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Sample records for bone surgical simulation

  1. Good experiences with interactive temporal bone surgical simulator

    DEFF Research Database (Denmark)

    Andersen, Steven A W; Mikkelsen, Peter Trier; Noe, Karsten Ostergaard;

    2014-01-01

    The Visible Ear Simulator (VES) is a freeware temporal bone surgical simulator utilizing a high-fidelity haptic and graphical voxel model compiled from segmented digital images of fresh frozen sections. A haptic device provides the 3-dimensional handling and drilling with force-feedback in real...

  2. Surgical Simulation and Competency.

    Science.gov (United States)

    Kim-Fine, Shunaha; Brennand, Erin A

    2016-09-01

    Simulation in surgical training is playing an increasingly important role as postgraduate medical education programs navigate an environment of increasing costs of education, increased attention on patient safety, and new duty hour restrictions. In obstetrics and gynecology, simulation has been used to teach many procedures; however, it lacks a standardized curriculum. Several different simulators exist for teaching various routes and aspects of hysterectomy. This article describes how a formal framework of increasing levels of competencies can be applied to simulation in teaching the procedure of hysterectomy. PMID:27521885

  3. [Surgical procedures for bone neoplasms in children].

    Science.gov (United States)

    Woźniak, W

    1991-01-01

    The treatment of 40 patients with bone tumors have been presented. The primary tumors were located in the following sites: femur (14), tibia (8), fibula (4), humerus (4), scapula (1), clavicle (2), pelvis (5), hand (1). Investigated group were: osteosarcoma (18), Ewing's sarcoma (14), chondrosarcoma (2), fibrosarcoma (1), synovial sarcoma (1), chondroblastoma (4). In the most frequent malignant bone tumors, osteosarcoma and Ewing's sarcoma, unified management was adapted. The treatment was initiated with multidrug chemotherapy and followed by surgery or radiotherapy (Ewing's sarcoma) of the primary site. Surgery was performed in 30 cases: 19 mutilating operations because of the broad local invasion, 11 conservative surgical procedures (limb -- salvage operations). Satisfactory oncological and functional effect can be achieved after limb-salvage surgical procedures in the cases of localized, especially semimalignant bone tumors. PMID:1369876

  4. Surgical simulation in orthopaedic skills training.

    Science.gov (United States)

    Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

    2012-07-01

    Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated. PMID:22751160

  5. Simulation-based surgical education.

    Science.gov (United States)

    Evgeniou, Evgenios; Loizou, Peter

    2013-09-01

    The reduction in time for training at the workplace has created a challenge for the traditional apprenticeship model of training. Simulation offers the opportunity for repeated practice in a safe and controlled environment, focusing on trainees and tailored to their needs. Recent technological advances have led to the development of various simulators, which have already been introduced in surgical training. The complexity and fidelity of the available simulators vary, therefore depending on our recourses we should select the appropriate simulator for the task or skill we want to teach. Educational theory informs us about the importance of context in professional learning. Simulation should therefore recreate the clinical environment and its complexity. Contemporary approaches to simulation have introduced novel ideas for teaching teamwork, communication skills and professionalism. In order for simulation-based training to be successful, simulators have to be validated appropriately and integrated in a training curriculum. Within a surgical curriculum, trainees should have protected time for simulation-based training, under appropriate supervision. Simulation-based surgical education should allow the appropriate practice of technical skills without ignoring the clinical context and must strike an adequate balance between the simulation environment and simulators. PMID:23088646

  6. Learning Basic Surgical Skills through Simulator Training

    Science.gov (United States)

    Silvennoinen, Minna; Helfenstein, Sacha; Ruoranen, Minna; Saariluoma, Pertti

    2012-01-01

    Computer-based surgical training simulators are instrumental in skill-based training and performance measurement. However, to date, the educational employment of these tools lacks empirically founded insights and effective practical guidelines. This study examined surgical residents during computer-based simulator training of basic laparoscopic…

  7. Surgical treatment and outcomes of temporal bone chondroblastoma.

    Science.gov (United States)

    Moon, In Seok; Kim, Jin; Lee, Ho-Ki; Lee, Won-Sang

    2008-12-01

    Chondroblastoma is an uncommon primary benign bone tumor that usually arises in the epiphyses of the long bones. Temporal bone chondroblastoma is a rare primary bone tumor that affects the floor of the middle cranial fossa and temporomandibular joint (TMJ). The biological nature of temporal bone chondroblastoma is occasionally aggressive because of local invasion and is known to have a high recurrence after curettage. Therefore, complete resection is recommended. However, the literature provides little information regarding long-term surgical outcomes and complications after surgical resection. The authors have retrospectively analyzed four cases of temporal bone chondroblastoma that had been completely excised by a single surgeon with an eventual long-term follow-up. A single surgeon operated on four patients, two males and two females, with a mean age of 34 years, at the Department of Otorhinolaryngology, Severance Hospital. In all cases, the tumor involved the middle cranial fossa dura and the mandibular fossa with variable degree of infiltration. All patients have had no tumor recurrence to date (mean follow-up period of 5 years). Complete surgical resection of the temporal bone chondroblastoma is the gold standard for treatment. Precise preoperative image evaluation of tumor extension and proper management of the dura mater and temporomandibular joint (TMJ) are the major important features in complete surgical removal that minimize complications in temporal bone chondroblastoma treatment.

  8. Surgical management of osteoradionecrosis of the temporal bone

    Energy Technology Data Exchange (ETDEWEB)

    Kveton, J.F.

    1988-03-01

    The surgical management of osteoradionecrosis of the temporal bone has met with limited success because of the difficulty in accurate assessment of the viability of nonnecrotic bone intraoperatively. Failure to resect all nonviable bone results in recurrence of a necrotic focus. With the use of hyperbaric oxygen therapy to stabilize marginal bone and oral tetracycline to label viable bone preoperatively, removal of all nonviable bone can be accomplished. Postoperatively, a second course of hyperbaric therapy enhances wound healing, thus assuring a successful outcome. This article details a successful systematic approach that was developed to resect a necrotic focus in the temporal bone of a 10-year-old boy who had undergone a full course of radiotherapy for treatment of a rhabdomyosarcoma.

  9. Consensus on Surgical Management of Myeloma Bone Disease.

    Science.gov (United States)

    2016-08-01

    Myeloma bone disease (MBD), the skeletal lesions caused by multiple myeloma, is also known as skeletal related events and includes bone pain, osteoporosis, pathological fractures, osteolytic bone lesions, spinal instability, spinal cord and nerve root compression and extramedullary plasmacytoma. It is now generally accepted that patients with these complications usually require surgical management and that such treatment is safe and effective. The aims of surgical interventions are to alleviate pain, improve quality of life, treat potential or existing pathological fractures, decompress the spinal cord and nerve roots, and reestablish bone continuity. Thus far, there have not been uniform standards for surgical treatment of MBD. The Surgeon's Committee of the Chinese Myeloma Working Group has therefore achieved a consensus with the aim of providing guidance for clinicians and benefitting patients with MBD. This consensus focuses on the treatment of MBD, including its clinical definition and characteristics, diagnosis and surgical management. This expert consensus document was compiled after discussion and revision by experts from several relevant institutions in China. However, it is only an interim guide that cannot be enforced legally. It will be updated with development of new techniques of treatment. PMID:27627707

  10. Standardization of surgical techniques used in facial bone contouring.

    Science.gov (United States)

    Lee, Tae Sung

    2015-12-01

    Since the introduction of facial bone contouring surgery for cosmetic purposes, various surgical methods have been used to improve the aesthetics of facial contours. In general, by standardizing the surgical techniques, it is possible to decrease complication rates and achieve more predictable surgical outcomes, thereby increasing patient satisfaction. The technical strategies used by the author to standardize facial bone contouring procedures are introduced here. The author uses various pre-manufactured surgical tools and hardware for facial bone contouring. During a reduction malarplasty or genioplasty procedure, double-bladed reciprocating saws and pre-bent titanium plates customized for the zygomatic body, arch and chin are used. Various guarded oscillating saws are used for mandibular angloplasty. The use of double-bladed saws and pre-bent plates to perform reduction malarplasty reduces the chances of post-operative asymmetry or under- or overcorrection of the zygoma contours due to technical faults. Inferior alveolar nerve injury and post-operative jawline asymmetry or irregularity can be reduced by using a guarded saw during mandibular angloplasty. For genioplasty, final placement of the chin in accordance with preoperative quantitative analysis can be easily performed with pre-bent plates, and a double-bladed saw allows more procedural accuracy during osteotomies. Efforts by the surgeon to avoid unintentional faults are key to achieving satisfactory results and reducing the incidence of complications. The surgical techniques described in this study in conjunction with various in-house surgical tools and modified hardware can be used to standardize techniques to achieve aesthetically gratifying outcomes. PMID:26346781

  11. The role and validity of surgical simulation.

    Science.gov (United States)

    Agha, Riaz A; Fowler, Alexander J

    2015-02-01

    In the last three decades, simulation has become a key tool in the training of doctors and the maintenance of patient safety. Simulation offers an immersive, realistic way of learning technical skills. Recent changes to the training schemes in many surgical specialities mean that the hours spent working between senior house officer and consultant have been reduced. This, combined with other pressures (such as reduced operating hours), means that surgery has moved away from its traditional apprenticeship model and toward a competency-based one. Simulation can be a standardized and safe method for training and assessing surgeons. Use of simulation for training has become significant alongside the development of laparoscopic techniques, and evidence suggests that skills obtained in simulation are applicable in real clinical scenarios. Simulation allows trainees to make mistakes, to ask the "what if?" questions, and to learn and reflect on such situations without risking patient safety. Virtual reality simulators have been used to allow experts to plan complicated operations and assess perioperative risks. Most recently, fully immersive simulations, such as those with whole theater teams involved, and patient-centered simulations allow development of other key skills aside from purely technical ones. Use of simulation in isolation from traditional teaching methods will furnish the surgeon in training with skills, but the best time and place to use such skills comes only with experience. In this article we examine the role of simulation in surgical training and its impact in the context of reduced training time. PMID:25692441

  12. Virtual reality simulation in endovascular surgical training.

    LENUS (Irish Health Repository)

    Tsang, J S

    2008-08-01

    Shortened trainingtimes duetothe European Working Time Directive (EWTD) and increased public scrutiny of surgical competency have led to a move away from the traditional apprenticeship model of training. Virtual reality (VR) simulation is a fascinating innovation allowing surgeons to develop without the need to practice on real patients and it may be a solution to achieve competency within a shortened training period.

