<p>Elevated blood pressure (BP) is a significant risk factor for cardiovascular diseases (CVD), which are the leading cause of morbidity and mortality. Dietary minerals such as sodium (Na) and potassium (K) play a crucial role in overall health and play a specific function in regulating blood pressure in the human body. Numerous studies have been conducted on the association between blood pressure and dietary intervention. While many nutritional intervention studies have shown adverse effects of excessive Na intake and the beneficial impact of supplemental K in humans, less is understood on Na and K tissue retention and health outcomes of such retention. The most commonly used biomarkers to study Na retention and regulation is urine Na. However, the use of urine Na concentration as an indicator of Na retention has its limitations and has been recently questioned. In-vivo neutron activation analysis (IVNAA) is a unique and powerful technique for elemental analysis in the human body that has the potential to quantify Na and K retention and monitor their bio-kinetics. This research work designed an in vivo neutron irradiation system with high sensitivity and minimal radiation dose to measure Na/K and monitor Na/K bio-kinetics. The system was characterized, tested, and validated for K measurement in mice and rats. Moreover, we developed a methodology for in vivo quantification of Na in pigs in bone and soft tissue after dietary intervention. The project's overall goal is to exploit the potential of a compact DD neutron generator-based neutron activation analysis system for in vivo quantification of Na and K in humans and small animals.</p>

Blastomycosis is an endemic systemic fungal infection that usually involves the lungs and superficial skin. Although head and neck involvement has been reported in the literature, no previous cases of neck mass resulting from direct extension of a pulmonary lesion have been published. We encountered an immunocompetent 31-year-old woman with a rapidly enlarging subcutaneous neck mass and a chronic upper lung infiltrate. Imaging studies showed contiguity between both lesions. Blastomyces dermatitidis was recovered from the sputum, and typical yeast was observed in fungal stains of needle aspirate from the neck mass. The patient responded favorably to a 6-month course of itraconazole. Blastomycosis should be considered in patients with subcutaneous neck masses in areas where this disease is endemic.

Hintergrund Es existieren keine Studien zur Inanspruchnahme psychoonkologischer Angebote durch Weichteilsarkompatienten in Deutschland. Ziel war es deshalb, die Häufigkeit der Inanspruchnahme psychoonkologischer Angebote im Krankenhaus in dieser Gruppe zu ermitteln und damit assoziierte Faktoren zu untersuchen. Methode Die Kohortenstudie PROSa (Krankheitslast und Versorgungssituation bei Sarkomen) wurde zwischen 2017 und 2020 in 39 deutschen Studienzentren durchgeführt. Für die vorliegende Analyse wurden Querschnittsdaten von erwachsenen Weichteilsarkompatienten ausgewertet. Faktoren auf Patienten- wie auf Einrichtungsebene wurden als mögliche Prädiktoren der Inanspruchnahme psychoonkologischer Beratung mittels logistischer Regression in einem verallgemeinerten linearen gemischten Modell exploriert. Resultate Bei 910 teilnehmenden Patienten lagen von 576 (63,3 %) Angaben zur Inanspruchnahme vor. 212 Patienten (unter Einbeziehung der fehlenden Angaben 23,3 %, ohne diese 36,7 %) nahmen psychoonkologische Angebote in Anspruch. Negativ mit der Inanspruchnahme assoziiert waren männliches (vs. weibliches) Geschlecht (Odds Ratio [OR] 0,62) und höheres Alter (18–< 40 Jahre vs. 65–< 75 Jahre: OR 0,32; 18–< 40 Jahre vs. ≥ 75 Jahre: OR 0,19). Positiv assoziiert waren Bildungsgrad (Abitur vs. Haupt‑/Volksschulabschluss [OR 2,01]) und Grading (High-grade-Tumoren vs. „low-grade“ [OR 4,41]). Wenn Psychoonkologen am Tumorboard beteiligt waren, war die Inanspruchnahme deutlich höher (OR 6,69). Konklusion Frauen, jüngere Personen, Patienten mit höherer Bildung und fortgeschrittenem Krankheitsstadium nehmen häufiger psychoonkologische Versorgung in Anspruch. Ein struktureller Faktor für eine erhöhte Inanspruchnahme ist die Beteiligung der Psychoonkologie am Tumorboard.

