WorldWideScience

Sample records for basal thumb prostheses

  1. The proprioception and neuromuscular stability of the basal thumb joint

    OpenAIRE

    Mobargha, Nathalie

    2015-01-01

    OBJECTIVES The basal thumb joint, or the first carpometacarpal joint (CMC1) is an enigmatic construction. The concavo-convex shape of the CMC1 and wide range of movement, allows for both precision and power grips and is particularly susceptible to the development of osteoarthritis. Previous theories regarding the development of CMC1 osteoarthritis have focused on the role of gender, excessive joint load and ligament laxity as causative factors. An emerging theory is the role o...

  2. Pre- and post-operative comorbidities in idiopathic carpal tunnel syndrome: cervical arthritis, basal joint arthritis of the thumb, and trigger digit.

    Science.gov (United States)

    Kim, J H; Gong, H S; Lee, H J; Lee, Y H; Rhee, S H; Baek, G H

    2013-01-01

    We retrospectively reviewed 633 hands in 362 patients who had idiopathic carpal tunnel syndrome and underwent carpal tunnel release between 1999 and 2009. Electrophysiological studies and simple radiographs of the wrist, cervical spine, and basal joint of the thumb were routinely checked, and patients were also assessed for the presence of trigger digit or de Quervain's disease before and after surgery. Among 362 patients, cervical arthritis was found in 253 patients (70%), and C5-C6 arthritis was the most common site. Basal joint arthritis of the thumb was observed in 216 (34%) of the 633 hands. Trigger digit or de Quervain's disease was observed in 85 of the 633 hands (13%) before surgery, and developed in 67 hands (11%) after surgery. Cervical arthritis, basal joint arthritis, and trigger digit commonly coexist with idiopathic carpal tunnel syndrome. Patient education about these disorders is very important when they coexist with idiopathic carpal tunnel syndrome.

  3. New basal iguanodonts from the Cedar Mountain formation of Utah and the evolution of thumb-spiked dinosaurs.

    Directory of Open Access Journals (Sweden)

    Andrew T McDonald

    Full Text Available BACKGROUND: Basal iguanodontian dinosaurs were extremely successful animals, found in great abundance and diversity almost worldwide during the Early Cretaceous. In contrast to Europe and Asia, the North American record of Early Cretaceous basal iguanodonts has until recently been limited largely to skulls and skeletons of Tenontosaurus tilletti. METHODOLOGY/PRINCIPAL FINDINGS: Herein we describe two new basal iguanodonts from the Yellow Cat Member of the Cedar Mountain Formation of eastern Utah, each known from a partial skull and skeleton. Iguanacolossus fortis gen. et sp. nov. and Hippodraco scutodens gen. et sp. nov. are each diagnosed by a single autapomorphy and a unique combination of characters. CONCLUSIONS/SIGNIFICANCE: Iguanacolossus and Hippodraco add greatly to our knowledge of North American basal iguanodonts and prompt a new comprehensive phylogenetic analysis of basal iguanodont relationships. This analysis indicates that North American Early Cretaceous basal iguanodonts are more basal than their contemporaries in Europe and Asia.

  4. Skiers thumb - aftercare

    Science.gov (United States)

    ... thumb; Ulnar collateral ligament injury; Gamekeeper's thumb References Safran MA, Zachazewski J, Stone DA. Ulnar collateral ligament ... of the thumb (gamekeeper's or skier's thumb). In: Safran MA, Zachazewski J, Stone DA. Instructions for Sports ...

  5. [Triphalangeal thumb].

    Science.gov (United States)

    Fernández-Vázquez, Juan Manuel; Schenk-Palao, Josef; Fernández-Palomo, Justino; Camacho-Galindo, Javier

    2003-01-01

    Triphalangeal thumb is often thought to be a rare congenital abnormality; it has an incidence of 1 in 25,000 births. We reviewed 49 triphalangeal thumbs in 28 Mexico City patients at the Diaz Lombardo Hospital from 1974 to 1979, Shriners Hospital from 1979 to 1982, Instituto Nacional de Ortopedia from 1981 to 1982, and at the ABC Hospital from 1971 to 1998. A total of 21 patients (75%) had bilateral deformity. Patients were classified according to Dieter Buck-Gramcko system and Müller teratologic line. All were surgically treated and evaluated with Cheng graduation scale, finding good results in 48 patients (97%), fair results in one (3%), and no poor results.

  6. Penile prostheses

    OpenAIRE

    2010-01-01

    Penile prosthesis implantation is recognized as a valid option to obtain an artificial erection satisfactory for sexual intercourse in those patients in which a pharmacological approach is contraindicated or ineffective. Penile prostheses are subbject to continuous development and they are achieving ever better mechanical reliability and safety. The devices are divided into two g...

  7. Penile prostheses.

    Science.gov (United States)

    Bettocchi, Carlo; Palumbo, Fabrizio; Spilotros, Marco; Palazzo, Silvano; Saracino, Gabriele A; Martino, Pasquale; Battaglia, Michele; Selvaggi, Francesco P; Ditonno, Pasquale

    2010-02-01

    Penile prosthesis implantation is recognized as a valid option to obtain an artificial erection satisfactory for sexual intercourse in those patients in which a pharmacological approach is contraindicated or ineffective. Penile prostheses are subbject to continuous development and they are achieving ever better mechanical reliability and safety. The devices are divided into two general types: semirigid (malleable and mechanical) and inflatables. The AMS® (American Medical Systems) and Coloplast Ltd® produce the majority of inflatable and semirigid devices.Malleable and mechanical prostheses have the disadvantage that the penis is always erect although it can be orientated in different ways, while the advantages are ease of use and the need for a simpler surgical procedure compared with inflatable prostheses. Three-component prostheses are more sophisticated than semirigid devices. The advantages of these devices are that the prosthesis feels softer than semirigid or two-piece devices when deflated, with a better cosmetic result, and it ensures a more natural erection than others kinds of prosthesis. The disadvantages are the possibility of malfunction and the need for a more complicated surgical technique. Implantation of a penile prosthesis can be performed in a short surgical time under locoregional anaesthesia, and for this reason hospitalization is usually brief and the patient can be discharged 2 days after the operation if complications are not evident. Patient and partner satisfaction reflect the quality and the effectiveness of this treatment. Even though the results are positive in the vast majority of patients, the possibility of several complications makes penile prosthesis implantation a delicate kind of surgery. Complications can happen when the operation is carried out, in the peri-operative and in the postoperative period, and include infections, erosions of the prosthesis and mechanical failure in case of inflatable prosthesis. Penile prostheses

  8. A large thumb mass.

    Science.gov (United States)

    Shah, Amit K; Macnair, Rory; Figus, Andrea

    2012-02-01

    A 31-year-old man presented with a 5-year history of a spontaneously occurring soft tissue mass on the palmar aspect of his left non dominant thumb. Over 5 months he was having progressive difficulty flexing at the interphalangeal joint. Magnetic resonance imaging demonstrated an heterogeneously enhancing soft tissue mass likely to be either a peripheral fibromatosis or giant cell tumour of the flexor tendon (Figure 1). Intraoperatively a large neuroma in continuity with the ulnar digital nerve was found and debulked (Figure 2). The diagnosis was confirmed histologically.

  9. Case Reports: Thumb Reconstruction Using Amputated Fingers

    OpenAIRE

    Hoang, Nguyen T.; Staudenmaier, R.; Hoehnke, C.

    2008-01-01

    Reconstruction of an irreparably amputated thumb in multiple digit amputations using amputated fingers can considerably improve hand function and allows creation of a newly transplanted thumb with acceptable cosmetic and functional attributes. However, the surgery is challenging and rarely reported. We report six cases using this procedure in patients with crushed thumbs unsuitable for replantation. In four of the patients, the remnant of the index finger was replanted on the thumb stump and ...

  10. Thumb injuries in downhill skiing.

    Science.gov (United States)

    Engkvist, O; Balkfors, B; Lindsjö, U

    1982-02-01

    Thumb injuries are next to knee injuries the most common injury in downhill skiing today. In this material they constituted 17% of all skiing injuries. Three-fourths of the thumb injuries were lesions of the ulnar collateral ligament of the metacarpophalangeal joint. Compared to a control population consisting of 1619 randomly chosen uninjured skiers, we found that no type of ski pole handle in common use today eliminated the risk of thumb injury, but the injury frequency was higher when using a ski pole with a big plate on the top of the handle. It was, however, of no importance how the skier gripped the ski pole in relation to the strap. It is suggested that the skier during a fall holds on to the ski pole until the very last moment before the hand hits the ground. The ski pole handle then remains in the hand and constitutes the hypomochlium that forces the thumb into abduction and extension, which causes the typical ulnar collateral ligament injury.

  11. Passive hand prostheses.

    Science.gov (United States)

    Soltanian, Hooman; de Bese, Genevieve; Beasley, Robert W

    2003-02-01

    For many mangled hands, appropriately designed passive prostheses now available, alone or in conjunction with surgical reconstruction, can offer the best available improvement, provided they are of high quality and backed by prompt and reliable after-delivery services. Invariably, there is improvement in physical capability along with restoration of good social presentation.

  12. Treatment of thumb carpometacarpal osteoarthritis; quo vadis?

    NARCIS (Netherlands)

    Spaans, AJ

    2016-01-01

    The unique prehensile ability of the human hand is largely due to the biomechanical function of its complex first carpometacarpal (CMC1) joint. This makes the thumb the most important digit of the hand. The unique demands placed on the thumb regarding mobility, stability and transmission of force ma

  13. Case reports: thumb reconstruction using amputated fingers.

    Science.gov (United States)

    Hoang, Nguyen T; Staudenmaier, R; Hoehnke, C

    2008-08-01

    Reconstruction of an irreparably amputated thumb in multiple digit amputations using amputated fingers can considerably improve hand function and allows creation of a newly transplanted thumb with acceptable cosmetic and functional attributes. However, the surgery is challenging and rarely reported. We report six cases using this procedure in patients with crushed thumbs unsuitable for replantation. In four of the patients, the remnant of the index finger was replanted on the thumb stump and in another two patients, an amputated middle finger and ring finger were used. The patients had a minimum followup of 12 months (mean, 18 months; range, 12-45 months). All newly transplanted thumbs survived resulting in the patients having satisfactory postoperative hand function and appearance.

  14. Dhyana-thumb-pus hing Manipulation

    Institute of Scientific and Technical Information of China (English)

    SHEN Guo-quan; CUI Xue-jun

    2003-01-01

    @@ The dhyana-thumb-pushing manipulation is the chief one inthe Dhyana Thumb Tuina School; it's also a characteristic manipulation and plays an important role in the TCM Tuina teaching and clinical treatment. The name came from Jingdechuanzhonglu() and was used in the Chan sect of Buddhism. According to the book, in Song Dynansty, Judi Buddhist Monk asked Tianlong Buddhist Monk for the dhyana. Tianlong erected a finger but said nothing, Judi deeply comprehended the dhyana. Later on, if someone asked him for the Buddhism doctrine, he did the same act. Before Judi died, he said: "I accepted a thumb Dhyana from Tianlong and benefited from it all my life."

  15. Toward a Phonetic Representation of Hand Configuration: The Thumb

    Science.gov (United States)

    Johnson, Robert E.; Liddell, Scott K.

    2012-01-01

    In this article, we present a system for the representation of the configurations of the thumb in the hand configurations of signed languages and for the interactions of the thumb with the four fingers proper. The configuration of the thumb is described as a componential combination of the descriptions of thumb opposition, abduction of the CM…

  16. On the classification of congenital thumb hypoplasia.

    Science.gov (United States)

    Tonkin, M A

    2014-11-01

    In 1937, Müller introduced the concept of a teratological sequence of thumb hypoplasia with increasing severity from mild deficiency, through severe deficiency, to thumb absence. Blauth subsequently detailed five specific grades. In 1992, Manske and McCarroll altered Blauth's classification such that Grade 3 was sub-divided into Grades 3A and 3B, according to a presence or absence of the proximal metacarpal. Buck-Gramcko added a Grade 3C in which there was only a remnant metacarpal head. This article investigates their publications and those of others to identify 'who said what' and clarify the definitions of grades of thumb hypoplasia. A modification of Blauth's classification is proposed, which retains the integrity of the concept of Müller and the skeletal and soft tissue grading of Blauth, but which also incorporates the disparate anomalies that may present in Grades 2 and 3 hypoplastic thumbs.

  17. Motion Analysis of Thumb in Cellular Phone Use

    Directory of Open Access Journals (Sweden)

    Naotaka Sakai

    2010-01-01

    Full Text Available The thumb motion of 10 normal subjects during cellular phone use was measured using a reflective marker detection system to compare the maximum, minimum and range of flexion angles of the interphalangeal (IP, metacarpophalangeal (MP and carpometacarpal (CM joints. Two micro-reflective markers 3 mm in diameter were each placed on the dorsal surface of the distal phalanx, basal phalanx and metacarpal bone of the thumb. Three markers were placed on the dorsal hand in order to define the dorsal hand plane. Each subject pushed the 12 keys of a folding cellular phone with an 85-mm-long and 40-mm-wide keypad, sequentially from ‘1’ to ‘#’, and the pushing motion was recorded by six infrared video cameras for 12 seconds, using the VICON 612 system. The mean maximum flexion angle of the MP joint was significantly (p < .05 larger than the CM joint, and the mean minimum flexion angle of the CM joint was significantly (p < .01 smaller than the IP and MP joints. The mean range of motion of the IP joint was significantly (p < .05 larger than the MP and the CM joints. In a comparison of different key-pushing motions, only the CM joint was significantly (p < .05 larger in its range of motion. In conclusion, thumb motion on pushing the keys of the cellular phone was produced mainly by the MP and the CM joints. In addition, the ability to reach keys in different areas of the cellular phone keypad is regulated by changing the flexion angle of the CM joint.

  18. Hypoplastic thumb type IIIB: An alternative method for surgical repair

    Directory of Open Access Journals (Sweden)

    Salih Onur Basat

    2014-08-01

    Full Text Available Hypoplastic thumb is the second most common congenital deformity of the thumb. Thumb hypoplasia is characterized by diminished thumb size, metacarpal adduction, metacarpophalangeal joint instability, and thenar muscle hypoplasia. In the literature, different classification types of hypoplastic thumb have been used and different treatment methods described. In this case we presented an alternative palliative treatment method for a ten-year-old patient with modified Blauth's classification type IIIB hypoplastic thumb and one-year follow-up results. [Hand Microsurg 2014; 3(2.000: 59-61

  19. MR imaging findings of trigger thumb

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Eric Y.; Chen, Karen C.; Chung, Christine B. [VA San Diego Healthcare System, Radiology Service, San Diego, CA (United States); University of California, San Diego Medical Center, Department of Radiology, San Diego, CA (United States)

    2015-08-15

    Trigger finger (or trigger thumb), also known as sclerosing tenosynovitis, is a common clinical diagnosis that rarely presents for imaging. Because of this selection bias, many radiologists may not be familiar with the process. Furthermore, patients who do present for imaging frequently have misleading examination indications. To our knowledge, magnetic resonance (MR) imaging findings of trigger thumb have not been previously reported in the literature. In this article, we review the entity of trigger thumb, the anatomy involved, and associated imaging findings, which include flexor pollicis longus tendinosis with a distinct nodule, A1 pulley thickening, and tenosynovitis. In addition, in some cases, an abnormal Av pulley is apparent. In the rare cases of trigger finger that present for MR imaging, accurate diagnosis by the radiologist can allow initiation of treatment and avoid further unnecessary workup. (orig.)

  20. Osseointegrated prostheses for rehabilitation following amputation : The pioneering Swedish model.

    Science.gov (United States)

    Li, Yan; Brånemark, Rickard

    2017-04-01

    The direct attachment of osseointegrated (OI) prostheses to the skeleton avoids the inherent problems of socket suspension. It also provides physiological weight bearing, improved range of motion in the proximal joint, as well as osseoperceptive sensory feedback, enabling better control of the artificial limbs by amputees. The present article briefly reviews the pioneering efforts on extremity osseointegration surgeries in Sweden and the development of the OPRA (Osseointegrated Prostheses for the Rehabilitation of Amputees) program. The standard implant design of the OPRA system and surgical techniques are described as well as the special rehabilitation protocols based on surgical sites. The results of long-term follow-up for transradial, transhumeral, and thumb amputee operations are briefly reported including the prospective study of transfemoral amputees according to OPRA protocol. The importance of refinement on implant designs and surgical techniques based on the biomechanical analysis and early clinical trials is emphasized. Future aspects on osseointegration surgery are briefly described, including novel treatment options using implanted electrodes.

  1. [Technologies for cardiac valve prostheses].

    Science.gov (United States)

    Nakano, Kiyoharu

    2009-07-01

    To show the technological development of cardiac valve prostheses, a historical review of both mechanical and biological valve prostheses and a current overview of modern cardiac valve devices are provided. Scince the 1st implantation of Starr-Edwards ball valve in 1960, both mechanical and biological valve prostheses have advanced. The valve design, the material of the leaflet and the hausing of mechanical prostheses have improved. Currently, the majority of the mechanical prostheses are bileaflet tilting disc valves made of pyrolytic carbon, which is antithromboembolic. However, anticoagulation therapy with warfarin is still required. As for the bioprostheses, although the fixation and anti-mineralization methods of the tissues improved, the durability of these valves is still limited. For the material of the current biological valves, the porcine aortic valve or bovine pericardium are used. The tissues are fixed by non-pressure or low-pressure method in glutaraldehyde solution. A stented and non-stented valves are available. Epoch-making events in this field are the implantation of new bioprosthetic valves using tissue engineering methods and the development of the transcatheter valve replacement therapies.

  2. Prosthetic Rehabilitation of Amputated Thumb: A Simplified Approach

    OpenAIRE

    2013-01-01

    This case report presents a case of prosthetic rehabilitation of an amputated thumb. It emphasizes that prosthetic replacement is a better option for aesthetic and psychological improvement, particularly in cases where the victim is unwilling to undergo complicated surgical procedures for reconstruction of thumb or where functioning of thumb cannot be restored even by multiple surgeries. In the present case, a 20 years old female patient, with missing thumb of her right hand was rehabilitated...

  3. Combined free toe and free deep inferior epigastric perforator flap for reconstruction of the thumb and thumb web space.

    Science.gov (United States)

    Li, X J; Tong, J; Wang, Y

    2000-08-01

    To repair a complexly injured hand with composite loss of the thumb and the thumb web space in one stage, the combined transfer of a free second toe and a free deep inferior epigastric perforator flap was designed. It was used to simultaneously reconstruct the thumb and thumb web space of the injured hand in five cases. All flaps survived and there were no complications at any donor site after the reconstructions. In follow-up averaging 35.6 months, the final functional and cosmetic outcomes of the reconstructed thumbs and thumb web spaces were satisfactory. Results demonstrated that the combined transfer of a free second toe and a free deep inferior epigastric perforator flap is a valid method for simultaneous reconstruction of the thumb and the thumb web space of the injured hand.

  4. Management of osteoarthrosis of the thumb joints.

    Science.gov (United States)

    Berger, Aaron J; Meals, Roy A

    2015-04-01

    We present current concepts and evidence to optimize diagnosis and management of osteoarthritis in the thumb joints. Numerous options and controversies exist for surgical treatment of carpometacarpal joint arthritis. Fewer options exist for metacarpophalangeal joint arthritis. Surgical treatment for interphalangeal arthritis is mainly arthrodesis.

  5. Problematic rules of thumb; Problematische Faustregeln

    Energy Technology Data Exchange (ETDEWEB)

    Petzold, Katrin

    2010-07-01

    Following rules of thumb may lead to underdimensioning of current inverters, as is illustrated here by the example of the German city of Nuremberg. The effect is even more significant on cloudy days when solar radiation may often be even more intensive. (orig.)

  6. Microbial biofilms on silicone facial prostheses

    NARCIS (Netherlands)

    Ariani, Nina

    2015-01-01

    Facial disfigurements can result from oncologic surgery, trauma and congenital deformities. These disfigurements can be rehabilitated with facial prostheses. Facial prostheses are usually made of silicones. A problem of facial prostheses is that microorganisms can colonize their surface. It is hard

  7. Marloye's harp and the thumb piano

    Science.gov (United States)

    Greenslade, Thomas B.

    2001-05-01

    This note has two sources: a 19th-century textbook illustration and the thumb pianos sold to tourists during my time at the University of West Indies in Jamaica in 1972-73. Both of these instruments produce sounds: one by setting bars into longitudinal vibrations, and the other using transverse vibrations. This note will show how the lengths of the bars to produce the same note are very different in the two cases.

  8. Amputation and prostheses in Khartoum.

    Science.gov (United States)

    Mohamed, I A; Ahmed, A R; Ahmed, M E

    1997-08-01

    One hundred and seventy patients with major lower limb amputation (MLLA) presenting to The National Prosthetic-Orthotic Centre (NPOC) in Khartoum over a 1-year period were studied. There were 141 males and 29 females giving a M:F ratio of 4.9: 1.0, with mean age of 37 years (range 5-72 years). Forty-one patients (24%) underwent amputation of diabetic septic foot, 30 patients (17.6%) underwent amputation as a result of trauma from road traffic accidents and Madura foot, and war injuries accounted for 29 amputations (17%). One hundred and eleven patients had below knee amputation (BKA), 52 had above knee amputation (AKA) and seven patients had Syme's amputation. Diabetic amputees had higher rate of revisional surgery compared with others because of sepsis and/or flap necrosis. Stump pain was reported by amputees with excessive scarring of the stump and those with undue prominence of bony ends. There are two types of prostheses provided by the NPOC for both BKA and AKA: the peg leg and the conventional prostheses. The Syme's amputees were fitted with either simple hoof or articulated prostheses with solid ankle cushion heel (SACH). The peg leg consists of a leather lined side bearing metal socket connected to a rocker base by side steels. It is used by the country natives as it suits different weather and job conditions, particularly farming, and it can be repaired locally. The urban population use the conventional prostheses which is lighter in weight, can be put on and taken off easily and is cosmetically acceptable. However, these prostheses are more expensive and require frequent repair or replacement. The functional outcome of patient's rehabilitation with the prostheses was significantly affected by the level and indication of amputation. Those with BKA and those amputated because of trauma or Madura foot experienced better functional outcome compared with the diabetics, independent of age. 50% of patients with the AKA and 19% of those with BKA reported poor

  9. Tracing the origin of the panda's thumb

    Science.gov (United States)

    Abella, Juan; Pérez-Ramos, Alejandro; Valenciano, Alberto; Alba, David M.; Ercoli, Marcos D.; Hontecillas, Daniel; Montoya, Plinio; Morales, Jorge

    2015-06-01

    We investigate the relative development of the carnivoran radial sesamoids to untangle the evolution of this iconic structure. In the pandas (both giant and red), this `false thumb' is known to perform a grasping role during bamboo feeding in both the red and giant pandas. An original locomotor role has been inferred for ailurids, but this remains to be ascertained for ursids. A large sample of radial sesamoids of Indarctos arctoides from the Miocene of Batallones-3 (Spain) indicates that this early ailuropodine bear displayed a relatively hypertrophied radial sesamoid, with a configuration more similar to that of the red panda and other carnivorans than to that of giant pandas. This false thumb is the first evidence of this feature in the Ursidae, which can be linked to a more herbivorous diet. Moreover, in the two extant pandas, the false thumb should not be interpreted as an anatomical convergence, but as an exaptive convergence regarding its use during the bamboo feeding, which changes the evolutionary view of this singular structure.

  10. Endoluminal vascular prostheses; Endoluminale Gefaessprothesen

    Energy Technology Data Exchange (ETDEWEB)

    Vorwerk, D. [Klinikum Ingolstadt (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Schuermann, K. [Technische Hochschule Aachen (Germany). Klinik fuer Radiologische Diagnostik

    2000-06-01

    Endoluminal vascular prostheses that can be implanted by percutaneous routes represent the most recent development in vascular interventional radiology. Various commercially available types of prosthesis are presented and the construction principles and applications are described. At present secure indications for the implantation of endoluminal prostheses are limited to the elimination of aneurysms and arteriovenous fistulae of the large vessels near the trunk in sections that do not cross a joint. The wide use in peripheral occlusive diseases cannot yet be recommended because confirmed data are not available. (orig.) [German] Endoluminale Gefaessprothesen, die perkutan implantierbar sind, stellen die juengste Entwicklung in der vaskulaeren interventionellen Radiologie dar. Verschiedene kommerziell erhaeltliche Prothesentypen werden vorgestellt, ihr Konstruktionsprinzip und ihre Applikation erlaeutert. Die gesicherten Indikationen zur endoluminalen Prothesenimplantation beschraenken sich zur Zeit auf die Ausschaltung von Aneurysmen und arteriovenoesen Fisteln der grossen stammnahen Gefaesse in nichtgelenkueberkreuzenden Abschnitten. Die breite Anwendung bei der peripheren Verschlusskrankheit hingegen kann nicht empfohlen werden, solange gesicherte Daten fehlen. (orig.)

  11. Cementless Hydroxyapatite Coated Hip Prostheses

    Directory of Open Access Journals (Sweden)

    Antonio Herrera

    2015-01-01

    Full Text Available More than twenty years ago, hydroxyapatite (HA, calcium phosphate ceramics, was introduced as a coating for cementless hip prostheses. The choice of this ceramic is due to its composition being similar to organic apatite bone crystals. This ceramic is biocompatible, bioactive, and osteoconductive. These qualities facilitate the primary stability and osseointegration of implants. Our surgical experience includes the implantation of more than 4,000 cementless hydroxyapatite coated hip prostheses since 1990. The models implanted are coated with HA in the acetabulum and in the metaphyseal area of the stem. The results corresponding to survival and stability of implants were very satisfactory in the long-term. From our experience, HA-coated hip implants are a reliable alternative which can achieve long term survival, provided that certain requirements are met: good design selection, sound choice of bearing surfaces based on patient life expectancy, meticulous surgical technique, and indications based on adequate bone quality.

  12. [Tracheostomy cannulas and voice prostheses].

    Science.gov (United States)

    Kramp, B; Dommerich, S

    2009-05-01

    Tracheostomy cannulas and voice prosthesis are mechanical aids for patients, who for different reasons underwent either tracheostomies or laryngectomies. In this review, indications, surgical procedures, and consequencies of the preceeding surgical intervention are reported for a better understanding of the specific requirements for the artificial aids. In spite of the increasing number of percutaneous dilatation tracheostomies, e. g. in intensive care units, a classical tracheostomy with epithelialized connections between trachea and skin still represents the method of choice for all cases, in which a longer lasting access to the trachea is requested. Special tubes made of different materials, offering different physical qualities are used to keep the tracheostomy open and guarantee an easy access to the lower respiratory tract. For each individual patient the most adequate device must be found out. Voice prostheses allow a fast and effective vocal rehabilitation after laryngectomy. As many models are on the market with differences in terms of material, principle and design of the underlying valve mechanism, size etc., again, in each individual patient the most suitable prosthesis has to be chosen. In combination with special heat and moisture exchangers (HME), such prostheses not only allow a good vocal but also pulmonary rehabilitation. The duration of such prostheses depend on material properties but also on formation of biofilms (mostly consisting of bacteria and fungi) that can destroy the valve mechanism. Whenever possible, and additional valve mechanism covering the opening of the tracheostomy should be used in order to avoid the necessity to close this opening manually during phonation. Each doctor taking care of patients with speech prostheses after laryngectomy should know exactly what to do in case the device fails or gets lost.

  13. An ergonomics study of thumb movements on smartphone touch screen.

    Science.gov (United States)

    Xiong, Jinghong; Muraki, Satoshi

    2014-01-01

    This study investigated the relationships between thumb muscle activity and thumb operating tasks on a smartphone touch screen with one-hand posture. Six muscles in the right thumb and forearm were targeted in this study, namely adductor pollicis, flexor pollicis brevis, abductor pollicis brevis (APB), abductor pollicis longus, first dorsal interosseous (FDI) and extensor digitorum. The performance measures showed that the thumb developed fatigue rapidly when tapping on smaller buttons (diameter: 9 mm compared with 3 mm), and moved more slowly in flexion-extension than in adduction-abduction orientation. Meanwhile, the electromyography and perceived exertion values of FDI significantly increased in small button and flexion-extension tasks, while those of APB were greater in the adduction-abduction task. This study reveals that muscle effort among thumb muscles on a touch screen smartphone varies according to the task, and suggests that the use of small touch buttons should be minimised for better thumb performance.

  14. Automatic tuning of myoelectric prostheses.

    Science.gov (United States)

    Bonivento, C; Davalli, A; Fantuzzi, C; Sacchetti, R; Terenzi, S

    1998-07-01

    This paper is concerned with the development of a software package for the automatic tuning of myoelectric prostheses. The package core consists of Fuzzy Logic Expert Systems (FLES) that embody skilled operator heuristics in the tuning of prosthesis control parameters. The prosthesis system is an artificial arm-hand system developed at the National Institute of Accidents at Work (INAIL) laboratories. The prosthesis is powered by an electric motor that is controlled by a microprocessor using myoelectric signals acquired from skin-surface electrodes placed on a muscle in the residual limb of the subject. The software package, Microprocessor Controlled Arm (MCA) Auto Tuning, is a tool for aiding both INAIL expert operators and unskilled persons in the controller parameter tuning procedure. Prosthesis control parameter setup and subsequent recurrent adjustments are fundamental for the correct working of the prosthesis, especially when we consider that myoelectric parameters may vary greatly with environmental modifications. The parameter adjustment requires the end-user to go to the manufacturer's laboratory for the control parameters setup because, generally, he/she does not have the necessary knowledge and instruments to do this at home. However, this procedure is not very practical and involves a waste of time for the technicians and uneasiness for the clients. The idea behind the MCA Auto Tuning package consists in translating technician expertise into an FLES knowledge database. The software interacts through a user-friendly graphic interface with an unskilled user, who is guided through a step-by-step procedure in the prosthesis parameter tuning that emulates the traditional expert-aided procedure. The adoption of this program on a large scale may yield considerable economic benefits and improve the service quality supplied to the users of prostheses. In fact, the time required to set the prosthesis parameters are remarkably reduced, as is the technician

  15. Myoelectric hand prostheses in very young children.

    Science.gov (United States)

    Egermann, Marcus; Kasten, Philip; Thomsen, Marc

    2009-08-01

    Myoelectric prostheses have generally been provided for adolescent or adult patients. The availability of smaller-sized electric hands has enabled the introduction of myoelectric prostheses to preschool children, mainly in the Scandinavian countries. This study evaluates the acceptance of myoelectric prostheses in 41 children with unilateral upper limb deficiency between the ages of two and five years. The prosthesis was used for an average time of 5.8 hours per day. The level of amputation was found to influence the acceptance rate. Furthermore, prosthetic use training by an occupational therapist is related to successful use of the prosthesis. The general drop-out rate in preschool children is very low compared to adults. Therefore, infants can profit from myoelectric hand prostheses. Since a correct indication and an intense training program significantly influence the acceptance rate, introduction of myoelectric prostheses to preschool children should take place at specialised centres with an interdisciplinary team.

  16. Prostheses

    Science.gov (United States)

    ... AS, Braunwald E, Kasper DL, et al (Eds). Harrison’s Principles of Internal Medicine , 17th ed. New York: McGraw-Hill Medical, 2008. Camp-Sorrell D, Hawkins RA. Clinical Manual for the Oncology Advanced Practice Nurse , Second Ed. ...

  17. Median nail dystrophy involving the thumb nail

    Directory of Open Access Journals (Sweden)

    Rahulkrishna Kota

    2016-01-01

    Full Text Available Median canaliform dystrophy of Heller is a rare entity characterized by a midline or a paramedian ridge or split and canal formation in nail plate of one or both the thumb nails. It is an acquired condition resulting from a temporary defect in the matrix that interferes with nail formation. Habitual picking of the nail base may be responsible for some cases. Histopathology classically shows parakeratosis, accumulation of melanin within and between the nail bed keratinocytes. Treatment of median nail dystrophy includes injectable triamcinalone acetonide, topical 0.1% tacrolimus, and tazarotene 0.05%, which is many a times challenging for a dermatologist. Psychiatric opinion should be taken when associated with the depressive, obsessive-compulsive, or impulse-control disorder. We report a case of 19-year-old male diagnosed as median nail dystrophy.

  18. TEFLON VS TITANIUM PROSTHESES IN STAPES SURGERY

    Directory of Open Access Journals (Sweden)

    Rajesh Vishwakarma

    2014-04-01

    Full Text Available BACKGROUND: Otosclerosis is one of the most leading causes of conductive hearing loss with intact tympanic membrane in adults. Stapes prostheses have seen many changes in its shape, design and material. Both Teflon and Titanium prostheses used in this study having different method of application are reviewed in detail. OBJECTIVE: To compare the outcomes of use of Teflon and Titanium prostheses in stapedotomy surgery in patients with conductive hearing loss. STUDY DESIGN: Prospective study SETTING: Tertiary referral centre METHODS: A prospective study of 50 patients of otosclerosis, who underwent stapedotomy at B.J.Medical College, Civil Hospital, Ahmedabad, with Teflon/Titanium prostheses, from June 2009-February 2012 was done. Follow up was done for a minimum period of 6 months. Revision cases were excluded. A comparison of prostheses was concluded by differences in AB (Air Bone Gap. RESULT: Postoperative ABG of 20db or less was seen in 96% in both groups. The mean postoperative ABGap was 8.2 dB and 11.5 dB for Teflon and Titanium group respectively. There was no statistically significance difference noted in ABGap between Teflon and Titanium pistons at 95% confidence limit at P<0.05. There was significant improvement of AC thresholds at each frequency except for above 4 kHz, in postoperative period. CONCLUSION: Both prostheses provide equal benefit to patients and there is no statistically significant difference between the uses of Teflon/Titanium prostheses. Long term results are still to be analyzed.

  19. Photodiode circuits for retinal prostheses.

    Science.gov (United States)

    Loudin, J D; Cogan, S F; Mathieson, K; Sher, A; Palanker, D V

    2011-10-01

    Photodiode circuits show promise for the development of high-resolution retinal prostheses. While several of these systems have been constructed and some even implanted in humans, existing descriptions of the complex optoelectronic interaction between light, photodiode, and the electrode/electrolyte load are limited. This study examines this interaction in depth with theoretical calculations and experimental measurements. Actively biased photoconductive and passive photovoltaic circuits are investigated, with the photovoltaic circuits consisting of one or more diodes connected in series, and the photoconductive circuits consisting of a single diode in series with a pulsed bias voltage. Circuit behavior and charge injection levels were markedly different for platinum and sputtered iridium-oxide film (SIROF) electrodes. Photovoltaic circuits were able to deliver 0.038 mC/cm(2) (0.75 nC/phase) per photodiode with 50- μm platinum electrodes, and 0.54-mC/cm(2) (11 nC/phase) per photodiode with 50-μ m SIROF electrodes driven with 0.5-ms pulses of light at 25 Hz. The same pulses applied to photoconductive circuits with the same electrodes were able to deliver charge injections as high as 0.38 and 7.6 mC/cm(2) (7.5 and 150 nC/phase), respectively. We demonstrate photovoltaic stimulation of rabbit retina in-vitro, with 0.5-ms pulses of 905-nm light using peak irradiance of 1 mW/mm(2). Based on the experimental data, we derive electrochemical and optical safety limits for pixel density and charge injection in various circuits. While photoconductive circuits offer smaller pixels, photovoltaic systems do not require an external bias voltage. Both classes of circuits show promise for the development of high-resolution optoelectronic retinal prostheses.

  20. Inverse Kinematic Analysis of Human Hand Thumb Model

    Science.gov (United States)

    Toth-Tascau, Mirela; Pater, Flavius; Stoia, Dan Ioan; Menyhardt, Karoly; Rosu, Serban; Rusu, Lucian; Vigaru, Cosmina

    2011-09-01

    This paper deals with a kinematic model of the thumb of the human hand. The proposed model has 3 degrees of freedom being able to model the movements of the thumb tip with respect to the wrist joint centre. The kinematic equations are derived based on Denavit-Hartenberg Convention and solved in both direct and inverse way. Inverse kinematic analysis of human hand thumb model reveals multiple and connected solutions which are characteristic to nonlinear systems when the number of equations is greater than number of unknowns and correspond to natural movements of the finger.

  1. Neuro-based Thumb-tip Force and Joint Angle Modelling for Development of Prosthetic Thumb Control

    Directory of Open Access Journals (Sweden)

    Nor Anija Jalaludin

    2013-10-01

    Full Text Available Human fingers have a specific role that contributes to different hand functions. Among these fingers, the thumb plays the most special function as an anchor to many hand activities. As a result, the loss of the thumb due to traumatic accidents can be catastrophic as proper hand function will be severely limited. In order to solve this problem, a prosthetic thumb is developed to be worn in complementing the function of the rest of the fingers. The movement of the prosthetic device can be naturally controlled by using electromyogram (EMG signals. In this work, the EMG signals from the human muscles were measured in different thumb configurations and thumb-tip forces in flexion movement. The muscles involved are the Adductor Pollicis (AP, Flexor Pollicis Brevis (FPB, Abductor Pollicis Brevis (APB and First Dorsal Interosseous (FDI. The classification of the EMG signals based on different force and thumb configurations is performed using an Artificial Neural Network (ANN. From a series of experiments, the results show that the neural network efficiently classified the signals and a unique set of EMG signals was generated for each thumb movement and force. Therefore, EMG signals were used to control the prosthetic movement with aid from the developed neural network.

  2. Visual Prostheses: Technological and Socioeconomic Challenges

    Directory of Open Access Journals (Sweden)

    John B. Troy

    2015-09-01

    Full Text Available Visual prostheses are now entering the clinical marketplace. Such prostheses were originally targeted for patients suffering from blindness through retinitis pigmentosa (RP. However, in late July of this year, for the first time a patient was given a retinal implant in order to treat dry age-related macular degeneration. Retinal implants are suitable solutions for diseases that attack photoreceptors but spare most of the remaining retinal neurons. For eye diseases that result in loss of retinal output, implants that interface with more central structures in the visual system are needed. The standard site for central visual prostheses under development is the visual cortex. This perspective discusses the technical and socioeconomic challenges faced by visual prostheses.

  3. Basal Cell Carcinoma

    Science.gov (United States)

    ... Kids’ zone Video library Find a dermatologist Basal cell carcinoma Overview Basal cell carcinoma: This skin cancer ... that has received years of sun exposure. Basal cell carcinoma: Overview Basal cell carcinoma (BCC) is the ...

  4. Trapezial topography in thumb carpometacarpal arthritis.

    Science.gov (United States)

    Van Nortwick, Sarah; Berger, Aaron; Cheng, Robert; Lee, Julia; Ladd, Amy L

    2013-08-01

    Objective Contradictory reported arthritic patterns of the metacarpal surface of the trapezium include preferential volar wear, radial wear, and dorsal-ulnar sparing. We investigated whether a predominant wear pattern exists in surgical trapeziectomy for advanced thumb carpometacarpal (CMC) arthritis. Methods We examined 36 intact trapezia from 34 thumb CMC arthroplasty patients over an 18-month period. The first metacarpal articular surface revealed three consistent morphology patterns: (1) saddle, (2) dish, and (3) cirque. The saddle represented cartilage loss with preservation of the normal trapezial morphology. The dish shape represented concave curvature, with loss of the normal saddle configuration. The cirque shape represented preferential volar concave wear, disrupting the convex volardorsal arc. Two surgeons classified the randomized specimens twice, blinded to patient identity and each other's categorization. Radiographic Eaton staging was correlated retrospectively for 35 of 36 of the trapezial specimens. Eight specimens were further quantified with micro-computed tomography (micro-CT). Results Thirty-six trapezia were classified as follows: 17 (47%) saddle, 12 (33%) dish, and 7 (19%) cirque. Intra-rater reliability was 0.97 and 0.95; inter-rater reliability in the second round was 0.95. The 36 trapezia represented 27 female (75%) and 9 male (25%) patients; 18 (50%) represented the dominant hand. Age at surgery averaged 64 (33-76). Complete cartilage loss of the entire metacarpal surface was seen in 15 (42%) of all specimens. Osteophyte presence was typically minimal in the saddle group; the dish group had characteristic extensive rimming osteophytes in a 91% female population (11/12), and the cirque group had volar osteophytes. Radiographic severity ranged from Eaton stage II to IV; less severe radiographic staging (Eaton II) predominated in the saddle configuration; advanced Eaton III-IV disease predominated in both cirque and dish shapes. Micro

  5. Prenatal diagnosis of a fetus with anencephaly and thumb agenesis.

    Science.gov (United States)

    Barone, Chiara; Bartoloni, Giovanni; Cataliotti, Antonella; Indaco, Lara; Pappalardo, Elisa; Barrano, Barbara; Ettore, Giuseppe; Bianca, Sebastiano

    2012-03-01

    Severe anomalies of the forebrain together with reduction limb anomalies are a rare congenital anomalies association. We report a prenatal diagnosis of acalvaria, anencephaly and thumb agenesis in a voluntary terminated fetus and discuss the role of genetic counseling.

  6. Prognostic value of thumb pain sensation in birth brachial plexopathy

    Directory of Open Access Journals (Sweden)

    Carlos O. Heise

    2012-08-01

    Full Text Available OBJECTIVE: To evaluate the prognostic value of absent thumb pain sensation in newborns and young infants with birth brachial plexopathy. METHODS: We evaluated 131 patients with birth brachial plexopathy with less than two months of age. Pain sensation was evoked by thumb nail bed compression to evaluate sensory fibers of the upper trunk (C6. The patients were followed-up monthly. Patients with less than antigravity elbow flexion at six months of age were considered to have a poor outcome. RESULTS: Thirty patients had absent thumb pain sensation, from which 26 showed a poor outcome. Sensitivity of the test was 65% and specificity was 96%. CONCLUSION: Evaluation of thumb pain sensation should be included in the clinical assessment of infants with birth brachial plexopathy.

  7. The use of a neoprene "thumb-sock" to prevent trauma in a thumb-sucking child with intractable epilepsy.

    Science.gov (United States)

    Dennison, P J; Walton-Jones, A

    1999-01-01

    A nine-year-old girl with spastic quadriplegia, mental retardation, poor vision, a gastrostomy, and intractable epilepsy was referred by her pediatrician for a dental assessment with a view to extracting her anterior teeth as a means of preventing repeated damage to the skin over the proximal phalanx of her left thumb, which she sucked at night. This was the time of day when the frequency of her epileptic seizures was highest. A simple solution to the problem was developed by a dentist and an occupational therapist in which nylon-coated 3-mm neoprene sheeting (wet-suit material) was formed into a "thumb-sock" with a simple Velcro fastening around the wrist. No trauma to the thumb from epileptic seizures has occurred since the "thumb-sock" was fitted 24 months ago.

  8. Maxillofacial prostheses of chlorinated polyethylene.

    Science.gov (United States)

    May, P D

    1978-05-01

    There is clearly a need for maxillofacial prosthetic materials with improved properties. The chlorinated polyethylenes are thermoplastic elastomers which have particularly promising properties, and were used by us to prepare improved maxillofacial prostheses. Suitable CPE resins were compounded with other polymers and with pigments on a heated rubber mill to form thin sheets in a variety of shades. These were heated at 190 degrees C for 10 min and placed between heated linotype mold halves. The prosthesis was formed in a hand press. Sometimes heating and pressing were repeated. After cooling in water, the prosthesis was removed and hand-shaded with oil-soluble dyes. Physical properties were evaluated using standard techniques; skin irritation studies were conducted by 14-day insult patch tests on rabbits. Clinical evaluations were conducted on human volunteers. Parallel evaluations were conducted on commerically available materials for comparison. The CPE was superior to all of the three commerical materials in most properties, and comparable to the better of the three in the remaining properties. On balance, CPE was significantly superior. Early results indicate that the materials and techniques required are easily handled in the dental lab and that the final prosthesis has excellent aesthetic and patient acceptability.

  9. Two Extension Block Kirschner Wires' Technique for Bony Mallet Thumb

    Science.gov (United States)

    Takase, Fumiaki; Ueda, Yasuhiro; Shinohara, Issei; Kuroda, Ryosuke; Kokubu, Takeshi

    2016-01-01

    Mallet fingers with an avulsion fracture of the distal phalanx or rupture of the terminal tendon of the extensor mechanism is known as a common injury, while mallet thumb is very rare. In this paper, the case of a 19-year-old woman with a sprained left thumb sustained while playing basketball is presented. Plain radiographs and computed tomography revealed an avulsion fracture involving more than half of the articular surface at the base of the distal phalanx. Closed reduction and percutaneous fixation were performed using the two extension block Kirschner wires' technique under digital block anesthesia. At 4 months postoperatively, the patient had achieved excellent results according to Crawford's evaluation criteria and had no difficulties in working or playing basketball. Various conservative and operative treatment strategies have been reported for management of mallet thumb. We chose the two extension block Kirschner wires' technique to minimize invasion of the extensor mechanism and nail bed and to stabilize the large fracture fragment.

  10. Prosthetic pollicization following thumb amputation: A case report

    Directory of Open Access Journals (Sweden)

    Pradeep Kumar

    2014-04-01

    Full Text Available The thumb contributes over 50% hand function, which is generally divided into motional, sensory and cosmetic functions. Optimal management of thumb loss necessitates individual consideration of surgical versus prosthetic options, in relation to the needs and circumstances of each patient. This paper presents a case of prosthetic pollicization of an amputated thumb and emphasizes on the fact that the prosthetic replacement has a definite edge over surgical procedures, where amputees refuse to undergo more complicated surgical procedures. The patient was rehabilitated successfully by a noninvasive and cost-effective approach by using high temperature-vulcanized (HTV silicone material and retaining the prosthesis with medical adhesives. On 3 months recall appointment, no complications were found. The prosthesis was in good shape, without need for any repairs.

  11. ACRYLATE-AMIDE FOAM CARDIOVASCULAR PROSTHESES.

    Science.gov (United States)

    thoracic and abdominal aorta. The use of a composite construction utilizing acrylate-amide foam is being evaluated in prostheses for mitral valve ...bleeding. The success of the initial experimental work has led to a clinical trial in which 99 replacement , bypass, or patch-angioplasty procedures... replacement , superior vena cava patch venoplasty, and esophageal replacement . (Author)

  12. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation

    OpenAIRE

    Rajendra Nehete; Anita Nehete; Sandeep Singla; Harshad Adhav

    2012-01-01

    In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally s...

  13. Thumb Sucking: Help Your Child Break the Habit

    Science.gov (United States)

    ... the process. References Nowak AJ, et al. Oral habits and orofacial development in children. http://www.uptodate.com/home. Accessed July 8, 2015. Ask your dentist about thumb, finger and pacifier habits. American Academy of Pediatric Dentistry. http://www.aapd. ...

  14. Conservative treatment of thumb base osteoarthritis : A systematic review

    NARCIS (Netherlands)

    Spaans, Anne J.; Van Minnen, L. Paul; Kon, Moshe; Schuurman, Arnold H.; Schreuders, A. R.; Vermeulen, Guus M.

    2015-01-01

    Purpose To provide a systematic review of randomized controlled trials regarding the conservative treatment of thumb base osteoarthritis (OA). Methods A systematic literature search was conducted in the electronic bibliographic databases Medline (Pubmed) and Embase (both starting year to May 2014) u

  15. Rules of Thumb for Up-and-Down Economics.

    Science.gov (United States)

    Kennedy, Peter

    1994-01-01

    Reports that economist Paul Krugman identifies three types of economic writing. Asserts that the major principles of macroeconomics can be synthesized into "Five Rules of Thumb" which can help to interpret economic news. Presents and discusses these five rules and includes a survey summary of journalists and economists on this issue.…

  16. Prevention of Thumb Web Space Contracture With Multiplanar External Fixation.

    Science.gov (United States)

    Harper, Carl M; Iorio, Matthew L

    2016-09-01

    Thumb web space contracture following hand trauma can be disabling with numerous reconstructive procedures existing to correct the resultant deformity. Following marked soft tissue injury to the hand we utilized the Stryker Hoffmann II Micro External Fixator System to link the first and second metacarpals by a multiplanar system using 1.6 or 2.0 mm self-drilling half-pins and 3 mm carbon fiber connecting rods. This facilitated placement of the thumb in maximal palmar abduction as well as allowed adjustment of thumb position throughout the postoperative period. This technique was performed on 5 patients. Two patients were treated with a first web space external fixator for table saw injuries to the radial aspect of the hand. An additional 2 patients were treated with a first web space external fixator following metacarpophalangeal joint capsular release in the setting of thermal burns. A fifth patient underwent second ray amputation, trapeziectomy and trapezoidectomy for squamous cell carcinoma with subsequent stabilization with the external fixator. The external fixator was left in place until soft tissues were healed (average 5.5 wk). The patients were allowed to mobilize their hand in as much as the external fixator allowed, and no device-associated complications were noted. Thumb web space was preserved with passive and supple thumb circumduction and web space abduction/adduction in all patients at an average follow-up of 5 months. The average Quick Dash Score was 35±5 and the average Modern Activity Subjective Survey of 2007 was 30±8.

  17. The caring moment and the green-thumb phenomenon among Swedish nurses

    DEFF Research Database (Denmark)

    Jensen, Kirsten Pryds; Bäck-Pettersson, Siv; Segesten, K

    1993-01-01

    People who have a special gift for gardening are sometimes described as having a green thumb. Likewise, some nurses have a green thumb for nursing. The aims of this study were to identify and describe the characteristics of green-thumb nurses and of caring situations. A descriptive......-exploratory design was used, and 16 nurses, recruited by their superiors, participated in semi-structured interviews. The findings revealed that the green-thumb nurse is competent, compassionate, and courageous. The essence of the caring moment was identified as the green-thumb nurse's ability to act on the spur...

  18. Regenerative Electrode Interfaces for Neural Prostheses.

    Science.gov (United States)

    Thompson, Cort H; Zoratti, Marissa J; Langhals, Nicholas B; Purcell, Erin K

    2016-04-01

    Neural prostheses are electrode arrays implanted in the nervous system that record or stimulate electrical activity in neurons. Rapid growth in the use of neural prostheses in research and clinical applications has occurred in recent years, but instability and poor patency in the tissue-electrode interface undermines the longevity and performance of these devices. The application of tissue engineering strategies to the device interface is a promising approach to improve connectivity and communication between implanted electrodes and local neurons, and several research groups have developed new and innovative modifications to neural prostheses with the goal of seamless device-tissue integration. These approaches can be broadly categorized based on the strategy used to maintain and regenerate neurons at the device interface: (1) redesign of the prosthesis architecture to include finer-scale geometries and/or provide topographical cues to guide regenerating neural outgrowth, (2) incorporation of material coatings and bioactive molecules on the prosthesis to improve neuronal growth, viability, and adhesion, and (3) inclusion of cellular grafts to replenish the local neuron population or provide a target site for reinnervation (biohybrid devices). In addition to stabilizing the contact between neurons and electrodes, the potential to selectively interface specific subpopulations of neurons with individual electrode sites is a key advantage of regenerative interfaces. In this study, we review the development of regenerative interfaces for applications in both the peripheral and central nervous system. Current and future development of regenerative interfaces has the potential to improve the stability and selectivity of neural prostheses, improving the patency and resolution of information transfer between neurons and implanted electrodes.

  19. Biomechanical Energy Harvester Design For Active Prostheses

    Directory of Open Access Journals (Sweden)

    Akın Oğuz Kaptı

    2012-06-01

    Full Text Available One of the factors restricting the functions of active prostheses is limited charge times and weights of the batteries. Therefore, some biomechanical energy harvesting studies are conducted for reducing the dependence on batteries and developing the systems that produce energy by utilizing one's own actions during daily living activities. In this study, as a new approach to meet energy needs of active-controlled lower limb prostheses, the design of a biomechanical energy harvester that produces electrical energy from the movements of the knee joint during gait were carried out. This harvester is composed of the generator, planetary gear system and one-way clutch that transmit just the knee extension. Low weight, low additional metabolic power consumption requirement and high electrical power generation are targeted in design process. The total reduction ratio of the transmission is 104, and the knee joint reaction torque applied by the system is 6 Nm. Average electrical powers that can be obtained are 17 W and 5,8 W for the swing extension phase and the entire cycle, respectively. These values seem to be sufficient for charging the battery units of many prostheses and similar medical systems, and portable electronic devices such as mobile phones, navigation devices and laptops.

  20. Esthetic prostheses in minor and major upper limb amputations.

    Science.gov (United States)

    Leow, M E; Pho, R W; Pereira, B P

    2001-08-01

    In summary, the impact and value of esthetic prostheses on amputee rehabilitation and their long-term use were demonstrated in this study to have no correlation with the severity of injury and level of amputation. All patients with traumatic amputation should be given equal opportunity to receive prostheses if the service is readily available. Whether use of prostheses is temporary or long-term, they help patients cope with the traumatic life experience of limb loss.

  1. Scientists Engineer a New Thumb for PatientFrom Reuters

    Institute of Scientific and Technical Information of China (English)

    单先心

    2001-01-01

    @@ 选注者言:断指再植,或是将脚趾移植到手指,这些已经是外科手术中广为应用的办法,而本文却让我们领略一种崭新的修复断指的手段,文章称之为tissueengineering,我们是否能称之为“人体组织工程”?其具体做法是:...took cellsfrom the patient and injected them into a coral scaffold fashioned(... 式的;... 风的 )in the shape of a thumb bone. The scaffold was implanted where the thumb tiphad been, with skin from the patient's stomach providing the finishing touch.] Taking a step forward in the brave new world of “tissue engineering,” doctorshave used a patient' s own body cells and a scaffold (本义: 脚手架)made of coral ( 珊瑚)to grow back a missing portion of his thumb.

  2. Two Extension Block Kirschner Wires’ Technique for Bony Mallet Thumb

    Directory of Open Access Journals (Sweden)

    Yutaka Mifune

    2016-01-01

    Full Text Available Mallet fingers with an avulsion fracture of the distal phalanx or rupture of the terminal tendon of the extensor mechanism is known as a common injury, while mallet thumb is very rare. In this paper, the case of a 19-year-old woman with a sprained left thumb sustained while playing basketball is presented. Plain radiographs and computed tomography revealed an avulsion fracture involving more than half of the articular surface at the base of the distal phalanx. Closed reduction and percutaneous fixation were performed using the two extension block Kirschner wires’ technique under digital block anesthesia. At 4 months postoperatively, the patient had achieved excellent results according to Crawford’s evaluation criteria and had no difficulties in working or playing basketball. Various conservative and operative treatment strategies have been reported for management of mallet thumb. We chose the two extension block Kirschner wires’ technique to minimize invasion of the extensor mechanism and nail bed and to stabilize the large fracture fragment.

  3. [Pollicization of the Index Finger in Patients with Congenital Thumb Hypoplasia].

    Science.gov (United States)

    Moser, U; Singer, G; Schmidt, B; Spendel, S

    2016-08-01

    Congenital thumb hypoplasia is a radial deficiency occurring in the form of sole dysplasia or in combination with additional aberrations. Thumb hypoplasia can be categorised into 5 grades ranging from mild deformity to complete absence of the thumb. Thumb hypoplasia leads to a disturbance of grip function depending on its severity. The choice of treatment is based on the degree of thumb hypoplasia. For hypoplasia greater than grade 3B, restoration of the thumb using pollicization of the index finger is the treatment of choice. For this purpose the index finger is transformed into a thumb and is transposed to the position of the thumb with vessels and nerves being retained. The skeleton has to be shortened, rotated and abducted, followed by reconstruction of the muscles in line with the function of the new thumb. This procedure facilitates a restoration with maximal stability, sensitivity and mobility. In cases of isolated thumb hypoplasia, pollicization of the index finger yields good results persisting into adulthood. If associated aberrations are present, the outcome is less predictable because of the preexistent stiffness of the index finger. Nevertheless, associated aberrations do not represent a contraindication for index finger pollicization.

  4. FEATURE EXTRACTION FOR EMG BASED PROSTHESES CONTROL

    Directory of Open Access Journals (Sweden)

    R. Aishwarya

    2013-01-01

    Full Text Available The control of prosthetic limb would be more effective if it is based on Surface Electromyogram (SEMG signals from remnant muscles. The analysis of SEMG signals depend on a number of factors, such as amplitude as well as time- and frequency-domain properties. Time series analysis using Auto Regressive (AR model and Mean frequency which is tolerant to white Gaussian noise are used as feature extraction techniques. EMG Histogram is used as another feature vector that was seen to give more distinct classification. The work was done with SEMG dataset obtained from the NINAPRO DATABASE, a resource for bio robotics community. Eight classes of hand movements hand open, hand close, Wrist extension, Wrist flexion, Pointing index, Ulnar deviation, Thumbs up, Thumb opposite to little finger are taken into consideration and feature vectors are extracted. The feature vectors can be given to an artificial neural network for further classification in controlling the prosthetic arm which is not dealt in this paper.

  5. Stimulation and recording electrodes for neural prostheses

    CERN Document Server

    Pour Aryan, Naser; Rothermel, Albrecht

    2015-01-01

    This book provides readers with basic principles of the electrochemistry of the electrodes used in modern, implantable neural prostheses. The authors discuss the boundaries and conditions in which the electrodes continue to function properly for long time spans, which are required when designing neural stimulator devices for long-term in vivo applications. Two kinds of electrode materials, titanium nitride and iridium are discussed extensively, both qualitatively and quantitatively. The influence of the counter electrode on the safety margins and electrode lifetime in a two electrode system is explained. Electrode modeling is handled in a final chapter.

  6. Lactobacilli : Important in biofilm formation on voice prostheses

    NARCIS (Netherlands)

    Buijssen, Kevin J. D. A.; Harmsen, Hermie J. M.; van der Mei, Henny C.; Busscher, Henk J.; van der Laan, Bernard F. A. M.

    2007-01-01

    OBJECTIVE: We sought to identify bacterial strains responsible for biofilm formation on silicone rubber voice prostheses. STUDY DESIGN: We conducted an analysis of the bacterial population in biofilms on used silicone rubber voice prostheses by using new microbiological methods. METHODS: Two microbi

  7. MECHANICAL HEART-VALVE PROSTHESES - SOUND LEVEL AND RELATED COMPLAINTS

    NARCIS (Netherlands)

    LAURENS, RRP; WIT, HP; EBELS, T

    1992-01-01

    In a randomised study, we investigated the sound production of mechanical heart valve prostheses and the complaints related to this sound. The CarboMedics, Bjork-Shiley monostrut and StJude Medical prostheses were compared. A-weighted levels of the pulse-like sound produced by the prosthesis were me

  8. Oral cavity anaerobic pathogens in biofilm formation on voice prostheses

    NARCIS (Netherlands)

    Bertl, Kristina; Zijnge, Vincent; Zatorska, Beata; Leonhard, Matthias; Schneider-Stickler, Berit; Harmsen, Hermie J. M.

    2015-01-01

    BACKGROUND: A polymerase chain reaction (PCR)-based method has been used to identify oral anaerobic pathogens in biofilms on voice prostheses. The purpose of the present study was to determine the location of those pathogens inside the biofilms. METHODS: Biofilms of 15 voice prostheses were sampled

  9. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation.

    Science.gov (United States)

    Nehete, Rajendra; Nehete, Anita; Singla, Sandeep; Adhav, Harshad

    2012-01-01

    In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally symmetric and aesthetically superior to the osteoplastic reconstruction. The technical details are discussed, and the long term functional and aesthetic results are presented.

  10. Bilateral microvascular second toe transfer for bilateral post-traumatic thumb amputation

    Directory of Open Access Journals (Sweden)

    Rajendra Nehete

    2012-01-01

    Full Text Available In bilateral thumb amputations, the functional impairment is serious and every attempt should be made to reconstruct the thumb. We report a case of bilateral post traumatic thumb amputation, reconstructed with bilateral second toe transfer. Only two such cases have been reported in literature so far. Though there are various modalities for the reconstruction of thumb, microvascular toe transfer has its own merits. The convalescent period is minimal with excellent function. It is bilaterally symmetric and aesthetically superior to the osteoplastic reconstruction. The technical details are discussed, and the long term functional and aesthetic results are presented.

  11. Laser vibrometer measurements and middle ear prostheses

    Science.gov (United States)

    Flock, Stephen T.; Dornhoffer, John; Ferguson, Scott

    1997-05-01

    One of us has developed an improved partial ossicular replacement prosthesis that is easier to implant and, based on pilot clinical measurements, results in better high-frequency hearing as compared to patients receiving one of the alternative prostheses. It is hypothesized that the primary reason for this is because of the relatively light weight (about 25 mg) and low compliance of the prosthesis, which could conceivably result in better high frequency vibrational characteristics. The purpose of our initial work was to develop an instrument suitable for objectively testing the vibrational characteristics of prostheses. We have developed a laser based device suitable for measuring the vibrational characteristics of the oval window or other structures of the middle ear. We have tested this device using a piezoelectric transducer excited at audio frequencies, as well as on the oval window in human temporal bones harvested from cadavers. The results illustrate that it is possible to non-invasively monitor the vibrational characteristics of anatomic structures with a very inexpensive photonic device.

  12. Creating a custom fabricated neoprene orthosis for optimal thumb positioning.

    Science.gov (United States)

    Trujillo, Leonard G; Amini, Debbie

    2013-01-01

    Neoprene orthoses are used extensively in treating conditions of the hand when flexibility and support are sought. Devices such as these may be prefabricated from Neoprene alone or may include a thermoplastic or metal stay. Neoprene devices can also be custom fabricated by a practitioner in a time effective manner and at low cost. The custom fabricated orthosis described in this article is designed to support the thumb in a position of palmar abduction and opposition while maintaining CMC extension and an adequately open web space to prevent soft tissue contracture.

  13. Finite element analysis of thumb carpometacarpal joint implants

    Energy Technology Data Exchange (ETDEWEB)

    Nielsen, C.

    1995-11-01

    The thumb carpometacarpal joint is frequently replaced in women who have developed severe osteoarthritis of the hand. A new, privately developed implant design consists of two components, trapezial and metacarpal, each with a saddle-shaped articulating surface. A three dimensional finite element model of this implant has been developed to analyze stresses on the device. The first simulations using the model involve loading the implant with forces normal to the trapezial component. Preliminary results show contact stress distributions at the particulating surfaces of the implant.

  14. Dysfunctional putamen modulation during bimanual finger-to-thumb movement in patients with Parkinson's disease.

    Science.gov (United States)

    Yan, Li-Rong; Wu, Yi-Bo; Zeng, Xiao-Hua; Gao, Li-Chen

    2015-01-01

    Parkinson's disease (PD) is a neurodegenerative disorder affecting middle-aged and elderly people. PD can be viewed as "circuit disorder," indicating that large scale cortico-subcortical pathways were involved in its pathophysiology. The brain network in an experimental context is emerging as an important biomarker in disease diagnosis and prognosis prediction. This context-dependent network for PD and the underling functional mechanism remains unclear. In this paper, the brain network profiles in 11 PD patients without dementia were studied and compared with 12 healthy controls. The functional magnetic resonance imaging (fMRI) data were acquired when the subjects were performing a pseudorandomized unimanual or bimanual finger-to-thumb movement task. The activation was detected and the network profiles were analyzed by psychophysiological interaction (PPI) toolbox. For the controls and PD patients, the motor areas including the primary motor and premotor areas, supplementary motor area, the cerebellum and parts of the frontal, temporal and parietal gyrus were activated. The right putamen exhibited significant control > PD activation and weaker activity during the bimanual movement relative to the unimanual movement in the control group. The decreased putamen modulation on some nucleus in basal ganglia, such as putamen, thalamus and caudate, and some cortical areas, such as cingulate, parietal, angular, frontal, temporal and occipital gyrus was detected in the bimanual movement condition relative to the unimanual movement condition. Between-group PPI difference was detected in cingulate gyrus, angular gyrus and precuneus (control > PD) and inferior frontal gyrus (PD > control). The deficient putamen activation and its enhanced connectivity with the frontal gyrus could be a correlate of impaired basal ganglia inhibition and frontal gyrus compensation to maintain the task performance during the motor programs of PD patients.

  15. Basal Reinforced Piled Embankments

    NARCIS (Netherlands)

    Van Eekelen, S.J.M.

    2015-01-01

    A basal reinforced piled embankment consists of a reinforced embankment on a pile foundation. The reinforcement consists of one or more horizontal layers of geosynthetic reinforcement (GR) installed at the base of the embankment. The design of the GR is the subject of this thesis. A basal reinforce

  16. Doppler echocardiography in normal functioning valve prostheses.

    Science.gov (United States)

    Cha, R; Yang, S S; Salvucci, T; DiBlasi, S

    1994-09-01

    Even though there has been some criticism regarding the Doppler evaluation in prosthetic valves because of inter-observer and intra-observer variability, among other factors, and Doppler study has a tendency to have falsely high gradients compared to invasive studies, especially mechanical aortic prostheses, Doppler evaluation can provide reliable hemodynamic information about valve function. This test may be particularly useful if used serially, when baseline values are known. Doppler measurement of gradient and valve area has an expected normal range that is specific for the prosthetic type, size, anatomical position, and chronological age. Clearly, a database involving these aspects is needed to provide a more accurate normal range. This study is intended to provide guidance for echocardiographers.

  17. The biomechanics of a thumb carpometacarpal immobilization splint: design and fitting.

    Science.gov (United States)

    Colditz, J C

    2000-01-01

    Splinting for the common osteoarthritis of the carpometacarpal (CMC) joint of the thumb is infrequently described in the literature, but the few splints that are described include one or both adjacent joints. This paper describes the design and biomechanics of a custom-molded thumb CMC immobilization splint that excludes the thumb metacarpophalangeal and wrist joints. The problem of the imbalance of extrinsic extensor/abductor forces against the intrinsic flexor/adductor forces is described. The accompanying weakening of the thumb CMC capsule allows dorsal shifting of the proximal end of the metacarpal, producing pain. The splint described in this paper 1) prevents motion of the first metacarpal in relation to the other metacarpals, 2) prevents tilting (flexion) of the first metacarpal during pinch, and 3) allows unrestricted thumb metacarpal and wrist joint motion. Attention to detail during construction is required for an accurate pattern, precise positioning of the CMC joint during molding, accurate molding around the first metacarpal, and well-distributed pressure. This design may also be used for protection following thumb CMC arthroplasty or thumb CMC sprain or strain and as a base for thumb metacarpophalangeal and/or interphalangeal mobilization splinting.

