3-D finite element model of the impaction of a press-fitted femoral stem under various biomechanical environments

BACKGROUND

Uncemented femoral stem insertion into the bone is achieved by applying successive impacts on an inserter tool called "ancillary". Impact analysis has shown to be a promising technique to monitor the implant insertion and to improve its primary stability.

METHOD

This study aims to provide a better understanding of the dynamic phenomena occurring between the hammer, the ancillary, the implant and the bone during femoral stem insertion, to validate the use of impact analyses for implant insertion monitoring. A dynamic 3-D finite element model of the femoral stem insertion via an impaction protocol is proposed. The influence of the trabecular bone Young's modulus (Et), the interference fit (IF), the friction coefficient at the bone-implant interface (μ) and the impact velocity (v0) on the implant insertion and on the impact force signal is evaluated.

RESULTS

For all configurations, a decrease of the time difference between the two first peaks of the impact force signal is observed throughout the femoral stem insertion, up to a threshold value of 0.23 ms. The number of impacts required to reach this value depends on Et, v0 and IF and varies between 3 and 8 for the set of parameters considered herein. The bone-implant contact ratio reached after ten impacts varies between 60% and 98%, increases as a function of v0 and decreases as a function of IF, μ and Et.

CONCLUSION

This study confirms the potential of an impact analyses-based method to monitor implant insertion and to retrieve bone-implant contact properties.

Characterization of the concentration of agar-based soft tissue mimicking phantoms by impact analysis

In various medical fields, a change of soft tissue stiffness is associated with its physio-pathological evolution. While elastography is extensively employed to assess soft tissue stiffness in vivo, its application requires a complex and expensive technology. The aim of this study is to determine whether an easy-to-use method based on impact analysis can be employed to determine the concentration of agar-based soft tissue mimicking phantoms. Impact analysis was performed on soft tissue mimicking phantoms made of agar gel with a mass concentration ranging from 1% to 5%. An indicator Δt is derived from the temporal variation of the impact force signal between the hammer and a small beam in contact with the sample. The results show a non-linear decrease of Δt as a function of the agar concentration (and thus of the sample stiffness). The value of Δt provides an estimation of the agar concentration with an error of 0.11%. This sensitivity of the impact analysis based method to the agar concentration is of the same order of magnitude than results obtained with elastography techniques. This study opens new paths towards the development of impact analysis for a fast, easy and relatively inexpensive clinical evaluation of soft tissue elastic properties.

Atom Interferometry with Rb Blue Transitions

We demonstrate a novel scheme for Raman-pulse and Bragg-pulse atom interferometry based on the 5S-6P blue transitions of ^{87}Rb that provides an increase by a factor ∼2 of the interferometer phase due to accelerations with respect to the commonly used infrared transition at 780 nm. A narrow-linewidth laser system generating more than 1 W of light in the 420-422 nm range was developed for this purpose. Used as a cold-atom gravity gradiometer, our Raman interferometer attains a stability to differential acceleration measurements of 1×10^{-8}  g at 1 s and 2×10^{-10}  g after 2000 s of integration time. When operated on first-order Bragg transitions, the interferometer shows a stability of 6×10^{-8}  g at 1 s, averaging to 1×10^{-9}  g after 2000 s of integration time. The instrument sensitivity, currently limited by the noise due to spontaneous emission, can be further improved by increasing the laser power and the detuning from the atomic resonance. The present scheme is attractive for high-precision experiments as, in particular, for the determination of the Newtonian gravitational constant.

Ultrasonic bandgaps in viscoelastic 1D-periodic media: Mechanical modeling and experimental validation

Multi-material additive manufacturing is receiving increasing attention in the field of acoustics, in particular towards the design of micro-architectured periodic media used to achieve programmable ultrasonic responses. To unravel the effect of the material properties and spatial arrangement of the printed constituents, there is an unmet need in developing wave propagation models for prediction and optimization purposes. In this study, we propose to investigate the transmission of longitudinal ultrasound waves through 1D-periodic biphasic media, whose constituent materials are viscoelastic. To this end, Bloch-Floquet analysis is applied in the frame of viscoelasticity, with the aim of disentangling the relative contributions of viscoelasticity and periodicity on ultrasound signatures, such as dispersion, attenuation, and bandgaps localization. The impact of the finite size nature of these structures is then assessed by using a modeling approach based on the transfer matrix formalism. Finally, the modeling outcomes, i.e., frequency-dependent phase velocity and attenuation, are confronted with experiments conducted on 3D-printed samples, which exhibit a 1D periodicity at length-scales of a few hundreds of micrometers. Altogether, the obtained results shed light on the modeling characteristics to be considered when predicting the complex acoustic behavior of periodic media in the ultrasonic regime.

Detection of periprosthetic fractures around the femoral stem by resonance frequency analysis: An in vitro study

Periprosthetic femoral bone fractures are frequent complications of Total Hip Arthroplasty (THA) and may occur during the insertion of uncemented Femoral Stems (FS), due to the nature of the press-fit fixation. Such fracture may lead to the surgical failure of the THA and require a revision surgery, which may have dramatic consequences. Therefore, an early detection of intra-operative fractures is important to avoid worsening the fracture and/or to enable a peroperative treatment. The aim of this in vitro study is to determine the sensitivity of a method based on resonance frequency analysis of the bone-stem-ancillary system for periprosthetic fractures detection. A periprosthetic fracture was artificially created close to the lesser-trochanter of 10 femoral bone mimicking phantoms. The bone-stem-ancillary resonance frequencies in the range (2-12) kHz were measured on an ancillary instrumented with piezoelectric sensors, which was fixed to the femoral stem. The measurements were repeated for different fracture lengths from 4 to 55 mm. The results show a decrease of the resonance frequencies due to the fracture occurrence and propagation. The frequency shift reached up to 170 Hz. The minimum fracture length that can be detected varies from 3.1±1.7 mm to 5.9±1.9 mm according to the mode and to the specimen. A significantly higher sensitivity (p = 0.011) was obtained for a resonance frequency around 10.6 kHz, corresponding to a mode vibrating in a plane perpendicular to the fracture. This study opens new paths toward the development of non-invasive vibration-based methods for intra-operative periprosthetic fractures detection.