  13. A novel surgical procedure for bridging of massive bone defects

    Directory of Open Access Journals (Sweden)

    Springfield Dempsey S

    2005-02-01

    Full Text Available Abstract Background Bony defects arising from tumor resection or debridement after infection, non-union or trauma present a challenging problem to orthopedic surgeons, as well as patients due to compliance issues. Current treatment options are time intensive, require more than one operation and are associated with high rate of complications. For this reason, we developed a new surgical procedure to bridge a massive long bone defect. Methods To bridge the gap, an in situ periosteal sleeve is elevated circumferentially off of healthy diaphyseal bone adjacent to the bone defect. Then, the adjacent bone is osteotomized and the transport segment is moved along an intramedullary nail, out of the periosteal sleeve and into the original diaphyseal defect, where it is docked. Vascularity is maintained through retention of the soft tissue attachments to the in situ periosteal sleeve. In addition, periosteal osteogenesis can be augmented through utilization of cancellous bone graft or in situ cortical bone adherent to the periosteal sleeve. Results The proposed procedure is novel in that it exploits the osteogenic potential of the periosteum by replacing the defect arising from resection of tissue out of a pathological area with a defect in a healthy area of tissue, through transport of the adjacent bone segment. Furthermore, the proposed procedure has several advantages over the current standard of care including ease of implementation, rapid patient mobilization, and no need for specialized implants (intramedullary nails are standard inventory for surgical oncology and trauma departments or costly orthobiologics. Conclusions The proposed procedure offers a viable and potentially preferable alternative to the current standard treatment modalities, particularly in areas of the world where few surgeons are trained for procedures such as distraction osteogenesis (e.g. the Ilizarov procedure as well as areas of the world where surgeons have little access to

  14. Time Simulation of Bone Adaptation

    DEFF Research Database (Denmark)

    Bagge, Mette

    1998-01-01

    The structural adaptation of a three-dimensional finite element model ofthe proximal femur is considered. Presuming the bone possesses the optimalstructure under the given loads, the bone material distribution is foundby minimizing the strain energy averaged over ten load cases with avolume...... constraint. Theoptimized design is used as a start-configuration for the remodelingsimulation.The parameter characterizing the equilibrium level where no remodeling occurs is estimated from the optimization parameters.The loads vary in magnitude, location and direction simulating timedependent loading. The...

  15. Is bone scintigraphy necessary in the initial surgical staging of chondrosarcoma of bone?

    Energy Technology Data Exchange (ETDEWEB)

    Douis, Hassan; James, Steven L.; Davies, Mark A. [Royal Orthopaedic Hospital, Department of Radiology, Birmingham (United Kingdom); Grimer, Robert J. [Royal Orthopaedic Hospital, Department of Orthopaedic Oncology, Birmingham (United Kingdom)

    2012-04-15

    To assess the value of whole-body bone scintigraphy in the initial surgical staging of chondrosarcoma of bone. A retrospective review was conducted of the bone scintigraphy reports of a large series of patients with peripheral or central chondrosarcoma of bone treated in a specialist orthopaedic oncology unit over a 13-year period. Abnormal findings were correlated against other imaging, histological grade and the impact on surgical staging. A total of 195 chondrosarcomas were identified in 188 patients. In 120 (63.8%) patients the reports of bone scintigraphy noted increased activity at the site of one or more chondrosarcomas. In one patient the tumour was outside the field-of-view of the scan, and in the remaining 67 (35.6%) cases, there was increased activity at the site of the chondrosarcoma and further abnormal activity in other areas of the skeleton. Causes of these additional areas of activity included degenerative joint disease, Paget's disease and in one case a previously undiagnosed melanoma metastasis. No cases of skeletal metastases from the chondrosarcoma were found in this series. Multifocal chondrosarcomas were identified in three cases. In two it was considered that all the tumours would have been adequately revealed on the initial MR imaging staging studies. In only the third multifocal case was an unsuspected, further presumed low-grade, central chondrosarcoma identified in the opposite asymptomatic femur. Although this case revealed an unexpected finding the impact on surgical staging was limited as it was decided to employ a watch-and-wait policy for this tumour. There is little role for the routine use of whole-body bone scintigraphy in the initial surgical staging in patients with chondrosarcoma of bone irrespective of the histological grade. (orig.)

  16. Stereoscopic virtual realistic surgical simulation in intracranial aneurysms

    Directory of Open Access Journals (Sweden)

    Hiromichi Nakabayashi

    2012-01-01

    Full Text Available Background: Three-dimensional (3D-computed tomographic angiography (CTA has been widely used for surgical simulation of intracranial aneurysms. Stereo imaging technology is progressing rapidly in recent years and stereo imaging may make more realistic surgical simulation possible. Therefore, we aimed at the establishment of a technique for stereoscopic viewing of minute volume rendering images while pursuing a low cost. Materials and Methods: Between January 2009 and June 2011, 54 patients with ruptured intracranial aneurysms were enrolled in this study. CTA data was transferred to the workstation equipped with image-processing software, and multilayer fusion images were processed by neurosurgeons. Image data for stereoscopic viewing of multilayer fusion image from arbitrary directions were collected form rotational trajectories around an aneurysm and were output to MPEG file. Stereoscopic viewing using MPEG data was achieved by the freeware named Stereo Movie Maker. Stereo viewing method using QuickTime VR format was also tried. Results: Multilayer fusion image created from CTA data displayed clearly the anatomical information about not only the aneurysm but also the surrounding structures, such as parent artery, venous system, brain tissue, skull bone, and scalp. The quality of the resulting multilayer fusion image was suitable for surgical simulation with virtual reality. Virtual realistic surgical simulation became possible by the combination of minute multilayer fusion image and stereoscopic viewing by our method. Conclusions: Our method for stereo viewing of multilayer fusion images resulted in an improvement in the capability of diagnostic imaging and the image-guided support for neurosurgical procedures in intracranial aneurysm.

  17. Surgical simulation and evaluation in anterior cruciate ligament reconstruction with image-free navigation

    Institute of Scientific and Technical Information of China (English)

    Wang Tianmiao; Hu Yan; Liu Wenyong; Sun Lei; Wang Junchen; Feng Hua; Hu Lei

    2009-01-01

    A surgical simulation and evaluation method in the anterior cruciate ligament (ACL) reconstruction with image-free navigation was presented. Firstly, video tracking module, bone surface reconstruction module and virtual simulation module of this system were discussed. Secondly, the coordinate relations of several surgery objects (including surgical instrument, anatomical, camera and screen) in the surgical environment, the tracking based on MicronTracker with two cameras and the bone surface real-time reconstruction based on the Delaunay algorithm were introduced in detail. Finally, experiments of anisometry measurement and virtual simulation on two plastics were carried out to verify the validity of the proposed method. The anisometry value of reconstructed ACL was 8.970039mm. The effectiveness of ACL reconstruction has been proved by preliminary evaluation trials.

  18. Osteoradionecrosis of the temporal bone: a surgical technique of treatment

    Energy Technology Data Exchange (ETDEWEB)

    Ma, K.H.; Fagan, P.A.

    1988-05-01

    Osteoradionecrosis of the temporal bone is a well-documented complication of radiotherapy to the ear, with potentially lethal complications. Three cases of advanced disease, treated surgically, are presented. In two of these, subtotal petrosectomy with blind-sac closure of the external auditory canal was carried out via an anterior approach. The enclosed space was obliterated with pedicled temporalis muscle. Primary healing took place. One case was similarly obliterated using a prolonged posterior incision. The wound broke down, requiring a microvascular free flap for closure. Radiotherapy jeopardizes the viability of skin flaps. An anterior incision bases the flap behind on the occipital and postauricular arteries. When radiotherapy has been used, this incision has theoretical and practical advantages over a standard posterior incision.

