Statistical analysis of collagen alignment in ligaments by scale-space analysis

Regulation of Joint Tissues and Joint Function: Is There Potential for Lessons to Be Learned Regarding Regulatory Control from Joint Hypermobility Syndromes?

Normal development of joints starts in utero with the establishment of a cellular and extracellular matrix template. Following birth, individual joint tissues grow and mature in response to biochemical and mechanical signals, leading to a coordinated pattern of further maturation resulting in a joint that functions as an organ system. Each joint develops and matures as an organ system defined by the biomechanical environment in which it will function. For those with joint hypermobility syndromes, either defined by specific genetic mutations or not (i.e., Ehlers-Danlos syndrome, Marfan syndrome, Loey-Dietz syndrome, hypermobility-type Ehlers-Danlos syndrome), this process is partially compromised, but many aspects of joint tissue maturation and resulting joint function is retained such that the organs form and retain partial function, but it is compromised. Comparing the characteristics of what is known regarding development, growth, maturation, and response to stressors such as puberty, pregnancy, and aging in joints of those without and with joint hypermobility leads to the conclusion that in those that have hypermobility syndromes, the joint systems may be compromised via a failure to undergo mechanical maturation, possibly via defective mechanotransduction. Given the breadth of the mutations involved in such hypermobility syndromes, further characterization of this concept may reveal commonalities in their impact on tissue maturation, which will further inform regulatory aspects of normal tissue and functional integrity. This review/perspective piece will attempt to detail such comparisons and summarize how further study will aid in further understanding.

UTILIZATION OF TWO-DIMENSIONAL FAST FOURIER TRANSFORM AND POWER SPECTRAL ANALYSIS FOR ASSESSMENT OF EARLY DEGENERATION OF ARTICULAR CARTILAGE

Degeneration of articular cartilage begins from deterioration of the collagen fibres in the superficial zone. Standard histology using 2D imaging technique is often used to determine the microstructure of collagen fibres and the physiological functions of articular cartilage. However, information of the 3D collageneous structure in the cartilage could be lost and misinterpreted in 2D observations. In contrast, confocal microscopy permits studying the 3D internal structure of bulk articular cartilage with minimal physical disturbing. Using fibre optic laser scanning confocal microscopy, a 3D histology has been previously developed to visualize the collagen matrix in the superficial zone by means of identifying the early arthritic changes in articular cartilage. In this study, we characterized the collagen orientation in the superficial zone of normal cartilage, the cartilage with surface disruption and fibrillated cartilage using Fast Fourier transforms and power spectral analysis techniques. Thus, we have established an objective method for assessing the early pathology changes in the articular cartilage.

Molecular events surrounding collagen fibril assembly in the early healing rabbit medial collateral ligament--failure to recapitulate normal ligament development

??Although injuries to the medial collateral ligament (MCL) can heal functionally without surgical intervention, the collagen fibers in the healing tissue remain compromised. The molecular basis for this poor healing potential was investigated by examining extracellular matrix-modifying molecules such as bone morphogenetic protein 1 (BMP-1), procollagen C proteinase enhancer (PCOLCE), lysyl oxidase (LOX), and transforming growth factor beta 1 (TGF-β1) involved in collagen fibrillogenesis during normal early postnatal ligament maturation and at comparable intervals after MCL injury. Samples of midsections of rabbit MCLs were collected from 3-, 6-, 14-, and 52-week-old normal animals and at 3, 6, and 14 weeks postinjury. Harvested midsubstance tissues were analyzed for collagen fibril diameter by transmission electron microscopy (TEM), and mRNA levels were assessed by reverse transcription-polymerase chain reaction (RT-PCR). Results showed different patterns of expression between normal MCL maturation and during scar maturation. BMP-1 and PCOLCE mRNA levels were upregulated in the 3?14-week period during maturation of normal ligaments but decreased at skeletal maturity. The scar tissue exhibited a 3.5-fold increase in PCOLCE mRNA levels during the early healing phase, but these decreased with time. After injury, BMP-1 mRNA levels in scars were low and did not change during healing. Both LOX and TGF-β1 mRNA levels were low during normal MCL development compared with levels at maturity and exhibited elevated mRNA levels during early healing that decreased with time postinjury. These results suggest that gene expression in scars during MCL healing does not recapitulate expression in normal ligament fibroblasts during maturation.

