Measurement of the Elasticity of Biological Soft Tissue of Finite Thickness

Elasticity is of profound significance to evaluating the function of a biological soft tissue. When the elasticity of a tissue is macroscopically changed, it means that the biological function of the tissue is abnormal and some disease or injury may occur. In the present work, an elastometer is developed to measure the elasticity of biological soft tissues. The measurement is based on the indentation method and the force is measured by the bending of the cantilever. The force-indentation data of the soft tissue is experimentally measured by this elastometer and Young＇s modulus of the tissue is calculated using the Hertz-Sneddon model. For comparison, a numerical model for the indentation method is established using the finite element method. The difference between the actual modulus and the measured modulus is discussed. The effect of the thickness of the specimen on the measurement is investigated. Young＇s moduli of beef, porcine liver and porcine kidney are experimentally measured. The results indicate that our elastometer is effective in measuring Young＇s modulus of a soft tissue quantitatively.

Increased liver stiffness in alcoholic liver disease:Differentiating fibrosis from steatohepatitis

AIM:To test if inflammation also interferes with liver stiffness (LS) assessment in alcoholic liver disease (ALD) and to provide a clinical algorithm for reliable fibrosis assessment in ALD by FibroScan (FS).METHODS:We first performed sequential LS analysis before and after normalization of serum transaminases in a learning cohort of 50 patients with ALD admitted for alcohol detoxification. LS decreased in almost all patients within a mean observation interval of 5.3 d. Six patients (12%) would have been misdiagnosed with F3and F4 fibrosis but LS decreased below critical cut-off values of 8 and 12.5 kPa after normalization of trans-aminases. RESULTS:Of the serum transaminases,the decrease in LS correlated best with the decrease in glutamic oxaloacetic transaminase (GOT). No significant chang-es in LS were observed below GOT levels of 100 U/L. After establishing the association between LS and GOT levels,we applied the rule of GOT < 100 U/L for reliable LS assessment in a second validation cohort of 101 patients with histologically confi rmed ALD. By ex-cluding those patients with GOT > 100 U/L at the time of LS assessment from this cohort,the area under the receiver operating characteristic (AUROC) for cirrhosis detection by FS improved from 0.921 to 0.945 while specificity increased from 80% to 90% at a sensitivity of 96%. A similar AUROC could be obtained for lower F3 fibrosis stage if LS measurements were restricted to patients with GOT < 50 U/L. Histological grading of inflammation did not further improve the diagnostic accuracy of LS.CONCLUSION:Coexisting steatohepatitis markedly increases LS in patients with ALD independent of fibrosis stage. Postponing cirrhosis assessment by FS during alcohol withdrawal until GOT decreases to < 100 U/mL signif icantly improves the diagnostic accuracy.

Tactile and Ultrasound Image Fusion for Functional Assessment of the Female Pelvic Floor

Introduction: The true etiology of pelvic organ prolapse and urinary incontinence and variations observed among individuals are not entirely understood. Tactile (stress) and ultrasound (anatomy, strain) image fusion may furnish new insights into the female pelvic floor conditions. This study aimed to explore imaging performance and clinical value of vaginal tactile and ultrasound image fusion for characterization of the female pelvic floor. Methods: A novel probe with 96 tactile and 192 ultrasound transducers was designed. Women scheduled for a urogynecological visit were considered eligible for enrollment to observational study. Intravaginal tactile and ultrasound images were acquired for vaginal wall deformations at probe insertion, elevation, rotation, Valsalva maneuver, voluntary contractions, involuntary relaxation, and reflex pelvic muscle contractions. Biomechanical mapping has included tactile/ultrasound imaging and functional imaging. Results: Twenty women were successfully studied with the probe. Tactile and ultrasound images for tissues deformation as well as functional images were recorded. Tactile (stress) and ultrasound (strain) images allowed creation of stress-strain maps for the tissues of interest in absolute scale. Functional images allowed identification of active pelvic structures and their biomechanical characterization (anatomical measurements, contractive mobility and strength). Fusion of the modalities has allowed recognition and characterization of levator ani muscles (pubococcygeal, puborectal, iliococcygeal), perineum, urethral and anorectal complexes critical in prolapse and/or incontinence development. Conclusions: Vaginal tactile and ultrasound image fusion provides unique data for biomechanical characterization of the female pelvic floor. Bringing novel biomechanical characterization for critical soft tissues/structures may provide extended scientific knowledge and improve clinical practice.

Complete Achilles Tenotomy:A New Improved Experimental Surgical Technique in Rats

Rupture of the Achilles tendon is one of the most frequent tendon injuries in humans. However, there is no standard surgical technique thus far to reproduce complete rupture of this tendon in rats. Surgical procedures were performed in Wistar rats under light microscopy, with posterior longitudinal incision and preservation of the plantaris tendon. The animals were sacrificed on 2nd and 8th postoperative week and we used hematoxilin and eosin, picrosirius-red and Weigert’s resorcin-fuchsin to observe general tendon healing. The mean operative time was one minute and 24 seconds. Histological studies showed cellular proliferation and fibrillogenesis at two weeks, with decreased amounts of cellularity and elastic fibers at the 8th week, besides changes in structural organization of collagen fibers. The complete Achilles tenotomy in rats, was improved under light microscopy and sparing the plantaris tendon. This surgical technique was simple and quick, showed signs of normal healing process, could be easily reproducible, and triggered translational researches in this area.