  19. Effects of bovine lactoferrin in surgically created bone defects on bone regeneration around implants.

    Science.gov (United States)

    Görmez, Ulaş; Kürkcü, Mehmet; E Benlidayi, Mehmet; Ulubayram, Kezban; Sertdemir, Yaşar; Dağlioğlu, Kenan

    2015-03-01

    The aim of this experimental study was to evaluate the effect of bovine lactoferrin (bLF)-loaded gelatin microspheres (GM) used in combination with anorganic bovine bone on bone regeneration in surgically created bone defects around tooth implants. Twenty-four uniform bone defects were created in the frontal bone via an extraoral approach in 12 domestic pigs. Twenty-four implants were placed at the center of the defects. In eight animals one of these defects was filled with 0.3 mL anorganic bovine bone while the other was left empty. In four animals, all defects were filled with 3 mg/defect bLF-loaded GM and anorganic bovine bone. All the defects were covered with collagen membranes. All animals were sacrificed after 10 weeks of healing, and the implants with the surrounding bone defects were removed en bloc. Undecalcified sections were prepared for histomorphometric analysis. The mean total area of hard tissue was 26.9 ± 6.0% in the empty defect group, 31.8 ± 8.4% in the graft group, and 47.6 ± 5.0% in the lactoferrin group (P < 0.001). The mean area of newly formed bone was 26.9 ± 6.0% in the empty defect group, 22.4 ± 8.2% in the graft group, and 46.1 ± 5.1% in the lactoferrin group (P < 0.001). The mean residual graft area was 9.4 ± 3.2% in the graft group and 1.5 ± 0.6% in the lactoferrin group (P < 0.001). The mean proportion of bone-implant contact in the defect region was 21.9 ± 8.4% in the empty defect group, 26.9 ± 10.1% in the graft group and 29.9 ± 10.3% in the lactoferrin group (P = 0.143). These data indicate that a combination of 3 mg bLF-loaded GM and bovine-derived HA promotes bone regeneration in defects around implants. PMID:25807903

  20. Modelling and simulation of acrylic bone cement injection and curing within the framework of vertebroplasty

    CERN Document Server

    Landgraf, Ralf; Kolmeder, Sebastian; Lion, Alexander; Lebsack, Helena; Kober, Cornelia

    2013-01-01

    The minimal invasive procedure of vertebroplasty is a surgical technique to treat compression fractures of vertebral bodies. During the treatment liquid bone cement gets injected into the affected vertebral body and therein cures to a solid. In order to investigate the treatment and the impact of injected bone cement on the vertebra, an integrated modelling and simulation framework has been developed. The framework includes (i) the generation of computer models based on microCT images of human cancellous bone, (ii) CFD simulations of bone cement injection into the trabecular structure of a vertebral body as well as (iii) non-linear FEM simulations of the bone cement curing. Thereby, microstructural models of trabecular bone structures are employed. Furthermore, a detailed description of the material behaviour of acrylic bone cements is provided. More precisely, a non-linear fluid flow model is chosen for the representation of the bone cement behaviour during injection and a non-linear viscoelastic material mo...

  1. Three-dimensional medical images and its application for surgical simulation of plastic and reconstructive surgery

    International Nuclear Information System (INIS)

    The author's three surgical simulation systems are presented. First the computer graphics surgical simulation system has been developed which make the three dimensional skull image from CT scans and the arbitrary osteotomy, mobilization of bone segments and prediction of post-operative appearance is made possible. The second system is solid modeling of the skull using laser curable resin and it is concluded that life-sized skull model is useful not only for surgical simulation of major craniofacial surgery but also educational purposes. The third one is solid modeling of the ear using non-contact 3-D shape measurement with slit laser scanner. The mirror image life-sized wax model is made from the normal side of th ear and the autologous cartilage framework is assembled to simulate the wax model, thus the precise three dimensional reconstruction of the auricle is made possible. (author)

  2. [Navigated implant placement using a bone supported CT-guided surgical template. Case report].

    Science.gov (United States)

    Teubner, Eckart; Rohner, Dennis; Deak, Alexander; Lorenzon, Andreas; Marinello, Carlo P

    2009-01-01

    Surgical navigation allows precise implant placement and minimizes the risk of interferences with anatomical structures. Computerized implant planning based on tomographic data can be clinically realized by surgical templates. These are normally produced by stereo lithographic rapid prototyping. Accurate placement of virtually planned dental implants depends on a precise fabrication and positioning of the surgical template. Bone-, tooth-, implant-, and/or soft tissue-supported surgical templates allow for different micromovements. This report documents the diagnostics and surgical procedures of implant placement in an edentulous patient. Implant fixed complete dentures in the maxilla and mandible were planned. In the maxilla implants were inserted with the aid of a conventional surgical template. In the mandible a bone supported CT-guided surgical template was used. PMID:20120091

  3. Links Between Surgical Landmarks of the Temporal Bone and Cochlear Implant Approaches

    Directory of Open Access Journals (Sweden)

    Gabriel Lostun

    2015-12-01

    Full Text Available Objective: We aimed to underline the surgical importance of the distances between the landmarks of the temporal bone, important for quantifying the benefits and disadvantages of two different cochlear implant techniques.

  4. Synthesis and Simulation of Surgical Process Models.

    Science.gov (United States)

    Claude, Guillaume; Gouranton, Valérie; Caillaud, Benoit; Gibaud, Bernard; Arnaldi, Bruno; Jannin, Pierre

    2016-01-01

    Virtual Reality for surgical training is mainly focused on technical surgical skills. We work on providing a novel approach to the use of Virtual Reality focusing on the procedural aspects. Our system relies on a specific work-flow generating a model of the procedure from real case surgery observation in the operating room. This article presents the different technologies created in the context of our project and their relations as other components of our workflow. PMID:27046555

  5. Historical review of surgical simulation--a personal perspective.

    Science.gov (United States)

    Satava, Richard M

    2008-02-01

    Although simulation is relatively new to surgical education, there is a long history in many other disciplines, such as military, aviation, and nuclear power plant operations, among others. In the late 1980s these technologies began to be adapted to the surgical world, along with the new technology of virtual reality. This is a review of the introduction of manikins, computers, and virtual reality into education and training for surgical skills. Two concomitant revolutions occurred: objective assessment of surgical skills and converting training from the apprenticeship model to one of criterion-based training. A personal perspective on these developments adds information not previously published. PMID:18097716

  6. Three-dimensional virtual reality surgical planning and simulation workbench for orthognathic surgery.

    Science.gov (United States)

    Xia, J; Samman, N; Yeung, R W; Shen, S G; Wang, D; Ip, H H; Tideman, H

    2000-01-01

    A new integrated computer system, the 3-dimensional (3D) virtual reality surgical planning and simulation workbench for orthognathic surgery (VRSP), is presented. Five major functions are implemented in this system: post-processing and reconstruction of computed tomographic (CT) data, transformation of 3D unique coordinate system geometry, generation of 3D color facial soft tissue models, virtual surgical planning and simulation, and presurgical prediction of soft tissue changes. The basic mensuration functions, such as linear and spatial measurements, are also included. The surgical planning and simulation are based on 3D CT reconstructions, whereas soft tissue prediction is based on an individualized, texture-mapped, color facial soft tissue model. The surgeon "enters" the virtual operatory with virtual reality equipment, "holds" a virtual scalpel, and "operates" on a virtual patient to accomplish actual surgical planning, simulation of the surgical procedure, and prediction of soft tissue changes before surgery. As a final result, a quantitative osteotomy-simulated bone model and predicted color facial model with photorealistic quality can be visualized from any arbitrary viewing point in a personal computer system. This system can be installed in any hospital for daily use.

  7. Progress in virtual reality simulators for surgical training and certification.

    Science.gov (United States)

    de Visser, Hans; Watson, Marcus O; Salvado, Olivier; Passenger, Joshua D

    2011-02-21

    There is increasing evidence that educating trainee surgeons by simulation is preferable to traditional operating-room training methods with actual patients. Apart from reducing costs and risks to patients, training by simulation can provide some unique benefits, such as greater control over the training procedure and more easily defined metrics for assessing proficiency. Virtual reality (VR) simulators are now playing an increasing role in surgical training. However, currently available VR simulators lack the fidelity to teach trainees past the novice-to-intermediate skills level. Recent technological developments in other industries using simulation, such as the games and entertainment and aviation industries, suggest that the next generation of VR simulators should be suitable for training, maintenance and certification of advanced surgical skills. To be effective as an advanced surgical training and assessment tool, VR simulation needs to provide adequate and relevant levels of physical realism, case complexity and performance assessment. Proper validation of VR simulators and an increased appreciation of their value by the medical profession are crucial for them to be accepted into surgical training curricula. PMID:21401487

  8. LR-Spring Mass Model for Cardiac Surgical Simulation

    DEFF Research Database (Denmark)

    Mosegaard, Jesper

    2004-01-01

    The purpose of the research conducted was to develop a real-time surgical simulator for preoperative planning of surgery in congenital heart disease. The main problem simulating procedures on cardiac morphology is the need for a large degree of detail and simulation speed. In combination with a d...... with a demand for physically realistic real-time behaviour this gives us tradeoffs not easily balanced. The LR-Spring Mass model handles these constraints by the use of domain specific knowledge....

  9. Haptic Feedback for the GPU-based Surgical Simulator

    DEFF Research Database (Denmark)

    Sørensen, Thomas Sangild; Mosegaard, Jesper

    2006-01-01

    The GPU has proven to be a powerful processor to compute spring-mass based surgical simulations. It has not previously been shown however, how to effectively implement haptic interaction with a simulation running entirely on the GPU. This paper describes a method to calculate haptic feedback...... with limited performance cost. It allows easy balancing of the GPU workload between calculations of simulation, visualisation, and the haptic feedback....

  10. Smoking and Bone Healing - A Risky Surgical Combination

    Science.gov (United States)

    ... the case of scheduled surgeries, many foot and ankle surgeries result from accidents or injuries that require an immediate response. In those cases, ... of a surgical procedure or fractured through an injury... ... in 1942, the American College of Foot and Ankle Surgeons is a specialty medical society of more ...

