The Achilles tendon (AT) consists of fibers originating from the soleus muscle (SOL), which lies deep, and the medial (GM) and lateral (GL) heads of the gastrocnemius muscle, which lie superficial. As the fibers descend toward the insertion of the AT, the individual subtendons twist around each other. The aim of this study was to investigate the twisted structure of the AT and its individual subtendons. Specimens of the AT, with preserved calcaneal bone and a fragment of the triceps surae muscle, were obtained from 53 fresh-frozen, male cadavers (n=106 lower limbs). The angle of torsion of each of the AT's subtendons was measured using a specially designed and 3D-printed tool. The mean distance between the most distal fibers of the triceps surae muscle and the superior border of the calcaneal bone was 60.77±14.15 mm. The largest component of the AT at the level of its insertion into the calcaneal bone is the subtendon from the GL (44.43%), followed by the subtendon from SOL (27.89%), and the subtendon from GM (27.68%). The fibers originating from the GM rotate on average 28.17±15.15°, while the fibers originating from the GL and SOL twist 135.98±33.58° and 128.58±29.63°, respectively. The torsion of superficial fibers (GM) comprising the AT is significantly lower than that of deeper fibers (GL and SOL). The cross-sectional area of the AT is smaller at the level of the musculo-tendinous junction than at the level of its insertion. This study illustrates the three types of the AT with differently twisting subtendons, as well as a generalized model of the AT. Types of AT torsion may potentially alter the biomechanical properties of the tendon, thus possibly influencing the pathophysiologic mechanisms leading to the development of various tendinopathies.

It was demonstrated that the thermographic measurements supplemented by the mathematical model offer a new approach to the quantification of allergen-induced skin reactions. Despite the applied simplifications, the proposed model reflected properly the mechanism of heat generation during skin prick test. Moreover, the continuous recording of the skin temperature represents an additional possibility to investigate the mechanism of the allergic reaction.

Skin dynamic termography supplemented by a mathematical model is presented as an objective and sensitive indicator of the skin prick test result. Termographic measurements were performed simultaneously with routine skin prick tests. The IR images were acquired every 70 s up to 910 s after skin prick. In the model histamine is treated as the principal mediator of the allergic reaction. Histamine produces vasolidation and the engorged vessels are responsible for an increase in skin temperature. The model parameters were determined by fitting the analytical solutions to the spatio-temporal distributions of the differences between measured and baseline temperatures. The model reproduces experimental data very well (coefficient of determination = 0.805÷0.995). The method offers a set of parameters to describe separately skin allergic reaction and skin reactivity. The release of histamine after allergen injection is the best indicator of allergic response. The diagnostic parameter better correlates with the standard evaluation of a skin prick test (correlation coefficient = 0.98) than the result of the thermographic planimetric method based on temperature and heated area determination (0.81). The high sensitivity of the method allows for determination of the allergic response in patients with the reduced skin reactivity.

ObjectiveAreal bone mineral density (aBMD) measured by dual-energy X-ray absorptiometry (DXA) is an important determinant of bone strength (BS), despite the fact that the correlation between aBMD and BS is relatively weak. Parameters that describe BS more accurately are desired. The aim of this study was to determine whether the geometrical corrections applied to aBMD would improve its ability for BS prediction. We considered new parameters, estimated from a single DXA measurement, as well as BMAD (bone mineral apparent density) reported in the literature.Materials and methodsIn vitro studies were performed with the L3 vertebrae from 20 cadavers, which were studied with DXA and quantitative computed tomography (QCT). A mechanical strength assessment was carried out. Two new parameters were introduced: and (WPAmin —minimal vertebral body width in postero-anterior (PA) view, WPAav — average PA vertebral body width). Volumetric BMD measured by QCT (vBMD), aBMD, BMAD, vBMDmin, and vBMDav were correlated to ultimate load and ultimate stress (Pmax) to find the best predictor of vertebrae BS.ResultsThe coefficients of correlation between Pmax and vBMDmin, vBMDav, as well as BMAD, were r = 0.626 (p = 0.005), r = 0.610 (p = 0.006) and r = 0.567 (p = 0.012), respectively. Coefficients for vBMD and aBMD are r = 0.648 (p = 0.003) and r = 0.511 (p = 0.03), respectively.ConclusionsOur results showed that aBMD normalized by vertebrae dimensions describes vertebrae BS better than aBMD alone. The considered indices vBMDav, vBMDmin, and BMAD can be measured in routine PA DXA and considerably improve BS variability prediction. vBMDmin is superior compared to vBMDav and BMAD.

Allergen sensitization is being diagnosed by commonly available methods in clinical practice-skin prick tests (SPTs) and specific immunoglobulin E test (sIgE). Recently, a new thermographic (TH) method for the assessment of SPT was developed, and it was demonstrated that the TH measurements of forearm temperature distribution during SPT, supported by a mathematical model, offer a new quantification method of allergen-induced skin reactions. The aim of this study is a comprehensive comparison of the TH method with SPT and sIgE techniques. The studies were performed for a group of 51 patients. The SPT and sIgE examinations were done in a routine way. For TH analyses, set of thermograms of both forearms were acquired after prick and analyzed with the use of developed software. All results were converted into categorized scale for comparison. The collected results indicate high correlation coefficients between methods equal to 0.76-0.99. Sensitivity and accuracy of TH assessment in respect of both SPT and sIgE methods is at good level (0.72-0.93). Acceptable level of specificity 0.60-0.88 was also achieved for most allergic responses. Excellent agreement between SPT and sIgE methods was observed which makes the TH assessment competitive. Due to higher precision and sensitivity of digital infrared technology, possibility of making error in diagnosis is significantly reduced. Additional advantage of the TH method relies on an estimation of the skin reactivity which allows highlighting the hypersensitivity patients and automatic correction of the diagnosis.