Using an Instrumented Hammer to Predict the Rupture of Bone Samples Subject to an Osteotomy

Osteotomies are common procedures in maxillofacial and orthopedic surgery. The surgeons still rely on their proprioception to control the progression of the osteotome. Our group has developed an instrumented hammer that was shown to provide information on the biomechanical properties of the tissue located around the osteotome tip. The objective of this study is to determine if this approach may be used to predict the rupture of a bone sample thanks to an instrumented hammer equipped with a force sensor. For each impact, an indicator τ is extracted from the signal corresponding to the variation of the force as a function of time. A linear by part regression analysis is applied to the curve corresponding to the variation of τ as a function of the distance d between the tip of the osteotome and the end of the sample. The experiments were conducted with plywood and bovine trabecular bone samples. The results show that τ starts increasing when the value of d is lower than 2.6 mm on average, which therefore corresponds to a typical threshold detection distance between the osteotome tip and the sample end. These findings open new paths for the development of this instrumented surgical hammer.

Influence of the biomechanical environment on the femoral stem insertion and vibrational behavior: a 3-D finite element study

The long-term success of cementless surgery strongly depends on the implant primary stability. The femoral stem initial fixation relies on multiple geometrical and material factors, but their influence on the biomechanical phenomena occurring during the implant insertion is still poorly understood, as they are difficult to quantify in vivo. The aim of the present study is to evaluate the relationship between the resonance frequencies of the bone-implant-ancillary system and the stability of the femoral stem under various biomechanical environments. The interference fit IF, the trabecular bone Young's modulus [Formula: see text] and the bone-implant contact friction coefficient [Formula: see text] are varied to investigate their influence on the implant insertion phenomena and on the system vibration behavior. The results exhibit for all the configurations, a nonlinear increase in the bone-implant contact throughout femoral stem insertion, until the proximal contact is reached. While the pull-out force increases with [Formula: see text], IF and [Formula: see text], the bone-implant contact ratio decreases, which shows that a compromise on the set of parameters could be found in order to achieve the largest bone-implant contact while maintaining sufficient pull-out force. The modal analysis on the range [2-7] kHz shows that the resonance frequencies of the bone-implant-ancillary system increase with the bone-implant contact ratio and the trabecular bone Young's modulus, with a sensitivity that varies over the modes. Both the pull-out forces and the vibration behavior are consistent with previous experimental studies. This study demonstrates the potential of using vibration methods to guide the surgeons for optimizing implant stability in various patients and surgical configurations.

Ultrasound characterization of the viscoelastic properties of additively manufactured photopolymer materials

Photopolymer-based additive manufacturing has received increasing attention in the field of acoustics over the past decade, specifically towards the design of tissue-mimicking phantoms and passive components for ultrasound imaging and therapy. While these applications rely on an accurate characterization of the longitudinal bulk properties of the materials, emerging applications involving periodic micro-architectured media also require the knowledge of the transverse bulk properties to achieve the desired acoustic behavior. However, a robust knowledge of these properties is still lacking for such attenuating materials. Here, we report on the longitudinal and transverse bulk properties, i.e., frequency-dependent phase velocities and attenuations, of photopolymer materials, which were characterized in the MHz regime using a double through-transmission method in oblique incidence. Samples were fabricated using two different printing technologies (stereolithography and polyjet) to assess the impact of two important factors of the manufacturing process: curing and material mixing. Overall, the experimentally observed dispersion and attenuation could be satisfactorily modeled using a power law attenuation to identify a reduced number of intrinsic ultrasound parameters. As a result, these parameters, and especially those reflecting transverse bulk properties, were shown to be very sensitive to slight variations of the manufacturing process.

Ultrasound characterization of bioinspired functionally graded soft-to-hard composites: Experiment and modeling

Functional grading is a distinctive feature adopted by nature to improve the transition between tissues that present a strong mismatch in mechanical properties, a relevant example being the tendon-to-bone attachment. Recent progress in multi-material additive manufacturing now allows for the design and fabrication of bioinspired functionally graded soft-to-hard composites. Nevertheless, this emerging technology depends on several design variables, including both material and mechanistic ingredients, that are likely to affect the mechanical performance of such composites. In this paper, a model-based approach is developed to describe the interaction of ultrasound waves with homogeneous and heterogeneous additively manufactured samples, which respectively display a variation either of the material ingredients (e.g., ratio of the elementary constituents) or of their spatial arrangement (e.g., functional gradients, damage). Measurements are performed using longitudinal bulk waves, which are launched and detected using a linear transducer array. First, model is calibrated by exploiting the signals measured on the homogeneous samples, which allow identifying relationships between the model parameters and the material composition. Second, the model is validated by comparing the signals measured on the heterogeneous samples with those predicted numerically. Overall, the reported results pave the way for characterizing and optimizing multi-material systems that display complex bioinspired features.

Anatomical subject validation of an instrumented hammer using machine learning for the classification of osteotomy fracture in rhinoplasty

Osteotomies during rhinoplasty are usually based on the surgeon's proprioception to determine the number and the strength of the impacts. The aim of this study is to determine whether a hammer instrumented with a force sensor can be used to classify fractures and to determine the location of the osteotome tip. Two lateral osteotomies were realized in nine anatomical subjects using an instrumented hammer recording the evolution of the impact force. Two indicators τ and λ were derived from the signal, and video analysis was used to determine whether the osteotome tip was located in nasal or frontal bone as well as the condition of the bone tissue around the osteotome tip. A machine-learning algorithm was used to predict the condition of bone tissue after each impact. The algorithm was able to predict the condition of the bone after the impacts with an accuracy of 83%, 91%, and 93% when considering a tolerance of 0, 1, and 2 impacts, respectively. Moreover, in nasal bone, the values of τ and λ were significantly lower (p < 10^-10) and higher (p < 10^-4) than in frontal bone, respectively. This study paves the way for the development of the instrumented hammer as a decision support system.