  18. Control of thumb force using surface functional electrical stimulation and muscle load sharing

    NARCIS (Netherlands)

    Westerveld, A.J.; Schouten, A.C.; Veltink, P.H.; Van der Kooij, H.

    2013-01-01

    Background Stroke survivors often have difficulties in manipulating objects with their affected hand. Thumb control plays an important role in object manipulation. Surface functional electrical stimulation (FES) can assist movement. We aim to control the 2D thumb force by predicting the sum of indiv

  19. Collagenase Treatment for Dupuytren Disease of the Thumb and First Web

    NARCIS (Netherlands)

    Dreise, Marieke M.; Stenekes, Martin W.; Werker, Paul M. N.

    2016-01-01

    Purpose To evaluate the short-term effectiveness of collagenase Clostridium histolyticum to treat thumb and first web contractures in Dupuytren disease. Methods We prospectively included 14 thumbs in 12 patients with a contracture at the metacarpophalangeal or interphalangeal joint of at least 20 de

  20. Long-term follow-up of surgical treatment for thumb duplication

    NARCIS (Netherlands)

    Larsen, M; Nicolai, JPA

    2005-01-01

    There are few long-term follow-up reports concerning the treatment of thumb duplication. We reviewed the treatment of 19 of 74 patients treated at our institution between 1956 and 2002. The average follow-up was 22 (range, 7 years to 35 years) years. Satisfactory function was achieved in 18 thumbs a

  1. Total ankle prostheses in rheumatoid arthropathy

    Science.gov (United States)

    Schutte, Bernard; Louwerens, Jan Willem K; van den Hoogen, Frank H J; de Waal Malefijt, Maarten C

    2009-01-01

    Background and purpose The first generations of total ankle replacements (TARs) showed a high rate of early failure. In the last decades, much progress has been made in the development of TARs, with the newer generation showing better results. We evaluated TARs implanted with rheumatoid arthritis (RA) or juvenile inflammatory arthritis (JIA) as indication. Patients and methods 58 total ankle prostheses (Buechel-Pappas and STAR type) were implanted in patients with RA (n = 53) or JIA (n = 5) in 54 patients (4 bilateral). After a mean follow-up of 2.7 (1–9) years, all patients were reviewed by two orthopedic surgeons who were not the surgeons who performed the operation. Standard AP and lateral radiographs were taken and a Kofoed ankle score was obtained; this is a clinical score ranging from 0–100 and consists of sub-scores for pain, disability, and range of motion. Results 2 patients died of unrelated causes. Of the 52 patients who were alive (56 prostheses), 51 implants were still in place and showed no signs of loosening on the most recent radiographs. The mean Kofoed score at follow-up was 73 points (SD 16, range 21–92). 4 patients showed a poor result (score < 50) with persistent pain for which no obvious reason could be found. 5 implants were removed, 4 because of infection and 1 because of aseptic loosening. Interpretation Medium-term results of the STAR and BP types of TAR in RA were satisfactory. The main reason for failure of the implant was infection. PMID:19634020

  2. Implant-retained craniofacial prostheses for facial defects

    OpenAIRE

    Federspil, Philipp A.

    2011-01-01

    Craniofacial prostheses, also known as epistheses, are artificial substitutes for facial defects. The breakthrough for rehabilitation of facial defects with implant-retained prostheses came with the development of the modern silicones and bone anchorage. Following the discovery of the osseointegration of titanium in the 1950s, dental implants have been made of titanium in the 1960s. In 1977, the first extraoral titanium implant was inserted in a patient. Later, various solitary extraoral impl...

  3. Prostacyclin production by blood-contacting surfaces of endothelialized vascular prostheses.

    Science.gov (United States)

    Greisler, H P; Klosak, J J; McGurrin, J F; Endean, E D; Ellinger, J; Pozar, J D; Henderson, S C; Kim, D U

    1990-01-01

    This study examines prostacyclin production by blood-contacting surfaces within woven vascular prostheses of polydioxanone (PDS), polyglactin 910 (PG910), or Dacron interposed into rabbit infrarenal aortas. Grafts and normal aortic segments were explanted after 1, 3, and 6 months for pulsatile perfusion with Medium-199 for 60 minutes. Aliquots were removed serially for 6-keto-PGF1 alpha assay. After 30 minutes sodium arachidonate (10 micrograms/ml) was added. Specimens were studied by light microscopy, SEM and TEM. Patency in all three groups exceeded 90%. All three showed re-endothelialization at one month. Normal aorta produced low basal 6-keto-PGF1 alpha with a marked evanescent post arachidonate increase. Dacron did not differ from normal aorta. PG910 and PDS both produced significantly less 6-keto-PGF1 alpha post arachidonate at one month but both increased to normal by three months.

  4. The Vascularized Medial Femoral Corticoperiosteal Flap for Thumb Reconstruction

    Science.gov (United States)

    Amin, Kavit; Darhouse, Nagham; Sivakumar, Bran; Floyd, David

    2015-01-01

    Summary: We present an interesting method of shaping a vascularized medial femoral condyle (MFC) flap into a “neophalanx” for phalangeal reconstruction. Our patient presented with limited strength and function secondary to fracture nonunion of the proximal phalanx of the dominant thumb. Following excision of the pseudarthrosis, an MFC corticoperiosteal flap was harvested, sculpted into a prism shape and inset. The superomedial genicular pedicle was anastomosed to the princeps pollicis artery and a cephalic tributary. On follow-up, new bone growth was seen on radiographs and the patient had substantially improved function, with full metacarpophalangeal extension, a Kapandji score of 9, and a markedly reduced Disabilities of the Arm, Shoulder and Hand score of 2.68. The MFC flap is useful for reconstruction of bony defects, with minimal donor morbidity. This versatile vascularized flap can be crafted to requisite shapes and is useful for small defects in the hand, including phalangeal reconstruction. PMID:26495205

  5. Acute finger injuries: part II. Fractures, dislocations, and thumb injuries.

    Science.gov (United States)

    Leggit, Jeffrey C; Meko, Christian J

    2006-03-01

    Family physicians can treat most finger fractures and dislocations, but when necessary, prompt referral to an orthopedic or hand surgeon is important to maximize future function. Examination includes radiography (oblique, anteroposterior, and true lateral views) and physical examination to detect fractures. Dislocation reduction is accomplished with careful traction. If successful, further treatment focuses on the concomitant soft tissue injury. Referral is needed for irreducible dislocations. Distal phalanx fractures are treated conservatively, and middle phalanx fractures can be treated if reduction is stable. Physicians usually can reduce metacarpal bone fractures, even if there is a large degree of angulation. An orthopedic or hand surgeon should treat finger injuries that are unstable or that have rotation. Collateral ligament injuries of the thumb should be examine with radiography before physical examination. Stable joint injuries can be treated with splinting or casting, although an orthopedic or hand surgeon should treat unstable joints.

  6. Mask roughness induced LER: a rule of thumb -- paper

    Energy Technology Data Exchange (ETDEWEB)

    McClinton, Brittany; Naulleau, Patrick

    2010-03-12

    Much work has already been done on how both the resist and line-edge roughness (LER) on the mask affect the final printed LER. What is poorly understood, however, is the extent to which system-level effects such as mask surface roughness, illumination conditions, and defocus couple to speckle at the image plane, and currently factor into LER limits. Here, we propose a 'rule-of-thumb' simplified solution that provides a fast and powerful method to obtain mask roughness induced LER. We present modeling data on an older generation mask with a roughness of 230 pm as well as the ultimate target roughness of 50 pm. Moreover, we consider feature sizes of 50 nm and 22 nm, and show that as a function of correlation length, the LER peaks at the condition that the correlation length is approximately equal to the resolution of the imaging optic.

  7. Failed total carpometacarpal joint prosthesis of the thumb

    DEFF Research Database (Denmark)

    Hansen, Torben Bæk; Homilius, Morten

    2010-01-01

    . The male:female ratio was 1:4 and the mean duration of observation 32 months (range 6-52). In three patients the revised implant was a MOJE uncemented carpometacarpal joint prosthesis and in seven patients an Elektra uncemented one. At follow-up grip strength was reduced to less than 90% of the other hand...... in eight of 10 patients, but the mean Disabilities of the arm, shoulder, and hand (DASH) scores, self-reported pinch-grip-related function, and pain were comparable with our earlier published results with the Elektra carpometacarpal total joint prosthesis.......Total joint prosthesis in carpometacarpal joint arthritis of the thumb often fails. Loosening of the implant is often treated by resection arthroplasty, and we reviewed 10 patients, mean age 54 years (range 47-63) who were treated by resection arthroplasty after a failed total joint prosthesis...

  8. Thumb Imprint Based Detection of Hyperbilirubinemia Using Luminescent Gold Nanoclusters

    Science.gov (United States)

    Basu, Srestha; Sahoo, Amaresh Kumar; Paul, Anumita; Chattopadhyay, Arun

    2016-12-01

    Early and easy detection of diseases, using point-of-care and inexpensive devices, not only provides option for early treatment but also reduces the risk of propagation. Herein we report the fabrication of a robust film based luminescence indicator of bilirubin, which can indicate hyperbilirubinemia through the thumb imprint of the patient. The UV-light induced luminescence intensity of the film, made out of chitosan stabilised gold (Au) nanoclusters, which was effectively quenched in the presence of Cu2+ ions, recovered in the presence of bilirubin from skin or blood serum. Moreover, the sensitivity of detection of bilirubin was tuneable with the amount of Cu2+ added, thereby facilitating the detection of the desired concentration range of bilirubin.

  9. Platelet thrombosis in cardiac-valve prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Dewanjee, M.K.

    1989-01-01

    The contribution of platelets and clotting factors in thrombosis on cardiovascular prostheses had been quantified with several tracers. Thrombus formation in vivo could be measured semiquantitatively in animal models and patients with indium-111, Technetium-99m labeled platelets, iodine-123, iodine-131 labeled fibrinogen, and In-111 and Tc-99m labeled antibody to the fibrinogen-receptor on the platelet- membrane, or fibrin. The early studies demonstrated that certain platelet-inhibitors, e.g. sulfinpyrazone, aspirin or aspirin- persantine increased platelet survival time with mechanical valves implanted in the baboon model and patients. Thrombus localization by imaging is possible for large thrombus on thrombogenic surface of prosthesis in the acute phase. The majority of thrombus was found in the sewing ring (Dacron) in the acute phase in both the mechanical and tissue valves. The amount of retained thrombus in both mechanical and tissue valves in our one-day study in the dog model was similar (< 1% if injected In-111 platelets = 5 billion platelets). As the fibrous ingrowth covered the sewing ring, the thrombus formation decreased significantly. Only a small amount of thrombus was found on the leaflets at one month in both the dog and calf models. 38 refs., 9 figs., 5 tabs.

  10. Alignment of lower-limb prostheses.

    Science.gov (United States)

    Zahedi, M S; Spence, W D; Solomonidis, S E; Paul, J P

    1986-04-01

    Alignment of a prosthesis is defined as the position of the socket relative to the other prosthetic components of the limb. During dynamic alignment the prosthetist, using subjective judgment and feedback from the patient, aims to achieve the most suitable limb geometry for best function and comfort. Until recently it was generally believed that a patient could only be satisfied with a unique "optimum alignment." The purpose of this systematic study of lower-limb alignment parameters was to gain an understanding of the factors that make a limb configuration or optimum alignment, acceptable to the patient, and to obtain a measure of the variation of this alignment that would be acceptable to the amputee. In this paper, the acceptable range of alignments for 10 below- and 10 above-knee amputees are established. Three prosthetists were involved in the majority of the 183 below-knee and 100 above-knee fittings, although several other prosthetists were also involved. The effects of each different prosthetist on the established range of alignment for each patient are reported to be significant. It is now established that an amputee can tolerate several alignments ranging in some parameters by as much as 148 mm in shifts and 17 degrees in tilts. This paper describes the method of defining and measuring the alignment of lower-limb prostheses. It presents quantitatively established values for bench alignment position and the range of adjustment required for incorporation into the design of new alignment units.

  11. Vibrotactile evaluation: osseointegrated versus socket-suspended transfemoral prostheses.

    Science.gov (United States)

    Häggström, Eva; Hagberg, Kerstin; Rydevik, Björn; Brånemark, Rickard

    2013-01-01

    This study investigated detection thresholds of vibrometric stimuli in patients with transfemoral amputation supplied with osseointegrated (OI) and socket-suspended prostheses. It included 17 patients tested preoperatively with socket-suspended prostheses and after 2 yr with OI prostheses and a control group (n = 17) using socket-suspended prostheses, evaluated once. Assessments on the prosthetic and intact feet were conducted at six frequencies (8, 16, 32, 64, 125, and 250 Hz). Furthermore, measurements were conducted to investigate how vibrometric signals are transmitted through a test prosthesis. The results showed that the OI group had improved ability to detect vibrations through the prosthesis at 125 Hz (p = 0.01) at follow-up compared with the preoperative measurement. Compared with the control group, the OI group at follow-up had better ability to detect high frequency vibrations through the prosthesis (125 Hz, p = 0.02; 250 Hz, p = 0.03). The vibrometric signal transmitted through the test prosthesis was reduced at 8, 125, and 250 Hz but was amplified at 16, 32, and 64 Hz. Differences between the OI and the control groups were found in the highest frequencies in which the test prosthesis showed reduction of the vibrometric signal. The study provides insight into the mechanisms of vibration transmission between the exterior and bone-anchored as well as socket-suspended amputation prostheses.

  12. Vibrotactile evaluation: Osseointegrated versus socket-suspended transfemoral prostheses

    Directory of Open Access Journals (Sweden)

    Eva Häggström, CPO

    2014-02-01

    Full Text Available This study investigated detection thresholds of vibrometric stimuli in patients with transfemoral amputation supplied with osseointegrated (OI and socket-suspended prostheses. It included 17 patients tested preoperatively with socket-suspended prostheses and after 2 yr with OI prostheses and a control group (n = 17 using socket-suspended prostheses, evaluated once. Assessments on the prosthetic and intact feet were conducted at six frequencies (8, 16, 32, 64, 125, and 250 Hz. Furthermore, measurements were conducted to investigate how vibrometric signals are transmitted through a test prosthesis. The results showed that the OI group had improved ability to detect vibrations through the prosthesis at 125 Hz (p = 0.01 at follow-up compared with the preoperative measurement. Compared with the control group, the OI group at follow-up had better ability to detect high frequency vibrations through the prosthesis (125 Hz, p = 0.02; 250 Hz, p = 0.03. The vibrometric signal transmitted through the test prosthesis was reduced at 8, 125, and 250 Hz but was amplified at 16, 32, and 64 Hz. Differences between the OI and the control groups were found in the highest frequencies in which the test prosthesis showed reduction of the vibrometric signal. The study provides insight into the mechanisms of vibration transmission between the exterior and bone-anchored as well as socket-suspended amputation prostheses.

  13. Relationship of hand preference to accuracy on a thumb-positioning task.

    Science.gov (United States)

    Riolo-Quinn, L

    1991-08-01

    This study was designed to examine the relationship of hand preference to performance on a thumb-positioning task. Two hypotheses were proposed on the basis of hemispheric lateralization. The first stated that all subjects would perform the task more accurately using the left thumb, regardless of hand preference. The second hypothesis tested was that left-handed subjects would perform more accurately than right-handed subjects. Each of 20 neurologically intact adults grouped by hand preference reproduced a criterion thumb position with both thumbs simultaneously. Absolute error, recorded for each movement and analyzed by mixed analysis of variance, did support the first hypothesis. However, the left-handed group did not perform statistically differently from right-handed subjects. Factors influencing the data are discussed and recommendations for further studies are made.

  14. Functional workspace for precision manipulation between thumb and fingers in normal hands.

    Science.gov (United States)

    Kuo, Li-Chieh; Chiu, Haw-Yen; Chang, Cheung-Wen; Hsu, Hsiu-Yun; Sun, Yun-Nien

    2009-10-01

    Prehensile functions of hand are based on thumb-finger relationships which are regarded as an essential element in various manipulations of our daily living activities. Although the maximal workspace provides clinicians a way to comprehend the ranges of digital movements, little is known about the "functional workspace" based on thumb-finger relationships. This study defines the functional workspace of the precision thumb-finger grasp as the range of all possible positions in which thumb-tip and each fingertip can simultaneously contact each other. We present a quantitative method for measuring the functional workspace of the human hand. The maximal motion trajectories of thumb-tip and fingertips of twenty subjects were recorded using a video-capture system. The functional workspace of the precision manipulation was calculated via numerical methods based on the maximal workspaces obtained of the thumb-tip and fingertip motions. The ratios of the functional workspace with respect to the maximal workspace of the index, middle, ring and little fingers were calculated as 33.7%, 27.1%, 23.5% and 19.1%, respectively. Although the present approach is still a descriptive work which might require more validations or evidences to justify, the results obtained may become normal standards for practical use in objective handicapped authentications, insurance claims, and rehabilitation programs as well as criteria for ergonomic design considerations in the near future.

  15. Implant-retained craniofacial prostheses for facial defects

    Directory of Open Access Journals (Sweden)

    Federspil, Philipp A.

    2009-01-01

    Full Text Available Craniofacial prostheses, also known as epistheses, are artificial substitutes for facial defects. The breakthrough for rehabilitation of facial defects with implant-retained prostheses came with the development of the modern silicones and bone anchorage. Following the discovery of the osseointegration of titanium in the 1950s, dental implants have been made of titanium in the 1960s. In 1977, the first extraoral titanium implant was inserted in a patient. Later, various solitary extraoral implant systems were developed. Grouped implant systems have also been developed which may be placed more reliably in areas with low bone presentation, as in the nasal and orbital region, or the ideally pneumatised mastoid process. Today, even large facial prostheses may be securely retained. The classical atraumatic surgical technique has remained an unchanged prerequisite for successful implantation of any system. This review outlines the basic principles of osseointegration as well as the main features of extraoral implantology.

  16. The radiation improvement of polyethylene prostheses. A preliminary study.

    Science.gov (United States)

    Grobbelaar, C J; du Plessis, T A; Marais, F

    1978-08-01

    The radiation crosslinking of high-density polyethylene prostheses was investigated over a wide range of doses in the presence and absence of gaseous crosslinking agents. It was found that in the bulk polymer the crosslinking pattern is completely different from the homogeneous crosslinking that occurs in polymer films. The presence of crosslinking agents causes highly crosslinked polymer to be formed on the surface while the bulk of the polymer is largely unaffected--which is explained in terms of diffusion phenomena. This surface crosslinking has a profound effect on the mechanical properties of the prostheses and restricts cold flow and deformation of the polymer without sacrificing the excellent abrasion-resistance properties of the polyethylene when subjected to high pressures. Based on this research a number of high-density polyethylene knee prostheses have been radiation-crosslinked and the results in vitro appear to be very promising.

  17. CAD/CAM generated all-ceramic primary telescopic prostheses.

    Science.gov (United States)

    Kurbad, A; Ganz, S; Kurbad, S

    2012-01-01

    Computer-aided design and manufacturing (CAD/CAM) systems have proven effective not only for the manufacture of crown and bridge frameworks, inlays, onlays and veneers, but also for the generation of all-ceramic primary telescopic prostheses in more than 10 years of use in dental technology. The new InLab 4.0 software generation makes it possible to design and mill primary telescopic prostheses with CAD/CAM technology. The computer-generated raw crowns for these restorations require very little manual adaptation. The secondary crowns are manufactured by electroforming and bonded onto the tertiary structure or framework.

  18. [Antithrombotic therapy in patients with mechanical valve prostheses].

    Science.gov (United States)

    Roudaut, R; Lorient-Roudaut, M F

    1996-11-01

    Mechanical valvular prostheses have the advantage of longevity but carry a risk of thrombosis which is itself dependent on many haemodynamic, haemostatic and parietal factors. Antithrombotic therapy in patients with mechanical valvular prostheses is based on vitamin-K antagonists, the optimal dosage of which should reflect the type and location of the prosthesis and the underlying pathology. The patient with a mechanical valvular prosthesis treated by oral anticoagulation must be fully informed and regularly followed up. Special situations: extracardiac surgery, dental extraction, gastrointestinal endoscopy, require specific, well established management.

  19. REDUCED THROMBOGENICITY OF VASCULAR PROSTHESES BY COATING WITH ADP-ASE

    NARCIS (Netherlands)

    VANDERLEI, B; ROBINSON, PH; BAKKER, WW; Bartels, H.

    1992-01-01

    In this pilot study ADP-ase coated polyurethane (PL) vascular prostheses and noncoated (control) PU vascular prostheses (all vascular prostheses: ID 1.5 mm, length 1,5 cm) were implanted into the carotid artery of the rabbit to test wheter ADP-ase might function as an adequate anti-thrombogenic coat

  20. Neuropsychiatry of the basal ganglia

    OpenAIRE

    Ring, H.; Serra-Mestres, J

    2002-01-01

    This review aims to relate recent findings describing the role and neural connectivity of the basal ganglia to the clinical neuropsychiatry of basal ganglia movement disorders and to the role of basal ganglia disturbances in "psychiatric"' states. Articles relating to the relevant topics were initially collected through MEDLINE and papers relating to the clinical conditions discussed were also reviewed. The anatomy and connections of the basal ganglia indicate that these structures are import...

  1. The contribution of the palmaris longus muscle to the strength of thumb abduction.

    Science.gov (United States)

    Gangata, Hope; Ndou, Robert; Louw, Graham

    2010-05-01

    The palmaris longus muscle (PLM) is described as a weak flexor of the wrist and a tensor of the palmar aponeurosis, but not a thumb abductor. The PLM is believed to aid thumb abduction through its insertion onto the thenar eminence. Two groups, both right hand dominant, were selected from 1,200 sampled participants. The first group comprised of 38 subjects with unilateral presence of the PLM and was used to determine the strength of thumb abduction. The second group comprised of 30 subjects, with bilateral presence of the PLM, and it was used to calculate the effects of hand dominance. A significant number of subjects with bilateral absence of the PLM were observed and undocumented. Using a dynamometer in subjects with unilateral presence of the PLM, the force of thumb abduction was significantly greater on the hand with a PLM than the one without it (P = 0.014), irrespective of hand dominance. In the second sample with bilateral PLM, thumb abduction on the dominant hand was 10% stronger than on the nondominant hand and was similar to the universally accepted average of 10% increase in grip strength of the dominant hand. Thus, 10% was deducted from all the dominant hands, and the force of thumb abduction remained greater on the hand with PLM than the hand without it (P = 0.049). The results of this study demonstrated the PLM to be involved in thumb abduction, and the authors therefore recommend that this action of the muscle be universally accepted by anatomists and hand surgeons.

  2. Tetrahydrofuran (co)polymers as potential materials for vascular prostheses

    NARCIS (Netherlands)

    Pol, B.J.M.; Does, van der L.; Bantjes, A.

    1993-01-01

    Polyethers were studied as potential materials for vascular prostheses. By crosslinking poly(tetramethylene oxide) (PTMO) with poly(ethylene oxide) (PEO), hydrophilic networks were obtained containing PTMO as well as PEO. Attempts were made to reduce the crystallinity and melting point of PTMO becau

  3. Novel strategies to improve the patency of vascular prostheses

    NARCIS (Netherlands)

    Heyligers, J.M.M.

    2006-01-01

    Two novel strategies to improve the patency of vascular prostheses are described in this thesis. To improve the outcome of synthetic vascular bypass surgery, cell seeding is a promising concept that has extensively been investigated and is still evolving. To improve the short term effects due to acu

  4. Composition and architecture of biofilms on used voice prostheses

    NARCIS (Netherlands)

    Buijssen, Kevin J. D. A.; van der Laan, Bernard F. A. M.; van der Mei, Henny C.; Atema-Smit, Jelly; van den Huijssen, Pauline; Busscher, Henk J.; Harmsen, Hermie J. M.

    2012-01-01

    Background Biofilms on medical devices are a frequent reason for failure of the device. Voice prostheses in laryngectomized patients deteriorate within 3 to 4 months due to adhering biofilms, impeding proper functioning. Recently, we showed that these biofilms are dominated by Candida and lactobacil

  5. Evaluation of pneumatic cylinder actuators for hand prostheses

    NARCIS (Netherlands)

    Peerdeman, Bart; Smit, Gerwin; Stramigioli, Stefano; Plettenburg, Dick; Misra, Sarthak

    2012-01-01

    DC motors are currently the preferred actuation method for externally powered hand prostheses. However, they are often heavy and large, which limits the number of actuators that can be integrated into the prosthesis. Alternative actuation methods are being researched, but have not yet found wide app

  6. RURS′ elbow guard: An innovative treatment of the thumb-sucking habit in a child with Hurler′s syndrome

    Directory of Open Access Journals (Sweden)

    Shetty R

    2010-09-01

    Full Text Available Thumb sucking is the process of sucking on the thumb for oral pleasure. Thumb and finger sucking habits, or nonnutritive sucking, are considered to be the most prevalent of oral habits. Some parents are concerned by thumb sucking and may even try to restrain the infant or child. In most cases, this is not necessary. Most children stop thumb sucking on their own. When older children continue to suck their thumbs, it could mean they are bored, anxious, or have emotional problems such as depression. This article presents a case report of a child with Hurler′s syndrome along with thumb sucking/biting habit. Hurler′s syndrome, also known as mucopolysaccharidosis I, is a rare condition inherited as an autosomal-recessive trait. It represents the classical prototype of mucopolysaccharide disorder. A unique appliance to prevent thumb sucking/biting was developed and termed as "RURS′ elbow guard," which was successfully used to break thumb sucking of the child with Hurler syndrome. The present report also describes the steps in fabrication of this new habit-breaking appliance, which is also designed to protect the finger from the effects of the sucking habit.

  7. Standard versus high-flexion posterior stabilized total knee prostheses.

    Science.gov (United States)

    Li, Ning; Li, Junwei; Li, Peng; Wang, Dan; Liu, Ming; Xia, Lei

    2015-03-01

    This meta-analysis compared clinical outcomes between standard and high-flexion posterior-stabilized total knee prostheses to evaluate which type of total knee prosthesis was superior. Randomized, controlled trials published until October 2013 comparing standard and high-flexion posterior-stabilized total knee prostheses were reviewed. Methodologic quality was assessed with the Physiotherapy Evidence Database scale. After data extraction, the authors compared results with fixed effects or random effects models, depending on the heterogeneity of the included studies. Eight randomized, controlled trials involving 660 patients met the predetermined inclusion criteria. No statistically significant differences between patients undergoing standard and high-flexion posterior-stabilized total knee prostheses were noted in postoperative range of motion (ROM) (weighted mean difference, -1.43; 95% confidence interval [CI], -4.52 to 1.67; P=.37); flexion angle (weighted mean difference, 0.54; 95% CI, -3.75 to 4.84; P=.80); Knee Society Score (weighted mean difference, 0.92; 95% CI, -0.64 to 2.48; P=.25); Hospital for Special Surgery knee score (weighted mean difference, 0.57; 95% CI, -0.42 to 1.55; P=.26); or Knee Society function score (weighted mean difference, 1.00; 95% CI, -1.49 to 3.49; P=.43). No statistical difference was found between the 2 prosthesis types in complications, involving 21 cases in the standard group and 14 cases in the high-flexion group. The current findings confirm that high-flexion posterior-stabilized total knee prostheses are not superior to standard prostheses in terms of ROM, flexion angle, knee scores, or complications with 5 years or less of follow-up.

  8. Cobalt release and complications resulting from the use of dental prostheses

    DEFF Research Database (Denmark)

    Al-Imam, Hiba; Benetti, Ana R.; Özhayat, Esben B.

    2016-01-01

    oral hygiene. CONCLUSIONS: Dental prostheses released cobalt during the fabrication stages, but not 1-5 years after insertion. No allergic reactions were observed. Signs of inflammation were related to candidiasis, insufficient oral hygiene, and ill-fitting prostheses.......) allergic reactions to components of dental prostheses, and (iii) to investigate the oral mucosa for inflammation 1-5 years after insertion of the prostheses. METHOD: Clinical oral examination was conducted in 66 patients with 84 dental prostheses. Cobalt release from 84 functional (used) and 32 non......-functional (new) prostheses was investigated with the cobalt spot test. Contact allergy was assessed by patch testing. Smear tests for Candida spp. were performed in patients showing signs of inflammation of the oral mucosa. The prostheses were assessed for biological and technical complications. RESULTS: None...

  9. Sensory Evaluation of Post Traumatic Thumb after Reconstruction with Reverse Radial Forearm Flap

    Directory of Open Access Journals (Sweden)

    Tayeb Ghadimi

    2013-09-01

    Full Text Available Background: Thumb is with a special role in hand function. Therefore, in addition to the significance of using thin, pliable, color-matched, and hairless cover in resurfacing the lesion in this area, recovery of sensation should also be taken into consideration. Materials and Methods: Thirteen patients with thumb degloving injuries were candidates for sensate reverse island radial forearm surgery. After transferring the flap, forearm lateral sensory nerve was sewn to the thumb digital nerve. At least for two years, these patients received regular diagnosis, and monofilament, static two point discrimination (S-2PD, and moving two point discrimination (M-2PD tests were taken from them.Results: Monofilament test did not show normal sensation recovery, at protective sensation threshold, in the parents. The difference between monofilament test and normal thumb was statistically significant (p<0.0001. In spite of this, the protective sensation was restored in all flaps after two years. According to the results from S-2PD and M-2PD tests, the restored sensation was at protective threshold or reduced, and the difference was statistically significant (p<0.0001.Conclusion: Given difficulties of performing free flaps, and also deficiencies of pedicle flaps, the forearm radial island flap is known as one of the primary choices in most of the thumb soft tissue and hand defects reconstruction, due to its advantages, especially restoring the sensation of the injured site.

  10. Osteonecrosis of Interphalangeal Joint of Thumb Two Months after Rattlesnake Bite.

    Science.gov (United States)

    Bonasso, Patrick; Lucke-Wold, Brandon; Jacob, Glen

    2015-01-01

    This case report details the osteonecrosis of the interphalangeal (IP) joint of the thumb two months after a rattlesnake bite. It describes the clinical presentation, imaging studies, histological review, pathology review, and review of literature. Our patient was a fifty-one year-old male who obtained a poisonous snakebite to the thumb. While in the hospital for acute treatment, a blood blister was debrided. He was seen two weeks after discharge for further debridement of epidermolysis. Patient presented one month later with a hand x-ray demonstrating bony erosions, and a bone scan showing active changes in the IP joint of his right thumb. He was taken to the OR for further debridement and definitive diagnosis. Pathology results confirmed osteonecrosis with negative bone cultures. The clinical presentation, diagnosis, and operative management of osteonecrosis offer a unique challenge, especially in a patient presenting with osteonecrosis from a poisonous snakebite.

  11. TIBIALIS ANTERIOR VASCULARIZED TRIPLE FLAPS IN ONE STAGE RECONSTRUCTION OF MUTILATED HAND WITH LOSS OF THUMB

    Institute of Scientific and Technical Information of China (English)

    钱云良; 章一新; 张余光; 王丹茹; 关文祥

    2004-01-01

    Objective To introduce a one stage technique in the reconstruction of mutilated hand with loss of thumb and eventual digits. Methods Tibialis anterior pediculated triple flaps (TAPTF) including distal lateral leg, dorsalis pedis flaps for skin defect covering and trimmed hallux for thumb reconstruction were presented.Results Mutilated hands in five patients were repaired by the technique with acceptable cosmetic and functional success. A three to twelve months follow-up in three patients resulted in the recovery of protective thermal sensation and pinch action of the reconstructed thumb. The donor sites were free from major disability. Conclusion TAPTF is ideal for one stage reconstruction of the mutilated hand with loss of digits.

  12. [SUBUNGUAL EXOSTOSIS OF THE THUMB - CASE REPORT IN AN EIGHT YEAR OLD GIRL].

    Science.gov (United States)

    Antabak, Anko; Đapić, Tomislav; Seiwerth, Sven; Papeš, Dino; Karlo, Robert; Luetić, Tomislav

    2015-01-01

    Subungual exostosis (SE) is a benign osteocartilaginous tumor of the distal phalanx of the finger, particularly of the toes. It affects both sexes, the most frequently occurring in the second and third decades of life, and very rarely in children younger than eight years. We present subungual exostosis (SE) in a eith year old female child affecting the terminal phalanx of the right thumb. She presented to us with gradually enlarging, painless, subungual hard nodule on the right thumb, spherical appearance size of 12 mm in diameter. Roentogram of the foot showed bony outgrowth arising from the terminal phalanx of right thumb. Lesion was excised with prior ablation of the nail, and sent for histopathological examination. Histology showed evidence of SE. No recurrence at postoperated site was seen till ten months of follow-up.

  13. Combined index finger pollicization with an anterolateral thigh flap for thumb reconstruction

    Institute of Scientific and Technical Information of China (English)

    Yu Guang; Xu Hongyan; Lei Hongyu; Guo Shuang; Huang Jianhua; Li Dibin

    2014-01-01

    A severe crush injury to the hand is devastating to patients. Under conditions in which the crush force is too great, the digits are not viable candidates for replantation. We present two cases in which the patients suffered from loss of the thumb ray at the first carpometacarpal joint and skin defect at the radial side. The tendons, radial nerve and metacarpal bone of the index finger were injured, and the second metacarpal head was retained. There was a comminuted fracture of the trapezium in both patients. The treatment protocols consisted of the index finger pollicization and the free anterolateral thigh flap transfer. The procedure was performed in a single operation. The new thumb is able to provide a stable post for pinch and grip after six months follow-up. Both patients were satisfied with the function and appearance of the reconstructed thumb.

  14. Pipeline rules of thumb handbook a manual of quick, accurate solutions to everyday pipeline engineering problems

    CERN Document Server

    McAllister, EW

    2014-01-01

    Presented in easy-to-use, step-by-step order, Pipeline Rules of Thumb Handbook is a quick reference for day-to-day pipeline operations. For more than 35 years, the Pipeline Rules of Thumb Handbook has served as the ""go-to"" reference for solving even the most day-to-day vexing pipeline workflow problems. Now in its 8th edition, this handbook continues to set the standard by which all other piping books are judged. Along with over 30% new or updated material regarding codes, construction processes, and equipment, this book continues to offer hundreds of ""how-to"" methods and ha

  15. A case of Goldenhar-Gorlin syndrome with unusual association of hypoplastic thumb

    Directory of Open Access Journals (Sweden)

    Das Amitava

    2008-01-01

    Full Text Available A case of Goldenhar-Gorlin syndrome in a seven-month-old male infant presented with the features of epibulbar dermoid, microtia and hemifacial microsomia associated with thumb defect. The dermoid was bilateral and microtia was unilateral. Preauricular appendages and pits were double and single respectively on both the sides. Hemifacial microsomia was unilateral and was associated with cleft lip, macrostomia, dental misalignment, large tongue and high arched palate. The association of hypoplastic thumb with Goldenhar-Gorlin syndrome has not been documented in the past.

  16. A systematic evaluation of the effect of thumb opponens splints on hand function in children with unilateral spastic cerebral palsy

    NARCIS (Netherlands)

    Ten Berge, S.R.; Boonstra, Antje; Dijkstra, P.U.; Hadders-Algra, M.; Haga, N.; Maathuis, C.G.B.

    2012-01-01

    Objective: To examine the effects of a neoprene thumb opponens splint on hand function during a self-selected activities of daily living task in children with unilateral spastic cerebral palsy with thumb-in-palm position of the affected hand. Design: Systematic evaluation of seven cases using a mult

  17. Vismodegib in basal cell carcinoma.

    Science.gov (United States)

    Amaria, R N; Bowles, D W; Lewis, K D; Jimeno, A

    2012-07-01

    Vismodegib is a novel, small-molecule inhibitor of smoothened, a key component of the hedgehog signaling pathway. Increased hedgehog pathway signaling is critical in the development of hereditary and spontaneous basal cell carcinomas of the skin, and has been implicated in the development of a number of other tumors. In preclinical models, vismodegib demonstrated potent antitumor activity in hedgehog-dependent tumors, particularly basal cell carcinomas. Clinically, phase I and II studies showed dramatic anticancer activity in patients with advanced basal cell carcinomas. In January 2012, vismodegib was approved by the FDA for the treatment of unresectable or metastatic basal cell carcinomas of the skin.

  18. Recent patents and designs on hip replacement prostheses.

    Science.gov (United States)

    Derar, H; Shahinpoor, M

    2015-01-01

    Hip replacement surgery has gone through tremendous evolution since the first procedure in 1840. In the past five decades the advances that have been made in technology, advanced and smart materials innovations, surgical techniques, robotic surgery and methods of fixations and sterilization, facilitated hip implants that undergo multiple design revolutions seeking the least problematic implants and a longer survivorship. Hip surgery has become a solution for many in need of hip joint remedy and replacement across the globe. Nevertheless, there are still long-term problems that are essential to search and resolve to find the optimum implant. This paper reviews several recent patents on hip replacement surgery. The patents present various designs of prostheses, different materials as well as methods of fixation. Each of the patents presents a new design as a solution to different issues ranging from the longevity of the hip prostheses to discomfort and inconvenience experienced by patients in the long-term.

  19. Prostheses, Cyborgs and Cyberspace – the Cyberpunk Trinity

    Directory of Open Access Journals (Sweden)

    Staša Sever

    2013-05-01

    Full Text Available This article will explore three elements that have collectively become the sine qua non of our lives: prostheses, cyborgs and cyberspace. The main concern of the article is to show the close connection between the technology-saturated reality of today and the literature of cyberpunk as the prototypical representative of merging the human and the technological. This will enable us to explore the interaction between literature and reality in the formation of the cyborg of today.

  20. Spatially Patterned Electrical Stimulation to Enhance Resolution of Retinal Prostheses

    OpenAIRE

    2014-01-01

    Retinal prostheses electrically stimulate neurons to produce artificial vision in people blinded by photoreceptor degenerative diseases. The limited spatial resolution of current devices results in indiscriminate stimulation of interleaved cells of different types, precluding veridical reproduction of natural activity patterns in the retinal output. Here we investigate the use of spatial patterns of current injection to increase the spatial resolution of stimulation, using high-density multie...

  1. Leg stiffness of sprinters using running-specific prostheses

    OpenAIRE

    McGowan, Craig P.; Grabowski, Alena M.; McDermott, William J.; Herr, Hugh M.; Kram, Rodger

    2012-01-01

    Running-specific prostheses (RSF) are designed to replicate the spring-like nature of biological legs (bioL) during running. However, it is not clear how these devices affect whole leg stiffness characteristics or running dynamics over a range of speeds. We used a simple spring–mass model to examine running mechanics across a range of speeds, in unilateral and bilateral transtibial amputees and performance-matched controls. We found significant differences between the affected leg (AL) of uni...

  2. Perception of socket alignment perturbations in amputees with transtibial prostheses

    OpenAIRE

    David A. Boone, PhD; Toshiki Kobayashi, PhD; Teri G . Chou, PhD; Adam K. Arabian, PhD; Kim L. Coleman, MS; Michael S. Orendurff, PhD; Ming Zhang, Ph

    2012-01-01

    A person with amputation’s subjective perception is the only tool available to describe fit and comfort to a prosthetist. However, few studies have investigated the effect of alignment on this perception. The aim of this article is to determine whether people with amputation could perceive the alignment perturbations of their prostheses and effectively communicate them. A randomized controlled perturbation of angular (3 and 6 degrees) and translational (5 and 10 mm) alignments in the sagittal...

  3. Clinical Management of Implant Prostheses in Patients with Bruxism

    Directory of Open Access Journals (Sweden)

    Osamu Komiyama

    2012-01-01

    Full Text Available There is general agreement that excessive stress to the bone-implant interface may result in implant overload and failure. Early failure of the implant due to excessive loading occurs shortly after uncovering the implant. Excess load on a final restoration after successful implant integration can result in physical failure of the implant structure. Many clinicians believe that overload of dental implants is a risk factor for vertical peri-implant bone loss and/or may be detrimental for the suprastructure in implant prostheses. It has been documented that occlusal parafunction, such as, bruxism (tooth grinding and clenching affects the outcome of implant prostheses, but there is no evidence for a causal relation between the failures and overload of dental implants. In spite of this lack of evidence, often metal restorations are preferred instead of porcelain for patients in whom bruxism is presumed on the basis of tooth wear. The purpose of this paper is to discuss the importance of the occlusal scheme used in implant restorations for implant longevity and to suggest a clinical approach and occlusal materials for implant prostheses in order to prevent complications related to bruxism.

  4. Clinical Management of Implant Prostheses in Patients with Bruxism

    Science.gov (United States)

    Komiyama, Osamu; Lobbezoo, Frank; De Laat, Antoon; Iida, Takashi; Kitagawa, Tsuyoshi; Murakami, Hiroshi; Kato, Takao; Kawara, Misao

    2012-01-01

    There is general agreement that excessive stress to the bone-implant interface may result in implant overload and failure. Early failure of the implant due to excessive loading occurs shortly after uncovering the implant. Excess load on a final restoration after successful implant integration can result in physical failure of the implant structure. Many clinicians believe that overload of dental implants is a risk factor for vertical peri-implant bone loss and/or may be detrimental for the suprastructure in implant prostheses. It has been documented that occlusal parafunction, such as, bruxism (tooth grinding and clenching) affects the outcome of implant prostheses, but there is no evidence for a causal relation between the failures and overload of dental implants. In spite of this lack of evidence, often metal restorations are preferred instead of porcelain for patients in whom bruxism is presumed on the basis of tooth wear. The purpose of this paper is to discuss the importance of the occlusal scheme used in implant restorations for implant longevity and to suggest a clinical approach and occlusal materials for implant prostheses in order to prevent complications related to bruxism. PMID:22701484

  5. Collateral ligament reconstruction of the chronic thumb injury with bio-tenodesis screw fixation

    DEFF Research Database (Denmark)

    Gvozdenovic, Robert; Boeckstyns, Michel

    2014-01-01

    We describe a new technique for the reconstruction of chronic lesions of the collateral ligaments of the metacarpophalangeal ligaments of the thumb, using a Bio-Tenodesis screw for the fixation of a tendon graft in a triangular manner with proximal apex and allowing early mobilization, starting 2...

  6. A family with hereditary ankyloglossia complicated by heterochromia irides and a congenital clasped thumb.

    Science.gov (United States)

    Sato, T; Iida, M; Yamaguchi, Y

    1983-10-01

    We experienced a family with hereditary ankyloglossia complicated by heterochromia irides and a congenital clasped thumb. This is considered to be a rare case because, to our knowledge, there have been no published reports on such cases of hereditary complications to date.

  7. The proportion of the face in younger adults using the thumb rule of Leonardo da Vinci.

    Science.gov (United States)

    Oguz, O

    1996-01-01

    The present study was conducted to examine whether the thumb rule of Leonardo da Vinci could be an objective method in the determination of the natural and artistic proportions of human face. In this study, a sample of 400 subjects (200 male and 200 female, 22-25 years old) was used. Measurements were made of the length of thumb, the length of ear, the approximate distances between the hair line and the glabella or eyebrows, between the glabella or eyebrows and the tip of the nose and the distance between the nose and the chin, and the distance between the ear and the lateral aspect of the eye. The results obtained in the males and females showed significant (p < 0.01) correlations between the length of thumb and the proportions of the face examined in the study. Additionally, the height of the face was found to be almost three times the length of the thumb. However, the measurements obtained from female subjects were on average smaller than those taken from males. The results obtained in this experiment could be of value in understanding of the evaluation of the face for the people working in plastic surgery or art.

  8. Partial trapeziectomy and interposition of fascia lata allograft in the operative treatment of thumb base osteoarthritis

    NARCIS (Netherlands)

    Spaans, Anne J.; Weijns, Marieke E.; Braakenburg, Assa; Van Minnen, Leo Paul; Mink Van Der Molen, Aebele B.

    2016-01-01

    Aim: The purpose of this retrospective cohort study was to evaluate the results of fascia lata allograft interposition after partial trapeziectomy in patients with symptomatic first carpometacarpal joint osteoarthritis. Methods and results: Twenty-one patients (22 thumbs) with Eaton-Glickel stage II

  9. The Effect of an Open Carpal Tunnel Release on Thumb CMC Biomechanics

    Directory of Open Access Journals (Sweden)

    Marc A. Tanner

    2012-01-01

    Full Text Available Purpose. We have observed worsening thumb pain following carpal tunnel release (CTR in some patients. Our purpose was to determine the effect of open CTR on thumb carpometacarpal (CMC biomechanics. Methods. Five fresh-frozen cadaver arms with intact soft tissues were used. Each specimen was secured to a jig which fixed the forearm at 45° supination, and the wrist at 20° dorsiflexion, with thumb pointing up. The thumb was axially loaded with a force of 130 N. We measured 3D translation and rotation of the trapezium, radius, and first metacarpal, before and after open CTR. Motion between radius and first metacarpal, radius and trapezium, and first metacarpal and trapezium during loading was calculated using rigid body mechanics. Overall stiffness of each specimen was determined. Results. Total construct stiffness following CTR was reduced in all specimens but not significantly. No significant changes were found in adduction, pronation, or dorsiflexion of the trapezium with respect to radius after open CTR. Motion between radius and first metacarpal, between radius and trapezium, or between first metacarpal and trapezium after open CTR was not decreased significantly. Conclusion. From this data, we cannot determine if releasing the transverse carpal ligament alters kinematics of the CMC joint.

  10. Capacity Value: Evaluation of WECC Rule of Thumb; NREL (National Renewable Energy Laboratory)

    Energy Technology Data Exchange (ETDEWEB)

    Milligan, Michael; Ibanez, Eduardo

    2015-06-09

    This presentation compares loss of load expectation and wind and solar capacity values to the rules of thumb used in the Western Interconnection planning and provides alternative recommendations to the modeling efforts of the Western Electricity Coordinating Council's Transmission Expansion Planning Policy Committee.

  11. Median Nerve Deformation and Displacement in the Carpal Tunnel during Index Finger and Thumb Motion

    NARCIS (Netherlands)

    van Doesburg, Margriet H. M.; Yoshii, Yuichi; Villarraga, Hector R.; Henderson, Jacqueline; Cha, Stephen S.; An, Kai-Nan; Amadio, Peter C.

    2010-01-01

    The purpose of this study was to investigate the deformation and displacement of the normal median nerve in the carpal tunnel during index finger and thumb motion, using ultrasound Thirty wrists from 15 asymptomatic volunteers were evaluated Cross-sectional images during motion from full extension t

  12. Assessing Financial Education Methods: Principles vs. Rules-of-Thumb Approaches

    Science.gov (United States)

    Skimmyhorn, William L.; Davies, Evan R.; Mun, David; Mitchell, Brian

    2016-01-01

    Despite thousands of programs and tremendous public and private interest in improving financial decision-making, little is known about how best to teach financial education. Using an experimental approach, the authors estimated the effects of two different education methodologies (principles-based and rules-of-thumb) on the knowledge,…

  13. Reverse flow first dorsal metacarpal artery flap for covering the defect of distal thumb.

    Science.gov (United States)

    Checcucci, Giuseppe; Galeano, Mariarosaria; Zucchini, Maura; Zampetti, Pier Giuseppe; Ceruso, Massimo

    2014-05-01

    Reconstruction of distal thumb injuries still remains a challenge for hand surgeons. Surgical treatment includes the use of local, regional, and free flaps. The purpose of this report is to present the results of the use of a sensitive reverse flow first dorsal metacarpal artery (FDMA) flap. The skin flap was designed on the radial side of the proximal phalanx of the index finger based on the ulnar and radial branch of the FDMA and a sensory branch of the superficial radial nerve. This neurovascular flap was used in five patients to cover distal soft-tissue thumb defects. All flaps achieved primary healing except for one patient in whom superficial partial necrosis of the flap occurred, and the defect healed by second intention. All patients maintained the thumb original length and were able to return to their previous daily activities. The reverse flow FDMA flap is a reliable option to cover immediate and delayed defects of distal thumb, offering acceptable functional and cosmetic outcomes in respect to sensibility, durability, and skin-match.

  14. Use of twin dorsal middle phalangeal finger flaps for thumb or index finger reconstruction.

    Science.gov (United States)

    Qi, W; Chen, K J

    2013-05-01

    Amputation or degloving injuries of the thumb or index finger are highly disabling. We describe the use of twin dorsal middle finger flaps harvested from the dorsal aspects of the middle and ring fingers, and based on one palmar proper digital artery, its venae comitantes, and the dorsal branches of the palmar digital nerves of the middle and ring fingers, respectively. These flaps offer advantages when large soft tissue defects of the thumb or index finger are present. In this study, twin dorsal middle finger flaps were used in nine patients (six thumbs, three index fingers). All flaps completely survived. At the mean follow-up of 20 months, the appearance of the reconstructed thumbs or index fingers was acceptable, the length was maintained, and the mean static 2-point discrimination values were 10 mm in the palmar flap and 13 mm in the dorsal flap of the reconstructed digit. All patients were satisfied with the appearance and mobility of the donor fingers. All but one donor finger showed normal finger pulp sensibility, with a static 2-point discrimination between 3 and 6 mm.

  15. The Engineer's Thumb or Sherlock Holmes on the trail of 'the uncanny'.

    Science.gov (United States)

    Batail, J

    1997-08-01

    Freud identified 'primal phantasies' (life in the womb, 'primal scene', seduction, castration). It is argued that 'The Engineer's Thumb', a short story from 'The Adventures of Sherlock Holmes', draws its uncanniness from the fact that it is underpinned by all the primal phantasies described by Freud. 'The Engineer's Thumb' therefore illustrates what analytical interpretation can contribute to the understanding of certain literary works. 'The Engineer's Thumb' may also serve as an introduction to a broader study of the Freudian concept of 'the uncanny'. This study seems to confirm what Freud said when he pointed out that 'an uncanny experience occurs either when infantile complexes which have been repressed are once more revived by some impression, or when primitive beliefs which have been surmounted seem once more to be confirmed' (1919, p. 249). 'The Engineer's Thumb' has another interesting feature: in this short story. Conan Doyle, by setting up a 'talking cure', anticipates the creation of psychoanalysis and highlights in a striking way certain aspects of what was to become psychoanalytical treatment.

  16. Bridging the gap between cadaveric and in vivo experiments: a biomechanical model evaluating thumb-tip endpoint forces.

    Science.gov (United States)

    Wohlman, Sarah J; Murray, Wendy M

    2013-03-15

    The thumb is required for a majority of tasks of daily living. Biomechanical modeling is a valuable tool, with the potential to help us bridge the gap between our understanding of the mechanical actions of individual thumb muscles, derived from anatomical cadaveric experiments, and our understanding of how force is produced by the coordination of all of the thumb muscles, derived from studies involving human subjects. However, current biomechanical models do not replicate muscle force production at the thumb-tip. We hypothesized that accurate representations of the axes of rotation of the thumb joints were necessary to simulate the magnitude of endpoint forces produced by human subjects. We augmented a musculoskeletal model with axes of rotation derived from experimental measurements (Holzbaur et al., 2005) by defining muscle-tendon paths and maximum isometric force-generating capacity for the five intrinsic muscles. We then evaluated if this augmented model replicated a broad range of experimental data from the literature and identified which parameters most influenced model performance. The simulated endpoint forces generated by the combined action of all thumb muscles in our model yielded comparable forces in magnitude to those produced by nonimpaired subjects. A series of 8 sets of Monte Carlo simulations demonstrated that the difference in the axes of rotation of the thumb joints between studies best explains the improved performance of our model relative to previous work. In addition, we demonstrate that the endpoint forces produced by individual muscles cannot be replicated with existing experimental data describing muscle moment arms.

  17. Choosing the Right Basal Reader.

    Science.gov (United States)

    Robbins, Ruth H.

    1980-01-01

    Looks at factors in the textbook publishing industry, especially costs and censorship, which affect the quality of available reading series. Notes the problem of readability and content bias. Finally, presents a checklist of basal reader evaluation criteria. (SJL)

  18. Antibiotic cements in articular prostheses: current orthopaedic concepts.

    Science.gov (United States)

    Langlais, F; Belot, N; Ropars, M; Thomazeau, H; Lambotte, J C; Cathelineau, G

    2006-08-01

    The possibilities and limits of antibiotic cements (ACs) have been assessed by many researchers. ACs are now approved by many drug agencies, including the US Food and Drug Administration (approval in 2003), with widespread use in prophylaxis and curative treatments. Laboratory experiments have achieved satisfactory antibiotic delivery without impairing the mechanical properties of ACs. Implantation in large animals (e.g. sheep) showed an antibiotic concentration in the bone cortex four times the minimal inhibitory concentration (MIC) 6 months after implantation. Human pharmacokinetics during total hip replacement (THR) show antibiotic concentrations 20 times the MIC in drainage fluids. No toxic concentrations have been detected in blood or urine, and no allergies, toxic effects, mechanical failures or selection of resistant microorganisms have been observed. Antibioprophylaxis has been assessed in prospective studies in over 1600 cases. In data from the Scandinavian arthroplasty registers, with an exhaustive follow-up of more than 240000 THRs, infection rate was reduced by ca. 50% (0.9% compared with 1.9%). In prostheses with severe infection, use of AC increases the infection control rate from 86% to 93% when using two-stage prosthetic exchanges. In moderate infection, a similar infection control rate (86%) was achieved either by two-stage exchange without local antibiotic or by one-stage exchange with AC; however, one-stage exchange achieved better functional results at lower cost and with reduced pain and hospital stay. Therefore, AC prophylaxis is widely used in countries with prostheses registers (Northern Europe), and use of ACs as treatment for infected prostheses is often considered as the gold standard in the EU and North America. However, AC is only an adjuvant treatment, and excision of infected and devascularized tissues as well as systemic antibiotic treatment managed by a multidisciplinary team remain the main factors of infection control.

  19. Walking Ability and Quality of Life in Subjects With Transfemoral Amputation: A Comparison of Osseointegration With Socket Prostheses.

    NARCIS (Netherlands)

    Meent, H. van de; Hopman, M.T.E.; Frolke, J.P.M.

    2013-01-01

    OBJECTIVE: To investigate walking ability and quality of life of osseointegrated leg prostheses compared with socket prostheses. DESIGN: Prospective case-control study. SETTING: University medical center. PARTICIPANTS: Subjects (N=22) with transfemoral amputation (1 bilateral) referred to our center

  20. Modular externally-powered system for limb prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Seamone, W.; Hoshall, C.H.; Schmeisser, G.

    Many upper limb amputees especially those who have sustained high level amputations of injury to remaining portions of the body, are unable to use conventional prosthetic devices effectively. In an effort to help the more severely handicapped amputees and those who may for other reasons require capabilities that standard prostheses cannot provide, the Applied Physics Laboratory, in conjunction with the Johns Hopkins Medical Institutions, has developed a prosthetic system which is powered by rechargeable batteries. The amputee need supply only a control signal. This article describes the concept which is now being evaluated with the aid of amputee subjects, and discusses results obtained to data in field tests.

  1. Clinical Practice Guidelines for Valvular Prostheses Dysfunction Treatment

    Directory of Open Access Journals (Sweden)

    Lázaro De la Cruz Avilés

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Valve Prostheses Dysfunction Treatment. The introduction of an artificial valve allows improving life quality and expectancy of an important number of patients and can be considered a common treatment within advanced heart valve disease. However, persons with this kind of prosthesis usually present another disease caused by the potential complications associated with the uses of anti-clotting medications. This document includes the different classifications of artificial heart valves and different kinds of dysfunctions, and updates those aspects related with treatment stressing the appropriate behaviour when valve or prosthesis thrombosis occurs. It includes assessment guidelines focused on the most important aspects to be accomplished.

  2. Sight restoration comes into focus: versions of visual prostheses.

    Science.gov (United States)

    Mertz, Leslie

    2012-01-01

    The first visual prosthetic is on the commercial stage now, and a variety of new retinal and cortical implants are in the wings. When it won the European stamp of approval last year, the Argus II became the first commercially available visual prosthesis. Now Second Sight Medical Products Inc. of Sylmar, California, the company behind the Argus II, hopes to receive approval to sell the device in the United States by late 2012. As the excitement over the Argus II continues at a fever pitch, other research groups are developing their own versions of visual prostheses, working to create the potential for restoring sight.

  3. Occlusion for maxillary dentures opposing osseointegrated mandibular prostheses.

    Science.gov (United States)

    Denissen, H W; Kalk, W; van Waas, M A; van Os, J H

    1993-01-01

    This paper presents a combination of several occlusal concepts designed to contribute to the successful use of maxillary dentures in opposition to osseointegrated mandibular prostheses. To ensure a positive outcome when designing such an occlusion, three factors must be considered: patient satisfaction, maxillary anterior bone preservation, and mandibular arch shortening. It is recommended that for centric occlusion the molars have a lingual contact occlusion, the premolars have a buccal contact occlusion, and the anterior teeth have an open occlusal relationship. For an eccentric occlusion, a balanced articulation is favored instead of mutually protected occlusion.

  4. Differences in aerodynamic characteristics of new and dysfunctional Provox (R) 2 voice prostheses in vivo

    NARCIS (Netherlands)

    Schwandt, LQ; Tjong-Ayong, HJ; van Weissenbruch, R; der Mei, HC; Albers, FWJ

    2006-01-01

    Tracheoesophageal voice prostheses need to be replaced due to increased airflow resistance or retrograde leakage of fluid into the trachea as a consequence of biofilm formation. Previous in vitro studies show a change of aerodynamic features of biofilm covered voice prostheses after removal of the p

  5. A study of technical changes to lower limb prostheses after initial fitting

    NARCIS (Netherlands)

    Rommers, GM; Vos, LDW; Klein, L; Groothoff, JW; Eisma, W H

    2000-01-01

    There is little published material in recent years about the use of lower limb prostheses in an elderly amputee population. In this study the authors were interested in the technical changes to lower limb prostheses after a first limb fitting procedure in a post-rehabilitation population in the Neth

  6. Movement characteristics of upper extremity prostheses during basic goal-directed tasks

    NARCIS (Netherlands)

    Bouwsema, Hanneke; van der Sluis, Corry K.; Bongers, Raoul M.

    2010-01-01

    Background: After an upper limb amputation a prosthesis is often used to restore the functionality. However, the frequency of prostheses use is generally low. Movement kinematics of prostheses use might suggest origins of this low use. The aim of this study was to reveal movement patterns of prosthe

  7. Trapeziometacarpal narrow pseudarthrosis: a new surgical technique to treat thumb carpometacarpal joint arthritis.

    Science.gov (United States)

    Rubino, M; Civani, A; Pagani, D; Sansone, V

    2013-10-01

    We describe a technique that arose from the observation of the clinical outcome of failed arthrodeses of the thumb carpometacarpal joint. In these cases a pseudoarthrosis developed which, surprisingly, rarely lead to a poor clinical outcome. Thus we developed a simple technique which deliberately caused the formation of a narrow pseudoarthrosis in the carpometacarpal joint. We present a retrospective review of 248 consecutive patients treated for Eaton stages II and III osteoarthritis. We observed a statistically significant improvement in mean appositional and oppositional pinch strength, mean DASH score (63.8 pre-operatively to 10.5 at final follow-up), and the mean pain score (8.3 to 0.2). We conclude that trapeziometacarpal limited excision arthroplasty is a simple and reliable alternative to existing surgical techniques for treating Stage II or III thumb carpometacarpal joint arthritis.

  8. Development of a Networked Thumb Print-Based Staff Attendance Management System

    OpenAIRE

    Tolulope Awode; Oluwagbemiga Shoewu; Oluwabukola Mayowa Ishola; Segun O. Olatinwo

    2016-01-01

    This paper focuses on the development of a networked thumb print-based attendance management system. Now, more than ever, it has become necessary to give more thought to the methods of time and attendance management. The traditional time clock, manual attendance registering often no longer makes sense and simply does not meet the needs of the modern work environment. This system offers a comprehensive software solution that will streamline company's operations, and simplify timekeeping. Nowad...

  9. Florid reactive periostitis of the thumb: a case report and review of the literature.

    Science.gov (United States)

    Solana, Jordi; Bosch, Manuel; Español, Isabel

    2003-04-01

    Florid reactive periostitis is a rare benign bone lesion that occurs most often in the phalanges of hands and feet. Histologic evaluation is commonly required to distinguish this benign lesion from clinically indistinguishable malignant and infectious disorders. The lesion is typically self-limiting or cured by local excision; however, in very aggressive cases ray amputation may be indicated. The authors report a case of florid reactive periostitis affecting the thumb with satisfactory outcome and without recurrence at 2-year follow-up.

  10. Prevalence of heat and perspiration discomfort inside prostheses: literature review.

    Science.gov (United States)

    Ghoseiri, Kamiar; Safari, Mohammad Reza

    2014-01-01

    People with limb amputation deal with thermal stresses in their daily activities. Unfortunately, in the majority of this population, all thermal transfer mechanisms, including convection, radiation, evaporation, and conduction, can be disturbed due to the prosthetic socket barrier, decreased body surface area, and/or vascular disease. The thermal environment inside prosthetic sockets, in addition to decreased quality of life and prosthesis use, comfort, and satisfaction, could endanger people with amputation with a high risk of skin irritations. The current review explores the importance of thermal and perspiration discomfort inside prosthetic sockets by providing an insight into the prevalence of the problem. The literature search was performed in two databases, PubMed and Web of Knowledge, to find relevant articles. After considering the review criteria and hand-searching the reference sections of the selected studies, 38 studies were listed for review and data extraction. This review revealed that more than 53% of people with amputation in the selected studies experienced heat and/or perspiration discomfort inside their prostheses. In spite of great technological advances, current prostheses are unable to resolve this problem. Therefore, more attention must be paid by researchers, clinicians, and manufacturers of prosthetic components to thermal-related biomechanics of soft tissues, proper fabrication technique, material selection, and introduction of efficient thermoregulatory systems.

  11. Oral Implant-Prostheses: New Teeth for a Brighter Brain

    Science.gov (United States)

    De Cicco, Vincenzo; Barresi, Massimo; Tramonti Fantozzi, Maria Paola; Cataldo, Enrico; Parisi, Vincenzo; Manzoni, Diego

    2016-01-01

    Several studies have demonstrated that chewing can be regarded as a preventive measure for cognitive impairment, whereas masticatory deficiency, associated with soft-diet feeding, is a risk factor for the development of dementia. At present the link between orofacial sensorimotor activity and cognitive functions is unknown. In subjects with unilateral molar loss we have shown asymmetries in both pupil size and masticatory muscles electromyographic (EMG) activity during clenching: the molar less side was characterized by a lower EMG activity and a smaller pupil. Since implant-prostheses, greatly reduced both the asymmetry in EMG activity and in pupil’s size, trigeminal unbalance, leading to unbalance in the activity of the Locus Coeruleus (LC), may be responsible for the pupil’s asymmetry. According to the findings obtained in animal models, we propose that the different activity of the right and left LC may induce an asymmetry in brain activity, thus leading to cognitive impairment. According to this hypothesis, prostheses improved the performance in a complex sensorimotor task and increased the mydriasis associated with haptic tasks. In conclusion, the present study indicates that the implant-prosthesis therapy, which reduces the unbalance of trigeminal proprioceptive afferents and the asymmetry in pupil’s size, may improve arousal, boosting performance in a complex sensorimotor task. PMID:26919258

  12. Titania nanotube arrays as interfaces for neural prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Sorkin, Jonathan A. [Department of Mechanical Engineering, Colorado State University, Fort Collins CO 80523 (United States); Hughes, Stephen [Department of Chemical and Biological Engineering, Colorado State University, Fort Collins CO 80523 (United States); School of Biomedical Engineering, Colorado State University, Fort Collins CO 80523 (United States); Soares, Paulo [Department of Mechanical Engineering, Polytechnic School, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901 (Brazil); Popat, Ketul C., E-mail: ketul.popat@colostate.edu [Department of Mechanical Engineering, Colorado State University, Fort Collins CO 80523 (United States); School of Biomedical Engineering, Colorado State University, Fort Collins CO 80523 (United States)

    2015-04-01

    Neural prostheses have become ever more acceptable treatments for many different types of neurological damage and disease. Here we investigate the use of two different morphologies of titania nanotube arrays as interfaces to advance the longevity and effectiveness of these prostheses. The nanotube arrays were characterized for their nanotopography, crystallinity, conductivity, wettability, surface mechanical properties and adsorption of key proteins: fibrinogen, albumin and laminin. The loosely packed nanotube arrays fabricated using a diethylene glycol based electrolyte, contained a higher presence of the anatase crystal phase and were subsequently more conductive. These arrays yielded surfaces with higher wettability and lower modulus than the densely packed nanotube arrays fabricated using water based electrolyte. Further the adhesion, proliferation and differentiation of the C17.2 neural stem cell line was investigated on the nanotube arrays. The proliferation ratio of the cells as well as the level of neuronal differentiation was seen to increase on the loosely packed arrays. The results indicate that loosely packed nanotube arrays similar to the ones produced here with a DEG based electrolyte, may provide a favorable template for growth and maintenance of C17.2 neural stem cell line. - Highlights: • Titania nanotube arrays can be fabricated with to have loosely or densely packed morphologies. • Titania nanotube arrays support higher C17.2 neural stem cell adhesion and proliferation. • Titania nanotube arrays support higher C17.2 neural stem cell differentiation towards neuronal lineage.

  13. Oral Implant-Prostheses: New Teeth for a Brighter Brain.

    Directory of Open Access Journals (Sweden)

    Vincenzo De Cicco

    Full Text Available Several studies have demonstrated that chewing can be regarded as a preventive measure for cognitive impairment, whereas masticatory deficiency, associated with soft-diet feeding, is a risk factor for the development of dementia. At present the link between orofacial sensorimotor activity and cognitive functions is unknown. In subjects with unilateral molar loss we have shown asymmetries in both pupil size and masticatory muscles electromyographic (EMG activity during clenching: the molar less side was characterized by a lower EMG activity and a smaller pupil. Since implant-prostheses, greatly reduced both the asymmetry in EMG activity and in pupil's size, trigeminal unbalance, leading to unbalance in the activity of the Locus Coeruleus (LC, may be responsible for the pupil's asymmetry. According to the findings obtained in animal models, we propose that the different activity of the right and left LC may induce an asymmetry in brain activity, thus leading to cognitive impairment. According to this hypothesis, prostheses improved the performance in a complex sensorimotor task and increased the mydriasis associated with haptic tasks. In conclusion, the present study indicates that the implant-prosthesis therapy, which reduces the unbalance of trigeminal proprioceptive afferents and the asymmetry in pupil's size, may improve arousal, boosting performance in a complex sensorimotor task.

