Measurement of spinal shrinkage (stadiometry) has been suggested to be a convenient measure of low-back load in workplace settings. This report documents three separate experiments that collectively form a central theme: Is the measurement of spinal shrinkage a suitable assessment technique to quantify the cumulative effect of loading on the low back given the many sources for variability in the signal? A stadiometer was fabricated to measure both sitting and standing height. The first experiment was to compare sitting with standing stature changes over time in an attempt to locate the major site of shrinkage. There were no statistically significant differences in stature change found between either the sitting or standing posture for any condition suggesting that nearly all height changes occur in the spine. The second experiment compared the cumulative effects from static load holding to dynamic load lifting. Some subjects experienced more shrinkage in the static task while others experienced more in the dynamic task. In the third experiment, subjects performed work-rest cycles consisting of periods of sitting and lifting, and repeated over two days, to examine the recovery phenomenon. No specific pattern emerged owing to unpredictable subject variability. The first general observation obtained from the results of all three experiments is that the response of subjects to a wide array of activities appears to be variable both within each subject and over repeated exposures to identical conditions on different days. While subject variability (and perhaps biological variability) is a liability, it may be feasible to develop load time integrals for load exposure in the future, since the asset of the spinal shrinkage approach appears to be that it is one of the few available techniques to assess cumulative loading for both isometric postures, prolonged sitting, repeated tasks and responds to the positive adaptive changes that occur from periods of rest. However, it would appear that more quantification of the relationships that modulate spinal shrinkage are required to account for the variance in stature measurements.
To estimate the mechanical load on the low back in manual materials handling, the Static Strength Prediction Model (SSPM, University of Michigan) is widely used in the occupational field. It requires (for practical reasons) only a small number of input variables (five body segment angles, standing height, total body mass, external load on the hands) on which basis the moment at the lumbo-sacral intervertebral joint (beside other parameters) is computed. The dynamic character of the activities is ignored in the calculations. To evaluate the validity of the SSPM in various situations, lumbar moments in lifting/lowering activities at different lifting techniques and speeds obtained by the SSPM, were compared with those obtained by a more comprehensive dynamic model (DM). An analysis of variance showed significant effects (p = 0.001) of the biomechanical model applied and the lifting speed used on the peak lumbar moment values. No effects of lifting technique were found. The differences in results from the SSPM and DM were dependent on the lifting speed: the SSPM peak lumbar moments were on average 9% (not significant), 21% (significant at p = 0.005) and 42% (p = 0.0001) smaller compared to the DM moments in the slow (mean velocity in a complete lifting/lowering cycle, 0.2 m s-1), normal (0.4 m s-1) and fast (0.8 m s-1) speed condition respectively. The results indicate that the static/dynamic difference between the models is a major source for the different lumbar moments, while other differences between the SSPM and DM are of minor importance.
Objective To investigate the effects of syncytiotrophoblast microvillous membranes (STBM) in concentrations, found in vivo in women with pre-eclampsia, on endothelial function in isolated resistance arteries. Setting Sample Twenty-nine myometrial resistance arteries isolated from biopsies of healthy term pregnant women, obtained during caesarean section.Methods The myometrial arteries were mounted in a pressure arteriograph and perfused intraluminally for three hours with STBM (20 to 2000ng/mL) or with erythrocyte membranes or physiological salt solution as controls, all substituted with 0.5% bovine serum albumin. Bradykinin concentration-response curves were performed before and after perfusion. Main outcome measures The bradykinin concentrationresponse curves were ®tted to the Hill equation and maximal dilation and the pEC 50 values were determined from these ®ts. Differences within groups were analysed with a paired Student's t test. Electron microscopic evaluation of the endothelium was performed.Results Neither STBM nor erythrocyte membrane perfusion affected maximal dilation or the pEC 50 values of the bradykinin concentration-response curves at any concentration. Examination by electron microscopy showed no obvious damage to the endothelium after perfusion with STBM or erythrocyte membranes.Conclusion Perfusion with STBM in concentrations up to 100 times those reported in pre-eclampsia has no signi®cant effect on bradykinin-mediated dilation in isolated myometrial arteries.
The current standard for sterilization of potentially infected bone graft by gamma irradiation and thermal or chemical inactivation potentially deteriorates the biomechanical properties of the graft. We performed an in vitro experiment to evaluate the use of high hydrostatic pressure (HHP); which is widely used as a disinfection process in the food processing industry, to sterilize bone grafts. Four femoral heads were divided into five parts each, of which 16 were contaminated (in duplicate) with 105–107 CFU/ml of Staphylococcus epidermidis, Bacillus cereus, or Pseudomonas aeruginosa or Candida albicans, respectively. Of each duplicate, one sample was untreated and stored similarly as the treated sample. The remaining four parts were included as sterile control and non-infected control. The 16 parts underwent HHP at the high-pressure value of 600 MPa. After HHP, serial dilutions were made and cultured on selective media and into enrichment media to recover low amounts of microorganism and spores. Three additional complete femoral heads were treated with 0, 300 and 600 MPa HHP respectively for histological evaluation. None of the negative-control bone fragments contained microorganisms. The measured colony counts in the positive-control samples correlated excellent with the expected colony count. None of the HHP treated bone fragments grew on culture plates or enrichment media. Histological examination of three untreated femoral heads showed that the bone structure remained unchanged after HHP. Sterilizing bone grafts by high hydrostatic pressure was successful and is a promising technique with the possible advantage of retaining biomechanical properties of bone tissue.
Background: Emerging infectious diseases can compromise the safety of tissues for transplantations. A recent outbreak of Q fever, a zoonosis caused by the bacterium Coxiella burnetii, in the Netherlands compelled the Dutch tissue banks to assess the risk of Q fever transmission through tissue transplantation in order to maintain optimal safety. Methods: This article describes the systematic approach that was followed in the Netherlands. This approach included a review of the literature, a qualitative risk assessment, expert opinion gathering and investigations for specific strategies that can help to maintain the balance between tissue safety and availability. Results: This resulted in a specific donor selection policy and in development of further research to fill in gaps in knowledge about Q fever in tissue transplantation. Conclusion: The strategy described in this article may be useful for tissue bankers facing similar outbreaks of emerging infections or may be useful for development of future guidelines or assessment strategies for tissue banking.
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