Validation of an Instrumented Hammer for Rhinoplasty Osteotomies: A Cadaveric Study

Background: Osteotomies during rhinoplasty are usually based on surgeon's proprioception to determine the number, energy, and trajectory of impacts. Objective: The first objective was to detect the occurrence of fractures. The second objective was to determine when the thicker frontal bone was encountered by the osteotome. Materials and Methods: An instrumented hammer was used to measure the impact force during lateral osteotomies on nine human anatomic specimens. A prediction algorithm was developed using machine learning techniques, to detect the occurrence of fractures, and the proximity of the osteotome to the frontal bone. Results: The algorithm was able to predict the occurrence of fractures and the proximity to the frontal bone with a prediction rate of 83%, 91%, and 93% when allowing for an error of 0, 1, and 2 impacts, respectively. The location of the osteotome in the frontal bone was predicted with an error of 7.7%. Conclusion: An osteotomy hammer measuring the impact force when performing lateral osteotomies can predict the occurrence of fractures and the proximity to the frontal bone, providing the surgeon with instant feedback.

Using an impact hammer to perform biomechanical measurements during osteotomies: Study of an animal model

Osteotomies are common surgical procedures used for instance in rhinoplasty and usually performed using an osteotome impacted by a mallet. Visual control being difficult, osteotomies are often based on the surgeon proprioception to determine the number and energy of each impact. The aim of this study is to determine whether a hammer instrumented with a piezoelectric force sensor can be used to (i) follow the displacement of the osteotome and (ii) determine when the tip of the osteotome arrives in frontal bone, which corresponds to the end of the osteotomy pathway. Seven New Zealand White rabbit heads were collected, and two osteotomies were performed on their left and right nasal bones using the instrumented hammer to record the variation of the force as a function of time during each impact. The second peak time τ was derived from each signal while the displacement of the osteotome tip D was determined using video motion tracking. The results showed a significant correlation between τ and D (ρ² = 0.74), allowing to estimate the displacement of the osteotome through the measurement of τ. The values of τ measured in the frontal bone were significantly lower than in the nasal bone (p<10^-10), which allows to determine the transition between the nasal and frontal bones when τ becomes lower than 0.78 its initial averaged value. Although results should be validated clinically, this technology could be used by surgeons in the future as a decision support system to help assessing the osteotome environment.

Assessing the effective elastic properties of the tendon-to-bone insertion: a multiscale modeling approach

The interphase joining tendon to bone plays the crucial role of integrating soft to hard tissues, by effectively transferring stresses across two tissues displaying a mismatch in mechanical properties of nearly two orders of magnitude. The outstanding mechanical properties of this interphase are attributed to its complex hierarchical structure, especially by means of competing gradients in mineral content and collagen fibers organization at different length scales. The goal of this study is to develop a multiscale model to describe how the tendon-to-bone insertion derives its overall mechanical behavior. To this end, the effective anisotropic stiffness tensor of the interphase is predicted by modeling its elastic response at different scales, spanning from the nanostructural to the mesostructural levels, using continuum micromechanics methods. The results obtained at a lower scale serve as inputs for the modeling at a higher scale. The obtained predictions are in good agreement with stochastic finite element simulations and experimental trends reported in literature. Such model has implication for the design of bioinspired bi-materials that display the functionally graded properties of the tendon-to-bone insertion.

Using an Impact Hammer to Estimate Elastic Modulus and Thickness of a Sample During an Osteotomy

Performing an osteotomy with a surgical mallet and an osteotome is a delicate intervention mostly based on the surgeon proprioception. It remains difficult to assess the properties of bone tissue being osteotomized. Mispositioning of the osteotome or too strong impacts may lead to bone fractures which may have dramatic consequences. The objective of this study is to determine whether an instrumented hammer may be used to retrieve information on the material properties around the osteotome tip. A hammer equipped with a piezo-electric force sensor was used to impact 100 samples of different composite materials and thicknesses. A model-based inversion technique was developed based on the analysis of two indicators derived from the analysis of the variation of the force as a function of time in order to (i) classify the samples depending on their material types, (ii) determine the materials stiffness, and (iii) estimate the samples thicknesses. The model resulting from the classification using support vector machines (SVM) learning techniques can efficiently predict the material of a new sample, with an estimated 89% prediction performance. A good agreement between the forward analytical model and the experimental data was obtained, leading to an average error lower than 10% in the samples thickness estimation. Based on these results, navigation and decision-support tools could be developed and allows surgeons to adapt their surgical strategy in a patient-specific manner.

A cadaveric validation of a method based on impact analysis to monitor the femoral stem insertion

The success of cementless hip arthroplasty depends on the primary stability of the femoral stem (FS). It remains difficult to assess the optimal impaction energy to guarantee the FS stability while avoiding bone fracture. The aim of this study is to compare the results of a method based on the use of an instrumented hammer to determine the insertion endpoint of cementless FS in a cadaveric model with two other methods using i) the surgeon proprioception and ii) video motion tracking. Different FS were impacted in nine human cadaveric femurs. For each configuration, the number of impacts realized when the surgeon felt that the FS was correctly inserted was noted N_surg. For each impact, the insertion depth E was measured and an indicator D was determined based on the time-variation of the force. The impact number N_vid (respectively N_d), corresponding to the end of the migration phase, was estimated analyzing the evolution of E (respectively D). The respective difference between N_surg, N_vid and N_d was similar and lower than 3 for more than 85% of the configurations. The results allow a validation of the use of an impact hammer to assess the moment when the surgeon should stop the impaction, paving the way towards the development of a decision support system to assist the surgeon.

Monitoring cementless femoral stem insertion by impact analyses: An in vitro study

The primary stability of the femoral stem (FS) implant determines the surgical success of cementless hip arthroplasty. During the insertion, a compromise must be found for the number and energy of impacts that should be sufficiently large to obtain an adapted primary stability of the FS and not too high to decrease fracture risk. The aim of this study is to determine whether a hammer instrumented with a force sensor can be used to monitor the insertion of FS. Cementless FS of different sizes were impacted in four artificial femurs with an instrumented hammer, leading to 72 configurations. The impact number when the surgeon empirically felt that the FS was fully inserted was noted N_surg. The insertion depth E was assessed using video motion tracking and the impact number N_vid corresponding to the end of the insertion was estimated. For each impact, two indicators noted I and D were determined based on the analysis of the variation of the force as a function of time. The pull-out force F was significantly correlated with the indicator I (R² = 0.67). The variation of D was analyzed using a threshold to determine an impact number N_d, which is shown to be closely related to N_surg and N_vid, with an average difference of around 0.2. This approach allows to determine i) the moment when the surgeon should stop the impaction procedure in order to obtain an optimal insertion of the FS and ii) the FS implant primary stability. This study paves the way towards the development of a decision support system to assist the surgeon in hip arthroplasty.