  11. GPU Accelerated Surgical Simulators for Complex Morhpology

    DEFF Research Database (Denmark)

    Mosegaard, Jesper; Sørensen, Thomas Sangild

    2005-01-01

    a springmass system in order to simulate a complex organ such as the heart. Computations are accelerated by taking advantage of modern graphics processing units (GPUs). Two GPU implementations are presented. They vary in their generality of spring connections and in the speedup factor they achieve...

  12. A GPU Accelerated Spring Mass System for Surgical Simulation

    DEFF Research Database (Denmark)

    Mosegaard, Jesper; Sørensen, Thomas Sangild

    2005-01-01

    There is a growing demand for surgical simulators to dofast and precise calculations of tissue deformation to simulateincreasingly complex morphology in real-time. Unfortunately, evenfast spring-mass based systems have slow convergence rates for largemodels. This paper presents a method to accele...... accelerate computation of aspring-mass system in order to simulate a complex organ such as theheart. This acceleration is achieved by taking advantage of moderngraphics processing units (GPU)....

  13. Preoperative surgical planning and simulation of complex cranial base tumors in virtual reality

    Institute of Scientific and Technical Information of China (English)

    YI Zhi-qiang; LI Liang; MO Da-peng; ZHANG Jia-yong; ZHANG Yang; BAO Sheng-de

    2008-01-01

    @@ The extremely complex anatomic relationships among bone,tumor,blood vessels and cranial nerves remains a big challenge for cranial base tumor surgery.Therefore.a good understanding of the patient specific anatomy and a preoperative planning are helpful and crocial for the neurosurgeons.Three dimensional (3-D) visualization of various imaging techniques have been widely explored to enhance the comprehension of volumetric data for surgical planning.1 We used the Destroscope Virtual Reality (VR) System (Singapore,Volume Interaction Pte Ltd,software:RadioDexterTM 1.0) to optimize preoperative plan in the complex cranial base tumors.This system uses patient-specific,coregistered,fused radiology data sets that may be viewed stereoscopically and can be manipulated in a virtual reality environment.This article describes our experience with the Destroscope VR system in preoperative surgical planning and simulation for 5 patients with complex cranial base tumors and evaluates the clinical usefulness of this system.

  14. High-grade MRI bone oedema is common within the surgical field in rheumatoid arthritis patients undergoing joint replacement and is associated with osteitis in subchondral bone

    DEFF Research Database (Denmark)

    McQueen, F M; Gao, A; Ostergaard, M;

    2007-01-01

    resected bone. METHODS: Preoperative contrast-enhanced MRI scans were obtained in 11 RA patients scheduled for orthopaedic surgery to the hands/wrists or feet. In 9, MRI scans were scored by 2 readers for bone oedema (RAMRIS system). Its distribution with respect to surgical site was investigated. In 4......OBJECTIVES: MRI bone oedema has been observed in early and advanced RA and may represent a cellular infiltrate (osteitis) in subchondral bone. We studied MRI scans from RA patients undergoing surgery, seeking to identify regions of bone oedema and examine its histopathological equivalent in...... patients, 7 bone samples were examined for a cellular infiltrate, and this was compared with MRI bone oedema, scored for spatial extent and intensity. RESULTS: Inter-reader intraclass correlation coefficients for bone oedema were 0.51 (all sites) and 0.98 (bone samples for histology). Bone oedema was...

  15. Structural Simulation of a Bone-Prosthesis System of the Knee Joint

    Directory of Open Access Journals (Sweden)

    Aivars Zemitis

    2008-09-01

    Full Text Available In surgical knee replacement, the damaged knee joint is replaced with artificial prostheses. An accurate clinical evaluation must be carried out before applying knee prostheses to ensure optimal outcome from surgical operations and to reduce the probability of having long-term problems. Useful information can be inferred from estimates of the stress acting onto the bone-prosthesis system of the knee joint. This information can be exploited to tailor the prosthesis to the patient’s anatomy. We present a compound system for pre-operative surgical planning based on structural simulation of the bone-prosthesis system, exploiting patient-specific data.

  16. Surgical Guides (Patient-Specific Instruments for Pediatric Tibial Bone Sarcoma Resection and Allograft Reconstruction

    Directory of Open Access Journals (Sweden)

    Laura Bellanova

    2013-01-01

    Full Text Available To achieve local control of malignant pediatric bone tumors and to provide satisfactory oncological results, adequate resection margins are mandatory. The local recurrence rate is directly related to inappropriate excision margins. The present study describes a method for decreasing the resection margin width and ensuring that the margins are adequate. This method was developed in the tibia, which is a common site for the most frequent primary bone sarcomas in children. Magnetic resonance imaging (MRI and computerized tomography (CT were used for preoperative planning to define the cutting planes for the tumors: each tumor was segmented on MRI, and the volume of the tumor was coregistered with CT. After preoperative planning, a surgical guide (patient-specific instrument that was fitted to a unique position on the tibia was manufactured by rapid prototyping. A second instrument was manufactured to adjust the bone allograft to fit the resection gap accurately. Pathologic evaluation of the resected specimens showed tumor-free resection margins in all four cases. The technologies described in this paper may improve the surgical accuracy and patient safety in surgical oncology. In addition, these techniques may decrease operating time and allow for reconstruction with a well-matched allograft to obtain stable osteosynthesis.

  17. Surgical skills simulation in trauma and orthopaedic training.

    Science.gov (United States)

    Stirling, Euan R B; Lewis, Thomas L; Ferran, Nicholas A

    2014-01-01

    Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in order to compensate for the reduction in 'hands-on' experience. Simulation training provides the opportunity to develop surgical skills in a controlled environment whilst minimising risks to patient safety, operating theatre usage and financial expenditure. Many options for simulation exist within orthopaedics from cadaveric or prosthetic models, to arthroscopic simulators, to advanced virtual reality and three-dimensional software tools. There are limitations to this form of training, but it has significant potential for trainees to achieve competence in procedures prior to real-life practice. The evidence for its direct transferability to operating theatre performance is limited but there are clear benefits such as increasing trainee confidence and familiarity with equipment. With progressively improving methods of simulation available, it is likely to become more important in the ongoing and future training and assessment of orthopaedic surgeons. PMID:25523023

  18. Adaptive scapula bone remodeling computational simulation: Relevance to regenerative medicine

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, Gulshan B., E-mail: gbsharma@ucalgary.ca [Emory University, Department of Radiology and Imaging Sciences, Spine and Orthopaedic Center, Atlanta, Georgia 30329 (United States); University of Pittsburgh, Swanson School of Engineering, Department of Bioengineering, Pittsburgh, Pennsylvania 15213 (United States); University of Calgary, Schulich School of Engineering, Department of Mechanical and Manufacturing Engineering, Calgary, Alberta T2N 1N4 (Canada); Robertson, Douglas D., E-mail: douglas.d.robertson@emory.edu [Emory University, Department of Radiology and Imaging Sciences, Spine and Orthopaedic Center, Atlanta, Georgia 30329 (United States); University of Pittsburgh, Swanson School of Engineering, Department of Bioengineering, Pittsburgh, Pennsylvania 15213 (United States)

    2013-07-01

    Shoulder arthroplasty success has been attributed to many factors including, bone quality, soft tissue balancing, surgeon experience, and implant design. Improved long-term success is primarily limited by glenoid implant loosening. Prosthesis design examines materials and shape and determines whether the design should withstand a lifetime of use. Finite element (FE) analyses have been extensively used to study stresses and strains produced in implants and bone. However, these static analyses only measure a moment in time and not the adaptive response to the altered environment produced by the therapeutic intervention. Computational analyses that integrate remodeling rules predict how bone will respond over time. Recent work has shown that subject-specific two- and three dimensional adaptive bone remodeling models are feasible and valid. Feasibility and validation were achieved computationally, simulating bone remodeling using an intact human scapula, initially resetting the scapular bone material properties to be uniform, numerically simulating sequential loading, and comparing the bone remodeling simulation results to the actual scapula’s material properties. Three-dimensional scapula FE bone model was created using volumetric computed tomography images. Muscle and joint load and boundary conditions were applied based on values reported in the literature. Internal bone remodeling was based on element strain-energy density. Initially, all bone elements were assigned a homogeneous density. All loads were applied for 10 iterations. After every iteration, each bone element’s remodeling stimulus was compared to its corresponding reference stimulus and its material properties modified. The simulation achieved convergence. At the end of the simulation the predicted and actual specimen bone apparent density were plotted and compared. Location of high and low predicted bone density was comparable to the actual specimen. High predicted bone density was greater than

  19. Adaptive scapula bone remodeling computational simulation: Relevance to regenerative medicine

    International Nuclear Information System (INIS)

    Shoulder arthroplasty success has been attributed to many factors including, bone quality, soft tissue balancing, surgeon experience, and implant design. Improved long-term success is primarily limited by glenoid implant loosening. Prosthesis design examines materials and shape and determines whether the design should withstand a lifetime of use. Finite element (FE) analyses have been extensively used to study stresses and strains produced in implants and bone. However, these static analyses only measure a moment in time and not the adaptive response to the altered environment produced by the therapeutic intervention. Computational analyses that integrate remodeling rules predict how bone will respond over time. Recent work has shown that subject-specific two- and three dimensional adaptive bone remodeling models are feasible and valid. Feasibility and validation were achieved computationally, simulating bone remodeling using an intact human scapula, initially resetting the scapular bone material properties to be uniform, numerically simulating sequential loading, and comparing the bone remodeling simulation results to the actual scapula’s material properties. Three-dimensional scapula FE bone model was created using volumetric computed tomography images. Muscle and joint load and boundary conditions were applied based on values reported in the literature. Internal bone remodeling was based on element strain-energy density. Initially, all bone elements were assigned a homogeneous density. All loads were applied for 10 iterations. After every iteration, each bone element’s remodeling stimulus was compared to its corresponding reference stimulus and its material properties modified. The simulation achieved convergence. At the end of the simulation the predicted and actual specimen bone apparent density were plotted and compared. Location of high and low predicted bone density was comparable to the actual specimen. High predicted bone density was greater than

  20. Simulation based planning of surgical interventions in pediatric cardiology

    Science.gov (United States)

    Marsden, Alison L.

