vitro approach was chosen to test the hypothesis that shear wave speed can be used to evaluate intervertebral disc mechanical properties and to assess measurement repeatability. In total, 11 oxtail intervertebral discs were tested in compression to determine their stiffness and apparent elastic modulus at rest and at 400 N. Elastographic measurements were performed in these two conditions and compared to these mechanical parameters. The protocol was repeated six times to determine elastographic measurement repeatability. Average shear wave speed over all samples was 5.3 ± 1.0 m/s, with a repeatability of 7% at rest and 4.6% at 400 N; stiffness and apparent elastic modulus were 266.3 ± 70.5 N/mm and 5.4 ± 1.1 MPa at rest, respectively, while at 400 N they were 781.0 ± 153.8 N/mm and 13.2 ± 2.4 MPa, respectively. Correlations were found between elastographic measurements and intervertebral disc mechanical properties; these preliminary results are promising for further in vivo application.ParisTech BiomecAM chair programProteorParisTechYves Cotrel Foundation

Is the remobilization of S and N reserves for seed filling of winter oilseed rape modulated by sulphate restrictions occurring at different growth stages?

How the remobilization of S and N reserves can meet the needs of seeds of oilseed rape subject to limitation of S fertilization remains largely unclear. Thus, this survey aims to determine the incidence of sulphate restriction [low S (LS)] applied at bolting [growth stage (GS) 32], visible bud (GS 53), and start of pod filling (GS 70) on source–sink relationships for S and N, and on the dynamics of endogenous/exogenous S and N contributing to seed yield and quality. Sulphate restrictions applied at GS 32, GS 53, and GS 70 were annotated LS32, LS53, and LS70. Long-term 34SO42− and 15NO3− labelling was used to explore S and N partitioning at the whole-plant level. In LS53, the sulphur remobilization efficiency (SRE) to seeds increased, but not enough to maintain seed quality. In LS32, an early S remobilization from leaves provided S for root, stem, and pod growth, but the subsequent demand for seed development was not met adequately and the N utilization efficiency (NUtE) was reduced when compared with high S (HS). The highest SRE (65±1.2% of the remobilized S) associated with an efficient foliar S mobilization (with minimal residual S concentrations of 0.1–0.2% dry matter) was observed under LS70 treatment, which did not affect yield components

Методические разработки для подготовки к практическим занятиям по оториноларингологии студентов 4-го курса стоматологического факультета ВГМУ

ГОРЛА БОЛЕЗНИНОСА БОЛЕЗНИОТОРИНОЛАРИНГОЛОГИЯУХА БОЛЕЗНИУЧЕБНО-МЕТОДИЧЕСКИЕ ПОСОБИЯВ методических разработках подробно изложены методики исследования ЛОР-органов, вопросы по анатомо-топографическим особенностям и физиологии уха, носа, глотки и гортани; представлены вопросы, касающиеся знаний и умений студентов по оториноларингологии, современные методы диагностики и лечения наиболее распространенных заболеваний ЛОР-органов; даны варианты тестов для определения уровня знаний, вопросы для самоподготовки к практическим занятиям

A specific scoliosis classification correlating with brace treatment: description and reliability

<p>Abstract</p> <p>Background</p> <p>Spinal classification systems for scoliosis which were developed to correlate with surgical treatment historically have been used in brace treatment as well. Previously, there had not been a scoliosis classification system developed specifically to correlate with brace design and treatment. The purpose of this study is to show the intra- and inter- observer reliability of a new scoliosis classification system correlating with brace treatment.</p> <p>Methods</p> <p>An original classification system ("Rigo Classification") was developed in order to define specific principles of correction required for efficacious brace design and fabrication. The classification includes radiological as well as clinical criteria. The radiological criteria are utilized to differentiate five basic types of curvatures including: (I) imbalanced thoracic (or three curves pattern), (II) true double (or four curve pattern), (III) balanced thoracic and false double (non 3 non 4), (IV) single lumbar and (V) single thoracolumbar. In addition to the radiological criteria, the Rigo Classification incorporates the curve pattern according to SRS terminology, the balance/imbalance at the transitional point, and L4-5 counter-tilting. To test the intra-and inter-observer reliability of the Rigo Classification, three observers (1 MD, 1 PT and 1 CPO) measured (and one of them, the MD, re-measured) 51 AP radiographs including all curvature types.</p> <p>Results</p> <p>The intra-observer Kappa value was 0.87 (acceptance >0.70). The inter-observer Kappa values fluctuated from 0.61 to 0.81 with an average of 0.71 (acceptance > 0.70).</p> <p>Conclusions</p> <p>A specific scoliosis classification which correlates with brace treatment has been proposed with an acceptable intra-and inter-observer reliability.</p

A Novel Classification of 3D Rib Cage Deformity in Subjects With Adolescent Idiopathic Scoliosis

