Walking on water: subchondral vascular physiology explains how joints work and why they become osteoarthritic.

This review of bone perfusion introduces a new field of joint physiology, important in understanding osteoarthritis. Intraosseous pressure (IOP) reflects conditions at the needle tip rather than being a constant for the whole bone. Measurements of IOP in vitro and in vivo, with and without proximal vascular occlusion confirm that cancellous bone is perfused at normal physiological pressures. Alternate proximal vascular occlusion may be used to give a perfusion range or bandwidth at the needle tip more useful than a single IOP measure. Bone fat is essentially liquid at body temperature. Subchondral tissues are relatively delicate but are micro-flexible. They tolerate huge pressures with loading. Collectively, the subchondral tissues transmit load mainly by hydraulic pressure to the trabeculae and cortical shaft. Normal MRI scans demonstrate subchondral vascular marks which are lost in early osteoarthritis. Histological studies confirm the presence of those marks and possible subcortical choke valves which support hydraulic pressure load transmission. Osteoarthritis appears to be at least partly a vasculo-mechanical disease. Understanding subchondral vascular physiology will be key to better MRI classification and prevention, control, prognosis and treatment of osteoarthritis and other bone diseases.

Outcomes Following Hydraulic Pressure Indirect Sinus Lift in Cases of Simultaneous Implant Placement With Platelet-Rich Fibrin.

Background To achieve a better long-term prognosis in the posterior maxilla with poor quality of bone, the sinus lift must ensure bone regeneration till the apex of the dental implant for osseointegration. An indirect sinus lift is a minimally invasive procedure where simultaneous bone condensation is achieved. During the sinus lift procedures, different graft materials are used to gain the height of the bone in the sinus. The present study aimed to evaluate the outcomes of indirect sinus lift with hydraulic pressure and the simultaneous placement of implant using platelet-rich fibrin (PRF). Methodology In total, 24 subjects aged 18-74 years with missing maxillary premolars and first and second molars who opted for dental implants placed with indirect sinus lift with hydraulic pressure and had low sinus with less residual ridge height, bone density, and bone height were assessed at one day, one week, one month, three months, and six months. Results The average mean height preoperatively was 5.573 ± 0.66 mm which showed a significant increase postoperatively to 9.603 ± 0.78 mm (p < 0.001). Mean sinus membrane lift was 4.8 ± 2.2 mm at six months. The implant stability quotient increased significantly at six months postoperatively from 69.07 ± 3.39 at the immediate postoperative time to 72.92 ± 2.714 at six months postoperatively (p < 0.001). Conclusions The current study suggests that minimally invasive indirect sinus lift with bone augmentation utilizing PRF increased residual alveolar ridge height and implant stability with fewer problems than previous sinus lift procedures in the posterior maxillary area.

Interface Engineering in Chip-Scale GaN Optical Devices for Near-Hysteresis-Free Hydraulic Pressure Sensing.

In this work, a compact, near-hysteresis-free hydraulic pressure sensor is presented through interface engineering in a GaN chip-scale optical device. The sensor consists of a monolithic GaN-on-sapphire device responsible for light emission and detection and a multilevel microstructured polydimethylsiloxane (PDMS) film prepared through a low-cost molding process using sandpaper as a template. The micro-patterned PDMS film functions as a pressure-sensing medium to effectively modulate the reflectance properties at the sapphire interface during pressure loading and unloading. The interface engineering endows the GaN optical device with near-hysteresis-free performance over a wide pressure range of up to 0-800 kPa. Verified by a series of experimental measurements on its dynamic responses, the tiny hydraulic sensor exhibits superior performance in hysteresis, stability, repeatability, and response time, indicating its considerable potential for a broad range of practical applications.

Trans-epithelial fluid flow and mechanics of epithelial morphogenesis.