OBJECTIFS : L’objectif de cette étude était de déterminer les changements verticaux et horizontaux des tissus mous par rapport aux changements des tissus durs après une génioplastie fonctionnelle isolée, l'effet de l'âge sur ces changements et de revoir le remodelage des tissus durs au niveau de la symphyse. MÉTHODES : 75 patients ayant subi une génioplastie fonctionnelle comme seule intervention chirurgicale ont été suivis pendant un minimum de 2 ans avec une téléradiographie de profil pris avant la chirurgie (T1), immédiatement après la chirurgie (T2) et 2 ans après la génioplastie (T3). Ces patients ont été regroupés par groupe d'âge (gr 1 : <15 ans, gr 2 : 15-19 ans, gr 3 : >19 ans). RÉSULTATS : Le modèle prédictif a révélé que le changement horizontal des tissus mous peut être prédit avec plus de précision horizontalement que verticalement. Les changements verticaux des tissus mous ont présenté une prédictibilité moindre, comme le montre l'équation de prédiction du groupe 3 et un coefficient de détermination de 48 %. Le pogonion de tissu dur a montré un changement net horizontal de 6,39 mm (IC95% 5,68 ; 7,10) tandis que le tissu mou a montré un changement net de 6,72 mm (IC95% 5,89 ; 7,54). Verticalement, le changement net du tissu dur au niveau du menton pour les femmes qui ne grandissent pas a montré une réduction nette de 1,63 (IC95% -3,37 ; 0,11) tandis que les hommes ont montré une réduction nette de 3,89 mm (IC95% -5,83 ; -1,95). La réduction verticale des tissus mous était similaire pour les hommes et les femmes qui ne grandissent pas, soit 1,7 mm (IC95% -2,96 : -0,45). CONCLUSION : Pour les patients qui ne grandissent pas, le changement horizontal des tissus durs était stable, et le changement des tissus mous représentait 92% des changements des tissus durs. Verticalement, le changement des tissus mous était moins prévisible. Des équations de prédiction ont été calculées. Les variations d'épaisseur des tissus mous après une génioplastie dans les deux directions peuvent être expliquées par l'obtention d'une occlusion labiale non forcée. Ces résultats confirment le bénéfice fonctionnel et esthétique de cette chirurgie. / OBJECTIVES: The aim of this study was to determine the vertical and horizontal soft tissue change versus hard tissue change following isolated functional genioplasty and to examine hard tissue remodeling at the symphysis. METHODS: 75 patients who underwent a functional genioplasty as an isolated procedure were followed for a minimum of 2 years with cephalograms taken before surgery (T1), immediately after surgery (T2), and 2 years post-surgery (T3). These patients were grouped by age (Gp 1: <15 y.o., Gp 2: 15-19 y.o., Gp 3: >19 y.o.). RESULTS: The predictive model reveals that soft tissue change can be predicted with more precision horizontally than vertically. Hard tissue pogonion showed a net horizontal change of 6.39 mm (CI95% 5.68; 7.10) while soft tissue showed a net change of 6.72 mm (CI95% 5.89; 7.54). Vertically, the hard tissue net change at menton for nongrowing females showed a net reduction of 1.63 (CI95% -3.37; 0.11) while males showed a net reduction of 3,89 mm (CI95% -5.83; -1.95). Soft tissue vertical reduction was similar for non-growing males and females at 1,7 mm (CI95% -2,96: -0,45). CONCLUSION: For non-growing patients, the horizontal hard tissue change was stable, and the soft tissue change is 92% of the hard tissue changes. Vertically, the soft tissue change was less predictable. Prediction equations have been calculated. The soft tissue thickness variations after genioplasty in both directions can be explained by the achievement of an unforced labial occlusion. These results support the functional and aesthetic benefits of this surgery.