  14. Elbow joint biomechanics for preclinical evaluation of total elbow prostheses.

    Science.gov (United States)

    Kincaid, Brian L; An, Kai-Nan

    2013-09-27

    Total elbow arthroplasty is a clinically successful procedure, yet long-term implant survival rates have historically lagged behind those reported for total hips and knees. Clinical complications associated with implant wear, osteolysis, stem loosening and device fracture have been implicated as reasons for limited long-term survivorship. Unfortunately, there is little published information on the biomechanics and method(s) for preclinical evaluation of total elbow prostheses that could provide insight into the mechanisms of failure. Additionally, there are no consensus testing standards or summaries of loading profiles of the humero-ulnar joint associated with a range of activities of daily living. Such data would facilitate the standardized preclinical assessment of total elbow devices such is commonplace for other large joints. The objective of the work here is therefore to provide a comprehensive review of elbow joint biomechanics as it relates to preclinical evaluation of total elbow implants. This summary includes a review of elbow joint forces, kinematics, the types and frequency of humero-ulnar joint motions associated with activities of daily living and clinical outcomes, as well as proposing a methodology for deriving humero-ulnar joint reaction force magnitudes and vector orientations as a function of a known mass/force at the hand. From these data, a scalable, bi-axial loading profile is proposed as a foundation for the development of clinically relevant, laboratory simulations for assessment of total elbow prostheses performance.

  15. Prevalence of heat and perspiration discomfort inside prostheses: Literature review

    Directory of Open Access Journals (Sweden)

    Kamiar Ghoseiri, PhD Candidate

    2014-10-01

    Full Text Available People with limb amputation deal with thermal stresses in their daily activities. Unfortunately, in the majority of this population, all thermal transfer mechanisms, including convection, radiation, evaporation, and conduction, can be disturbed due to the prosthetic socket barrier, decreased body surface area, and/or vascular disease. The thermal environment inside prosthetic sockets, in addition to decreased quality of life and prosthesis use, comfort, and satisfaction, could put people with amputation at high risk for skin irritations. The current review explores the importance of thermal and perspiration discomfort inside prosthetic sockets by providing an insight into the prevalence of the problem. The literature search was performed in two databases, PubMed and Web of Knowledge, to find relevant articles. After considering the review criteria and hand-searching the reference sections of the selected studies, 38 studies were listed for review and data extraction. This review revealed that more than 53% of people with amputation in the selected studies experienced heat and/or perspiration discomfort inside their prostheses. In spite of great technological advances, current prostheses are unable to resolve this problem. Therefore, more attention must be paid by researchers, clinicians, and manufacturers of prosthetic components to thermal-related biomechanics of soft tissues, proper fabrication technique, material selection, and introduction of efficient thermoregulatory systems.

  16. Sustained attention to spontaneous thumb sensations activates brain somatosensory and other proprioceptive areas.

    Science.gov (United States)

    Bauer, Clemens C C; Díaz, José-Luis; Concha, Luis; Barrios, Fernando A

    2014-06-01

    The present experiment was designed to test if sustained attention directed to the spontaneous sensations of the right or left thumb in the absence of any external stimuli is able to activate corresponding somatosensory brain areas. After verifying in 34 healthy volunteers that external touch stimuli to either thumb effectively activate brain contralateral somatosensory areas, and after subtracting attention mechanisms employed in both touch and spontaneous-sensation conditions, fMRI evidence was obtained that the primary somatosensory cortex (specifically left BA 3a/3b) becomes active when an individual is required to attend to the spontaneous sensations of either thumb in the absence of external stimuli. In addition, the left superior parietal cortex, anterior cingulate gyrus, insula, motor and premotor cortex, left dorsolateral prefrontal cortex, Broca's area, and occipital cortices were activated. Moreover, attention to spontaneous-sensations revealed an increased connectivity between BA 3a/3b, superior frontal gyrus (BA 9) and anterior cingulate cortex (BA 32), probably allowing top-down activations of primary somatosensory cortex. We conclude that specific primary somatosensory areas in conjunction with other left parieto-frontal areas are involved in processing proprioceptive and interoceptive bodily information that underlies own body-representations and that these networks and cognitive functions can be modulated by top-down attentional processes.

  17. The evolution of the hominin thumb and the influence exerted by the non-dominant hand during stone tool production.

    Science.gov (United States)

    Key, Alastair J M; Dunmore, Christopher J

    2015-01-01

    Modern humans possess a highly derived thumb that is substantially stronger and more robust than the fingers. Previous hypotheses concerning the evolution of such traits have focused upon the manipulation of hammerstones during stone tool production and of stone tools during their use. To date there has been no research on the manipulative pressures exerted by the non-dominant (core-holding) hand during stone tool production and its potential influence on the evolutionary history of the thumb. Here we provide the first investigation into the frequencies of digit recruitment and the relative manipulative forces experienced in the non-dominant hand during stone tool production. Eight experienced knappers produced flake cutting tools under four distinct conditions while pressure sensors, secured to the volar pads of the thumb, index and middle fingers of the non-dominant hand, recorded manipulative forces. Results indicate that relative to the fingers, the thumb was recruited significantly more frequently and experienced significantly greater manipulative forces during core repositioning events and the securing of the core during flake detachments. Our results support the hypothesis that the robust thumb anatomy observed in the hominin lineage was selected for, at least in part, as a result of more frequent and greater manipulative pressures acting upon the thumb relative to the fingers on the non-dominant hand during stone tool production.

  18. Nevoid basal cell carcinoma syndrome

    Directory of Open Access Journals (Sweden)

    Kannan Karthiga

    2006-01-01

    Full Text Available Binkley and Johnson first reported this syndrome in 1951. But it was in 1960, Gorlin-Goltz established the association of basal cell epithelioma, jaw cyst and bifid ribs, a combination which is now frequently known as Gorlin-Goltz syndrome as well as Nevoid Basal Cell Carcinoma Syndrome (NBCCS. NBCCS is inherited as an autosomal dominant trait with high penetrance and variable expressivity. NBCCS is characterized by variety of cutaneous, dental, osseous, opthalmic, neurologic and sexual abnormalities. One such case of Gorlin-Goltz syndrome is reported here with good illustrations.

  19. Relationship between obesity and early failure of total knee prostheses

    Directory of Open Access Journals (Sweden)

    De Palma Rossana

    2009-03-01

    Full Text Available Abstract Background Obesity is a risk factor for knee arthritis. Total knee arthroplasty is the definitive surgical treatment of this disease. Therefore, a high percentage of subjects treated are overweight. Since 2000 in the Emilia-Romagna Region the Register of Orthopedic Prosthetic Implantology, RIPO, has recorded data of all the primary and revision operations performed on the knee; height and weight of patients at the time of surgery have also been recorded. Methods To understand how overweight and obesity affect the outcome of knee arthroplasty, a population of subjects treated with cemented total knee arthroplasty between 2000 and 2005 was studied. 9735 knee prostheses were implanted in 8892 patients; 18.9% of the patients were normal weight, 48.2% were overweight (25 40. Mean and range of follow-up were respectively 3.1 and 1.5–6 yrs. Implant failure was defined as the exchange of at least one component for whatever reason. Results In normal weight patients there were 36 failures out of 1840 implants (1.96%, in overweight patients there were 87 out of 4692 (1.85%, in obese 59 out of 3031 (1.94%, and in morbidly obese there were 4 out of 172 (2.3%. The mean time to failure for each class was 1.57, 1.48, 1.60, 1.77 yrs. Cox regression analyses showed that the risk of implant failure was not influenced by BMI, absolute body weight, or sex. Conversely, an increased failure risk was observed in mobile meniscus prostheses in comparison with those with a fixed meniscus (Rate Ratio 1.88; an increased failure risk was also related to age (Rate Ratio 1.05 per year. These results were also confirmed when considering septic loosening as the end-point. There were no differences in the rate of perioperative complications and death in the 4 classes of BMI. Conclusion In conclusion, cemented knee prostheses, implanted in patients with arthritis do not have significantly different rates of survival or perioperative complications in obese subjects

  20. Cryotherapy in basal cell carcinoma

    Directory of Open Access Journals (Sweden)

    Sandra A

    1999-01-01

    Full Text Available Cryotherapy has proved to be an effective tool in the management of various dermatoses. We report 6 patients with histopathologically proven basal cell carcinoma of variable sizes treated with liquid nitrogen cryotherapy by the open spray technique. Lesions tended to heal with depigmentation and scar formation. However depigmented areas often repigmented over a period of time.

  1. Brain Prostheses as a Dynamic System (Immortalizing the Human Brain?)

    CERN Document Server

    Astakhov, Vadim

    2007-01-01

    Interest in development of brain prostheses, which might be proposed to recover mental functions lost due to neuron-degenerative disease or trauma, requires new methods in molecular engineering and nanotechnology to build artificial brain tissues. We develop a Dynamic Core model to analyze complexity of damaged biological neural network as well as transition and recovery of the system functionality due to changes in the system environment. We provide a method to model complexity of physical systems which might be proposed as an artificial tissue or prosthesis. Delocalization of Dynamic Core model is developed to analyze migration of mental functions in dynamic bio-systems which undergo architecture transition induced by trauma. Term Dynamic Core is used to define a set of causally related functions and Delocalization is used to describe the process of migration. Information geometry and topological formalisms are proposed to analyze information processes. A holographic model is proposed to construct dynamic e...

  2. Auditory Neural Prostheses – A Window to the Future

    Directory of Open Access Journals (Sweden)

    Mohan Kameshwaran

    2015-06-01

    Full Text Available Hearing loss is one of the commonest congenital anomalies to affect children world-over. The incidence of congenital hearing loss is more pronounced in developing countries like the Indian sub-continent, especially with the problems of consanguinity. Hearing loss is a double tragedy, as it leads to not only deafness but also language deprivation. However, hearing loss is the only truly remediable handicap, due to remarkable advances in biomedical engineering and surgical techniques. Auditory neural prostheses help to augment or restore hearing by integration of an external circuitry with the peripheral hearing apparatus and the central circuitry of the brain. A cochlear implant (CI is a surgically implantable device that helps restore hearing in patients with severe-profound hearing loss, unresponsive to amplification by conventional hearing aids. CIs are electronic devices designed to detect mechanical sound energy and convert it into electrical signals that can be delivered to the coch­lear nerve, bypassing the damaged hair cells of the coch­lea. The only true prerequisite is an intact auditory nerve. The emphasis is on implantation as early as possible to maximize speech understanding and perception. Bilateral CI has significant benefits which include improved speech perception in noisy environments and improved sound localization. Presently, the indications for CI have widened and these expanded indications for implantation are related to age, additional handicaps, residual hearing, and special etiologies of deafness. Combined electric and acoustic stimulation (EAS / hybrid device is designed for individuals with binaural low-frequency hearing and severe-to-profound high-frequency hearing loss. Auditory brainstem implantation (ABI is a safe and effective means of hearing rehabilitation in patients with retrocochlear disorders, such as neurofibromatosis type 2 (NF2 or congenital cochlear nerve aplasia, wherein the cochlear nerve is damaged

  3. The thumb subdomain of yeast mitochondrial RNA polymerase is involved in processivity, transcript fidelity and mitochondrial transcription factor binding.

    Science.gov (United States)

    Velazquez, Gilberto; Sousa, Rui; Brieba, Luis G

    2015-01-01

    Single subunit RNA polymerases have evolved 2 mechanisms to synthesize long transcripts without falling off a DNA template: binding of nascent RNA and interactions with an RNA:DNA hybrid. Mitochondrial RNA polymerases share a common ancestor with T-odd bacteriophage single subunit RNA polymerases. Herein we characterized the role of the thumb subdomain of the yeast mtRNA polymerase gene (RPO41) in complex stability, processivity, and fidelity. We found that deletion and point mutants of the thumb subdomain of yeast mtRNA polymerase increase the synthesis of abortive transcripts and the probability that the polymerase will disengage from the template during the formation of the late initial transcription and elongation complexes. Mutations in the thumb subdomain increase the amount of slippage products from a homopolymeric template and, unexpectedly, thumb subdomain deletions decrease the binding affinity for mitochondrial transcription factor (Mtf1). The latter suggests that the thumb subdomain is part of an extended binding surface area involved in binding Mtf1.

  4. Measurement of quality of life among patient undergoing arthroplasty of the thumb to treat CMC arthritis

    Directory of Open Access Journals (Sweden)

    Marcio Aurélio Aita

    2016-08-01

    Full Text Available ABSTRACT OBJECTIVE: To present the clinical and functional results, including measurement of quality of life, of patients undergoing trapeziometacarpal arthroplasty. METHOD: This was a prospective evaluation on 45 patients (53 thumbs with a diagnosis of idiopathic rhizarthrosis who underwent resection arthroplasty and interposition of an uncemented Ascension(r implant, made of pyrocarbon. The clinical and functional results were analyzed through radiography, range of motion (ROM in degrees (°, visual analog scale (VAS for pain and the disability of arm, shoulder and hand (DASH questionnaire for quality of life. In the group analyzed, 38 were women and seven were men, and their mean age was 63.17 years (range: 50-78. Eight patients were treated bilaterally. RESULTS: After 42.08 months of follow-up (range: 8-73, the subjective pain evaluation (VAS score was 1.37 (range: 1-4. The complete ROM of the thumb increased to 95.75% (range: 75-100% in relation to the contralateral side. The mean DASH questionnaire score was 9.98 (range: 1-18. The complication rate (negative events was 11.32%. Five patients presented dislocation of the thumb prosthesis. All of them were reoperated by means of dorsal capsuloplasty using a portion of the retinaculum of the extensors as a graft, and good clinical evolution was achieved in these cases. One patient presented fracturing of the metacarpal and was treated by means of osteosynthesis using Kirschner wires. CONCLUSION: This method is effective for treating rhizarthrosis, according to the measurements made on the clinical and functional results, even after taking the complication rate into consideration. Moreover, it provides an improvement of quality of life for these patients.

  5. Effects of quaternary ammonium silane coatings on mixed fungal and bacterial biofilms on tracheoesophageal shunt prostheses

    NARCIS (Netherlands)

    Oosterhof, JJH; Buijssen, KJDA; Busscher, HJ; van der Laan, BFAM; van der Mei, HC

    2006-01-01

    Two quaternary ammonium silanes (QAS) were used to coat silicone rubber tracheoesophageal shunt prostheses, yielding a positively charged surface. One QAS coating [(trimethoxysilyl)-propyidimethylocta-decylammonium chloride] was applied through chemical bonding, while the other coating, Biocidal ZF,

  6. Compression neuropathy of the ulnar digital nerves in the thumbs of a massage therapist.

    Science.gov (United States)

    Chen, Chien-Chang; Chien, Hsiung-Fei; Chen, Chien-Lian

    2014-01-01

    Compression neuropathies of digital nerves, caused by hypertrophied or anomalous muscles, are rare compared with such occurrences above the wrist. We reported a case of compression neuropathy of the ulnar digital nerves in bilateral thumbs of a massage therapist. Entrapment of the digital nerves by the hypertrophied first dorsal interosseous and adductor pollicis muscles over the first web space of the right hand was detected by magnetic resonance imaging. Surgical debulking of the muscles and neurolysis were performed on the dominant right hand. The left hand was successfully treated with botulinum toxin. No recurrence was noted in a follow-up of 36 months.

  7. Modified quad helix appliance for thumb sucking and cross bite correction

    Directory of Open Access Journals (Sweden)

    C Vinay

    2013-01-01

    Full Text Available Digit sucking habit is a learned pattern of behavior commonly seen in children of preschool age. Prolonged digit sucking beyond the preschool age, lead to the development of malocclusion such as anterior open bite, maxillary constriction and posterior crossbite. Treatment strategies include interception of habit and correction of the malocclusion. The present case report describes a modified quad helix appliance used successfully in a 9-year-old child to intercept thumb sucking habit and simultaneous correction of posterior crossbite. The appliance has the advantage of easy fabrication, being versatile and more patients compliant.

  8. Squamous cell carcinoma arising from an epidermal cyst in the thumb

    Science.gov (United States)

    Sakamoto, Akio; Shiba, Eisuke; Hisaoka, Masanori

    2015-01-01

    Introduction Squamous cell carcinoma arising from an epidermal cyst is rare, and the most frequently affected region is the head and neck. Presentation of case A 41-year-old man noticed swelling and a small ulceration in the thumb pulp. A lesion with a 2-cm diameter was simply resected based on a diagnosis of infected epidermal cyst. Pathological diagnosis of the resected material was squamous cell carcinoma arising from an epidermal cyst. Consequent amputation was performed. Discussion and conclusion The clinical symptoms of squamous cell carcinoma arising from an epidermal cyst can mimic those of an infected epidermal cyst. The current report facilitates awareness of such disease. PMID:25912006

  9. New electronic habit reminder for the management of thumb-sucking habit

    Directory of Open Access Journals (Sweden)

    Srinath Krishnappa

    2016-01-01

    Full Text Available Methods for intervention of nonnutritive sucking habits include counseling, positive reinforcement, calendar with rewards, adhesive bandage, bitter nail polish, long sleeves, and appliance therapy. All these methods have been reported in the literature with variable success rates. We present a case of an 8-year-old child with thumb-sucking habit successfully managed in a short period of 5 months by a new electronic habit reminder, an extraoral appliance which was designed to overcome the disadvantages associated with intraoral appliances.

  10. Fabrication of low cost soft tissue prostheses with the desktop 3D printer

    OpenAIRE

    Yong He; Guang-huai Xue; Jian-zhong Fu

    2014-01-01

    Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used ...

  11. Patterned electrical stimulation of primate retina for the development of retinal prostheses

    OpenAIRE

    2012-01-01

    Epiretinal prostheses are designed to restore vision to people blinded by retinal degenerations, using electrical stimulation with an array of electrodes implanted on the surface of the retina to convey artificial visual signals to the brain. Current clinical prostheses provide limited visual function, in part because the activity that they generate is different from natural retinal responses to visual stimuli. An ideal retinal prosthesis would stimulate the retinal ganglion cells (RGCs) in a...

  12. Treatment of midfacial defects using prostheses supported by ITI dental implants.

    Science.gov (United States)

    Scolozzi, Paolo; Jaques, Bertrand

    2004-11-01

    The purpose of this study was to evaluate retrospectively the use of ITI dental implants used for anchoring facial prostheses in the restorative treatment of midface defects. The authors analyzed the clinical data of 26 patients with orbital defects (n = 11), orbitonasal defects (n = 4), orbitonasomaxillary defects (n = 3), and nasal defects (n = 8). Data included age, sex, primary disease, implant position, implant length, implant failure, prosthetic attachment, radiation therapy, and peri-implant skin reactions. Follow-up was at 1, 3, 6, and 12 months and then on a yearly basis. The authors noted the status of healing and complications, if any. In total, 62 implants were placed as follows: 27 (43.5 percent) for orbital prostheses, 12 (19.4 percent) for orbitonasal prostheses, 14 (22.6 percent) for orbitonasomaxillary prostheses, and nine (14.5 percent) for nasal prostheses. Thirty-eight implants (61.3 percent) were placed in previously irradiated areas in 18 patients (69.2 percent). Mild skin reactions together with mild accumulation of sebaceous crusting around implants were recorded in 14.2 percent of the skin observations. No patient experienced severe inflammation requiring administration of systemic antibiotics or surgical revision. Implant success was 100 percent in both irradiated and nonirradiated patients. In conclusion, ITI dental implants result in a high rate of success in retaining midface prostheses and offer good stability and aesthetic satisfaction.

  13. Thumb Sprains

    Science.gov (United States)

    ... Gardening Safety Turkey Carving Removing a Ring Español Artritis de la base del pulgar Dedo en gatillo ... Gardening Safety Turkey Carving Removing a Ring Español Artritis de la base del pulgar Dedo en gatillo ...

  14. Thumb Arthritis

    Science.gov (United States)

    ... Gardening Safety Turkey Carving Removing a Ring Español Artritis de la base del pulgar Dedo en gatillo ... Gardening Safety Turkey Carving Removing a Ring Español Artritis de la base del pulgar Dedo en gatillo ...

  15. Racial Variation in Treatment of Traumatic Finger/Thumb Amputation: A National Comparative Study of Replantation and Revision Amputation

    Science.gov (United States)

    Mahmoudi, Elham; Swiatek, Peter R.; Chung, Kevin C.; Ayanian, John Z.

    2016-01-01

    Background Traumatic finger/thumb amputations are some of the most prevalent traumatic injuries affecting Americans each year. Rates of replantation after traumatic finger/thumb amputation, however, have been steadily declining across U.S. hospitals, which may make these procedures less accessible to minorities and vulnerable populations. The specific aim of this study was to examine racial variation in finger replantation after traumatic finger/thumb amputation. Methods Using a two-level hierarchical model, we retrospectively compared replantation rates for African-American patients with those of Whites, adjusting for patient and hospital characteristics. Patients younger than 65 with traumatic finger/thumb amputation injuries who sought care at a U.S. trauma center between 2007 and 2012 were included in the study sample. Results We analyzed 13,129 patients under 65 years of age with traumatic finger/thumb amputation. Replantation rates declined over time from 19% to 14% (p = 0.004). Adjusting for patient and hospital characteristics, African-Americans (OR=0.81; CI: 0.66–0.99; p = 0.049) were less likely to undergo replantation procedures than Whites, and uninsured patients (OR=0.73; CI: 0.62–0.84; p advancements in microsurgical techniques and the increasing use of reconstructive surgery in other fields, finger/thumb replantation rates are declining in the U.S. and vulnerable populations are less likely to undergo replantation after amputation injuries. Regionalization of care for these injuries may not only provide a higher quality care but also reduce variations in treatment. PMID:26910702

  16. Dystrophic calcinosis in a child with a thumb sucking habit: case report

    Directory of Open Access Journals (Sweden)

    Giovannini Cesar Abrantes Lima de Figueiredo

    2000-10-01

    Full Text Available We present an uncommon case of a 3-year-old boy with a finger sucking habit who developed dystrophic calcification in his left thumb. Two years after excision, there was no recurrence, and the thumb retained full range of motion. We also discuss its probable pathogenesis and present a brief review of the literature about orthopedic complications in the hand due to this habit.Os autores apresentam caso incomum de uma criança de três anos de idade com o hábito de chupar o dedo que desenvolveu calcinose distrófica no polegar esquerdo. Dois anos após a ressecção cirúrgica, não ocorreu recidiva e o polegar mantém todos os movimentos. Discutem, ainda, sua provável patogênese e fazem breve revisão da literatura a respeito das complicações ortopédicas na mão devido a este hábito.

  17. Post-traumatic instability of the metacarpophalangeal joint of the thumb.

    Science.gov (United States)

    Smith, R J

    1977-01-01

    Of eithty-six patients with collateral ligament instability of the metacarpophalangeal joint of the thumb, sixty-six (77 per cent) had ulnar and twenty (23 per cent) had radial instability, while in addition twenty-four had fractures and twenty-nine had volar subluxation of the proximal phalanx. Of the sixty-nine patients operated on, sixty-five had an abnormality of the ulnar or radial collateral ligament proper or of its attachment; two, subluxation of the extensor pollicis longus; and two, stretching of the adductor expansion. Stability was restored by collateral ligament repair or reconstruction, by fixation of a fracture fragment with a Kirschner wire, or by arthrodesis in all but five thumbs. Of the five patients who did not have stability of the metacarpophalangeal joint following surgery, three had had the collateral ligament sutured more than three weeks after injury and two had had reconstruction of the collateral ligament using a tendon graft. Early surgical treatment is recommended for all patients with post-traumatic instability of the metacarpophalangeal joint greater than 45 degrees and for those with volar subluxation of the proximal phalanx or a displaced fracture of the base of the proximal phalanx. Collateral ligament repair is indicated for patients operated on within three weeks of injury, and reconstruction of the ligament by means of a tendon graft is recommended for those treated more than three weeks after injury.

  18. The human airway epithelial basal cell transcriptome.

    Directory of Open Access Journals (Sweden)

    Neil R Hackett

    Full Text Available BACKGROUND: The human airway epithelium consists of 4 major cell types: ciliated, secretory, columnar and basal cells. During natural turnover and in response to injury, the airway basal cells function as stem/progenitor cells for the other airway cell types. The objective of this study is to better understand human airway epithelial basal cell biology by defining the gene expression signature of this cell population. METHODOLOGY/PRINCIPAL FINDINGS: Bronchial brushing was used to obtain airway epithelium from healthy nonsmokers. Microarrays were used to assess the transcriptome of basal cells purified from the airway epithelium in comparison to the transcriptome of the differentiated airway epithelium. This analysis identified the "human airway basal cell signature" as 1,161 unique genes with >5-fold higher expression level in basal cells compared to differentiated epithelium. The basal cell signature was suppressed when the basal cells differentiated into a ciliated airway epithelium in vitro. The basal cell signature displayed overlap with genes expressed in basal-like cells from other human tissues and with that of murine airway basal cells. Consistent with self-modulation as well as signaling to other airway cell types, the human airway basal cell signature was characterized by genes encoding extracellular matrix components, growth factors and growth factor receptors, including genes related to the EGF and VEGF pathways. Interestingly, while the basal cell signature overlaps that of basal-like cells of other organs, the human airway basal cell signature has features not previously associated with this cell type, including a unique pattern of genes encoding extracellular matrix components, G protein-coupled receptors, neuroactive ligands and receptors, and ion channels. CONCLUSION/SIGNIFICANCE: The human airway epithelial basal cell signature identified in the present study provides novel insights into the molecular phenotype and biology of

  19. The basal ganglia and apraxia.

    Science.gov (United States)

    Pramstaller, P P; Marsden, C D

    1996-02-01

    Ever since Liepmann's original descriptions at the beginning of the century apraxia has usually been attributed to damage confined to the cerebral cortex and/or cortico-cortical connecting pathways. However, there have been suggestions that apraxia can be due to deep subcortical lesions, which raises the question as to whether damage to the basal ganglia or thalamus can cause apraxia. We therefore analysed 82 cases of such 'deep' apraxias reported in the literature. These reports consisted of a small number (n=9) of cases studied neuropathologically, and a much larger group (n=73) in which CT or MRI was used to identify the size and extent of the lesion. The reports were subdivided into (i) those with small isolated lesions which involved nuclei of the basal ganglia or thalamus only, and not extending to involve periventricular or peristriatal white matter; (ii) those with large lesions which involved two or more of the nuclei, or one or more of these deep structures plus damage to closely adjacent areas including the internal capsule, periventricular or peristriatal white matter; and (iii) lesions sparing basal ganglia and thalamus but involving adjacent white matter. The main conclusions to be drawn from this meta-analysis are that lesions confined to the basal ganglia (putamen, caudate nucleus and globus pallidus) rarely, if ever, cause apraxia. Lesions affecting the lenticular nucleus or putamen nearly always intruded into the adjacent lateral white matter to involve association fibres, in particular those of the superior longitudinal fasciculus and frontostriatal connections. Apraxia occurred with deep lesions of the basal ganglia apparently sparing white matter in only eight out of the 82 cases. Apraxia was most commonly seen when there were lesions in the lenticular nucleus or putamen (58 out of 72 cases) with additional involvement of capsular, and particularly of periventricular or peristriatal, white matter. Lesions of the globus pallidus (no cases) or

  20. Increase in twitch force of the adductor pollicis muscle with stabilized preload at constant thumb abduction before and after administration of muscle relaxant

    NARCIS (Netherlands)

    van Santen, G; Wierda, JMKH; Fidler, [No Value

    1999-01-01

    Objective. To determine whether the twitch force of the adductor pollicis remains stable when 0.1 Hz single twitch stimulation is started after stabilization of the thumb preload at a constant degree of thumb abduction; also to study any possible increase in twitch force before the onset of and afte

  1. Quantification of dental prostheses on cone-beam CT images by the Taguchi method.

    Science.gov (United States)

    Kuo, Rong-Fu; Fang, Kwang-Ming; Ty, Wong; Hu, Chia Yu

    2016-01-08

    The gray values accuracy of dental cone-beam computed tomography (CBCT) is affected by dental metal prostheses. The distortion of dental CBCT gray values could lead to inaccuracies of orthodontic and implant treatment. The aim of this study was to quantify the effect of scanning parameters and dental metal prostheses on the accuracy of dental cone-beam computed tomography (CBCT) gray values using the Taguchi method. Eight dental model casts of an upper jaw including prostheses, and a ninth prosthesis-free dental model cast, were scanned by two dental CBCT devices. The mean gray value of the selected circular regions of interest (ROIs) were measured using dental CBCT images of eight dental model casts and were compared with those measured from CBCT images of the prosthesis-free dental model cast. For each image set, four consecutive slices of gingiva were selected. The seven factors (CBCTs, occlusal plane canting, implant connection, prosthesis position, coping material, coping thickness, and types of dental restoration) were used to evaluate scanning parameter and dental prostheses effects. Statistical methods of signal to noise ratio (S/N) and analysis of variance (ANOVA) with 95% confidence were applied to quantify the effects of scanning parameters and dental prostheses on dental CBCT gray values accuracy. For ROIs surrounding dental prostheses, the accuracy of CBCT gray values were affected primarily by implant connection (42%), followed by type of restoration (29%), prostheses position (19%), coping material (4%), and coping thickness (4%). For a single crown prosthesis (without support of implants) placed in dental model casts, gray value differences for ROIs 1-9 were below 12% and gray value differences for ROIs 13-18 away from pros-theses were below 10%. We found the gray value differences set to be between 7% and 8% for regions next to a single implant-supported titanium prosthesis, and between 46% and 59% for regions between double implant

  2. Footprint Mismatch of Cervical Disc Prostheses with Chinese Cervical Anatomic Dimensions

    Institute of Scientific and Technical Information of China (English)

    Liang Dong; Ming-Sheng Tan; Qin-Hua Yan; Ping Yi; Feng Yang; Xiang-Sheng Tang; Qing-Ying Hao

    2015-01-01

    Background:The footprint of most prostheses is designed according to Caucasian data.Total disc replacement (TDR) has been performed widely for cervical degenerative diseases in China.It is essential to analyze the match sizes of prostheses footprints and Chinese cervical anatomic dimensions in our study.Methods:The anatomic dimensions of the C4-C7 segments of 138 patients (age range 16-77 years) in a Chinese population were measured by computed tomography scans.We compared the footprints of the most commonly used cervical disc prostheses (Bryan:Medtronic,Minneapolis,MN,USA; Prestige LP:Medtronic,Fridley,Minnesota,USA; Discover:DePuy,Raynham,MA,USA; Prodisc-C:Synthes,West Chester,PA,USA) in China with Chinese cervical anatomic dimensions and assessed the match of their size.Results:The mismatch of available dimensions of prostheses and anatomic data of cervical endplates ranged from 17.03% (C4/C5,Prestige LP,Prodisc-C) to 57.61% (C6/C7,Discover) in the anterior-posterior (AP) diameter,and 35.51% (C4/C5,Prodisc-C,Prestige LP) to 94.93% (C6/C7,Bryan) in the center mediolateral (CML) diameter.About 21.01% of endplates were larger than the largest prostheses in the AP diameter and 57.25% in the CML diameter.All available footprints of prostheses expect the Bryan with an unfixed height,can accommodate the disc height (DH),however,36.23% of the middle DH was less than the smallest height of the prostheses.The average disc sagittal angles (DSAs) of C4-C7 junctions were 5.04°,5.15°,and 4.13° respectively.Only the Discover brand had a built-in 7° lordotic angle,roughly matching with the DSA.Conclusions:There is a large discrepancy between footprints of prostheses and Chinese cervical anatomic data.In recent years,possible complications of TDR related with mismatch sizes are increasing,such as subsidence,displacement,and heterotopic ossification.Manufacturers of prostheses should introduce or produce additional footprints of prostheses for Chinese TDR.

  3. Salter-Harris type IV fracture of the proximal phalanx of the thumb with rotation of the epiphysis: Outcome 10 years following open reduction and K-wire fixation

    Directory of Open Access Journals (Sweden)

    Mohammad M. Al-Qattan

    2017-01-01

    Conclusion: We present a rare case of Salter-Harris type IV fracture of the proximal phalanx of the thumb with rotation of the epiphysis. Long term outcome was satisfactory but there was diaphyseal constriction leading to a narrower thumb.

  4. Tibiofemoral conformity and kinematics of rotating-bearing knee prostheses.

    Science.gov (United States)

    D'Lima, D D; Trice, M; Urquhart, A G; Colwell, C W

    2001-05-01

    Increasing tibiofemoral articular conformity theoretically increases articular contact area and reduces contact stresses in total knee arthroplasty. Fixed-bearing knee designs possess relatively low tibiofemoral conformity, in part to allow tibiofemoral rotation without generating excessive stresses at the articulation or the implant-bone interface. This study analyzed knee kinematics of mobile-bearing designs in a closed chain dynamic knee extension model in posterior cruciate-retaining design with high- and low tibiofemoral conformity and posterior cruciate-substituting designs with and without rotational constraint. Overall, for all conditions, the mobile-bearing insert rotated with the femur in the presence of tibiofemoral axial rotation. In addition, the correlation of bearing rotation with femoral rotation was stronger for the high-conformity and rotationally-constrained designs than for the low-conformity designs and strongest for the posterior cruciate-retaining high-conformity condition. Changes in conformity or rotational constraint did not appear to affect femoral roll back, tibiofemoral axial rotation, or varus-valgus angulation. The results suggest that mobile-bearing inserts rotate with the femur and increasing conformity or rotational constraint in mobile-bearing design knee prostheses does not affect knee kinematics adversely, at least under closed chain knee extension conditions in vitro.

  5. Leg stiffness of sprinters using running-specific prostheses

    Science.gov (United States)

    McGowan, Craig P.; Grabowski, Alena M.; McDermott, William J.; Herr, Hugh M.; Kram, Rodger

    2012-01-01

    Running-specific prostheses (RSF) are designed to replicate the spring-like nature of biological legs (bioL) during running. However, it is not clear how these devices affect whole leg stiffness characteristics or running dynamics over a range of speeds. We used a simple spring–mass model to examine running mechanics across a range of speeds, in unilateral and bilateral transtibial amputees and performance-matched controls. We found significant differences between the affected leg (AL) of unilateral amputees and both ALs of bilateral amputees compared with the bioL of non-amputees for nearly every variable measured. Leg stiffness remained constant or increased with speed in bioL, but decreased with speed in legs with RSPs. The decrease in leg stiffness in legs with RSPs was mainly owing to a combination of lower peak ground reaction forces and increased leg compression with increasing speeds. Leg stiffness is an important parameter affecting contact time and the force exerted on the ground. It is likely that the fixed stiffness of the prosthesis coupled with differences in the limb posture required to run with the prosthesis limits the ability to modulate whole leg stiffness and the ability to apply high vertical ground reaction forces during sprinting. PMID:22337629

  6. Running-specific prostheses limit ground-force during sprinting

    Science.gov (United States)

    Grabowski, Alena M.; McGowan, Craig P.; McDermott, William J.; Beale, Matthew T.; Kram, Rodger; Herr, Hugh M.

    2010-01-01

    Running-specific prostheses (RSP) emulate the spring-like behaviour of biological limbs during human running, but little research has examined the mechanical means by which amputees achieve top speeds. To better understand the biomechanical effects of RSP during sprinting, we measured ground reaction forces (GRF) and stride kinematics of elite unilateral trans-tibial amputee sprinters across a range of speeds including top speed. Unilateral amputees are ideal subjects because each amputee's affected leg (AL) can be compared with their unaffected leg (UL). We found that stance average vertical GRF were approximately 9 per cent less for the AL compared with the UL across a range of speeds including top speed (p < 0.0001). In contrast, leg swing times were not significantly different between legs at any speed (p = 0.32). Additionally, AL and UL leg swing times were similar to those reported for non-amputee sprinters. We infer that RSP impair force generation and thus probably limit top speed. Some elite unilateral trans-tibial amputee sprinters appear to have learned or trained to compensate for AL force impairment by swinging both legs rapidly. PMID:19889694

  7. Application of dexterous space robotics technology to myoelectric prostheses

    Science.gov (United States)

    Hess, Clifford; Li, Larry C. H.; Farry, Kristin A.; Walker, Ian D.

    1994-02-01

    Future space missions will require robots equipped with highly dexterous robotic hands to perform a variety of tasks. A major technical challenge in making this possible is an improvement in the way these dexterous robotic hands are remotely controlled or teleoperated. NASA is currently investigating the feasibility of using myoelectric signals to teleoperate a dexterous robotic hand. In theory, myoelectric control of robotic hands will require little or no mechanical parts and will greatly reduce the bulk and weight usually found in dexterous robotic hand control devices. An improvement in myoelectric control of multifinger hands will also benefit prosthetics users. Therefore, as an effort to transfer dexterous space robotics technology to prosthetics applications and to benefit from existing myoelectric technology, NASA is collaborating with the Limbs of Love Foundation, the Institute for Rehabilitation and Research, and Rice University in developing improved myoelectric control multifinger hands and prostheses. In this paper, we will address the objectives and approaches of this collaborative effort and discuss the technical issues associated with myoelectric control of multifinger hands. We will also report our current progress and discuss plans for future work.

  8. BIOSIMILAR ARTIFICIAL KNEE FOR TRANSFEMORAL PROSTHESES AND EXOSKELETONS

    Directory of Open Access Journals (Sweden)

    Aleksandr Poliakov

    2016-12-01

    Full Text Available Artificial knees play an important role in transfemoral prostheses, lower extremity exoskeletons and walking robots. Their designs must provide natural kinematics, high strength and stiffness required in the stance phase of gait. Additionally, modern artificial knee is the principal module by means of which the prosthesis control is performed. This paper presents a prototype of an artificial polycentric knee, designed on the basis of the hinge mechanism with cross links. In order to increase strength and stiffness, the elements of the joint have curved supporting surfaces formed in the shape of centroids in relative motion of links of the hinge mechanism. Such construction is a mechanical system with redundant links but it allows for providing desirable characteristics of the artificial knee. Synthesis of the hinge mechanism is made by a method of systematic study of the parameter space, uniformly distributed in a finite dimensional cube. Stiffness of bearing surfaces elements of knee was determined by solving the contact problem with slippage of surfaces relative to each other.

  9. Hydrogel-Electrospun Fiber Mat Composite Coatings for Neural Prostheses

    Directory of Open Access Journals (Sweden)

    Ning eHan

    2011-03-01

    Full Text Available Achieving stable, long-term performance of implanted neural prosthetic devices has been challenging because of implantation related neuron loss and a foreign body response that results in encapsulating glial scar formation. To improve neuron-prosthesis integration and form chronic, stable interfaces, we investigated the potential of neurotrophin-eluting hydrogel-electrospun fiber mat (EFM composite coatings. In particular, poly(ethylene glycol-poly(ε-caprolactone (PEGPCL hydrogel- poly(ε-caprolactone (PCL EFM composites were applied as coatings for multielectrode arrays (MEAs. Coatings were stable and persisted on electrode surfaces for over 1 month under an agarose gel tissue phantom and over 9 months in a PBS immersion bath. To demonstrate drug release, a neurotrophin, nerve growth factor (NGF, was loaded in the PEGPCL hydrogel layer, and coating cytotoxicity and sustained NGF release were evaluated using a PC12 cell culture model. Quantitative MTT assays showed that these coatings had no significant toxicity toward PC12 cells, and neurite extension at day 7 and 14 confirmed sustained release of NGF at biologically significant concentrations for at least 2 weeks. Our results demonstrate that hydrogel-EFM composite materials can be applied to neural prostheses as a means to improve neuron-electrode proximity and enhance long-term device performance and function.

  10. [Communication prostheses and behavioral alignment in hospital leaflets].

    Science.gov (United States)

    Vasconcellos-Silva, Paulo Roberto; Rivera, Francisco Javier Uribe; Rozemberg, Brani

    2003-08-01

    Review was made of publications that describe experience with printed material distributed to the lay public in hospital institutions. From the 146 leaflets examined, those aimed at professionals or disabled people, thus leaving 75 papers that illustrate the present pattern for the rationality behind the production, use and evaluation of this type of resource. In a general manner, such leaflets invest in the power of "ideal printed information" to align behavior with the hospital's biomedical agenda. The underlying rationality that permeates them perceives the "perfect information package" as one that efficiently describes its technical content for the purpose of unidirectional persuasion, is up-to-date in relation to readability scales and embellished by graphic design, and emphasizes the priorities defined by the professionals. Such "communication prostheses" should be capable of electronic validation by means of software suitable for proportioning the "doses" to the subject matter. Information as a drug, cognitivism, the lack of research on message reception and the need for communicative action for the deconstruction of systems of closed thinking within the hospital environment have been discussed.

  11. Migraine attacks the Basal Ganglia

    Directory of Open Access Journals (Sweden)

    Bigal Marcelo

    2011-09-01

    Full Text Available Abstract Background With time, episodes of migraine headache afflict patients with increased frequency, longer duration and more intense pain. While episodic migraine may be defined as 1-14 attacks per month, there are no clear-cut phases defined, and those patients with low frequency may progress to high frequency episodic migraine and the latter may progress into chronic daily headache (> 15 attacks per month. The pathophysiology of this progression is completely unknown. Attempting to unravel this phenomenon, we used high field (human brain imaging to compare functional responses, functional connectivity and brain morphology in patients whose migraine episodes did not progress (LF to a matched (gender, age, age of onset and type of medication group of patients whose migraine episodes progressed (HF. Results In comparison to LF patients, responses to pain in HF patients were significantly lower in the caudate, putamen and pallidum. Paradoxically, associated with these lower responses in HF patients, gray matter volume of the right and left caudate nuclei were significantly larger than in the LF patients. Functional connectivity analysis revealed additional differences between the two groups in regard to response to pain. Conclusions Supported by current understanding of basal ganglia role in pain processing, the findings suggest a significant role of the basal ganglia in the pathophysiology of the episodic migraine.

  12. Anatomy is important, but need not be destiny: novel uses of the thumb in aye-ayes compared to other lemurs.

    Science.gov (United States)

    Pellis, Sergio M; Pellis, Vivien C

    2012-06-01

    Aye-ayes (Daubentonia madagascerensis) have highly specialized hands with long digits, especially the thin middle one (D3), which is used for extracting food, such as beetle larvae, under bark. Due to the elongation of their fingers, including the thumb, it is presumed that aye-ayes have a rather limited capacity for delicate manipulation of objects. However, studies have reported independent movement of digits D3 and D4, and one report noted a seemingly independent thumb (D1) movement in holding food. Sixteen captive adult aye-ayes were videotaped feeding on a diverse range of foods so as to document how the thumb is used during food holding. To determine if the patterns observed were unique to aye-ayes, 24 individuals from 9 other species of lemurs were also videotaped. Two patterns of thumb use idiosyncratic to aye-ayes and one other lemur, the sifaka (Propithecus verreauxi), were identified: (1) when holding a food item in one hand, the thumb was used to secure the food, with the other digits playing a secondary role; (2) when holding a food item with both hands, the thumbs once again took a predominant role in securing the food. In the majority of these cases, whether held by one or two thumbs, the thumbs curled around the item, but some descriptive evidence is provided that suggests that aye-ayes exaggerate the role of the thumbs by shifting the hold to the outer edge. The novel uses of the thumbs in aye-ayes demonstrate that brain mechanisms can sometimes override the behavioral (or motor) limitations imposed by the morphology of the body.

  13. 3D printed self-driven thumb-sized motors for in-situ underwater pollutant remediation

    Science.gov (United States)

    Yu, Fen; Hu, Qipeng; Dong, Lina; Cui, Xiao; Chen, Tingtao; Xin, Hongbo; Liu, Miaoxing; Xue, Chaowen; Song, Xiangwei; Ai, Fanrong; Li, Ting; Wang, Xiaolei

    2017-02-01

    Green fuel-driven thumb sized motors (TSM) were designed and optimized by 3D printing to explore their in-situ remediation applications in rare studied underwater area. Combined with areogel processing and specialized bacteria domestication, each tiny TSM could realize large area pollutant treatment precisely in an impressive half-automatically manner.

  14. Fabrication of low cost soft tissue prostheses with the desktop 3D printer.

    Science.gov (United States)

    He, Yong; Xue, Guang-huai; Fu, Jian-zhong

    2014-11-27

    Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used to polish the casting mold by removing the staircase effect and acquiring a smooth surface. Finally, the last step is to cast medical grade silicone into the mold. After the silicone is cured, the fine soft prostheses can be removed from the mold. Utilizing the SPPC method, soft prostheses with smooth surface and complicated structure can be fabricated at a low cost. Accordingly, the total cost of fabricating ear prosthesis is about $30, which is much lower than the current soft prostheses fabrication methods.

  15. Fabrication of low cost soft tissue prostheses with the desktop 3D printer

    Science.gov (United States)

    He, Yong; Xue, Guang-Huai; Fu, Jian-Zhong

    2014-11-01

    Soft tissue prostheses such as artificial ear, eye and nose are widely used in the maxillofacial rehabilitation. In this report we demonstrate how to fabricate soft prostheses mold with a low cost desktop 3D printer. The fabrication method used is referred to as Scanning Printing Polishing Casting (SPPC). Firstly the anatomy is scanned with a 3D scanner, then a tissue casting mold is designed on computer and printed with a desktop 3D printer. Subsequently, a chemical polishing method is used to polish the casting mold by removing the staircase effect and acquiring a smooth surface. Finally, the last step is to cast medical grade silicone into the mold. After the silicone is cured, the fine soft prostheses can be removed from the mold. Utilizing the SPPC method, soft prostheses with smooth surface and complicated structure can be fabricated at a low cost. Accordingly, the total cost of fabricating ear prosthesis is about $30, which is much lower than the current soft prostheses fabrication methods.

  16. Effect of geometrical parameters on the performance of longitudinal functionally graded femoral prostheses.

    Science.gov (United States)

    Oshkour, Azim Ataollahi; Talebi, Hossein; Seyed Shirazi, Seyed Farid; Yau, Yat Huang; Tarlochan, Faris; Abu Osman, Noor Azuan

    2015-02-01

    This study aimed to assess the performance of different longitudinal functionally graded femoral prostheses. This study was also designed to develop an appropriate prosthetic geometric design for longitudinal functionally graded materials. Three-dimensional models of the femur and prostheses were developed and analyzed. The elastic modulus of these prostheses in the sagittal plane was adjusted along a gradient direction from the distal end to the proximal end. Furthermore, these prostheses were composed of titanium alloy and hydroxyapatite. Results revealed that strain energy, interface stress, and developed stress in the femoral prosthesis and the bone were influenced by prosthetic geometry and gradient index. In all of the prostheses with different geometries, strain energy increased as gradient index increased. Interface stress and developed stress decreased. The minimum principal stress and the maximum principal stress of the bone slightly increased as gradient index increased. Hence, the combination of the femoral prosthetic geometry and functionally graded materials can be employed to decrease stress shielding. Such a combination can also be utilized to achieve equilibrium in terms of the stress applied on the implanted femur constituents; thus, the lifespan of total hip replacement can be prolonged.

  17. Simulating auditory and visual sensorineural prostheses: a comparative review

    Science.gov (United States)

    Hallum, L. E.; Dagnelie, G.; Suaning, G. J.; Lovell, N. H.

    2007-03-01

    Microelectronic vision prosthesis proposes to render luminous spots (so-called phosphenes) in the visual field of the otherwise blind subject by way of an implanted array of stimulating electrodes, and in doing so restore some spatial vision. There are now many research teams worldwide working towards a therapeutic device, analogous to the cochlear implant, for the profoundly blind. Despite the similarities between the cochlear implant and vision prostheses, there are few instances in the literature where the two approaches are compared and contrasted with a mind to informing the science and engineering of the latter. This is the focus of the present review; specifically, our interest is psychophysics and signal processing. Firstly, we examine the cochlear implant, and review a handful of psychophysical work: the acoustic simulation of cochlear implants and the method used. We focus on the use of normally hearing subjects (played coloured noise bands or sine waves) as a means of investigating cochlear-implant efficacy and speech processing algorithms. These results provide guidance to vision researchers, for they address the interpretation of simulation data, and flag key areas, such as 'artificial' perception in the presence of noise, that require experimental work in coming years. Secondly, we provide an up-to-date review of the body of analogous psychophysical work: the visual simulation, involving normal observers, of microelectronic vision prosthesis. These simulations allow predictions as to the likely clinical efficacy of the prosthesis; indeed, results to date suggest that a number on the order of 100 implanted electrodes will afford subjects mobility and recognition of faces (and other complex stimuli), while even fewer electrodes facilitate reading printed text and very simple visuomanual tasks. Further, the simulations allow investigations of image and signal processing strategies, plus they provide researchers in the field, and other interested persons

  18. Dentistry investigations of teeth and dental prostheses using OCT

    Science.gov (United States)

    Sinescu, C.; Duma, V.-F.; Canjau, S.; Dobre, G.; Demian, D.; Cernat, R.; Negrutiu, M. L.; Todea, C.; Topala, F. I.; Hutiu, Gh.; Bradu, A.; Podoleanu, A. G.

    2016-04-01

    We present some of our recent investigations in Dental Medicine using Optical Coherence Tomography (OCT). Time Domain (TD), Spectral Domain (SD), and Swept Source (SS) OCT in-house developed systems are being used, for both ex vivo and in vivo investigations in the oral cavity. We study ex vivo the interface between the tooth and the dental sealant and demonstrate the limitations of the X-rays investigations that are now the gold standard for such procedures. Using OCT, defects in the interface that cannot be identified in radiographs can be determined both as position and magnitude. The drilling process of teeth can also be characterized in real time using OCT, to monitor the remaining dentin thickness (RDT) in order to avoid opening the pulp chamber. We demonstrate in this respect that an RDT of 0.5 mm is the minimum value to assure the integrity of the dentin wall between the drilled cavity and the pulp chamber; at an RDT of 0.3 mm or less a fracture is initiated, the dentin is punctured and endodontic treatment must follow. In vivo OCT investigations in the oral cavity were also performed (i.e., for metalloceramic prostheses and for ceramic inlay tooth interfaces), with the low cost, light weight and versatile handheld probes with 1D galvoscanners that we have developed and applied for a range of in-house developed OCT systems, in various clinical applications. They are briefly discussed, as well as some of our current and future work in the field, including for studies of soft tissue in the mouth.

  19. [Klippel-Feil syndrome with tracheoesophageal fistula, bifid thumb and cerebral angiolipoma.

    Science.gov (United States)

    Urdaneta Carruyo, Eliéxer; Rojas Zerpa, Gustavo; Urdaneta Contreras, Adriana; Maldonado Alviarez, Malvy; Brito Rodríguez, Miguel

    2016-12-01

    The Klippel-Feil syndrome is a congenital malformation of the skull flap involving complex cervical vertebrae and organs, characterized by a classic triad: short neck, limitation of movement of the head due to cervical spine fusion and low hairline in occipital region. It results from an error in the axial skeleton segmentation of the embryo; its incidence is estimated at 1/40,000-42,000 births and predominates in females. The aim of this paper is to describe the clinical picture of a patient with Klippel-Feil syndrome and multiple malformations, including tracheoesophageal fistula, bifid thumb and intracranial lipomas/angiolipomas,that have not been previously described in the syndrome, so it is considered an exceptional finding.

  20. Development of a Networked Thumb Print-Based Staff Attendance Management System

    Directory of Open Access Journals (Sweden)

    Tolulope Awode

    2016-07-01

    Full Text Available This paper focuses on the development of a networked thumb print-based attendance management system. Now, more than ever, it has become necessary to give more thought to the methods of time and attendance management. The traditional time clock, manual attendance registering often no longer makes sense and simply does not meet the needs of the modern work environment. This system offers a comprehensive software solution that will streamline company's operations, and simplify timekeeping. Nowadays, the need of a solution for Time and Attendance in the modern company is a necessity. It is important to be able to manage and control the workers by means of a system of control of times and schedules.

  1. Ectopic banking of amputated great toe for delayed thumb reconstruction: case report.

    Science.gov (United States)

    Valerio, Ian L; Hui-Chou, Helen G; Zelken, Jonathan; Basile, Patrick L; Ipsen, Derek; Higgins, James P

    2014-07-01

    Ectopic banking of amputated parts is a recognized technique for delayed replantation of an amputated part when the amputation stump will not permit immediate replantation. This is conventionally performed with the intent of transferring the injured part back to its anatomic position when the amputation stump is more appropriate for replantation. Current warfare conditions have led to a commonly encountered military trauma injury pattern of multiple extremity amputations with protected trunk and core structures. This pattern poses many challenges, including the limit or absence of donor sites for immediate or delayed flap reconstructive procedures. We describe a case in which we ectopically banked the great toe of an amputated lower extremity for delayed thumb reconstruction.

  2. An evaluation of the use made of cosmetic and functional prostheses by unilateral upper limb amputees.

    Science.gov (United States)

    Fraser, C M

    1998-12-01

    There is currently a distinction drawn between a prosthesis considered to be provided for purely cosmetic reasons and a functional prosthesis provided to enable the amputee to achieve basic hand function. Using video analysis the study reported in this paper demonstrates that for non-manipulative actions cosmetic prostheses are actively used in the performance of everyday tasks as frequently as functional prostheses. The study provides evidence for a cosmetic prosthesis to be presented to an amputee as a realistic initial prosthesis and not as the option of last resort if a functional prosthesis is rejected. It is also recommended that training is provided in the use of cosmetic prostheses in two-handed tasks.

  3. Study of the different types of actuators and mechanisms for upper limb prostheses.

    Science.gov (United States)

    Cura, Vanderlei O Del; Cunha, Fransérgio L; Aguiar, Manoel L; Cliquet, Alberto

    2003-06-01

    Research in the area of actuators and mechanisms has shown steadily growing technological advances in externally activated upper limb prostheses. From among the actuators, advances include the use of piezoelectric materials, special metal alloys, polymers, and new motor applications, while the advances in mechanisms include mechanical designs based on the anatomy of the human hand and improvements in the way these components are combined. These efforts are aimed at meeting the need for anthropomorphic and functional prosthetic devices that enable patients to carry out basic daily tasks more easily and reduce the rejection rate of prostheses. This article technically discusses the several types of actuators and mechanisms, listing their main characteristics, applications, and advantages and disadvantages, and the current state of research in the area of rehabilitation of upper limb functions through the use of active prostheses. Comparisons of these devices are made with regard to the main criteria of construction and operation required to achieve optimal prosthetic performance.

  4. Prostheses, pain and sequelae of amputation, as seen by the amputee.

    Science.gov (United States)

    Chadderton, H C

    1978-04-01

    Results of a survey of 19 organizations belonging to World Veterans Federation indicate that major complains of amputees include; poor fitting, poor dissemination of knowledge to doctors and amputees regarding new prostheses, lack of opportunity for "input" from amputees at research level and inadequate measures to deal with phantom and stump pain. Suggested improvements by amputees; decrease in weight of prostheses, reduction in maintenance for swing and stance-phase control units development of recreational prostheses, more frequent checks through use of X-ray and film techniques, particularly during the "break-in" of a new appliance. Older veterans showed increasing concern in regard to development of consequential disabilities arising from amputation; premature arthritic changes in spine and remaining limb, circulatory problems and gastro-intestinal problems due to ingestion of drugs to control pain.

  5. Progress in the clinical development and utilization of vision prostheses: an update

    Directory of Open Access Journals (Sweden)

    Brandli A

    2016-05-01

    Full Text Available Alice Brandli, Chi D Luu, Robyn H Guymer, Lauren N Ayton Centre for Eye Research Australia, Department of Surgery (Ophthalmology, The University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia Abstract: Vision prostheses, or “bionic eyes”, are implantable medical bionic devices with the potential to restore rudimentary sight to people with profound vision loss or blindness. In the past two decades, this field has rapidly progressed, and there are now two commercially available retinal prostheses in the US and Europe, and a number of next-generation devices in development. This review provides an update on the development of these devices and a discussion on the future directions for the field. Keywords: vision prostheses, bionic eye, vision restoration, blindness, medical bionics, retinitis pigmentosa

  6. The Basal Ganglia and Motor Control

    OpenAIRE

    Groenewegen, Henk J.

    2003-01-01

    This paper briefly reviews the functional anatomy of the basal ganglia and their relationships with the thalamocortical system. The basal ganglia, including the striatum, pallidum, subthalamic nucleus, and substantia nigra, are involved in a number of parallel, functionally segregated cortical-subcortical circuits. These circuits support a wide range of sensorimotor, cognitive and emotional-motivational brain functions. A main role of the basal ganglia is the learning and selection of the mos...

  7. Functional Neuroanatomy of the Basal Ganglia

    OpenAIRE

    Lanciego, José L.; Luquin, Natasha; Obeso, José A.

    2012-01-01

    The “basal ganglia” refers to a group of subcortical nuclei responsible primarily for motor control, as well as other roles such as motor learning, executive functions and behaviors, and emotions. Proposed more than two decades ago, the classical basal ganglia model shows how information flows through the basal ganglia back to the cortex through two pathways with opposing effects for the proper execution of movement. Although much of the model has remained, the model has been modified and amp...

  8. Oral health-related quality-of-life in patients to be treated with fixed or removable partial dental prostheses

    DEFF Research Database (Denmark)

    Øzhayat, Esben Boeskov; Gotfredsen, Klaus

    2013-01-01

    Abstract Objectives. The aims of this study were to measure and describe the Oral Health-Related Quality-of-Life (OHRQoL) in a population about to receive removable dental prostheses (RDP) or fixed dental prostheses (FDP). Materials and methods. The Oral Health Impact Profile 49 (OHIP-49) was com...

  9. An innovative prostheses design for rehabilitation of severely mutilated dentition: a case report.

    Science.gov (United States)

    Abduo, Jaafar

    2011-03-01

    Partial edentulism has multiple implications in relation to function, esthetics and future rehabilitative treatment. This case report illustrates the management of a patient with extreme consequences of partial edentulism. The main clinical findings were unopposed remaining teeth, overeruption of the remaining teeth, loss of vertical dimension of occlusion, and significant disfigurement of the occlusal plane. Following the diagnostic procedure, a well-coordinated prosthodontic treatment involving liaison with other dental disciplines was indicated. The management involved an innovative combination of fixed and removable prostheses in conjunction with crown lengthening surgery and strategic implant placement. Series of provisional prostheses were applied to facilitate the transition to the final treatment.

  10. IMPROVED HEALING OF SMALL-CALIBER POLYTETRAFLUOROETHYLENE PROSTHESES BY INDUCTION OF A CLOT LAYER - A REVIEW OF EXPERIMENTAL STUDIES IN RATS

    NARCIS (Netherlands)

    VANDERLEI, B; STRONCK, JW; WILDEVUUR, CRH

    1991-01-01

    This report reviews our experiments that have been undertaken to test the hypothesis whether the induction of a clot layer on the graft surface of small-caliber polytetrafluoroethylene ( PTFE) prostheses might improve their healing. 1 2 PTFE prostheses with a fibril length of 30-mu-m, PTFE prosthese

  11. Reacción tisular a las prótesis mamarias: Contractura capsular periprotésica Tissue reaction to breast prostheses: Periprosthetic capsular contracture

    Directory of Open Access Journals (Sweden)

    F. J. Escudero

    2005-01-01

    Full Text Available Las prótesis mamarias de silicona provocan el desarrollo de una envoltura fibrosa o cápsula periprotésica. La contractura de la cápsula, por retracción del tejido fibroso, es la complicación más frecuente e importante de estos implantes. Produce un endurecimiento de grado variable y, en los casos avanzados, deformidad de la mama. Se ha relacionado estrechamente con el tipo de superficie del implante (lisa o texturada y con la disposición de las fibras de colágeno, habiéndose sugerido que la formación de una cápsula continua, con fibras de colágeno dispuestas paralela y circularmente alrededor de las prótesis lisas, promueve el desarrollo de fuerzas contráctiles concéntricas, que traccionando al unísono producirían la contractura. Con las prótesis texturadas microporosas se ha demostrado una incidencia significativamente más baja de contractura capsular en comparación con las lisas. Se considera que el crecimiento tisular dentro de la estructura microporosa origina fuerzas contráctiles multidireccionales, con tendencia a neutralizarse entre ellas cuando su efecto se suma sobre el implante. La cápsula de estos implantes presenta una zona basal compuesta de múltiples capas de fibras de colágeno alineadas paralelamente, la cual podría contraerse. Sin embargo, la adherencia de las prótesis texturadas microporosas podría contrarrestar las fuerzas contráctiles.Silicone breast prostheses prompt the development of a fibrous casing or periprosthetic capsule. Capsular contracture, due to retraction of the fibrous tissue, is the most frequent and important complication of these implants. It produces varying degrees of hardening and, in advanced cases, deformity of the breast. It has been closely related to the type of surface of the implant (smooth or textured and with the alignment of the collagen fibers, and it has been suggested that the formation of a continuous capsule, with collagen fibers aligned in parallel and

  12. Early recognition of basal cell naevus syndrome

    NARCIS (Netherlands)

    Veenstra-Knol, HE; Scheewe, JH; van der Vlist, GJ; van Doorn, ME; Ausems, MGEM

    2005-01-01

    The basal cell naevus syndrome is an autosomal dominant syndrome characterised by major manifestations such as basal cell carcinomas, jaw cysts, palmar or plantar pits, and intracranial calcifications. Early recognition is important in order to reduce morbidity due to cutaneous and cerebral malignan

  13. Nevoid Basal Cell Carcinoma Syndrome (Gorlin Syndrome).

    Science.gov (United States)

    Bresler, Scott C; Padwa, Bonnie L; Granter, Scott R

    2016-06-01

    Nevoid basal cell carcinoma syndrome, or basal cell nevus syndrome (Gorlin syndrome), is a rare autosomal dominantly inherited disorder that is characterized by development of basal cell carcinomas from a young age. Other distinguishing clinical features are seen in a majority of patients, and include keratocystic odontogenic tumors (formerly odontogenic keratocysts) as well as dyskeratotic palmar and plantar pitting. A range of skeletal and other developmental abnormalities are also often seen. The disorder is caused by defects in hedgehog signaling which result in constitutive pathway activity and tumor cell proliferation. As sporadic basal cell carcinomas also commonly harbor hedgehog pathway aberrations, therapeutic agents targeting key signaling constituents have been developed and tested against advanced sporadically occurring tumors or syndromic disease, leading in 2013 to FDA approval of the first hedgehog pathway-targeted small molecule, vismodegib. The elucidation of the molecular pathogenesis of nevoid basal cell carcinoma syndrome has resulted in further understanding of the most common human malignancy.

  14. Queuing Rule of Thumb based on M/M/s Queuing Theory with Applications in Construction Management

    Directory of Open Access Journals (Sweden)

    Teknomo K.

    2012-01-01

    Full Text Available The current trend of queuing theory development is toward more precision which requires higher mathematical manipulation. In this paper, we attempted to reverve the current trend toward simplification of queuing formulas such that it can be used in more practical purposes, especially in construction industry. Through numerical examples of two case studies on concreting and earth moving, how to model the construction activities as queuing systems is illustrated systematically. Through the numerical examples, it is shown that when the customer cost is much lower than the server cost, queuing system can be simplified only to incorporate the constraint equation. The queueing constraint equation is suggested to be used as queuing rule of thumb. The proposed rule of thumb is rather conservative in term of queuing performance compared to the standard stochastic queuing formula because it is assumed that all the customers arrive at once in the beginning of the service.

  15. Economic evaluation of neuro-prostheses: a review of outcome assessment and valuation techniques

    NARCIS (Netherlands)

    IJzerman, Maarten J.; Creasey, Graham H.

    2004-01-01

    The scientific progress in neuro-prostheses during the last ten years has led to a number of clinical applications that are being introduced in the health care system. Whereas the research so far has been carried out in the biomedical research environment it now enters the clinical area. This clinic

  16. Is acuity enough? Other considerations in clinical investigations of visual prostheses.

    Science.gov (United States)

    Lepri, Bernard P

    2009-06-01

    Visual impairing eye diseases are the major frontier facing ophthalmic research today in light of our rapidly aging population. The visual skills necessary for improving the quality of daily function and life are inextricably linked to these impairing diseases. Both research and reimbursement programs are emphasizing outcome-based results. Is improvement in visual acuity alone enough to improve the function and quality of life of visually impaired persons? This perspective summarizes the types of effectiveness endpoints for clinical investigations of visual prostheses that go beyond visual acuity. The clinical investigation of visual prostheses should include visual function, functional vision and quality of life measures. Specifically, they encompass contrast sensitivity, orientation and mobility, activities of daily living and quality of life assessments. The perspective focuses on the design of clinical trials for visual prostheses and the methods of determining effectiveness above and beyond visual acuity that will yield outcomes that are measured by improved function in the visual world and quality of life. The visually impaired population is the primary consideration in this presentation with particular emphases on retinitis pigmentosa and age-related macular degeneration. Clinical trials for visual prostheses cannot be isolated from the need for medical rehabilitation in order to obtain measurements of effectiveness that produce outcomes/evidence-based success. This approach will facilitate improvement in daily function and quality of life of patients with diseases that cause chronic vision impairment.

  17. Using speech for mode selection in control of multifunctional myoelectric prostheses.

    Science.gov (United States)

    Fang, Peng; Wei, Zheng; Geng, Yanjuan; Yao, Fuan; Li, Guanglin

    2013-01-01

    Electromyogram (EMG) recorded from residual muscles of limbs is considered as suitable control information for motorized prostheses. However, in case of high-level amputations, the residual muscles are usually limited, which may not provide enough EMG for flexible control of myoelectric prostheses with multiple degrees of freedom of movements. Here, we proposed a control strategy, where the speech signals were used as additional information and combined with the EMG signals to realize more flexible control of multifunctional prostheses. By replacing the traditional "sequential mode-switching (joint-switching)", the speech signals were used to select a mode (joint) of the prosthetic arm, and then the EMG signals were applied to determine a motion class involved in the selected joint and to execute the motion. Preliminary results from three able-bodied subjects and one transhumeral amputee demonstrated the proposed strategy could achieve a high mode-selection rate and enhance the operation efficiency, suggesting the strategy may improve the control performance of commercial myoelectric prostheses.

  18. [Survival rate and complications of stemmed shoulder prostheses in primary osteoarthritis].