Influence of soft tissue in the assessment of the primary fixation of acetabular cup implants using impact analyses

BACKGROUND

The acetabular cup (AC) implant primary stability is an important determinant for the success of cementless hip surgery but it remains difficult to assess the AC implant fixation in the clinic. A method based on the analysis of the impact produced by an instrumented hammer on the ancillary has been developed by our group (Michel et al., 2016a). However, the soft tissue thickness present around the acetabulum may affect the impact response, which may hamper the robustness of the method. The aim of this study is to evaluate the influence of the soft tissue thickness (STT) on the acetabular cup implant primary fixation evaluation using impact analyses.

METHODS

To do so, different AC implants were inserted in five bovine bone samples. For each sample, different stability conditions were obtained by changing the cavity diameter. For each configuration, the AC implant was impacted 25 times with 10 and 30 mm of soft tissues positioned underneath the sample. The averaged indicator I_m was determined based on the amplitude of the signal for each configuration and each STT and the pull-out force was measured.

FINDINGS

The results show that the resonance frequency of the system increases when the value of the soft tissue thickness decreases. Moreover, an ANOVA analysis shows that there was no significant effect of the value of soft tissue thickness on the values of the indicator I_m (F = 2.33; p-value = 0.13).

INTERPRETATION

This study shows that soft tissue thickness does not appear to alter the prediction of the acetabular cup implant primary fixation obtained using the impact analysis approach, opening the path towards future clinical trials.

Ex Vivo Evaluation of Cementless Acetabular Cup Stability Using Impact Analyses with a Hammer Instrumented with Strain Sensors

The acetabular cup (AC) implant stability is determinant for the success of cementless hip arthroplasty. A method based on the analysis of the impact force applied during the press-fit insertion of the AC implant using a hammer instrumented with a force sensor was developed to assess the AC implant stability. The aim of the present study was to investigate the performance of a method using a hammer equipped with strain sensors to retrieve the AC implant stability. Different AC implants were inserted in five bovine samples with different stability conditions leading to 57 configurations. The AC implant was impacted 16 times by the two hammers consecutively. For each impact; an indicator I_S (respectively I_F) determined by analyzing the time variation of the signal corresponding to the averaged strain (respectively force) obtained with the stress (respectively strain) hammer was calculated. The pull-out force F was measured for each configuration. F was significantly correlated with I_S (R² = 0.79) and I_F (R² = 0.80). The present method has the advantage of not modifying the shape of the hammer that can be sterilized easily. This study opens new paths towards the development of a decision support system to assess the AC implant stability.

Canceling the Gravity Gradient Phase Shift in Atom Interferometry

Gravity gradients represent a major obstacle in high-precision measurements by atom interferometry. Controlling their effects to the required stability and accuracy imposes very stringent requirements on the relative positioning of freely falling atomic clouds, as in the case of precise tests of Einstein's equivalence principle. We demonstrate a new method to exactly compensate the effects introduced by gravity gradients in a Raman-pulse atom interferometer. By shifting the frequency of the Raman lasers during the central π pulse, it is possible to cancel the initial position- and velocity-dependent phase shift produced by gravity gradients. We apply this technique to simultaneous interferometers positioned along the vertical direction and demonstrate a new method for measuring local gravity gradients that does not require precise knowledge of the relative position between the atomic clouds. Based on this method, we also propose an improved scheme to determine the Newtonian gravitational constant G towards the 10 ppm relative uncertainty.

Influence of anisotropic bone properties on the biomechanical behavior of the acetabular cup implant: a multiscale finite element study

Although the biomechanical behavior of the acetabular cup (AC) implant is determinant for the surgical success, it remains difficult to be assessed due to the multiscale and anisotropic nature of bone tissue. The aim of the present study was to investigate the influence of the anisotropic properties of peri-implant trabecular bone tissue on the biomechanical behavior of the AC implant at the macroscopic scale. Thirteen bovine trabecular bone samples were imaged using micro-computed tomography (μCT) with a resolution of 18 μm. The anisotropic biomechanical properties of each sample were determined at the scale of the centimeter based on a dedicated method using asymptotic homogenization. The material properties obtained with this multiscale approach were used as input data in a 3D finite element model to simulate the macroscopic mechanical behavior of the AC implant under different loading conditions. The largest stress and strain magnitudes were found around the equatorial rim and in the polar area of the AC implant. All macroscopic stiffness quantities were significantly correlated (R² > 0.85, p < 6.5 e-6) with BV/TV (bone volume/total volume). Moreover, the maximum value of the von Mises stress field was significantly correlated with BV/TV (R² > 0.61, p < 1.6 e-3) and was always found at the bone-implant interface. However, the mean value of the microscopic stress (at the scale of the trabeculae) decrease as a function of BV/TV for vertical and torsional loading and do not depend on BV/TV for horizontal loading. These results highlight the importance of the anisotropic properties of bone tissue.

Quantum test of the equivalence principle for atoms in coherent superposition of internal energy states

The Einstein equivalence principle (EEP) has a central role in the understanding of gravity and space-time. In its weak form, or weak equivalence principle (WEP), it directly implies equivalence between inertial and gravitational mass. Verifying this principle in a regime where the relevant properties of the test body must be described by quantum theory has profound implications. Here we report on a novel WEP test for atoms: a Bragg atom interferometer in a gravity gradiometer configuration compares the free fall of rubidium atoms prepared in two hyperfine states and in their coherent superposition. The use of the superposition state allows testing genuine quantum aspects of EEP with no classical analogue, which have remained completely unexplored so far. In addition, we measure the Eötvös ratio of atoms in two hyperfine levels with relative uncertainty in the low 10^-9, improving previous results by almost two orders of magnitude.