In this thesis, two algorithms are introduced for use in ultrasound elastography. Ultrasound elastography is a technique developed in the last 20 years by which anomalous regions in soft tissue are located and diagnosed without the need for biopsy. Due to this, the relativity cheap cost of ultrasound imaging and the high level of accuracy in the methods, ultrasound elastography methods have shown great potential for the diagnosis of cancer in soft tissues. The algorithms introduced in this thesis represent an advance in this field. The first algorithm is a two-step iteration procedure consisting of two minimization problems - displacement estimation and elastic parameter calculation that allow for diagnosis of any anomalous regions within soft tissue. The algorithm represents an improvement on existing methods in several ways. A weighting factor is introduced for each different point in the tissue dependent on the confidence in the accuracy of the data at that point, an exponential substitution is made for the elasticity modulus, an adjoint method is used for efficient calculation of the gradient vector and a total variation regularization technique is used. Most importantly, an adaptive mesh refinement strategy is introduced that allows highly efficient calculation of the elasticity distribution of the tissue though using a number of degrees of freedom several orders lower than methods that use a uniform mesh refinement strategy. Results are presented that show the algorithm is robust even in the presence of significant noise and that it can locate a tumour of 4mm in diameter within a 5cm square region of tissue. Also, the algorithm is extended into 3 dimensions and results are presented that show that it can calculate a 3 dimensional elasticity distribution efficiently. This extension into 3-d is a significant advance in the field. The second algorithm is a one-step algorithm that seeks to combine the two problems of elasticity distribution and displacement calculation into one. As in the two-step algorithm, a weighting factor, exponential substitution for the elasticity parameter, adjoint method for calculation of the gradient vector, total variation regularization and adaptive mesh refinement strategy are incorporated. Results are presented that show that this original approach can locate tumours of varying sizes and shapes in the presence of varying levels of added artificial noise and that it can determine the presence of a tumour in images taken from breast tissue in vivo.

The hands and feet account for half of the complexity of the musculoskeletal system, while the skin of the hand is specialised with many important structures. Much of the subtlety of the mechanism of the hand lies in the soft tissues, and the tactile and proprioceptive sensitivity depends on the large number of mechanoreceptors embedded in specific structures of the soft tissues. This thesis investigates synthetic materials and manufacturing techniques to enable building robots that reproduce the biomechanics and tactile sensitivity of vertebrates – histomimetic robotics. The material and mechanical anatomy of the hand is reviewed, highlighting difficulty of numerical measurement in soft-tissue anatomy, and the predictive nature of descriptive anatomical knowledge. The biomechanical mechanisms of the hand and their support of sensorimotor control are presented. A palate of materials and layup techniques are identified for emulating ligaments, joint surfaces, tendon networks, sheaths, soft matrices, and dermal structures. A method for thermoplastically drawing fine elastic fibres, with liquid metal amalgam cores, for connecting embedded sensors is demonstrated. The performance requirements of skeletal muscles are identified. Two classes of muscle-like bulk MEMS electrostatic actuators are shown theoretically to be capable of meeting these requirements. Means to manufacture them, and their additional application as mechanoreceptors are described. A novel machine perception algorithm is outlined as a solution to the problem of measuring soft tissue anatomy, CAD/CAE/CNC for layup of histomimetic robots, and sensory perception by such robots. The results of the work support the view that histomimetic robotics is a viable approach, and identify a number of areas for further investigation including: polymer modification by graft-polymerisation, automated layup tools, and machine perception.