    Science.gov (United States)

    Irlenbusch, U

    2013-07-01

    Survivorship and survival rate of shoulder prostheses can be affected by a large number of possible complications. An evaluation of the current literature and the prosthesis register, however, shows an overall low revision (1.39 revisions per 100 observation years) and loosening rates (implant-related 10-year survival rate up to 99%), comparable to that of hip and knee endoprostheses. It must be emphasized that cementless stems more often cause problems than cemented components (4.34 compared to 0.77 revisions per 100 observation years) and that secondary rotator cuff rupture (4.6%; functional deficit up to 30%) occurs more frequently than was generally assumed and is often not diagnosed or treated adequately. The infection rate amounts to approximately 1% and according to latest literature the dislocation rate is regressive and is estimated to be approximately 5%.The low complication and revision rates do not justify the replacement of stemmed prostheses by stemless implants and short stem prostheses and the preference given to the new implants is attributed more to the better revision possibilities and easier convertibility into inverse prostheses.

  19. In vitro evaluation of failure loads of nonmetal cantilevered resin-bonded fixed dental prostheses

    NARCIS (Netherlands)

    van Dalen, A.; Feilzer, A.J.; Kleverlaan, C.J.

    2008-01-01

    Purpose: To evaluate in vitro the influence of fiber reinforcement on the failure loads of resin composite beams, simulating cantilevered two-unit resin-bonded fixed dental prostheses, and compare the results with similarly obtained failure loads of ZrO2 and CoCr beams of a comparable design. Materi

  20. The development of artificial organs and prostheses worldwide and in the Ottoman Empire.

    Science.gov (United States)

    Birdane, Leman; Cingi, Cemal; Elçioğlu, Ömür; Muluk, Nuray Bayar

    2016-08-01

    An artificial organ or prosthesis is a man-made device that is implanted or integrated into a human to replace a natural organ. There were many historical steps in the development of artificial organs and prostheses. New surgical techniques, the development of prosthetic materials and the creative ideas of engineers led to progress in this field.

  1. [Loading and strength of single- and multi-unit fixed dental prostheses. 1. Retention and resistance

    NARCIS (Netherlands)

    Baat, C. de; Witter, D.J.; Meijers, C.C.A.J.; Vergoossen, E.L.; Creugers, N.H.J.

    2014-01-01

    The degree to which single- and multi-unit fixed dental prostheses are able to withstand loading forces is dependent, among other things, on the quality of their retention and resistance. The quality of the retention and resistance of the configuration of an abutment tooth prepared for a metal and m

  2. [Image processing system of visual prostheses based on digital signal processor DM642].

    Science.gov (United States)

    Xie, Chengcheng; Lu, Yanyu; Gu, Yun; Wang, Jing; Chai, Xinyu

    2011-09-01

    This paper employed a DSP platform to create the real-time and portable image processing system, and introduced a series of commonly used algorithms for visual prostheses. The results of performance evaluation revealed that this platform could afford image processing algorithms to be executed in real time.

  3. Screening of patients for first time prostheses after amputation of lower limbs

    Directory of Open Access Journals (Sweden)

    Vetra A.

    2016-01-01

    More than 25% of those who followed the recommended treatment and rehabilitation programme to prepare the amputation stump, reduced contracture and enhanced physical working abilities were declared to be appropriate for further prostheses. This indicates serious shortcomings in medical treatments during the early post-amputation period.

  4. Ultrastructural analysis of guided nerve regeneration using progesterone- and pregnenolone-loaded chitosan prostheses.

    Science.gov (United States)

    Chávez-Delgado, M E; Gomez-Pinedo, U; Feria-Velasco, A; Huerta-Viera, M; Castañeda, S Castro; Toral, F A López-Dellamary; Parducz, A; Anda, S Luquín-De; Mora-Galindo, J; García-Estrada, J

    2005-07-01

    Recently, numerous guide chambers for the treatment of injured nerves made up of different biomaterials have been designed, capable of hosting living cells or carrying neurotrophic or neuroactive substances to be directly released to the injured tissue. In this study, chitosan prostheses containing neurosteroids (progesterone and pregnenolone) were used for bridging a 10-mm gap in the rabbit facial nerve. Gas chromatography was used to quantify neurosteroid content in the prostheses prior to and after subcutaneous implantation at different periods of up to 60 days. The regeneration of the nerve fibers were evaluated at 15 and 45 days after axotomy by means of ultrastructural morphometric analysis. Different nerve fibers regenerative patterns were seen depending the groups studied and the analyzed stages. At 15 days after axotomy, the newly regenerating tissue revealed Schwann cells holding nonmyelinated nerve fiber bundles in an incipient and organized regenerative pattern. At 45 days, the regenerating tissue showed myelinated nerve fibers of different sizes, shapes, and myelin sheath thickness. Although the regeneration of the nerve fibers under neurosteroid treatment showed statistically significant differences in comparison with vehicle regenerated tissue, progesterone-loaded chitosan prostheses produced the best guided nerve regeneration response. These findings indicate that chitosan prostheses allowed regeneration of nerve fibers in their lumen, and when containing neurosteroids produced a faster guided nerve regeneration acting as a long-lasting release delivery vehicle.

  5. Tablet Keyboard Configuration Affects Performance, Discomfort and Task Difficulty for Thumb Typing in a Two-Handed Grip.

    Science.gov (United States)

    Trudeau, Matthieu B; Catalano, Paul J; Jindrich, Devin L; Dennerlein, Jack T

    2013-01-01

    When holding a tablet computer with two hands, the touch keyboard configuration imposes postural constraints on the user because of the need to simultaneously hold the device and type with the thumbs. Designers have provided users with several possible keyboard configurations (device orientation, keyboard layout and location). However, potential differences in performance, usability and postures among these configurations have not been explored. We hypothesize that (1) the narrower standard keyboard layout in the portrait orientation leads to lower self-reported discomfort and less reach than the landscape orientation; (2) a split keyboard layout results in better overall outcomes compared to the standard layout; and (3) the conventional bottom keyboard location leads to the best outcomes overall compared to other locations. A repeated measures laboratory experiment of 12 tablet owners measured typing speed, discomfort, task difficulty, and thumb/wrist joint postures using an active marker system during typing tasks for different combinations of device orientation (portrait and landscape), keyboard layout (standard and split), and keyboard location (bottom, middle, top). The narrower standard keyboard with the device in the portrait orientation was associated with less discomfort (least squares mean (and S.E.) 2.9±0.6) than the landscape orientation (4.5±0.7). Additionally, the split keyboard decreased the amount of reaching required by the thumb in the landscape orientation as defined by a reduced range of motion and less MCP extension, which may have led to reduced discomfort (2.7±0.6) compared to the standard layout (4.5±0.7). However, typing speed was greater for the standard layout (127±5 char./min.) compared to the split layout (113±4 char./min.) regardless of device orientation and keyboard location. Usage guidelines and designers can incorporate these findings to optimize keyboard design parameters and form factors that promote user performance and

  6. Ultrasound-Assisted Extraction of Syringin from the Bark of Ilex rotunda Thumb Using Response Surface Methodology

    OpenAIRE

    Hui Wang; Li-Chun Zhao; Wei Li; Xin Deng; Xiang-Hua Xia; Jian Liang; Geng-Liang Yang; Ying He

    2012-01-01

    In this work, a rapid extraction method based on ultrasound-assisted extraction (UAE) of syringin from the bark of Ilex rotunda Thumb using response surface methodology (RSM) is described. The syringin was analyzed and quantified by high performance liquid chromatography coupled with UV detection (HPLC-UV). The extraction solvent, extraction temperature and extraction time, the three main factors for UAE, were optimized with Box-Behnken design (BBD) to obtain the highest ...

  7. Evaluation of taper joints with combined fatigue and crevice corrosion testing: Comparison to human explanted modular prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Reclaru, L., E-mail: lucien.reclaru@pxgroup.com [PX Group S.A., Dep R and D Corrosion and Biocompatibility Group, Bd. des Eplatures 42, CH-2304 La Chaux-de-Fonds (Switzerland); Brooks, R.A. [Orthopaedic Research, Addenbrooke' s Hospital, University of Cambridge, Box 180 Hills Road, CB2 0QQ Cambridge (United Kingdom); Zuberbühler, M. [Smith and Nephew Orthopaedics AG, Schachenalle 29, 5001 Aarau (Switzerland); Eschler, P.-Y.; Constantin, F. [PX Group S.A., Dep R and D Corrosion and Biocompatibility Group, Bd. des Eplatures 42, CH-2304 La Chaux-de-Fonds (Switzerland); Tomoaia, G. [University of Medicine and Pharmacy Iuliu Hateganu of Cluj-Napoca, Dept. of Orthopaedics and Traumatology, Cluj-Napoca (Romania)

    2014-01-01

    The requirement for revision surgery of total joint replacements is increasing and modular joint replacement implants have been developed to provide adjustable prosthetic revision systems with improved intra-operative flexibility. An electrochemical study of the corrosion resistance of the interface between the distal and proximal modules of a modular prosthesis was performed in combination with a cyclic fatigue test. The complexity resides in the existence of interfaces between the distal part, the proximal part, and the dynamometric screw. A new technique for evaluating the resistance to cyclic dynamic corrosion with crevice stimulation was used and the method is presented. In addition, two components of the proximal module of explanted Ti6Al4V and Ti6Al7Nb prostheses were investigated by optical and electron microscopy. Our results reveal that: The electrolyte penetrates into the interface between the distal and proximal modules during cyclic dynamic fatigue tests, the distal module undergoes cracking and corrosion was generated at the interface between the two models; The comparison of the explanted proximal parts with the similar prostheses evaluated following cyclic dynamic crevice corrosion testing showed that there were significant similarities indicating that this method is suitable for evaluating materials used in the fabrication of modular prostheses. - Highlights: • Electrochemical crevice corrosion testing combined with fatigue test conducted on Ti6Al7Nb and Ti6Al4V modular prostheses • Cations released from integral prostheses • Comparison of human explanted modular prostheses with the similar prostheses evaluated in cyclic dynamic crevice corrosion.

  8. Metastatic Basal Cell Carcinoma Accompanying Gorlin Syndrome

    Directory of Open Access Journals (Sweden)

    Yeliz Bilir

    2014-01-01

    Full Text Available Gorlin-Goltz syndrome or basal cell nevus syndrome is an autosomal dominant syndrome characterized by skeletal anomalies, numerous cysts observed in the jaw, and multiple basal cell carcinoma of the skin, which may be accompanied by falx cerebri calcification. Basal cell carcinoma is the most commonly skin tumor with slow clinical course and low metastatic potential. Its concomitance with Gorlin syndrome, resulting from a mutation in a tumor suppressor gene, may substantially change morbidity and mortality. A 66-year-old male patient with a history of recurrent basal cell carcinoma was presented with exophthalmus in the left eye and the lesions localized in the left lateral orbita and left zygomatic area. His physical examination revealed hearing loss, gapped teeth, highly arched palate, and frontal prominence. Left orbital mass, cystic masses at frontal and ethmoidal sinuses, and multiple pulmonary nodules were detected at CT scans. Basal cell carcinoma was diagnosed from biopsy of ethmoid sinus. Based on the clinical and typical radiological characteristics (falx cerebri calcification, bifid costa, and odontogenic cysts, the patient was diagnosed with metastatic skin basal cell carcinoma accompanied by Gorlin syndrome. Our case is a basal cell carcinoma with aggressive course accompanying a rarely seen syndrome.

  9. Metastatic Basal cell carcinoma accompanying gorlin syndrome.

    Science.gov (United States)

    Bilir, Yeliz; Gokce, Erkan; Ozturk, Banu; Deresoy, Faik Alev; Yuksekkaya, Ruken; Yaman, Emel

    2014-01-01

    Gorlin-Goltz syndrome or basal cell nevus syndrome is an autosomal dominant syndrome characterized by skeletal anomalies, numerous cysts observed in the jaw, and multiple basal cell carcinoma of the skin, which may be accompanied by falx cerebri calcification. Basal cell carcinoma is the most commonly skin tumor with slow clinical course and low metastatic potential. Its concomitance with Gorlin syndrome, resulting from a mutation in a tumor suppressor gene, may substantially change morbidity and mortality. A 66-year-old male patient with a history of recurrent basal cell carcinoma was presented with exophthalmus in the left eye and the lesions localized in the left lateral orbita and left zygomatic area. His physical examination revealed hearing loss, gapped teeth, highly arched palate, and frontal prominence. Left orbital mass, cystic masses at frontal and ethmoidal sinuses, and multiple pulmonary nodules were detected at CT scans. Basal cell carcinoma was diagnosed from biopsy of ethmoid sinus. Based on the clinical and typical radiological characteristics (falx cerebri calcification, bifid costa, and odontogenic cysts), the patient was diagnosed with metastatic skin basal cell carcinoma accompanied by Gorlin syndrome. Our case is a basal cell carcinoma with aggressive course accompanying a rarely seen syndrome.

  10. A Case of Mayer-Rokitansky-Kuster-Hayser Syndrome with Absence of the Right Thumb

    Directory of Open Access Journals (Sweden)

    Pal Ranabir

    2008-01-01

    Full Text Available A 14-year-old feminine adolescent, presented with congenital absence of right thumb, scoliosis, severe anemia, primary amenorrhea without secondary sexual characteristics, except for normally developed breasts. In the genital area, there was a pair of ill developed labia majora fused at upper end with a whirling pattern containing inside the urethral opening. The lower end of genitalia had loose skin folds containing adequate amounts of rugae with a raphe, mimicking the texture of scrotal skin. There was no vaginal orifice. Diagnostic work-up included routine hematological studies, skeletal radiography, renal ultrasonography, and renal scan to demonstrate possible association between the congenital genitourinary and skeletal anomalies. Ultrasound imaging studies confirmed that she had structures close to uterus with hematometra, but vagina and ovary were not found. Sonologically, the left kidney could not be visualized. Renal scan confirmed agenesis of the left kidney and hypoplastic, parenchymally insufficient, right kidney. Cytogenetic karyotyping revealed a 46, XX karyotyping and the presence of Barr chromatin body. Based on the clinical examination and investigations, a diagnosis of Mayer-Rokitansky-Kuster-Hauser syndrome was established with associated limb and skeletal deformities.

  11. Adaptability of Paulownia tomentosa (thumb. Sieb. et Zucc. on green areas in Belgrade

    Directory of Open Access Journals (Sweden)

    Stojičić Đurđa

    2010-01-01

    Full Text Available The taxa with the improved esthetical characteristics, increased or decreased productivity, higher resistance to diseases, insect attacks, air pollution, as well as with optimal adaptability in urban coenoses are of great importance to land­scape architecture, horticulture and forestry. The criteria for the selection of individual plants out of the number of many individuals depend on their future usage, but also on their esthetical features, morphology and physiology. One of the species that fulfils the above criteria is Paulownia tomentosa (Thumb. Sieb. et Zucc. Different morphophysiological features of royal paulownia cultivated on green areas in Banovo Brdo, Dorćol, Tašmajdan, Novi Beograd and Zemun are analyzed. The study results prove the adaptability of royal paulownia on green areas in Belgrade, but also the need to select the parent trees with the best combining features prior to production, aiming at the improvement and production of planting material for urban coenoses and specific-purpose plantations of this species.

  12. The Leaf of Diospyros kaki Thumb Ameliorates Renal Oxidative Damage in Mice with Type 2 Diabetes

    Science.gov (United States)

    Choi, Myung-Sook; Jeong, Mi Ji; Park, Yong Bok; Kim, Sang Ryong; Jung, Un Ju

    2016-01-01

    Diabetic kidney disease is the most common and severe chronic complication of diabetes. The leaf of Diospyros kaki Thumb (persimmon) has been commonly used for herbal tea and medicinal purposes to treat a variety of conditions, including hypertension and atherosclerosis. However, the effect of persimmon leaf on kidney failure has not been investigated. This study aimed to examine the role of persimmon leaf in protecting the diabetes-associated kidney damage in a mouse model of type 2 diabetes. Mice were fed either a normal chow diet with or without powered persimmon leaf (5%, w/w) for 5 weeks. In addition to kidney morphology and blood markers of kidney function, we assessed levels of oxidative stress markers as well as antioxidant enzymes activities and mRNA expression in the kidney. Supplementation of the diet with powered persimmon leaf not only decreased the concentration of blood urea nitrogen in the plasma but also improved glomerular hypertrophy. Furthermore, the persimmon leaf significantly decreased the levels of hydrogen peroxide and lipid peroxide in the kidney. The activities of superoxide dismutase, catalase, and glutathione peroxidase and the mRNA expression of their respective genes were also increased in the kidney of persimmon leaf-supplemented db/db mice. Taken together, these results suggest that supplementation with the persimmon leaf may have protective effects against type 2 diabetes-induced kidney dysfunction and oxidative stress. PMID:28078262

  13. Trapezium excision and suture suspensionplasty (TESS) for the treatment of thumb carpometacarpal arthritis.

    Science.gov (United States)

    Putnam, Matthew D; Meyer, Nicholas J; Baker, Daniel; Brehmer, Jess; Carlson, Brent D

    2014-06-01

    Basilar thumb arthritis, or first carpometacarpal arthritis, is a common condition affecting older women and some men. It is estimated that as many as one third of postmenopausal woman are affected. Surgical treatment of this condition includes options ranging from arthrodesis to prosthetic arthroplasty. Intermediate options include complete or partial trapezial excision with or without interposition of a cushioning/stabilizing material (auto source, allo source, synthetic source). A multitude of methods appear to offer similar end results, although some methods definitely involve more surgical work and perhaps greater patient risk. Through retrospective evaluation of a cohort of patients who underwent suture suspensionplasty, we determined the postoperative effect on strength, motion, patient satisfaction, complications, and radiographic maintenance of the scaphoid-metacarpal distance. This review shows the method to be clinically effective and, by comparison with a more traditional ligament reconstruction trapezial interposition arthroplasty, the method does not require use of autograft or allograft tendon and has fewer surgical steps. Forty-four patients were included in this retrospective study. The results showed that 91% of patients were satisfied with the procedure. Pinch and grip strength remained the same preoperatively and postoperatively. A Disabilities of the Arm, Shoulder, and Hand patient-reported outcome instrument (DASH) scores averaged 30 at final follow-up. Three patients developed a late complication requiring further surgical intervention. In summary, this technique appears to be technically reproducible, requires no additional tendon material, and achieves objectively and subjectively similar results to other reported procedures used to manage first CMC Arthritis.

  14. Thermodynamic Significance of Human Basal Metabolism

    Institute of Scientific and Technical Information of China (English)

    WangCuncheng

    1993-01-01

    The human basal state,a non-equilibrium steady state,is analysed in this paper in the light of the First and Second Laws of Thermodynamics whereby the thermodynamic significance of the basal metabolic rate and its distinction to the dissipation function and exergy loss are identified.The analysis demonstrates the correct expression of the effects of the blood flow on the heat balance in a human-body bio-heat model and the relationship between the basal metabolic rate and the blood perfusion.

  15. Neglected giant scalp Basal cell carcinoma

    DEFF Research Database (Denmark)

    Larsen, Anne Kristine; El-Charnoubi, Waseem-Asim Ghulam; Gehl, Julie;

    2014-01-01

    SUMMARY: Rarely, basal cell carcinoma grows to a giant size, invading the underlying deep tissue and complicating the treatment and reconstruction modalities. A giant basal cell carcinoma on the scalp is in some cases treated with a combination of surgery and radiation therapy, resulting in local...... control, a satisfactory long-term cosmetic and functional result. We present a case with a neglected basal cell scalp carcinoma, treated with wide excision and postoperative radiotherapy, reconstructed with a free latissimus dorsi flap. The cosmetic result is acceptable and there is no sign of recurrence...

  16. Neglected Giant Scalp Basal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Anne Kristine Larsen, MD

    2014-03-01

    Full Text Available Summary: Rarely, basal cell carcinoma grows to a giant size, invading the underlying deep tissue and complicating the treatment and reconstruction modalities. A giant basal cell carcinoma on the scalp is in some cases treated with a combination of surgery and radiation therapy, resulting in local control, a satisfactory long-term cosmetic and functional result. We present a case with a neglected basal cell scalp carcinoma, treated with wide excision and postoperative radiotherapy, reconstructed with a free latissimus dorsi flap. The cosmetic result is acceptable and there is no sign of recurrence 1 year postoperatively.

  17. Fixed full-arch implant-supported prostheses in a patient with epidermolysis bullosa: a clinical case history report.

    Science.gov (United States)

    Agustín-Panadero, Rubén; Gomar-Vercher, Sonia; Peñarrocha-Oltra, David; Guzmán-Letelier, Marcelo; Peñarrocha-Diago, Miguel

    2015-01-01

    Epidermolysis bullosa (EB) is a rare skin disorder characterized by blister formation in response to minor trauma and accompanied by extracutaneous manifestations. The use of endosseous implants to support fixed prostheses for the rehabilitation of patients with recessive dystrophic EB might provide a considerably better clinical treatment outcome than traditional prosthodontic interventions. This case history report describes the clinical management of such an afflicted patient. Implants were placed immediately following teeth extractions and subsequently loaded with fixed full-arch prostheses. This treatment option is proposed for patients with recessive dystrophic EB to preclude mucosal irritation associated with wearing removable prostheses.

  18. Apico-basal polarity complex and cancer

    Indian Academy of Sciences (India)

    Mohammed Khursheed; Murali Dharan Bashyam

    2014-03-01

    Apico-basal polarity is a cardinal molecular feature of adult eukaryotic epithelial cells and appears to be involved in several key cellular processes including polarized cell migration and maintenance of tissue architecture. Epithelial cell polarity is maintained by three well-conserved polarity complexes, namely, PAR, Crumbs and SCRIB. The location and interaction between the components of these complexes defines distinct structural domains of epithelial cells. Establishment and maintenance of apico-basal polarity is regulated through various conserved cell signalling pathways including TGF, Integrin and WNT signalling. Loss of cell polarity is a hallmark for carcinoma, and its underlying molecular mechanism is beginning to emerge from studies on model organisms and cancer cell lines. Moreover, deregulated expression of apico-basal polarity complex components has been reported in human tumours. In this review, we provide an overview of the apico-basal polarity complexes and their regulation, their role in cell migration, and finally their involvement in carcinogenesis.

  19. Automatic basal slice detection for cardiac analysis

    Science.gov (United States)

    Paknezhad, Mahsa; Marchesseau, Stephanie; Brown, Michael S.

    2016-03-01

    Identification of the basal slice in cardiac imaging is a key step to measuring the ejection fraction (EF) of the left ventricle (LV). Despite research on cardiac segmentation, basal slice identification is routinely performed manually. Manual identification, however, has been shown to have high inter-observer variability, with a variation of the EF by up to 8%. Therefore, an automatic way of identifying the basal slice is still required. Prior published methods operate by automatically tracking the mitral valve points from the long-axis view of the LV. These approaches assumed that the basal slice is the first short-axis slice below the mitral valve. However, guidelines published in 2013 by the society for cardiovascular magnetic resonance indicate that the basal slice is the uppermost short-axis slice with more than 50% myocardium surrounding the blood cavity. Consequently, these existing methods are at times identifying the incorrect short-axis slice. Correct identification of the basal slice under these guidelines is challenging due to the poor image quality and blood movement during image acquisition. This paper proposes an automatic tool that focuses on the two-chamber slice to find the basal slice. To this end, an active shape model is trained to automatically segment the two-chamber view for 51 samples using the leave-one-out strategy. The basal slice was detected using temporal binary profiles created for each short-axis slice from the segmented two-chamber slice. From the 51 successfully tested samples, 92% and 84% of detection results were accurate at the end-systolic and the end-diastolic phases of the cardiac cycle, respectively.

  20. Biomarkers for Basal-like Breast Cancer

    OpenAIRE

    Choo, Jennifer R.; Torsten O. Nielsen

    2010-01-01

    Initially recognized through microarray-based gene expression profiling, basal-like breast cancer, for which we lack effective targeted therapies, is an aggressive form of carcinoma with a predilection for younger women. With some success, immunohistochemical studies have attempted to reproduce the expression profile classification of breast cancer through identification of subtype-specific biomarkers. This review aims to present an in depth summary and analysis of the current status of basal...

  1. Fitting a bilateral transhumeral amputee with utensil prostheses and their functional assessment 10 years later: a case report.

    Science.gov (United States)

    Hung, Jen Wen; Wu, Yee Hwa

    2005-11-01

    Traumatic transhumeral amputations resulting from electric burn injury are uncommon and present a significant rehabilitation challenge. Compensating for loss of fine, coordinated function of the upper extremities with prostheses is difficult medically, technologically, psychologically, and socially. We followed up a patient with traumatic bilateral transhumeral amputation who was fitted with specially designed bilateral low-temperature utensil prostheses for 10 years. A bilateral utensil prosthesis consists of 2 thermoplastic sockets, an elastic harness, 2 utensil holders, and several different utensils. The characteristics of utensil prostheses are low cost, quick fabrication, and responsiveness to a patient's needs. Ten years after the patient's first prosthesis fitting, he still used these specially designed prostheses. By using these devices and his feet, the patient has regained independence in most activities of daily living and gained a new working skill.

  2. How Weight Affects the Perceived Spacing between the Thumb and Fingers during Grasping.

    Directory of Open Access Journals (Sweden)

    Annie A Butler

    Full Text Available We know much about mechanisms determining the perceived size and weight of lifted objects, but little about how these properties of size and weight affect the body representation (e.g. grasp aperture of the hand. Without vision, subjects (n = 16 estimated spacing between fingers and thumb (perceived grasp aperture while lifting canisters of the same width (6.6cm but varied weights (300, 600, 900, and 1200 g. Lifts were performed by movement of either the wrist, elbow or shoulder to examine whether lifting with different muscle groups affects the judgement of grasp aperture. Results for perceived grasp aperture were compared with changes in perceived weight of objects of different sizes (5.2, 6.6, and 10 cm but the same weight (600 g. When canisters of the same width but different weights were lifted, perceived grasp aperture decreased 4.8% [2.2 ‒ 7.4] (mean [95% CI]; P < 0.001 from the lightest to the heaviest canister, no matter how they were lifted. For objects of the same weight but different widths, perceived weight decreased 42.3% [38.2 ‒ 46.4] from narrowest to widest (P < 0.001, as expected from the size-weight illusion. Thus, despite a highly distorted perception of the weight of objects based on their size, we conclude that proprioceptive afferents maintain a reasonably stable perception of the aperture of the grasping hand over a wide range of object weights. Given the small magnitude of this 'weight-grasp aperture' illusion, we propose the brain has access to a relatively stable 'perceptual ruler' to aid the manipulation of different objects.

  3. Effect of alignment changes on socket reaction moments during gait in transfemoral and knee-disarticulation prostheses: Case series

    OpenAIRE

    Kobayashi, Toshiki; Orendurff, Michael S.; Boone, David A.

    2013-01-01

    The alignment of a lower-limb prosthesis is critical to the successful prosthetic fitting and utilization by the wearer. Loads generated by the socket applied to the residual limb while walking are thought to be different in transfemoral and knee-disarticulation prostheses. The aim of this case series was to compare the socket reaction moments between transfemoral and knee-disarticulation prostheses and to investigate the effect of alignment changes on them. Two amputees, one with a transfemo...

  4. A root submergence technique for pontic site development in fixed dental prostheses in the maxillary anterior esthetic zone

    OpenAIRE

    Choi, Sunyoung; Yeo, In-Sung; Kim, Sung-Hun; Lee, Jai-Bong; Cheong, Chan Wook; Han, Jung-Suk

    2015-01-01

    Purpose This case report discusses the effect of a root submergence technique on preserving the periodontal tissue at the pontic site of fixed dental prostheses in the maxillary anterior aesthetic zone. Methods Teeth with less than ideal structural support for fixed retainer abutments were decoronated at the crestal bone level. After soft tissue closure, the final fixed dental prostheses were placed with the pontics over the submerged root area. Radiographic and clinical observations at the p...

  5. Towards Long-Life Replacement Joint Prostheses-A Surface Engineering Approach

    Institute of Scientific and Technical Information of China (English)

    HanshanDong

    2004-01-01

    How to improve the wear resistance of bearing surfaces, hereby achieving long life of orthopaedic joint prostheses has long been a technical challenge with much fundamental interest and social and economic impacts. Surface engineering has been emerging as one of the most promising technologies to improve the tribological properties of biomedical materials. A current area of research within the Birmingham Surface Engineering Group has been directed at developing novel surface engineering technologies for biomedical materials towards long-life joint prostheses. Following a brief introduction, the author reports their recent progress in the surface engineering of biomedical materials particular for joint prosthesis. The potential of these innovative surface engineering technologies in enhancing the performance of oral and maxillofacial implants and surgical devices is also discussed.

  6. Knee Angle Estimation Algorithm for Myoelectric Control of Active Transfemoral Prostheses

    Science.gov (United States)

    Delis, Alberto López; de Carvalho, João Luiz Azevedo; Da Rocha, Adson Ferreira; de Oliveira Nascimento, Francisco Assis; Borges, Geovany Araújo

    This paper presents a bioinstrumentation system for the acquisition and pre-processing of surface electromyographic (SEMG) signals, and a knee angle estimation algorithm for control of active transfemoral leg prostheses, using methods for feature extraction and classification of myoelectric signal patterns. The presented microcontrolled bioinstrumentation system is capable of recording up to four SEMG channels, and one electrogoniometer channel. The proposed neural myoelectric controller algorithm is capable of predicting the intended knee joint angle from the measured SEMG signals. The algorithm is designed in three stages: feature extraction, using auto-regressive model and amplitude histogram; feature projection, using self organizing maps; and pattern classification, using a Levenberg-Marquardt neural network. The use of SEMG signals and additional mechanical information such as that provided by the electrogoniometer may improve precision in the control of leg prostheses. Preliminary results are presented.

  7. Three-dimensional computerized selection of hip prostheses in patients with congenital dislocated hips.

    Science.gov (United States)

    Gelalis, L D; Xenakis, T A; Hantes, M; Vartziotis, K; Soucacos, P N

    2001-11-01

    This study assessed the effectiveness of the combined use of computed tomography (CT) and computer-aided design (CAD) in the preoperative evaluation and implant selection in 20 patients (20 hips) with congenital dislocation of the hip who were scheduled to undergo total hip arthroplasty. Computerized selection of the femoral implant with optimum fit and fill was made after a three-dimensional reconstruction of the femoral canal using CT data and CAD. Implantation of all sizes of 5 noncemented and 2 cemented femoral implants was simulated using CATIA software (IBM, Kingstone, NY). When patients underwent surgery, 18 of 20 preselected prostheses agreed by type and size with the prostheses implanted. The remaining 2 preselected implants agreed by type only. In patients with dislocated and dysplastic hips, combined use of CT and CAD allows effective preoperative planning by providing the surgeon with vital information about the proximal femoral canal geometry and the possible femoral implant with optimum fit and fill to be used.

  8. Towards Long-Life Replacement Joint Prostheses - A Surface Engineering Approach

    Institute of Scientific and Technical Information of China (English)

    Hanshan Dong

    2004-01-01

    How to improve the wear resistance of bearing surfaces, hereby achieving long life of orthopaedic joint prostheses has long been a technical challenge with much fundamental interest and social and economic impacts. Surface engineering has been emerging as one of the most promising technologies to improve the tribological properties of biomedical materials.A current area of research within the Birmingham Surface Engineering Group has been directed at developing novel surface engineering technologies for biomedical materials towards long-life joint prostheses. Following a brief introduction, the author reports their recent progress in the surface engineering of biomedical materials particular for joint prosthesis. The potential of these innovative surface engineering technologies in enhancing the performance of oral and maxillofacial implants and surgical devices is also discussed.

  9. The History, Technical Specifications and Efficacy of Plasma Spray Coatings Applied to Joint Replacement Prostheses

    Directory of Open Access Journals (Sweden)

    Andrew McCabe

    2016-12-01

    Full Text Available Thermal plasma sprayed coatings are designed to improve both the biocompatibility and durability of implantable medical devices, and include pure titanium, cobalt/chrome alloy and hydroxyapatite.  Coated joint replacements have now been in continuous clinical use for thirty years and are applied to products manufactured or used in Europe, North America, South America, Africa, Asia and Australasia. Prostheses incorporating such coatings have been successfully implanted into several million of patients worldwide and to date there have been very few reports of any failure of an implant which could be attributed to problems with, or failure of, the coating. This paper summarises the early history of cementless prostheses and subsequent development, specification, validation, regulatory requirements and clinical performance of thermal plasma spray coatings provided by Accentus Medical.

  10. Optimal restoration of dental esthetics and function with advanced implant-supported prostheses: a clinical report.

    Science.gov (United States)

    Meulen, Peter van der; Linden, Wynand van der; Eeden, Ronnie van

    2012-07-01

    For more than 25 years, computer-aided design and computer-aided manufacturing (CAD/CAM) technology has been used in implant restorative dentistry. Today this technology offers a means of milling titanium frameworks that fit dental implants accurately. This report presents a restoratively driven protocol employing advanced implant restorative and surgical techniques. Treatment of a patient with advanced periodontitis with extensive loss of hard and soft tissues is presented. After extraction of the patient's remaining hopeless teeth, dental implants were placed, along with interim, fixed-margin abutments and abutment protection caps. Two days later, acrylic resin fixed-interim prostheses restored the patient's esthetics and partial masticatory function. After implant osseointegration, maxillary, and mandibular frameworks for definitive prostheses were milled from Ti alloy, using one specific CAD/CAM technology. The benefits of this technology are also discussed.

  11. Restoring natural sensory feedback in real-time bidirectional hand prostheses

    DEFF Research Database (Denmark)

    Raspopovic, Stanisa; Capogrosso, Marco; Petrini, Francesco Maria

    2014-01-01

    feedback. We show that by stimulating the median and ulnar nerve fascicles using transversal multichannel intrafascicular electrodes, according to the information provided by the artificial sensors from a hand prosthesis, physiologically appropriate (near-natural) sensory information can be provided......Hand loss is a highly disabling event that markedly affects the quality of life. To achieve a close to natural replacement for the lost hand, the user should be provided with the rich sensations that we naturally perceive when grasping or manipulating an object. Ideal bidirectional hand prostheses...... should involve both a reliable decoding of the user’s intentions and the delivery of nearly “natural” sensory feedback through remnant afferent pathways, simultaneously and in real time. However, current hand prostheses fail to achieve these requirements, particularly because they lack any sensory...

  12. Similar Marginal Precision of Zirconia- and Metal-Ceramic Fixed Dental Prostheses

    DEFF Research Database (Denmark)

    Nicolaisen, Maj Høygaard; Bahrami, Golnosh; Schropp, Lars

    Similar Marginal Precision of Zirconia- and Metal-Ceramic Posterior Fixed Dental Prostheses Objective: An increased gap between restoration and prepared tooth causes more luting material to be exposed to the oral environment resulting in increased deterioration, leading to bacterial accumulation...... which can cause marginal periodontitis and secondary caries. The purpose of this randomized clinical study was to compare the marginal precision of CAD/CAM Zirconia-ceramic (ZC) and cast gold alloy metal-ceramic (MC) posterior fixed dental prostheses. Methods: As part of an ongoing randomized controlled...... clinical trial, 34 patients were randomized into two groups to receive a 3-unit fixed dental prosthesis (FDP) replacing a second premolar or a first molar. 17 ZC FDPs (BeCe CAD Zirkon, BEGO with Vita VM9, VITA ) and 17 MC FDPs (Bio PontoStar, BEGO with Vita VM13, VITA). All FDPs were made in accordance...

  13. Tissue reaction around loosened prostheses: a histological, X-ray microanalytic and immunological study.

    Directory of Open Access Journals (Sweden)

    Hayashi,Takashi

    1986-10-01

    Full Text Available Tissue reactions at the cement-bone and artificial implant-bone interface were examined light and electron microscopically in thirty-six patients who underwent revisory operation of hip or knee replacement. The reactions were classified into three types: inert tissue, active tissue with giant cell proliferation, and active tissue with predominant foamy cell proliferation. The third type of reaction was found only in total hip replacement with bone cement. No evidence of allergic reaction to implanted materials was found in any replacement, though active cellular infiltrations were observed around loosened prostheses especially in cemented arthroplasty. The tissue reactions always occurred around instable or loosened prostheses. Thus, the present study shows that mechanical instability is the primary cause of such undesired tissue reactions.

  14. An up-to-date overview of the most recent transcatheter implantable aortic valve prostheses.

    Science.gov (United States)

    Wiegerinck, Esther M A; Van Kesteren, Floortje; Van Mourik, Martijn S; Vis, Marije M; Baan, Jan

    2016-01-01

    Over the past decade transcatheter aortic valve implantation (TAVI) has evolved towards the routine therapy for high-risk patients with severe aortic valve stenosis. Technical refinements in TAVI are rapidly evolving with a simultaneous expansion of the number of available devices. This review will present an overview of the current status of development of TAVI-prostheses; describes the technical features and applicability of each device and the clinical data available.

  15. PERSPECTIVE: Is acuity enough? Other considerations in clinical investigations of visual prostheses

    Science.gov (United States)

    Lepri, Bernard P.

    2009-06-01

    Visual impairing eye diseases are the major frontier facing ophthalmic research today in light of our rapidly aging population. The visual skills necessary for improving the quality of daily function and life are inextricably linked to these impairing diseases. Both research and reimbursement programs are emphasizing outcome-based results. Is improvement in visual acuity alone enough to improve the function and quality of life of visually impaired persons? This perspective summarizes the types of effectiveness endpoints for clinical investigations of visual prostheses that go beyond visual acuity. The clinical investigation of visual prostheses should include visual function, functional vision and quality of life measures. Specifically, they encompass contrast sensitivity, orientation and mobility, activities of daily living and quality of life assessments. The perspective focuses on the design of clinical trials for visual prostheses and the methods of determining effectiveness above and beyond visual acuity that will yield outcomes that are measured by improved function in the visual world and quality of life. The visually impaired population is the primary consideration in this presentation with particular emphases on retinitis pigmentosa and age-related macular degeneration. Clinical trials for visual prostheses cannot be isolated from the need for medical rehabilitation in order to obtain measurements of effectiveness that produce outcomes/evidence-based success. This approach will facilitate improvement in daily function and quality of life of patients with diseases that cause chronic vision impairment. The views and opinions are those of the author and do not necessarily reflect those of the US Food and Drug Administration, the US Department of Health and Human Services or the Public Health Service.

  16. In vivo implant fixation of carbon fiber-reinforced PEEK hip prostheses in an ovine model.

    Science.gov (United States)

    Nakahara, Ichiro; Takao, Masaki; Bandoh, Shunichi; Bertollo, Nicky; Walsh, William R; Sugano, Nobuhiko

    2013-03-01

    Carbon fiber-reinforced polyetheretherketone (CFR/PEEK) is theoretically suitable as a material for use in hip prostheses, offering excellent biocompatibility, mechanical properties, and the absence of metal ions. To evaluate in vivo fixation methods of CFR/PEEK hip prostheses in bone, we examined radiographic and histological results for cementless or cemented CFR/PEEK hip prostheses in an ovine model with implantation up to 52 weeks. CFR/PEEK cups and stems with rough-textured surfaces plus hydroxyapatite (HA) coatings for cementless fixation and CFR/PEEK cups and stems without HA coating for cement fixation were manufactured based on ovine computed tomography (CT) data. Unilateral total hip arthroplasty was performed using cementless or cemented CFR/PEEK hip prostheses. Five cementless cups and stems and six cemented cups and stems were evaluated. On the femoral side, all cementless stems demonstrated bony ongrowth fixation and all cemented stems demonstrated stable fixation without any gaps at both the bone-cement and cement-stem interfaces. All cementless cases and four of the six cemented cases showed minimal stress shielding. On the acetabular side, two of the five cementless cups demonstrated bony ongrowth fixation. Our results suggest that both cementless and cemented CFR/PEEK stems work well for fixation. Cup fixation may be difficult for both cementless and cemented types in this ovine model, but bone ongrowth fixation on the cup was first seen in two cementless cases. Cementless fixation can be achieved using HA-coated CFR/PEEK implants, even under load-bearing conditions.

  17. Mechanical compatibility of sol–gel annealing with titanium for orthopaedic prostheses

    OpenAIRE

    Greer, Andrew I.M.; Lim, Teoh S.; Brydone, Alistair S.; Gadegaard, Nikolaj

    2016-01-01

    Sol–gel processing is an attractive method for large-scale surface coating due to its facile and inexpensive preparation, even with the inclusion of precision nanotopographies. These are desirable traits for metal orthopaedic prostheses where ceramic coatings are known to be osteoinductive and the effects may be amplified through nanotexturing. However there are a few concerns associated with the application of sol–gel technology to orthopaedics. Primarily, the annealing stage required to tra...

  18. Localized basal meningeal enhancement in tuberculous meningitis

    Energy Technology Data Exchange (ETDEWEB)

    Theron, Salomine; Andronikou, Savvas; Grobbelaar, Marie; Steyn, Freda; Mapukata, Ayanda; Plessis, Jaco du [University of Stellenbosch, Department of Radiology, Tygerberg Hospital, P.O. BOX 19063, Tygerberg (South Africa)

    2006-11-15

    Focal basal meningeal enhancement may produce a confusing CT picture in children with suspected tuberculous meningitis (TBM). To demonstrate the incidence, distribution and appearance of localized basal meningeal enhancement in children with TBM. CT scans of patients with definite (culture proven) and probable (CSF suggestive) TBM were retrospectively evaluated by two observers. Localized basal enhancement was documented as involving: unilateral cistern of the lateral fossa (CLF), unilateral sylvian fissure, unilateral CLF and sylvian fissure in combination, unilateral CLF and sylvian fissure with ipsi- or contralateral ambient cistern and isolated quadrigeminal plate cistern. The study included 130 patients with TBM (aged 2 months to 13 years 9 months). Focal basal enhancement was seen in 11 patients (8.5%). The sylvian fissure was involved most commonly, followed by the lateral fossa cistern. The ambient cistern was involved in three patients and the quadrigeminal plate cistern in one. Focal areas of enhancement corresponded to the areas of infarction in every patient. Focal basal meningeal enhancement is common (8.5%) in paediatric TBM. This must be kept in mind when evaluating CT scans in children presenting with focal neurological findings, seizures or meningism in communities where TBM is endemic. (orig.)

  19. Somatotopic organization of the primate basal ganglia

    Directory of Open Access Journals (Sweden)

    Atsushi eNambu

    2011-04-01

    Full Text Available Somatotopic organization is a fundamental and key concept to understand how the cortico-basal ganglia loop works. It is also indispensable knowledge to perform stereotaxic surgery for movement disorders. Here I would like to describe the somatotopic organization of the basal ganglia, which consist of the striatum, subthalamic nucleus, globus pallidus and substantia nigra. Projections from motor cortical regions representing different body parts terminate in different regions of these nuclei. Basal ganglia neurons respond not only to the stimulation of the corresponding regions of the motor cortices, but also to active and passive movements of the corresponding body parts. On the basis of these anatomical and physiological findings, somatotopic organization can be identified in the motor territories of these nuclei in the basal ganglia. In addition, projections from functionally interrelated cortical areas partially converge through the cortico-basal ganglia loop, but nevertheless the somatotopy is still preserved. Disorganized somatotopy may explain, at least in part, the pathophysiology of movement disorders, such as Parkinson’s disease and dystonia.

  20. Mid-term results after implantation of rotating-hinge knee prostheses: primary versus revision

    Directory of Open Access Journals (Sweden)

    Turgay Efe

    2012-12-01

    Full Text Available The aim of the study was to evaluate the mid-term clinical results and survivorship of a rotating-hinge knee prosthesis (LINK® Endo-Model in difficult primary and complex revision situations. Results after primary implantation were compared with those of revision procedures. Forty-nine prostheses in 45 patients were reviewed clinically during follow up. Twenty-one of these were implanted in primary and 28 in revision situations. Outcome was evaluated using commonly used scores (Knee Society, UCLA Activity, Lequesne and a visual analog scale after a mean follow up of 56±37 months for 49 prostheses. Implant survival was analyzed using the Kaplan-Meier method. There were no significant differences in clinical examination and evaluation scores between the two groups (P>0.05. Survival rates at final follow up were 95% after primary implantation and 76% in revision procedures. The risk of prosthesis loss (odds ratio 5.7 was significantly higher after revision procedures (P=0.004. These data suggest that rotating-hinge knee prostheses provided good clinical and functional results in selected cases of advanced primary gonarthrosis associated with severe bone loss, ligamentous instability or comminuted fractures. They also provide good results in revision situations. However, the failure rate was significantly higher in cases of revision surgery.

  1. Towards high-resolution retinal prostheses with direct optical addressing and inductive telemetry

    Science.gov (United States)

    Ha, Sohmyung; Khraiche, Massoud L.; Akinin, Abraham; Jing, Yi; Damle, Samir; Kuang, Yanjin; Bauchner, Sue; Lo, Yu-Hwa; Freeman, William R.; Silva, Gabriel A.; Cauwenberghs, Gert

    2016-10-01

    Objective. Despite considerable advances in retinal prostheses over the last two decades, the resolution of restored vision has remained severely limited, well below the 20/200 acuity threshold of blindness. Towards drastic improvements in spatial resolution, we present a scalable architecture for retinal prostheses in which each stimulation electrode is directly activated by incident light and powered by a common voltage pulse transferred over a single wireless inductive link. Approach. The hybrid optical addressability and electronic powering scheme provides separate spatial and temporal control over stimulation, and further provides optoelectronic gain for substantially lower light intensity thresholds than other optically addressed retinal prostheses using passive microphotodiode arrays. The architecture permits the use of high-density electrode arrays with ultra-high photosensitive silicon nanowires, obviating the need for excessive wiring and high-throughput data telemetry. Instead, the single inductive link drives the entire array of electrodes through two wires and provides external control over waveform parameters for common voltage stimulation. Main results. A complete system comprising inductive telemetry link, stimulation pulse demodulator, charge-balancing series capacitor, and nanowire-based electrode device is integrated and validated ex vivo on rat retina tissue. Significance. Measurements demonstrate control over retinal neural activity both by light and electrical bias, validating the feasibility of the proposed architecture and its system components as an important first step towards a high-resolution optically addressed retinal prosthesis.

  2. Comparison of various functionally graded femoral prostheses by finite element analysis.

    Science.gov (United States)

    Oshkour, Azim Ataollahi; Talebi, Hossein; Shirazi, Seyed Farid Seyed; Bayat, Mehdi; Yau, Yat Huang; Tarlochan, Faris; Abu Osman, Noor Azuan

    2014-01-01

    This study is focused on finite element analysis of a model comprising femur into which a femoral component of a total hip replacement was implanted. The considered prosthesis is fabricated from a functionally graded material (FGM) comprising a layer of a titanium alloy bonded to a layer of hydroxyapatite. The elastic modulus of the FGM was adjusted in the radial, longitudinal, and longitudinal-radial directions by altering the volume fraction gradient exponent. Four cases were studied, involving two different methods of anchoring the prosthesis to the spongy bone and two cases of applied loading. The results revealed that the FG prostheses provoked more SED to the bone. The FG prostheses carried less stress, while more stress was induced to the bone and cement. Meanwhile, less shear interface stress was stimulated to the prosthesis-bone interface in the noncemented FG prostheses. The cement-bone interface carried more stress compared to the prosthesis-cement interface. Stair climbing induced more harmful effects to the implanted femur components compared to the normal walking by causing more stress. Therefore, stress shielding, developed stresses, and interface stresses in the THR components could be adjusted through the controlling stiffness of the FG prosthesis by managing volume fraction gradient exponent.

  3. Finite element analysis of stress distribution of obturator prostheses for acquired unilateral maxillary defects

    Institute of Scientific and Technical Information of China (English)

    FENG Yun-zhi; FENG Hai-lan; WU Han-jiang

    2005-01-01

    Objective To assess stresses produced by different obturator prostheses. Methods Three-dimensional finite clement models of unilateral maxillary defects rehabilitated with different obturators were constructed. The different stresses were analyzed by three-dimensional finite element method under different load angle. Results The Von Mises stress values obtained for the remaining tissues adjacent to defect cavity were higher when rehabilitated by inferior hollow obturator in comparison with by superior hollow obturator. The maximum of Von Mises were higher when rehabilitated by resilient hollow obturator than by rigid hollow obturator. It was also observed that in the rigid type stress distribution contours formed in the remaining tissues adjacent to defect cavity, while in resilient hollow obturator prostheses the stress distributed mainly in the prosthesis itself. The oblique load shows the most maximum of Von Mises among all types of obturator prostheses. Conclusions A high lateral wall of an obturator may be more better in preserving the remaining structures than a shorter prosthesis lateral wall. A soft liner may be incorporated to reduce the pain of the residual maxillary structures and mucosa. When load on defect, higher stress would be generated to the residual maxillary structures. The adjustment of occlusual relationship is very important.

  4. Comparison of Various Functionally Graded Femoral Prostheses by Finite Element Analysis

    Directory of Open Access Journals (Sweden)

    Azim Ataollahi Oshkour

    2014-01-01

    Full Text Available This study is focused on finite element analysis of a model comprising femur into which a femoral component of a total hip replacement was implanted. The considered prosthesis is fabricated from a functionally graded material (FGM comprising a layer of a titanium alloy bonded to a layer of hydroxyapatite. The elastic modulus of the FGM was adjusted in the radial, longitudinal, and longitudinal-radial directions by altering the volume fraction gradient exponent. Four cases were studied, involving two different methods of anchoring the prosthesis to the spongy bone and two cases of applied loading. The results revealed that the FG prostheses provoked more SED to the bone. The FG prostheses carried less stress, while more stress was induced to the bone and cement. Meanwhile, less shear interface stress was stimulated to the prosthesis-bone interface in the noncemented FG prostheses. The cement-bone interface carried more stress compared to the prosthesis-cement interface. Stair climbing induced more harmful effects to the implanted femur components compared to the normal walking by causing more stress. Therefore, stress shielding, developed stresses, and interface stresses in the THR components could be adjusted through the controlling stiffness of the FG prosthesis by managing volume fraction gradient exponent.

  5. EFFICIENCY OF PROSTHETIC TREATMENT WITH POST RESECTION PROSTHESES WITH SOLID SUBSTITUTE PART

    Directory of Open Access Journals (Sweden)

    Ivan Gerdzhikov

    2016-08-01

    Full Text Available Aim: The aim of this study is to track the effectiveness of prosthetic treatment with post resection dentures with solid substitute part and their role in the restoration of damaged functions. Materials and methods: The study included 14 patients (9 men and 5 women with different size and location of defects in the upper jaw treated in the period 2010-2016 with post resection prostheses with a solid substitute part. The impressions were taken with irreversible hydrocolloid impression material. The prostheses were completed by heat-curing acrylic with low quantity residual monomer. The effectiveness of prosthetics was evaluated by the method of Mihaylov for both oral-nasal examination of the pressure with the device "Oronasopneumotest." For objectifying and assess the occlusal-articulation ratios was held computerized occlusal analysis with the system T-SCAN 8. Results: The results showed successful obturation and sealing of defects in all patients. It was found satisfactory recovery of the speaking function and normalization of occlusal-articulation ratios. Conclusion: The prosthetic treatment with post resection prostheses with a solid substitute part allows successful recovery of the lost speech and chewing functions, helping to restore self esteem and social rehabilitation of patients.

  6. Three-phase bone scintigraphy pattern of loosening in uncemented hip prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Rubello, D. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Borsato, N. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Chierichetti, F. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Zanco, P. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy); Ferlin, G. [Dept. of Nuclear Medicine, General Hospital of Castelfranco Veneto (Italy)

    1995-04-01

    The three-phase bone scintigraphy pattern of loosening in uncemented hip prostheses (UHPs) has not previously been elucidated. We evaluated 28 patients with complicated UHPs who had undergone total hip arthroplasty a very long time previously (range 3-20 years, mean 8.4). All the patients were surgically reviewed: 26 UHPs were found to be loosened and two infected. Nine asymptomatic UHPs were taken as controls. The dynamic phase was invariably negative in both loosened and asymptomatic UHPs while markedly positive in the infected ones. The blood pool phase was positive to various degrees in 16 of the 26 loosened UHPs as well as in the infected UHPs, but was invariably negative in painless replacements. In the bone phase, areas of significantly (discrete to marked) increased uptake were observed in all the loosened prostheses as well as in two-thirds of the asymptomatic ones. However, the regions of the lesser trochanter and/or tip and/or shaft were involved exclusively in the case of the loosened UHPs, and diffuse periprosthetic uptake was found only with loosened or infected implants. Areas of slight methylene diphosphonate (MDP) uptake were found at every periprosthetic site and areas of discrete to marked MDP uptake were commonly found in the acetabulum and/or the greater trochanter with both loosened and painless prostheses and are thus considered to be nonspecific findings. (orig.)

  7. Evaluation of Osseous Integration of PVD-Silver-Coated Hip Prostheses in a Canine Model

    Directory of Open Access Journals (Sweden)

    Gregor Hauschild

    2015-01-01

    Full Text Available Infection associated with biomaterials used for orthopedic prostheses remains a serious complication in orthopedics, especially tumor surgery. Silver-coating of orthopedic (megaprostheses proved its efficiency in reducing infections but has been limited to surface areas exposed to soft tissues due to concerns of silver inhibiting osseous integration of cementless stems. To close this gap in the bactericidal capacity of silver-coated orthopedic prostheses extension of the silver-coating on surface areas intended for osseous integration seems to be inevitable. Our study reports about a PVD- (physical-vapor-deposition- silver-coated cementless stem in a canine model for the first time and showed osseous integration of a silver-coated titanium surface in vivo. Radiological, histological, and biomechanical analysis revealed a stable osseous integration of four of nine stems implanted. Silver trace elemental concentrations in serum did not exceed 1.82 parts per billion (ppb and can be considered as nontoxic. Changes in liver and kidney functions associated with the silver-coating could be excluded by blood chemistry analysis. This was in accordance with very limited metal displacement from coated surfaces observed by laser ablation inductively coupled plasma-mass spectrometry (LA-ICP-MS 12 months after implantation. In conclusion our results represent a step towards complete bactericidal silver-coating of orthopedic prostheses.

  8. APPLICATION OF SELECTIVE LASER MELTING IN MANUFACTURING OF FIXED DENTAL PROSTHESES

    Directory of Open Access Journals (Sweden)

    Dzhendo Dzhendov

    2016-12-01

    Full Text Available The additive technologies characterize with the building of one layer at a time from a powder or liquid that is bonded by means of melting, fusing or polymerization. They offer a number of advantages over traditional methods: production of complex personalized objects without the need of complex machinery; manufacturing of parts with dense as well as the porous structure and predetermined surface roughness; controllable, easy and relatively quick process. The methods, mostly used in prosthetic dentistry, include stereolithography, selective laser sintering, and selective laser melting. The aim of the present paper is to review the features of the Selective Laser Melting (SLM process and the possibilities of its application for production of fixed dental prostheses. The features of the SLM process, the microstructure and mechanical characteristics of dental alloys as well as the properties of fixed dental prostheses, fabricated via SLM, were discussed. It was revealed that the SLM Co-Cr dental alloys possess higher mechanical and tribo-corrosion properties, comparatively good fitting ability and higher adhesion strength of the porcelain comparing to the cast alloys. All this is a good precondition for successful application of the SLM process in the production of fixed dental prostheses, mainly of frameworks for metal-ceramic and constructions covered with polymer/composite, intended for areas with high loading.

  9. Control Capabilities of Myoelectric Robotic Prostheses by Hand Amputees: A Scientific Research and Market Overview.

    Science.gov (United States)

    Atzori, Manfredo; Müller, Henning

    2015-01-01

    Hand amputation can dramatically affect the capabilities of a person. Cortical reorganization occurs in the brain, but the motor and somatosensorial cortex can interact with the remnant muscles of the missing hand even many years after the amputation, leading to the possibility to restore the capabilities of hand amputees through myoelectric prostheses. Myoelectric hand prostheses with many degrees of freedom are commercially available and recent advances in rehabilitation robotics suggest that their natural control can be performed in real life. The first commercial products exploiting pattern recognition to recognize the movements have recently been released, however the most common control systems are still usually unnatural and must be learned through long training. Dexterous and naturally controlled robotic prostheses can become reality in the everyday life of amputees but the path still requires many steps. This mini-review aims to improve the situation by giving an overview of the advancements in the commercial and scientific domains in order to outline the current and future chances in this field and to foster the integration between market and scientific research.

  10. Visual prostheses: The enabling technology to give sight to the blind

    Directory of Open Access Journals (Sweden)

    Mohammad Hossein Maghami

    2014-01-01

    Full Text Available Millions of patients are either slowly losing their vision or are already blind due to retinal degenerative diseases such as retinitis pigmentosa (RP and age-related macular degeneration (AMD or because of accidents or injuries. Employment of artificial means to treat extreme vision impairment has come closer to reality during the past few decades. Currently, many research groups work towards effective solutions to restore a rudimentary sense of vision to the blind. Aside from the efforts being put on replacing damaged parts of the retina by engineered living tissues or microfabricated photoreceptor arrays, implantable electronic microsystems, referred to as visual prostheses, are also sought as promising solutions to restore vision. From a functional point of view, visual prostheses receive image information from the outside world and deliver them to the natural visual system, enabling the subject to receive a meaningful perception of the image. This paper provides an overview of technical design aspects and clinical test results of visual prostheses, highlights past and recent progress in realizing chronic high-resolution visual implants as well as some technical challenges confronted when trying to enhance the functional quality of such devices.

  11. Biomedical Titanium alloy prostheses manufacturing by means of Superplastic and Incremental Forming processes

    Directory of Open Access Journals (Sweden)

    PiccininniAntonio

    2016-01-01

    Full Text Available The present work collects some results of the three-years Research Program “BioForming“, funded by the Italian Ministry of Education (MIUR and aimed to investigate the possibility of using flexible sheet forming processes, i.e. Super Plastic Forming (SPF and Single Point Incremental Forming (SPIF, for the manufacturing of patient-oriented titanium prostheses. The prosthetic implants used as case studies were from the skull; in particular, two different Ti alloys and geometries were considered: one to be produced in Ti-Gr23 by SPF and one to be produced in Ti-Gr2 by SPIF. Numerical simulations implementing material behaviours evaluated by characterization tests were conducted in order to design both the manufacturing processes. Subsequently, experimental tests were carried out implementing numerical results in terms of: (i gas pressure profile able to determine a constant (and optimal strain rate during the SPF process; (ii tool path able to avoid rupture during the SPIF process. Post forming characteristics of the prostheses in terms of thickness distributions were measured and compared to data from simulations for validation purposes. A good correlation between numerical and experimental thickness distributions has been obtained; in addition, the possibility of successfully adopting both the SPF and the SPIF processes for the manufacturing of prostheses has been demonstrated.

  12. Control Capabilities of Myoelectric Robotic Prostheses by Hand Amputees: A Scientific Research and Market Overview

    Directory of Open Access Journals (Sweden)

    Manfredo eAtzori

    2015-11-01

    Full Text Available Hand amputation can dramatically affect the capabilities of a person. Cortical reorganization occurs in the brain, but the motor and somatosensorial cortex can interact with the remnant muscles of the missing hand even many years after the amputation, leading to the possibility to restore the capabilities of hand amputees through myoelectric prostheses. Myoelectric hand prostheses with many degrees of freedom are commercially available and recent advances in rehabilitation robotics suggest that their natural control can be performed in real life. The first commercial products exploiting pattern recognition to recognize the movements have recently been released, however the most common control systems are still usually unnatural and must be learned through long training. Dexterous and naturally controlled robotic prostheses can become reality in the everyday life of amputees but the path still requires many steps. This mini-review aims to improve the situation by giving an overview of the advancements in the commercial and scientific domains in order to outline the current and future chances in this field and to foster the integration between market and scientific research.

  13. Restoring natural sensory feedback in real-time bidirectional hand prostheses.

    Science.gov (United States)

    Raspopovic, Stanisa; Capogrosso, Marco; Petrini, Francesco Maria; Bonizzato, Marco; Rigosa, Jacopo; Di Pino, Giovanni; Carpaneto, Jacopo; Controzzi, Marco; Boretius, Tim; Fernandez, Eduardo; Granata, Giuseppe; Oddo, Calogero Maria; Citi, Luca; Ciancio, Anna Lisa; Cipriani, Christian; Carrozza, Maria Chiara; Jensen, Winnie; Guglielmelli, Eugenio; Stieglitz, Thomas; Rossini, Paolo Maria; Micera, Silvestro

    2014-02-05

    Hand loss is a highly disabling event that markedly affects the quality of life. To achieve a close to natural replacement for the lost hand, the user should be provided with the rich sensations that we naturally perceive when grasping or manipulating an object. Ideal bidirectional hand prostheses should involve both a reliable decoding of the user's intentions and the delivery of nearly "natural" sensory feedback through remnant afferent pathways, simultaneously and in real time. However, current hand prostheses fail to achieve these requirements, particularly because they lack any sensory feedback. We show that by stimulating the median and ulnar nerve fascicles using transversal multichannel intrafascicular electrodes, according to the information provided by the artificial sensors from a hand prosthesis, physiologically appropriate (near-natural) sensory information can be provided to an amputee during the real-time decoding of different grasping tasks to control a dexterous hand prosthesis. This feedback enabled the participant to effectively modulate the grasping force of the prosthesis with no visual or auditory feedback. Three different force levels were distinguished and consistently used by the subject. The results also demonstrate that a high complexity of perception can be obtained, allowing the subject to identify the stiffness and shape of three different objects by exploiting different characteristics of the elicited sensations. This approach could improve the efficacy and "life-like" quality of hand prostheses, resulting in a keystone strategy for the near-natural replacement of missing hands.

  14. Robust identification of three-dimensional thumb and index finger kinematics with a minimal set of markers.

    Science.gov (United States)

    Nataraj, Raviraj; Li, Zong-Ming

    2013-09-01

    This study presents a methodology to determine thumb and index finger kinematics while utilizing a minimal set of markers. The motion capture of skin-surface markers presents inherent challenges for the accurate and comprehensive measurement of digit kinematics. As such, it is desirable to utilize robust methods for assessing digit kinematics with fewer markers. The approach presented in this study involved coordinate system alignment, locating joint centers of rotation, and a solution model to estimate three-dimensional (3-D) digit kinematics. The solution model for each digit was based on assumptions of rigid-body interactions, specific degrees of freedom (DOFs) at each located joint, and the aligned coordinate system definitions. Techniques of inverse kinematics and optimization were applied to calculate the 3-D position and orientation of digit segments during pinching between the thumb and index finger. The 3-D joint center locations were reliably fitted with mean coefficients of variation below 5%. A parameterized form of the solution model yielded feasible solutions that met specified tolerance and convergence criteria for over 85% of the test points. The solution results were intuitive to the pinching function. The thumb was measured to be rotated about the CMC joint to bring it into opposition to the index finger and larger rotational excursions (>10 deg) were observed in flexion/extension compared to abduction/adduction and axial rotation for all joints. While the solution model produced results similar to those computed from a full marker set, the model facilitated the usage of fewer markers, which inherently lessened the effects of passive motion error and reduced the post-experimental effort required for marker processing.

  15. A patient with isochromosome 18q, radial-thumb aplasia, thrombocytopenia, and an unbalanced 10;18 chromosome translocation.

    Science.gov (United States)

    Sahoo, Trilochan; Naeem, Rizwan; Pham, Kim; Chheng, Sou; Noblin, Sarah T; Bacino, Carlos A; Gambello, Michael J

    2005-02-15

    We report on the clinical and cytogenetic findings in a newborn with a de novo isochromosome 18q. Radial/thumb aplasia and thrombocytopenia were significant features in addition to multiple congenital anomalies. Comparison with reported cases suggests that the genes for such features are located on the 18q arm. An additional finding of a non-reciprocal translocation between chromosome 18p telomere and chromosome 10q telomere was also observed in a majority of cells examined. This additional rearrangement likely has minimal phenotypic consequences, but does raise the possibility that cryptic translocations of telomeric ends of the deleted arm in isochromosome cases may be more common than appreciated.

  16. Volar dislocation of the index carpometacarpal joint in association with a Bennett's fracture of the thumb: a rare injury pattern.

    LENUS (Irish Health Repository)

    Dillon, J P

    2012-02-03

    We describe a case of volar dislocation of the index carpometacarpal (CMC) joint in association with a Bennett\\'s fracture of the thumb following a motorcycle accident. Volar dislocation of the index carpometacarpal joint is an exceedingly rare but easily missed injury, with only a few reported cases in the literature. This report highlights the importance of a true lateral radiograph and close scrutiny of the film to detect this injury. Closed reduction supplemented with Kirschner wire fixation restored normal anatomical relations and achieved an excellent clinical result.

  17. Identification of triple-negative and basal-like canine mammary carcinomas using four basal markers.

    Science.gov (United States)

    Kim, N H; Lim, H Y; Im, K S; Kim, J H; Sur, J-H

    2013-05-01

    Molecular-based classification of canine mammary carcinomas (CMCs) has been a recent research focus. In human breast cancer, triple-negative and basal-like phenotypes are distinct molecular subgroups that are known for their poor prognosis, but these tumours are not yet well defined in the dog. The aim of this study was to determine whether CMCs include triple-negative and basal-like phenotypes by immunohistochemical assessment of expression of the oestrogen receptor (OR), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and four basal markers, cytokeratin (CK) 14, CK5/6, p63 and the epidermal growth factor receptor (EGFR). In this study of 241 CMCs, 45 triple-negative tumours (OR(-), PR(-) and HER2(-)) were identified and this phenotype was associated with an unfavourable prognosis. In these tumours, the expression of CK14, CK5/6 and EGFR was related to clinicopathological parameters, while the expression of p63 was not relevant. The majority of the triple-negative tumours were of the basal-like phenotype, given that 75.6% of them expressed more than two basal markers. However, three of the basal markers were not uniformly expressed; therefore, the proportion of the basal-like phenotype was altered on the basis of the selection of the markers. Although both triple-negative and basal-like phenotypes are distinct entities in CMC, further study is needed to differentiate one from the other.