Measurement of the gravity-field curvature by atom interferometry

We present the first direct measurement of the gravity-field curvature based on three conjugated atom interferometers. Three atomic clouds launched in the vertical direction are simultaneously interrogated by the same atom interferometry sequence and used to probe the gravity field at three equally spaced positions. The vertical component of the gravity-field curvature generated by nearby source masses is measured from the difference between adjacent gravity gradient values. Curvature measurements are of interest in geodesy studies and for the validation of gravitational models of the surrounding environment. The possibility of using such a scheme for a new determination of the Newtonian constant of gravity is also discussed.

Measuring the Newtonian constant of gravitation G with an atomic interferometer

We have recently completed a measurement of the Newtonian constant of gravitation G using atomic interferometry. Our result is G=6.67191(77)(62)×10(-11) m(3) kg(-1) s(-2) where the numbers in parenthesis are the type A and type B standard uncertainties, respectively. An evaluation of the measurement uncertainty is presented and the perspectives for improvement are discussed. Our result is approaching the precision of experiments based on macroscopic sensing masses showing that the next generation of atomic gradiometers could reach a total relative uncertainty in the 10 parts per million range.

Improvement of ESR dosimetry for thermal neutron beams through the addition of gadolinium

In this paper, the addition of gadolinium is proposed as a useful tool to enhance the electron spin resonance (ESR) sensitivity of organic compounds to thermal neutrons. The target of this work is the detection, through the ESR technique, of the thermal neutron fluence in a mixed field of photons and neutrons. Gadolinium was chosen because it has a very high capture cross section to thermal neutrons; its nuclear reaction with thermal neutrons induces complex inner shell transitions that generate, besides other particles, Auger electrons, which in turn release their energy in the neighborhood (only several nanometers) of the place of reaction. Gadolinium was added to two organic molecules: alanine and ammonium tartrate. The main result obtained was a greater neutron sensitivity for dosimeters with gadolinium than for those without gadolinium for both organic molecules used. Since a dosimeter pair is required to discriminate between the two components of a mixed field, we studied the response of each dosimeter pair irradiated in a mixed field. Through a blind test we verified the usefulness of this dosimetric system and we obtained an estimate of the fluence in the mixed field with a relative uncertainty of 3%, when the pair composed of an alanine dosimeter and a dosimeter with alanine and gadolinium is used.

Dose distributions in phantoms irradiated in thermal columns of two different nuclear reactors

In-phantom dosimetry studies have been carried out at the thermal columns of a thermal- and a fast-nuclear reactor for investigating: (a) the spatial distribution of the gamma dose and the thermal neutron fluence and (b) the accuracy at which the boron concentration should be estimated in an explanted organ of a boron neutron capture therapy patient. The phantom was a cylinder (11 cm in diameter and 12 cm in height) of tissue-equivalent gel. Dose images were acquired with gel dosemeters across the axial section of the phantom. The thermal neutron fluence rate was measured with activation foils in a few positions of this phantom. Dose and fluence rate profiles were also calculated with Monte Carlo simulations. The trend of these profiles do not show significant differences for the thermal columns considered in this work.

Alanine blends for ESR measurements of thermal neutron fluence in a mixed radiation field

In this paper, the results of a study on the electron spin resonance (ESR) dosimetry to measure thermal neutron fluence in a mixed radiation field (neutron and photons) are presented. The ESR responses of alanine dosemeters with different additives are compared. In particular, the (10)B-acid boric and the Gd-oxide were chosen to enhance the sensitivity of alanine dosemeters to thermal neutrons. Irradiations were carried out inside the thermal column of the TAPIRO reactor of the ENEA center, Casaccia Rome. The main results are a greater neutron sensitivity and a smaller lowest detectable fluence for the dosemeters with gadolinium than for dosemeters of alanine with (10)B, which is well known to be much more sensitive to thermal neutrons than simple alanine.

The new hybrid thermal neutron facility at TAPIRO reactor for BNCT radiobiological experiments

A new thermal neutron irradiation facility, devoted to carry out both dosimetric and radiobiological studies on boron carriers, which are being developed in the framework of INFN BNCT project, has been installed at the ENEA Casaccia TAPIRO research fast reactor. The thermal column, based on an original, hybrid, neutron spectrum shifter configuration, has been recently become operative. In spite of its low power (5 kW), the new facility is able to provide a high thermal neutron flux level, uniformly distributed inside the irradiation cavity, with a quite low gamma background. The main features and preliminary benchmark measurements of the Beam-shaping assembly are here presented and discussed.

In-phantom imaging of all dose components in boron neutron capture therapy by means of gel dosimeters

The experimental method for in-phantom imaging and profiling the absorbed dose in neutron capture therapy has been improved. The method separates the contributions of the various secondary radiation components and is based on suitably designed gel dosimeters in the form of layers. The discrimination of the dose components is achieved by means of pixel-to-pixel manipulations of images obtained with gel dosimeters having different isotopic composition. Large dose images are obtainable with this method, because the layer geometry of dosimeters avoids sensible variation of neutron transport due to the isotopic composition of gel. Operation modalities aimed at attaining more reliable results have been studied. Some results, together with the results of punctual measurements performed with conventional dosimeters and with MC calculations, are here reported.

Monte Carlo optimisation of a BNCT facility for treating brain gliomas at the TAPIRO reactor

An epithermal boron neutron capture therapy facility for treating brain gliomas is currently under construction at the 5 kW fast-flux reactor TAPIRO located at ENEA, Casaccia, near Rome. In this work, the sensitivity of the results to the boron concentrations in healthy tissue and tumour is investigated and the change in beam quality on modifying the moderator thickness (within design limits) is studied. The Monte Carlo codes MCNP and MCNPX were used together with the DSA in-house variance reduction patch. Both usual free beam parameters and the in-phantom treatment planning figures-of-merit have been calculated in a realistic anthropomorphic phantom ('ADAM').