Background: Hibernomas are rare benign soft-tissue tumours arising from brown fat tissue. Although imaging characteristics are not specific certain imaging features, common locations and patient demographics may suggest hibernoma as a differential diagnosis. Case presentation: We report on two 48-year-old male patients with hibernoma. The tumour presented with local swelling of the inguinal region in the first patient and was an incidental imaging finding in the second patient. Imaging included magnetic resonance imaging in both patients and computed tomography as well as 18 F-fluorodeoxyglucose positron emission tomography-computed tomography in the second patient. In both cases histological diagnosis was initially based on excisional and needle core biopsy, respectively. Complete surgical resection confirmed the diagnosis of hibernoma thereafter. Conclusion: In soft tissue tumours with fatty components hibernoma may be included into the differential diagnosis. Because of the risk of sampling errors in hibernoma-like tissue components of myxoid and well-differentiated liposarcoma, complete resection is mandatory. This article also reviews the current imaging literature of hibernomas.

Vascular tissue engineering (VTE) with the use of polymeric scaffolds offers the potential to generate small-diameter (<6 mm) arteries. In this thesis, a degradable polar hydrophobic ionic (D-PHI) polyurethane porous scaffold was synthesized with the objective of demonstrating its potential application for VTE. D-PHI scaffold synthesis was optimized, maximizing isocyanate and methacrylate monomer conversion. Through the incorporation of a lysine-based crosslinker, scaffold mechanical properties and swelling were manipulated. Furthermore, D-PHI scaffolds demonstrated the ability to support the growth and adhesion of A10 vascular smooth muscle cells (VSMCs) during two weeks of culture. This study also investigated the effect of a double porogen approach on D-PHI scaffold properties, demonstrating an increase in the total scaffold porosity and pore interconnectivity. Specifically, it was found that the use of 10 wt% polyethylene glycol and 65 wt% sodium bicarbonate porogens resulted in a porous (79±3%) D-PHI scaffold with the mechanical properties (elastic modulus=0.16±0.03 MPa, elongation-at-yield=31±5%, and tensile strength=0.04±0.01 MPa) required to withstand the physiologically-relevant cyclic mechanical strain (CMS) that is experienced by VSMCs in vivo. Furthermore, the effects of uniaxial CMS (10% strain, 1 Hz, 4 weeks) on human coronary artery smooth muscle cells (hCASMCs), which were cultured in a porous D-PHI scaffold, were studied using a customized bioreactor. Four weeks of CMS was shown to yield greater DNA mass, more cell area coverage, a better distribution of cells within the scaffold, the maintenance of contractile protein expression and the improvement of tensile mechanical properties. The in vitro and in vivo degradation as well as the in vivo biocompatibility of D-PHI scaffolds were also investigated. Following their subcutaneous implantation in rats (100 days), porous D-PHI scaffolds demonstrated more cell/tissue infiltration within their pores and degraded in a controlled manner and at a faster rate when compared to in vitro studies (120 days), retaining the mechanical integrity required during neo-tissue formation. This thesis provides significant insight into the role of the D-PHI scaffold in combination with physiologically-relevant CMS in modulating VSMC proliferation and phenotype. The findings of this work can be used to tailor vascular tissue regeneration by regulating VSMC function in a directed manner.