    2013-10-01

    Hemodynamics plays an essential role in the progression and treatment of cardiovascular disease. However, while medical imaging provides increasingly detailed anatomical information, clinicians often have limited access to hemodynamic data that may be crucial to patient risk assessment and treatment planning. Computational simulations can now provide detailed hemodynamic data to augment clinical knowledge in both adult and pediatric applications. There is a particular need for simulation tools in pediatric cardiology, due to the wide variation in anatomy and physiology in congenital heart disease patients, necessitating individualized treatment plans. Despite great strides in medical imaging, enabling extraction of flow information from magnetic resonance and ultrasound imaging, simulations offer predictive capabilities that imaging alone cannot provide. Patient specific simulations can be used for in silico testing of new surgical designs, treatment planning, device testing, and patient risk stratification. Furthermore, simulations can be performed at no direct risk to the patient. In this paper, we outline the current state of the art in methods for cardiovascular blood flow simulation and virtual surgery. We then step through pressing challenges in the field, including multiscale modeling, boundary condition selection, optimization, and uncertainty quantification. Finally, we summarize simulation results of two representative examples from pediatric cardiology: single ventricle physiology, and coronary aneurysms caused by Kawasaki disease. These examples illustrate the potential impact of computational modeling tools in the clinical setting.

  1. The simulated operating theatre: comprehensive training for surgical teams.

    Science.gov (United States)

    Aggarwal, R; Undre, S; Moorthy, K; Vincent, C; Darzi, A

    2004-10-01

    Surgical excellence is traditionally defined in terms of technical performance, with little regard for the importance of interpersonal communication and leadership skills. Studies in the aviation industry have stressed the role of human factors in causing error and, in an attempt to reduce the occurrence of adverse events, led to the organisation of simulation based training scenarios. Similar strategies have recently been employed for the surgical team with the development of a simulated operating theatre project. This enables technical and non-technical performance of the surgeon and circulating staff to be assessed by experts situated in an adjacent control room, and provides an opportunity for constructive feedback. The scenarios have good face validity and junior surgeons can benefit from the process of learning new technical skills in a realistic environment. The effect of external influences such as distractions, new technology, or a crisis scenario can also be defined, with the ultimate aim of reducing the number of adverse events arising in the real operating room. PMID:15465952

  2. Bone mineral density, Bone mineral contents, MMP-8 and MMP-9 levels in Human Mandible and alveolar bone: Simulated microgravity

    Science.gov (United States)

    Rai, Balwant; Kaur, Jasdeep; Catalina, Maria

    Exposure to microgravity has been associated with several physiological changes in astronauts and cosmonauts, including an osteoporosis-like loss of bone mass. It has been reported that head-down tilt bed-rest studies mimic many of the observations seen in flights. There is no study on the correlation on effects of mandibular bone and alveolar bone loss in both sex in simulating microgravity. This study was designed to determine the Bone mineral density and GCF MMP-8 MMP-9 in normal healthy subject of both sexes in simulated microgravity condition of -6 head-down-tilt (HDT) bed rest. The subjects of this investigation were 10 male and 10 female volunteers participated in three weeks 6 HDT bed-rest exposure. The Bone density and bone mineral contents were measured by dual energy X-ray absorptiometry before and in simulated microgravity. The GCF MMP-8 MMP-8 were measured by Enzyme-linked immunosorbent assays (Human Quantikine MMP-8,-9 ELISA kit). The bone mineral density and bone mineral contents levels were significantly decreased in simulated microgravity condition in both genders, although insignificantly loss was higher in females as compared to males. MMP-8 MMP-9 levels were significantly increased in simulated microgravity as compared to normal condition although insignificantly higher in females as compared to males. Further study is required on large samples size including all factors effecting in simulated microgravity and microgravity. Keys words-Simulated microgravity condition, head-down-tilt, Bone loss, MMP-8, MMP-9, Bone density, Bone mineral contents.

  3. Three Dimensional Finite Element Analysis of Stress Distribution and Displacement of the Maxilla Following Surgically Assisted Rapid Maxillary Expansion with Tooth- and Bone-Borne Devices

    Directory of Open Access Journals (Sweden)

    Mohsen Dalband

    2015-10-01

    Full Text Available Objectives: The aim of this study was to investigate the displacement and stress distri- bution during surgically assisted rapid maxillary expansion under different surgical conditions with tooth- and bone-borne devices.Materials and Methods: Three-dimensional (3D finite element model of a maxilla was constructed and an expansion force of 100 N was applied to the left and right molars and premolars with tooth-borne devices and the left and right of mid-palatal sutures at the first molar level with bone-borne devices. Five CAD models were simulated as fol- lows and surgical procedures were used:  G1: control group (without surgery; G2: Le Fort I osteotomy; G3: Le Fort I osteotomy and para-median osteotomy; G4: Le Fort I osteotomy and pterygomaxillary separation; and G5: Le Fort I osteotomy, para-median osteotomy, and pterygomaxillary separation.Results: Maxillary displacement showed a gradual increase from group 1 to group 5 in all three planes of space, indicating that Le Fort I osteotomy combined with para-me- dian osteotomy and pterygomaxillary separation produced the greatest displacement of the maxilla with both bone- and tooth-borne devices. Surgical relief and bone-borne devices resulted in significantly reduced stress on anchored teeth.Conclusion: Combination of Le Fort I and para-median osteotomy with pterygomaxil-lary separation seems to be an effective procedure for increasing maxillary expansion, and excessive stress side effects are lowered around the anchored teeth with the use of bone-borne devices.

  4. Clinical Outcomes of Surgical Treatments for Primary Malignant Bone Tumors Arising in the Acetabulum

    Directory of Open Access Journals (Sweden)

    Tomohiro Fujiwara

    2015-01-01

    Full Text Available The functional and oncologic results of eighteen patients with primary malignant periacetabular tumors were reviewed to determine the impact of surgical treatment. The reconstruction procedures were endoprosthesis (11, hip transposition (4, iliofemoral arthrodesis (2, and frozen bone autograft (1. After a mean follow-up of 62 months, 13 patients were alive and 5 had died of their disease; the 5-year overall survival rate was 67.2%. The corresponding mean MSTS scores of patients with endoprosthesis (11 and other reconstructions (7 were 42% and 55% (49%, 68%, and 50%, respectively. Overall, postoperative complications including deep infection or dislocation markedly worsened the functional outcome. Iliofemoral arthrodesis provided better function than the other procedures, whereas endoprosthetic reconstruction demonstrated poor functional outcome except for patients who were reconstructed with the adequate soft tissue coverage. Avoiding postoperative complications is highly important for achieving better function, suggesting that surgical procedures with adequate soft tissue coverage or without the massive use of nonbiological materials are preferable. Appropriate selection of the reconstructive procedures for individual patients, considering the amount of remaining bone and soft tissues, would lead to better clinical outcomes.

  5. Simulation-based planning of surgical interventions in pediatric cardiology

    Science.gov (United States)

    Marsden, Alison

    2012-11-01

    Hemodynamics plays an essential role in the progression and treatment of cardiovascular disease. This is particularly true in pediatric cardiology, due to the wide variation in anatomy observed in congenital heart disease patients. While medical imaging provides increasingly detailed anatomical information, clinicians currently have limited knowledge of important fluid mechanical parameters. Treatment decisions are therefore often made using anatomical information alone, despite the known links between fluid mechanics and disease progression. Patient-specific simulations now offer the means to provide this missing information, and, more importantly, to perform in-silico testing of new surgical designs at no risk to the patient. In this talk, we will outline the current state of the art in methods for cardiovascular blood flow simulation and virtual surgery. We will then present new methodology for coupling optimization with simulation and uncertainty quantification to customize treatments for individual patients. Finally, we will present examples in pediatric cardiology that illustrate the potential impact of these tools in the clinical setting.

  6. The behavior of adaptive bone-remodeling simulation models

    NARCIS (Netherlands)

    H.H. Weinans (Harrie); R. Huiskes (Rik); H.J. Grootenboer

    1992-01-01

    textabstractThe process of adaptive bone remodeling can be described mathematically and simulated in a computer model, integrated with the finite element method. In the model discussed here, cortical and trabecular bone are described as continuous materials with variable density. The remodeling rule

  7. Realistic tool-tissue interaction models for surgical simulation and planning

    NARCIS (Netherlands)

    Misra, Sarthak

    2009-01-01

    Surgical simulators present a safe and potentially effective method for surgical training, and can also be used in pre- and intra-operative surgical planning. Realistic modeling of medical interventions involving tool-tissue interactions has been considered to be a key requirement in the development

  8. Surgical Technique of Corrective Osteotomy for Malunited Distal Radius Fracture Using the Computer-Simulated Patient Matched Instrument.