An epithermal facility for treating brain gliomas at the TAPIRO reactor

An epithermal facility for treating patients with brain gliomas has been designed and is under construction at the fast reactor TAPIRO at ENEA Casaccia (Italy). The calculational design tools employed were the Monte Carlo codes MCNP/MCNPX together with the DSA in-house variance reduction patch. A realistic anthropomorphic phantom ("ADAM") was included to optimise dose profiles and in-phantom treatment-planning figures-of-merit. The adopted approach was to minimise the treatment time whilst maintaining a reasonable therapeutic ratio. It is shown that TAPIRO, in spite of its low power of 5 kW, is able to provide an epithermal beam that is of good quality and of sufficient intensity to allow a single beam patient irradiation, under conservative assumptions, of 50 min.

Study of a method based on TLD detectors for in-phantom dosimetry in BNCT

A method has been developed, based on thermoluminescent dosemeters (TLD), aimed at measuring the absorbed dose in tissue-equivalent phantoms exposed to thermal or epithermal neutrons, separating the contributions of various secondary radiation generated by neutrons. The proposed method takes advantage of the very low sensitivity of CaF2:Tm (TLD-300) to low energy neutrons and to the different responses to thermal neutrons of LiF:Mg,Ti dosemeters with different 6Li percentage (TLD-100, TLD-700, TLD-600). The comparison of the results with those obtained by means of gel dosemeters and activation foils has confirmed the reliability of the method. The experimental modalities allowing reliable results have been studied. The glow curves of TLD-300 after gamma or neutron irradiation have been compared; moreover, both internal irradiation effect and energy dependence have been investigated. For TLD-600, TLD-100 and TLD-700, the suitable fluence limits have been determined in order to avoid radiation damage and loss of linearity.

BNCT microdosimetry at the tapiro reactor thermal column

A thermal column is available for dosimetric and radiobiological studies by the fast reactor TAPIRO, located at the ENEA research centre Casaccia. The TAPIRO neutron field has been studied (in the frame of LNL BNCT project) with a tissue-equivalent proportional counter, which has worked alternatively with an ordinary tissue-equivalent cathode and with a boron-enriched cathode. Measurements have been performed with polyethylene caps of different thickness. Both the absorbed dose and the microdosimetric-calculated biological effective dose show a maximum at approximately 0.5 mg cm(-2) of depth. The different dose components have been calculated and the results are discussed.

Characterisation of the TAPIRO BNCT epithermal facility

A collimated epithermal beam for boron neutron capture therapy (BNCT) research has been designed and built at the TAPIRO fast research reactor. A complete experimental characterisation of the radiation field in the irradiation chamber has been performed, to verify agreement with IAEA requirements. Slow neutron fluxes have been measured by means of an activation technique and with thermoluminescent detectors (TLDs). The fast neutron dose has been determined with gel dosemeters, while the fast neutron spectrum has been acquired by means of a neutron spectrometer based on superheated drop detectors. The gamma-dose has been measured with gel dosemeters and TLDs. For an independent verification of the experimental results, fluxes, doses and neutron spectra have been calculated with Monte Carlo simulations using the codes MCNP4B and MCNPX_2.1.5 with the direct statistical approach (DSA). The results obtained confirm that the epithermal beams achievable at TAPIRO are of suitable quality for BNCT purposes.

Characterisation of the TAPIRO BNCT thermal facility

Dosimetry and spectrometry measurements have been carried out in the thermal column of the research fast reactor RSV-TAPIRO (ENEA-Casaccia, Rome) in order to investigate its suitability for irradiation of cells or mice, with a view to research in the interests of boron neutron capture therapy (BNCT). The thermal column consists of a graphite moderator (40 cm thick) containing a lead shield (13 cm thick) in order to shield reactor background. The irradiation volume, inside this structure, has cubic shape (18 x 18 x 18 cm3). Besides measurements of fluence and dose rates in air or in phantom performed with thermoluminescence dosemeters (TLDs) and using the activation technique, dose and fluence profiles have been generated using a method based on gel dosemeters analysed with optical imaging. To check the consistency of the results, spectrometry measurements in the same irradiation volume have been performed by means of bubble detectors.

Alanine and TLD coupled detectors for fast neutron dose measurements in neutron capture therapy (NCT)

A method was investigated to measure gamma and fast neutron doses in phantoms exposed to an epithermal neutron beam designed for neutron capture therapy (NCT). The gamma dose component was measured by TLD-300 [CaF2:Tm] and the fast neutron dose, mainly due to elastic scattering with hydrogen nuclei, was measured by alanine dosemeters [CH3CH(NH2)COOH]. The gamma and fast neutron doses deposited in alanine dosemeters are very near to those released in tissue, because of the alanine tissue equivalence. Couples of TLD-300 and alanine dosemeters were irradiated in phantoms positioned in the epithermal column of the Tapiro reactor (ENEA-Casaccia RC). The dosemeter response depends on the linear energy transfer (LET) of radiation, hence the precision and reliability of the fast neutron dose values obtained with the proposed method have been investigated. Results showed that the combination of alanine and TLD detectors is a promising method to separate gamma dose and fast neutron dose in NCT.

Fricke gel dosimetry in boron neutron capture therapy

Gel dosimetry allows three-dimensional (3D) measurement of absorbed dose in tissue-equivalent dosemeter phantoms. Gel phantoms are imaged using optical techniques. In neutron capture therapy (NCT), properly designed gel dosemeters can give 3D dose distributions, due to the various components of the secondary radiation, in phantoms exposed in the thermal or epithermal column of a nuclear reactor. In addition to the therapeutic dose arising from the reaction 10B(n,alpha)7Li, the other dose components are also obtainable, i.e. the gamma dose (due to reactor background and to the reaction 1H(n,gamma)2H of thermal neutrons with hydrogen, the dose due to protons emitted in the reaction 14N(n,p)14C of thermal neutrons with nitrogen and the dose due to recoil protons resulting from elastic scattering of epithermal neutrons.