  18. Radiologic study of basal cell nevus syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Park, Tae Won [Dept. of Oral Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

    1988-11-15

    Several cases of jaw cyst-basal cell nevus-bifid rib syndrome are presented. This syndrome consists principally of multiple jaw cysts, basal cell nevi, and bifid ribs but no one component is present in all patients. The purpose of this paper is to review the multiple characteristics of this syndrome and present three cases in a family and additional 4 cases. The many malformations associated with the syndrome have variable expressively. In the cases, multiple jaw cysts, pal mar and plantar pittings, bridging of sella, temporoparietal bossing, hypertelorism, cleft palate, and dystopia canthoru m have been observed.

  19. Examination of the torque required to passively palmar abduct the thumb CMC joint in a pediatric population with hemiplegia and stroke.

    Science.gov (United States)

    Stirling, Leia; Ahmad, Mona Qureshi; Kelty-Stephen, Damian; Correia, Annette

    2015-12-16

    Many activities of daily living involve precision grasping and bimanual manipulation, such as putting toothpaste on a toothbrush or feeding oneself. However, children afflicted by stroke, cerebral palsy, or traumatic brain injury may have lost or never had the ability to actively and accurately control the thumb. To translate insights from adult rehabilitation robotics to innovative therapies for hand rehabilitation in pediatric care, specifically for thumb deformities, an understanding of the torque needed to abduct the thumb to assist grasping tasks is required. Participants (n=16, 10 female, 13.2±3.1 years) had an upper extremity evaluation and measures were made of their passive range of motion, anthropometrics, and torques to abduct the thumb for both their affected and non-affected sides. Torque measures were made using a custom wrist orthosis that was adjusted for each participant. The torque to achieve maximum abduction was 1.47±0.61inlb for the non-affected side and 1.51±0.68inlb for the affected side, with a maximum recorded value of 4.87inlb. The overall maximum applied torque was observed during adduction and was 5.10inlb. We saw variation in the applied torque, which could have been due to the applied torques by the Occupational Therapist or the participant actively assisting or resisting the motion rather than remaining passive. We expect similar muscle and participant variation to exist with an assistive device. Thus, the data presented here can be used to inform the specifications for the development of an assistive thumb orthosis for children with "thumb-in-palm" deformity.

  20. Basal Cell Carcinoma in The Netherlands

    NARCIS (Netherlands)

    S.C. Flohil (Sophie)

    2012-01-01

    textabstractThere are many different cutaneous malignancies, but malignant melanoma, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) represent approximately 98% of all skin cancers.In literature, these three skin cancers are often divided into melanoma and nonmelanoma skin cancers (NMSC

  1. Immunosuppressive Environment in Basal Cell Carcinoma

    DEFF Research Database (Denmark)

    Omland, Silje H; Nielsen, Patricia S; Gjerdrum, Lise M R;

    2016-01-01

    Interaction between tumour survival tactics and anti-tumour immune response is a major determinant for cancer growth. Regulatory T cells (T-regs) contribute to tumour immune escape, but their role in basal cell carcinoma (BCC) is not understood. The fraction of T-regs among T cells was analysed...

  2. Parallel basal ganglia circuits for decision making.

    Science.gov (United States)

    Hikosaka, Okihide; Ghazizadeh, Ali; Griggs, Whitney; Amita, Hidetoshi

    2017-02-02

    The basal ganglia control body movements, mainly, based on their values. Critical for this mechanism is dopamine neurons, which sends unpredicted value signals, mainly, to the striatum. This mechanism enables animals to change their behaviors flexibly, eventually choosing a valuable behavior. However, this may not be the best behavior, because the flexible choice is focused on recent, and, therefore, limited, experiences (i.e., short-term memories). Our old and recent studies suggest that the basal ganglia contain separate circuits that process value signals in a completely different manner. They are insensitive to recent changes in value, yet gradually accumulate the value of each behavior (i.e., movement or object choice). These stable circuits eventually encode values of many behaviors and then retain the value signals for a long time (i.e., long-term memories). They are innervated by a separate group of dopamine neurons that retain value signals, even when no reward is predicted. Importantly, the stable circuits can control motor behaviors (e.g., hand or eye) quickly and precisely, which allows animals to automatically acquire valuable outcomes based on historical life experiences. These behaviors would be called 'skills', which are crucial for survival. The stable circuits are localized in the posterior part of the basal ganglia, separately from the flexible circuits located in the anterior part. To summarize, the flexible and stable circuits in the basal ganglia, working together but independently, enable animals (and humans) to reach valuable goals in various contexts.

  3. Giant basal cell carcinoma Carcinoma basocelular gigante

    Directory of Open Access Journals (Sweden)

    Nilton Nasser

    2012-06-01

    Full Text Available The basal cell carcinoma is the most common skin cancer but the giant vegetating basal cell carcinoma reaches less than 0.5 % of all basal cell carcinoma types. The Giant BCC, defined as a lesion with more than 5 cm at its largest diameter, is a rare form of BCC and commonly occurs on the trunk. This patient, male, 42 years old presents a Giant Basal Cell Carcinoma which reaches 180 cm2 on the right shoulder and was negligent in looking for treatment. Surgical treatment was performed and no signs of dissemination or local recurrence have been detected after follow up of five years.O carcinoma basocelular é o tipo mais comum de câncer de pele, mas o carcinoma basocelular gigante vegetante não atinge 0,5% de todos os tipos de carcinomas basocelulares. O Carcinoma Basocelular Gigante, definido como lesão maior que 5 cm no maior diâmetro, é uma forma rara de carcinoma basocelular e comumente ocorre no tronco. Este paciente apresenta um Carcinoma Basocelular Gigante com 180cm² no ombro direito e foi negligente em procurar tratamento. Foi realizado tratamento cirúrgico e nenhum sinal de disseminação ou recorrência local foi detectada após 5 anos.

  4. Use of inflatable penile prostheses AMS CX with momentary squeeze in a patient with Peyronie’s disease after removal of two previously implanted penile prostheses

    Directory of Open Access Journals (Sweden)

    Patrizio Vicini

    2014-03-01

    Full Text Available Objective: Peyronie's disease (PD is a fibrotic wound-healing condition of the tunica albuginea that results in penile deformity, curvature, hinging, narrowing and shortening, penile pain, and in some cases, erectile dysfunction (ED. Surgery remains the gold standard treatment option, ensuring the faster and trustworthy treatment. For those patients who have erectile dysfunction and PD, penile prosthesis placement with straightening procedure is the best method to solve both diseases. The aim of this article is to present the use of hydraulic penile prostheses AMS CX with Momentary Squeeze associated with a complete isolation of the neurovascular bundle in a complex case after removal of two previously implanted prostheses in a man suffering from Peyronie’s disease and erectile dysfunction. Material and method: A 50 year-old patient underwent two previous prosthetic implants in another hospital. The first implantation was performed using an infrapubic approach followed by placement of a three-component hydraulic penile prosthesis. After six months the prosthesis was removed using an infra-pubic approach and two soft prosthesis Virilis II were implanted during the same surgery. One year after the second operation we implanted a hydraulic penile prosthesis AMS CX with Mo - mentary Squeeze after complete isolation of the neurovascular bundle, fixing the two crural tips at the same level of albuginea of the two corpora cavernosa. Result: Twelve months after surgery the penis was completely straight without penile shortening and the patient was fully satisfied with his sexual life. Conclusion: The procedure enabled a perfect alignment of the cylinders along the longitudinal axis and penile prosthetic symmetry to obtain a good penile rigidity and a perfect penile straightening.

  5. Incidence of revision after primary implantation of the Salto ® mobile version and Salto Talaris ™ total ankle prostheses: a systematic review.

    Science.gov (United States)

    Roukis, Thomas S; Elliott, Andrew D

    2015-01-01

    The incidence of revision of total ankle replacement prostheses remains unclear. We undertook a systematic review to identify the material relating to the incidence of revision after implantation of the Salto(®) mobile version and Salto Talaris™ total ankle prostheses. Studies were eligible for inclusion only if they had involved primary total ankle replacement with these prostheses and had included the incidence of revision. Eight studies involving 1,209 Salto(®) mobile version prostheses, with a weighted mean follow-up period of 55.2 months, and 5 studies involving 212 Salto Talaris™ total ankle prostheses, with a weighted mean follow-up period of 34.9 months, were included. Forty-eight patients with Salto(®) mobile version prostheses (4%) underwent revision, of whom 24 (70.5%) underwent ankle arthrodesis, 9 (26.5%) metallic component replacement, and 1 (3%) below-the-knee amputation. Five (2.4%) Salto Talaris™ total ankle prostheses underwent revision (3 metallic component replacement and 2 ankle arthrodeses). Restricting the data to the inventor, design team, or disclosed consultants, the incidence of revision was 5.2% for the Salto(®) mobile version and 2.6% for the Salto Talaris™ total ankle prostheses. In contrast, data that excluded these individuals had an incidence of revision of 2.8% for the Salto(®) mobile version and 2.0% for the Salto Talaris™ total ankle prostheses. We could not identify any obvious difference in the etiology responsible for the incidence of revision between these mobile- and fixed-bearing prostheses. The incidence of revision for the Salto(®) mobile version and Salto Talaris™ total ankle prostheses was lower than those reported through systematic review for the Agility™ and Scandinavian Total Ankle Replacement™ systems without obvious selection (inventor) or publication (conflict of interest) bias.

  6. Impact of fixed implant supported prostheses in edentulous patients: protocol for a systematic review

    Science.gov (United States)

    López, Carolina S; Saka, Constanza H; Rada, Gabriel; Valenzuela, Daniela D

    2016-01-01

    Introduction Edentulism is a debilitating and irreversible condition described as the ‘final marker of disease burden for oral health’. Therapy with dental implants is being used on a large scale to replace missing teeth and to rehabilitate edentulous patients with overdentures and implant supported fixed dentures as a method of solving the problem of instability and lack of retention associated with conventional removable prostheses. Fixed implant supported prostheses are an alternative for implant rehabilitation treatment that allow patients to have new fixed teeth. They can be indicated in partial or total edentulous patients, and they can replace single teeth, or teeth and supporting tissues (hybrid prosthesis). They overcome the limitations of conventional dentures, increasing stability and retention, providing functional and psychological advantages for the patients. Methods and analysis We will electronically search for randomised controlled trials evaluating the effects of fixed implant supported prostheses in edentulous patients in the following databases: Pubmed/MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials. We will also try to obtain literature screening references of included studies, searching for trial protocols in the WHO International Clinical Trials Registry Platform, reviewing International Team for Implantology conference proceedings and searching for non-published studies through Open Gray. Two researchers will independently undertake selection of studies, data extraction and assessment of the quality of the included studies. Data synthesis and subgroup analyses will be performed using special Review Manager software. Data will be combined in a meta-analysis using a random effects model. Results The results will be presented as risk ratios for dichotomous data, and as mean difference or standardised mean difference for continuous data. Ethics and dissemination No ethics approval is considered necessary. The results

  7. Whole-body angular momentum during stair walking using passive and powered lower-limb prostheses.

    Science.gov (United States)

    Pickle, Nathaniel T; Wilken, Jason M; Aldridge, Jennifer M; Neptune, Richard R; Silverman, Anne K

    2014-10-17

    Individuals with a unilateral transtibial amputation have a greater risk of falling compared to able-bodied individuals, and falling on stairs can lead to serious injuries. Individuals with transtibial amputations have lost ankle plantarflexor muscle function, which is critical for regulating whole-body angular momentum to maintain dynamic balance. Recently, powered prostheses have been designed to provide active ankle power generation with the goal of restoring biological ankle function. However, the effects of using a powered prosthesis on the regulation of whole-body angular momentum are unknown. The purpose of this study was to use angular momentum to evaluate dynamic balance in individuals with a transtibial amputation using powered and passive prostheses relative to able-bodied individuals during stair ascent and descent. Ground reaction forces, external moment arms, and joint powers were also investigated to interpret the angular momentum results. A key result was that individuals with an amputation had a larger range of sagittal-plane angular momentum during prosthetic limb stance compared to able-bodied individuals during stair ascent. There were no significant differences in the frontal, transverse, or sagittal-plane ranges of angular momentum or maximum magnitude of the angular momentum vector between the passive and powered prostheses during stair ascent or descent. These results indicate that individuals with an amputation have altered angular momentum trajectories during stair walking compared to able-bodied individuals, which may contribute to an increased fall risk. The results also suggest that a powered prosthesis provides no distinct advantage over a passive prosthesis in maintaining dynamic balance during stair walking.

  8. A biodegradable gentamicin-hydroxyapatite-coating for infection prophylaxis in cementless hip prostheses

    Directory of Open Access Journals (Sweden)

    D Neut

    2015-01-01

    Full Text Available A degradable, poly (lactic-co-glycolic acid (PLGA, gentamicin-loaded prophylactic coating for hydroxyapatite (HA-coated cementless hip prostheses is developed with similar antibacterial efficacy as offered by gentamicin-loaded cements for fixing traditional, cemented prostheses in bone. We describe the development pathway, from in vitro investigation of antibiotic release and antibacterial properties of this PLGA-gentamicin-HA-coating in different in vitro models to an evaluation of its efficacy in preventing implant-related infection in rabbits. Bone in-growth in the absence and presence of the coating was investigated in a canine model. The PLGA-gentamicin-HA-coating showed high-burst release, with antibacterial efficacy in agar-assays completely disappearing after 4 days, minimising risk of inducing antibiotic resistance. Gentamicin-sensitive and gentamicin-resistant staphylococci were killed by the antibiotic-loaded coating, in a simulated prosthesis-related interfacial gap. PLGA-gentamicin-HA-coatings prevented growth of bioluminescent staphylococci around a miniature-stem mounted in bacterially contaminated agar, as observed using bio-optical imaging. PLGA-gentamicin-HA-coated pins inserted in bacterially contaminated medullary canals in rabbits caused a statistically significant reduction in infection rates compared to HA-coated pins without gentamicin. Bone ingrowth to PLGA-gentamicin-HA-coated pins, in condylar defects of Beagle dogs was not impaired by the presence of the degradable, gentamicin-loaded coating. In conclusion, the PLGA-gentamicin-HA-coating constitutes an effective strategy for infection prophylaxis in cementless prostheses.

  9. Long term results of mechanical prostheses for treatment of active infective endocarditis

    Science.gov (United States)

    Guerra, J; Tornos, M; Permanyer-Miralda, G; Almirante, B; Murtra, M; Soler-Soler, J

    2001-01-01

    OBJECTIVE—To analyse the long term results of mechanical prostheses for treating active infective endocarditis.
DESIGN—Prospective cohort study of a consecutive series of patients diagnosed with infective endocarditis and operated on in the active phase of the infection for insertion of a mechanical prosthesis.
SETTING—Tertiary referral centre in a metropolitan area.
RESULTS—Between 1975 and 1997, 637 cases of infective endocarditis were diagnosed in the centre. Of these, 436 were left sided (with overall mortality of 20.3%). Surgical treatment in the active phase of the infection was needed in 141 patients (72% native, 28% prosthetic infective endocarditis). Mechanical prostheses were used in 131 patients. Operative mortality was 30.5% (40 patients). Ninety one survivors were followed up prospectively for (mean (SD)) 5.4 (4.5) years. Thirteen patients developed prosthetic valve dysfunction. Nine patients suffered reinfection: four of these (4%) were early and five were late. The median time from surgery for late reinfection was 1.4 years. During follow up, 12 patients died. Excluding operative mortality, actuarial survival was 86.6% at five years and 83.7% at 10 years; actuarial survival free from death, reoperation, and reinfection was 73.1% at five years and 59.8% at 10 years.
CONCLUSIONS—In patients surviving acute infective endocarditis and receiving mechanical prostheses, the rate of early reinfection compares well with reported results of homografts. In addition, prosthesis dysfunction rate is low and long term survival is good. These data should prove useful for comparison with long term studies, when available, using other types of valve surgery in active infective endocarditis.


Keywords: infective endocarditis; surgery; mechanical prosthesis PMID:11410564

  10. Long-term role of external breast prostheses after total mastectomy.

    Science.gov (United States)

    Glaus, Simone W; Carlson, Grant W

    2009-01-01

    After total mastectomy, many women choose to wear external breast prosthesis rather than undergo breast reconstruction. The purpose of this study was to evaluate long-term satisfaction among external breast prosthesis wearers and the impact of satisfaction on prosthesis use. A questionnaire was designed to assess demographic information, prosthesis information provision, prosthesis use, and satisfaction with prosthesis. Fifty-nine women who had undergone total mastectomy without breast reconstruction completed the questionnaire. The majority of women (68%) were at least 5 years out from mastectomy. Approximately half (49%) of the women had received information about breast prostheses prior to mastectomy; 29% received information from the surgeon performing the operation. Frequent and prolonged prosthesis use was prevalent with 64% of participants reporting prosthesis use all the time, 6-7 days/week. Participants showed high rates (83%) of overall satisfaction. However, women who wore their prosthesis out in public only were less satisfied than more frequent wearers (50% versus 89%, chi(2) = 8.83, d.f. = 1, alpha = 0.05). Satisfaction increased over time, as women who were greater than 5 years out from mastectomy were more satisfied than women less that 5 years post-mastectomy (90% versus 67%, chi(2) = 4.43, d.f. = 1, alpha = 0.05). The vast majority of women are satisfied with their external breast prosthesis several years after mastectomy. Most women used their prosthesis all the time and overall satisfaction contributed to higher levels of prosthesis use. Given the long-term importance of external breast prostheses for women who have undergone mastectomy, a greater effort to inform patients about external breast prostheses prior to surgery is needed.

  11. High-density EMG e-textile systems for the control of active prostheses

    DEFF Research Database (Denmark)

    Farina, Dario; Lorrain, Thomas; Negro, Francesco

    2010-01-01

    Myoelectric control of active prostheses requires electrode systems that are easy to apply for daily repositioning of the electrodes by the user. In this study we propose the use of Smart Fabric and Interactive Textile (SFIT) systems as an alternative solution for recording high-density EMG signals...... classified with linear discriminant analysis. The average classification accuracy for the nine tasks was 89.1 1.9 %. These results show that SFIT systems can be used as an effective way for muscle-machine interfacing....

  12. Intraocular and extraocular cameras for retinal prostheses: Effects of foveation by means of visual prosthesis simulation

    Science.gov (United States)

    McIntosh, Benjamin Patrick

    Blindness due to Age-Related Macular Degeneration and Retinitis Pigmentosa is unfortunately both widespread and largely incurable. Advances in visual prostheses that can restore functional vision in those afflicted by these diseases have evolved rapidly from new areas of research in ophthalmology and biomedical engineering. This thesis is focused on further advancing the state-of-the-art of both visual prostheses and implantable biomedical devices. A novel real-time system with a high performance head-mounted display is described that enables enhanced realistic simulation of intraocular retinal prostheses. A set of visual psychophysics experiments is presented using the visual prosthesis simulator that quantify, in several ways, the benefit of foveation afforded by an eye-pointed camera (such as an eye-tracked extraocular camera or an implantable intraocular camera) as compared with a head-pointed camera. A visual search experiment demonstrates a significant improvement in the time to locate a target on a screen when using an eye-pointed camera. A reach and grasp experiment demonstrates a 20% to 70% improvement in time to grasp an object when using an eye-pointed camera, with the improvement maximized when the percept is blurred. A navigation and mobility experiment shows a 10% faster walking speed and a 50% better ability to avoid obstacles when using an eye-pointed camera. Improvements to implantable biomedical devices are also described, including the design and testing of VLSI-integrable positive mobile ion contamination sensors and humidity sensors that can validate the hermeticity of biomedical device packages encapsulated by hermetic coatings, and can provide early warning of leaks or contamination that may jeopardize the implant. The positive mobile ion contamination sensors are shown to be sensitive to externally applied contamination. A model is proposed to describe sensitivity as a function of device geometry, and verified experimentally. Guidelines are

  13. Ossiculoplasty with J.B. Causse composite prostheses: our experience with 500 cases.

    Science.gov (United States)

    Vincent, R; Gratacap, B; Vandeventer, G

    1995-01-01

    In ossicular pathology, many options are available when the restoration of the columellar effect is required. Autoplasty, heteroplasty and homoplasty have advantages and disadvantages, but considerable recent progress in development of the prosthesis has changed the state of the situation. 500 partial and total prostheses (Porp and Torp) of composite material (Flex HA and Teflon HA) designed by Jean-Bernard Causse and developed by Microtek, were used from January 1992 until December 1993. The authors present results at short and middle term involving all aspects of otologic surgery, as well as surgical techniques that were used.

  14. Total aortic arch replacement: superior ventriculo-arterial coupling with decellularized allografts compared with conventional prostheses.

    Directory of Open Access Journals (Sweden)

    Alexander Weymann

    Full Text Available To date, no experimental or clinical study provides detailed analysis of vascular impedance changes after total aortic arch replacement. This study investigated ventriculoarterial coupling and vascular impedance after replacement of the aortic arch with conventional prostheses vs. decellularized allografts.After preparing decellularized aortic arch allografts, their mechanical, histological and biochemical properties were evaluated and compared to native aortic arches and conventional prostheses in vitro. In open-chest dogs, total aortic arch replacement was performed with conventional prostheses and compared to decellularized allografts (n = 5/group. Aortic flow and pressure were recorded continuously, left ventricular pressure-volume relations were measured by using a pressure-conductance catheter. From the hemodynamic variables end-systolic elastance (Ees, arterial elastance (Ea and ventriculoarterial coupling were calculated. Characteristic impedance (Z was assessed by Fourier analysis.While Ees did not differ between the groups and over time (4.1±1.19 vs. 4.58±1.39 mmHg/mL and 3.21±0.97 vs. 3.96±1.16 mmHg/mL, Ea showed a higher increase in the prosthesis group (4.01±0.67 vs. 6.18±0.20 mmHg/mL, P<0.05 in comparison to decellularized allografts (5.03±0.35 vs. 5.99±1.09 mmHg/mL. This led to impaired ventriculoarterial coupling in the prosthesis group, while it remained unchanged in the allograft group (62.5±50.9 vs. 3.9±23.4%. Z showed a strong increasing tendency in the prosthesis group and it was markedly higher after replacement when compared to decellularized allografts (44.6±8.3 dyn·sec·cm(-5 vs. 32.4±2.0 dyn·sec·cm(-5, P<0.05.Total aortic arch replacement leads to contractility-afterload mismatch by means of increased impedance and invert ventriculoarterial coupling ratio after implantation of conventional prostheses. Implantation of decellularized allografts preserves vascular impedance thereby improving

  15. Biological adaptation to misfits of immediately loaded fixed prostheses following computer-guided surgery.

    Science.gov (United States)

    Puterman, Israel; Kan, Joseph Y K; Rungcharassaeng, Kitichai; Oyama, Kotaro; Morimoto, Taichiro; Lozada, Jaime

    2012-04-01

    In this clinical report, following computer-guided (3D Procera Software Planning Program, Nobel Biocare, Yorba Linda, CA) placement and immediate provisionalization of 12 dental implants (NobelSpeedy™ Replace, Nobel Biocare), misfits of the prefabricated screw-retained interim prostheses were noted at several implant-abutment junctions. Nevertheless, adaptation of the misfits was observed 10 days later, after the loosened screws were tightened. While a high mean marginal bone loss of 2.1 mm (range: 1.4 to 3.5 mm) was noted, all implants remained osseointegrated at 3-year follow-up.

  16. The Influence Of Component Alignment On The Life Of Total Knee Prostheses

    Science.gov (United States)

    Bugariu, Delia; Bereteu, Liviu

    2012-12-01

    An arthritic knee affects the patient's life by causing pain and limiting movement. If the cartilage and the bone surfaces are severely affected, the natural joint is replaced with an artificial joint. The procedure is called total knee arthroplasty (TKA). Lately, the numbers of implanted total knee prostheses grow steadily. An important factor in TKA is the perfect alignment of the total knee prosthesis (TKP) components. Component misalignment can lead to the prosthesis loss by producing wear particles. The paper proposes a study on mechanical behaviors of a TKP based on numerical analysis, using ANSYS software. The numerical analysis is based on both the normal and the changed angle of the components alignment.

  17. Bilateral germinoma of the basal ganglia.

    Science.gov (United States)

    Rossi, Andrea; Garrè, Maria Luisa; Ravegnani, Marcello; Nozza, Paolo; Abbruzzese, Arturo; Giangaspero, Felice; Tortori-Donati, Paolo

    2008-01-01

    Germinoma arising in the bilateral basal ganglia is exceedingly rare, with only five cases reported to date. Owing to non-specific clinical findings and the frequent presence of ill-defined abnormalities without a definite tumor mass on neuroimaging, the diagnosis can be difficult. We describe a case in which magnetic resonance spectroscopy (MRS) findings suggested a tumor and supported the decision to perform biopsy of the lesion.

  18. Basal ganglia lesions in children and adults

    Energy Technology Data Exchange (ETDEWEB)

    Bekiesinska-Figatowska, Monika, E-mail: m.figatowska@mp.pl [Department of Diagnostic Imaging, Institute of Mother and Child, ul. Kasprzaka 17a, 01-211 Warsaw (Poland); Mierzewska, Hanna, E-mail: h.mierzewska@gmail.com [Department of Neurology of Children and Adolescents, Institute of Mother and Child, ul. Kasprzaka 17a, 01-211 Warsaw (Poland); Jurkiewicz, Elżbieta, E-mail: e-jurkiewicz@o2.pl [Department of Diagnostic Imaging, Children' s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw (Poland)

    2013-05-15

    The term “basal ganglia” refers to caudate and lentiform nuclei, the latter composed of putamen and globus pallidus, substantia nigra and subthalamic nuclei and these deep gray matter structures belong to the extrapyramidal system. Many diseases may present as basal ganglia abnormalities. Magnetic resonance imaging (MRI) and computed tomography (CT) – to a lesser degree – allow for detection of basal ganglia injury. In many cases, MRI alone does not usually allow to establish diagnosis but together with the knowledge of age and circumstances of onset and clinical course of the disease is a powerful tool of differential diagnosis. The lesions may be unilateral: in Rassmussen encephalitis, diabetes with hemichorea/hemiballism and infarction or – more frequently – bilateral in many pathologic conditions. Restricted diffusion is attributable to infarction, acute hypoxic–ischemic injury, hypoglycemia, Leigh disease, encephalitis and CJD. Contrast enhancement may be seen in cases of infarction and encephalitis. T1-hyperintensity of the lesions is uncommon and may be observed unilaterally in case of hemichorea/hemiballism and bilaterally in acute asphyxia in term newborns, in hypoglycemia, NF1, Fahr disease and manganese intoxication. Decreased signal intensity on GRE/T2*-weighted images and/or SWI indicating iron, calcium or hemosiderin depositions is observed in panthotenate kinase-associated neurodegeneration, Parkinson variant of multiple system atrophy, Fahr disease (and other calcifications) as well as with the advancing age. There are a few papers in the literature reviewing basal ganglia lesions. The authors present a more detailed review with rich iconography from the own archive.

  19. Basal hydraulic conditions of Ice Stream B

    Science.gov (United States)

    Engelhardt, Hermann; Kamb, Barclay

    1993-01-01

    Fifteen boreholes have been drilled to the base of Ice Stream B in the vicinity of UpB Camp. The boreholes are spread over an area of about 500 x 1000 m. Several till cores were retrieved from the bottom of the 1000-m-deep holes. Laboratory tests using a simple shear box revealed a yield strength of basal till of 2 kPa. This agrees well with in-situ measurements using a shear vane. Since the average basal shear stress of Ice Stream B with a surface slope of 0.1 degree is about 20 kPa, the ice stream cannot be supported by till that weak. Additional support for this conclusion comes from the basal water pressure that has been measured in all boreholes as soon as the hot water drill reached bottom. In several boreholes, the water pressure has been continuously monitored; in two of them, over several years. The water pressure varies but stays within 1 bar of flotation where ice overburden pressure and water pressure are equal. The ratio of water and overburden pressure lies between 0.986 and 1.002. This is an extremely high value as compared to other fast-moving ice masses; e.g., Variegated Glacier in surge has a ratio of 0.8, and Columbia Glacier - a fast-moving tidewater glacier - has a ratio of 0.9. It implies that water flow under the glacier occurs in a thin film and not in conduits that would drain away water too rapidly. It also implies that basal sliding must be very effective. Water flow under the glacier was measured in a salt-injection experiment where a salt pulse was released at the bottom of a borehole while 60 m down-glacier, the electrical resistance was measured between two other boreholes. A flow velocity of 7 mm/s was obtained.

  20. Effect of treatment with fixed and removable dental prostheses. An oral health-related quality of life study

    DEFF Research Database (Denmark)

    Øzhayat, Esben Boeskov; Gotfredsen, Klaus

    2012-01-01

    The aim of the study was to evaluate patient-reported effects of treatment with fixed dental prostheses (FDP) and removable dental prostheses (RDP) and relate the change in Oral Health Related Quality of Life (OHRQoL) to the type of treatment and objective dental variables of aesthetics...... and mastication. Additionally, the purpose of the study was to identify aspects of impairment and improvement that the treatments caused. Fixed dental prostheses treatment was performed in 200 patients and RDP treatment in 107 patients. Gender, age, region of replacement, and number of teeth present and replaced...... were obtained. The participants completed the Oral Health Impact Profile 49 (OHIP-49) before and after treatment. A control group with no need for dental treatment also completed the OHIP-49. All participants had a significant improvement in OHRQoL. The improvement was higher for the RDP group than...

  1. Efficacy of cleansing agents in killing microorganisms in mixed species biofilms present on silicone facial prostheses-an in vitro study

    NARCIS (Netherlands)

    Ariani, Nina; Visser, Anita; Teulings, Margot R. I. M.; Dijk, Melissa; Rahardjo, Tri Budi W.; Vissink, Arjan; van der Mei, Henny C.

    2015-01-01

    The purpose of this study was to assess the efficacy of different cleansing agents in killing mixed species biofilms on silicone facial prostheses. Two bacterial and three yeast strains, isolated from silicone facial prostheses, were selected for the mixed species biofilms. A variety of agents used

  2. Simultaneous extraarticular fracture of the base of the first metacarpal and dislocation of the metacarpophalangeal joint of the thumb: A case report

    Institute of Scientific and Technical Information of China (English)

    Anani Abalo; Sena Amouzou; Kouami Amakoutou; Assang Dossim

    2015-01-01

    Double fracture-dislocations of the thumb are rare.Only a single case report of a simultaneous extraarticular fracture of the base of the first metacarpal and dislocation of the metacarpophalangeal joint has been previously reported.We report the second case report of this injury in a 20-year-old man.The patient had an excellent outcome after treatment.

  3. Novel missense mutation in the L1 gene in a child with corpus callosum agenesis, retardation, adducted thumbs, spastic paraparesis, and hydrocephalus

    NARCIS (Netherlands)

    Sztriha, L; Frossard, P; Hofstra, RMW; Verlind, E; Nork, M

    2000-01-01

    Corpus callosum agenesis, retardation, adducted thumbs, spastic paraparesis, and hydrocephalus (CRASH syndrome) is an X-linked recessive disorder caused by mutations in the neuronal cell adhesion molecule L1 (L1CAM) gene. L1 plays a key role in axon outgrowth and pathfinding during the development o

  4. Preservation of Hypermobile Teeth by Establishing Posterior Occlusal Support Using Implant Prostheses: A 5-Year Follow-Up.

    Science.gov (United States)

    Doh, Re-Mee; Park, Wonse; Kim, Kee-Deog; Jung, Bock-Young

    2015-08-01

    For patients with periodontally compromised, hypermobile teeth, implant-supported fixed dental prostheses (FDPs) or removable dentures are often used after extracting mobile teeth. The loss of native teeth may carry social consequences, depending upon the patient's age, state of health, and degree of social functioning. This report represents successful stabilization and preservation of questionable, hypermobile teeth that have been damaged by traumatic occlusion due to the loss of posterior support with a cross-arch splinted FDP, as well as the implementation of posterior support using implant-supported prostheses.

  5. Simulator comparison of thumball, thumb switch, and touch screen input concepts for interaction with a large screen cockpit display format

    Science.gov (United States)

    Jones, Denise R.; Parrish, Russell V.

    1990-01-01

    A piloted simulation study was conducted comparing three different input methods for interfacing to a large screen, multiwindow, whole flight deck display for management of transport aircraft systems. The thumball concept utilized a miniature trackball embedded in a conventional side arm controller. The multifunction control throttle and stick (MCTAS) concept employed a thumb switch located in the throttle handle. The touch screen concept provided data entry through a capacitive touch screen installed on the display surface. The objective and subjective results obtained indicate that, with present implementations, the thumball concept was the most appropriate for interfacing with aircraft systems/subsystems presented on a large screen display. Not unexpectedly, the completion time differences between the three concepts varied with the task being performed, although the thumball implementation consistently outperformed the other two concepts. However, pilot suggestions for improved implementations of the MCTAS and touch screen concepts could reduce some of these differences.

  6. Giant cell tumor of the tendon sheath restricting joint movement in the thumb: A case study and review of literature

    Directory of Open Access Journals (Sweden)

    Muzaffer Durmus

    2015-04-01

    Full Text Available Giant cell tumors of the tendon sheath are the second most common type of subcutaneous benign tumors found in the hand. These tumors are slow growing soft tissue mases that develop over a long period of time and can occur at any age. Although such lesions are usually painless, there is a possibility of recurrence of the tumor. Patients should seek postoperative management in order to prevent any possibility of recurrence. In view of the current literature, we present a case involving a patient suffering from a multifocal giant cell tumor of the tendon sheath that restricted movement of the interphalangeal joints of the thumb. [Hand Microsurg 2015; 4(1.000: 16-19

  7. Ultrasound-assisted extraction of syringin from the bark of Ilex rotunda thumb using response surface methodology.

    Science.gov (United States)

    Zhao, Li-Chun; He, Ying; Deng, Xin; Xia, Xiang-Hua; Liang, Jian; Yang, Geng-Liang; Li, Wei; Wang, Hui

    2012-01-01

    In this work, a rapid extraction method based on ultrasound-assisted extraction (UAE) of syringin from the bark of Ilex rotunda Thumb using response surface methodology (RSM) is described. The syringin was analyzed and quantified by high performance liquid chromatography coupled with UV detection (HPLC-UV). The extraction solvent, extraction temperature and extraction time, the three main factors for UAE, were optimized with Box-Behnken design (BBD) to obtain the highest extraction efficiency. The optimal conditions were the use of a sonication frequency of 40 kHz, 65% methanol as the solvent, an extraction time of 30 min and an extraction temperature of 40 °C. Using these optimal conditions, the experimental values agreed closely with the predicted values. The analysis of variance (ANOVA) indicated a high goodness of model fit and the success of the RSM method for optimizing syringin extraction from the bark of I. rotunda.

  8. The wrist hyperflexion and abduction of the thumb (WHAT) test: a more specific and sensitive test to diagnose de Quervain tenosynovitis than the Eichhoff's Test.

    Science.gov (United States)

    Goubau, J F; Goubau, L; Van Tongel, A; Van Hoonacker, P; Kerckhove, D; Berghs, B

    2014-03-01

    De Quervain's disease has different clinical features. Different tests have been described in the past, the most popular test being the Eichhoff's test, often wrongly named as the Finkelstein's test. Over the years, a misinterpretation has occurred between these two tests, the latter being confused with the first. To compare the Eichhoff's test with a new test, the wrist hyperflexion and abduction of the thumb test, we set up a prospective study over a period of three years for a cohort of 100 patients (88 women, 12 men) presenting spontaneous pain over the radial side of the styloid of the radius (de Quervain tendinopathy). The purpose of the study was to compare the accuracy of the Eichhoff's test and wrist hyperflexion and abduction of the thumb test to diagnose correctly de Quervain's disease by comparing clinical findings using those tests with the results on ultrasound. The wrist hyperflexion and abduction of the thumb test revealed greater sensitivity (0.99) and an improved specificity (0.29) together with a slightly better positive predictive value (0.95) and an improved negative predictive value (0.67). Moreover, the study showed us that the wrist hyperflexion and abduction of the thumb test is very valuable in diagnosing dynamic instability after successful decompression of the first extensor compartment. Our results support that the wrist hyperflexion and abduction of the thumb test is a more precise tool for the diagnosis of de Quervain's disease than the Eichhoff's test and thus could be adopted to guide clinical diagnosis in the early stages of de Quervain's tendinopathy.

  9. Genetics Home Reference: familial idiopathic basal ganglia calcification

    Science.gov (United States)

    ... idiopathic basal ganglia calcification ( FIBGC , formerly known as Fahr disease) is a condition characterized by abnormal deposits of ... on chromosome 14q for idiopathic basal ganglia calcification (Fahr disease). Am J Hum Genet. 1999 Sep;65(3): ...

  10. Use of a Two-Axis Joystick for Control of Externally Powered, Shoulder Disarticulation Prostheses

    Science.gov (United States)

    Lipschutz, Robert D.; Lock, Blair; Sensinger, Jonathon; Schultz, Aimee E.; Kuiken, Todd A.

    2015-01-01

    We explored a new method for simple and accurate control of shoulder movement for externally powered shoulder disarticulation prostheses using a two-axis joystick. Ten subjects with intact shoulders and arms were tested to determine the average amount of shoulder motion and force available for control of an electronic input device. This information was then applied to two different input strategies in order to examine their effectiveness: (1) a traditional strategy implemented with a rocker potentiometer and a pair of force-sensing resistors (FSRs), and (2) a strategy implemented with a two-axis joystick. Three able-bodied subjects and two subjects with shoulder disarticulation amputations attempted to control an experimental powered shoulder using both control strategies. Two powered arms were tested, one with powered flexion/extension and humeral rotation, and one with powered flexion/extension and adduction/abduction. Overwhelmingly, the subjects preferred the joystick control, as it was more intuitively linked with their shoulder movement. Additionally, two motions (one in each axis) could be controlled simultaneously. This pilot study provides valuable insight into an effective means of controlling high-level, externally powered prostheses via a two-axis joystick. PMID:21938653

  11. 500 penile prostheses implanted by a surgeon in Italy in the last 30 years

    Directory of Open Access Journals (Sweden)

    Diego Pozza

    2015-09-01

    Full Text Available Objectives: The aim of our study was to report our experience with patients affected by Erectile Dysfunction (ED and undergoing penile prosthetic implantation (PPI in a single center by a single surgeon. Material and Methods: We retrospectively evaluated the clinical outcome of 500 patients (mean age: 51.5 years, range: 20-86 years affected by ED and referred to our private andrological center from January 1984 to December 2013 who underwent penile prosthesis implantation, including the reported level of patient satisfaction. Results: 182 silicone, 180 malleable, 18 monocomponent hydraulic and 120 multicomponents hydraulic prostheses were implanted by the same experienced surgeon. All patients were hospitalized for the procedure. All patients were evaluated immediately, 1 month (496 patients and, for the great majority, every year after implantation. One hundred twenty five patients were lost to follow-up. Twenty two patients underwent revision surgery for complications in the postoperative period. The most serious postoperative complications were mechanical problems (45 patients, 9.0% and infection (15 patients, 3%. Forty two (8.4% prostheses were explanted. Overall, 80% (400/500 of patients were able to have sexual intercourse and were fully satisfied with the results. Conclusions: In our experience prosthetic surgery should be considered a good solution for men affected by ED and not responsive to other therapeutic solutions. Prosthetic surgery can be performed not only in large public hospitals but also in smaller private facilities.

  12. Effect of load on the bone around bone-anchored amputation prostheses.

    Science.gov (United States)

    Stenlund, Patrik; Trobos, Margarita; Lausmaa, Jukka; Brånemark, Rickard; Thomsen, Peter; Palmquist, Anders

    2016-06-24

    Osseointegrated transfemoral amputation prostheses have proven successful as an alternative method to the conventional socket-type prostheses. The method improves prosthetic use and thus increases the demands imposed on the bone-implant system. The hypothesis of the present study was that the loads applied to the bone-anchored implant system of amputees would result in locations of high stress and strain transfer to the bone tissue and thus contribute to complications such as unfavourable bone remodeling and/or elevated inflammatory response and/or compromised sealing function at the tissue-abutment interface. In the study, site-specific loading measurements were made on amputees and used as input data in finite element analyses to predict the stress and strain distribution in the bone tissue. Furthermore, a tissue sample retrieved from a patient undergoing implant revision was characterized in order to evaluate the long-term tissue response around the abutment. Within the limit of the evaluated bone properties in the present experiments, it is concluded that the loads applied to the implant system may compromise the sealing function between the bone and the abutment, contributing to resorption of the bone in direct contact with the abutment at the most distal end. This was supported by observations in the retrieved clinical sample of bone resorption and the formation of a soft tissue lining along the abutment interface. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

  13. [Single- and multi-unit fixed dental prostheses in relation to the occlusal system].

    Science.gov (United States)

    Witter, D J; Gerritsen, A E; van Spijker, A; Creugers, N H J

    2013-02-01

    Occlusion concepts based on functional aspects offer more solid ground in the diagnostic process and in the treatment of (reduced) dentitions than morphologically and mechanically oriented occlusion concepts. Nevertheless, for occlusal reconstruction morphologically oriented guidelines are necessary. These guidelines are based on the border movements and positions of the mandible in the orofacial system, and on the location and modelling of the occlusal contacts in the occlusal system. The modelling of single- and multi-unit fixed dental prostheses must harmonize with the occlusal system. Moreover, an important feature is the relation of the anterior teeth which enables mutually protected occlusion. Characteristics of a healthy orofacial and occlusal system are: absence of pathology, perceived sufficient oral functions, variability inform and function, and adaptive capacity. When designing single- or multiunit fixed dental prostheses, a pragmatic starting point is to maintain the existing occlusion and the existing speech pattern unless arguments can be provided for alterations. The occlusal design should aim at optimizing oral functions, such as mandibular and occlusal stability.

  14. A simple method for screening photoelectric dyes towards their use for retinal prostheses.

    Directory of Open Access Journals (Sweden)

    Matsuo T

    2003-10-01

    Full Text Available Photoelectric dyes absorb light and convert photon energy to electric potentials. To test whether these dyes could be used for retinal prostheses, a simple in vitro screening system was developed. Retinal neurons were cultured from the eyes of chick embryos at the 10-day embryonic stage, at which time no retinal photoreceptor cells have yet developed. Intracellular calcium elevation was observed with Fluo-4 in cultured retinal neurons before and after photoelectric dye was applied at varying concentrations to the culture medium. Five of 7 photoelectric dyes tested in this in vitro system induced intracellular calcium elevation in cultured chick retinal neurons. The intracellular calcium elevation generated by the 5 photoelectric dyes was blocked by extracellular calcium depletion in the case of all 5 dyes, and, except for one dye, by the presence of voltage-gated calcium channel blockers. The photoelectric dyes absorbed light under an inverted microscope and stimulated retinal neurons. This simple in vitro system allows the screening of photoelectric dyes which can be used for retinal prostheses.

  15. Electromyographic evaluation of mastication and swallowing in elderly individuals with mandibular fixed implant-supported prostheses

    Directory of Open Access Journals (Sweden)

    Giédre Berretin-Felix

    2008-04-01

    Full Text Available This study evaluated the effect of implant-supported oral rehabilitation in the mandible on the electromyographic activity during mastication and swallowing in edentulous elderly individuals. Fifteen patients aged more than 60 years were evaluated, being 10 females and 5 males. All patients were edentulous, wore removable complete dentures on both dental arches, and had the mandibular dentures replaced by implant-supported prostheses. All patients were submitted to electromyographic evaluation of the masseter, superior orbicularis oris muscles, and the submental muscles, before surgery and 3, 6 and 18 months postoperatively, using foods of different textures. The results obtained at the different periods were analyzed statistically by Kruskal-Wallis non-parametric test. Statistical analysis showed that only the masseter muscle had a significant loss in electromyographic activity (p<0.001, with a tendency of similar response for the submental muscles. Moreover, there was an increase in the activity of the orbicularis oris muscle during rubber chewing after treatment, yet without statistically significant difference. Mandibular fixed implant-supported prostheses in elderly individuals revealed a decrease in electromyographic amplitude for the masseter muscles during swallowing, which may indicate adaptation to new conditions of stability provided by fixation of the complete denture in the mandibular arch.

  16. Use of two-axis joystick for control of externally powered shoulder disarticulation prostheses.

    Science.gov (United States)

    Lipschutz, Robert D; Lock, Blair; Sensinger, Jonathon; Schultz, Aimee E; Kuiken, Todd A

    2011-01-01

    We explored a new method for simple and accurate control of shoulder movement for externally powered shoulder disarticulation prostheses with a two-axis joystick. We tested 10 subjects with intact shoulders and arms to determine the average amount of shoulder motion and force available to control an electronic input device. We then applied this information to two different input strategies to examine their effectiveness: (1) a traditional rocker potentiometer and a pair of force-sensing resistors and (2) a two-axis joystick. Three nondisabled subjects and two subjects with shoulder disarticulation amputations attempted to control an experimental externally powered shoulder using both control strategies. Two powered arms were tested, one with powered flexion/extension and humeral rotation and one with powered flexion/extension and adduction/abduction. Overwhelmingly, the subjects preferred the joystick control, because it was more intuitively linked with their shoulder movement. Additionally, two motions (one in each axis) could be controlled simultaneously. This pilot study provides valuable insight into an effective means of controlling high-level, externally powered prostheses with a two-axis joystick.

  17. Abstract and proportional myoelectric control for multi-fingered hand prostheses.

    Science.gov (United States)

    Pistohl, Tobias; Cipriani, Christian; Jackson, Andrew; Nazarpour, Kianoush

    2013-12-01

    Powered hand prostheses with many degrees of freedom are moving from research into the market for prosthetics. In order to make use of the prostheses' full functionality, it is essential to study efficient ways of high dimensional myoelectric control. Human subjects can rapidly learn to employ electromyographic (EMG) activity of several hand and arm muscles to control the position of a cursor on a computer screen, even if the muscle-cursor map contradicts directions in which the muscles would act naturally. But can a similar control scheme be translated into real-time operation of a dexterous robotic hand? We found that despite different degrees of freedom in the effector output, the learning process for controlling a robotic hand was surprisingly similar to that for a virtual two-dimensional cursor. Control signals were derived from the EMG in two different ways, with a linear and a Bayesian filter, to test how stable user intentions could be conveyed through them. Our analysis indicates that without visual feedback, control accuracy benefits from filters that reject high EMG amplitudes. In summary, we conclude that findings on myoelectric control principles, studied in abstract, virtual tasks can be transferred to real-life prosthetic applications.

  18. Atherosclerosis in vascular grafts for peripheral vascular disease. Part 2. Synthetic arterial prostheses.

    Science.gov (United States)

    Walton, K W; Slaney, G; Ashton, F

    1986-08-01

    Thirty-nine synthetic (32 Dacron and 7 Teflon) arterial prostheses (from 38 patients with peripheral arterial disease) removed after periods between 2 months and 18 years, were examined by histology and immuno-histology. The grafts were initially permeated by thrombus containing platelet antigens and this became organised and converted to granulation, and then to fibrous, tissue. The newly-formed tissue contained 'foreign-body' giant-cells in contact with the plastic prosthesis and showed evidence of permeation by plasma proteins. In grafts of over 2 years duration, this reactive tissue no longer contained platelet antigens but invariably revealed bound lipid, identifiable as apolipoprotein-B-containing lipoproteins (LpB), and fibrinogen-related antigens (FRA), in a distribution resembling that seen in atherosclerotic arteries. LpB and FRA were also seen in organised, or partially organised, mural thrombi in older grafts. The oldest grafts additionally showed stenosis, calcification or aneurysm formation. Lipid deposition increases with the age of grafts; is independent of the nature of the plastic fibre used or its mode of fabrication; and sometimes contributes to graft failure. Immuno-histology indicates that this is an insudative process indistinguishable from 'true' atherosclerosis which occurs in graft-linings of prostheses of long duration and in old mural thrombi in grafts and that the lipid in these lesions derives from plasma LpB rather than from platelets. This source for the lipid suggests that the insudative and thrombogenic theories of atherogenesis can be reconciled.

  19. Closed-Loop Control of Myoelectric Prostheses With Electrotactile Feedback: Influence of Stimulation Artifact and Blanking.

    Science.gov (United States)

    Hartmann, Cornelia; Dosen, Strahinja; Amsuess, Sebastian; Farina, Dario

    2015-09-01

    Electrocutaneous stimulation is a promising approach to provide sensory feedback to amputees, and thus close the loop in upper limb prosthetic systems. However, the stimulation introduces artifacts in the recorded electromyographic (EMG) signals, which may be detrimental for the control of myoelectric prostheses. In this study, artifact blanking with three data segmentation approaches was investigated as a simple method to restore the performance of pattern recognition in prosthesis control (eight motions) when EMG signals are corrupted by stimulation artifacts. The methods were tested over a range of stimulation conditions and using four feature sets, comprising both time and frequency domain features. The results demonstrated that when stimulation artifacts were present, the classification performance improved with blanking in all tested conditions. In some cases, the classification performance with blanking was at the level of the benchmark (artifact-free data). The greatest pulse duration and frequency that allowed a full performance recovery were 400 μs and 150 Hz, respectively. These results show that artifact blanking can be used as a practical solution to eliminate the negative influence of the stimulation artifact on EMG pattern classification in a broad range of conditions, thus allowing to close the loop in myoelectric prostheses using electrotactile feedback.

  20. Design of an expert system to automatically calibrate impedance control for powered knee prostheses.

    Science.gov (United States)

    Wang, Ding; Liu, Ming; Zhang, Fan; Huang, He

    2013-06-01

    Many currently available powered knee prostheses (PKP) use finite state impedance control to operate a prosthetic knee joint. The desired impedance values were usually manually calibrated with trial-and-error in order to enable near-normal walking pattern. However, such a manual approach is inaccurate, time consuming, and impractical. This paper aimed to design an expert system that can tune the control impedance for powered knee prostheses automatically and quickly. The expert system was designed based on fuzzy logic inference (FLI) to match the desired knee motion and gait timing while walking. The developed system was validated on an able-bodied subject wearing a powered prosthesis. Preliminary experimental results demonstrated that the developed expert system can converge the user's knee profile and gait timing to the desired values within 2 minutes. Additionally, after the auto-tuning procedure, the user produced more symmetrical gait. These preliminary results indicate the promise of the designed expert system for quick and accuracy impedance calibration, which can significantly improve the practical value of powered lower limb prosthesis. Continuous engineering efforts are still needed to determine the calibration objectives and validate the expert system.

  1. Wireless radio channel for intramuscular electrode implants in the control of upper limb prostheses.

    Science.gov (United States)

    Stango, Antonietta; Yazdandoost, Kamya Yekeh; Farina, Dario

    2015-01-01

    In the last few years the use of implanted devices has been considered also in the field of myoelectric hand prostheses. Wireless implanted EMG (Electromyogram) sensors can improve the functioning of the prosthesis, providing information without the disadvantage of the wires, and the usability by amputees. The solutions proposed in the literature are based on proprietary communication protocols between the implanted devices and the prosthesis controller, using frequency bands that are already assigned to other purposes. This study proposes the use of a standard communication protocol (IEEE 802.15.6), specific for wireless body area networks (WBANs), which assign a specific bandwidth to implanted devices. The propagation losses from in-to-on body were investigated by numerical simulation with a 3D human model and an electromagnetic solver. The channel model resulting from the study represents the first step towards the development of myoelectric prosthetic hands which are driven by signals acquired by implanted sensors. However these results can provide important information to researchers for further developments, and manufacturers, which can decrease the production costs for hand prostheses having a common standard of communication with assigned frequencies of operation.

  2. Comparison of CAD-CAM and hand made sockets for PTB prostheses.

    Science.gov (United States)

    Köhler, P; Lindh, L; Netz, P

    1989-04-01

    The aim of the present study was to compare sockets for below-knee (BK) prostheses made by Computer Aided Design-Computer Aided Manufacture (CAD-CAM) to those made by hand. The patients in the study were provided with two prostheses each, which apart from the sockets, were identical. One socket was made by the CAD-CAM technique developed at the Bioengineering Centre, Roehampton, University College London and one was made by hand at the OT-Centre, Stockholm, Sweden. The results were based on investigation of eight unilateral below-knee amputees evaluating their own sockets by Visual Analogous Scale with respect to comfort, pressure, and pain. The sockets were evaluated on seven occasions, at two tests, on delivery, after use every second day for six days and every second week for two weeks. All CAD-CAM sockets except one had to be changed once as compared to the hand made of which only two had to be changed. As to comfort it could not be demonstrated that there was any significant difference between the two types of sockets and both types were well accepted by all patients. Differences in pressure and pain were rarely reported. There were obvious differences between the two types of socket with respect to height, width, and inner surface configuration. The authors feel that CAD-CAM will in the near future be an excellent tool for design and manufacture of prosthetic sockets.

  3. Decoding brain responses to pixelized images in the primary visual cortex: implications for visual cortical prostheses.

    Science.gov (United States)

    Guo, Bing-Bing; Zheng, Xiao-Lin; Lu, Zhen-Gang; Wang, Xing; Yin, Zheng-Qin; Hou, Wen-Sheng; Meng, Ming

    2015-10-01

    Visual cortical prostheses have the potential to restore partial vision. Still limited by the low-resolution visual percepts provided by visual cortical prostheses, implant wearers can currently only "see" pixelized images, and how to obtain the specific brain responses to different pixelized images in the primary visual cortex (the implant area) is still unknown. We conducted a functional magnetic resonance imaging experiment on normal human participants to investigate the brain activation patterns in response to 18 different pixelized images. There were 100 voxels in the brain activation pattern that were selected from the primary visual cortex, and voxel size was 4 mm × 4 mm × 4 mm. Multi-voxel pattern analysis was used to test if these 18 different brain activation patterns were specific. We chose a Linear Support Vector Machine (LSVM) as the classifier in this study. The results showed that the classification accuracies of different brain activation patterns were significantly above chance level, which suggests that the classifier can successfully distinguish the brain activation patterns. Our results suggest that the specific brain activation patterns to different pixelized images can be obtained in the primary visual cortex using a 4 mm × 4 mm × 4 mm voxel size and a 100-voxel pattern.

  4. Safety of magnetic resonance imaging in patients with implanted cardiac prostheses and metallic cardiovascular electronic devices.

    Science.gov (United States)

    Baikoussis, Nikolaos G; Apostolakis, Efstratios; Papakonstantinou, Nikolaos A; Sarantitis, Ioannis; Dougenis, Dimitrios

    2011-06-01

    Magnetic resonance imaging (MRI) in patients with implanted cardiac prostheses and metallic cardiovascular electronic devices is sometimes a risky procedure. Thus MRI in these patients should be performed when it is the only examination able to help with the diagnosis. Moreover the diagnostic benefit must outweigh the risks. Coronary artery stents, prosthetic cardiac valves, metal sternal sutures, mediastinal vascular clips, and epicardial pacing wires are not contraindications for MRI, in contrast to pacemakers and implantable cardioverter-defibrillators. Appropriate patient selection and precautions ensure MRI safety. However it is commonly accepted that although hundreds of patients with pacemakers or implantable cardioverter-defibrillators have undergone safe MRI scanning, it is not a safe procedure. Currently, heating of the pacemaker lead is the major problem undermining MRI safety. According to the US Food and Drug Administration (FDA), there are currently neither "MRI-safe" nor "MRI-compatible" pacemakers and implantable cardioverter-defibrillators. In this article we review the international literature in regard to safety during MRI of patients with implanted cardiac prostheses and metallic cardiovascular electronic devices.

  5. A training method for locomotion mode prediction using powered lower limb prostheses.

    Science.gov (United States)

    Young, Aaron J; Simon, Ann M; Hargrove, Levi J

    2014-05-01

    Recently developed lower-limb prostheses are capable of actuating the knee and ankle joints, allowing amputees to perform advanced locomotion modes such as step-over-step stair ascent and walking on sloped surfaces. However, transitions between these locomotion modes and walking are neither automatic nor seamless. This study describes methods for construction and training of a high-level intent recognition system for a lower-limb prosthesis that provides natural transitions between walking, stair ascent, stair descent, ramp ascent, and ramp descent. Using mechanical sensors onboard a powered prosthesis, we collected steady-state and transition data from six transfemoral amputees while the five locomotion modes were performed. An intent recognition system built using only mechanical sensor data was 84.5% accurate using only steady-state training data. Including training data collected while amputees performed seamless transitions between locomotion modes improved the overall accuracy rate to 93.9%. Training using a single analysis window at heel contact and toe off provided higher recognition accuracy than training with multiple analysis windows. This study demonstrates the capability of an intent recognition system to provide automatic, natural, and seamless transitions between five locomotion modes for transfemoral amputees using powered lower limb prostheses.

  6. Use of two-axis joystick for control of externally powered shoulder disarticulation prostheses

    Directory of Open Access Journals (Sweden)

    Robert D. Lipschutz, BSME, CP

    2011-07-01

    Full Text Available We explored a new method for simple and accurate control of shoulder movement for externally powered shoulder disarticulation prostheses with a two-axis joystick. We tested 10 subjects with intact shoulders and arms to determine the average amount of shoulder motion and force available to control an electronic input device. We then applied this information to two different input strategies to examine their effectiveness: (1 a traditional rocker potentiometer and a pair of force-sensing resistors and (2 a two-axis joystick. Three nondisabled subjects and two subjects with shoulder disarticulation amputations attempted to control an experimental externally powered shoulder using both control strategies. Two powered arms were tested, one with powered flexion/extension and humeral rotation and one with powered flexion/extension and adduction/abduction. Overwhelmingly, the subjects preferred the joystick control, because it was more intuitively linked with their shoulder movement. Additionally, two motions (one in each axis could be controlled simultaneously. This pilot study provides valuable insight into an effective means of controlling high-level, externally powered prostheses with a two-axis joystick.

  7. Use of prostheses and footwear in 110 inner-city partial-foot amputees.

    Science.gov (United States)

    Sobel, E; Japour, C J; Giorgini, R J; Levitz, S J; Richardson, H L

    2001-01-01

    The number of partial-foot amputations performed is increasing, and many recommendations have been made regarding the use of prostheses and footwear designed to prevent higher-level amputations in this population. The present study investigated the use of prostheses and shoe inserts and the types of footwear worn by partial-foot amputees in the inner city to determine whether previous recommendations are being followed as well as whether new prosthetic styles are being used. The study surveyed 110 patients (73 men and 37 women) with a mean age of 58.6 years (range, 21 to 86 years) with partial-foot amputations of all levels. The results showed that about one-half of all patients wore a shoe-insert orthosis. Although 54% wore some form of special footwear to accommodate and protect the residual foot, no patient in this study wore a shoe with a rocker-bottom sole. Only one patient with a transmetatarsal amputation used a brace and only one patient in the entire study wore a modern cosmetic foot prosthesis.

  8. A Training Strategy for Learning Pattern Recognition Control for Myoelectric Prostheses.

    Science.gov (United States)

    Powell, Michael A; Thakor, Nitish V

    2013-01-01

    Pattern recognition-based control of myoelectric prostheses offers amputees a natural, intuitive way of controlling the increasing functionality of modern myoelectric prostheses. While this approach to prosthesis control is certainly attractive, it is a significant departure from existing control methods. The transition from the more traditional methods of direct or proportional control to pattern recognition-based control presents a training challenge that will be unique to each amputee. In this paper we describe specific ways that a transradial amputee, prosthetist, and occupational therapist team can overcome these challenges by developing consistent and distinguishable muscle patterns. A central part of this process is the employment of a computer-based pattern recognition training system with which an amputee can learn and improve pattern recognition skills throughout the process of prosthesis fitting and testing. We describe in detail the manner in which four transradial amputees trained to improve their pattern recognition-based control of a virtual prosthesis by focusing on building consistent, distinguishable muscle patterns. We also describe a three-phase framework for instruction and training: 1) initial demonstration and conceptual instruction, 2) in-clinic testing and initial training, and 3) at-home training.

  9. Thumb reconstruction after traumatic loss%外伤性拇指缺损的重建

    Institute of Scientific and Technical Information of China (English)

    施海峰; 芮永军; 张全荣; 许亚军; 糜菁熠; 陆征峰; 寿奎水

    2013-01-01

    Objective To investigate the best reconstructive method for traumatic loss of the thumb at different degree. Methods There were 189 patients whose thumbs were reconstructed for all types of traumatic loss from Jan,2003 to Jan,2010 in our hospital. Different methods were used to reconstruct . type Ⅰ: bone loss at the level of the distal phalanx or at the level of the IP joint. Reconstructed by hallux wrap-around flap with part or complete distal phalanx of the big toe (63 patients); type Ⅱ: bone loss at the level of the proximal phalanx or at the level of the MP joint. Reconstructed thumb by the contralateral second toe transfer,if the skin was not enough, combined of pulp flap of the homolateral big toe (92 patients).; another method was to graft iliac bone covered with flap(s) (16 patients). type Ⅲ: bone loss at the level of the metacarpal bone or at the level of the CMC joint. Method Ⅰ: pollicization by index finger of the injury hand combined a flap to cover the first web space (5 patients); Method 2: reconstructed by hallux wrap-around flap combined with bone, tendon and joints of the second toe, a island or free flap covered the first web space (13 patients). Results There're 155 patients were followed up for more than 6 months, and a satisfactory appearance of the reconstructed thumb and functional restoration were obtained. Grip strength was not significantly less than normal side, but pinch strength was significantly less than normal side and 2-PD was worse than normal finger. The function of thumb was better over time. The functions of donor feet were not significantly loss. Conclusion Reconstruction of the traumatic thumb by tissues of toe is effective. We could also chose pollicization by index finger of the injury hand or bone grafting covered by flaps according to the patient's aspiration.%目的 探讨不同程度外伤性拇指缺损的最佳重建方法.方法 根据Serafin的三度分类法,对自2003年1月~2010年1月收治的189例不

  10. Integrated profiling of basal and luminal breast cancers.

    NARCIS (Netherlands)

    Adelaide, J.; Finetti, P.; Bekhouche, I.; Repellini, L.; Geneix, J.; Sircoulomb, F.; Charafe-Jauffret, E.; Cervera, N.; Desplans, J.; Parzy, D.; Schoenmakers, E.F.P.M.; Viens, P.; Jacquemier, J.; Birnbaum, D.; Bertucci, F.; Chaffanet, M.

    2007-01-01

    Basal and luminal are two molecular subtypes of breast cancer with opposite histoclinical features. We report a combined, high-resolution analysis of genome copy number and gene expression in primary basal and luminal breast cancers. First, we identified and compared genomic alterations in 45 basal

  11. Adenoid basal cell carcinoma and its mimics

    Directory of Open Access Journals (Sweden)

    Sujata Jetley

    2013-01-01

    Full Text Available Basal cell carcinoma (BCC is the most common malignant tumor of skin. The most common site (80% is head and neck. BCC exhibits a varied morphology such as adenoid, keratotic, sebaceous, basosquamous, apocrine, eccrine or fibroepithelial. Tumors with a similar histopathological picture are cutaneous adenoid cystic carcinoma and primary cutaneous cribriform apocrine carcinoma. Immunohistochemistry, along with clinical findings, acts as an adjunct in reaching an accurate diagnosis. Here, we present an interesting case of adenoid BCC in a 55-year-old man.

  12. Nonsurgical Treatment Options for Basal Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Mary H. Lien

    2011-01-01

    Full Text Available Basal cell carcinoma (BCC remains the most common form of nonmelanoma skin cancer (NMSC in Caucasians, with perhaps as many as 2 million new cases expected to occur in the United States in 2010. Many treatment options, including surgical interventions and nonsurgical alternatives, have been utilized to treat BCC. In this paper, two non-surgical options, imiquimod therapy and photodynamic therapy (PDT, will be discussed. Both modalities have demonstrated acceptable disease control rates, cosmetically superior outcomes, and short-term cost-effectiveness. Further studies evaluating long-term cure rates and long-term cost effectiveness of imiquimod therapy and PDT are needed.

  13. Mössbauer spectroscopy of Basal Ganglia

    Energy Technology Data Exchange (ETDEWEB)

    Miglierini, Marcel, E-mail: marcel.miglierini@stuba.sk [Institute of Nuclear and Physical Engineering, Faculty of Electrical Engineering and Information Technology, Slovak University of Technology, Ilkovičova 3, 812 19 Bratislava, Slovakia and Regional Centre of Advanced Technologies and Materials (Czech Republic); Lančok, Adriana [Institute of Inorganic Chemistry AS CR, v. v. i., 250 68 Husinec-Řež 1001 (Czech Republic); Kopáni, Martin [Institute of Medical Physics, Biophysics, Informatics and Telemedicine, Faculty of Medicine, Comenius University, Sasinkova 2, 811 08 Bratislava (Slovakia); Boča, Roman [Department of Chemistry, Faculty of Natural Sciences, University of SS. Cyril and Methodius, 917 01 Trnava (Slovakia)

    2014-10-27

    Chemical states, structural arrangement, and magnetic features of iron deposits in biological tissue of Basal Ganglia are characterized. The methods of SQUID magnetometry and electron microscopy are employed. {sup 57}Fe Mössbauer spectroscopy is used as a principal method of investigation. Though electron microscopy has unveiled robust crystals (1-3 μm in size) of iron oxides, they are not manifested in the corresponding {sup 57}Fe Mössbauer spectra. The latter were acquired at 300 K and 4.2 K and resemble ferritin-like behavior.

  14. Archaefructaceae, a new basal angiosperm family.

    Science.gov (United States)

    Sun, Ge; Ji, Qiang; Dilcher, David L; Zheng, Shaolin; Nixon, Kevin C; Wang, Xinfu

    2002-05-03

    Archaefructaceae is proposed as a new basal angiosperm family of herbaceous aquatic plants. This family consists of the fossils Archaefructus liaoningensis and A. sinensis sp. nov. Complete plants from roots to fertile shoots are known. Their age is a minimum of 124.6 million years from the Yixian Formation, Liaoning, China. They are a sister clade to all angiosperms when their characters are included in a combined three-gene molecular and morphological analysis. Their reproductive axes lack petals and sepals and bear stamens in pairs below conduplicate carpels.

  15. Experimental and Monte Carlo evaluation of Eclipse treatment planning system for effects on dose distribution of the hip prostheses.