Structural inhomogeneity and fiber orientation in the inner arterial media

The microstructural orientation of vascular wall constituents is of interest to scientists and clinicians because alterations in their native states are associated with various cardiovascular diseases. In the arterial media, the orientation of these constituents is often described as circumferential. However, it has been noted that, just below the endothelial surface, the vascular wall constituents are oriented axially. To further study this reported change in orientation, and to resolve previous observations (which were made under conditions of no load), we used nonlinear optical microscopy to examine the orientation of collagen and elastin fibers in the inner medial region of bovine common carotid arteries. Images were obtained from this part of the arterial wall under varying degrees of mechanical strain: 0%, 10% axial, 10% circumferential, and 10% biaxial. We observed that close to the endothelium these components are aligned in the axial direction but abruptly change to a circumferential alignment at a depth of approximately 20 mum from the endothelial surface. The application of mechanical strain resulted in a significantly greater degree of fiber alignment, both collagen and elastin, in the strain direction, regardless of their initial unloaded orientation. Furthermore, variations in strain conditions resulted in an increase or a decrease in the overall degree of fiber alignment in the subendothelial layer depending on the direction of the applied strain. This high-resolution investigation adds more detail to existing descriptions of complex structure-function relationships in vascular tissue, which is essential for a better understanding of the pathophysiological processes resulting from injury, disease progression, and interventional therapies.

Biomechanical considerations of fracture treatment and bone quality maintenance in elderly patients and patients with osteoporosis

Osteoporosis is a major public health problem that is characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures of the hip, spine, and wrist. Poor bone quality in patients with osteoporosis presents the surgeon with difficult treatment decisions. Bone fracture repair has more pathways with combinations of bone formation mechanisms, which depend on the type of fracture fixation to be applied to achieve the desirable immobilization. There only may be one remodeling principle and in less than ideal conditions, mechanical and biophysical stimuli may provide effective augmentation of fracture healing in elderly patients. A different stimulus may limit its association to a specific healing mechanism. However, no matter which fixation method is used, an accurate reduction is a requisite for bone healing. Failure to realign the fracture site would result in delayed union, malunion, or nonunion. Therefore, a basic understanding of the biomechanics of osteoporotic bone and its treatment is necessary for clinicians to establish appropriate clinical treatment principles to minimize complications and enhance the patient's quality of life. We describe the biomechanical considerations of osteoporosis and fracture treatment from various aspects. First, bone structure and strength characterization are discussed using a hierarchical approach, followed by an innovative knowledge-based approach for fracture reduction planning and execution, which particularly is beneficial to osteoporotic fracture. Finally, a brief review of the results of several experimental animal models under different fracture types, gap morphologic features, rigidity of fixation devices, subsequent loading conditions, and biophysical stimulation is given to elucidate adverse mechanical conditions associated with different bone immobilization techniques that can compromise normal bone fracture healing significantly.

Analysis of asymmetry in mammograms via directional filtering with Gabor wavelets

This paper presents a procedure for the analysis of left-right (bilateral) asymmetry in mammograms. The procedure is based upon the detection of linear directional components by using a multiresolution representation based upon Gabor wavelets. A particular wavelet scheme with two-dimensional Gabor filters as elementary functions with varying tuning frequency and orientation, specifically designed in order to reduce the redundancy in the wavelet-based representation, is applied to the given image. The filter responses for different scales and orientation are analyzed by using the Karhunen-Loève (KL) transform and Otsu's method of thresholding. The KL transform is applied to select the principal components of the filter responses, preserving only the most relevant directional elements appearing at all scales. The selected principal components, thresholded by using Otsu's method, are used to obtain the magnitude and phase of the directional components of the image. Rose diagrams computed from the phase images and statistical measures computed thereof are used for quantitative and qualitative analysis of the oriented patterns. A total of 80 images from 20 normal cases, 14 asymmetric cases, and six architectural distortion cases from the Mini-MIAS (Mammographic Image Analysis Society, London, U.K.) database were used to evaluate the scheme using the leave-one-out methodology. Average classification accuracy rates of up to 74.4% were achieved.