Total antioxidant capacity and nuclear DNA damage in keratinocytes after exposure to H2O2

Studies of oxidative stress have classically been performed by analyzing specific, single antioxidants. In this study, susceptibility to oxidative stress in the human keratinocyte cell line NCTC2544 exposed to hydrogen peroxide (H2O2) was measured by the TOSC (total oxyradical scavenging capacity) assay, which discriminates between the antioxidant capacity toward peroxyl radicals and hydroxyl radical. The generation of H2O2-induced DNA damage, total antioxidant capacity and levels of antioxidant enzymes (catalase, superoxide dismutase, glutathione reductase, glutathione S-transferase, glutathione peroxidase) were studied. Exposure to H2O2-induced DNA damage that was gradually restored while a significant reduction in cellular TOSC values was obtained independently of stressor concentrations and the degree of DNA repair. Whereas TOSC values and cell resistance to H2O2 showed a good relationship, the extent of DNA damage is independent from cellular total antioxidant capacity. Indeed, maximum DNA damage and cell mortality were observed in the first 4 h, whereas TOSC remained persistently low until 48 h. Catalase levels were significantly lower in exposed cells after 24 and 48 h. Keratinocytes exposed after 48 h to a second H2O2 treatment exhibited massive cell death. A possible linkage was observed between TOSC values and NCTC2544 resistance to H2O2 challenge. The TOSC assay appears to be a useful tool for evaluating cellular resistance to oxidative stress.

Expression of glyoxalase I and II in normal and breast cancer tissues

The present work aimed to study the activities of glyoxalase system enzymes, glyoxalase I (G I) and glyoxalase II (G II), as well as the expression of their genes in human breast carcinoma. Samples of tumoral tissue and normal counterparts were drawn from several patients during surgery. They served either for preparing extracts to be used in enzyme activity evaluations or for RNA extraction and subsequent northern blot analysis. A far higher activity level of G I and G II occurs in the tumor compared with pair-matched normal tissue, as shown by both spectrophotometrical assay and electrophoretic pattern. Such increased activities of G I and G II likely result from an enhanced enzyme synthesis as a consequence of increased expression of the respective genes in the tumoral tissue, as evidenced by northern blot. The present findings confirm a key-role of glyoxalase system to detoxify cytotoxic methylglyoxal and modulate S-D-lactoylglutathione levels in tumor cells. Moreover, they suggest a possible employment of GI inhibitors as anti-cancer drugs.

Gadolinium in human glioblastoma cells for gadolinium neutron capture therapy

157Gd is a potential agent for neutron capture cancer therapy (GdNCT). We directly observed the microdistribution of Gd in cultured human glioblastoma cells exposed to Gd-diethylenetriaminepentaacetic acid (Gd-DTPA). We demonstrated, with three independent techniques, that Gd-DTPA penetrates the plasma membrane, and we observed no deleterious effect on cell survival. A systematic microchemical analysis revealed a higher Gd accumulation in cell nuclei compared with cytoplasm. This is significant for prospective GdNCT because the proximity of Gd to DNA increases the cell-killing potential of the short-range, high-energy electrons emitted during the neutron capture reaction. We also exposed Gd-containing cells to thermal neutrons and demonstrated the GdNC reaction effectiveness in inducing cell death. These results in vitro stimulated in vivo Gd-DTPA uptake studies, currently underway, in human glioblastoma patients.

Soluble and membrane-bound acetylcholinesterases in Mytilus galloprovincialis (Pelecypoda: Filibranchia) from the northern Adriatic sea

Three forms of acetylcholinesterase (AChE) were detected in samples of the bivalve mollusc Mytilus galloprovincialis collected in sites of the Adriatic sea. Apart from the origin of the mussels, two spontaneously soluble (SS) AChE occur in the hemolymph and represent about 80% of total activity, perhaps hydrolyzing metabolism-borne choline esters. These hydrophilic enzymes (forms A and B) copurified by affinity chromatography (procainamide-Sepharose gel) and were separated by sucrose gradient centrifugation. They are, respectively, a globular tetramer (11.0-12.0 S) and a dimer (6.0-7.0 S) of catalytic subunits. The third form, also purified from tissue extracts by the same affinity matrix, proved to be an amphiphilic globular dimer (7.0 S) with a phosphatidylinositol tail giving cell membrane insertion, detergent (Triton X-100, Brij 96) interaction and self-aggregation. Such an AChE is likely functional in cholinergic synapses. All three AChE forms show a good substrate specificity and are inactive on butyrylthiocholine. Studies with inhibitors showed low inhibition by eserine and paraoxon, especially on SS forms, high sensitivity to 1,5-bis(4-allyldimethylammoniumphenyl)-pentan-3-one dibromide (BW284c51) and no inhibition with propoxur and diisopropylfluorophosphate (DFP). The ChE forms in M. galloprovincialis are possibly encoded by different genes. Some kinetic features of these enzymes suggest a genetic polymorphism.

Discrimination of various contributions to the absorbed dose in BNCT: Fricke-gel imaging and intercomparison with other experimental results

A method is described for the 3D measurements of absorbed dose in a ferrous sulphate gel phantom, exposed in the thermal column of a nuclear reactor. The method, studied for Boron Neutron Capture Therapy (BNCT) purposes, allows absorbed dose imaging and profiling, with the separation of different contributions coming from different secondary radiations, generated from thermal neutrons. In fact, the biological effectiveness of the different radiations is different. Tests with conventional dosimeters were performed too.

Molecular cloning and expression of a full-length cDNA encoding acetylcholinesterase in optic lobes of the squid Loligo opalescens: a new member of the cholinesterase family resistant to diisopropyl fluorophosphate

Acetylcholinesterase cDNA was cloned by screening a library from Loligo opalescens optic lobes; cDNA sequence analysis revealed an open reading frame coding for a protein of 610 amino acids that showed 20-41% amino acid identity with the acetylcholinesterases studied so far. The characteristic structure of cholinesterase (the choline binding site, the catalytic triad, and six cysteines that form three intrachain disulfide bonds) was conserved in the protein. The heterologous expression of acetylcholinesterase in COS cells gave a recovery of acetylcholinesterase activity 20-fold higher than in controls. The enzyme, partially purified by affinity chromatography, showed molecular and kinetic features indistinguishable from those of acetylcholinesterase expressed in vivo, which displays a high catalytic efficiency. Both enzymes are true acetylcholinesterase corresponding to phosphatidylinositol-anchored G2a dimers of class I, with a marked substrate specificity for acetylthiocholine. The deduced amino acid sequence may explain some particular kinetic characteristics of Loligo acetylcholinesterase, because the presence of a polar amino acid residue (S313) instead of a nonpolar one [F(288) in Torpedo] in the acyl pocket of the active site could justify the high substrate specificity of the enzyme, the absence of hydrolysis with butyrylthiocholine, and the poor inhibition by the organophosphate diisopropyl fluorophosphate.