Active fluid transport across epithelial monolayers is emerging as a major driving force of tissue morphogenesis in a variety of healthy and diseased systems, as well as during embryonic development. Cells use directional transport of ions and osmotic gradients to drive fluid flow across the cell surface, in the process also building up fluid pressure. The basic physics of this process is described by the osmotic engine model, which also underlies actin-independent cell migration. Recently, the trans-epithelial fluid flux and the hydraulic pressure gradient have been explicitly measured for a variety of cellular and tissue model systems across various species. For the kidney, it was shown that tubular epithelial cells behave as active mechanical fluid pumps: the trans-epithelial fluid flux depends on the hydraulic pressure difference across the epithelial layer. When a stall pressure is reached, the fluid flux vanishes. Hydraulic forces generated from active fluid pumping are important in tissue morphogenesis and homeostasis, and could also underlie multiple morphogenic events seen in other developmental contexts. In this review, we highlight findings that examined the role of trans-epithelial fluid flux and hydraulic pressure gradient in driving tissue-scale morphogenesis. We also review organ pathophysiology due to impaired fluid pumping and the loss of hydraulic pressure sensing at the cellular scale. Finally, we draw an analogy between cellular fluidic pumps and a connected network of water pumps in a city. The dynamics of fluid transport in an active and adaptive network is determined globally at the systemic level, and transport in such a network is best when each pump is operating at its optimal efficiency.

Crossing Total Occlusions Using a Hydraulic Pressure Wave: Development of the Wave Catheter.

With the ongoing miniaturization of surgical instruments, the ability to apply large forces on tissues for resection becomes challenging and the risk of buckling becomes more real. In an effort to allow for high force application in slender instruments, in this study, we have investigated using a hydraulic pressure wave (COMSOL model) and developed an innovative 5F cardiac catheter (L = 1,000 mm) that allows for applying high forces up to 9.0 ± 0.2 N on target tissues without buckling. The catheter uses high-speed pressure waves to transfer high-force impulses through a slender flexible shaft consisted of a flat wire coil, a double braid, and a nylon outer coating. The handle allows for single-handed operation of the catheter with easy adjusting of the input impulse characteristic, including frequency (1-10 Hz), time and number of strokes using a solenoid actuator, and easy connection of an off-the-shelf inflator for catheter filling. In a proof-of-principle experiment, we illustrated that the Wave catheter was able to penetrate a phantom model of a coronary Chronic Total Occlusion (CTO) manufactured out of hydroxyapatite and gelatin. It was found that the time until puncture decreased from 80 ± 5.4 s to 7.8 ± 0.4 s, for a stroke frequency of 1-10 Hz, respectively. The number of strikes until puncture was approximately constant at 80 ± 5.4, 76.7 ± 2.6, and 77.7 ± 3.9 for the different stroke frequencies. With the development of the Wave catheter, first steps have been made toward high force application through slender shafts.

Subantral sinus augmentation using hydraulic lift system and alloplastic phosphosilicate putty followed by simultaneous implant placement for the rehabilitation of an atrophic posterior maxilla: A case report.

Background: Tooth extraction is generally accompanied by bone remodeling and pneumatization of the maxillary sinus in the posterior region of the maxilla, which can result in a reduction in the height and width of the bone and compromise the placement of the implant. However, this anatomic deficiency can be restored through maxillary sinus elevation. Among the various surgical methods used, the indirect sinus floor elevation technique is relatively less invasive and less complex. Aim: Herein, we present the case of a 58-year-old partially edentulous female who underwent rehabilitation of the right maxillary molar region using the indirect sinus floor elevation technique. The hydraulic lift system was used followed by immediate implant placement. Relevance for Patients: This technique incorporates the advantages of both the lateral wall and crestal approaches for sinus elevation and is associated with a lower incidence of sinus membrane perforation and minimum bone loss.

Piezoelectricity induced by pulsed hydraulic pressure enables in situ membrane demulsification and oil/water separation.