    Science.gov (United States)

    Murase, Tsuyoshi

    2016-06-01

    The conventional corrective osteotomy for malunited distal radius fracture that employs dorsal approach and insertion of a trapezoidal bone graft does not always lead to precise correction or result in a satisfactory surgical outcome. Corrective osteotomy using a volar locking plate has recently become an alternative technique. In addition, the use of patient-matched instrument (PMI) via computed tomography simulation has been developed and is expected to simplify surgical procedures and improve surgical precision. The use of PMI makes it possible to accurately position screw holes prior to the osteotomy and simultaneously perform the correction and place the volar locking plate once the osteotomy is completed. The bone graft does not necessarily require a precise block form, and the problem of the extensor tendon contacting the dorsal plate is avoided. Although PMI placement and soft tissue release technique require some degree of specialized skill, they comprise a very useful surgical procedure. On the other hand, because patients with osteoporosis are at risk of peri-implant fracture, tandem ulnar shortening surgery should be considered to avoid excessive lengthening of the radius. PMID:27454626

  9. Physics-Based Haptic Simulation of Bone Machining.

    Science.gov (United States)

    Arbabtafti, M; Moghaddam, M; Nahvi, A; Mahvash, M; Richardson, B; Shirinzadeh, B

    2011-01-01

    We present a physics-based training simulator for bone machining. Based on experimental studies, the energy required to remove a unit volume of bone is a constant for every particular bone material. We use this physical principle to obtain the forces required to remove bone material with a milling tool rotating at high speed. The rotating blades of the tool are modeled as a set of small cutting elements. The force of interaction between a cutting element and bone is calculated from the energy required to remove a bone chip with an estimated thickness and known material stiffness. The total force acting on the cutter at a particular instant is obtained by integrating the differential forces over all cutting elements engaged. A voxel representation is used to represent the virtual bone and removed chips for calculating forces of machining. We use voxels that carry bone material properties to represent the volumetric haptic body and to apply underlying physical changes during machining. Experimental results of machining samples of a real bone confirm the force model. A real-time haptic implementation of the method in a dental training simulator is described.

  10. Radiographic Assessment of Bone Formation Using rhBMP2 at Maxillary Periapical Surgical Defects: A Case Series.

    Science.gov (United States)

    Kumar, M Siva; Kumar, M Hari; Vishalakshi, K; Sabitha, H

    2016-04-01

    Periapical cysts are the most common inflammatory odontogenic cysts arising from untreated dental caries with pulp necrosis and periapical infection. The choice of treatment is often influenced by various factors like size, extension of the lesion, proximity to vital structures, systemic condition and compliance of the patient too. The treatment protocol for management of periapical cysts is still under discussion and options vary from conservative treatment by means of endodontic technique to surgical treatment like decompression or a marsupialisation or even to enucleation. Large bony defect secondary to periapical surgery compromising the tooth integrity often requires bone graft to enhance bone formation and thus restoring function at the earliest. The present case series included 10 patients who had established periapical pathology secondary to history of trauma on upper anterior teeth as well patients with history of carious teeth with an apparent failure in root canal therapy. All ten patients were treated with cyst enucleation and apiceotomy along with 1.4cc Recombinant Human Bone Morphogenetic Protein-2 soaked Absorbable Collagen Sponge implantation at surgical defect. Radiographs and clinical examinations were done upto 3 months to evaluate healing. Radiographic and clinical assessments revealed bone regeneration and restoration of the maxillary surgical defects in all 10 patients. No evidence of graft failure was noted. The Recombinant Human Bone Morphogenetic Protein-2 soaked Absorbable Collagen Sponge carrier is thus proved to be a viable option for the treatment of maxillary periapical surgical defects. PMID:27190972

  11. Radiographic Assessment of Bone Formation Using rhBMP2 at Maxillary Periapical Surgical Defects: A Case Series

    Science.gov (United States)

    Kumar, M. Hari; Vishalakshi, K.; Sabitha, H.

    2016-01-01

    Periapical cysts are the most common inflammatory odontogenic cysts arising from untreated dental caries with pulp necrosis and periapical infection. The choice of treatment is often influenced by various factors like size, extension of the lesion, proximity to vital structures, systemic condition and compliance of the patient too. The treatment protocol for management of periapical cysts is still under discussion and options vary from conservative treatment by means of endodontic technique to surgical treatment like decompression or a marsupialisation or even to enucleation. Large bony defect secondary to periapical surgery compromising the tooth integrity often requires bone graft to enhance bone formation and thus restoring function at the earliest. The present case series included 10 patients who had established periapical pathology secondary to history of trauma on upper anterior teeth as well patients with history of carious teeth with an apparent failure in root canal therapy. All ten patients were treated with cyst enucleation and apiceotomy along with 1.4cc Recombinant Human Bone Morphogenetic Protein-2 soaked Absorbable Collagen Sponge implantation at surgical defect. Radiographs and clinical examinations were done upto 3 months to evaluate healing. Radiographic and clinical assessments revealed bone regeneration and restoration of the maxillary surgical defects in all 10 patients. No evidence of graft failure was noted. The Recombinant Human Bone Morphogenetic Protein-2 soaked Absorbable Collagen Sponge carrier is thus proved to be a viable option for the treatment of maxillary periapical surgical defects. PMID:27190972

  12. The tent pole splint: a bone-supported stereolithographic surgical splint for the soft tissue matrix expansion graft procedure.

    Science.gov (United States)

    Cillo, Joseph E; Theodotou, Nicholas; Samuels, Marc; Krajekian, Joseph

    2010-06-01

    This report details the use of computer-aided planning and intraoperative stereolithographic direct-bone-contact surgical splints for the accurate extraoral placement of dental implants in the soft tissue matrix expansion (tent pole) graft of the severely resorbed mandible. PMID:20231048

  13. Surgical repair of central slip avulsion injuries with Mitek bone anchor--retrospective analysis of a case series.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2007-01-01

    The purpose of this study is to describe our technique of central slip repair using the Mitek bone anchor and to evaluate the treatment outcome. Eight digits in eight patients were reconstructed using the bone anchor: three little fingers, two middle fingers, two index fingers and one ring finger. There were two immediate and six delayed repairs (range from one day to eight months). Four patients had pre-operative intensive splinting and physiotherapy to restore passive extension of the proximal interphalangeal joint prior to central slip reconstruction. All patients have made good progress since surgery. No patient requires a second procedure and none of the bone anchors have dislodged or loosened. We conclude that the Mitek bone anchor is a reliable technique to achieve soft tissue to bone fixation in central slip avulsion injuries. We recommend that this technique be considered as a treatment option for patients requiring surgical repair.

  14. CHRONIC OTITIS MEDIA: HIGH RESOLUTION COMPUTED TOMOGRAPHIC EVALUATION OF THE TEMPORAL BONE WITH SURGICAL CORRELATION

    Directory of Open Access Journals (Sweden)

    Chakenahalli P.

    2016-05-01

    Full Text Available PURPOSE To correlate the sensitivity and specificity of High Resolution Computed Tomography (HRCT findings of temporal bone in chronic otitis media with surgical findings. MATERIALS & METHODS HRCT of temporal bone of fifty patients with chronic otitis media were evaluated prospectively between July 2012 and December 2013. The various pathological findings, complications and important anatomical variations were evaluated. These findings were compared with intraoperative findings. Statistical methods were carried out using SPSS for Windows (Version 16.0 and Minitab (Version 11.0 for windows. The sensitivity, specificity, false positive and false negative rates were calculated. The level of significance was considered significant for P-values <0.05. RESULTS HRCT is reliable for all the parameters like scutum erosion, ossicular erosion, mastoid pneumatisation, low lying dura, anterior lying sigmoid, Korner’s septum, cholesteatoma extension in middle ear and mastoid, and presence of complications like mastoiditis, mastoid abscess, mastoid cortex dehiscence, sigmoid sinus plate erosion, facial canal dehiscence, tegmen mastoideum erosion, labyrinthine fistula and intracranial complications with a P value <0.05 but not reliable for tegmen tympani erosion and posterior fossa dural plate erosion. Among the findings related to adjacent neurovascular structures, facial canal dehiscence was commonest followed by anterior lying sigmoid sinus and low lying dura. In ossicular erosion, incus was most commonly involved followed by stapes and malleus. Most of the mastoid in this study was sclerotic followed by pneumatised and diploic. The epitympanum and mastoid antrum were the most commonly involved areas in cholesteatoma followed by aditus, mastoid air cells, posterior tympanum, mesotympanum, hypotympanum, protympanum and perilabyrinthine air cells in decreasing order of frequency. CONCLUSIONS HRCT temporal bone is a reliable investigation in preoperative

  15. [Approach to the jugular foramen and related structures - an analysis of the surgical technique based on cadaver simulation].

