Heoung-Jae Chun

Hygroscopic aspects of epoxy/carbon fiber composite laminates in aircraft environments

Abstract In this study, various hygroscopic effects of such parameters as hygrothermal temperature, matrix volume ratio (Vm), void volume ratio (Vv), specimen thickness, lay-up sequence and internal stress were investigated for epoxy/carbon fiber composite laminates. The specimen thickness and lay-up sequence had little effect on the through-the-thickness water absorption behavior of composite laminates, but the other parameters affected the moisture absorption rate and equilibrium water uptake in different ways and intensities. The glass transition temperature of composite laminates was strongly affected and linearly decreased by the quantity of equilibrium water uptake. A characteristic length of moisture migration through the unidirectional laminates was proposed as a function of fiber angle to the exposed laminate surface. In this approach, the fibers imbedded in the matrix were assumed to act as a barrier to the penetrating water molecules, and the developed model was well compared with the experimental results.

Enhancement of ectopic bone formation by bone morphogenetic protein-2 delivery using heparin-conjugated PLGA nanoparticles with transplantation of bone marrow-derived mesenchymal stem cells.

This study was performed to determine if a combination of previously undifferentiated bone marrow-derived mesenchymal stem cells (BMMSCs) and exogenous bone morphogenetic protein-2 (BMP-2) delivered via heparin-conjugated PLGA nanoparticles (HCPNs) would extensively regenerate bone in vivo. In vitro testing found that the HCPNs were able to release BMP-2 over a 2-week period. Human BMMSCs cultured in medium containing BMP-2-loaded HCPNs for 2 weeks differentiated toward osteogenic cells expressing alkaline phosphatase (ALP), osteopontin (OPN) and osteocalcin (OCN) mRNA, while cells without BMP-2 expressed only ALP. In vivo testing found that undifferentiated BMMSCs with BMP-2-loaded HCPNs induce far more extensive bone formation than either implantation of BMP-2-loaded HCPNs or osteogenically differentiated BMMSCs. This study demonstrates the feasibility of extensive in vivo bone regeneration by transplantation of undifferentiated BMMSCs and BMP-2 delivery via HCPNs.

Tissue Engineering of the Intervertebral Disc With Cultured Nucleus Pulposus Cells Using Atelocollagen Scaffold and Growth Factors

Study Design. In vitro experiment using rabbit nucleus pulposus (NP) cells seeded in atelocollagen scaffolds under the stimulation of growth factors. Objective. To demonstrate the effect of anabolic growth factors in rabbit NP cells cultured in atelocollagen type I and type II. Summary of Background Data. Atelocollagen provides intervertebral disc (IVD) cells for a biocompatible environment to produce extracellular matrix. IVD cells with exogenous transforming growth factor-beta 1 (TGF-&bgr;1) and bone morphogenetic protein-2 (BMP-2) also render an increase in matrix synthesis. However, the effect of anabolic growth factors in NP cells cultured in atelocollagens was not elucidated before. Methods. Rabbit NP cell was harvested, enzymatically digested, and cultured. The NP cells were seeded to atelocollagen type I and type II scaffolds, and then cultures were exposed to TGF-&bgr;1 (10 ng/mL) and/or BMP-2 (100 ng/mL). DNA synthesis was measured using [4H]-thymidine incorporation. Newly synthesized proteoglycan was measured using [35S]-sulfate incorporation. Reverse transcription-polymerase chain reactions (RT-PCRs) for mRNA expression of aggrecan, collagen type I, collagen type II, and osteocalcin were performed. Results. Rabbit NP cells cultured in atelocollagen type I scaffold showed an increase (1.7 to 2.4-fold) in DNA synthesis in response to TGF-&bgr;1 and/or BMP-2 (P < 0.05), whereas NP cultures in atelocollagen type II demonstrated a 30% increase in DNA synthesis only with combination of both growth factors compared with control (P < 0.05). Rabbit NP cells in atelocollagen type II scaffold with TGF-&bgr;1 and combination of both growth factors exhibited robust 5.3- and 5.4-fold increases in proteoglycan synthesis (P < 0.05), whereas any cultures in atelocollagen type I failed to show any significant increase compared with control. Rabbit NP cells in atelocollagen type I and type II scaffolds with TGF-&bgr;1 and/or BMP-2 demonstrated the upregulation of aggrecan, collagen type I, and collagen type II mRNA expression compared with saline control (P < 0.05). The response in transcriptional level was more robust in atelocollagen type II than in type I. In any event, there is no recognizable expression of osteocalcin (P < 0.05). Conclusion. NP cells in atelocollagens under the stimulation of TGF-&bgr;1 and BMP-2 exhibited anabolic responses in transcriptional and translational levels. Hence, such an approach can provide a suitable engineered tissue for IVD regeneration with potential for robust refurbishment of matrix.

Zonal responsiveness of the human intervertebral disc to bone morphogenetic protein-2.