Recovering oil from oily wastewater is not only for economic gains but also for mitigating environmental pollution. However, demulsification of oil droplets stabilized with surfactants is challenging because of their low surface energy. Although the widely used oil/water separation membrane technologies based on size screening have attracted considerable attention in the past few decades, they are incapable of demulsification of stabilized oil emulsions and the membrane concentrates often require post-processing. Herein, the piezoelectric ceramic membrane (PCM), which can respond to the inherent transmembrane pressure in the pressure-driven membrane processes, was employed to transform hydraulic pressure pulses into electroactive responses to in situ demulsification. The pulsed transmembrane pressure on the PCM results in the generation of considerable rapid voltage oscillations over 3.2 V and a locally high electric field intensity of 7.2 × 107 V/m, which is capable of electrocoalescence with no additional stimuli or high voltage devices. Negative dielectrophoresis (DEP) force occurred in this membrane process and repelled the large size of oil after demulsification away from the PCM surface, ensuring continuous membrane demulsification and oil/water separation. Overall, PCM provides a further opportunity to develop an environmentally friendly and energy-saving electroresponsive membrane technology for practical applications in wastewater treatment.

Effectiveness of hydraulic pressure-assisted sinus augmentation in a rabbit sinus model: a preclinical study.

OBJECTIVES: To investigate the effectiveness of hydraulic pressure-assisted sinus augmentation (SA) in a rabbit sinus model in terms of radiographical and histological healing. MATERIALS AND METHODS: Bilateral SA was performed in 12 rabbits. Each sinus was randomly assigned to either a hydraulic pressure-assisted SA (test) or a conventional SA (control) group. Healing periods of 2 and 4 weeks were applied (n = 6 for each week). Healing pattern including newly formed bone (NB) and residual bone substitute material (RM) was analyzed with microcomputed tomographically, histologically, and histomorphometrically. RESULTS: No sinus membrane perforation was detected in either group. In the microcomputed tomographic analysis, the test group exhibited higher apico-coronal spread of RM compared to the control group (p < 0.05). Particularly, the test group exhibited several masses of NB out of the cluster of RM. Histologically, the test group showed an elongated shape of the augmented space, whereas the control group generally presented a dome shape. Histomorphometrically, the total augmented area and the area of NB (1.32 ± 0.56 vs. 0.84 ± 0.40 mm2 at 2 weeks, 2.24 ± 1.09 vs. 2.22 ± 0.85 mm2 at 4 weeks) were not significantly different between the test and the control groups at both healing periods (p > 0.05). CONCLUSION: Hydraulic pressure-assisted SA led to new bone formation in the distant areas from the bony access hole, but similar histological healing pattern to conventional SA. CLINICAL RELEVANCE: Hydraulic pressure-assisted SA is a promising option for treating pneumatized posterior maxilla.

The Selective Transport of Ions in Charged Nanopore with Combined Multi-Physics Fields.

The selective transport of ions in nanopores attracts broad interest due to their potential applications in chemical separation, ion filtration, seawater desalination, and energy conversion. The ion selectivity based on the ion dehydration and steric hindrance is still limited by the very similar diameter between different hydrated ions. The selectivity can only separate specific ion species, lacking a general separation effect. Herein, we report the highly ionic selective transport in charged nanopore through the combination of hydraulic pressure and electric field. Based on the coupled Poisson-Nernst-Planck (PNP) and Navier-Stokes (NS) equations, the calculation results suggest that the coupling of hydraulic pressure and electric field can significantly enhance the ion selectivity compared to the results under the single driven force of hydraulic pressure or electric field. Different from the material-property-based ion selective transport, this method endows the general separation effect between different kinds of ions. Through the appropriate combination of hydraulic pressure and electric field, an extremely high selectivity ratio can be achieved. Further in-depth analysis reveals the influence of nanopore diameter, surface charge density and ionic strength on the selectivity ratio. These findings provide a potential route for high-performance ionic selective transport and separation in nanofluidic systems.

An Improved Large-Scale Stress-Controlled Apparatus for Long-Term Seepage Study of Coarse-Grained Cohesive Soils.