    Science.gov (United States)

    Ladziński, Piotr; Maliszewski, Mariusz; Kaspera, Wojciech; Szczygieł, Majchrzak; Tymowski, Michał

    2011-01-01

    This study presents consecutive stages of the approach to the jugular foramen and related structures. Eleven simulations of the approach were performed on non-fixed human cadavers without any known pathologies in the head and neck. The consecutive stages of the procedure were documented with photographs and schematic diagrams. The starting point for the discussed approach is removal of the mastoid and petrosal parts of the temporal bone, as well as the jugular process and the jugular tuberculum. It allows penetration of the jugular foramen from the back. Widening of the approach enables penetration of the jugular foramen from above and the front. Approach to the jugular foramen is a reproducible technique, which provides surgical penetration of this foramen and related structures. This approach is particularly useful in the surgical treatment of tumours expanding in the petrous pyramid, surroundings of the petrosal part of the internal carotid artery, cerebellopontine angle, subtemporal fossa and nervous-vascular bundle of the neck. PMID:21866483

  16. Mastering surgical skills through simulation-based learning: Practice makes one perfect

    Directory of Open Access Journals (Sweden)

    Niti Khunger

    2016-01-01

    Full Text Available Simulation-based learning in surgery is a learning model where an environment similar to real life surgical situation is created for the trainee to learn various surgical skills. It can be used to train a new operator as well to assess his skills. This methodology helps in repetitive practice of surgical skills on nonliving things so that the operator can be near-perfect when operating on a live patient. Various models are available for learning different dermatosurgery skills.

  17. Mastering surgical skills through simulation-based learning: Practice makes one perfect

    OpenAIRE

    Niti Khunger; Sushruta Kathuria

    2016-01-01

    Simulation-based learning in surgery is a learning model where an environment similar to real life surgical situation is created for the trainee to learn various surgical skills. It can be used to train a new operator as well to assess his skills. This methodology helps in repetitive practice of surgical skills on nonliving things so that the operator can be near-perfect when operating on a live patient. Various models are available for learning different dermatosurgery skills.

  18. Mastering Surgical Skills Through Simulation-Based Learning: Practice Makes One Perfect.

    Science.gov (United States)

    Khunger, Niti; Kathuria, Sushruta

    2016-01-01

    Simulation-based learning in surgery is a learning model where an environment similar to real life surgical situation is created for the trainee to learn various surgical skills. It can be used to train a new operator as well to assess his skills. This methodology helps in repetitive practice of surgical skills on nonliving things so that the operator can be near-perfect when operating on a live patient. Various models are available for learning different dermatosurgery skills. PMID:27081246

  19. Notes From the Field: Secondary Task Precision for Cognitive Load Estimation During Virtual Reality Surgical Simulation Training.

    Science.gov (United States)

    Rasmussen, Sebastian R; Konge, Lars; Mikkelsen, Peter T; Sørensen, Mads S; Andersen, Steven A W

    2016-03-01

    Cognitive load (CL) theory suggests that working memory can be overloaded in complex learning tasks such as surgical technical skills training, which can impair learning. Valid and feasible methods for estimating the CL in specific learning contexts are necessary before the efficacy of CL-lowering instructional interventions can be established. This study aims to explore secondary task precision for the estimation of CL in virtual reality (VR) surgical simulation and also investigate the effects of CL-modifying factors such as simulator-integrated tutoring and repeated practice. Twenty-four participants were randomized for visual assistance by a simulator-integrated tutor function during the first 5 of 12 repeated mastoidectomy procedures on a VR temporal bone simulator. Secondary task precision was found to be significantly lower during simulation compared with nonsimulation baseline, p precision. This finding suggests that even though considerable changes in CL are reflected in secondary task precision, it lacks sensitivity. In contrast, secondary task reaction time could be more sensitive, but requires substantial postprocessing of data. Therefore, future studies on the effect of CL modifying interventions should weigh the pros and cons of the various secondary task measurements.

  20. Assessment of simulated mandibular condyle bone lesions by cone beam computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Marques, Alexandre Perez; Perrella, Andreia; Arita, Emiko Saito; Pereira, Marlene Fenyo Soeiro de Matos; Cavalcanti, Marcelo de Gusmao Paraiso, E-mail: alexperez34@gmail.co [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Odontologia. Dept. de Estomatologia

    2010-10-15

    There are many limitations to image acquisition, using conventional radiography, of the temporomandibular joint (TMJ) region. The Computed Tomography (CT) scan is a better option, due to its higher accuracy, for purposes of diagnosis, surgical planning and treatment of bone injuries. The aim of the present study was to analyze two protocols of cone beam computed tomography for the evaluation of simulated mandibular condyle bone lesions. Spherical lesions were simulated in 30 dry mandibular condyles, using dentist drills and drill bits sizes 1, 3 and 6. Each of the mandibular condyles was submitted to cone beam computed tomography (CBCT) using two protocols: axial, coronal and sagittal multiplanar reconstruction (MPR); and sagittal plus coronal slices throughout the longitudinal axis of the mandibular condyles. For these protocols, 2 observers analyzed the CBCT images independently, regarding the presence or not of injuries. Only one of the observers, however, performed on 2 different occasions. The results were compared to the gold standard, evaluating the percentage of agreement, degree of accuracy of CBCT protocols and observers' examination. The z test was used for the statistical analysis. The results showed there were no statistically significant differences between the 2 protocols. There was greater difficulty in the assessment of small-size simulated lesions (drill no.1). From the results of this study, it can be concluded that CBCT is an accurate tool for analyzing mandibular condyle bone lesions, with the MPR protocol showing slightly better results than the sagittal plus coronal slices throughout the longitudinal axis. (author)

  1. Assessment of simulated mandibular condyle bone lesions by cone beam computed tomography

    Directory of Open Access Journals (Sweden)

    Alexandre Perez Marques

    2010-12-01

    Full Text Available There are many limitations to image acquisition, using conventional radiography, of the temporomandibular joint (TMJ region. The Computed Tomography (CT scan is a better option, due to its higher accuracy, for purposes of diagnosis, surgical planning and treatment of bone injuries. The aim of the present study was to analyze two protocols of cone beam computed tomography for the evaluation of simulated mandibular condyle bone lesions. Spherical lesions were simulated in 30 dry mandibular condyles, using dentist drills and drill bits sizes 1, 3 and 6. Each of the mandibular condyles was submitted to cone beam computed tomography (CBCT using two protocols: 1 axial, coronal and sagittal multiplanar reconstruction (MPR; and 2 sagittal plus coronal slices throughout the longitudinal axis of the mandibular condyles. For these protocols, 2 observers analyzed the CBCT images independently, regarding the presence or not of injuries. Only one of the observers, however, performed on 2 different occasions. The results were compared to the gold standard, evaluating the percentage of agreement, degree of accuracy of CBCT protocols and observers' examination. The z test was used for the statistical analysis. The results showed there were no statistically significant differences between the 2 protocols. There was greater difficulty in the assessment of small-size simulated lesions (drill # 1. From the results of this study, it can be concluded that CBCT is an accurate tool for analyzing mandibular condyle bone lesions, with the MPR protocol showing slightly better results than the sagittal plus coronal slices throughout the longitudinal axis.

  2. Initial experiences with RoSS surgical simulator in residency training: a validity and model analysis.

    Science.gov (United States)

    Colaco, Marc; Balica, Adrian; Su, Daniel; Barone, Joseph

    2013-03-01

    Robotic surgery is an important new tool in many surgical procedures, and training curriculums must adapt to this new technology. Robotic surgical simulators have been developed as a means of providing training without the inherent risks of actual surgery. The purpose of this study is to evaluate the construct validity of the RoSS surgical simulator by correlating simulator performance with amount of time in training and to create a performance model in which time in training is a parameter. A total of eight residents with varying amounts of training were given access to the RoSS surgical simulator and were evaluated on performance of a simulated surgical task. This data was then used to create Akaike information criteria to compare goodness of fit. Participants were also given a questionnaire as to their experience with the simulator and their feelings about the use of simulators in training. Training time and performance within the simulator were shown to have a linear relationship. Correlations were high, with R (2) values of 0.95, 0.94, and 0.86 for each of the three performance metrics. Likelihood ratios were similarly high at 4.25 × 10(9), 10,950, and 362. Participant opinion showed that residents feel that robotic training is an important part of their education and that the simulator is an effective supplement. The RoSS surgical simulator accurately corresponds to training level and is a valid evaluation tool of training experience. These findings are encouraging for the use of robotic simulators in surgical training. PMID:27000895

  3. Development and Evaluation of a Novel Pan-Specialty Virtual Reality Surgical Simulator for Smartphones.

    Science.gov (United States)

    Nehme, Jean; Bahsoun, Ali N; Chow, Andre

    2016-01-01

    Touch Surgery is a novel simulator that allows cognitive task simulation and rehearsal of surgical procedures. Touch Surgery is designed for Apple and Android smartphones and tablets. This allows a global community of surgical professionals to review the steps of a procedure and test their competence. Content on Touch Surgery is developed with expert surgeons in the field from world leading institutions. Here we describe the development of Touch Surgery, its adoption by the global training community.

  4. Medical Visualization and Simulation for Customizable Surgical Guides

    NARCIS (Netherlands)

    Kroes, T.