Study Design. In vitro experiment using bone morphogenetic protein-2 (BMP-2) and cells from the nucleus pulposus (NP), transitional zone (TZ), and anulus fibrosus (AF) of the human intervertebral disc (IVD). Objective. To demonstrate the differential effect of BMP-2 on DNA synthesis, proteoglycan synthesis, and osteocalcin mRNA expression in human IVD cells from the NP, TZ, and AF, respectively. Summary of Background Data. BMP-2 has been proven to be effective in stimulating proteoglycan synthesis in articular chondrocytes and IVD cells from the NP. Nevertheless, the effect of BMP-2 on cells from different regions of the IVD has not yet been thoroughly elucidated. Methods. Human IVDs were harvested from surgical disc procedures and tissue from the NP, TZ, and AF was obtained. Disc tissue was enzymatically digested, and IVD cells were cultured three-dimensionally in alginate beads. Then IVD cell cultures from the NP, TZ, and AF were exposed to BMP-2. DNA synthesis and newly synthesized proteoglycan were measured. Reverse transcription-polymerase chain reaction for mRNA expression of bone sialoprotein, DLX5, osteocalcin, and collagen type I, was performed. Results. Cells from the AF responded to BMP-2 with mitogenesis. There was no significant increase in DNA synthesis in cultures from the NP and TZ treated with BMP-2. Only cells from the NP showed a significant increase in newly synthesized proteoglycan in response to BMP-2. IVD cells from all zones demonstrated no significant expression of bone sialoprotein, DLX5, osteocalcin mRNA after treatment with BMP-2. Conclusion. BMP-2 clearly exerted a mitogenic effect on AF cells, and stimulated proteoglycan synthesis in NP cells. However, BMP-2 did not have an osteogenic effect in any IVD region. Taken together, these results confirm that BMP-2 can be used as an anabolic agent for mitogenesis in AF cells and NP cell matrix regeneration without the possibility of osteogenesis.

The biomechanical influence of the facet joint orientation and the facet tropism in the lumbar spine

BACKGROUND CONTEXT Facet joint orientation and facet tropism (FT) are presented as the potential anatomical predisposing factors for lumbar degenerative changes that may lead in turn to early degeneration and herniation of the corresponding disc or degenerative spondylolisthesis. However, no biomechanical study of this concept has been reported. PURPOSE To investigate the biomechanical influence of the facet orientation and FT on stress on the corresponding segment. STUDY DESIGN Finite element analysis. METHODS Three models, F50, F55, and F60 were simulated with different facet joint orientations (50°, 55°, and 60° relative to coronal plane) at both L2-L3 facet joints. A FT model was also simulated to represent a 50° facet joint angle at the right side and a 60° facet joint angle at the left side in the L2-L3 segment. In each model, the intradiscal pressures were investigated under four pure moments and anterior shear force. Facet contact forces at the L2-L3 segment were also analyzed under extension and torsion moments and anterior shear force. This study was supported by 5000 CHF grant of 2011 AO Spine Research Korea fund. The authors of this study have no topic-specific potential conflicts of interest related to this study. RESULTS The F50, F55, and F60 models did not differ in the intradiscal pressures generated under four pure moments: but under anterior shear force, the F60 and FT models showed increases of intradiscal pressure. The F50 model under extension and the F60 model under torsion each generated an increase in facet contact force. In all conditions tested, the FT model yielded the greatest increase of intradiscal pressure and facet contact force of all the models. CONCLUSIONS The facet orientation per se did not increase disc stress or facet joint stress prominently at the corresponding level under four pure moments, but FT could make the corresponding segment more vulnerable to external moments or anterior shear force.

The Biomechanical Effect of Pedicle Screws' Insertion Angle and Position on the Superior Adjacent Segment in 1 Segment Lumbar Fusion

Study Design. A finite element analysis. Objective. To investigate the association between the position of an inserted pedicle screw and the corresponding facet contact force or intradiscal pressure. Summary of Background Data. Although superior facet joint violation by pedicle screws is not an uncommon occurrence in instrumented lumbar fusion surgery, its actual biomechanical significance is not well understood. Furthermore, the association between the position of the pedicle screw and the stress on the corresponding disc/facet joint has yet to be investigated. Methods. According to the positions of pedicle screws in L4 of the L4–L5 lumbar fusion, 4 L4–L5 fusion models were simulated. These models included the violation of both L3–L4 superior facet joints by pedicle screws (facet joint violation [FV] model), the nonencroachment of both L3–L4 superior facet joints by pedicle screws (facet joint preservation [FP] model), and the removal state of pedicle screws in the FV model (removal of violated pedicle screws [rFV] model). The facet joint contact [FC] model represented the scenario in which the pedicle screws did not encroach upon either facet joint but were inserted close to the L3–L4 facet joint surface. Moreover, the uninstrumented fusion [UF] model represented the uninstrumented L4–L5 fusion. In each scenario, the intradiscal pressures and facet contact forces at the L2–L3 and L3–L4 segments were analyzed under extension and torsion moments. Results. The FV model yielded the greatest increases in facet contact force and intradiscal pressure at the L3–L4 segment under extension and torsion moments. Following the FV model, the increases in intradiscal pressure and facet contact force were the second highest in the FC model followed by the FP model. Furthermore, the rFV model represented prominent reductions of previously increased facet contact force and intradiscal pressure at the L3–L4 segment. Conclusion. In models of 1-segment lumbar fusion surgery, the positions of pedicle screws were closely linked with corresponding disc stresses and facet contact forces. However, even in cases of facet violation by pedicle screws, removal of the pedicle screw after fusion completion can reduce facet contract forces and disc stresses under both extension and torsional moments.