Study Design: This was a multicentric cross-sectional descriptive study. Objective: To analyze patterns of 3D rib cage deformity in subjects with adolescent idiopathic scoliosis (AIS) and their relationship with the spinal deformity. Summary of Background Data: Subjects with AIS present with rib cage deformity that can affect respiratory functions. The 3D rib cage deformities in AIS and their relationship to the spinal deformity are still unelucidated. Methods: A total of 200 AIS and 71 controls underwent low-dose biplanar x-rays and had their spine and rib cage reconstructed in 3-dimensional (D). Classic spinopelvic parameters were calculated in 3D and: rib cage gibbosity, thickness, width, volume and volumetric spinal penetration index (VSPI). Subjects with AIS were classified as: group I with mild rib cage deformity (n=88), group II with severe rib cage deformity (n=112) subgrouped into IIa (high gibbosity, n=48), IIb (high VSPI, n=48), and IIc (both high gibbosity and VSPI, n=16). Results: Groups IIa and IIb had a higher Cobb angle (33 vs. 54 degrees and 46 degrees, respectively) and torsion index (11 vs. 14 degrees and 13 degrees, respectively) than group I. Group IIb showed more severe hypokyphosis (IIb=21 degrees; IIa=33 degrees; I=36 degrees; control=42 degrees) with a reduced rib cage volume (IIb=4731 cm3; IIa=4985 cm3; I=5257 cm3; control=5254 cm3) and thickness (IIb=135 mm; IIa=148 mm; I=144 mm; control=144 mm). Group IIa showed an increasingly large local gibbosity descending from proximal to distal levels and did not follow the axial rotation of the spine. Group IIc showed characteristics of both groups IIa and IIb. Conclusions: This new classification of 3D rib cage deformity in AIS shows that the management of cases with high VSPI (groups IIb and IIc) should focus on restoring as much kyphosis as possible to avoid respiratory repercussions. Treatment indications in groups I and IIa would follow the consensual basic principles reported in the literature regarding bracing and surgery

GLOBAL STABILITY AND BIFURCATIONS ANALYSIS OF AN EPIDEMIC MODEL WITH CONSTANT REMOVAL RATE OF THE INFECTIVE

In this thesis we consider an epidemic model with a constant removal rate of infective individuals is proposed to understand the effect of limited resources for treatment of infective on the disease spread. It is found that it is unnecessary to take such a large treatment capacity that endemic equilibria disappear to eradicate the disease. It is shown that the outcome of disease spread may depend on the position of the initial states for certain range of parameters. It is also shown that the model undergoes a sequence of bifurcations including saddle-node bifurcation, subcritical Hopf bifurcation. Keyword: Epidemic model, nonlinear incidence rate, basic reproduction number, local and global stabilit

Effect of mineral sulphur availability on nitrogen and sulphur uptake and remobilization during the vegetative growth of Brassica napus L.

Because it has a high demand for sulphur (S), oilseed rape is particularly sensitive to S limitation. However, the physiological effects of S limitation remain unclear, especially during the rosette stage. For this reason a study was conducted to determine the effects of mineral S limitation on nitrogen (N) and S uptake and remobilization during vegetative growth of oilseed rape at both the whole-plant and leaf rank level for plants grown during 35 d with 300 μM 34SO42– (control plants; +S) or with 15 μM 34SO42– (S-limited plants; –S). The results highlight that S-limited plants showed no significant differences either in whole-plant and leaf biomas or in N uptake, when compared with control plants. However, total S and 34S (i.e. deriving from S uptake) contents were greatly reduced for the whole plant and leaf after 35 d, and a greater redistribution of endogenous S from leaves to the benefit of roots was observed. The relative expression of tonoplast and plasmalemma sulphate transporters was also strongly induced in the roots. In conclusion, although S-limited plants had 20 times less mineral S than control plants, their development remained surprisingly unchanged. During S limitation, oilseed rape is able to recycle endogenous S compounds (mostly sulphate) from leaves to roots. However, this physiological adaptation may be effective only over a short time scale (i.e. vegetative growth)

"Rehabilitation schools for scoliosis" thematic series: describing the methods and results

The Scoliosis Rehabilitation model begins with the correct diagnosis and evaluation of the patient, to make treatment decisions oriented to the patient. The treatment is based on observation, education, scoliosis specific exercises, and bracing. The state of research in the field of conservative treatment is insufficient. There is some evidence supporting scoliosis specific exercises as a part of the rehabilitation treatment, however, the evidence is poor and the different methods are not known by most of the scientific community. The only way to improve the knowledge and understanding of the different physiotherapy methodologies (specific exercises), integrated into the whole rehabilitation program, is to establish a single and comprehensive source of information about it. This is what the SCOLIOSIS Journal is going to do through the "Rehabilitation Schools for Scoliosis" Thematic Series, where technical papers coming from the different schools will be published