    Science.gov (United States)

    Catlı, Serap; Tanır, Güneş

    2013-01-01

    The present study aimed to investigate the effects of titanium, titanium alloy, and stainless steel hip prostheses on dose distribution based on the Monte Carlo simulation method, as well as the accuracy of the Eclipse treatment planning system (TPS) at 6 and 18MV photon energies. In the present study the pencil beam convolution (PBC) method implemented in the Eclipse TPS was compared to the Monte Carlo method and ionization chamber measurements. The present findings show that if high-Z material is used in prosthesis, large dose changes can occur due to scattering. The variance in dose observed in the present study was dependent on material type, density, and atomic number, as well as photon energy; as photon energy increased back scattering decreased. The dose perturbation effect of hip prostheses was significant and could not be predicted accurately by the PBC method for hip prostheses. The findings show that for accurate dose calculation the Monte Carlo-based TPS should be used in patients with hip prostheses.

  16. Experimental and Monte Carlo evaluation of Eclipse treatment planning system for effects on dose distribution of the hip prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Çatlı, Serap, E-mail: serapcatli@hotmail.com [Gazi University, Faculty of Sciences, 06500 Teknikokullar, Ankara (Turkey); Tanır, Güneş [Gazi University, Faculty of Sciences, 06500 Teknikokullar, Ankara (Turkey)

    2013-10-01

    The present study aimed to investigate the effects of titanium, titanium alloy, and stainless steel hip prostheses on dose distribution based on the Monte Carlo simulation method, as well as the accuracy of the Eclipse treatment planning system (TPS) at 6 and 18 MV photon energies. In the present study the pencil beam convolution (PBC) method implemented in the Eclipse TPS was compared to the Monte Carlo method and ionization chamber measurements. The present findings show that if high-Z material is used in prosthesis, large dose changes can occur due to scattering. The variance in dose observed in the present study was dependent on material type, density, and atomic number, as well as photon energy; as photon energy increased back scattering decreased. The dose perturbation effect of hip prostheses was significant and could not be predicted accurately by the PBC method for hip prostheses. The findings show that for accurate dose calculation the Monte Carlo-based TPS should be used in patients with hip prostheses.

  17. Sport prostheses and prosthetic adaptations for the upper and lower limb amputees : an overview of peer reviewed literature

    NARCIS (Netherlands)

    Bragaru, Mihai; Dekker, Rienk; Geertzen, Jan H. B.

    2012-01-01

    Background: Sport prostheses are used by both upper- and lower-limb amputees while participating in sports and other physical activities. Although the number of these devices has increased over the past decade, no overview of the peer reviewed literature describing them has been published previously

  18. Antibacterial Efficacy of a New Gentamicin-Coating for Cementless Prostheses Compared to Gentamicin-Loaded Bone Cement

    NARCIS (Netherlands)

    Neut, Danielle; Dijkstra, Rene J. B.; Thompson, Jonathan I.; van der Mei, Henny C.; Busscher, Henk J.

    2011-01-01

    Cementless prostheses are increasingly popular but require alternative prophylactic measures than the use of antibiotic-loaded bone cements. Here, we determine the 24-h growth inhibition of gentamicin-releasing coatings from grit-blasted and porous-coated titanium alloys, and compare their antibacte

  19. [A study on individual mandibular prostheses according to 3D reconstruction of CT images and CNC simulation method].

    Science.gov (United States)

    Pan, Liu-guo; Sun, Li-qun

    2007-03-01

    The new method of manufacturing individual mandibular prostheses, in combination with CT data and CNC technique, can duplicate bone tissues accurately, and can have the individual mandibular prosthesis made to order, and repair the mandibular defect (especially the lager mandibular segmental defect).

  20. The effect of buttermilk consumption on biofilm formation on silicone rubber voice prostheses in an artificial throat

    NARCIS (Netherlands)

    Busscher, HJ; Bruinsma, G; van Meissenbruch, R; Leunisse, C; van der Mei, HC; Dijk, F; Albers, FVJ

    1998-01-01

    Biofilm formation on indwelling silicone rubber voice prostheses in laryngectomized patients is still the main reason for dysfunction of the valve, leading to frequent replacements. Within patient support groups in The Netherlands, laryngectomees have suggested that the consumption of buttermilk pro

  1. [Determining and recording maxillomandibular relationships for the fabrication of single-unit and multi-unit fixed dental prostheses

    NARCIS (Netherlands)

    Wiersema, E.J.; Kreulen, C.M.; Baat, C. de; Witter, D.J.; Creugers, N.H.J.

    2013-01-01

    In a correctly functioning occlusal system, the design of the occlusal parts of single-unit and multi-unit fixed dental prostheses is generally determined by the maximum intercuspation. Determining and recording the maxillomandibular relationships is only required in case the adjacent teeth do not o

  2. No justification for cervical disk prostheses in clinical practice: a meta-analysis of randomized controlled trials.

    NARCIS (Netherlands)

    Bartels, R.H.M.A.; Donk, R.; Verbeek, A.L.M.

    2010-01-01

    OBJECTIVE: A meta-analysis was performed to evaluate whether a beneficial clinical effect of cervical disk prostheses over conventional cervical diskectomy with fusion exists. METHODS: A literature search was completed ending February 4, 2009, that included the abstract books of recent major spine c

  3. ENHANCED HEALING OF 30-MU-M GORE-TEX PTFE MICROARTERIAL PROSTHESES BY ALCOHOL-PRETREATMENT

    NARCIS (Netherlands)

    VANDERLEI, B; STRONCK, JW; WILDEVUUR, CRH

    1991-01-01

    Polytetrafluoroethylene (PTFE) microvascular prostheses with a fibril length of 30-mu-m were pretreated with alcohol (n = 18), implanted into the abdominal aorta of rats and were evaluated at 1 day (n = 3), 1 week (n = 3), 3 weeks (n = 6) and 6 weeks (n = 6) to determine whether alcohol-pretreatment

  4. Three-dimensional finite element analysis of anterior two-unit cantilever resin-bonded fixed dental prostheses

    NARCIS (Netherlands)

    Keulemans, F.; Shinya, A.; Lassila, L.V.J.; Vallittu, P.K.; Kleverlaan, C.J.; Feilzer, A.J.; De Moor, R.J.G.

    2015-01-01

    The aim of this study was to evaluate the influence of different framework materials on biomechanical behaviour of anterior two-unit cantilever resin-bonded fixed dental prostheses (RBFDPs). A three-dimensional finite element model of a two-unit cantilever RBFDP replacing a maxillary lateral incisor

  5. Objective clinical performance outcome of total knee prostheses. A study of mobile bearing knees using fluoroscopy, electromyography and roentgenstereophotogrammetry

    NARCIS (Netherlands)

    Garling, Eric Harald

    2008-01-01

    The aim of the thesis was to to assess with accurate and objective methods the function and fixation of total knee prostheses with special emphasis on mobile bearing total knee designs. The mobile bearing of a rotating platform design showed limited motion or no motion during a step-up task thereby

  6. Basal cell nevus syndrome or Gorlin syndrome.

    Science.gov (United States)

    Thalakoti, Srikanth; Geller, Thomas

    2015-01-01

    Basal cell nevus syndrome (BCNS) or Gorlin syndrome is a rare neurocutaneous syndrome sometimes known as the fifth phacomatosis, inherited in autosomal dominant fashion with complete penetrance and variable expressivity. Gorlin syndrome is characterized by development of multiple basal cell carcinomas (BCCs), jaw cysts, palmar or plantar pits, calcification of falx cerebri, various developmental skeletal abnormalities such as bifid rib, hemi- or bifid vertebra and predisposition to the development of various tumors. BCNS is caused by a mutation in the PTCH1 gene localized to 9q22.3. Its estimated prevalence varies between 1/55600 and 1/256000 with an equal male to female ratio. The medulloblastoma variant seen in Gorlin syndrome patients is of the desmoplastic type, characteristically presenting during the first 3 years of life. Therefore, children with desmoplastic medulloblastoma should be carefully screened for other features of BCNS. Radiation therapy for desmoplastic medulloblastoma should be avoided in BCNS patients as it may induce development of invasive BCCs and other tumors in the skin area exposed to radiation. This syndrome is a multisystem disorder so involvement of multiple specialists with a multimodal approach to detect and treat various manifestations at early stages will reduce the long-term sequelae and severity of the condition. Life expectancy is not significantly altered but morbidity from complications and cosmetic scarring can be substantial.

  7. The Reality of Myoelectric Prostheses: Understanding What Makes These Devices Difficult for Some Users to Control.

    Science.gov (United States)

    Chadwell, Alix; Kenney, Laurence; Thies, Sibylle; Galpin, Adam; Head, John

    2016-01-01

    Users of myoelectric prostheses can often find them difficult to control. This can lead to passive-use of the device or total rejection, which can have detrimental effects on the contralateral limb due to overuse. Current clinically available prostheses are "open loop" systems, and although considerable effort has been focused on developing biofeedback to "close the loop," there is evidence from laboratory-based studies that other factors, notably improving predictability of response, may be as, if not more, important. Interestingly, despite a large volume of research aimed at improving myoelectric prostheses, it is not currently known which aspect of clinically available systems has the greatest impact on overall functionality and everyday usage. A protocol has, therefore, been designed to assess electromyographic (EMG) skill of the user and predictability of the prosthesis response as significant parts of the control chain, and to relate these to functionality and everyday usage. Here, we present the protocol and results from early pilot work. A set of experiments has been developed. First, to characterize user skill in generating the required level of EMG signal, as well as the speed with which users are able to make the decision to activate the appropriate muscles. Second, to measure unpredictability introduced at the skin-electrode interface, in order to understand the effects of the socket-mounted electrode fit under different loads on the variability of time taken for the prosthetic hand to respond. To evaluate prosthesis user functionality, four different outcome measures are assessed. Using a simple upper limb functional task prosthesis users are assessed for (1) success of task completion, (2) task duration, (3) quality of movement, and (4) gaze behavior. To evaluate everyday usage away from the clinic, the symmetricity of their real-world arm use is assessed using activity monitoring. These methods will later be used to assess a prosthesis user cohort to

  8. The reality of myoelectric prostheses: Understanding what makes these devices difficult for some users to control

    Directory of Open Access Journals (Sweden)

    Alix Chadwell

    2016-08-01

    Full Text Available Users of myoelectric prostheses can often find them difficult to control. This can lead to passive-use of the device or total rejection, which can have detrimental effects on the contralateral limb due to overuse.Current clinically available prostheses are ‘open loop’ systems, and although considerable effort has been focused on developing biofeedback to close the loop, there is evidence from laboratory-based studies that other factors, notably improving predictability of response, may be as, if not more, important. Interestingly, despite a large volume of research aimed at improving myoelectric prostheses, it is not currently known which aspect of clinically available systems has the greatest impact on overall functionality and everyday usage. A protocol has therefore been designed to assess EMG skill of the user and predictability of the prosthesis response as significant parts of the control chain, and to relate these to functionality and everyday usage. Here we present the protocol and results from early pilot work.A set of experiments has been developed. Firstly to characterize user skill in generating the required level of EMG signal, as well as the speed with which users are able to make the decision to activate the appropriate muscles. Secondly, to measure unpredictability introduced at the skin-electrode interface, in order to understand the effects of the socket mounted electrode fit under different loads on the variability of time taken for the prosthetic hand to respond.To evaluate prosthesis user functionality, four different outcome measures are assessed. Using a simple upper limb functional task prosthesis users are assessed for (1 success of task completion, (2 task duration, (3 quality of movement, and (4 gaze behavior. To evaluate everyday usage away from the clinic, the symmetricity of their real-world arm use is assessed using activity monitoring.These methods will later be used to assess a prosthesis user cohort, to

  9. The Reality of Myoelectric Prostheses: Understanding What Makes These Devices Difficult for Some Users to Control

    Science.gov (United States)

    Chadwell, Alix; Kenney, Laurence; Thies, Sibylle; Galpin, Adam; Head, John

    2016-01-01

    Users of myoelectric prostheses can often find them difficult to control. This can lead to passive-use of the device or total rejection, which can have detrimental effects on the contralateral limb due to overuse. Current clinically available prostheses are “open loop” systems, and although considerable effort has been focused on developing biofeedback to “close the loop,” there is evidence from laboratory-based studies that other factors, notably improving predictability of response, may be as, if not more, important. Interestingly, despite a large volume of research aimed at improving myoelectric prostheses, it is not currently known which aspect of clinically available systems has the greatest impact on overall functionality and everyday usage. A protocol has, therefore, been designed to assess electromyographic (EMG) skill of the user and predictability of the prosthesis response as significant parts of the control chain, and to relate these to functionality and everyday usage. Here, we present the protocol and results from early pilot work. A set of experiments has been developed. First, to characterize user skill in generating the required level of EMG signal, as well as the speed with which users are able to make the decision to activate the appropriate muscles. Second, to measure unpredictability introduced at the skin–electrode interface, in order to understand the effects of the socket-mounted electrode fit under different loads on the variability of time taken for the prosthetic hand to respond. To evaluate prosthesis user functionality, four different outcome measures are assessed. Using a simple upper limb functional task prosthesis users are assessed for (1) success of task completion, (2) task duration, (3) quality of movement, and (4) gaze behavior. To evaluate everyday usage away from the clinic, the symmetricity of their real-world arm use is assessed using activity monitoring. These methods will later be used to assess a prosthesis user

  10. Simulation of epiretinal prostheses - Evaluation of geometrical factors affecting stimulation thresholds

    Directory of Open Access Journals (Sweden)

    Bertsch Arnaud

    2011-08-01

    Full Text Available Abstract Background An accurate understanding of the electrical interaction between retinal prostheses and retinal tissue is important to design effective devices. Previous studies have used modelling approaches to simulate electric fields generated by epiretinal prostheses in saline and to simulate retinal ganglion cell (RGC activation using passive or/and active biophysical models of the retina. These models have limited scope for studying an implanted human retinal prosthesis as they often do not account for real geometry and composition of the prosthesis-retina interface. This interface consists of real dimensions and location of stimulation and ground electrodes that are separated by the retinal tissue and surrounded by physiological fluids. Methods In this study, we combined the prosthesis-retina interface elements into a framework to evaluate the geometrical factors affecting stimulation thresholds for epiretinal prostheses used in clinical human trials, as described by Balthasar et al. in their Investigative Ophthalmology and Visual Science (IOVS paper published in 2008 using the Argus I epiretinal implants. Finite element method (FEM based computations were used to estimate threshold currents based on a threshold criterion employing a passive electric model of the retina. Results Threshold currents and impedances were estimated for different electrode-retina distances. The profiles and the values for thresholds and impedances obtained from our simulation framework are within the range of measured values in the only elaborate published clinical trial until now using Argus I epiretinal implants. An estimation of resolution for the electrodes used in these trials was provided. Our results reiterate the importance of close proximity between electrodes and retina for safe and efficient retinal stimulation. Conclusions The validation of our simulation framework being relevant for epiretinal prosthesis research is derived from the good

  11. 示指拇化治疗重度拇指发育不全%Index finger pollicization for treatment of severe congenital hypoplasia of the thumb

    Institute of Scientific and Technical Information of China (English)

    芮永军; 施海峰; 张全荣; 糜菁熠; 许亚军; 张辉; 邱扬; 寿奎水

    2009-01-01

    目的 介绍示指拇化治疗先天性重度拇指发育不全(ⅢB~V型)的手术方法.方法 对Ⅳ型(漂浮拇)2例、ⅢB型(腕掌关节缺如)2例采用示指拇化,将示指自掌骨部位转位重建拇指.结果 4例移位指全部存活.术后随访2~3年,虎口开大70°~90°,接近健侧.拇指掌指关节屈曲后可与所有手指对指,近指间关节活动度从0°至100~120°,远指间关节活动度从0°至90°.指端两点分辨觉同健侧,外观和功能满意.结论 采用示指转位治疗重度发育不全的拇指,外形和功能满意,克服了以往采用皮瓣和骨瓣移植的缺点,是一种实用而可取的方法,值得推广.%Objective To introduce the surgical techniques of index finger pollicization for treatment of severe congenital thumb hypoplasia (type III B to V ). Methods Two cases of type IV thumb hypoplasia (floating thumb) and 2 cases of type III B thumb hypoplasia ( carpometacarpal joint absence) were treated by transferring the index finger at the level of metacarpal bone to the position of the missing thumb. Results All 4 pollicized fingers survived. The patients were followed up for 2 to 3 years postoperatively. The first web space was similar to the normal side, with maximum open degree of 70° to 90°. Range of motion of the proximal interphalangeal joint improved from 0° to 100°-120°, while that of the distal interphalangeal joint from 0° to 90°. 2-PD was the same as the normal side. The overall appearance and function were satisfaction. Conclusion Index finger pollicization can achieve satisfactory appearance and function in treating severe thumb hypoplasia. It overcomes the disadvantages of flap or osseocutaneous flap transfer. This method is practical and therefore worth of popularization.

  12. Effect of alignment changes on socket reaction moments during gait in transfemoral and knee-disarticulation prostheses: case series.

    Science.gov (United States)

    Kobayashi, Toshiki; Orendurff, Michael S; Boone, David A

    2013-09-27

    The alignment of a lower-limb prosthesis is critical to the successful prosthetic fitting and utilization by the wearer. Loads generated by the socket applied to the residual limb while walking are thought to be different in transfemoral and knee-disarticulation prostheses. The aim of this case series was to compare the socket reaction moments between transfemoral and knee-disarticulation prostheses and to investigate the effect of alignment changes on them. Two amputees, one with a transfemoral prosthesis and another with a knee-disarticulation prosthesis, participated in this study. A Smart Pyramid™ was used to measure socket reaction moments while walking under 9 selected alignment conditions; including nominally aligned, angle malalignments of 6° (flexion, extension, abduction and adduction) and translation malalignments of 15 mm (anterior, posterior, medial and lateral) of the socket relative to the foot. This study found that the pattern of the socket reaction moments was similar between transfemoral and knee-disarticulation prostheses. An extension moment in the sagittal plane and a varus moment in the coronal plane were dominant during stance under the nominally aligned condition. This study also demonstrated that alignment changes might have consistent effects on the socket reaction moments in transfemoral and knee-disarticulation prostheses. Extension and posterior translation of the socket resulted in increases in an extension moment, while abduction and lateral translation of the socket resulted in increases in a varus moment. The socket reaction moments may potentially serve as useful biomechanical parameters to evaluate alignment in transfemoral and knee-disarticulation prostheses.

  13. Shock machine for the mechanical behaviour of hip prostheses: a description of performance capabilities

    CERN Document Server

    Uribe, Juliana; Forest, Bernard; 10.1002/ls.167

    2012-01-01

    The aim of this study was to describe the behaviour of a shock machine designed for testing hip prostheses. A microseparation between head and cup occurs inducing a shock of several times the body weight, leading to fracture of ceramic femoral components. Femoral heads and cups of diameter 32 mm manufactured from alumina were tested in dry and wet conditions. Implants were subjected to shocks with a load profile of 9 kN load at 2 Hz and various microseparations. Position is monitored and force is measured with two acquisition systems. The working range and the device capabilities were investigated. Only cups tested in dry conditions failed. Observations by scanning electron microscopy revealed intergranular and transgranular fractures. Two wear stripes were observed on the heads. Three-dimensional roughness of wear stripes was measured. Since experimental results are in good agreement with retrieved femoral heads, the shocks machine reproduces the in vivo degradations.

  14. Ultra Low-Power Algorithm Design for Implantable Devices: Application to Epilepsy Prostheses

    Directory of Open Access Journals (Sweden)

    Shriram Raghunathan

    2011-05-01

    Full Text Available Low-power circuit design techniques have enabled the possibility of integrating signal processing and feature extraction algorithms on-board implantable medical devices, eliminating the need for wireless transfer of data outside the patient. Feature extraction algorithms also serve as valuable tools for modern-day artificial prostheses, made possible by implantable brain-computer-interface systems. This paper intends to review the challenges in designing feature extraction blocks for implantable devices, with specific focus on developing efficacious but computationally efficient algorithms to detect seizures. Common seizure detection features used to construct algorithms are evaluated and algorithmic, mathematical as well as circuit-level design techniques are suggested to effectively translate the algorithms into hardware implementations on low-power platforms.

  15. Sparse generalized volterra model of human hippocampal spike train transformation for memory prostheses.

    Science.gov (United States)

    Song, Dong; Robinson, Brian S; Hampson, Robert E; Marmarelis, Vasilis Z; Deadwyler, Sam A; Berger, Theodore W

    2015-01-01

    In order to build hippocampal prostheses for restoring memory functions, we build multi-input, multi-output (MIMO) nonlinear dynamical models of the human hippocampus. Spike trains are recorded from the hippocampal CA3 and CA1 regions of epileptic patients performing a memory-dependent delayed match-to-sample task. Using CA3 and CA1 spike trains as inputs and outputs respectively, second-order sparse generalized Laguerre-Volterra models are estimated with group lasso and local coordinate descent methods to capture the nonlinear dynamics underlying the spike train transformations. These models can accurately predict the CA1 spike trains based on the ongoing CA3 spike trains and thus will serve as the computational basis of the hippocampal memory prosthesis.

  16. Chemical and Structural Characterization of Several Mid-Term Explanted Breast Prostheses

    Directory of Open Access Journals (Sweden)

    Angela Amoresano

    2016-08-01

    Full Text Available The recent scandal of poly implant prostheses (PIP, which were found in some cases to be made of non-medical grade silicone (as reported by the European Scientific Committee on Emerging and Newly Identified Health Risks, had a great social impact. Thousands of patients asked for implant removal with significant costs for public health care systems. We analysed, by a multidisciplinary approach, sixteen different breast implants after explantation by using several analytical and structural techniques, such as Fourier Transform infrared spectroscopy (FT-IR, mass spectrometry equipped by ion coupled plasma (ICP-MS, gas-chromatography (GC-MS, and tensile testing. Traces of organic (fatty acid and inorganic (Fe, Cr, Pt, Na, and other metals substances were found in all samples, and, even if these values are under danger threshold levels, our study results highlight the possibility of bioaccumulation and tissue contamination, implying the need for continuous medical surveillance and monitoring of material aging.

  17. The use of interlocking prostheses for both temporary and definitive management of infected periprosthetic femoral fractures.

    Science.gov (United States)

    Konan, Sujith; Rayan, Faizal; Manketelow, Andrew R J; Haddad, Fares S

    2011-12-01

    Infected periprosthetic fractures around total hip arthroplasties are an extremely challenging problem. We describe our experience of managing infected periprosthetic femoral fractures using interlocking long-stem femoral prostheses either as temporary functional spacers or as definitive implants. The Cannulock (Orthodesign, Christchurch, United Kingdom) uncoated stem was used in 12 cases, and the Kent hip prosthesis (Biomet Merck, Bridgend, United Kingdom), in 5 cases. Satisfactory outcome was noted in all cases, and in 11 cases, revision to a definitive stem has been undertaken after successful control of infection and fracture union. The use of interlocking stems offers a relatively appealing solution for a complex problem and avoids the complications that would be associated with resection of the entire femur or the use of large quantities of bone cement.

  18. Percutaneous implantation of CoreValve aortic prostheses in patients with a mechanical mitral valve.

    Science.gov (United States)

    Bruschi, Giuseppe; De Marco, Federico; Oreglia, Jacopo; Colombo, Paola; Fratto, Pasquale; Lullo, Francesca; Paino, Roberto; Frigerio, Maria; Martinelli, Luigi; Klugmann, Silvio

    2009-11-01

    Concerns exist in the field of transcatheter aortic valve implantation regarding the treatment of patients with mechanical mitral valve for possible interference between the percutaneous aortic valve and the mechanical mitral prosthesis. We report our experience with percutaneous aortic valve implantation in 4 patients with severe aortic stenosis, previously operated on for mitral valve replacement with a mechanical prosthesis. All patients underwent uneventful percutaneous retrograde CoreValve implantation (CoreValve Inc, Irvine, CA). No deformation of the nitinol tubing of the prostheses (ie, neither distortion nor malfunction of the mechanical valve in the mitral position) occurred in any of the patients. All patients are alive and asymptomatic at a mean follow-up of 171 days.

  19. High-density EMG E-textile systems for the control of active prostheses.

    Science.gov (United States)

    Farina, Dario; Lorrain, Thomas; Negro, Francesco; Jiang, Ning

    2010-01-01

    Myoelectric control of active prostheses requires electrode systems that are easy to apply for daily repositioning of the electrodes by the user. In this study we propose the use of Smart Fabric and Interactive Textile (SFIT) systems as an alternative solution for recording high-density EMG signals for myoelectric control. A sleeve covering the upper and lower arm, which contains 100 electrodes arranged in four grids of 5 × 5 electrodes, was used to record EMG signals in 3 subjects during the execution of 9 tasks of the wrist and hand. The signals were analyzed by extracting wavelet coefficients which were classified with linear discriminant analysis. The average classification accuracy for the nine tasks was 89.1 ± 1.9 %. These results show that SFIT systems can be used as an effective way for muscle-machine interfacing.

  20. Development and evaluation of new coupling system for lower limb prostheses with acoustic alarm system.

    Science.gov (United States)

    Eshraghi, Arezoo; Osman, Noor Azuan Abu; Gholizadeh, Hossein; Ahmadian, Jalil; Rahmati, Bizhan; Abas, Wan Abu Bakar Wan

    2013-01-01

    Individuals with lower limb amputation need a secure suspension system for their prosthetic devices. A new coupling system was developed that is capable of suspending the prosthesis. The system's safety is ensured through an acoustic alarm system. This article explains how the system works and provides an in vivo evaluation of the device with regard to pistoning during walking. The system was designed to be used with silicone liners and is based on the requirements of prosthetic suspension systems. Mechanical testing was performed using a universal testing machine. The pistoning during walking was measured using a motion analysis system. The new coupling device produced significantly less pistoning compared to a common suspension system (pin/lock). The safety alarm system would buzz if the suspension was going to fail. The new coupling system could securely suspend the prostheses in transtibial amputees and produced less vertical movement than the pin/lock system.

  1. Antifungal activity of components used for decontamination of dental prostheses on the growth of Candida albicans

    Directory of Open Access Journals (Sweden)

    Cíntia Lima Gouveia

    Full Text Available Introduction: The effectiveness of antimicrobial solutions employed in dental prosthesis decontamination is still uncertain. Aim: To evaluate the antifungal activity of cleaners used in the decontamination of dental prostheses on the growth of Candida albicans. Material and method: The evaluated products were: Corega Tabs(r (S1, Sodium Hypochlorite 1% (S2, Sodium Bicarbonate 1% (S3, Hydrogen Peroxide 1% (S4, Chlorhexidine Digluconate 0.12% - Periogard (r (S5, Mouthrinse based on essential oils - Listerine(r (S6, essential oil from Rosmarinus officinalis (rosemary at concentrations of 1% (S7 and 2% (S8. The antifungal activity of the products was evaluated by agar diffusion technique and the determination of microbial death curve of samples of C. albicans (ATCC 90028 in concentration 1.5 × 106 CFU/mL. The tests were performed in triplicate and statistical analysis was made by ANOVA Two-Way and Tukey tests, with the confidence level of 95%. Result: The average of the zones of inhibition growth, in millimeters, obtained for the products were: 0.0 (S1, 44.7 (S2, 0.0 (S3, 21.6 (S4, 10.0 (S5, 6.1 (S6, 0.0 (S7 and 2.4 (S8. Considering the determination of microbial death curve, all products showed a statistical difference (p<0.01 from control (0.85% sodium chloride and S3 groups. Fungal growth less than 2×104 CFU/mL and an accentuation of the microbial death curve were observed after 30 minutes, with exception for S3 and control groups. Conclusion: The studied compounds, with the exception of Sodium Bicarbonate, have antifungal effect against C. albicans, which contribute for dental prostheses hygiene.

  2. Effect of alignment changes on sagittal and coronal socket reaction moment interactions in transtibial prostheses.

    Science.gov (United States)

    Kobayashi, Toshiki; Orendurff, Michael S; Zhang, Ming; Boone, David A

    2013-04-26

    Alignment is important for comfortable and stable gait of lower-limb prosthesis users. The magnitude of socket reaction moments in the multiple planes acting simultaneously upon the residual limb may be related to perception of comfort in individuals using prostheses through socket interface pressures. The aim of this study was to investigate the effect of prosthetic alignment changes on sagittal and coronal socket reaction moment interactions (moment-moment curves) and to characterize the curves in 11 individuals with transtibial amputation using novel moment-moment interaction parameters measured by plotting sagittal socket reaction moments versus coronal ones under various alignment conditions. A custom instrumented prosthesis alignment component was used to measure socket reaction moments during walking. Prosthetic alignment was tuned to a nominally aligned condition by a prosthetist, and from this position, angular (3° and 6° of flexion, extension, abduction or adduction of the socket) and translational (5mm and 10mm of anterior, posterior, medial or lateral translation of the socket) alignment changes were performed in either the sagittal or the coronal plane in a randomized manner. A total of 17 alignment conditions were tested. Coronal angulation and translation alignment changes demonstrated similar consistent changes in the moment-moment curves. Sagittal alignment changes demonstrated more complex changes compared to the coronal alignment changes. Effect of sagittal angulations and translations on the moment-moment curves was different during 2nd rocker (mid-stance) with extension malalignment appearing to cause medio-lateral instability. Presentation of coronal and sagittal socket reaction moment interactions may provide useful visual information for prosthetists to understand the biomechanical effects of malalignment of transtibial prostheses.

  3. Analysis of using EMG and mechanical sensors to enhance intent recognition in powered lower limb prostheses

    Science.gov (United States)

    Young, A. J.; Kuiken, T. A.; Hargrove, L. J.

    2014-10-01

    Objective. The purpose of this study was to determine the contribution of electromyography (EMG) data, in combination with a diverse array of mechanical sensors, to locomotion mode intent recognition in transfemoral amputees using powered prostheses. Additionally, we determined the effect of adding time history information using a dynamic Bayesian network (DBN) for both the mechanical and EMG sensors. Approach. EMG signals from the residual limbs of amputees have been proposed to enhance pattern recognition-based intent recognition systems for powered lower limb prostheses, but mechanical sensors on the prosthesis—such as inertial measurement units, position and velocity sensors, and load cells—may be just as useful. EMG and mechanical sensor data were collected from 8 transfemoral amputees using a powered knee/ankle prosthesis over basic locomotion modes such as walking, slopes and stairs. An offline study was conducted to determine the benefit of different sensor sets for predicting intent. Main results. EMG information was not as accurate alone as mechanical sensor information (p < 0.05) for any classification strategy. However, EMG in combination with the mechanical sensor data did significantly reduce intent recognition errors (p < 0.05) both for transitions between locomotion modes and steady-state locomotion. The sensor time history (DBN) classifier significantly reduced error rates compared to a linear discriminant classifier for steady-state steps, without increasing the transitional error, for both EMG and mechanical sensors. Combining EMG and mechanical sensor data with sensor time history reduced the average transitional error from 18.4% to 12.2% and the average steady-state error from 3.8% to 1.0% when classifying level-ground walking, ramps, and stairs in eight transfemoral amputee subjects. Significance. These results suggest that a neural interface in combination with time history methods for locomotion mode classification can enhance intent

  4. Basal Cell Nevus Syndrome. A Case Presentation

    Directory of Open Access Journals (Sweden)

    Ángel Luis Cruz Leiva

    2007-12-01

    Full Text Available Basal Cell Nevus Syndrome is an infrequent entity of very low incidence according to reports in medical literature. It is characterized by considerable groups of alterations which are presented in the organism in a variable way, and with localized lesions in the maxillofacial area. A 61 year-old white male patient who lives in the urban area of Cienfuegos city is presented. He has family references of numerous physical deformities since he was born such as mental retardation, presence of moles since the first decade of his life and augmentation of the mandibular body volume. The diagnosis was keratocysts based on the clinical and radiological examinations as well as histopathological studies.

  5. Basal body temperature recordings in spontaneous abortion.

    Science.gov (United States)

    Cohen, J; Iffy, L; Keyser, H H

    1976-01-01

    Basal body temperature (BBT) charts taken during the cycle of conception in cases that resulted in spontaneous abortion appear to provide the best available information concerning events associated with time of fertilization in doomed gestations. This study is based on a series of 227 patients who had early spontaneous abortion occurring between January 1967 and December 1974. A diagnosis of pregnancy initiated regular assays of urinary estrogen and pregnanediol excretion. Patients were instructed to report any bleeding episode which might occur, and to preserve all tissues that might be expelled. A total of 11 basal body temperature charts were obtained from patients who had subsequent early spontaneous abortion. Chromosome studies and histologic investigations were conducted. Another group of 11 consecutive BBT records were obtained from patients who had normal deliveries. The study shows that women with normal cycles experience a midcycle temperature rise requiring 1 to 3 days. In subsequent patients, this time limit was exceeded in 7 out of 11 cases of early abortion, and in 4 of 11 fertilization that resulted in an apparently normal gestation and infant. As temperature rise resulted from vigorous progesterone secretion by the corpus luteum, subnormal levels indicate inadequate steroidogenesis in the early luteal phase, and falling estrogen and progesterone levels predicted fetal demise in all cases. These findings are useful in the management of early pregnancy that follows repeated spontaneous first trimester abortions or a prolonged period of infertility. They also confirm experimental and clinical evidence regarding the role of ovulation defects in the occurrence of various types of reproductive wastage, including early abortion, anatomic and chromosome defects of the embryo and others. Prospective studies of cycles of conception through BBT recordings/hormone assays may shed light in the understanding of defects of human reproduction.

  6. Concentrated insulins: the new basal insulins

    Directory of Open Access Journals (Sweden)

    Lamos EM

    2016-03-01

    Full Text Available Elizabeth M Lamos,1 Lisa M Younk,2 Stephen N Davis3 1Division of Endocrinology, Diabetes and Nutrition, 2Department of Medicine, University of Maryland School of Medicine, 3Department of Medicine, University of Maryland Medical Center, Baltimore, MD, USA Introduction: Insulin therapy plays a critical role in the treatment of type 1 and type 2 diabetes mellitus. However, there is still a need to find basal insulins with 24-hour coverage and reduced risk of hypoglycemia. Additionally, with increasing obesity and insulin resistance, the ability to provide clinically necessary high doses of insulin at low volume is also needed. Areas covered: This review highlights the published reports of the pharmacokinetic (PK and glucodynamic properties of concentrated insulins: Humulin-R U500, insulin degludec U200, and insulin glargine U300, describes the clinical efficacy, risk of hypoglycemic, and metabolic changes observed, and finally, discusses observations about the complexity of introducing a new generation of concentrated insulins to the therapeutic market. Conclusion: Humulin-R U500 has a similar onset but longer duration of action compared with U100 regular insulin. Insulin glargine U300 has differential PK/pharmacodynamic effects when compared with insulin glargine U100. In noninferiority studies, glycemic control with degludec U200 and glargine U300 is similar to insulin glargine U100 and nocturnal hypoglycemia is reduced. Concentrated formulations appear to behave as separate molecular entities when compared with earlier U100 insulin analog compounds. In the review of available published data, newer concentrated basal insulins may offer an advantage in terms of reduced intraindividual variability as well as reducing the injection burden in individuals requiring high-dose and large volume insulin therapy. Understanding the PK and pharmacodynamic properties of this new generation of insulins is critical to safe dosing, dispensing, and administration

  7. Habit persistence, non-separability between consumption and leisure, or rule-of thumb consumers: which accounts for the predictability of consumption growth?

    OpenAIRE

    Michael T. Kiley

    2007-01-01

    Consumption growth is predictable, a basic violation of the permanent-income hypothesis. This paper examines three possible explanations: rule-of-thumb behavior, in which households allow consumption to track per-period income flows rather than permanent income; habit persistence; and non-separability in preferences over consumption and leisure. The data appear most consistent with non-separable preferences over consumption and leisure.

  8. Comparison of the effects of flexion and extension of the thumb and fingers on the position and cross-sectional area of the median nerve.

    Directory of Open Access Journals (Sweden)

    Yasushi Toge

    Full Text Available OBJECTIVE: To assess the separate effects of thumb and finger extension/flexion on median nerve position and cross-sectional area. METHODS: Ultrasonography was used to assess median nerve transverse position and cross-sectional area within the carpal tunnel at rest and its movement during volitional flexion of the individual digits of the hand. Both wrists of 165 normal subjects (11 men, 4 women, mean age, 28.6, range, 22 to 38 were studied. RESULTS: Thumb flexion resulted in transverse movement of the median nerve in radial direction (1.2 ± 0.6 mm, whereas flexion of the fingers produced transverse movement in ulnar direction, which was most pronounced during flexion of the index and middle fingers (3.2 ± 0.9 and 3.1 ± 1.0 mm, respectively. Lesser but still statistically significant movements were noted with flexion of the ring finger (2.0 ± 0.8 mm and little finger (1.2 ± 0.5 mm. Flexion of the thumb or individual fingers did not change median nerve cross-sectional area (8.5 ± 1.1 mm(2. CONCLUSIONS: Volitional flexion of the thumb and individual fingers, particularly the index and middle fingers, produced significant transverse movement of the median nerve within the carpal tunnel but did not alter the cross-sectional area of the nerve. The importance of these findings on the understanding of the pathogenesis of the carpal tunnel syndrome and its treatment remains to be investigated.

  9. 耳聋与助听设备的选择%Deafness and Hearing Aid or Prostheses Selection

    Institute of Scientific and Technical Information of China (English)

    银力; 屠文河; 高姗仙; 童丹阳; 滕晓芳; 许泽荣; 曹永茂; 胡宝华; 曾凡钢

    2016-01-01

    When deafness occurred, the patient and their family wil face a lot of choices, including medical treatment, selection of hearing aid or prostheses, rehabilitation and so on. This paper presents the deafness classiifcation and hearing aid or prostheses selection. Selection of hearing aid or prostheses is closely related to the side, the nature and degree of deafness, such as bilateral moderate sensorineural hearing loss should ifrst consider hearing aid iftting, while profound sensorineural hearing loss should consider cochlear implants ifrst. For a beter understanding of deafness and hearing aid or prostheses, this paper wil review anatomy and physiology of ear ifrstly, then expound the classiifcation of the deafness and hearing aid or prostheses, and ifnaly match different deafness with different hearing aid or prostheses, which will help people in need choose different hearing aid or prostheses according to different deafness. User of hearing aid or prostheses should have very high motivation but appropriate expectations and keep using the device, no mater which type of hearing aid or prostheses wil be used. Besides, short term or long term of hearing and speech training should be taken according to the individual condition of the recipients. Thus, the optimal outcome may be achieved.%发生耳聋后,患者和他们的家人会面临许多选择,包括治疗、选用助听设备、康复学习等。本文就耳聋与助听设备的选择进行阐述。助听设备的选择与发生耳聋的侧别、性质和程度是密切相关的。比如双侧中度感音神经性耳聋就应首选助听器验配,而深度(极重度)感音神经性聋就应积极考虑人工耳蜗植入。为了能更好地理解耳聋和助听设备,本文先回顾耳的解剖和生理,进而讲解耳聋和助听设备的分类,最后将不同的耳聋与相应的助听设备相匹配,帮助有需要的听障人士根据其耳聋情况选取不同的助听设备。无论

  10. THUMB-LOOPS UP FOR CATALYSIS: A STRUCTURE/FUNCTION INVESTIGATION OF A FUNCTIONAL LOOP MOVEMENT IN A GH11 XYLANASE

    Directory of Open Access Journals (Sweden)

    Gabriel Paës

    2012-07-01

    Full Text Available Dynamics is a key feature of enzyme catalysis. Unfortunately, current experimental and computational techniques do not yet provide a comprehensive understanding and description of functional macromolecular motions. In this work, we have extended a novel computational technique, which combines molecular modeling methods and robotics algorithms, to investigate functional motions of protein loops. This new approach has been applied to study the functional importance of the so-called thumb-loop in the glycoside hydrolase family 11 xylanase from Thermobacillus xylanilyticus (Tx-xyl. The results obtained provide new insight into the role of the loop in the glycosylation/deglycosylation catalytic cycle, and underline the key importance of the nature of the residue located at the tip of the thumb-loop. The effect of mutations predicted in silico has been validated by in vitro site-directed mutagenesis experiments. Overall, we propose a comprehensive model of Tx-xyl catalysis in terms of substrate and product dynamics by identifying the action of the thumb-loop motion during catalysis.

  11. A novel mutation in the SHH long-range regulator (ZRS) is associated with preaxial polydactyly, triphalangeal thumb, and severe radial ray deficiency.

    Science.gov (United States)

    Al-Qattan, Mohammad M; Al Abdulkareem, Ibrahim; Al Haidan, Yazied; Al Balwi, Mohammed

    2012-10-01

    Sonic Hedgehog (SHH) within the posteriorly located zone of polarizing activity is the main controller of the antero-posterior axis of limb development. The ZRS (zone of polarizing activity regulatory sequence) is a long-range limb-specific SHH enhancer. Several point mutations in the ZRS have been described in humans. These mutations cause enhanced SHH activity and ectopic anterior expression of SHH and a variable phenotype of preaxial polydactyly and triphalangeal thumb. Absent thumb or radius has not been reported with ZRS mutations. Here, we report on a family with a variable phenotype of preaxial polydactyly as well as absent thumb and radius, with kidney and cardiac defects. The family was screened for SALL1, SALL4, and TBX5 mutations, but all were normal. Finally, they were screened for ZRS mutations, which showed a novel point mutation within the ZRS, NG_009240.1: g.106954C>T (traditional nomenclature: ZRS619C>T) in the five affected members. This mutation was not previously reported in any public domain database, and was not found in our healthy and ethnically matched control individuals or unaffected family members. We hypothesize that interactions of SHH and SALL1 explain the overlapping features of the family described here and patients with Townes-Brocks syndrome.

  12. Abnormal Basal Ganglia Functional Connectivity in Idiopathic Generalized Epilepsy

    Institute of Scientific and Technical Information of China (English)

    Cheng Luo; Yang Xia; Zhi-Wei Guo; Dong Zhou

    2011-01-01

    The basal ganglia have been implicated in a modulation role in idiopathic generalized epilepsy (IGE) by an invasive electrophysioigic means.This paper investigates the basal ganglia functional connectivity by using the region-wise functional connection analysis in resting-state functional magnetic resonance imaging (fMRi) in IGE.The increased functional connectivity within basal ganglia,and between the basal ganglia and the thalamus,and decreased functional connectivity between basal ganglia and motor cortex are found in IGE compared with the controls. These findings not only implicate dysfunctional integration in the motor loop in IGE and the enhanced interaction in the modulated loop,but also suggest that the basal ganglia modulate the generalized epileptic discharges with the influence over thalamus in the corticothalamus network.

  13. Thumb-size ultrasonic-assisted spectroscopic imager for in-situ glucose monitoring as optional sensor of conventional dialyzers

    Science.gov (United States)

    Nogo, Kosuke; Mori, Keita; Qi, Wei; Hosono, Satsuki; Kawashima, Natsumi; Nishiyama, Akira; Wada, Kenji; Ishimaru, Ichiro

    2016-03-01

    We proposed the ultrasonic-assisted spectroscopic imaging for the realization of blood-glucose-level monitoring during dialytic therapy. Optical scattering and absorption caused by blood cells deteriorate the detection accuracy of glucose dissolved in plasma. Ultrasonic standing waves can agglomerate blood cells at nodes. In contrast, around anti-node regions, the amount of transmitted light increases because relatively clear plasma appears due to decline the number of blood cells. Proposed method can disperse the transmitted light of plasma without time-consuming pretreatment such as centrifugation. To realize the thumb-size glucose sensor which can be easily attached to dialysis tubes, an ultrasonic standing wave generator and a spectroscopic imager are required to be small. Ultrasonic oscillators are ∅30[mm]. A drive circuit of oscillators, which now size is 41×55×45[mm], is expected to become small. The trial apparatus of proposed one-shot Fourier spectroscopic imager, whose size is 30×30×48[mm], also can be little-finger size in principal. In the experiment, we separated the suspension mixed water and micro spheres (Θ10[mm) into particles and liquid regions with the ultrasonic standing wave (frequency: 2[MHz]). Furthermore, the spectrum of transmitted light through the suspension could be obtained in visible light regions with a white LED.

  14. Explicit tracking of uncertainty increases the power of quantitative rule-of-thumb reasoning in cell biology.

    Science.gov (United States)

    Johnston, Iain G; Rickett, Benjamin C; Jones, Nick S

    2014-12-01

    Back-of-the-envelope or rule-of-thumb calculations involving rough estimates of quantities play a central scientific role in developing intuition about the structure and behavior of physical systems, for example in so-called Fermi problems in the physical sciences. Such calculations can be used to powerfully and quantitatively reason about biological systems, particularly at the interface between physics and biology. However, substantial uncertainties are often associated with values in cell biology, and performing calculations without taking this uncertainty into account may limit the extent to which results can be interpreted for a given problem. We present a means to facilitate such calculations where uncertainties are explicitly tracked through the line of reasoning, and introduce a probabilistic calculator called CALADIS, a free web tool, designed to perform this tracking. This approach allows users to perform more statistically robust calculations in cell biology despite having uncertain values, and to identify which quantities need to be measured more precisely to make confident statements, facilitating efficient experimental design. We illustrate the use of our tool for tracking uncertainty in several example biological calculations, showing that the results yield powerful and interpretable statistics on the quantities of interest. We also demonstrate that the outcomes of calculations may differ from point estimates when uncertainty is accurately tracked. An integral link between CALADIS and the BioNumbers repository of biological quantities further facilitates the straightforward location, selection, and use of a wealth of experimental data in cell biological calculations.

  15. Basal cell carcinoma in oculo-cutaneous albinism

    Directory of Open Access Journals (Sweden)

    Ajay Kumar

    2016-06-01

    Full Text Available The basal cell carcinoma is the most common skin tumour especially affecting the white individuals worldwide. The exact incidence of basal cell carcinoma is not known from India but non melanoma skin cancers comprises about 1-2% of cutaneous tumour in India. The most common skin tumour is squamous cell carcinoma in albinism and the incidence of basal cell carcinoma is less. Hereby, we report a peculiar case of basal cell carcinoma in albinism to highlights the importance of early recognition and diagnosis of suspected lesions by performing histopathological examination in unusual circumstances. [Int J Res Med Sci 2016; 4(6.000: 2452-2454

  16. Nevoid basal cell carcinoma syndrome (Gorlin syndrome

    Directory of Open Access Journals (Sweden)

    Lo Muzio Lorenzo

    2008-11-01

    Full Text Available Abstract Nevoid basal cell carcinoma syndrome (NBCCS, also known as Gorlin syndrome, is a hereditary condition characterized by a wide range of developmental abnormalities and a predisposition to neoplasms. The estimated prevalence varies from 1/57,000 to 1/256,000, with a male-to-female ratio of 1:1. Main clinical manifestations include multiple basal cell carcinomas (BCCs, odontogenic keratocysts of the jaws, hyperkeratosis of palms and soles, skeletal abnormalities, intracranial ectopic calcifications, and facial dysmorphism (macrocephaly, cleft lip/palate and severe eye anomalies. Intellectual deficit is present in up to 5% of cases. BCCs (varying clinically from flesh-colored papules to ulcerating plaques and in diameter from 1 to 10 mm are most commonly located on the face, back and chest. The number of BBCs varies from a few to several thousand. Recurrent jaw cysts occur in 90% of patients. Skeletal abnormalities (affecting the shape of the ribs, vertebral column bones, and the skull are frequent. Ocular, genitourinary and cardiovascular disorders may occur. About 5–10% of NBCCS patients develop the brain malignancy medulloblastoma, which may be a potential cause of early death. NBCCS is caused by mutations in the PTCH1 gene and is transmitted as an autosomal dominant trait with complete penetrance and variable expressivity. Clinical diagnosis relies on specific criteria. Gene mutation analysis confirms the diagnosis. Genetic counseling is mandatory. Antenatal diagnosis is feasible by means of ultrasound scans and analysis of DNA extracted from fetal cells (obtained by amniocentesis or chorionic villus sampling. Main differential diagnoses include Bazex syndrome, trichoepithelioma papulosum multiplex and Torre's syndrome (Muir-Torre's syndrome. Management requires a multidisciplinary approach. Keratocysts are treated by surgical removal. Surgery for BBCs is indicated when the number of lesions is limited; other treatments include laser

  17. Efficacy of combined conservative therapies on clinical outcomes in patients with thumb base osteoarthritis: protocol for a randomised, controlled trial (COMBO)

    Science.gov (United States)

    Deveza, Leticia A; Wajon, Anne; Bennell, Kim L; Vicenzino, Bill; Hodges, Paul; Eyles, Jillian P; Jongs, Ray; Riordan, Edward A; Duong, Vicky; Min Oo, Win; O'Connell, Rachel; Meneses, Sarah R F

    2017-01-01

    Introduction Management of thumb base osteoarthritis (OA) using a combination of therapies is common in clinical practice; however, evidence for the efficacy of this approach is lacking. The aim of this study is to determine the effect of a combination of conservative therapies for the treatment of thumb base OA compared with an education control group. Methods and analysis This is a randomised, controlled, single-centre, two-arm superiority trial with 1:1 allocation ratio; with assessor and statistician blinded. Participants are blinded to the trial's hypothesis and to the interventions received by the opposite group. A total of 204 participants will be recruited from the community and randomised using a computer-generated schedule. The intervention group will receive education for joint protection and OA, a splint for the base of the thumb, hand exercises and topical diclofenac sodium 1% gel over 6 weeks. The control group will receive education for joint protection and OA alone. Main inclusion criteria are pain ≥40 mm (Visual Analogue Scale, 0–100) at the base of the thumb, impairment in hand function ≥6 (Functional Index for Hand Osteoarthritis, 0–30) and radiographic thumb base OA (Kellgren Lawrence grade ≥2). Participants currently receiving any of the intervention components will be excluded. Outcomes will be measured at 2, 6 and 12 weeks. The primary outcome is change in pain and hand function from baseline to 6 weeks. Other outcomes include changes in grip and pinch strength, quality of life, presence of joint swelling and tenderness, duration of joint stiffness, patient's global assessment and use of rescue medication. Analysis will be performed according to the intention-to-treat principle. Adverse events will be monitored throughout the study. Ethics and dissemination This protocol is approved by the local ethics committee (HREC/15/HAWKE/479). Dissemination will occur through presentations at international conferences and publication

  18. No bias of ignored bilaterality when analysing the revision risk of knee prostheses: Analysis of a population based sample of 44,590 patients with 55,298 knee prostheses from the national Swedish Knee Arthroplasty Register

    Directory of Open Access Journals (Sweden)

    Ranstam Jonas

    2003-02-01

    Full Text Available Abstract Background The current practice of the Swedish Knee Register is not to take into consideration if one or both knees in a patient are subject to surgery when evaluating risk of revision after arthroplasty. Risk calculations are typically done by statistical methods, such as Kaplan-Meier analyses and Cox's proportional hazards models, that are based on the assumption that observed events are independent, and this is rarely appreciated. The purpose of this study was to investigate if ignoring bilateral operations when using these methods biases the results. Methods The bias of not taking bilateral operations into account was investigated by statistically analysing 55 298 prostheses in 44 590 patients, undergoing knee arthroplasty surgery in Sweden during 1985–1999, using traditional proportional hazards analysis, which assumes that all observations are independent, and a shared gamma frailty model, which allows patients to contribute repeated observations. Results The effect of neglecting bilateral prostheses is minute, possibly because bilateral prosthesis failure is a rare event. Conclusion We conclude that the revision risk of knee prostheses in general can be analysed without consideration for subject dependency, at least in study populations with a relatively low proportion of subjects having experienced bilateral revisions.

  19. [Vismodegib Therapy for Periocular Basal Cell Carcinoma].

    Science.gov (United States)

    Keserü, M; Green, S; Dulz, S

    2017-01-01

    Background Basal cell carcinoma (BCC) is the commonest periorbital tumour. Mohs' micrographic surgery and secondary reconstruction is the therapeutic gold standard for periorbital BCC. In cases of inoperability for any reason, therapeutic alternatives are needed. Since the approval of vismodegib, an orally administered, targeted BCC therapy is available. Nevertheless there is little information on the use of vismodegib for periorbital BCC. Patients and Methods In a retrospective study, we analysed the data of 4 patients treated with vismodegib since 2014. The patients' mean age before starting therapy was 87 years. The mean maximum tumour diameter was 22.0 mm. Results The median follow-up was 17 months. The median treatment duration was 7.5 months. In 75 % of patients, complete clinical remission of BCC was achieved. In 25 % of patients, interim stabilisation of tumour growth was possible. The most common side effect of therapy was muscle spasm. Conclusion Vismodegib is an effective treatment option for patients with periorbital BCC, in whom surgical treatment is not possible for any reason.

  20. How Basal Ganglia Outputs Generate Behavior

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    Henry H. Yin

    2014-01-01

    Full Text Available The basal ganglia (BG are a collection of subcortical nuclei critical for voluntary behavior. According to the standard model, the output projections from the BG tonically inhibit downstream motor centers and prevent behavior. A pause in the BG output opens the gate for behavior, allowing the initiation of actions. Hypokinetic neurological symptoms, such as inability to initiate actions in Parkinson’s disease, are explained by excessively high firing rates of the BG output neurons. This model, widely taught in textbooks, is contradicted by recent electrophysiological results, which are reviewed here. In addition, I also introduce a new model, based on the insight that behavior is a product of closed loop negative feedback control using internal reference signals rather than sensorimotor transformations. The nervous system is shown to be a functional hierarchy comprising independent controllers occupying different levels, each level controlling specific variables derived from its perceptual inputs. The BG represent the level of transition control in this hierarchy, sending reference signals specifying the succession of body orientations and configurations. This new model not only explains the major symptoms in movement disorders but also generates a number of testable predictions.

  1. Full mouth rehabilitation with maxillary tooth supported and mandibular tooth and implant supported combination prostheses: a 4-year case report.

    Science.gov (United States)

    Pramod Kumar, A V; Vinni, T K; Mahesh, Mehul R

    2012-06-01

    The primary objectives of successful prosthetic rehabilitation are to provide function, esthetics and comfort to the patient. Combination prosthesis is one which is supported by both natural teeth and implant. The periodontal ligament and osseointegrated interface distribute force differently to the supporting bone. Therefore problems can develop when tooth and implants are combined in the same prosthesis. However, clinicians can apply biomechanical principles, to negate the deleterious leverages exerted by the fixed prosthesis by using non rigid components and to equalize the stress applied by the prosthesis on implant and teeth. A case of partially edentulous situation was rehabilitated successfully with a combination of prostheses. Maxillary arch was restored to function with crowns, fixed dental prosthesis and with an extra coronal castable attachment prosthesis and the mandibular arch with a combination of tooth and implant supported attachment prosthesis. The clinical and laboratory steps for the fabrication of these prostheses are explained in this report.

  2. Focal Electrical Stimulation of Major Ganglion Cell Types in the Primate Retina for the Design of Visual Prostheses

    OpenAIRE

    2013-01-01

    Electrical stimulation of retinal neurons with an advanced retinal prosthesis may eventually provide high-resolution artificial vision to the blind. However, the success of future prostheses depends on the ability to activate the major parallel visual pathways of the human visual system. Electrical stimulation of the five numerically dominant retinal ganglion cell types was investigated by simultaneous stimulation and recording in isolated peripheral primate (Macaca sp.) retina using multi-el...

  3. Determining the Marker Configuration and Modeling Technique to Optimize the Biomechanical Analysis of Running-Specific Prostheses

    Science.gov (United States)

    2012-03-01

    Prosthetics; 2005. 13. Nolan L. Carbon fibre prostheses and running in amputees: A review. Foot and Ankle Surgery 2008;14:125-9. 14. Gailey R...activity level may be insufficient guidelines for prescribing a stiffness category. A stiffer forefoot , wider c-curve, and thinner lay-up resulted... Surgery 2008;14:125-9. 14. Gailey R. Optimizing prosthetic running performance of the transtibial amputee. Proceedings of the Proceedings of the

  4. Aortic annulus eccentricity before and after transcatheter aortic valve implantation: Comparison of balloon-expandable and self-expanding prostheses

    Energy Technology Data Exchange (ETDEWEB)

    Schuhbaeck, Annika, E-mail: annika.schuhbaeck@uk-erlangen.de [Department of Cardiology, University of Erlangen, Erlangen (Germany); Weingartner, Christina [Department of Cardiology, University of Gießen, Giessen (Germany); Arnold, Martin; Schmid, Jasmin; Pflederer, Tobias; Marwan, Mohamed [Department of Cardiology, University of Erlangen, Erlangen (Germany); Rixe, Johannes; Nef, Holger [Department of Cardiology, University of Gießen, Giessen (Germany); Schneider, Christian [Department of Radiology, University of Gießen, Giessen (Germany); Lell, Michael; Uder, Michael [Department of Radiology, University of Erlangen, Erlangen (Germany); Ensminger, Stephan [Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen (Germany); Feyrer, Richard; Weyand, Michael [Department of Cardiothoracic Surgery, University of Erlangen, Erlangen (Germany); Achenbach, Stephan [Department of Cardiology, University of Erlangen, Erlangen (Germany)

    2015-07-15

    Highlights: • Post-implant geometry of catheter-based aortic valve prostheses is influenced by aortic valve calcification. • Balloon-expandable prostheses are more circular as compared to self-expanding prostheses. • The impact of post-implant geometry on valve function needs to be investigated. - Abstract: Introduction: The geometry of the aortic annulus and implanted transcatheter aortic valve prosthesis might influence valve function. We investigated the influence of valve type and aortic valve calcification on post-implant geometry of catheter-based aortic valve prostheses. Methods: Eighty consecutive patients with severe aortic valve stenosis (mean age 82 ± 6 years) underwent computed tomography before and after TAVI. Aortic annulus diameters were determined. Influence of prosthesis type and degree of aortic valve calcification on post-implant eccentricity were analysed. Results: Aortic annulus eccentricity was reduced in patients after TAVI (0.21 ± 0.06 vs. 0.08 ± 0.06, p < 0.0001). Post-TAVI eccentricity was significantly lower in 65 patients following implantation of a balloon-expandable prosthesis as compared to 15 patients who received a self-expanding prosthesis (0.06 ± 0.05 vs. 0.15 ± 0.07, p < 0.0001), even though the extent of aortic valve calcification was not different. After TAVI, patients with a higher calcium amount retained a significantly higher eccentricity compared to patients with lower amounts of calcium. Conclusions: Patients undergoing TAVI with a balloon-expandable prosthesis show a more circular shape of the implanted prosthesis as compared to patients with a self-expanding prosthesis. Eccentricity of the deployed prosthesis is affected by the extent of aortic valve calcification.

  5. Combining Vibrotactile Feedback with Volitional Myoelectric Control for Robotic Transtibial Prostheses

    Science.gov (United States)

    Chen, Baojun; Feng, Yanggang; Wang, Qining

    2016-01-01

    In recent years, the development of myoelectric control for robotic lower-limb prostheses makes it possible for amputee users to volitionally control prosthetic joints. However, the human-centered control loop is not closed due to the lack of sufficient feedback of prosthetic joint movement, and it may result in poor control performance. In this research, we propose a vibrotactile stimulation system to provide the feedback of ankle joint position, and validate the necessity of combining it with volitional myoelectric control to achieve improved control performance. The stimulation system is wearable and consists of six vibrators. Three of the vibrators are placed on the anterior side of the thigh and the other three on the posterior side of the thigh. To explore the potential of applying the proposed vibrotactile feedback system for prosthetic ankle control, eight able-bodied subjects and two transtibial amputee subjects (TT1 and TT2) were recruited in this research, and several experiments were designed to investigate subjects’ sensitivities to discrete and continuous vibration stimulations applied on the thigh. Then, we proposed a stimulation controller to produce different stimulation patterns according to current ankle angle. Amputee subjects were asked to control a virtual ankle displayed on the computer screen to reach different target ankle angles with a myoelectric controller, and control performances under different feedback conditions were compared. Experimental results indicated that subjects were more sensitive to stimulation position changes (identification accuracies were 96.39 ± 0.86, 91.11, and 93.89% for able-bodied subjects, TT1, and TT2, respectively) than stimulation amplitude changes (identification accuracies were 89.89 ± 2.40, 87.04, and 85.19% for able-bodied subjects, TT1, and TT2, respectively). Response times of able-bodied subjects, TT1, and TT2 to stimulation pattern changes were 0.47 ± 0.02 s, 0.53 s, and 0.48

  6. Combining vibrotactile feedback with volitional myoelectric control for robotic transtibial prostheses

    Directory of Open Access Journals (Sweden)

    Baojun Chen

    2016-08-01

    Full Text Available In recent years, the development of myoelectric control for robotic lower-limb prostheses makes it possible for amputee users to volitionally control prosthetic joints. However, the human-centered control loop is not closed due to the lack of sufficient feedback of prosthetic joint movement, and it may result in poor control performance. In this research, we propose a vibrotactile stimulation system to provide the feedback of ankle joint position, and validate the necessity of combining it with volitional myoelectric control to achieve improved control performance. The stimulation system is wearable and consists of six vibrators. Three of the vibrators are placed on the anterior side of the thigh and the other three on the posterior side of the thigh. To explore the potential of applying the proposed vibrotactile feedback system for prosthetic ankle control, eight able-bodied subjects and two transtibial amputee subjects (TT1 and TT2 were recruited in this research, and several experiments were designed to investigate subjects' sensitivities to discrete and continuous vibration stimulations applied on the thigh. Then, we proposed a stimulation controller to produce different stimulation patterns according to current ankle angle. Amputee subjects were asked to control a virtual ankle displayed on the computer screen to reach different target ankle angles with a myoelectric controller, and control performances under different feedback conditions were compared. Experimental results indicated that subjects were more sensitive to stimulation position changes (identification accuracies were 96.39pm0.86%, 91.11% and 93.89% for able-bodied subjects, TT1 and TT2, respectively than stimulation amplitude changes (identification accuracies were 89.89pm2.40%, 87.04% and 85.19% for able-bodied subjects, TT1 and TT2, respectively. Response times of able-bodied subjects, TT1 and TT2 to stimulation pattern changes were 0.47pm0.02s, 0.53s and 0.48s, respectively

  7. A 10-Year Clinical Evaluation of Resin-Bonded Fixed Dental Prostheses on Non-Prepared Teeth.

    Science.gov (United States)

    Piemjai, Morakot; Özcan, Mutlu; Garcia-Godoy, Franklin; Nakabayashi, Nobuo

    2016-06-01

    This study evaluated the conditions of the non-invasive resin-bonded fixed dental prostheses (FDP) and patient satisfaction up to 10 years of clinical function. A total of 23 patients who required fixed prostheses in the areas of mandibular anterior and premolar, and maxillary anterior region received resin-bonded restorations between 1999-2003. In 13 patients with 14 edentulous areas were restored with an adhesive pontic (natural tooth, acrylic and porcelain). Two indirect proximal veneers using resin composite were placed in each space in 10 patients having 13 edentulous spaces. All prostheses were bonded to the proximal surface of adjacent teeth using resin cement based on 4-META/MMA-TBB. No debonding of proximal veneers but 4 pontic debonding was observed which were rebonded and remained functional until final follow up. The abutments in pontic and proximal veneer groups were free of caries and hypersensitivity. Periodontal health was improved after treatment and was maintained for 10 years except for 4 abutments that still showed some bleeding on probing. Non-invasive resin-bonded FDPs are simple, pain-free, less costly treatment procedures that could provide acceptable clinical longevity with high patient satisfaction.

  8. A Prognostic Dilemma of Basal Cell Carcinoma with Intravascular Invasion

    Science.gov (United States)

    Niumsawatt, Vachara; Castley, Andrew

    2016-01-01

    Summary: Basal cell carcinoma is the most common malignancy; however, it very rarely metastasizes. Despite the low mortality caused by this cancer, once it spreads, it has dim prognosis. We report a case of basal cell carcinoma with rare intravascular invasion and review the literature for risk factors and management of metastasis.

  9. Mineralizing angiopathy with basal ganglia stroke in an infant

    Directory of Open Access Journals (Sweden)

    Puneet Jain

    2015-01-01

    Full Text Available Basal ganglia stroke is known following trivial head trauma. Recently a distinct clinic-radiological entity termed ′mineralizing angiopathy′ was described. We report an infant who developed basal ganglia stroke following trivial fall. His clinic-radiological features are described.

  10. Vismodegib resistance in basal cell carcinoma: not a smooth fit.

    Science.gov (United States)

    Ridky, Todd W; Cotsarelis, George

    2015-03-09

    In this issue of Cancer Cell, two complementary papers by Atwood and colleagues and Sharpe and colleagues show that basal cell carcinomas resistant to the Smoothened (SMO) inhibitor vismodegib frequently harbor SMO mutations that limit drug binding, with mutations at some sites also increasing basal SMO activity.

  11. Evolution and diversification of the basal transcription machinery.

    Science.gov (United States)

    Duttke, Sascha H C

    2015-03-01

    Transcription initiation was once thought to be regulated primarily by sequence-specific transcription factors with the basal transcription machinery being largely invariant. Gradually it became apparent that the basal transcription machinery greatly diversified during evolution and new studies now demonstrate that diversification of the TATA-binding protein (TBP) family yielded specialized and largely independent transcription systems.

  12. Basal ganglia - thalamus and the crowning enigma

    Directory of Open Access Journals (Sweden)

    Marianela eGarcia-Munoz

    2015-11-01

    Full Text Available When Hubel (1982 referred to layer 1 of primary visual cortex as …a ‘crowning mystery’ to keep area-17 physiologists busy for years to come... he could have been talking about any cortical area. In the 80’s and 90’s there were no methods to examine this neuropile on the surface of the cortex: a tangled web of axons and dendrites from a variety of different places with unknown specificities and doubtful connections to the cortical output neurons some hundreds of microns below. Recently, three changes have made the crowning enigma less of an impossible mission: the clear presence of neurons in layer 1 (L1, the active conduction of voltage along apical dendrites and optogenetic methods that might allow us to look at one source of input at a time. For all of those reasons alone, it seems it is time to take seriously the function of L1. The functional properties of this layer will need to wait for more experiments but already L1 cells are GAD67 positive, i.e., inhibitory! They could reverse the sign of the thalamic glutamate (GLU input for the entire cortex. It is at least possible that in the near future normal activity of individual sources of L1 could be detected using genetic tools. We are at the outset of important times in the exploration of thalamic functions and perhaps the solution to the crowning enigma is within sight. Our review looks forward to that solution from the solid basis of the anatomy of the basal ganglia output to motor thalamus. We will focus on L1, its afferents, intrinsic neurons and its influence on responses of pyramidal neurons in layers 2/3 and 5. Since L1 is present in the whole cortex we will provide a general overview considering evidence mainly from the somatosensory cortex before focusing on motor cortex.