A structurally based stress-stretch relationship for tendon and ligament

We propose a mechanical model for tendon or ligament stress-stretch behavior that includes both microstructural and tissue level aspects of the structural hierarchy in its formulation. At the microstructural scale, a constitutive law for collagen fibers is derived based on a strain-energy formulation. The three-dimensional orientation and deformation of the collagen fibrils that aggregate to form fibers are taken into consideration. Fibril orientation is represented by a probability distribution function that is axisymmetric with respect to the fiber. Fiber deformation is assumed to be incompressible and axisymmetric. The matrix is assumed to contribute to stress only through a constant hydrostatic pressure term. At the tissue level, an average stress versus stretch relation is computed by assuming a statistical distribution for fiber straightening during tissue loading. Fiber straightening stretch is assumed to be distributed according to a Weibull probability distribution function. The resulting comprehensive stress-stretch law includes seven parameters, which represent structural and microstructural organization, fibril elasticity, as well as a failure criterion. The failure criterion is stretch based. It is applied at the fibril level for disorganized tissues but can be applied more simply at a fiber level for well-organized tissues with effectively parallel fibrils. The influence of these seven parameters on tissue stress-stretch response is discussed and a simplified form of the model is shown to characterize the nonlinear experimentally determined response of healing medial collateral ligaments. In addition, microstructural fibril organizational data (Frank et al., 1991, 1992) are used to demonstrate how fibril organization affects material stiffness according to the formulation. A simplified form, assuming a linearly elastic fiber stress versus stretch relationship, is shown to be useful for quantifying experimentally determined nonlinear toe-in and failure behavior of tendons and ligaments. We believe this ligament and tendon stress-stretch law can be useful in the elucidation of the complex relationships between collagen structure, fibril elasticity, and mechanical response.

A small angle light scattering device for planar connective tissue microstructural analysis

The planar fibrous connective tissues of the body are composed of a dense extracellular network of collagen and elastin fibers embedded in a ground matrix, and thus can be thought of as biocomposites. Thus, the quantification of fiber architecture is an important step in developing an understanding of the mechanics of planar tissues in health and disease. We have used small angle light scattering (SALS) to map the gross fiber orientation of several soft membrane connective tissues. However, the device and analysis methods used in these studies required extensive manual intervention and were unsuitable for large-scale fiber architectural mapping studies. We have developed an improved SALS device that allows for rapid data acquisition, automated high spatial resolution specimen positioning, and new analysis methods suitable for large-scale mapping studies. Extensive validation experiments revealed that the SALS device can accurately measure fiber orientation for up to a tissue thickness of at least 500 microns to an angular resolution of approximately 1 degree and a spatial resolution of +/-254 microns. To demonstrate the new device's capabilities, structural measurements from porcine aortic valve leaflets are presented. Results indicate that the new SALS device provides an accurate method for rapid quantification of the gross fiber structure of planar connective tissues.

Collagen fiber architecture of a cultured dermal tissue

Advances in tissue engineering have led to the development of artificially grown dermal tissues for use in burn and ulcer treatments. An example of such an engineered tissue is Dermagraft, which is grown using human neonatal fibroblasts on rectangular sheets of biodegradable mesh. Using small angle light scattering (SALS), we quantified the collagen fiber architecture of Dermagraft with the mesh scaffold contributions removed through the use of a structurally based optical model. Dermagraft collagen fibers were found to have a preferred direction nearly parallel to the long dimension of the kite-shaped mesh opening with small spatial variations over the mesh. This study demonstrated the utility of SALS as a rapid and inexpensive technique for the evaluation of gross collagen fiber architecture in engineered tissues.

Quantitative analysis of the fine vascular anatomy of articular ligaments

An image analysis technique has been developed to quantitatively describe the fine vascular patterns observed in ligament tissue. The longitudinal orientational distribution and total vessel volume of India-ink-perfused blood vessel segments in normal and healing ligaments were determined. The methods involved special vascular preparation of adult rabbit knee medial collateral ligaments (MCL) by India-ink perfusion. Black and white microscope images of ink-perfused tissue sections were subjected to a thresholding procedure to binarize digitized ligament images, which were then skeletonized and analyzed for directional distribution based on the least-squares technique. Analysis of medial collateral ligaments in New Zealand White rabbits using this method has shown that scarred tissue is more vascular and has a more chaotic angular distribution of blood-vessel segments than normal ligament tissue.