Clay-gravel mixture has been widely used in high embankment dams and understanding its seepage characteristics is critical to dam safety. From the instrumental perspective, the realization of continuous pressurized water supply becomes a key technical challenge, significantly restricting the working conditions replicated in previous seepage apparatuses. To this end, a novel water provision system, relying on parallel-disposed sensor-based pressure devices, was introduced, so that the application of an existing large-scale stress-controlled apparatus can be expanded to long-term seepage tests regarding coarse-grained cohesive soils. Constant-head permeability tests were conducted on original-graded clay-gravel mixtures to investigate their hydraulic properties, incorporating the influence of stress relaxation. Test results show that with 35% gravel content, the clay-gravel mixture is suitable for dam construction as the core material. The stress relaxation holds a marginal effect on the hydraulic conductivity of soil. The functionality of this improved apparatus is verified, especially under long-term seepage conditions.

Ultrasonic vibration and thermo-hydrodynamic technique for filling root canals: Technical overview and a case series.

AIM: To present a novel root canal filling technique: Ultrasonic Vibration & Thermo-Hydrodynamic Obturation (VibraTHO), and its rationale with a series of cases. SUMMARY: The VibraTHO technique was used to fill the root canals of three clinically challenging cases: A C-shaped mandibular molar with complex anatomy, a C-shaped mandibular molar with an infected root canal system and a periapical lesion that required retreatment, and apically bifurcating mesiobuccal canals with a common orifice in a maxillary second molar. The cases were followed up for 15, 7 and 37 months, respectively. After follow-up, normal periapical status was observed without any noticeable radiographic change in the root canal fillings in each case. Periapical radiographs revealed complete healing of the periapical area in cases with pre-operative periapical lesions.

Theoretical Analysis of a Mathematical Relation between Driving Pressures in Membrane-Based Desalting Processes.

Osmotic and hydraulic pressures are both indispensable for operating membrane-based desalting processes, such as forward osmosis (FO), pressure-retarded osmosis (PRO), and reverse osmosis (RO). However, a clear relation between these driving pressures has not thus far been identified; hence, the effect of change in driving pressures on systems has not yet been sufficiently analyzed. In this context, this study formulates an actual mathematical relation between the driving pressures of membrane-based desalting processes by taking into consideration the presence of energy loss in each driving pressure. To do so, this study defines the pseudo-driving pressures representing the water transport direction of a system and the similarity coefficients that quantify the energy conservation rule. Consequently, this study finds three other theoretical constraints that are required to operate membrane-based desalting processes. Furthermore, along with the features of the similarity coefficients, this study diagnoses the commercial advantage of RO over FO/PRO and suggests desirable optimization sequences applicable to each process. Since this study provides researchers with guidelines regarding optimization sequences between membrane parameters and operational parameters for membrane-based desalting processes, it is expected that detailed optimization strategies for the processes could be established.

A Theoretical Analysis of Relations between Pressure Changes along Xylem Vessels and Propagation of Variation Potential in Higher Plants.

Variation potential (VP) is an important long-distance electrical signal in higher plants that is induced by local damages, influences numerous physiological processes, and participates in plant adaptation to stressors. The transmission of increased hydraulic pressure through xylem vessels is the probable mechanism of VP propagation in plants; however, the rates of the pressure transmission and VP propagation can strongly vary. We analyzed this problem on the basis of a simple mathematical model of the pressure distribution along a xylem vessel, which was approximated by a tube with a pressure gradient. It is assumed that the VP is initiated if the integral over pressure is more than a threshold one, taking into account that the pressure is transiently increased in the initial point of the tube and is kept constant in the terminal point. It was shown that this simple model can well describe the parameters of VP propagation in higher plants, including the increase in time before VP initiation and the decrease in the rate of VP propagation with an increase in the distance from the zone of damage. Considering three types of the pressure dynamics, our model predicts that the velocity of VP propagation can be stimulated by an increase in the length of a plant shoot and also depends on pressure dynamics in the damaged zone. Our results theoretically support the hypothesis about the impact of pressure variations in xylem vessels on VP propagation.

Lymphatic Vessels and Their Surroundings: How Local Physical Factors Affect Lymph Flow.