  13. The field size matters: low dose external beam radiotherapy for thumb carpometacarpal osteoarthritis : Importance of field size.

    Science.gov (United States)

    Kaltenborn, Alexander; Bulling, Elke; Nitsche, Mirko; Carl, Ulrich Martin; Hermann, Robert Michael

    2016-08-01

    The purpose of this work was to evaluate the efficacy of low-dose radiotherapy (RT) for thumb carpometacarpal osteoarthritis (rhizarthrosis). The responses of 84 patients (n = 101 joints) were analyzed 3 months after therapy (n = 65) and at 12 months (n = 27). Patients were treated with 6 fractions of 1 Gy, two times a week, with a linear accelerator. At the end of therapy, about 70 % of patients reported a response (partial remission or complete remission), 3 months later about 60 %, and 1 year after treatment 70 %. In univariate regression analysis, higher patient age and field size greater than 6 × 4 cm were associated with response to treatment, while initial increase of pain under treatment was predictive for treatment failure. Duration of RT series (more than 18 days), gender, time of symptoms before RT, stress pain or rest pain, or prior ortheses use, injections, or surgery of the joint were not associated with treatment efficacy. In multivariate regression analysis, only field size and initial pain increase were highly correlated with treatment outcome. In conclusion, RT represents a useful treatment option for patients suffering from carpometacarpal osteoarthritis. In contrast to other benign indications, a larger field size (>6 × 4 cm) seems to be more effective than smaller fields and should be evaluated in further prospective studies.

  14. Two thumbs and one index: A comparison of manual coordination in touch-typing and mobile-typing.

    Science.gov (United States)

    Cerni, Tania; Longcamp, Marieke; Job, Remo

    2016-06-01

    It has been extensively demonstrated that in touch-typing, manual alternation is performed faster than manual repetition (see i.e. Rumelhart & Norman, 1982), due to parallel activation of successive keystrokes. In this experiment, we tested whether the manual coordination patterns typical of touch-typing can be observed in mobile-typing. We recruited skilled touch-typists and divided them into two groups depending on their typing habits on the mobile device. The "one-hand" group typed with one index finger on the mobile, and therefore produced words exclusively through manual repetition. The "two-hands" group used two thumbs, and therefore produced words through a combination of mobile-typing repetitions and alternations. The two groups were tested in a typing to dictation task with both a standard keyboard and a mobile keyboard. Results showed that manual alternation and manual repetition patterns are similar in touch-typing and in mobile-typing. For the "two-hands" group, the mean interkeystroke intervals (IKIs) for touch-typing decreased as manual alterations in words increased in both touch- and mobile-typing. The "one-hand" group showed an opposite pattern in mobile-typing. Bigram frequency was correlated with IKIs per bigrams in both tasks and groups, but the correlation for the "one-hand" group in mobile-typing was different. Our results suggest that manual coordination processes are the same in touch-typing and in mobile-typing despite different effectors, provided that both hands are used to type.

  15. Structural and regulatory elements of HCV NS5B polymerase--β-loop and C-terminal tail--are required for activity of allosteric thumb site II inhibitors.

    Directory of Open Access Journals (Sweden)

    Sarah E Boyce

    Full Text Available Elucidation of the mechanism of action of the HCV NS5B polymerase thumb site II inhibitors has presented a challenge. Current opinion holds that these allosteric inhibitors stabilize the closed, inactive enzyme conformation, but how this inhibition is accomplished mechanistically is not well understood. Here, using a panel of NS5B proteins with mutations in key regulatory motifs of NS5B--the C-terminal tail and β-loop--in conjunction with a diverse set of NS5B allosteric inhibitors, we show that thumb site II inhibitors possess a distinct mechanism of action. A combination of enzyme activity studies and direct binding assays reveals that these inhibitors require both regulatory elements to maintain the polymerase inhibitory activity. Removal of either element has little impact on the binding affinity of thumb site II inhibitors, but significantly reduces their potency. NS5B in complex with a thumb site II inhibitor displays a characteristic melting profile that suggests stabilization not only of the thumb domain but also the whole polymerase. Successive truncations of the C-terminal tail and/or removal of the β-loop lead to progressive destabilization of the protein. Furthermore, the thermal unfolding transitions characteristic for thumb site II inhibitor-NS5B complex are absent in the inhibitor-bound constructs in which interactions between C-terminal tail and β-loop are abolished, pointing to the pivotal role of both regulatory elements in communication between domains. Taken together, a comprehensive picture of inhibition by compounds binding to thumb site II emerges: inhibitor binding provides stabilization of the entire polymerase in an inactive, closed conformation, propagated via coupled interactions between the C-terminal tail and β-loop.

  16. Automated generation of IMRT treatment plans for prostate cancer patients with metal hip prostheses: Comparison of different planning strategies

    Energy Technology Data Exchange (ETDEWEB)

    Voet, Peter W. J.; Dirkx, Maarten L. P.; Breedveld, Sebastiaan; Heijmen, Ben J. M. [Erasmus MC - Daniel den Hoed Cancer Center, Department of Radiation Oncology, Groene Hilledijk 301, 3075EA Rotterdam (Netherlands)

    2013-07-15

    Purpose: To compare IMRT planning strategies for prostate cancer patients with metal hip prostheses.Methods: All plans were generated fully automatically (i.e., no human trial-and-error interactions) using iCycle, the authors' in-house developed algorithm for multicriterial selection of beam angles and optimization of fluence profiles, allowing objective comparison of planning strategies. For 18 prostate cancer patients (eight with bilateral hip prostheses, ten with a right-sided unilateral prosthesis), two planning strategies were evaluated: (i) full exclusion of beams containing beamlets that would deliver dose to the target after passing a prosthesis (IMRT{sub remove}) and (ii) exclusion of those beamlets only (IMRT{sub cut}). Plans with optimized coplanar and noncoplanar beam arrangements were generated. Differences in PTV coverage and sparing of organs at risk (OARs) were quantified. The impact of beam number on plan quality was evaluated.Results: Especially for patients with bilateral hip prostheses, IMRT{sub cut} significantly improved rectum and bladder sparing compared to IMRT{sub remove}. For 9-beam coplanar plans, rectum V{sub 60Gy} reduced by 17.5%{+-} 15.0% (maximum 37.4%, p= 0.036) and rectum D{sub mean} by 9.4%{+-} 7.8% (maximum 19.8%, p= 0.036). Further improvements in OAR sparing were achievable by using noncoplanar beam setups, reducing rectum V{sub 60Gy} by another 4.6%{+-} 4.9% (p= 0.012) for noncoplanar 9-beam IMRT{sub cut} plans. Large reductions in rectum dose delivery were also observed when increasing the number of beam directions in the plans. For bilateral implants, the rectum V{sub 60Gy} was 37.3%{+-} 12.1% for coplanar 7-beam plans and reduced on average by 13.5% (maximum 30.1%, p= 0.012) for 15 directions.Conclusions: iCycle was able to automatically generate high quality plans for prostate cancer patients with prostheses. Excluding only beamlets that passed through the prostheses (IMRT{sub cut} strategy) significantly improved

  17. Aesthetic life-like finger and hand prostheses: prosthetic prescription and factors influencing choices.

    Science.gov (United States)

    Leow, M E; Pereira, B P; Kour, A K; Pho, R W

    1997-11-01

    This paper reviews the authors' experience with fitting life-like finger and hand prosthesis. The methodology and technical considerations in producing these prostheses, the prosthetic prescription according to the level of amputation and the challenges faced with each level are discussed. In cases where the amputation is sufficiently distal, a thimble prosthesis has been used. This is compared to fitting a full-length finger prosthesis. Besides allowing free range of motion of the proximal finger joints which would otherwise be covered and restricted with fitting a finger prosthesis, a thimble prosthesis minimises skin coverage for optimal sensibility and is easier to don and doff. In cases of amputations where a digital fitting is precluded, a partial or a total hand is prescribed. A comparison between fitting a finger, a partial hand prosthesis and a total hand prosthesis is also discussed. Cases of a digital, transcarpal and a more proximal transmetacarpal amputations are relatively easy to fit with a prosthesis. An incomplete transmetacarpal amputation where much of the breadth of the hand is preserved presents a difficult challenge as it necessitates fitting with a partial hand prosthesis. Besides the need to cover a large area of the intact skin and the associated problems with reduced sensibility and stump perspiration, a partial hand prosthesis is difficult to don and doff.

  18. Design of Complete Dentures by Adopting CAD Developed for Fixed Prostheses.

    Science.gov (United States)

    Li, Yanfeng; Han, Weili; Cao, Jing; Iv, Yuan; Zhang, Yue; Han, Yishi; Shen, Yi; Ma, Zheng; Liu, Huanyue

    2016-11-21

    The demand for complete dentures is expected to increase worldwide, but complete dentures are mainly designed and fabricated manually involving a broad series of clinical and laboratory procedures. Therefore, the quality of complete dentures largely depends on the skills of the dentist and technician, leading to difficulty in quality control. Computer-aided design and manufacturing (CAD/CAM) has been used to design and fabricate various dental restorations including dental inlays, veneers, crowns, partial crowns, and fixed partial dentures (FPDs). It has been envisioned that the application of CAD/CAM technology could reduce intensive clinical/laboratory work for the fabrication of complete dentures; however, CAD/CAM is seldom used to fabricate complete dentures due to the lack of suitable CAD software to design virtual complete dentures although the CAM techniques are in a much advanced stage. Here we report the successful design of virtual complete dentures using CAD software of 3Shape Dental System 2012, which was developed for designing fixed prostheses instead of complete dentures. Our results demonstrated that complete dentures could be successfully designed by the combination of two modeling processes, single coping and full anatomical FPD, available in the 3Shape Dental System 2012.

  19. Enhancing the soft tissue seal around intraosseous transcutaneous amputation prostheses using silanized fibronectin titanium alloy

    Energy Technology Data Exchange (ETDEWEB)

    Chimutengwende-Gordon, M; Pendegrass, C; Blunn, G, E-mail: mukai.cg@mac.com [Centre for Biomedical Engineering, Institute of Orthopaedics and Musculoskeletal Science, University College London, Brockley Hill, Stanmore, HA7 4LP (United Kingdom)

    2011-04-15

    The success of intraosseous transcutaneous amputation prostheses (ITAP) relies on achieving a tight seal between the soft tissues and the implant in order to avoid infection. Fibronectin (Fn) may be silanized onto titanium alloy (Ti-6Al-4V) in order to promote soft-tissue attachment. The silanization process includes passivation with sulphuric acid, which alters surface characteristics. This study aimed to improve in vitro fibroblast adhesion to silanized fibronectin (SiFn) titanium alloy by omitting the passivation stage. Additionally, the study assessed the effects of SiFn on in vivo dermal attachment, comparing the results with adsorbed Fn, hydroxyapatite (HA), Fn adsorbed onto HA (HAFn) and uncoated controls. Surface topography was assessed using scanning electron microscopy, profilometry and contact angle measurement. Anti-vinculin antibodies were used to immunolocalize fibroblast adhesion sites. A histological assessment of soft-tissue attachment and cell alignment relative to implants in an in vivo ovine model was performed. Passivation resulted in rougher, more hydrophobic, microcracked surfaces and was associated with poorer fibroblast adhesion than unpassivated controls. SiFn and HAFn surfaces resulted in more favourable cell alignment in vivo, implying that dermal attachment was enhanced. These results suggest that SiFn and HAFn surfaces could be useful in optimizing the soft tissue seal around ITAP.

  20. Myoelectric forearm prostheses: State of the art from a user-centered perspective

    Directory of Open Access Journals (Sweden)

    Bart Peerdeman, MSc

    2011-07-01

    Full Text Available User acceptance of myoelectric forearm prostheses is currently low. Awkward control, lack of feedback, and difficult training are cited as primary reasons. Recently, researchers have focused on exploiting the new possibilities offered by advancements in prosthetic technology. Alternatively, researchers could focus on prosthesis acceptance by developing functional requirements based on activities users are likely to perform. In this article, we describe the process of determining such requirements and then the application of these requirements to evaluating the state of the art in myoelectric forearm prosthesis research. As part of a needs assessment, a workshop was organized involving clinicians (representing end users, academics, and engineers. The resulting needs included an increased number of functions, lower reaction and execution times, and intuitiveness of both control and feedback systems. Reviewing the state of the art of research in the main prosthetic subsystems (electromyographic [EMG] sensing, control, and feedback showed that modern research prototypes only partly fulfill the requirements. We found that focus should be on validating EMG-sensing results with patients, improving simultaneous control of wrist movements and grasps, deriving optimal parameters for force and position feedback, and taking into account the psychophysical aspects of feedback, such as intensity perception and spatial acuity.

  1. FACTORS RELATED TO ORAL CANDIDIASIS IN ELDERLY USERS AND NON-USERS OF REMOVABLE DENTAL PROSTHESES.

    Science.gov (United States)

    Bianchi, Cyra Maria Pires de Carvalho; Bianchi, Hélcio Aparecido; Tadano, Tomoko; Paula, Claudete Rodrigues de; Hoffmann-Santos, Hugo Dias; Leite Jr, Diniz Pereira; Hahn, Rosane Christine

    2016-01-01

    This study examined the association between oral candidiasis in elderly users and nonusers of prosthesis and its predisposing factors. To this end, we performed a cross-sectional study where saliva samples from 48 patients were collected they used prosthesis and 43 patients (control group) who did not use. Among the 91 patients, Candida spp were isolated in 40 (83.3%) who used prosthesis and in 23 (53.5%) in the control group. A statistically significant association was determined between the two groups, the isolation of yeasts and dental prosthesis (p oral candidiasis (n = 24), 83.3% (n = 20) belonged to the group that wore dentures, while only 16.7% (n = 4) belonged to the control group. Elderly patients with diabetes had 4.4 times higher estimated risk of developing oral candidiasis when compared with individuals without this condition. There was no statistically significant association between being user prostheses and have diabetes with the onset of candidiasis. No statistically significant association was determined between xerostomia, use of prosthesis and oral candidiasis. The use of prosthetics and poor oral hygiene in elderly patients predisposes to the development of oral candidiasis.

  2. Mechanical compatibility of sol-gel annealing with titanium for orthopaedic prostheses.

    Science.gov (United States)

    Greer, Andrew I M; Lim, Teoh S; Brydone, Alistair S; Gadegaard, Nikolaj

    2016-01-01

    Sol-gel processing is an attractive method for large-scale surface coating due to its facile and inexpensive preparation, even with the inclusion of precision nanotopographies. These are desirable traits for metal orthopaedic prostheses where ceramic coatings are known to be osteoinductive and the effects may be amplified through nanotexturing. However there are a few concerns associated with the application of sol-gel technology to orthopaedics. Primarily, the annealing stage required to transform the sol-gel into a ceramic may compromise the physical integrity of the underlying metal. Secondly, loose particles on medical implants can be carcinogenic and cause inflammation so the coating needs to be strongly bonded to the implant. These concerns are addressed in this paper. Titanium, the dominant material for orthopaedics at present, is examined before and after sol-gel processing for changes in hardness and flexural modulus. Wear resistance, bending and pull tests are also performed to evaluate the ceramic coating. The findings suggest that sol-gel coatings will be compatible with titanium implants for an optimum temperature of 500 °C.

  3. Finite element modelling of shock-induced damages on ceramic hip prostheses

    CERN Document Server

    Uribe, Juliana; Geringer, Jean; 10.5402/2011/121486

    2012-01-01

    The aim of this work was to simulate the behaviour of hip prostheses under mechanical shocks. When hip joint is replaced by prosthesis, during the swing phase of the leg, a microseparation between the prosthetic head and the cup could occur. Two different sizes of femoral heads were studied: 28 and 32 mm diameter, made, respectively, in alumina and zirconia. The shock-induced stress was determined numerically using finite element analysis (FEA), Abaqus software. The influence of inclination, force, material, and microseparation was studied. In addition, an algorithm was developed from a probabilistic model, Todinov's approach, to predict lifetime of head and cup. Simulations showed maximum tensile stresses were reached on the cup's surfaces near to rim. The worst case was the cup-head mounted at 30^{\\circ}. All simulations and tests showed bulk zirconia had a greater resistance to shocks than bulk alumina. The probability of failure could be bigger than 0.9 when a porosity greater than 0.7% vol. is present in...

  4. FACTORS RELATED TO ORAL CANDIDIASIS IN ELDERLY USERS AND NON-USERS OF REMOVABLE DENTAL PROSTHESES

    Directory of Open Access Journals (Sweden)

    Cyra Maria Pires de Carvalho BIANCHI

    2016-01-01

    Full Text Available This study examined the association between oral candidiasis in elderly users and nonusers of prosthesis and its predisposing factors. To this end, we performed a cross-sectional study where saliva samples from 48 patients were collected they used prosthesis and 43 patients (control group who did not use. Among the 91 patients, Candida spp were isolated in 40 (83.3% who used prosthesis and in 23 (53.5% in the control group. A statistically significant association was determined between the two groups, the isolation of yeasts and dental prosthesis (p < 0.05, OR = 4.3. The most common etiological agent was Candida albicans (37 isolates, with 23 (62.2% in the denture group and 14 (37.8% (control group. Among patients who presented clinical manifestations of oral candidiasis (n = 24, 83.3% (n = 20 belonged to the group that wore dentures, while only 16.7% (n = 4 belonged to the control group. Elderly patients with diabetes had 4.4 times higher estimated risk of developing oral candidiasis when compared with individuals without this condition. There was no statistically significant association between being user prostheses and have diabetes with the onset of candidiasis. No statistically significant association was determined between xerostomia, use of prosthesis and oral candidiasis. The use of prosthetics and poor oral hygiene in elderly patients predisposes to the development of oral candidiasis.

  5. Computer simulation on fatigue behavior of cemented hip prostheses: a physiological model.

    Science.gov (United States)

    Hung, Jui-Pin; Chen, Jian-Horng; Chiang, Hsiu-Lu; Wu, James Shih-Shyn

    2004-11-01

    This paper is concerned with the investigation on the fatigue failure of implant fixation by numerical approaches. A computer algorithm based on finite element analysis and continuum damage mechanics was proposed to quantify the fatigue damage rate of cement mantle under physiological conditions. In examining the interfacial debonding effect, the interface elements were introduced at cement-stem interfaces and calibrated with the increase of loading cycles. Current results reveal that the major sites for failure initiation are in the proximal anterior-medial regions and at the distal prosthesis tip, which clearly demonstrate the same failure scenario as observed in clinical studies. Such fatigue failures not only result in the corruption of cement-stem interfaces, but also greatly affect the cement stress distribution and the damage rate in subsequent loading cycles. Another significant result is that the predicted damage rate increases steadily with gait cycles. This trend in damage development is consistent with the findings obtained from fatigue tests available in literature. It is anticipated that presented methodology can serve as a pre-clinical validation of cemented hip prostheses.

  6. Evaluating the Surface Topography of Pyrolytic Carbon Finger Prostheses through Measurement of Various Roughness Parameters

    Directory of Open Access Journals (Sweden)

    Andrew Naylor

    2016-04-01

    Full Text Available The articulating surfaces of four different sizes of unused pyrolytic carbon proximal interphalangeal prostheses (PIP were evaluated though measuring several topographical parameters using a white light interferometer: average roughness (Sa; root mean-square roughness (Sq; skewness (Ssk; and kurtosis (Sku. The radii of the articulating surfaces were measured using a coordinate measuring machine, and were found to be: 2.5, 3.3, 4.2 and 4.7 mm for proximal, and 4.0, 5.1, 5.6 and 6.3 mm for medial components. ANOVA was used to assess the relationship between the component radii and each roughness parameter. Sa, Sq and Ssk correlated negatively with radius (p = 0.001, 0.001, 0.023, whilst Sku correlated positively with radius (p = 0.03. Ergo, the surfaces with the largest radii possessed the better topographical characteristics: low roughness, negative skewness, high kurtosis. Conversely, the surfaces with the smallest radii had poorer topographical characteristics.

  7. Evaluating the Surface Topography of Pyrolytic Carbon Finger Prostheses through Measurement of Various Roughness Parameters.

    Science.gov (United States)

    Naylor, Andrew; Talwalkar, Sumedh C; Trail, Ian A; Joyce, Thomas J

    2016-01-01

    The articulating surfaces of four different sizes of unused pyrolytic carbon proximal interphalangeal prostheses (PIP) were evaluated though measuring several topographical parameters using a white light interferometer: average roughness (Sa); root mean-square roughness (Sq); skewness (Ssk); and kurtosis (Sku). The radii of the articulating surfaces were measured using a coordinate measuring machine, and were found to be: 2.5, 3.3, 4.2 and 4.7 mm for proximal, and 4.0, 5.1, 5.6 and 6.3 mm for medial components. ANOVA was used to assess the relationship between the component radii and each roughness parameter. Sa, Sq and Ssk correlated negatively with radius (p = 0.001, 0.001, 0.023), whilst Sku correlated positively with radius (p = 0.03). Ergo, the surfaces with the largest radii possessed the better topographical characteristics: low roughness, negative skewness, high kurtosis. Conversely, the surfaces with the smallest radii had poorer topographical characteristics.

  8. Principles and experimentation of wrist prostheses of the universal joint type.

    Science.gov (United States)

    Kapandji, I A

    1982-01-01

    The till now wrist prosthesis have a poor rotatory stability either they are flexible or rigid; specially the spheric ones, they are unable, from their very conception, to transmit the pronation-supination; the condylar ones have an incomplete stability because of their insufficient embedding. The prono-supination transmission needs a "universal joint" prosthesis, whose sellar surfaces are deeply embedded; so, it is possible to get in the same time firm stability and normal ranges of motion. The articular components, crescent roll shaped, are chained each other in perpendicularly plans and fixed in the radius and in the carpus-metacarpus. This is the mono-articular prosthesis, radio-carpal, type A. With an ulna piece, articulated with the radial one by a spherical pivot, we have a bi-articular prosthesis, type B, including the lower radio-ulnar joint: so we have the true total wrist prosthesis. Experimented on cadaveric specimens, these two prostheses, inserted by dorsal approach, have physiologic ranges of motion and absolute rotatory stability. Further studies may define the best dimensions of the prosthesis according to individual variations and ancillary tools set, before beginning the clinical experimentation.

  9. Effect of different stapes prostheses on the passive vibration of the basilar membrane.

    Science.gov (United States)

    Kwacz, Monika; Marek, Piotr; Borkowski, Paweł; Gambin, Wiktor

    2014-04-01

    The effect of different stapes prostheses on the basilar membrane (BM) motion was determined. To that end, a three dimensional finite element (FE) model of the passive human cochlea was developed. Passive responses of the BM were found based on coupled fluid-structure interactions between the cochlear solid structures and the scala fluids. The passive BM vibrations in normal (healthy) cochlea were compared with vibrations in the cochlea in which a 0.4-mm piston or a proposed new type of prosthesis was implanted. The proposed chamber prosthesis was not experimentally implanted, but only numerically simulated. Design of the new chamber stapes prosthesis is presented for the first time in this paper. The simulation results showed 10-20 dB decrease in BM displacement amplitude in the case of the piston. In contrast, the BM responses in the cochlea with the new prosthesis are higher with respect to the healthy ear. The results obtained in this study are promising for further research to optimize the design of the new chamber stapes prosthesis.

  10. Wettability, water sorption and water solubility of seven silicone elastomers used for maxillofacial prostheses.

    Science.gov (United States)

    Hulterström, Anna Karin; Berglund, Anders; Ruyter, I Eystein

    2008-01-01

    The wettability, water sorption and solubility of silicone elastomers used for maxillofacial prostheses were studied. The hypothesis was, that a material that has absorbed water would show an increase in the wettability and thus also the surface free energy of the material. Seven silicone elastomers, both addition- and condensation type polymers, were included. Five specimens of each material were subjected to treatment according to ISO standards 1567:1999 and 10477: 2004 for water sorption and solubility. The volumes of the specimens were measured according to Archimedes principle. The contact angle was measured with a contact angle goniometer at various stages of the sorption/solubility test. Wettability changed over the test period, but not according to theory. The addition type silicones showed little or no sorption and solubility, but two of the condensation type polymers tested had a significant sorption and solubility. This study showed that condensation type polymers may show too large volumetric changes when exposed to fluids, and therefore should no longer be used in prosthetic devices. The results of this study also suggests that it might be of interest to test sorption and solubility of materials that are to be implanted, since most of the materials had some solubility.

  11. Total alloplastic temporomandibular joint reconstruction using Biomet stock prostheses: the University of Florida experience.

    Science.gov (United States)

    Sanovich, R; Mehta, U; Abramowicz, S; Widmer, C; Dolwick, M F

    2014-09-01

    The purpose of this study was to report the subjective and objective outcomes of temporomandibular joint (TMJ) replacement with Biomet stock prostheses at a single institution in Florida. In this retrospective study, patients who underwent TMJ replacement using a Biomet stock prosthesis from 2005 to 2012 were analyzed. Subjective (pain, diet) and objective (maximal incisal opening) information was obtained. In addition, a quality of life measure was obtained pre- and postoperatively. Significance was set at Biomet stock prosthesis were eligible for the study. Maximal incisal opening improved from 26.1mm preoperatively to a mean of 34.4mm postoperatively. The pain score decreased from 7.9 preoperatively to a mean of 3.8 postoperatively. Diet restriction decreased from 6.8 preoperatively to a mean of 3.5 postoperatively. Quality of life improved from a median of 4 preoperatively to a postoperative median of 2. Four implants were removed/replaced because of heterotopic bone formation, infection, and/or loose hardware. Follow-up ranged from 6 to 83 months. Overall, TMJ reconstruction using the Biomet stock joint is effective and safe in this patient population.

  12. Post-operative hemimaxillectomy rehabilitation using prostheses supported by zygoma implants and remaining natural teeth

    Directory of Open Access Journals (Sweden)

    Xing Zhou Qu

    Full Text Available OBJECTIVES: This study aimed to evaluate the stability of prostheses supported by zygoma implants and remaining teeth for subjects who had undergone hemi-maxillectomy. METHODS: Ten patients were included in the study. Oral rehabilitation was performed using a temporary prosthesis that was supported by remaining teeth for the first three months. Then, a zygoma implant was placed to provide support for a final prosthesis in addition to the remaining teeth. Each prosthesis was tailor-made according to biomechanical three-dimensional finite element analysis results. The patients were assessed using the prosthesis functioning scale of the Memorial Sloan-Kettering Cancer Center. In addition, retention and bite force were recorded for both the temporary prosthesis and the final prosthesis. RESULTS: The mean bite force of the prosthetic first molar was increased to 69.2 N. The mean retentive force increased to 13.5 N after zygoma implant insertion. The bite force on the prosthetic first molar was improved to 229.3 N. CONCLUSION: Bite force increased significantly with the support of a zygoma implant. The use of zygoma implants in the restoration of maxillary defects improved functional outcome and patient satisfaction.

  13. Influence of malalignment on socket reaction moments during gait in amputees with transtibial prostheses.

    Science.gov (United States)

    Boone, David A; Kobayashi, Toshiki; Chou, Teri G; Arabian, Adam K; Coleman, Kim L; Orendurff, Michael S; Zhang, Ming

    2013-04-01

    Alignment - the process and measured orientation of the prosthetic socket relative to the foot - is important for proper function of a transtibial prosthesis. Prosthetic alignment is performed by prosthetists using visual gait observation and amputees' feedback. The aim of this study was to investigate the effect of transtibial prosthesis malalignment on the moments measured at the base of the socket: the socket reaction moments. Eleven subjects with transtibial amputation were recruited from the community. An instrumented prosthesis alignment component was used to measure socket reaction moments during ambulation under 17 alignment conditions, including nominally aligned using conventional clinical methods, and angle perturbations of 3° and 6° (flexion, extension, abduction, and adduction) and translation perturbations of 5mm and 10mm (anterior, posterior, lateral, and medial) referenced from the nominal alignment. Coronal alignment perturbations caused systematic changes in the coronal socket reaction moments. All angle and translation perturbations revealed statistically significant differences on coronal socket reaction moments compared to the nominal alignment at 30% and 75% of stance phase (Psocket reaction moments was not as responsive as that of the coronal perturbations. The sagittal angle and translation perturbations of the socket led to statistically significant changes in minimum moment, maximum moment, and moments at 45% of stance phase in the sagittal plane. Therefore, malalignment affected the socket reaction moments in amputees with transtibial prostheses.

  14. Stance phase mechanical characterization of transtibial prostheses distal to the socket: A review

    Directory of Open Access Journals (Sweden)

    Matthew J. Major, PhD

    2012-08-01

    Full Text Available Achieving the required functionality of a transtibial prosthesis during the stance phase of gait (e.g., shock absorption, close to normal roll-over characteristics, and smooth transition into swing depends on the Amputee Independent Prosthesis Properties (AIPPs, defined here as the mechanical properties of the prosthesis that directly influence the performance of the amputee. Accordingly, if research studies are to advance the design of prostheses to achieve improved user performance, AIPPs must be a primary consideration. However, the majority of reported studies can be categorized as either human performance testing of commercial prosthetic components or AIPP characterization; only in a few notable cases have studies combined these two approaches. Moreover, very little consistency exists in the current methods used for AIPP characterization, thus making comparisons between the results of such studies very difficult. This article introduces a framework for studying prosthesis design, which includes AIPP characterization, human performance and/or gait simulation studies, and detailed design. This framework provides a structure for reviewing previous approaches to AIPP characterization, discussing both their merits and shortcomings and their use in previous experimental and simulation studies. For the purposes of this review, stance phase AIPP models have been categorized as either lumped parameter or roll-over shape based.

  15. Thermal time constant: optimising the skin temperature predictive modelling in lower limb prostheses using Gaussian processes

    Science.gov (United States)

    Buis, Arjan

    2016-01-01

    Elevated skin temperature at the body/device interface of lower-limb prostheses is one of the major factors that affect tissue health. The heat dissipation in prosthetic sockets is greatly influenced by the thermal conductive properties of the hard socket and liner material employed. However, monitoring of the interface temperature at skin level in lower-limb prosthesis is notoriously complicated. This is due to the flexible nature of the interface liners used which requires consistent positioning of sensors during donning and doffing. Predicting the residual limb temperature by monitoring the temperature between socket and liner rather than skin and liner could be an important step in alleviating complaints on increased temperature and perspiration in prosthetic sockets. To predict the residual limb temperature, a machine learning algorithm – Gaussian processes is employed, which utilizes the thermal time constant values of commonly used socket and liner materials. This Letter highlights the relevance of thermal time constant of prosthetic materials in Gaussian processes technique which would be useful in addressing the challenge of non-invasively monitoring the residual limb skin temperature. With the introduction of thermal time constant, the model can be optimised and generalised for a given prosthetic setup, thereby making the predictions more reliable. PMID:27695626

  16. Shape modifications of porous hydroxyapatite prostheses to improve rigid implant fixation: Experience in 12 cases

    Science.gov (United States)

    Rienzo, Alessandro Di; Iacoangeli, Maurizio; di Somma, Lucia G. M.; Alvaro, Lorenzo; Nocchi, Niccolò; Scerrati, Massimo

    2012-01-01

    Background: Various methods of fixation have been described for custom made hydroxyapatite cranial implants. Their poor malleability limits most of the common used fixation techniques because of the high risk of cranioplasty's fracturing or higher exposure to infections. We present our experience with a new fixation technique, based on an appositely premodified hydroxyapatite implants. Methods: In a 2-year time period, 12 patients underwent cranioplasty by a modified custom made porous hydroxyapatite implant. Once the three-dimensional computer model of the prostheses was performed, three semicircular extensions placed at strategic positions were drawn and the final prosthesis was realized. At surgery, holes fitting the extensions were drilled into the skull borders and the implant was easily embedded inside the defect. Small titanium meshes overlying the extensions were fixed by screws to the surrounding bone. Results: A minimal increase of operative times was recorded, with drilling and fixation requiring additional 30 and 15 minutes, respectively. Optimal contact between cranioplasty and skull borders was always observed at control computed tomography (CT) scans. Permanent rigid fixation was obtained in all cases, with good functional and aesthetic results at follow-up. Conclusions: Modifications of hydroxyapatite implants are obtained without additional costs. The minimal increase of operative times is largely counterbalanced by optimal fixation results. Finally, the bone drilling and the immediate proximity of bone to prosthesis might enhance the potential for osteogenesis and osteointegration. PMID:23372977

  17. Oral impact on daily performance: need and use of dental prostheses among Brazilian adults.

    Science.gov (United States)

    Ilha, L; Martins, A B; Abegg, C

    2016-02-01

    Although there is a large amount of evidence that demonstrates the relationship between oral health status and oral impact daily performance, there are few studies that have evaluated the impact of prosthetic status, particularly the need for a dental prosthesis. Therefore, the aim of this study was to investigate the relationship between need and use of dental prostheses and the prevalence of oral impact on daily performance. A sample of 720 subjects, aged between 50 and 74 years, was evaluated using a cross-sectional study. Participants were selected through a multistage proportional random sampling. The impact of oral health status on daily performance (oral impact on daily performance--OIDP) and socio-demographic data was assessed using a standardised questionnaire, and clinical data were assessed by oral examination. The outcome was the prevalence of impact. The association between the explanatory variables and the outcome was analysed through two models of multivariate Poisson regression. In the adjusted model, the variables need of upper and lower prosthesis and use of lower prosthesis maintained a statistically significant association. No statistically relevant relation between socio-demographic variables and outcomes was found. Findings show that the need and use and of a prosthesis are related to oral health quality of life.

  18. Electrostatic endothelial cell seeding technique for small-diameter (<6 mm) vascular prostheses: feasibility testing.

    Science.gov (United States)

    Bowlin, G L; Rittgers, S E

    1997-01-01

    Multiple studies have indicated the importance of surface charge in the adhesion of multiple cardiovascular cell lines including platelets and endothelial cells on the substrate materials (1,4,7-10,12-15). It is the purpose of this article to report a feasibility study conducted using an electrostatic endothelial cell seeding technique. The feasibility study was conducted using human umbilical vein endothelial cells (HUVEC), a static pool apparatus, a voltage source, and a parallel plate capacitor. The HUVEC concentration and seeding times were constant at 560,000 HUVEC/ml and 30 min, respectively. Scanning electron microscopy examination of the endothelial cell adhesion indicated that an induced temporary positive surface charge on e-PTFE graft material enhances the number and the maturation (flattening) of HUVECs adhered. The results indicated that the total number of endothelial cells adhered (70.9 mm2) was increased from 9198 +/- 1194 HUVECs on the control (no induced surface charge) e-PTFE to 22,482 +/- 4814 HUVECs (2.4 x control) on the maximum induced positive surface charge. The total number of cells in the flattened phase of adhesion increased from 837 +/- 275 to 6785 +/- 1012 HUVECs (8.1x) under identical conditions. Thus, the results of the feasibility study support the premise that electrostatic interaction is an important factor in both the endothelial cell adhesion and spreading processes and suggest that the electrostatic seeding technique may lead to an increased patency of small diameter (<6 mm) vascular prostheses.

  19. Simulation of the fluid dynamics in artificial aortic roots: comparison of two different types of prostheses.

    Science.gov (United States)

    Bara, Christoph L; Verhey, Janko F

    2008-01-01

    As a consequence of the growing number of elderly people, the incidence of degenerative aortic diseases continues to increase. Often, artificial aortic roots are needed to replace the native tissue. Some physical characteristics of the artificial aortic root, however, are quite different from native aorta and need to be optimized. The supposed benefit of a prosthesis with artificial sinuses of Valsalva could first be checked by numerical calculations. Two simplified base geometries were used for simulating the flow and pressure distributions, especially in the coronary arteries. One model approximates the ascending aorta as a tube, and the other uses a design with toroidal dilation of the aortic root to approximate the native geometry of the sinuses of Valsalva. The flow and pressure distributions in both models were compared in the ascending aorta as well as in the right and the left coronary arteries. Both the pressure and the velocity distribution in the coronary artery region were not significantly higher in the model with the sinus design compared to the tube model. The sinus design only slightly increased the mean pressures and the velocities in both the ascending aorta and in the coronary arteries. Higher pressure in the coronary arteries should improve the blood circulation and decrease the risk of a surgery-related coronary incident. The sinus design did not show the hoped-for benefits, and therefore it is only a minor factor in optimizing future aortic root prostheses.

  20. Functionalization of polydimethylsiloxane membranes to be used in the production of voice prostheses

    Directory of Open Access Journals (Sweden)

    Paula Ferreira, Álvaro Carvalho, Tiago Ruivo Correia, Bernardo Paiva Antunes, Ilídio Joaquim Correia and Patrícia Alves

    2013-01-01

    Full Text Available The voice is produced by the vibration of vocal cords which are located in the larynx. Therefore, one of the major consequences for patients subjected to laryngectomy is losing their voice. In these cases, a synthetic one-way valve set (voice prosthesis can be implanted in order to allow restoration of speech. Most voice prostheses are produced with silicone-based materials such as polydimethylsiloxane (PDMS. This material has excellent properties, such as optical transparency, chemical and biological inertness, non-toxicity, permeability to gases and excellent mechanical resistance that are fundamental for its application in the biomedical field. However, PDMS is very hydrophobic and this property causes protein adsorption which is followed by microbial adhesion and biofilm formation. To overcome these problems, surface modification of materials has been proposed in this study. A commercial silicone elastomer, SylgardTM 184 was used to prepare membranes whose surface was modified by grafting 2-hydroxyethylmethacrylate and methacrylic acid by low-pressure plasma treatment. The hydrophilicity, hydrophobic recovery and surface energy of the produced materials were determined. Furthermore, the cytotoxicity and antibacterial activity of the materials were also assessed. The results obtained revealed that the PDMS surface modification performed did not affect the material's biocompatibility, but decreased their hydrophobic character and bacterial adhesion and growth on its surface.

  1. Experiences in the provision, fitting and supply of external breast prostheses: findings from a national survey.

    Science.gov (United States)

    Gallagher, P; Buckmaster, A; O'Carroll, S; Kiernan, G; Geraghty, J

    2009-11-01

    A good-quality external breast prosthesis and prosthesis-fitting service is integral to recovery post-mastectomy. However, this area of care has minimal information or research available. The aim of this study was to investigate women's experience of the provision, fitting, supply and use of breast prostheses in Ireland. Three national surveys were undertaken with women (n = 527), breast care nurses (BCNs) (n = 32) and retail prosthesis fitters (n = 12). The findings identified the importance of the prosthesis for shape, appearance to self, appearance to others, sense of well-being, self-confidence and femininity. Dissatisfaction with weight, comfort and movement of the prosthesis was identified. Cost and travel distance were found to influence the replacement of the prosthesis. Dissatisfaction emerged with the display and choice of products, and brochure availability at the prosthesis fitting. Women preferred to be fitted for the first silicone prosthesis by a BCN in a hospital setting whereas for the replacement prosthesis they preferred a trained fitter at a specialized prosthesis supplier. BCNs and retail fitters identified the need for service guidelines and increased availability of professional development opportunities in prosthesis-fitting. These findings contributed to the development of standards of care for breast prosthesis-fitting services to benefit women and to provide guidelines for those providing the service.

  2. Anatomy and clinic application of reverse-flow island flaps on dorsal thumb web with dorsoulnar artery of thumb as a pedicle%拇指尺侧指背动脉为蒂的虎口背侧逆行岛状皮瓣的解剖与临床应用

    Institute of Scientific and Technical Information of China (English)

    史增元; 尹维刚; 俞淼; 董文伟; 毛海蛟; 唐旭

    2014-01-01

    Objective To explore a surgical treatment of skin defects on the thumb by reverse-flow island flaps on dorsal thumb web with dorsoulnar artery of thumb as a pedicle.Methods The origin,courses and distribution of dorsoulnar artery of thumb from 70 adult cadaveric hand specimens perfused by red latex were explored.Skin defects on the thumb of 8 cases were repaired with reverse-flow island flaps on dorsal thumb web.The cut areas of flaps vary from 4.5 cm × 3.0 cm to 7.5 cm × 4.0 cm.Results There were 4 types of the dorsoulnar artery of thumb basing on the origin and courses.Type Ⅰ was outside the first dorsal interosseous muscle type,which was the dorsoulnar artery of thumb mainly originated from the first dorsal metacarpal artery and cross through the surface of the first dosal interosseous muscle(42.9%).Type Ⅱ was under the first dorsal interosseous muscle type,which was from the thumb principal artery or deep branch of radial artery and run under the first dorsal interosseous muscle(41.4%).Type Ⅲ was mixed type from the anastomose point of above two arteries at the level of the first metacarpophalangeal joint(11.4%).Type Ⅳ was absence type (4.3%).Eight flaps fully survived.Excellent texture and satisfying appearance of the flaps as well as normal thumb web function were verified after 8 months' follow-up.Conclusion It is significant to determine the type of dorsoulnar artery of thumb to decide different operations due to the artery's considerable variation.The reverse-flow island flap on dorsal thumb is an ideal method to repair soft tissue defect on the thumb for its convenient operating and little effect in the donor area.%目的 探讨拇指尺侧指背动脉为蒂虎口背侧逆行岛状皮瓣修复拇指皮肤缺损的手术方法.方法 用70侧成人尸手标本,经动脉灌注红色乳胶,解剖观测拇指尺侧指背动脉的来源、走行和分布范围.在临床上应用该逆行岛状皮瓣修复8例拇指

  3. The interaction between the first transmembrane domain and the thumb of ASIC1a is critical for its N-glycosylation and trafficking.

    Directory of Open Access Journals (Sweden)

    Lan Jing

    Full Text Available Acid-sensing ion channel-1a (ASIC1a, the primary proton receptor in the brain, contributes to multiple diseases including stroke, epilepsy and multiple sclerosis. Thus, a better understanding of its biogenesis will provide important insights into the regulation of ASIC1a in diseases. Interestingly, ASIC1a contains a large, yet well organized ectodomain, which suggests the hypothesis that correct formation of domain-domain interactions at the extracellular side is a key regulatory step for ASIC1a maturation and trafficking. We tested this hypothesis here by focusing on the interaction between the first transmembrane domain (TM1 and the thumb of ASIC1a, an interaction known to be critical in channel gating. We mutated Tyr71 and Trp287, two key residues involved in the TM1-thumb interaction in mouse ASIC1a, and found that both Y71G and W287G decreased synaptic targeting and surface expression of ASIC1a. These defects were likely due to altered folding; both mutants showed increased resistance to tryptic cleavage, suggesting a change in conformation. Moreover, both mutants lacked the maturation of N-linked glycans through mid to late Golgi. These data suggest that disrupting the interaction between TM1 and thumb alters ASIC1a folding, impedes its glycosylation and reduces its trafficking. Moreover, reducing the culture temperature, an approach commonly used to facilitate protein folding, increased ASIC1a glycosylation, surface expression, current density and slowed the rate of desensitization. These results suggest that correct folding of extracellular ectodomain plays a critical role in ASIC1a biogenesis and function.

  4. Osteoarthritis of the carpometacarpal joint of the thumb: a new MR imaging technique for the standardized detection of relevant ligamental lesions

    Energy Technology Data Exchange (ETDEWEB)

    Dumont, Clemens [University Medical Center Goettingen, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Georg-August-Universitaet, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Lerzer, Sebastian; Tezval, Mohammad; Stuermer, Klaus Michael [University Medical Center Goettingen, Department of Trauma Surgery, Plastic and Reconstructive Surgery, Goettingen (Germany); Vafa, Morad Ali; Lotz, Joachim [University Medical Center Goettingen, Department of Diagnostic Radiology and Interventional Radiology, Goettingen (Germany); Dechent, Peter [University Medical Center Goettingen, MR-Research in Neurology and Psychiatry, Department of Cognitive Neurology, Goettingen (Germany)

    2014-10-15

    To assess ligament lesions and subluxations of the carpometacarpal joints of the thumbs (CMC I) of asymptomatic volunteers and of patients with CMC I osteoarthritis using advanced magnetic resonance imaging (MRI). A total of 20 CMC I joints of 14 asymptomatic volunteers (6 x both sides) and 28 CMC I joints of 22 patients (6 x both sides) with symptomatic and X-ray-diagnosed osteoarthritis of CMC I joints were studied. During extension, flexion, abduction and adduction of the thumb, the anterior oblique (AOL), intermetacarpal (IML), posterior oblique (POL) and dorsal radial (DRL) ligaments were evaluated using 3-T MRI on two standard planes, and translation of metacarpal I (MC I) was assessed. The MRI demonstrated that ligament lesions of the AOL and IML are frequent. Isolated rupture of the AOL was found in 6 of 28 (21 %), combined rupture of the AOL + IML in 5 of 28 (18 %) and isolated IML rupture in 4 of 28 (14 %) joints. The patients had a significantly increased dorsal translation of MC I during extension with a median of 6.4 mm vs. 5.4 mm in asymptomatic volunteers (p < 0.05). MRIs of CMC I in two standardized planes frequently show combined ligament ruptures. The dorsal subluxation of MC I, which is increased in patients, correlates with OA severity based on X-ray and can be quantified by MRI. For joint-preserving surgical procedures and for prosthesis implantation of the CMC I, we recommend performing an MRI in two planes of the thumb - extension and abduction - to evaluate the ligaments and dorsal subluxation of MC I. (orig.)

  5. Discovery of benzimidazole-diamide finger loop (Thumb Pocket I) allosteric inhibitors of HCV NS5B polymerase: Implementing parallel synthesis for rapid linker optimization.

    Science.gov (United States)

    Goulet, Sylvie; Poupart, Marc-André; Gillard, James; Poirier, Martin; Kukolj, George; Beaulieu, Pierre L

    2010-01-01

    Previously described SAR of benzimidazole-based non-nucleoside finger loop (Thumb Pocket I) inhibitors of HCV NS5B polymerase was expanded. Prospecting studies using parallel synthesis techniques allowed the rapid identification of novel cinnamic acid right-hand sides that provide renewed opportunities for further optimization of these inhibitors. Novel diamide derivatives such as 44 exhibited comparable potency (enzymatic and cell-based HCV replicon) as previously described tryptophan-based inhibitors but physicochemical properties (e.g., aqueous solubility and lipophilicity) have been improved, resulting in molecules with reduced off-target liabilities (CYP inhibition) and increased metabolic stability.

  6. Risks resulting from using rules-of-thumb when cementing oil wells; Riscos decorrentes do uso de chavoes nas cimentacoes de pocos de petroleo

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Maria das Gracas Pena; Miranda, Cristiane Richard de [PETROBRAS, Rio de Janeiro, RJ (Brazil). Centro de Pesquisas. Superintendencia de Pesquisa de Exploracao e Producao

    1994-07-01

    In the oil industry the two most popular rules-of-thumb related to interpreting the thickening time tests are: 'On reaching 50 Uc (consistency units) the cement slurries are no longer pumpable' and 'Time spent on mixing and displacing the slurries should not exceed 60% of the thickening time'. To check these rules more then 200 experimental tests were carried out which show that depending on the additives used, the consistometry curves may require individual interpretation and slurries with different composition have great changes of showing different apparent viscosities even when having the same consistency. (author)

  7. Modified Bluegrass Appliance: A Nonpunitive Therapy for Thumb Sucking in Pediatric Patients—A Case Report with Review of the Literature

    Directory of Open Access Journals (Sweden)

    Amish Diwanji

    2013-01-01

    Full Text Available Oral habits in form of digit/thumb sucking are common phenomenon and part of childhood behavior. They are normally associated with oral pleasure, hunger, anxiety, and sometimes psychological disturbances. Chronic practice can cause major orthopedic alterations to the skeletal structures of the oral cavity and lower face. Aversive approaches in form of punitive therapy have been moderately effective. Modified bluegrass appliance is nonpunitive therapy to treat sucking habits. It acts as a habit reversal technique and installs positive reinforcement in children. Modified blue grass appliance proved to be very comfortable to patients and encourages neuromuscular stimulations.

  8. Obturator or "lateral" bypass in the management of infected vascular prostheses at the groin

    Directory of Open Access Journals (Sweden)

    Davidović Lazar B.

    2002-01-01

    Full Text Available The infection of the previously implanted vascular graft at the groin, is associated with great mortality and morbidity rate [1]. The authors present a retrospective study in which they analyzed management of infected vascular prostheses at the groin, using obturator bypass in 26 cases, and "lateral" bypass in 15 cases. The indications for obturator bypass reconstructions included: 20 infections of aorto-femoral grafts, two infected pse udoaneurysms in the groin after RTA of the superficial femoral artery, and 4 infections of iliac-femoral grafts. The indications for lateral bypass reconstructions were: infections after aorto-femoral reconstructions - 8 cases; infection after femora-popliteal reconstructions - 4 cases; infection after iliac-femoral reconstruction - 2 patients, and one infected pseudoaneurysm in the groin after RTA of the superficial femoral artery. In 3 subjects obturator bypass was performed using extraperitoneal approach while in other 23 patients transperitoneal approach was done by donor's artery. The obturator bypass was performed using a PTFE graft in 3 cases and Dacron graft in 23. The donor's artery used for obturator bypass was a noninfected proximal part of aortofemoral graft in 20 cases, and iliac artery in 6 patients. The superfical femoral artery was recipient artery for obturator bypass in 3 cases, deep femoral artery in one case, and above the knee popliteal artery in 22 cases (Figure 1. In two patients transperitoenal approach to donors artery for "lateral" bypass has been used, and in 13 cases extraperitoneal. The proximal noninfected part of aorto femoral graft was used as a donor's artery for lateral bypass in 8 patients, while common iliac artery in 7 subjects. In 5 cases recon structions were performed using PTFE grafts, in 3 using autologous saphenous vein grafts, and in 7 using Dacron grafts. The recipient artery for "lateral" bypass was deep femoral in 8 cases, superficial femoral in three patients and

  9. Basal ganglia calcification on computed tomography in systemic lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Nagaoka, Shohei; Tani, Kenji; Ishigatsubo, Yoshiaki and others

    1988-09-01

    The development of basal ganglia calcification was studied in 85 patients with systemic lupus erythematosus (SLE) by computed tomography (CT). Bilateral calcification of the basal ganglia was found to occur in 5 patients (5.9 %) with SLE, but was not seen in patients with rheumatoid arthritis and progressive systemic sclerosis. All were female with a mean age of 42 years (range 29 - 49). The patients with calcification of the basal ganglia had neurological symptoms, such as psychiatric problems (3 cases), grand mal seizures (1 case), CSF abnormalities (2 cases), and EEG changes (4 cases). There were significantly higher incidences of alopecia, cutaneous vasculitis, leukopenia, and thrombocytopenia in the group with calcifications than those in the group with normal CT findings. Circulating immune complexes were detected and LE tests were positive in 2 patients. Endocrinological examination showed no abnormality in any. We suggest that basal ganglia calcification in SLE might be related to cerebral vasculitis.

  10. Multiple superficial basal cell carcinomas (basalomatosis) following cobalt irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Wollenberg, A.; Przybilla, B. [Muenchen Univ. (Germany). Dermatologische Klinik und Poliklinik; Peter, R.U. [Federal Armed Forces Medical Academy, Munich (Germany). Inst. of Radiobiology

    1995-10-01

    Basalomatosis is an uncommon skin condition characterized by the occurrence of multiple basal cell carcinomas. Many cases reported in the literature have been attributed to arsenic treatment in psoriasis patients. We report a patient with basalomatosis caused by cobalt-60 ({sup 60}Co) irradiation. A 55-year-old farmer developed 43 basal cell carcinomas 20 years after treatment of an immuno-blastoma with {sup 60}Co irradiation. All the tumours were located within the radiation fields. Other possible causes of basalomatosis, such as arsenic intoxication and basal cell naevus syndrome, were excluded. The patient`s multiple superficial basal cell carcinomas probably represent a late adverse effect of the {sup 60}Co irradiation. (Author).

  11. Design, control, and sensory feedback of externally powered hand prostheses: a literature review.

    Science.gov (United States)

    Cloutier, Aimee; Yang, James

    2013-01-01

    In recent years, there has been a steep rise in the quality of prostheses for patients with upper limb amputations. Researchers have begun to identify methods of making prosthetic hands both functional and cosmetically appealing, in contrast to past designs. Many improvements have occurred because of novel design strategies, such as the use of underactuated mechanisms, which allow for more degrees of freedom (DOF) or help reduce the weight of the prosthesis. The increase in functionality is also due in large part to advancements in control strategies for prosthetic hands. One common control method, using electromyographic (EMG) signals generated by muscle contractions, has allowed for an increase in the DOF of hand designs and a larger number of available grip patterns with little added complexity for the wearer. Another recent improvement in prosthetic hand design instead employs electroneurographic (ENG) signals, requiring an interface directly with the peripheral nervous system (PNS) or the central nervous system (CNS). Despite the recent progress in design and control strategies, however, prosthetic hands are still far more limited than the actual human hand. This review outlines the recent progress in the development of electrode-based prosthetic hands, detailing advancements in the areas of design, sensory feedback, and control through EMG and ENG signals (with a particular focus on interfaces with the PNS). The potential benefits and limitations of both control strategies, in terms of signal classification, invasiveness, and sensory feedback, are discussed. Finally, a brief overview of interfaces with the CNS is provided, and potential future developments for prosthetic hand design are discussed.

  12. Occurrence and antimicrobial susceptibility of enteric rods and pseudomonads isolated from the dental prostheses biofilm

    Directory of Open Access Journals (Sweden)

    Sanrrangers Sales Silva

    Full Text Available ABSTRACT Aspiration of oral bacteria leads to cardiac and respiratory infectious diseases and dentures can act as a reservoir for pathogenic microorganisms. Objective: To determine the occurrence and the in vitro antimicrobial susceptibility of enteric rods and pseudomonads from the denture biofilm of 52 subjects at the Center for Dental Specialties of Sobral/ Ceara, Brazil. Material and Methods: Denture biofilm was collected and samples plated on MacConkey agar. The isolated bacterial colonies were identified using the BBL Crystal enteric/non-fermenter system. Antibiotic bacterial susceptibility was assessed by the disc diffusion method of amoxicillin, amoxicillin/clavulanic acid, doxycycline, tetracycline, tobramycin, imipenem, cefotaxime, and ciprofloxacin. The Minimum Inhibitory Concentration (MIC of cefotaxime, tobramycin, doxycycline, imipenem, and ciprofloxacin was determined for 40 species by E-test. Results: 34 subjects (65.4% harbored enteric rods in their prostheses. Klebsiella pneumoniae (26.5%, Escherichia coli (23.5%, and Enterobacter aerogenes (23.5% were the most prevalent species. All organisms were susceptible to ciprofloxacin and most species were resistant to amoxicillin or amoxicillin/clavulanic acid, demonstrating variable sensitivity patterns to other antimicrobials. However, the MIC showed the emergence of strains with reduced sensitivity to ciprofloxacin (MIC90≥3 μg/ mL and cefotaxime (MIC90≥2 μg/mL. Conclusion: The findings show high prevalence of nosocomial diseases-related bacterial species and low susceptibility to antimicrobial drugs. Therefore, these results imply caution against the indiscriminate use of broad spectrum antibiotics in dental practice.

  13. CT metal artefact reduction of total knee prostheses using angled gantry multiplanar reformation.

    Science.gov (United States)

    Lewis, Mark; Toms, Andoni P; Reid, Karen; Bugg, William

    2010-08-01

    This study was designed to determine whether or not acquiring CT images of total knee prostheses by using an angled gantry and multiplanar reformation can reduce beam hardening artefact. A CT phantom was created with a total knee prosthesis suspended in gelatine with a known attenuation. CT data was acquired with a gantry angled at 0 degrees, 5 degrees, 10 degrees and 15 degrees in both craniocaudal oblique planes. Axial images where then reformatted from these datasets. Two independent observers selected regions of interest to measure the mean and standard deviation (SD) of attenuation in the gelatine for all reformatted axial images. Artefact was measured as SD of the background attenuation and areas under the curve of SD for each gantry angle acquisition were compared. Inter-observer reliability was excellent (ICC=0.89, CI 0.875-0.908). The most accurate mean attenuation values for tissues around a TKR were obtained with a CT gantry using 10 degrees to 15 degrees anteroinferior to posterosuperior angulation. The smallest area under the curve for SD of attenuation for the whole prosthesis, and the femoral component in isolation, was obtained with a 5 degrees gantry angle in the same direction. The smallest area under the curve for the tibial component in isolation occurred with a gantry angle of 15 degrees. We conclude that acquiring CT data with a gantry angle can reduce metal artefact around a TKR. Optimal overall metal artefact reduction can be achieved with a small angle from anteroinferior to posterosuperior. Further selective artefact reduction around the tibial component can be achieved with larger angles.

  14. The quality of working impressions for the fabrication of fixed prosthodontics prostheses (crown and bridgework

    Directory of Open Access Journals (Sweden)

    Ahmad Syahir Ahmad Zu Saifudin

    2014-01-01

    Full Text Available Objective: The study was carried out to assess the quality of working impressions sent to commercial laboratories for fabrication of fixed prostheses. Materials and Methods: Impressions (n: 200 received by four dental laboratories were evaluated by two calibrated examiners. The type of work, tray designs, impression materials and techniques were recorded for each impression. Quality data on crucial details of the tooth preparations, voids at tooth preparations, tears along the finished margin line and flow of materials were documented and each criterion scored either with 2 (Good, 1 (Acceptable or 0 (Unacceptable. The Chi-square test for independence was done for relationship analysis of the impression defects and different type of impression materials. Results: From 200 examined impressions, 53.9% were for crown works, 35.9% bridge works, 1.4% posts and cores and 8.8% for other types of work. The impression materials used were polyether (39.5% and polyvinyl-siloxane (60.5%. The two main types of trays were metal stock (48.5% and disposable plastic (37.5%. Impression techniques were monophase one-step technique (50.0%, putty wash two-steps technique (23.5%, putty wash one-step technique (15.5% and dual phase one-step technique (11.0%. Overall, 64.5% of the impressions sent had unacceptable quality (0 score recorded for at least one criteria. The proportions of impression defects were significant to the type of impression materials (P < 0.05. Conclusion: The percentage of unacceptable impressions (64.5% sent to the laboratories is a serious concern, as it contributes to the inaccuracy of the crown and bridgeworks provided to patients.

  15. Microscale resolution fracture toughness profiling at the zirconia-porcelain interface in dental prostheses

    Science.gov (United States)

    Lunt, Alexander J. G.; Mohanty, Gaurav; Neo, Tee K.; Michler, Johann; Korsunsky, Alexander M.

    2015-12-01

    The high failure rate of the Yttria Partially Stabilized Zirconia (YPSZ)-porcelain interface in dental prostheses is influenced by the micro-scale mechanical property variation in this region. To improve the understanding of this behavior, micro-scale fracture toughness profiling by nanoindentation micropillar splitting is reported for the first time. Sixty 5 μm diameter micropillars were machined within the first 100 μm of the interface. Berkovich nanoindentation provided estimates of the bulk fracture toughness of YPSZ and porcelain that matched the literature values closely. However, the large included tip angle prevented precise alignment of indenter with the pillar center. Cube corner indentation was performed on the remainder of the pillars and calibration between nanoindentation using different tip shapes was used to determine the associated conversion factors. YPSZ micropillars failed by gradual crack propagation and bulk values persisted to within 15 μm from the interface, beyond which scatter increased and a 10% increase in fracture toughness was observed that may be associated with grain size variation at this location. Micropillars straddling the interface displayed preferential fracture within porcelain parallel to the interface at a location where nano-voiding has previously been observed and reported. Pure porcelain micropillars exhibited highly brittle failure and a large reduction of fracture toughness (by up to ~90%) within the first 50 μm of the interface. These new insights constitute a major advance in understanding the structure-property relationship of this important bi-material interface at the micro-scale, and will improve micromechanical modelling needed to optimize current manufacturing routes and reduce failure.

  16. Occurrence and antimicrobial susceptibility of enteric rods and pseudomonads isolated from the dental prostheses biofilm

    Science.gov (United States)

    Silva, Sanrrangers Sales; Ribeiro, Maximilo de Oliveira; Gomes, Francisco Isaac Fernandes; Chaves, Hellíada Vasconcelos; Silva, Antonio Alfredo Rodrigues e; Zanin, Iriana Carla Junqueira; Barbosa, Francisco Cesar Barroso

    2016-01-01

    ABSTRACT Aspiration of oral bacteria leads to cardiac and respiratory infectious diseases and dentures can act as a reservoir for pathogenic microorganisms. Objective: To determine the occurrence and the in vitro antimicrobial susceptibility of enteric rods and pseudomonads from the denture biofilm of 52 subjects at the Center for Dental Specialties of Sobral/ Ceara, Brazil. Material and Methods: Denture biofilm was collected and samples plated on MacConkey agar. The isolated bacterial colonies were identified using the BBL Crystal enteric/non-fermenter system. Antibiotic bacterial susceptibility was assessed by the disc diffusion method of amoxicillin, amoxicillin/clavulanic acid, doxycycline, tetracycline, tobramycin, imipenem, cefotaxime, and ciprofloxacin. The Minimum Inhibitory Concentration (MIC) of cefotaxime, tobramycin, doxycycline, imipenem, and ciprofloxacin was determined for 40 species by E-test. Results: 34 subjects (65.4%) harbored enteric rods in their prostheses. Klebsiella pneumoniae (26.5%), Escherichia coli (23.5%), and Enterobacter aerogenes (23.5%) were the most prevalent species. All organisms were susceptible to ciprofloxacin and most species were resistant to amoxicillin or amoxicillin/clavulanic acid, demonstrating variable sensitivity patterns to other antimicrobials. However, the MIC showed the emergence of strains with reduced sensitivity to ciprofloxacin (MIC90≥3 μg/ mL) and cefotaxime (MIC90≥2 μg/mL). Conclusion: The findings show high prevalence of nosocomial diseases-related bacterial species and low susceptibility to antimicrobial drugs. Therefore, these results imply caution against the indiscriminate use of broad spectrum antibiotics in dental practice. PMID:27812616

  17. Investigation of Timing to Switch Control Mode in Powered Knee Prostheses during Task Transitions.

    Directory of Open Access Journals (Sweden)

    Fan Zhang

    Full Text Available Current powered prosthetic legs require switching control modes according to the task the user is performing (e.g. level-ground walking, stair climbing, walking on slopes, etc.. To allow prosthesis users safely and seamlessly transition between tasks, it is critical to determine when to switch the prosthesis control mode during task transitions. Our previous study defined critical timings for different types of task transitions in ambulation; however, it is unknown whether it is the unique timing that allows safe and seamless transitions. The goals of this study were to (1 systematically investigate the effects of mode switch timing on the prosthesis user's performance in task transitions, and (2 identify appropriate timing to switch the prosthesis control mode so that the users can seamlessly transition between different locomotion tasks. Five able-bodied (AB and two transfemoral (TF amputee subjects were tested as they wore a powered knee prosthesis. The prosthesis control mode was switched manually at various times while the subjects performed different types of task transitions. The subjects' task transition performances were evaluated by their walking balance and success in performing seamless task transitions. The results demonstrated that there existed a time window within which switching the prosthesis control mode neither interrupted the subjects' task transitions nor disturbed their walking balance. Therefore, the results suggested the control mode switching of a lower limb prosthesis can be triggered within an appropriate time window instead of a specific timing or an individual phase. In addition, a generalized criterion to determine the appropriate mode switch timing was proposed. The outcomes of this study could provide important guidance for future designs of neurally controlled powered knee prostheses that are safe and reliable to use.

  18. Effect of running speed and leg prostheses on mediolateral foot placement and its variability.

    Directory of Open Access Journals (Sweden)

    Christopher J Arellano

    Full Text Available This study examined the effects of speed and leg prostheses on mediolateral (ML foot placement and its variability in sprinters with and without transtibial amputations. We hypothesized that ML foot placement variability would: 1. increase with running speed up to maximum speed and 2. be symmetrical between the legs of non-amputee sprinters but asymmetrically greater for the affected leg of sprinters with a unilateral transtibial amputation. We measured the midline of the body (kinematic data and center of pressure (kinetic data in the ML direction while 12 non-amputee sprinters and 7 Paralympic sprinters with transtibial amputations (6 unilateral, 1 bilateral ran across a range of speeds up to maximum speed on a high-speed force measuring treadmill. We quantified ML foot placement relative to the body's midline and its variability. We interpret our results with respect to a hypothesized relation between ML foot placement variability and lateral balance. We infer that greater ML foot placement variability indicates greater challenges with maintaining lateral balance. In non-amputee sprinters, ML foot placement variability for each leg increased substantially and symmetrically across speed. In sprinters with a unilateral amputation, ML foot placement variability for the affected and unaffected leg also increased substantially, but was asymmetric across speeds. In general, ML foot placement variability for sprinters with a unilateral amputation was within the range observed in non-amputee sprinters. For the sprinter with bilateral amputations, both affected legs exhibited the greatest increase in ML foot placement variability with speed. Overall, we find that maintaining lateral balance becomes increasingly challenging at faster speeds up to maximum speed but was equally challenging for sprinters with and without a unilateral transtibial amputation. Finally, when compared to all other sprinters in our subject pool, maintaining lateral balance

  19. Effect of running speed and leg prostheses on mediolateral foot placement and its variability.

    Science.gov (United States)

    Arellano, Christopher J; McDermott, William J; Kram, Rodger; Grabowski, Alena M

    2015-01-01

    This study examined the effects of speed and leg prostheses on mediolateral (ML) foot placement and its variability in sprinters with and without transtibial amputations. We hypothesized that ML foot placement variability would: 1. increase with running speed up to maximum speed and 2. be symmetrical between the legs of non-amputee sprinters but asymmetrically greater for the affected leg of sprinters with a unilateral transtibial amputation. We measured the midline of the body (kinematic data) and center of pressure (kinetic data) in the ML direction while 12 non-amputee sprinters and 7 Paralympic sprinters with transtibial amputations (6 unilateral, 1 bilateral) ran across a range of speeds up to maximum speed on a high-speed force measuring treadmill. We quantified ML foot placement relative to the body's midline and its variability. We interpret our results with respect to a hypothesized relation between ML foot placement variability and lateral balance. We infer that greater ML foot placement variability indicates greater challenges with maintaining lateral balance. In non-amputee sprinters, ML foot placement variability for each leg increased substantially and symmetrically across speed. In sprinters with a unilateral amputation, ML foot placement variability for the affected and unaffected leg also increased substantially, but was asymmetric across speeds. In general, ML foot placement variability for sprinters with a unilateral amputation was within the range observed in non-amputee sprinters. For the sprinter with bilateral amputations, both affected legs exhibited the greatest increase in ML foot placement variability with speed. Overall, we find that maintaining lateral balance becomes increasingly challenging at faster speeds up to maximum speed but was equally challenging for sprinters with and without a unilateral transtibial amputation. Finally, when compared to all other sprinters in our subject pool, maintaining lateral balance appears to be the

  20. Familial idiopathic basal ganglia calcification (Fahr’s disease)

    OpenAIRE

    Mufaddel, Amir A.; Al-Hassani, Ghanem A.