Acetylcholinesterase at high catalytic efficiency and substrate specificity in the optic lobe of Eledone moschata (Cephalopoda: Octopoda): biochemical characterization and histochemical localization

In the optic lobe of the cephalopod mollusc Eledone moschata, two acetylcholinesterase forms I and II were detected, both showing a marked active site specificity with differently sized substrates. Catalytic efficiency (kcat/Km) of the prevailing form II is similar to that of acetylcholinesterases from vertebrate nervous system. Enzyme forms I and II were co-purified from a high-salt-Triton X-100 soluble extract of optic lobe by consecutive affinity chromatographies on procainamide- and concanavalin A-Sepharose columns and then separately obtained by preparative density gradient centrifugation. According to gel-filtration chromatography, sedimentation analysis and SDS-PAGE, the major form II is an amphiphilic globular dimer (135-136 kDa, 6.3-7.4 S) of monomers (66 kDa) S-S linked between terminal segments. Phosphatidylinositol anchors give cell membrane insertion, self-aggregation and detergent (Triton X-100, Brij 97) interaction. Form I, characterized only in part owing to its small amount, showed molecular size (129 kDa) and sedimentation coefficient (7.5 S) similar to those of form II; it is likely to be attached to the cell membrane by electrostatic interactions. Both forms behaved similarly with various inhibitors and underwent excess-substrate inhibition. The results obtained suggest a common origin of both form I and II from a single gene. The former could be a degradation product of the prevailing one (II), which is likely to be functional in cholinergic synapses.

Expression of a single dimeric membrane-bound acetylcholinesterase in Parascaris equorum

A single form of cholinesterase was detected in the parasitic nematode Parascaris equorum and purified from a low-salt Triton X-100 extract of whole animals by affinity chromatography on an edrophonium-Sepharose matrix. Based on gel-filtration chromatography, sedimentation analysis and SDS-PAGE, such a cholinesterase is an amphiphilic globular (G2) dimer (125-129 kDa, 6.1 S). It includes some hydrophobic domain other than phosphatidylinositol, which gives autoaggregation, detergent interaction and also anchors the molecule to the cell membrane. The enzyme, probably functional in cholinergic neurotransmission, is an acetylcholinesterase showing a fairly low substrate specificity with thiocholine esters. Electrostatic interactions seem to play a major role in the catalytic activity. Studies with inhibitors gave complete inhibition with 1 mM eserine, low sensitivity for procainamide and for tetra(monoisopropyl)pyrophosphortetramide as well as higher inhibition with edrophonium chloride and 1,5-bis(4allyldimethylammoniumphenyl)-pentan-3-one dibromide. The enzyme also showed excess-substrate inhibition with acetylthiocholine. No cross-hybridization occurred between the gene(s) encoding acetylcholinesterase in P. equorum and ace-1 from the free-living nematode Caenorhabditis elegans. The expression of a single cholinesterase form in P. equorum, unusual in free-living nematodes, could be due to parasitic life adaptation with resulting reduction of locomotor activity.

Synthesis and study of thiocarbonate derivatives of choline as potential inhibitors of acetylcholinesterase

Fourteen alkyl and aryl thiocarbonate derivatives of choline were synthesized and studied as potential inhibitors of acetylcholinesterase (AChE). Twelve of the compounds inhibited AChEs derived from calf forebrain, human red blood cells, and octopus brain ranging from low to moderately high inhibition potency. The concentration of each inhibitory compound giving 50% inhibition of enzyme activity (IC50 values, which ranged from 1 x 10(-2) to 8 x 10(-7) M) was determined and is reported; inhibitor constants (Ki values) for the most inhibitory compounds, (1-pentylthiocarbonyl)choline chloride and (1-heptylthiocarbonyl)choline chloride, were calculated from kinetic data and are also reported. The inhibitors are competitive with substrate, and they are not hydrolyzed by the AChE activities. Certain of these new compounds may provide direction for the development of new drugs that have anticholinesterase activity and may be used for the treatment of Alzheimer's disease.

Acetylcholinesterase in Spirographis spallanzanii (Polychaeta: Sedentaria): presence of two dimeric membrane-bound forms

In the annelid polychaete Spirographis spallanzanii two acetylcholinesterases, named DS and HSDS, were detected. They differ in relative amount, membrane anchoring and pharmacological properties. Studies with inhibitors evidenced complete inhibition of both acetylcholinesterases by 10(-3) M eserine and different sensitivities for edrophonium or procainamide. Both enzymes, sensitive to BW284c51, were unaffected by iso-OMPA; at variance, only the HSDS form underwent excess-substrate inhibition. DS and HSDS enzymes were solubilized by homogenization in a low-salt or high-salt-Triton X-100 buffer and then purified by affinity chromatography on edrophonium- or procainamide-Sepharose column respectively. According to gel-filtration chromatography, sedimentation analysis and SDS-PAGE, the least represented (30%) DS form is a G2 amphiphilic globular dimer (124-130 kDa, 6.0-7.0S) with S-S linked monomers (66 kDa). Phosphatidylinositol anchors give cell membrane insertion, self-aggregation and detergent (Triton X-100, Brij 97) interaction. The prevailing (70%) HSDS acetylcholinesterase is once again a G2 form similar to DS enzyme in its molecular size (117-125 kDa), sedimentation coefficient (6.0S) of the native form and presence of S-S linked subunits (66 kDa). However, it is likely attached to the cell membrane by involvement of strong electrostatic interactions. DS acetylcholinesterase displays moderate active site specificity with differently sized substrates. The HSDS form is inactive on butyrylthiocholine. DS and HSDS forms show a comparable catalytic efficiency (kcat/K(m)) approaching that of other invertebrate enzymes. The results suggest that DS and HSDS enzymes, likely encoded by distinct genes, are both functional in cholinergic synapses.