Lymphatic vessels drain and propel lymph by exploiting external forces that surrounding tissues exert upon vessel walls (extrinsic mechanism) and by using active, rhythmic contractions of lymphatic muscle cells embedded in the vessel wall of collecting lymphatics (intrinsic mechanism). The latter mechanism is the major source of the hydraulic pressure gradient where scant extrinsic forces are generated in the microenvironment surrounding lymphatic vessels. It is mainly involved in generating pressure gradients between the interstitial spaces and the vessel lumen and between adjacent lymphatic vessels segments. Intrinsic pumping can very rapidly adapt to ambient physical stimuli such as hydraulic pressure, lymph flow-derived shear stress, fluid osmolarity, and temperature. This adaptation induces a variable lymph flow, which can precisely follow the local tissue state in terms of fluid and solutes removal. Several cellular systems are known to be sensitive to osmolarity, temperature, stretch, and shear stress, and some of them have been found either in lymphatic endothelial cells or lymphatic muscle. In this review, we will focus on how known physical stimuli affect intrinsic contractility and thus lymph flow and describe the most likely cellular mechanisms that mediate this phenomenon.

The importance of water and hydraulic pressure in cell dynamics.

All mammalian cells live in the aqueous medium, yet for many cell biologists, water is a passive arena in which proteins are the leading players that carry out essential biological functions. Recent studies, as well as decades of previous work, have accumulated evidence to show that this is not the complete picture. Active fluxes of water and solutes of water can play essential roles during cell shape changes, cell motility and tissue function, and can generate significant mechanical forces. Moreover, the extracellular resistance to water flow, known as the hydraulic resistance, and external hydraulic pressures are important mechanical modulators of cell polarization and motility. For the cell to maintain a consistent chemical environment in the cytoplasm, there must exist an intricate molecular system that actively controls the cell water content as well as the cytoplasmic ionic content. This system is difficult to study and poorly understood, but ramifications of which may impact all aspects of cell biology from growth to metabolism to development. In this Review, we describe how mammalian cells maintain the cytoplasmic water content and how water flows across the cell surface to drive cell movement. The roles of mechanical forces and hydraulic pressure during water movement are explored.

Nonlinear Hydraulic Pressure Response of an Improved Fiber Tip Interferometric High-Pressure Sensor.

We demonstrate a silica diaphragm-based fiber tip Fabry-Perot interferometer (FPI) for high-pressure (40 MPa) sensing. By using a fiber tip polishing technique, the thickness of the silica diaphragm could be precisely controlled and the pressure sensitivity of the fabricated FPI sensor was enhanced significantly by reducing the diaphragm thickness; however, the relationship between the pressure sensitivity and diaphragm thickness is not linear. A high sensitivity of -1.436 nm/MPa and a linearity of 0.99124 in hydraulic pressure range of 0 to 40 MPa were demonstrated for a sensor with a diaphragm thickness of 4.63 µm. The achieved sensitivity was about one order of magnitude higher than the previous results reported on similar fiber tip FPI sensors in the same pressure measurement range. Sensors with a thinner silica diaphragm (i.e., 4.01 and 2.09 µm) rendered further increased hydraulic pressure sensitivity, but yield a significant nonlinear response. Two geometric models and a finite element method (FEM) were carried out to explain the nonlinear response. The simulation results indicated the formation of cambered internal silica surface during the arc discharge process in the fiber tip FPI sensor fabrication.

Novel trickling microbial fuel cells for electricity generation from wastewater.

There are two main challenges associated with the scale-up of air-cathode microbial fuel cells (MFCs): performance reduction and cathode leakage/flooding. In this study, a novel 13.4 L reactor that contains 4 tubular MFCs was designed and operated in a trickling mode for 65 days under different conditions. The trickling water flow through the horizontally aligned MFCs alleviated the hydraulic pressure applied to the air-cathodes. With a total cathode working area of over 1700 cm2, this reactor generated power densities up to 1 W/m2 with coulombic efficiencies over 50% using acetate. Using a brewery waste stream as carbon source, an average power density of 0.27 W/m2 was generated with ∼60% COD removal at hydraulic retention time of 1.6 h. The decent performance of this reactor compared with other air-cathode MFCs at the similar scale and the alleviated hydraulic pressure on air-cathodes demonstrate the great potential of this design and operation for future MFC optimization and scaling up.