The risk assessment of a fall in patients with lumbar spinal stenosis

Study Design. A prospective case control study. Objectives. To investigate the risk of a fall by using functional mobility tests in patients with lumbar spinal stenosis (LSS) via a comparison with patients with knee osteoarthritis (KOA). Summary of Background Data. LSS is a degenerative arthritic disease in the spine that results in decreasing function, impaired balance, and gait deficit, with increased levels of leg and back pain. This physical impairment may result in an increased risk of fall later in the disease process, as shown in KOA. However, there has been no study regarding the association between the risk of a fall and LSS. Methods. The study was an age- and weight-matched case control study consisting of two groups: one group consisting of 40 patients with LSS who were scheduled to undergo spine surgery (LSS group) and the other group consisting of 40 patients with advanced osteoarthritis in both knees, scheduled to undergo TKA on both knees (KOA group). For both groups, four functional mobility tests, such as a Six-Meter-Walk Test (SMT), Sit-to-Stand test (STS), Alternative-Step Test (AST), and Timed Up and Go Test (TUGT), were performed. Results. There was no difference in demographic data between both groups except for body mass index. For the SMT and STS, the patients in the LSS group spent significantly more time performing these tests than the patients in the KOA. For the AST, however, patients in the KOA group presented a statistically worse performance in functional mobility, compared with the LSS group. The mean TUGT time was not statistically different between the two groups. Conclusions. The current study highlights that patients with symptomatic LSS have a risk of a fall comparable with the patients who had degenerative KOA based on the results of functional mobility tests (SMT, STS, AST, and TUGT).

A validated finite element analysis of nerve root stress in degenerative lumbar scoliosis

Few studies have shown the relationship between the curve pattern and nerve root symptoms in degenerative lumbar scoliosis, and its mechanism remains unclear. We developed a finite element model of two patterns of scoliotic curves (isolated lateral bending curve, lateral bending combined with rotation curve). The stress on the nerve root was calculated on both sides (right and left) of the apex vertebra. In the lateral bending curves without rotation, the compressive nerve root stress on the concave side was greater than the tensile stress on the convex side at the apex vertebra. In contrast, when the segmental rotation of the vertebrae was added to the lateral bending curve, there was significantly higher tensile stress on the convex side, and lower compressive stress on the concave side. To conclude, rotatory listhesis may be an important pathomechanism in the development of neurologic symptoms on the convex side of the curve.

Analysis of biomechanical changes after removal of instrumentation in lumbar arthrodesis by finite element analysis

The purpose of this study is to investigate the change in biomechanical milieu following removal of pedicle screws in instrumented single level lumbar arthrodesis. Using a validated finite element (FE) model of the intact lumbar spine (L2–5), two scenarios of L3–4 lumbar fusion were simulated: posterolateral fusion (PLF) at L3–4 using pedicle screws (PLF with pedicle screws; WiP) and L3–4 lumbar posterolateral fusion state after removal of pedicle screws (PLF without pedicle screws; WoP). The WiP model had greater range of motion (ROM) at each adjacent segment than the WoP model. This phenomenon became pronounced at the proximal adjacent segment under flexion moment. Similarly, removal of pedicle screws (the WoP model) relieved the maximal von Mises stress at adjacent segments under 4 moments compared to the WiP model. This study demonstrated that removal of pedicle screws could decrease stiffness of fusion segments, which would reduce the disk stress of adjacent segments.

Computational model-based probabilistic analysis of in vivo material properties for ligament stiffness using the laxity test and computed tomography

The objective of this paper was to evaluate in vivo material properties in order to address technical aspects of computational modeling of ligaments in the tibiofemoral joint using a probabilistic method. The laxity test was applied to the anterior-posterior drawer under 30° and 90° of flexion with a series of stress radiographs, a Telos device, and computed tomography. Ligament stiffness was investigated using sensitivity analysis based on the Monte-Carlo method with a subject-specific finite element model generated from in vivo computed tomography and magnetic resonance imaging data, subjected to laxity test conditions. The material properties of ligament stiffness and initial ligament strain in a subject-specific finite element model were optimized to minimize the differences between the movements of the tibia and femur in the finite element model and the computed tomography images in the laxity test. The posterior cruciate ligament was the most significant factor in flexion and posterior drawer, while the anterior cruciate ligament primarily was the most significant factor for the anterior drawer. The optimized material properties model predictions in simulation and the laxity test were more accurate than predictions based on the initial material properties in subject-specific computed tomography measurement. Thus, this study establishes a standard for future designs in allograft, xenograft, and artificial ligaments for anterior cruciate ligament and posterior cruciate ligament injuries.