Vascular tissue engineering (VTE) with the use of polymeric scaffolds offers the potential to generate small-diameter (<6 mm) arteries. In this thesis, a degradable polar hydrophobic ionic (D-PHI) polyurethane porous scaffold was synthesized with the objective of demonstrating its potential application for VTE. D-PHI scaffold synthesis was optimized, maximizing isocyanate and methacrylate monomer conversion. Through the incorporation of a lysine-based crosslinker, scaffold mechanical properties and swelling were manipulated. Furthermore, D-PHI scaffolds demonstrated the ability to support the growth and adhesion of A10 vascular smooth muscle cells (VSMCs) during two weeks of culture. This study also investigated the effect of a double porogen approach on D-PHI scaffold properties, demonstrating an increase in the total scaffold porosity and pore interconnectivity. Specifically, it was found that the use of 10 wt% polyethylene glycol and 65 wt% sodium bicarbonate porogens resulted in a porous (79±3%) D-PHI scaffold with the mechanical properties (elastic modulus=0.16±0.03 MPa, elongation-at-yield=31±5%, and tensile strength=0.04±0.01 MPa) required to withstand the physiologically-relevant cyclic mechanical strain (CMS) that is experienced by VSMCs in vivo. Furthermore, the effects of uniaxial CMS (10% strain, 1 Hz, 4 weeks) on human coronary artery smooth muscle cells (hCASMCs), which were cultured in a porous D-PHI scaffold, were studied using a customized bioreactor. Four weeks of CMS was shown to yield greater DNA mass, more cell area coverage, a better distribution of cells within the scaffold, the maintenance of contractile protein expression and the improvement of tensile mechanical properties. The in vitro and in vivo degradation as well as the in vivo biocompatibility of D-PHI scaffolds were also investigated. Following their subcutaneous implantation in rats (100 days), porous D-PHI scaffolds demonstrated more cell/tissue infiltration within their pores and degraded in a controlled manner and at a faster rate when compared to in vitro studies (120 days), retaining the mechanical integrity required during neo-tissue formation. This thesis provides significant insight into the role of the D-PHI scaffold in combination with physiologically-relevant CMS in modulating VSMC proliferation and phenotype. The findings of this work can be used to tailor vascular tissue regeneration by regulating VSMC function in a directed manner.

L'analyse du mouvement humain s'appuie généralement sur des techniques de suivi de marqueurs cutanés pour reconstruire la cinématique articulaire. Cependant, ces techniques d'acquisition présentent d'importantes limites dont les " artefacts de tissus mous " (i.e., le mouvement relatif entre les marqueurs cutanés et le squelette sous-jacent). La méthode d'optimisation multi-segmentaire viseà compenser ces artefacts en imposant aux trajectoires de marqueurs les degrés de liberté d'un modèle cinématique prédéfini. Les liaisons mécaniques modélisant classiquement les articulations empêchent toutefois une estimation satisfaisante de la cinématique articulaire. Cette thèse aborde des perspectives d'amélioration de la méthode d'optimisation multi-segmentaire pour l'estimation de la cinématique articulaire du membre inférieur,à travers différentes approches : (1) la reconstruction de la cinématique par suivi de la vitesse angulaire, de l'accélération et de l'orientation de centrales inertiellesà la place du suivi de marqueurs, (2) l'introduction d'un modèle articulaire élastique basé sur la matrice de raideur du genou, permettant une estimation physiologique de la cinématique articulaire et (3) l'introduction d'un modèle des artefacts de tissus mous " cinématique-dépendant ", visantà évaluer et compenser les artefacts de tissus mous simultanément avec l'estimation la cinématique articulaire. Ce travail a démontré la polyvalence de la méthode d'optimisation multi-segmentaire. Les résultats obtenus laissent espérer une amélioration significative de cette méthode qui devient de plus en plus utilisée en biomécanique, en particulier pour la modélisation musculo-squelettique / Human movement analysis generally relies on skin markers monitoring techniques to reconstruct the joint kinematics. However, these acquisition techniques have important limitations including the "soft tissue artefacts" (i.e., the relative movement between the skin markers and the underlying bones). The multi-body optimization method aims to compensate for these artefacts by imposing the degrees of freedom from a predefined kinematic model to markers trajectories. The mechanical linkages typically used for modeling the joints however prevent a satisfactory estimate of the joint kinematics. This thesis addresses the prospects of improvement of the multi-body optimization method for the estimation of joint kinematics of the lower limb through different approaches: (1) the reconstruction of the kinematics by monitoring the angular velocity, the acceleration and the orientation of magneto-inertial measurement units instead of tracking markers, (2) the introduction of an elastic joint model based on the knee stiffness matrix, enabling a physiological estimation of joint kinematics and (3) the introduction of a "kinematic-dependent" soft tissue artefact model to assess and compensate for soft tissue artefact concurrently with estimating the joint kinematics. This work demonstrated the versatility of the multi-body optimization method. The results give hope for significant improvement in this method which is becoming increasingly used in biomechanics, especially for musculoskeletal modeling