    2014-01-01

    Familial idiopathic basal ganglia calcification (Fahr’s disease) is a rare neurodegenerative disorder characterized by symmetrical and bilateral calcification of the basal ganglia. Calcifications may also occur in other brain regions such as dentate nucleus, thalamus, and cerebral cortex. Both familial and non-familial cases of Fahr’s disease have been reported, predominantly with autosomal-dominant fashion. The disease has a wide range of clinical presentations, predominantly with neuropsych...

  1. Basal Dynamics and Internal Structure of Ice Sheets

    Science.gov (United States)

    Wolovick, Michael J.

    The internal structure of ice sheets reflects the history of flow and deformation experienced by the ice mass. Flow and deformation are controlled by processes occurring within the ice mass and at its boundaries, including surface accumulation or ablation, ice rheology, basal topography, basal sliding, and basal melting or freezing. The internal structure and basal environment of ice sheets is studied with ice-penetrating radar. Recently, radar observations in Greenland and Antarctica have imaged large englacial structures rising from near the bed that deform the overlying stratigraphy into anticlines, synclines, and overturned folds. The mechanisms that may produce these structures include basal freeze-on, travelling slippery patches at the ice base, and rheological contrasts within the ice column. In this thesis, I explore the setting and mechanisms that produce large basal stratigraphic structures inside ice sheets. First, I use radar data to map subglacial hydrologic networks that deliver meltwater uphill towards freeze-on structures in East Antarctica. Next, I use a thermomechanical flowline model to demonstrate that trains of alternating slippery and sticky patches can form underneath ice sheets and travel downstream over time. The disturbances to the ice flow field produced by these travelling patches produce stratigraphic folds resembling the observations. I then examine the overturned folds produced by a single travelling sticky patch using a kinematic flowline model. This model is used to interpret stratigraphic measurements in terms of the dynamic properties of basal slip. Finally, I use a simple local one-dimensional model to estimate the thickness of basal freeze-on that can be produced based on the supply of available meltwater, the thermal boundary conditions, ice sheet geometry, and the ice flow regime.

  2. Photodynamic therapy as adjunctive therapy for morpheaform basal cell carcinoma.

    Science.gov (United States)

    Torres, T; Fernandes, I; Costa, V; Selores, M

    2011-01-01

    The authors decided to evaluate the possible use of methyl-aminolevulinate photodynamic therapy (MAL-PDT) as adjunctive therapy for morpheaform basal cell carcinoma prior to standard surgical excision in order to reduce tumor size and volume and to facilitate surgical treatment. It was observed that MAL-PDT may be an option as an adjunctive therapy prior to standard surgical excision of morpheaform basal cell carcinoma, leading to less invasive surgery.

  3. Photodynamic therapy as adjunctive therapy for morpheaform basal cell carcinoma

    OpenAIRE

    Torres, T.; I. Fernandes; Costa, V.; Selores, M

    2011-01-01

    The authors decided to evaluate the possible use of methyl-aminolevulinate photodynamic therapy (MAL-PDT) as adjunctive therapy for morpheaform basal cell carcinoma prior to standard surgical excision in order to reduce tumor size and volume and to facilitate surgical treatment. It was observed that MAL-PDT may be an option as an adjunctive therapy prior to standard surgical excision of morpheaform basal cell carcinoma, leading to less invasive surgery.

  4. Reassessing Models of Basal Ganglia Function and Dysfunction

    OpenAIRE

    Nelson, Alexandra B.; Kreitzer, Anatol C.

    2014-01-01

    The basal ganglia are a series of interconnected subcortical nuclei. The function and dysfunction of these nuclei has been studied intensively as it pertains to motor control, but more recently our knowledge of these functions has broadened to include prominent roles in cognition and affective control. This review will summarize historical models of basal ganglia function, findings which have supported or conflicted with these models, and emphasize recent work in animals and humans directly t...

  5. Cognitive-motor interactions of the basal ganglia in development

    OpenAIRE

    Gerry eLeisman; Orit eBraun-Benjamin; Robert eMelillo

    2014-01-01

    Neural circuits linking activity in anatomically segregated populations of neurons in subcortical structures and the neocortex throughout the human brain regulate complex behaviors such as walking, talking, language comprehension, and other cognitive functions associated with frontal lobes. The basal ganglia, which regulate motor control, are also crucial elements in the circuits that confer human reasoning and adaptive function. The basal ganglia are key elements in the control of reward-bas...

  6. Basal cell carcinomas in elderly patients treated by cryotherapy.

    Science.gov (United States)

    Chiriac, Anca; Mihaila, Doina; Foia, Liliana; Solovan, Caius

    2013-01-01

    Basal cell carcinoma is a malignant skin tumor with high incidence in our country, especially in rural areas, on sun-exposed skin (particularly on the face) in elderly patients. We present three cases of basal cell carcinoma with good results with cryotherapy. This report aims to outline and to prove that in some difficult situations, a simple, inexpensive, easy-to-perform procedure with no contraindications and with minimal side effects (erythema, mild pain) can be applied and resolve such cases.

  7. No More Green Thumbs!

    Science.gov (United States)

    Bland, Judith A.

    1977-01-01

    An alternative method of bacterial spore staining using malachite green is described. This technique is designed to save time and expense by a less messy procedure. Advantages and adaptations of the technique are also given. (MR)

  8. An MRI atlas of the mouse basal ganglia.

    Science.gov (United States)

    Ullmann, Jeremy F P; Watson, Charles; Janke, Andrew L; Kurniawan, Nyoman D; Paxinos, George; Reutens, David C

    2014-07-01

    The basal ganglia are a group of subpallial nuclei that play an important role in motor, emotional, and cognitive functions. Morphological changes and disrupted afferent/efferent connections in the basal ganglia have been associated with a variety of neurological disorders including psychiatric and movement disorders. While high-resolution magnetic resonance imaging has been used to characterize changes in brain structure in mouse models of these disorders, no systematic method for segmentation of the C57BL/6 J mouse basal ganglia exists. In this study we have used high-resolution MR images of ex vivo C57BL/6 J mouse brain to create a detailed protocol for segmenting the basal ganglia. We created a three-dimensional minimum deformation atlas, which includes the segmentation of 35 striatal, pallidal, and basal ganglia-related structures. In addition, we provide mean volumes, mean T2 contrast intensities and mean FA and ADC values for each structure. This MR atlas is available for download, and enables researchers to perform automated segmentation in genetic models of basal ganglia disorders.

  9. Optimization of scan time in MRI for total hip prostheses. SEMAC tailoring for prosthetic implants containing different types of metals

    Energy Technology Data Exchange (ETDEWEB)

    Deligianni, X. [University of Basel Hospital, Basel (Switzerland). Div. of Radiological Physics; Merian Iselin Klinik, Basel (Switzerland). Inst. of Radiology; Bieri, O. [University of Basel Hospital, Basel (Switzerland). Div. of Radiological Physics; Elke, R. [Orthomerian, Basel (Switzerland); Wischer, T.; Egelhof, T. [Merian Iselin Klinik, Basel (Switzerland). Inst. of Radiology

    2015-12-15

    Magnetic resonance imaging (MRI) of soft tissues after total hip arthroplasty is of clinical interest for the diagnosis of various pathologies that are usually invisible with other imaging modalities. As a result, considerable effort has been put into the development of metal artifact reduction MRI strategies, such as slice encoding for metal artifact correction (SEMAC). Generally, the degree of metal artifact reduction with SEMAC directly relates to the overall time spent for acquisition, but there is no specific consensus about the most efficient sequence setup depending on the implant material. The aim of this article is to suggest material-tailored SEMAC protocol settings. Five of the most common total hip prostheses (1. Revision prosthesis (S-Rom), 2. Titanium alloy, 3. Mueller type (CoNiCRMo alloy), 4. Old Charnley prosthesis (Exeter/Stryker), 5. MS-30 stem (stainless-steel)) were scanned on a 1.5 T MRI clinical scanner with a SEMAC sequence with a range of artifact-resolving slice encoding steps (SES: 2 - 23) along the slice direction (yielding a total variable scan time ranging from 1 to 10 min). The reduction of the artifact volume in comparison with maximal artifact suppression was evaluated both quantitatively and qualitatively in order to establish a recommended number of steps for each case. The number of SES that reduced the artifact volume below approximately 300 mm{sup 3} ranged from 3 to 13, depending on the material. Our results showed that although 3 SES steps can be sufficient for artifact reduction for titanium prostheses, at least 11 SES should be used for prostheses made of materials such as certain alloys of stainless steel. Tailoring SES to the implant material and to the desired degree of metal artifact reduction represents a simple tool for workflow optimization of SEMAC imaging near total hip arthroplasty in a clinical setting.

  10. Pulgar flotante. Descripción y reconstrucción: Caso clínico Floating thumb. Description and reconstruction: case report

    Directory of Open Access Journals (Sweden)

    E. Revelo Jirón

    2006-03-01

    Full Text Available En este artículo se presenta la descripción clínica y los hallazgos radiológicos de un caso de pulgar flotante parcialmente tratado en su infancia. Además se plantean las líneas generales a seguir de forma previa al tratamiento ante una malformación congénita del miembro superior y específicamente a nivel de la mano y del pulgar, destacando la clasificación y valoración de los aspectos estético-funcionales. Posteriormente se plantean las conductas quirúrgicas que pueden seguirse y los resultados obtenidos en el caso tratado.This paper deals with the clinical and radiological findings in a case of floating thumb, whose treatment began in the childhood. The general approach to the upper limb and particularly hand and thumb congenital malformations is outlined, as well as their classification and assessment of the cosmetic and functional aspects. Finally the different surgical approaches to this pathology are mentioned and the results obtained in the present case are shown.

  11. The first metatarsal web space:its applied anatomy and usage in tracing the first dorsal metatarsal artery in thumb reconstruction

    Institute of Scientific and Technical Information of China (English)

    徐永清; 李军; 钟世镇; 徐达传; 徐小山; 郭远发; 汪新民; 李主一; 朱跃良

    2004-01-01

    Objective: To clarify the anatomical relationship of the structures in the first toe webbing space for better dissection of toes in thumb reconstruction.Methods: The first dorsal metatarsal artery, the first deep transverse metatarsal ligament and the extensor expansion were observed on 42 adult cadaveric lower extremities. Clinically the method of tracing the first dorsal metatarsal artery around the space of the extensor expansion was used in 36 cases of thumb reconstruction.Results: The distal segments of the first dorsal metatarsal artery of Gilbert types I and II were located superficially to the extensor expansion. The harvesting time of a toe was shortened from 90 minutes to 50 minutes with 100% survival of reconstructed fingers. Conclusions: The distal segment of the first dorsal metatarsal artery lies constantly at the superficial layer of the extensor expansion. Most of the first metatarsal arteries of Gilbert types I and II can be easily located via the combined sequential and reverse dissection around the space of the extensor expansion.

  12. Electromyogram pattern recognition for control of powered upper-limb prostheses: State of the art and challenges for clinical use

    Directory of Open Access Journals (Sweden)

    Erik Scheme, MSc, PEng

    2011-07-01

    Full Text Available Using electromyogram (EMG signals to control upper-limb prostheses is an important clinical option, offering a person with amputation autonomy of control by contracting residual muscles. The dexterity with which one may control a prosthesis has progressed very little, especially when controlling multiple degrees of freedom. Using pattern recognition to discriminate multiple degrees of freedom has shown great promise in the research literature, but it has yet to transition to a clinically viable option. This article describes the pertinent issues and best practices in EMG pattern recognition, identifies the major challenges in deploying robust control, and advocates research directions that may have an effect in the near future.

  13. Proposing national identification number on dental prostheses as universal personal identification code - A revolution in forensic odontology.

    Science.gov (United States)

    Baad, Rajendra K; Belgaumi, Uzma; Vibhute, Nupura; Kadashetti, Vidya; Chandrappa, Pramod Redder; Gugwad, Sushma

    2015-01-01

    The proper identification of a decedent is not only important for humanitarian and emotional reasons, but also for legal and administrative purposes. During the reconstructive identification process, all necessary information is gathered from the unknown body of the victim and hence that an objective reconstructed profile can be established. Denture marking systems are being used in various situations, and a number of direct and indirect methods are reported. We propose that national identification numbers be incorporated in all removable and fixed prostheses, so as to adopt a single and definitive universal personal identification code with the aim of achieving a uniform, standardized, easy, and fast identification method worldwide for forensic identification.

  14. Patellofemoral complications after total knee arthroplasty: a comparison of Modular Porous-Coated Anatomic with Duracon prostheses.

    Science.gov (United States)

    Mont, M A; Becher, O J; Lee, C W; LaPorte, D M; Hungerford, D S

    1999-04-01

    Clinical and radiographic analyses were used to compare results obtained in 45 patients who underwent a Modular Porous-Coated Anatomic total knee arthroplasty with results in a similar group of 45 patients who underwent a Duracon total knee arthroplasty. The surgeries were consecutively performed over an 8-month period, and follow-up evaluation averaged 63 months. The two patient groups were similar with regard to the following variables: age, sex, diagnosis, height, weight, and preoperative and postoperative activity levels. Whereas both Duracon and Modular total knee arthroplasty prostheses yielded similar results approximately 5 years after surgery, the data suggest that Duracon appears to minimize patellofemoral complications.

  15. Adaptation to prostheses among patients with major lower-limb amputations and its association with sociodemographic and clinical data

    Directory of Open Access Journals (Sweden)

    Marco Antonio Nunes

    Full Text Available CONTEXT AND OBJECTIVE: Lower-limb amputation compromises patients' independence and autonomy, and therefore they should be referred for rehabilitation in order to adapt to prostheses and regain autonomy. The aim here was to assess adaptation to prostheses among patients with major lower-limb amputations and its association with sociodemographic and clinical data. DESIGN AND SETTING: This was a cross-sectional study in the city of Aracaju, Brazil. METHODS: The patients were identified by primary healthcare teams. The inclusion criterion was that these should be patients who underwent major lower-limb amputations of any etiology. Associations between sociodemographic and clinical variables and the adaptation to lower-limb prostheses were assessed. RESULTS: 149 patients were examined. Adaptation to the prosthesis occurred in 40% (60/149 of them, but only 62% (37/60 were using it. Adaptation occurred more often among male patients (P = 0.017 and among those who had a higher educational level (P = 0.013, with a longer time since amputation (P = 0.049 and when the etiology was trauma (P = 0.003. The result from logistic regression analysis showed that only patients with low education (P = 0.031 were significantly associated with a lower frequency of adaptation to prostheses. CONCLUSION: It was found that patients with a low educational level became adapted to the prosthesis less frequently. CONTEXTO E OBJETIVO: A amputação de membros inferiores compromete a independência e a autonomia dos pacientes, por isso, eles devem ser encaminhados para a reabilitação para a adaptação das próteses e assim viabilizar a recuperação da autonomia. O objetivo foi avaliar a adaptação de prótese em pacientes com amputações maiores de membros inferiores e sua associação com dados sócio-demográficos e clínicos.

  16. Указание большим пальцем: основные лингвистические функции (The linguistic functions of thumb pointing

    Directory of Open Access Journals (Sweden)

    Elena Grishina

    2012-12-01

    Full Text Available This study analyzes the main linguistic meanings of thumb pointing in Russian. The author uses A. Kendon's methodology as a basis and supplements it with statistical analysis and with data from the Multimodal Russian Corpus (MURCO. The main functions of thumb pointing in Russian include the anaphoric function, functions of activation and alienation of the pointed object, and the contrasting function.

  17. Cognitive-Motor Interactions of the Basal Ganglia in Development

    Directory of Open Access Journals (Sweden)

    Gerry eLeisman

    2014-02-01

    Full Text Available Neural circuits linking activity in anatomically segregated populations of neurons in subcortical structures regulate complex behaviors such as walking, talking, language comprehension, and other cognitive functions associated with frontal lobes. The basal ganglia are also crucial elements in the circuits that confer human reasoning and adaptive function and are key elements in the control of reward-based learning, sequencing, discrete elements that constitute complete motor acts, and cognitive function. Imaging studies of intact humans and electrophysiologic studies of the brains and behavior of other species confirm these findings. We know that the relation between the basal ganglia and the cerebral cortical region allows for connections organized into discrete circuits. Rather than serving as a means for widespread cortical areas to gain access to the motor system, these loops reciprocally interconnect a large and diverse set of cerebral cortical areas with the basal ganglia. Neuronal activity within the basal ganglia associated with motor areas of the cerebral cortex is highly correlated with parameters of movement. Neuronal activity within the basal ganglia and cerebellar loops associated with the prefrontal cortex is related to the aspects of cognitive function. Thus, individual loops appear to be involved in distinct behavioral functions. Damage to the basal ganglia of circuits with motor areas of the cortex leads to motor symptoms, whereas damage to the subcortical components of circuits with non-motor areas of the cortex causes higher-order deficits. In this report, we review some of the anatomic, physiologic, and behavioral findings that have contributed to a reappraisal of function concerning the basal ganglia and cerebellar loops with the cerebral cortex and apply it in clinical applications to ADHD with biomechanics and a discussion of retention of primitive reflexes being highly associated with the condition.

  18. Vismodegib (ERIVEDGE°) In basal cell carcinoma: too many unknowns.

    Science.gov (United States)

    2015-01-01

    Basal cell carcinomas are the most common skin cancers. They are usually localised and carry a good prognosis. There is no standard treatment for the rare patients with metastatic basal cell carcinoma or very extensive basal cell carcinoma for whom surgery or radiotherapy is inappropriate. Vismodegib, a cytotoxic drug, is claimed to prevent tumour growth by inhibiting a pathway involved in tissue repair and embryogenesis. It has been authorised in the European Union for patients with metastatic or locally advanced and extensive basal cell carcinoma. Clinical evaluation of vismodegib is based on a non-comparative clinical trial involving 104 patients, providing only weak evidence. Twenty-one months after the start of the trial, 7 patients with metastases (21%) and 6 patients with advanced basal cell carcinoma (10%) had died. Given the lack of a placebo group, there is no way of knowing whether vismodegib had any effect, positive or negative, on survival. There were no complete responses among patients with metastases, but about one-third of them had partial responses. Among the 63 patients with locally advanced basal cell carcinoma, there were 14 complete responses and 16 partial responses. The recurrence rate in patients with complete responses was not reported. Similar results were reported in two other uncontrolled trials available in mid-2014. Vismodegib has frequent and sometimes serious adverse effects, including muscle spasms, fatigue and severe hyponatraemia. Cases of severe weight loss, alopecia, ocular disorders, other cancers (including squamous cell carcinoma) and anaemia have also been reported. More data are needed on possible hepatic and cardiovascular adverse effects. A potent teratogenic effect was seen in experimental animals. As vismodegib enters semen, contraception is mandatory for both men (condoms) and women. In practice, vismodegib has frequent and varied adverse effects, some of which are serious, while its benefits are poorly documented

  19. Toward sophisiticated basal ganglia neuromodulation: review on basal gaglia deep brain stimulation

    Science.gov (United States)

    Da Cunha, Claudio; Boschen, Suelen L.; Gómez-A, Alexander; Ross, Erika K.; Gibson, William S. J.; Min, Hoon-Ki; Lee, Kendall H.; Blaha, Charles D.

    2015-01-01

    This review presents state-of-the-art knowledge about the roles of the basal ganglia (BG) in action-selection, cognition, and motivation, and how this knowledge has been used to improve deep brain stimulation (DBS) treatment of neurological and psychiatric disorders. Such pathological conditions include Parkinson’s disease, Huntington’s disease, Tourette syndrome, depression, and obsessive-compulsive disorder. The first section presents evidence supporting current hypotheses of how the cortico-BG circuitry works to select motor and emotional actions, and how defects in this circuitry can cause symptoms of the BG diseases. Emphasis is given to the role of striatal dopamine on motor performance, motivated behaviors and learning of procedural memories. Next, the use of cutting-edge electrochemical techniques in animal and human studies of BG functioning under normal and disease conditions is discussed. Finally, functional neuroimaging studies are reviewed; these works have shown the relationship between cortico-BG structures activated during DBS and improvement of disease symptoms. PMID:25684727

  20. Conditioning and sampling issues of EMG signals in motion recognition of multifunctional myoelectric prostheses.

    Science.gov (United States)

    Li, Guanglin; Li, Yaonan; Yu, Long; Geng, Yanjuan

    2011-06-01

    Historically, the investigations of electromyography (EMG) pattern recognition-based classification of intentional movements for control of multifunctional prostheses have adopted the filter cut-off frequency and sampling rate that are commonly used in EMG research fields. In practical implementation of a multifunctional prosthesis control, it is desired to have a higher high-pass cut-off frequency to reduce more motion artifacts and to use a lower sampling rate to save the data processing time and memory of the prosthesis controller. However, it remains unclear whether a high high-pass cut-off frequency and a low-sampling rate still preserve sufficient neural control information for accurate classification of movements. In this study, we investigated the effects of high-pass cut-off frequency and sampling rate on accuracy in identifying 11 classes of arm and hand movements in both able-bodied subjects and arm amputees. Compared to a 5-Hz high-pass cut-off frequency, excluding the EMG components below 60 Hz decreased the average accuracy of 0.1% in classifying the 11 movements across able-bodied subjects and increased the average accuracy of 0.1 and 0.4% among the transradial (TR) and shoulder disarticulation (SD) amputees, respectively. Using a 500 Hz instead of a 1-kHz sampling rate, the average classification accuracy only dropped about 2.0% in arm amputees. The combination of sampling rate and high-pass cut-off frequency of 500 and 60 Hz only resulted in about 2.3% decrease in average accuracy for TR amputees and 0.4% decrease for SD amputees in comparison to the generally used values of 1 kHz and 5 Hz. These results suggest that the combination of sampling rate of 500 Hz and high-pass cut-off frequency of 60 Hz should be an optimal selection in EMG recordings for recognition of different arm movements without sacrificing too much of classification accuracy which can also remove most of motion artifacts and power-line interferences for improving the

  1. Thenar reversed island flap combined with thumb dorsoulnar neurocutaneous vascular flap for repairing of distal thumb degloving injury%大鱼际逆行岛状皮瓣联合拇指尺背侧皮神经营养血管皮瓣修复拇指末节套脱伤

    Institute of Scientific and Technical Information of China (English)

    沈泳; 施海峰; 钱俊; 吴柯; 芮永军

    2016-01-01

    目的 介绍大鱼际逆行岛状皮瓣联合拇指尺背侧皮神经营养血管皮瓣修复拇指末节套脱伤的方法,并评价其临床疗效.方法 自2010年3月至2012年6月,我们采用大鱼际逆行岛状皮瓣联合拇指尺背侧皮神经营养血管皮瓣修复拇指末节套脱伤12例.大鱼际逆行岛状皮瓣切取面积为2.5 cm× 1.0 cm~4.0 cm× 3.0 cm,修复拇指掌侧创面;拇指尺背侧皮神经营养血管皮瓣切取面积为2.0 cm× 1.2 cm~3.5 cm× 2.5 cm,修复拇指背侧创面;供区直接缝合或全厚皮片植皮修复.结果 本组12例皮瓣全部存活,术后随访时间为6~18个月,平均10个月,皮瓣均无臃肿,色泽正常,外形满意,感觉及运动功能恢复良好,根据中华医学会手外科学会上肢部分功能评定试用标准评定:优8例,良3例,可1例.指腹的大鱼际逆行岛状皮瓣两点分辨觉为6.5~9.5 mm,平均7.8 mm;指背的拇指尺背侧皮神经营养血管皮瓣两点分辨觉为7.0~11.0 mm,平均8.5 mm;按英国医学研究会(BMRC)评级标准评定为S2~S4,平均S3+.结论 大鱼际逆行岛状皮瓣联合拇指尺背侧皮神经营养血管皮瓣修复拇指末节套脱伤,手术操作简单,无需深部解剖,不破坏知名血管,手术创伤小、时间短,术后疗效满意.%Objective To introduce a new surgical procedure for repairing distal thumb degloving injury with thenar reversed island flap in combination with the thumb dorsoulnar neurocutaneous vascular flap and evaluate the clinical outcomes.Methods From March 2010 to June 2012,12 cases of degloving injury of the distal thumb were treated with combined transfer of thenar reversed island flap and dorsoulnar neurocutaneous vascular flap from the thumb.The thenar reversed island flaps ranged from 2.5 cm × 1.0 cm to 4.0 cm × 3.0 cm in size and were used to cover volar aspect of the thumb.The dorsoulnar neurocutaneous vascular flaps ranged from 2.0 cm × 1.2 cm to 3.5 cm × 2.5 cm in size and were

  2. Short-term hearing results after primary stapedotomy with nitinol and teflon-platinum prostheses for otosclerosis.

    Science.gov (United States)

    Gouveris, Haralampos; Tóth, Miklós; Koutsimpelas, Dimitrios; Schmidtmann, Irene; Mann, Wolf J

    2013-08-01

    The aim of this study is to determine differences in postoperative air-bone gap (ABG) after placement of teflon-platinum or nitinol middle ear prostheses in primary stapedotomy patients with otosclerosis. Thirty otosclerosis patients (24 female, 6 male; age 10-61 years) with primary stapedotomy were studied prospectively. Before and after surgery, the mean and standard deviations of the ABG were measured at eight frequencies (0.25-4 kHz). Patients were randomized into one of two groups receiving either teflon-platinum or nitinol prostheses. Hearing results were assessed 1 year after surgery. To assess the joint influence of treatment and frequency on ABG reduction, a linear mixed model was used (significance level was p = 5%). The Tukey-Kramer method was used to adjust for multiple comparisons. Significant differences were found between treatment groups (p nitinol group. However, after adjusting for multiple comparisons, we could not identify a single frequency with a significant difference in reduction of conductive components. Use of the teflon-platinum prosthesis results in statistically non-significant better ABG closure at 0.25-4 kHz 1 year postoperatively than the use of the nitinol prosthesis.

  3. Low in vitro third-body wear on total hip prostheses induced by calcium sulphate used for local antibiotic therapy

    Directory of Open Access Journals (Sweden)

    R Heuberger

    2014-10-01

    Full Text Available In case of implant associated infection, implant preservation is associated with high failure rates. Therefore, a removal or exchange of the implant is most often mandatory for treatment success. Alternatively, under certain conditions, local antibiotic delivery can be applied – preserving the implant, using for example calcium sulphate as a resorbable carrier. In this work, third-body wear on total hip prostheses caused by calcium sulphate particles was tested in a hip simulator. Inlays made of ultra-high-molecular-weight polyethylene (UHMWPE and cross-linked polyethylene (XLPE against 28 mm CoCrMo heads and 36 mm alumina pairings were tested in triplicate, both with and without calcium sulphate particles in the test liquid. Neither the alumina articulations nor the CoCrMo heads were affected by the calcium sulphate particles since calcium sulphate is a relatively soft material. The polyethylene inlays showed 39-89 % higher wear during exposure compared to references, but wear returned to normal when no more particles were added. Thus, calcium sulphate might be used as antibiotic carrier even in the presence of total hip prostheses without fearing excessive third-body wear.

  4. Low in vitro third-body wear on total hip prostheses induced by calcium sulphate used for local antibiotic therapy.

    Science.gov (United States)

    Heuberger, R; Wahl, P; Krieg, J; Gautier, E

    2014-10-23

    In case of implant associated infection, implant preservation is associated with high failure rates. Therefore, a removal or exchange of the implant is most often mandatory for treatment success. Alternatively, under certain conditions, local antibiotic delivery can be applied - preserving the implant, using for example calcium sulphate as a resorbable carrier. In this work, third-body wear on total hip prostheses caused by calcium sulphate particles was tested in a hip simulator. Inlays made of ultra-high-molecular-weight polyethylene (UHMWPE) and cross-linked polyethylene (XLPE) against 28 mm CoCrMo heads and 36 mm alumina pairings were tested in triplicate, both with and without calcium sulphate particles in the test liquid. Neither the alumina articulations nor the CoCrMo heads were affected by the calcium sulphate particles since calcium sulphate is a relatively soft material. The polyethylene inlays showed 39-89 % higher wear during exposure compared to references, but wear returned to normal when no more particles were added. Thus, calcium sulphate might be used as antibiotic carrier even in the presence of total hip prostheses without fearing excessive third-body wear.

  5. Characterization of In-Body to On-Body Wireless Radio Frequency Link for Upper Limb Prostheses

    Science.gov (United States)

    Stango, Antonietta; Yazdandoost, Kamya Yekeh; Negro, Francesco; Farina, Dario

    2016-01-01

    Wireless implanted devices can be used to interface patients with disabilities with the aim of restoring impaired motor functions. Implanted devices that record and transmit electromyographic (EMG) signals have been applied for the control of active prostheses. This simulation study investigates the propagation losses and the absorption rate of a wireless radio frequency link for in-to-on body communication in the medical implant communication service (MICS) frequency band to control myoelectric upper limb prostheses. The implanted antenna is selected and a suitable external antenna is designed. The characterization of both antennas is done by numerical simulations. A heterogeneous 3D body model and a 3D electromagnetic solver have been used to model the path loss and to characterize the specific absorption rate (SAR). The path loss parameters were extracted and the SAR was characterized, verifying the compliance with the guideline limits. The path loss model has been also used for a preliminary link budget analysis to determine the feasibility of such system compliant with the IEEE 802.15.6 standard. The resulting link margin of 11 dB confirms the feasibility of the system proposed. PMID:27764182

  6. Reconstruction of cranial defects with individually formed cranial prostheses made of polypropylene polyester knitwear: an analysis of 48 consecutive patients.

    Science.gov (United States)

    Kasprzak, Piotr; Tomaszewski, Grzegorz; Kotwica, Zbigniew; Kwinta, Borys; Zwoliński, Jerzy

    2012-04-10

    This article presents a new method of cranioplasty in which polypropylene polyester knitwear was used as the filling material. The basis for prosthesis shaping was a three-dimensional model of the defect made according to the patient's CT scans. Previously, such material has never been a subject of computer-aided design and computer-aided manufacturing (CAD/CAM) individual forming. The process of the prosthesis design included CT bone scans and mold preparation for each patient. Such prostheses were implanted in 48 patients with cranial defects. The total number of prostheses applied was 51. The follow-up time was at least 6 months up to 36 months. The group of treated patients is described here, and sample pictures are shown to illustrate the results. The smallest defect had a size of 15 cm(2); the biggest, 178 cm(2). The coverage and the aesthetic results were very good in all cases. Two patients had postoperative complications. The cranioplastic solution described here is a valuable addition to the existing reconstructive methods, because of the low cost of the implant, the ease of its adjustment to the shape of the defect, and the short time of preparation.

  7. Lubricin and smooth muscle α-actin-containing myofibroblasts in the pseudomembranes around loose hip and knee prostheses.

    Science.gov (United States)

    Cheriyan, Thomas; Ready, John E; Brick, Gregory W; Martin, Scott D; Martin, Tamara L; Schmid, Thomas M; Padera, Robert F; Spector, Myron

    2013-03-01

    The objective was to evaluate the presence and distribution of the lubricating and anti-adhesion glycoprotein lubricin and cells containing the contractile isoform smooth muscle α-actin (SMA) in pseudomembranes around loose hip prostheses. Periprosthetic tissue was obtained at revision arthroplasty of eight aseptic, loose hip implants, and for comparison three loose knee prostheses. Immunohistochemical analysis was performed in 3 zones: zone 1, within 300μm of the edge of the implant-tissue interface; zone 2, between zones 1 and 3; zone 3, within 300μm of the resected/trimmed edge. The presence of lubricin was extensive in all samples: (1) as a discrete layer at the implant-tissue interface; (2) within the extracellular matrix (ECM); (3) intracellularly. There was significantly more high grade (>50%) lubricin surface staining at the implant-tissue interface compared with the resected edge. While there was also a significant effect of location of high grade ECM lubricin staining, there was no significant effect of implant type (i.e. hip versus knee). All but two hip pseudomembrane samples showed the presence of many SMA-containing cells. There was a significant effect of location on the number of SMA-expressing cells, but not of implant type. These findings might explain why the management of loose prosthesis is so challenging.

  8. Four-year clinical results of fixed dental prostheses with zirconia substructures (Cercon): end abutments vs. cantilever design.

    Science.gov (United States)

    Wolfart, Stefan; Harder, Sönke; Eschbach, Stefanie; Lehmann, Frank; Kern, Matthias

    2009-12-01

    The purpose of this prospective study was to evaluate the clinical outcome of three- to four-unit posterior all-ceramic fixed dental prostheses (FDPs) made of yttria-stabilized tetragonal zirconia-polycrystal ceramic frameworks (CerconBase; Degudent). Fifty-eight restorations were placed in 48 patients. Twenty-four FDPs had an end abutment design (EAD) replacing 3 premolars and 21 molars. Thirty-four FDPs had a cantilever design (CD) replacing 11 premolars and 23 molars. The frameworks had a minimum proximal connector dimension of 3 x 3 mm. The fixed dental prostheses were cemented with glass-ionomer cement after air-abrading the inner crown surfaces. Three FDPs were defined as drop-outs. The mean observation period was 48 +/- 7 months for the EAD (21 patients/24 FDPs) and 50 +/- 14 months for the CD (25 patients/31 FDPs). The 4-yr survival rate, according to the Kaplan-Meier analyses, was 96% for the EAD and 92% for the CD. The technical complication rate was 13% for the EAD and 12% for the CD, and the biological complication rate was 21% for the EAD and 15% for the CD. For none of the analyses were significant differences found between both groups. After 4 yr the clinical outcome of three- to four-unit posterior FDPs with EAD and CD was promising.

  9. Percutaneous bone cement refixation of aseptically loose hip prostheses: the effect of interface tissue removal on injected cement volumes

    Energy Technology Data Exchange (ETDEWEB)

    Malan, Daniel F. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands); Delft University of Technology, Department of Intelligent Systems, Delft (Netherlands); Valstar, Edward R. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands); Delft University of Technology, Department of Biomechanical Engineering, Delft (Netherlands); Nelissen, Rob G.H.H. [Leiden University Medical Center, Department of Orthopaedics, Leiden (Netherlands)

    2014-11-15

    To quantify whether injected cement volumes differed between two groups of patients who underwent experimental minimally invasive percutaneous cement injection procedures to stabilize aseptically loose hip prostheses. One patient group was preoperatively treated using gene-directed enzyme prodrug therapy to remove fibrous interface tissue, while the other group received no preoperative treatment. It was hypothesized that cement penetration may have been inhibited by the presence of fibrous interface tissue in periprosthetic lesions. We analyzed 17 patients (14 female, 3 male, ages 72-91, ASA categories 2-4) who were treated at our institution. Osteolytic lesions and injected cement were manually delineated using 3D CT image segmentation, and the deposition of injected cement was quantified. Patients who underwent preoperative gene-directed enzyme therapy to remove fibrous tissue exhibited larger injected cement volumes than those who did not. The observed median increase in injected cement volume was 6.8 ml. Higher cement leakage volumes were also observed for this group. We conclude that prior removal of periprosthetic fibrous interface tissue may enable better cement flow and penetration. This might lead to better refixation of aseptically loosened prostheses. (orig.)

  10. HIPOPLASIA DEL PULGAR: PRESENTACIÓN CLÍNICA Y RECONSTRUCCIÓN Hipoplasia of the thumb: Clinical presentation and reconstruction

    Directory of Open Access Journals (Sweden)

    Enrique M Vergara Amador

    2008-03-01

    ógicas o renales. Pacientes con deficiencia longitudinal del radio tienen peores resultados que los pacientes que tuvieron hipoplasia única del pulgar. En general los resultados fueron buenos y están de acuerdo con los reportes de la literatura donde escriben que el procedimiento ideal para la reconstrucción de un pulgar hipoplásico tipo IIIb, IV y V sigue siendo la pulgarización.Background. in the genesis of the partial or total absence of the thumb they are genetic, environmental factors or a combination of both. It is take part of a syndrome or to be isolated and frequently associated with problems of radial longitudinal deficiency of the forearm. Objective. The purpose of this study is mostar the experience, the focus of the processing and the results obtained since the point esthetic and functional view. The most it accepted classification is the proposal by Blauth that helps to determine the forecast and the processing. Materials and methods. it is a work type series of cases in 22 children with hipoplasia of the thumb, with a minimum of 12 months, (average 28 months. In 15 cases there were association of radial dysplasia or another anomaly among them 4 patients with VATER, and the 7 remaining they corresponded to hipoplasia of the thumb as only entity. We carried out tendon transfer, with opening of the first comisure in 2 patients with hipoplasia type II. In 3 patients, with hipoplasia type III A, one carries out corner opening, transfer of the superficial flexor of the 4 finger to correct instability of the articulation MF and opposition of the thumb, and transfer for extension of the thumb. In 17 cases one carries out pollicization of the index. Results. The outcome was evaluated in: non pinch, lateral pinch and fingertip pinch; the grade of opposition like good, minimal and non opposition, and the aesthetic result according to the satisfaction of the parents in bad, regular and good. The five children reconstructed with transfers of tendons and comisure

  11. Basal cell carcinomas in elderly patients treated by cryotherapy

    Directory of Open Access Journals (Sweden)

    Chiriac A

    2013-03-01

    Full Text Available Anca Chiriac,1 Doina Mihaila,2 Liliana Foia,3, Caius Solovan4 1Department of Dermatology, Nicolina Medical Center, 2Department of Pathology, St Maria Children's Hospital, 3Surgical Department, Grigore T Popa University of Medicine and Pharmacy, Iaşi, Romania; 4Victor Babe University of Medicine, Timişoara, Romania Abstract: Basal cell carcinoma is a malignant skin tumor with high incidence in our country, especially in rural areas, on sun-exposed skin (particularly on the face in elderly patients. We present three cases of basal cell carcinoma with good results with cryotherapy. This report aims to outline and to prove that in some difficult situations, a simple, inexpensive, easy-to-perform procedure with no contraindications and with minimal side effects (erythema, mild pain can be applied and resolve such cases. Keywords: basal cell carcinoma, cryotherapy

  12. An Unusual Location of Basal Cell Carcinoma: Two Case Reports

    Directory of Open Access Journals (Sweden)

    Birgül Tepe

    2012-06-01

    Full Text Available Basal cell carcinoma is the most common malignant skin tumour. Chronic sun exposure is considered as the main etiologic factor in its development. Although it mainly occurs on sun-exposed areas as the face and neck, it rarely develops on the forearms and/or arms. The etiologic factors which affect the anatomic distribution of basal cell carcinoma are not well-known. Here we report two patients who developed basal cell carcinoma on the forearm. None of the patients had a specific etiologic factor except for chronic sunlight exposure. The aim of our report is to show that this prevalant cutaneous malignancy can be encountered in rare/unusual areas. (Turk J Dermatol 2012; 6: 51-4

  13. Multiple jaw cysts not associated with basal cell nevus syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Suk Ja; Kang, Byung Cheol [Chonnam National University College of Medicine, Kwangju (Korea, Republic of)

    2003-09-15

    We present two cases of multiple jaw cysts not associated with basal cell nevus syndrome. Case 1 : a nine year-old boy visited CNU Hospital for orthodontic treatment and his radiographs showed cystic lesions surrounding the crowns of teeth 13 and 17 respectively, which were diagnosed as dentigerous cysts. Subsequently, two more cysts were found on his follow-up radiographs in 12 and 15 months. The two cysts were determined to be odontogenic keratocysts. The boy had no skeletal abnormalities and no skin lesions associated with basal cell nevus syndrome. Case 2: a fifty-eight year old man had three impacted third molars with pericoronal radiolucencies, which were diagnosed as dentigerous cysts. He had no additional abnormalities associated with basal cell nevus syndrome. Multiple jaw cysts can occur at any age, and periodic radiographic surveillance may be needed for any cases of impacted tooth.

  14. Computed tomography of granulomatous basal meningitis caused by pneumococcus

    Energy Technology Data Exchange (ETDEWEB)

    Sonobe, Makoto; Takahashi, Shinichiro (Mito National Hospital, Ibaraki (Japan)); Ohara, Kazuo

    1983-07-01

    A case of 3-month-old female with ''granulomatous basal meningitis'' caused by pneumococcus was described. She suffered from high fever, vomiting, convulsion and loss of consciousness on January 28th, 1982. On admission the protein content of the spinal fluid was 280 mg/100 ml, the glucose 4 mg/100 ml and the cell count was 1206/3(L : 845, N : 361). Her symptoms and signs were deteriorated in spite of antibiotics and anticonvulsants. CT scan on the 10th day showed the enhanced basal cistern. She died on the 11th day but autopsy was not carried out. In this case, pneumococcus was cultured in CSF. This seemed to be the first case of ''granulomatous basal meningitis'' due to purulent meningitis in Japan.

  15. Kinome expression profiling and prognosis of basal breast cancers

    Directory of Open Access Journals (Sweden)

    Jacquemier Jocelyne

    2011-07-01

    Full Text Available Abstract Background Basal breast cancers (BCs represent ~15% of BCs. Although overall poor, prognosis is heterogeneous. Identification of good- versus poor-prognosis patients is difficult or impossible using the standard histoclinical features and the recently defined prognostic gene expression signatures (GES. Kinases are often activated or overexpressed in cancers, and constitute targets for successful therapies. We sought to define a prognostic model of basal BCs based on kinome expression profiling. Methods DNA microarray-based gene expression and histoclinical data of 2515 early BCs from thirteen datasets were collected. We searched for a kinome-based GES associated with disease-free survival (DFS in basal BCs of the learning set using a metagene-based approach. The signature was then tested in basal tumors of the independent validation set. Results A total of 591 samples were basal. We identified a 28-kinase metagene associated with DFS in the learning set (N = 73. This metagene was associated with immune response and particularly cytotoxic T-cell response. On multivariate analysis, a metagene-based predictor outperformed the classical prognostic factors, both in the learning and the validation (N = 518 sets, independently of the lymphocyte infiltrate. In the validation set, patients whose tumors overexpressed the metagene had a 78% 5-year DFS versus 54% for other patients (p = 1.62E-4, log-rank test. Conclusions Based on kinome expression, we identified a predictor that separated basal BCs into two subgroups of different prognosis. Tumors associated with higher activation of cytotoxic tumor-infiltrative lymphocytes harbored a better prognosis. Such classification should help tailor the treatment and develop new therapies based on immune response manipulation.

  16. Molecular characterization of Italian nevoid basal cell carcinoma syndrome patients.

    Science.gov (United States)

    Pastorino, L; Cusano, R; Nasti, S; Faravelli, F; Forzano, F; Baldo, C; Barile, M; Gliori, S; Muggianu, M; Ghigliotti, G; Lacaita, M G; Lo Muzio, L; Bianchi-Scarra, G

    2005-03-01

    Mutations in the PTCH gene, the human homolog of the Drosophila patched gene, have been found to lead to the autosomal dominant disorder termed Nevoid Basal Cell Carcinoma Syndrome (NBCCS, also called Gorlin Syndrome). Patients display an array of developmental anomalies and are prone to develop a variety of tumors, with multiple Basal Cell Carcinomas occurring frequently. We provide here the results of molecular testing of a set of Italian Nevoid Basal Cell Carcinoma Syndrome patients. Twelve familial patients belonging to 7 kindreds and 5 unaffected family members, 6 non-familial patients and an additional set of 7 patients with multiple Basal Cell Carcinoma but no other criteria for the disease were examined for mutations in the PTCH gene. All of the Nevoid Basal Cell Carcinoma Syndrome patients were found to carry variants of the PTCH gene. We detected nine novel mutations (1 of which occurring twice): 1 missense mutation (c.1436T>G [p.L479R]), 1 nonsense mutation (c.1138G>T [p.E380X]), 6 frameshift mutations (c.323_324ins2, c.2011_2012dup, c.2535_2536dup, c.2577_2583del, c.3000_3005del, c.3050_3051del), 1 novel splicing variant (c.6552A>T) and 3 mutations that have been previously reported (c.3168+5G>A, c.1526G>T [p.G509V], and c.3499G>A [p.G1167R]). None of the patients with multiple Basal Cell Carcinoma but no other criteria for the syndrome, carried germline coding region mutations.

  17. A review of stand basal area growth models

    Institute of Scientific and Technical Information of China (English)

    Sun Hong-gang; Zhang Jian-guo; Duan Ai-guo; He Cai-yun

    2007-01-01

    Growth and yield modeling has a long history in forestry. The methods of measuring the growth of stand basal area have evolved from those developed in the U.S.A. and Germany during the last century. Stand basal area modeling has progressed rapidly since the first widely used model was published by the U.S. Forest Service. Over the years, a variety of models have been developed for predicting the growth and yield of uneven/even-aged stands using stand-level approaches. The modeling methodology has not only moved from an empirical approach to a more ecological process-based approach but also accommodated a variety of techniques such as: 1) simultaneous equation methods, 2) difference models, 3) artificial neural network techniques, 4) linear/nonlinear regression models, and 5) matrix models. Empirical models using statistical methods were developed to reproduce accurately and precisely field observations. In contrast, process models have a shorter history, developed originally as research and education tools with the aim of increasing the understanding of cause and effect relationships. Empirical and process models can be married into hybrid models in which the shortcomings of both component approaches can, to some extent, be overcome. Algebraic difference forms of stand basal area models which consist of stand age, stand density and site quality can fully describe stand growth dynamics. This paper reviews the current literature regarding stand basal area models, discusses the basic types of models and their merits and outlines recent progress in modeling growth and dynamics of stand basal area. Future trends involving algebraic difference forms, good fitting variables and model types into stand basal area modeling strategies are discussed.

  18. Nevoid Basal Cell Carcinoma Syndrome : A Case Report

    Directory of Open Access Journals (Sweden)

    K Rajanikanth

    2004-01-01

    Full Text Available The nevoid basal cell carcinoma syndrome (NBCCS or Gorlin - Goltz syndrome is an autosomal disorder principally characterized by cutaneous basal cell carcinomas, multiple keratocysts, and skeletal anomalies. The major organ systems involved are skin, bones, central nervous system, eyes, gonads and endocrine. This particular syndrome is extensively described in the literature under different names. However, there are only few cases reported in the Indian literature. An unusual case of a 33-year old male with large odontogenic keratocyst involving impacted canine in the mandible, along with multiple cysts and impacted teeth in the maxilla; bifid rib and vertebral anomalies has been described.

  19. Metastatic basal cell carcinoma caused by carcinoma misdiagnosed as acne - case report and literature review

    DEFF Research Database (Denmark)

    Aydin, Dogu; Hölmich, Lisbet Rosenkrantz; Jakobsen, Linda P

    2016-01-01

    Basal cell carcinoma can be misdiagnosed as acne; thus, carcinoma should be considered in treatment-resistant acne. Although rare, neglected basal cell carcinoma increases the risk of metastasis.......Basal cell carcinoma can be misdiagnosed as acne; thus, carcinoma should be considered in treatment-resistant acne. Although rare, neglected basal cell carcinoma increases the risk of metastasis....

  20. De la generación del pulgar a la generación del índice From thumb's generation to forefinger's generation

    Directory of Open Access Journals (Sweden)

    Henar León Barroso

    2012-06-01

    Full Text Available La aparición en 2010 de las tablets y el uso espontáneo que los niños desde primera infancia hacen de ellos, nos lleva a replantearnos si no estaremos delante de una nueva generación, la Generación del índice, frente a la llamada, hace unos años, Generación del Pulgar.The emergence of tablets in 2010 and the spontaneous use that children from early childhood make them, leads us to rethink whether we are in front of a new generation, the forefinger's generation , compared to the call, a few years ago, thumb's generation.

  1. Discovery of Novel Thiophene-Based, Thumb Pocket 2 Allosteric Inhibitors of the Hepatitis C NS5B Polymerase with Improved Potency and Physicochemical Profiles.

    Science.gov (United States)

    Court, John J; Poisson, Carl; Ardzinski, Andrzej; Bilimoria, Darius; Chan, Laval; Chandupatla, Kishan; Chauret, Nathalie; Collier, Philip N; Das, Sanjoy Kumar; Denis, Francois; Dorsch, Warren; Iyer, Ganesh; Lauffer, David; L'Heureux, Lucille; Li, Pan; Luisi, Brian S; Mani, Nagraj; Nanthakumar, Suganthi; Nicolas, Olivier; Rao, B Govinda; Ronkin, Steven; Selliah, Subajini; Shawgo, Rebecca S; Tang, Qing; Waal, Nathan D; Yannopoulos, Constantin G; Green, Jeremy

    2016-07-14

    The hepatitis C viral proteins NS3/4A protease, NS5B polymerase, and NS5A are clinically validated targets for direct-acting antiviral therapies. The NS5B polymerase may be inhibited directly through the action of nucleosides or nucleotide analogues or allosterically at a number of well-defined sites. Herein we describe the further development of a series of thiophene carboxylate allosteric inhibitors of NS5B polymerase that act at the thumb pocket 2 site. Lomibuvir (1) is an allosteric HCV NS5B inhibitor that has demonstrated excellent antiviral activity and potential clinical utility in combination with other direct acting antiviral agents. Efforts to further explore and develop this series led to compound 23, a compound with comparable potency and improved physicochemical properties.

  2. Assessment of Body-Powered Upper Limb Prostheses by Able-Bodied Subjects, using the Box and Blocks Test and the Nine Hole Peg Test

    NARCIS (Netherlands)

    Haverkate, L.; Smit, G.; Plettenburg, D.H.

    2014-01-01

    Study Design: Experimental trial. Background: The functional performance of currently available body-powered prostheses is unknown. Objective: The goal of this study was to objectively assess and compare the functional performance of three commonly used body-powered upper limb terminal devices. Meth

  3. Exploiting arm posture synergies in activities of daily living to control the wrist rotation in upper limb prostheses: A feasibility study.

    Science.gov (United States)

    Montagnani, Federico; Controzzi, Marco; Cipriani, Christian

    2015-01-01

    Although significant technological advances have been made in the last forty years, natural and effortless control of upper limb prostheses is still an open issue. Commercially available myoelectric prostheses present limited Degrees of Freedom (DoF) mainly because of the lack of available and reliable independent control signals from the human body. Thus, despite the crucial role that an actuated wrist could play in a transradial prosthesis in terms of avoiding compensatory movements, commercial hand prostheses present only manually adjustable passive wrists or actuated rotators controlled by (unnatural) sequential control strategies. In the present study we investigated the synergies between the humeral orientation with respect to the trunk and the forearm pronation/supination angles during the execution of a wide range of activities of daily living, in healthy subjects. Our results showed consistent postural synergies between the two selected body segments for almost the totality of the activities of daily living under investigation. This is a promising result because these postural synergies could be exploited to automatically control the wrist rotator unit in transradial prostheses improving the fluency and the dexterity of the amputee.

  4. Prospective clinical phase II study of two new indwelling voice prostheses (Provox Vega 22.5 and 20 Fr) and a novel anterograde insertion device (Provox Smart Inserter)

    NARCIS (Netherlands)

    Hilgers, F.J.M.; Ackerstaff, A.H.; Jacobi, I.; Balm, A.J.M.; Tan, I.B.; van den Brekel, M.W.M.

    2010-01-01

    Objectives/Hypothesis: To assess device life of the new Provox Vega 22.5 and 20 Fr prostheses, to establish whether the optimized airflow characteristics of these devices materialize in better voice characteristics in comparison to Provox2, and to assess the feasibility of voice prosthesis replaceme

  5. Influence of retainer design on two-unit cantilever resin-bonded glass fiber reinforced composite fixed dental prostheses: An in vitro and finite element analysis study

    NARCIS (Netherlands)

    Keulemans, F.; de Jager, N.; Kleverlaan, C.J.; Feilzer, A.J.

    2008-01-01

    Purpose: The aim of this study was to evaluate in vitro the influence of retainer design on the strenght of two-unit cantilever resin-bonded glass fiber-reinforced composite (FRC) fixed dental prostheses (FDP). Conclusion: A dual-wing retainer is the optimal design for replacement of a single premol

  6. Static and dynamic failure load of fiber-reinforced composite and particulate filler composite cantilever resin-bonded fixed dental prostheses

    NARCIS (Netherlands)

    Keulemans, F.; van Dalen, A.; Kleverlaan, C.J.; Feilzer, A.J.

    2010-01-01

    Purpose: The aim of this study was to evaluate in vitro the influence of fiber reinforcement and luting cement on the static failure load (SFL) and dynamic failure load (DFL) of simulated two-unit cantilever resin-bonded fixed dental prostheses (RBFDPs). Materials and Methods: Forty-six particulate

  7. To what extent does the longevity of fixed dental prostheses depend on the function of the cement? Working Group 4 materials : cementation

    NARCIS (Netherlands)

    Edelhoff, Daniel; Ozcan, Mutlu

    2007-01-01

    Aims/Background: The objective of this review was to define the impact of cementation mode on the longevity of different types of single tooth restorations and fixed dental prostheses (FDP). Methods: Literature search by PubMed as the major database was used utilizing the terms namely, adhesive tech

  8. 鼻烟窝皮瓣修复拇指大面积皮肤缺损的临床应用%Snuff-box Flap for Treatment of Thumb Large Area Skin Defects

    Institute of Scientific and Technical Information of China (English)

    张扬; 林平; 高峰

    2014-01-01

    探讨鼻烟窝皮瓣在修复拇指大面积皮肤缺损中的方法和治疗效果。从2008年1月~2013年10月间应用桡动脉在解剖鼻烟窝穿支为血管蒂的鼻烟窝皮瓣,逆行修复拇指大面积皮肤缺损26例,年龄17岁~55岁。术后平均随访时间25个月,皮瓣全部成活。皮瓣色泽及质地与健侧拇指背侧皮肤相近,拇指活动度基本正常。因此,鼻烟窝皮瓣是一种简便经济、效果理想、患者易于接受的术式,适合应用于拇指大面积皮肤缺损的治疗。%To explore the surgical technique and clinical outcomes of snuff-box flap to repair large area skin defects in thumbs ,26 patients ,age 17 to 55 years old ,had the snuff-box flap ,which used the perforator vessel of radial artery in snuff-box as pedicle vascular to repair large area skin defects in the thumb from January 2008 to October 2013 were included .All the flaps are alive .The patients were followed up with an average of 25 months .The color and texture of the flaps are similar to that of the contralateral thumb .The sphere of thumb movement is relatively normal .The operation of using snuff-box flap to repair large area skin defects in thumbs has economic material benefit ,ideal effect and be accepted .

  9. Metal-on-metal hip prostheses and systemic health: a cross-sectional association study 8 years after implantation.

    Directory of Open Access Journals (Sweden)

    Jennifer R Prentice

    Full Text Available There is public concern over the long term systemic health effects of metal released from hip replacement prostheses that use large-diameter metal-on-metal bearings. However, to date there has been no systematic study to determine which organs may be at risk, or the magnitude of any effect. We undertook a detailed cross-sectional health screen at a mean of 8 years after surgery in 35 asymptomatic patients who had previously received a metal-on-metal hip resurfacing (MoMHR versus 35 individually age and sex matched asymptomatic patients who had received a conventional hip replacement. Total body bone mineral density was 5% higher (mean difference 0.05 g/cm², P = 0.02 and bone turnover was 14% lower (TRAP 5b, mean difference -0.56IU/L, P = 0.006; osteocalcin, mean difference -3.08 ng/mL, P = 0.03 in the hip resurfacing versus conventional hip replacement group. Cardiac ejection fraction was 7% lower (mean absolute difference -5%, P = 0.04 and left ventricular end-diastolic diameter was 6% larger (mean difference 2.7 mm, P = 0.007 in the hip resurfacing group versus those patients who received a conventional hip replacement. The urinary fractional excretion of metal was low (cobalt 5%, chromium 1.5% in patients with MoMHR, but creatinine clearance was normal. Diuretic prescription was associated with a 40% increase in the fractional excretion of chromium (mean difference 0.5%, P = 0.03. There was no evidence of difference in neuropsychological, renal tubular, hepatic or endocrine function between groups (P>0.05. Our findings of differences in bone and cardiac function between patient groups suggest that chronic exposure to low elevated metal concentrations in patients with well-functioning MoMHR prostheses may have systemic effects. Long-term epidemiological studies in patients with well-functioning metal on metal hip prostheses should include musculoskeletal and cardiac endpoints to quantitate the risk of clinical disease.

  10. Basal Cell Carcinoma of the Umbilicus: A Comprehensive Literature Review

    Science.gov (United States)

    Cohen, Philip R

    2016-01-01

    Basal cell carcinoma (BCC) typically occurs in sun-exposed sites. Only 16 individuals with umbilical BCC have been described in the literature, and the characteristics of patients with umbilical BCC are summarized. PubMed was used to search the following terms: abdomen, basal cell carcinoma, basal cell nevus syndrome, and umbilicus. Papers with these terms and references cited within these papers were reviewed. BCC of the umbilicus has been reported in five men and 11 women; one man had two tumors. Two patients had basal cell nevus syndrome (BCNS). Other risk factors for BCC were absent. The tumor most commonly demonstrated nodular histology (64%, 9/14); superficial and fibroepithelioma of Pinkus variants were noted in three and two patients, respectively. The tumor was pigmented in eight individuals. Treatment was conventional surgical excision (87%, 13/15) or Mohs micrographic surgery (13%, 2/15); either adjuvant laser ablation or radiotherapy was performed in two patients. The prognosis after treatment was excellent with no recurrence or metastasis (100%, 16/16). In conclusion, BCC of the umbilicus is rare. It usually presents as a tumor with a non-aggressive histologic subtype in an individual with no risk factors for this malignancy. There has been no recurrence or metastasis following excision of the cancer. PMID:27738570

  11. Basal Cell Carcinoma Developing from Trichoepithelioma: Review of Three Cases

    Science.gov (United States)

    Satyanarayana, M. Ananta; Aryasomayajula, Sirish; Krishna, B.A. Rama

    2016-01-01

    Trichoepitheliomas (TE) are benign tumours but occasionally can undergo transformation to malignant neoplasms more commonly as Basal Cell Carcinoma (BCC). The correct diagnosis between these tumours is very important because basal cell carcinoma is locally aggressive neoplasm and requires total surgical excision with wide healthy margins while trichoepithelioma needs simple excision. We describe three patients who developed basal cell carcinoma with facial trichoepitheliomas. The only clinical feature that distinguished the carcinomas from the trichoepitheliomas was their larger size, in all three patients, one patient with recurrent, hyper pigmented swelling with surface ulceration and in another patient there are multiple trichoepitheliomas, and other family members are also affected. The history, clinical features and histopathological findings were suggestive of the evolution of basal cell carcinoma directly from trichoepithelioma in our first two cases, but in the third case TE and BCC were separate lesions on face and we are uncertain about whether the BCC developed independently or by transformation from a trichoepithelioma. Based on our clinicopathological observations in the three patients and reports in the recent literature, BCC with follicular differentiation and trichoepithelioma are considered to be highly related. PMID:27134936

  12. PERIANTH DEVELOPMENT IN THE BASAL MONOCOT TRIGLOCHIN MARITIMA (JUNCAGINACEAE)

    DEFF Research Database (Denmark)

    Buzgo, Matyas; Soltis, Douglas E.; Soltis, Pamela S.;

    2006-01-01

    Basal monocots exhibit considerable variation in inflorescence and floral structure. In some cases, such as Triglochin maritima, it is not clear whether the lateral and terminal structures of the inflores- cence are flowers or pseudanthia, or where the limits between flowers and inflorescence lie...

  13. Metacomprehension during Basal Reader Instruction: Do Teachers Promote It?

    Science.gov (United States)

    Schmitt, Maribeth Cassidy; Baumann, James F.

    1990-01-01

    Analyzes elementary teachers' interactions with students during guided reading of basal reader selections to determine the extent to which the interactions promote students' metacomprehension abilities. Finds that teachers assumed most of the responsibility for students' comprehension themselves rather than conducting the lessons in a manner that…

  14. Utilizing Psycholinguistic Insights in Teaching via the Basal Reader.

    Science.gov (United States)

    Newman, Harold

    Ideas of educational psycholinguists Frank Smith and Kenneth Goodman can be combined with the ideas presented in current basal reader manuals to help teachers teach reading more effectively. Since reading and speaking are parallel processes, teachers may invite children to "read" with them, hearing the melody of language as they point to…

  15. Saccade learning with concurrent cortical and subcortical basal ganglia loops

    Directory of Open Access Journals (Sweden)

    Steve eN'guyen

    2014-04-01

    Full Text Available The Basal Ganglia is a central structure involved in multiple cortical and subcortical loops. Some of these loops are believed to be responsible for saccade target selection. We study here how the very specific structural relationships of these saccadic loops can affect the ability of learning spatial and feature-based tasks.We propose a model of saccade generation with reinforcement learning capabilities based onour previous basal ganglia and superior colliculus models. It is structured around the interactions of two parallel cortico-basal loops and one tecto-basal loop. The two cortical loops separately deal with spatial and non-spatial information to select targets in a concurrent way. The subcortical loop is used to make the final target selection leading to the production of thesaccade. These different loops may work in concert or disturb each other regarding reward maximization. Interactions between these loops and their learning capabilities are tested on different saccade tasks.The results show the ability of this model to correctly learn basic target selection based on different criteria (spatial or not. Moreover the model reproduces and explains training dependent express saccades toward targets based on a spatial criterion. Finally, the model predicts that in absence of prefrontal control, the spatial loop should dominate.

  16. Mephedrone alters basal ganglia and limbic neurotensin systems.

    Science.gov (United States)

    German, Christopher L; Hoonakker, Amanda H; Fleckenstein, Annette E; Hanson, Glen R

    2014-08-01

    Mephedrone (4-methylmethcathinone) is a synthetic cathinone designer drug that alters pre-synaptic dopamine (DA) activity like many psychostimulants. However, little is known about the post-synaptic dopaminergic impacts of mephedrone. The neuropeptide neurotensin (NT) provides inhibitory feedback for basal ganglia and limbic DA pathways, and post-synaptic D1 -like and D2 -like receptor activity affects NT tissue levels. This study evaluated how mephedrone alters basal ganglia and limbic system NT content and the role of NT receptor activation in drug consumption behavior. Four 25 mg/kg injections of mephedrone increased NT content in basal ganglia (striatum, substantia nigra and globus pallidus) and the limbic regions (nucleus accumbens core), while a lower dosage (5 mg/kg/injection) only increased striatal NT content. Mephedrone-induced increases in basal ganglia NT levels were mediated by D1 -like receptors in the striatum and the substantia nigra by both D1 -like and D2 -like receptors in the globus pallidus. Mephedrone increased substance P content, another neuropeptide, in the globus pallidus, but not in the dorsal striatum or substantia nigra. Finally, the NT receptor agonist PD149163 blocked mephedrone self-administration, suggesting reduced NT release, as indicated by increased tissue levels, likely contributing to patterns of mephedrone consumption.

  17. Basal ganglia play a crucial role in decision making

    OpenAIRE

    Thibaut, Florence

    2016-01-01

    Many studies have suggested that the striatum, located at the interface of the cortico-basal ganglia-thalamic circuit, consists of separate circuits that serve distinct functions It plays an important role in motor planning, value processing, and decision making.

  18. Normal sexual dimorphism in the human basal ganglia.

    NARCIS (Netherlands)

    Rijpkema, M.J.P.; Everaerd, D.S.; Pol, C.; Franke, B.; Tendolkar, I.; Fernandez, G.S.E.

    2012-01-01

    Male and female brains differ in both structure and function. Investigating this sexual dimorphism in healthy subjects is an important first step to ultimately gain insight into sex-specific differences in behavior and risk for neuropsychiatric disorders. The basal ganglia are among the main regions

  19. [Successful therapy of metastatic basal cell carcinoma with vismodegib].

    Science.gov (United States)

    Zutt, M; Mazur, F; Bergmann, M; Lemke, A J; Kaune, K M

    2014-11-01

    A 71-year-old man presented with giant basal cell carcinoma on the abdomen which had metastasized. He was treated with oral vismodegib. Both the primary ulcerated tumor on the abdomen and the metastases responded. Vismodegib was well tolerated without significant side effects. The tumor recurred promptly after vismodegib was discontinued, and then was resistant to therapy when vismodegib was re-administered.

  20. Study of effects of metallic prostheses in radiotherapy treatments in prostate cancer; Estudio de los efectos de las protesis metalicas en tratamientos radioterapicos en irradiacion pelvica

    Energy Technology Data Exchange (ETDEWEB)

    Cabrera, P.; Mateos, J. C.; Herrador, M.; Ortiz, M. J.

    2006-07-01

    In this work it is described the problems related to the radiotherapy treatments of patients with prostate cancer and hip implants Analyze the effects of metallic prostheses in radiotherapy treatments and present the methods to overcome the problems that arise in these situations. Our patients are student in a TAC Philips with a range of Hounsfield number of-1000 to 4000. The planning and measurement of CT numbers are done in a RTP ADAC Pinnacle that have a maximum of 32767 CT units. The metallic implants more frequently used, titanium, stainless steel and cobalt-chromium-molybdenum, generate CT numbers from 2000 to 3000, and cause saturation effects. This problem may be solved with modern scanners that use the extended CT range. It is an algorithm that expand the usual range by a factor of 10. An alternative solution to this problem can be used if the prostheses are able to scan to select the window parameters that allow an automatic region of interest (roi) definition that match to the dimensions of the implants. Finally it is assigned the electronic/physical densities to the created roi's. The clinical dosimetry of patients with prostheses have been done defining the usual regions of interests (target volume and risk organs) in first place. Finally the prostheses are outlined using the window parameters previously measured and assigned the electronic or physical densities. The attenuation of the implant may then be calculated accurately. The presence of implants in the treatment fields originate artifacts in the TAC images of patients and underdosage of target volume that range between 12% and 30% in function of material an energy used. It is necessary the application of methods that correct the dose behind the implant, if it is not possible to prevent the incidence of the treatment beams over the prostheses. (Author)