Influence of Hydraulic Pressure on Performance Deterioration of Direct Contact Membrane Distillation (DCMD) Process.

Direct contact membrane distillation (DCMD) is a membrane distillation (MD) configuration where feed and distillate directly contact with a hydrophobic membrane. Depending on its operating conditions, the hydraulic pressures of the feed and distillate may be different, leading to adverse effects on the performance of the DCMD process. Nevertheless, little information is available on how hydraulic pressure affects the efficiency of DCMD. Accordingly, this paper investigates the effect of external hydraulic pressure on the process efficiency of DCMD. Gas permeabilities of MD membranes were measured to analyze the effect of membrane compaction by external pressure. Mass transfer coefficients were calculated using experimental data to quantitatively explain the pressure effect. Experiments were also carried out using a laboratory-scale DCMD set-up. After applying the pressure, the cross-sections and surfaces of the membranes were examined using a scanning electron microscope (SEM). Results showed that the membrane structural parameters such as porosity and thickness were changed under relatively high pressure conditions (>30 kPa), leading to reduction in flux. The mass transfer coefficients were also significantly influenced by the hydraulic pressure. Moreover, local wetting of the membranes were observed even below the liquid entry pressure (LEP), which decreased the rejection of salts. These results suggest that the control of hydraulic pressure is important for efficient operation of DCMD process.

Clinical comparison between a percutaneous hydraulic pressure delivery system and balloon tamp system using high-viscosity cement for the treatment of osteoporotic vertebral compression fractures

OBJECTIVES: Osteoporotic vertebral compression fractures (OVCFs) affect the elderly population, especially postmenopausal women. Percutaneous kyphoplasty is designed to treat painful vertebral compression fractures for which conservative therapy has been unsuccessful. High-viscosity cement can be injected by either a hydraulic pressure delivery system (HPDS) or a balloon tamp system (BTS). Therefore, the purpose of this study was to compare the safety and clinical outcomes of these two systems. METHODS: A random, multicenter, prospective study was performed. Clinical and radiological assessments were carried out, including assessments of general surgery information, visual analog scale, quality of life, cement leakage, and height and angle restoration. RESULTS: Using either the HPDS or BTS to inject high-viscosity cement effectively relieved pain and improved the patients' quality of life immediately, and these effects lasted at least two years. The HPDS using high-viscosity cement reduced cost, surgery time, and radiation exposure and showed similar clinical results to those of the BTS. In addition, the leakage rate and the incidence of adjacent vertebral fractures after the HPDS treatment were reduced compared with those after treatment using the classic vertebroplasty devices. However, the BTS had better height and angle restoration abilities. CONCLUSIONS: The percutaneous HPDS with high-viscosity cement has similar clinical outcomes to those of traditional procedures in the treatment of vertebral fractures in the elderly. The HPDS with high-viscosity cement is better than the BTS in the treatment of mild and moderate OVCFs and could be an alternative method for the treatment of severe OVCFs.

Intracellular Pressure: A Driver of Cell Morphology and Movement.

Intracellular pressure, generated by actomyosin contractility and the directional flow of water across the plasma membrane, can rapidly reprogram cell shape and behavior. Recent work demonstrates that cells can generate intracellular pressure with a range spanning at least two orders of magnitude; significantly, pressure is implicated as an important regulator of cell dynamics, such as cell division and migration. Changes to intracellular pressure can dictate the mechanisms by which single human cells move through three-dimensional environments. In this review, we chronicle the classic as well as recent evidence demonstrating how intracellular pressure is generated and maintained in metazoan cells. Furthermore, we highlight how this potentially ubiquitous physical characteristic is emerging as an important driver of cell morphology and behavior.