    2015-01-01

    This thesis revolves around the development of medical visualization tools for the planning of CSG-based surgery. To this end, we performed an extensive computerassisted surgery (CAS) literature study, developed a novel optimization technique for customizable surgical guides (CSG), and introduce thr

  5. Fast garment simulation with aid of hybrid bones

    Institute of Scientific and Technical Information of China (English)

    吴博; 陈寅; 徐凯; 程志全; 熊岳山

    2015-01-01

    A data-driven method was proposed to realistically animate garments on human poses in reduced space. Firstly, a gradient based method was extended to generate motion sequences and garments were simulated on the sequences as our training data. Based on the examples, the proposed method can fast output realistic garments on new poses. Our framework can be mainly divided into offline phase and online phase. During the offline phase, based on linear blend skinning (LBS), rigid bones and flex bones were estimated for human bodies and garments, respectively. Then, rigid bone weight maps on garment vertices were learned from examples. In the online phase, new human poses were treated as input to estimate rigid bone transformations. Then, both rigid bones and flex bones were used to drive garments to fit the new poses. Finally, a novel formulation was also proposed to efficiently deal with garment-body penetration. Experiments manifest that our method is fast and accurate. The intersection artifacts are fast removed and final garment results are quite realistic.

  6. Medical Visualization and Simulation for Customizable Surgical Guides

    OpenAIRE

    Kroes, T.

    2015-01-01

    This thesis revolves around the development of medical visualization tools for the planning of CSG-based surgery. To this end, we performed an extensive computerassisted surgery (CAS) literature study, developed a novel optimization technique for customizable surgical guides (CSG), and introduce three visualization techniques to make the planning more realistic and allow for remote visualization. In Chapter 2 we document the results of an extensive overview study, in which the use of visualiz...

  7. Update on Simulation-Based Surgical Training and Assessment in Ophthalmology

    DEFF Research Database (Denmark)

    Thomsen, Ann Sofia S; Subhi, Yousif; Kiilgaard, Jens Folke;

    2015-01-01

    TOPIC: This study reviews the evidence behind simulation-based surgical training of ophthalmologists to determine (1) the validity of the reported models and (2) the ability to transfer skills to the operating room. CLINICAL RELEVANCE: Simulation-based training is established widely within...... ophthalmology, although it often lacks a scientific basis for implementation. METHODS: We conducted a systematic review of trials involving simulation-based training or assessment of ophthalmic surgical skills among health professionals. The search included 5 databases (PubMed, EMBASE, PsycINFO, Cochrane......; 4 trials (65 participants) evaluated the effect of simulation-based training on patient-related outcomes. Because of heterogeneity of the studies, it was not possible to conduct a quantitative analysis. CONCLUSIONS: The methodologic rigor of trials investigating simulation-based surgical training...

  8. Surgical construction of a novel simulated carotid siphon in canines

    International Nuclear Information System (INIS)

    Objective: To develop in vivo carotid siphon models by surgical method using the shaped devices for testing the performance of covered stent specially designed for intracranial vascular diseases. Methods: Six carotid siphon-shaped devices were established using stereolithographic biomodeling and the lost-wax technique. Six canines underwent surgery to expose and isolate bilateral CCA. The right CCA origin was ligated and incised distal to the ligation point after the distal right CCA was temporarily closed. The distal left CCA was ligated and incised proximal to the ligation point after the left CCA origin was closed. The proximal isolated left CCA was passed through the shaped device. The distal isolated right CCA and the proximal isolated left CCA were anastomosed end-to-end. Finally, the shaped device of carotid siphon was fixed with suture and embedded in the left neck. The intraarterial DSA was performed on postprocedural 7 days, 2 weeks and 1 month. The morphological characteristics of carotid siphon models were visually evaluated by two observers. The patency of siphon model and the stenosis of anastomotic stoma were followed-up. Results: All animals tolerated the surgical procedure well with mean model time construction of 90 minutes. The morphological characteristics of siphon models were similar to those in human. The anastomotic stoma stenosis occurred in 2 siphon models, and thrombosis of anastomotic stoma in 1, but all siphons of these models were patent on post-procedural follow-up angiography. Conclusion: Surgical construction of an in vivo carotid siphon model of canine with shaped device is practically feasible. This model can be used for testing neurovascular devices. (authors)

  9. Surgical simulators in urological training--views of UK Training Programme Directors.

    Science.gov (United States)

    Forster, James A; Browning, Anthony J; Paul, Alan B; Biyani, C Shekhar

    2012-09-01

    What's known on the subject? and What does the study add? The role of surgical simulators is currently being debated in urological and other surgical specialties. Simulators are not presently implemented in the UK urology training curriculum. The availability of simulators and the opinions of Training Programme Directors' (TPD) on their role have not been described. In the present questionnaire-based survey, the trainees of most, but not all, UK TPDs had access to laparoscopic simulators, and that all responding TPDs thought that simulators improved laparoscopic training. We hope that the present study will be a positive step towards making an agreement to formally introduce simulators into the UK urology training curriculum. To discuss the current situation on the use of simulators in surgical training. To determine the views of UK Urology Training Programme Directors (TPDs) on the availability and use of simulators in Urology at present, and to discuss the role that simulators may have in future training. An online-questionnaire survey was distributed to all UK Urology TPDs. In all, 16 of 21 TPDs responded. All 16 thought that laparoscopic simulators improved the quality of laparoscopic training. The trainees of 13 TPDs had access to a laparoscopic simulator (either in their own hospital or another hospital in the deanery). Most TPDs thought that trainees should use simulators in their free time, in quiet time during work hours, or in teaching sessions (rather than incorporated into the weekly timetable). We feel that the current apprentice-style method of training in urological surgery is out-dated. We think that all TPDs and trainees should have access to a simulator, and that a formal competency based simulation training programme should be incorporated into the urology training curriculum, with trainees reaching a minimum proficiency on a simulator before undertaking surgical procedures. PMID:22233327

  10. Bone mineral content reduction in youth with surgical form of Schistosomiasis mansoni: factors involved in the pathogenesis

    Directory of Open Access Journals (Sweden)

    Brandt Carlos Teixeira

    2001-01-01

    Full Text Available Thirty two children and adolescents from 14 to 20 years of age, suffering from hepatosplenic schistosomiasis mansoni and bleeding esophageal varicose veins, were evaluated for bone mineral density (BMD, before undergoing medical and surgical treatment. The surgical protocol was splenectomy, autoimplantation of spleen tissue into a pouch of the major omentum and ligature of the left gastric vein. Follow up of these patients? ranges from one to ten years with a mean of five years. The BMD was measured at the lumbar spine (L2 - L4 through the dual energy absorptionmetry X-ray (DEXA, using a LUNAR DPX-L densitometer. The degree of Symmers´ fibrosis was assessed by semiautomatic hystomorphometry. In eleven patients, the serum magnesium was measured before an intravenous overload of this ion and subsequently after eight and twenty four hours. Urine was collected 24 hours before and 24 hours after the magnesium overload. Deficiency of magnesium was considered when the uptake of this ion was greater than 40%. There was a significant trend of association between the status of bone mineral content and the Symmers´ fibrosis degree (c² = 6.606 R = 0.01017. There was also a moderate agreement between the greater fibrosis densities ( > the mean percentage and bone mineral deficits. Although the normal bone mineral content was more found among the patients with better hepatic functional reserve, the results did not reach statistical significance. There was a marked magnesium retention (>95% in one patient who had severe osteoporosis and a slight depletion (<5% in another patient, who presented no bone mineral deficit. It was concluded that the patients included in this series, showed an important BMD deficit, specially among the females which has had a significant improvement after medical and surgical treatment. Bone mineral deficit was associated with the degree of Symmers´ fibrosis. Magnesium depletion was present in two out of eleven patients. It is

  11. Artificial Gravity as a Bone Loss Countermeasure in Simulated Weightlessness

    Science.gov (United States)

    Smith, S. M.; Zwart, S. R.; Crawford, G. E.; Gillman, P. L.; LeBlanc, A.; Shackelford, L. C.; Heer, M. A.

    2007-01-01

    The impact of microgravity on the human body is a significant concern for space travelers. We report here initial results from a pilot study designed to explore the utility of artificial gravity (AG) as a countermeasure to the effects of microgravity, specifically to bone loss. After an initial phase of adaptation and testing, 15 male subjects underwent 21 days of 6 head-down bed rest to simulate the deconditioning associated with space flight. Eight of the subjects underwent 1 h of centrifugation (AG, 1 gz at the heart, 2.5 gz at the feet) each day for 21 days, while 7 of the subjects served as untreated controls (CN). Blood and urine were collected before, during, and after bed rest for bone marker determinations. At this point, preliminary data are available on the first 8 subjects (6 AG, and 2 CN). Comparing the last week of bed rest to before bed rest, urinary excretion of the bone resorption marker n-telopeptide increased 95 plus or minus 59% (mean plus or minus SD) in CN but only 32 plus or minus 26% in the AG group. Similar results were found for another resorption marker, helical peptide (increased 57 plus or minus 0% and 35 plus or minus 13% in CN and AG respectively). Bone-specific alkaline phosphatase, a bone formation marker, did not change during bed rest. At this point, sample analyses are continuing, including calcium tracer kinetic studies. These initial data demonstrate the potential effectiveness of short-radius, intermittent AG as a countermeasure to the bone deconditioning that occurs during bed rest.

  12. Foot bone kinematics as measured in a cadaveric robotic gait simulator.

    Science.gov (United States)

    Whittaker, Eric C; Aubin, Patrick M; Ledoux, William R

    2011-04-01

    The bony motion of the foot during the stance phase of gait is useful to further our understanding of joint function, disease etiology, injury prevention and surgical intervention. In this study, we used a 10-segment in vitro foot model with anatomical coordinate systems and a robotic gait simulator (RGS) to measure the kinematics of the tibia, talus, calcaneus, cuboid, navicular, medial cuneiform, first metatarsal, hallux, third metatarsal, and fifth metatarsal from six cadaveric feet. The RGS accurately reproduced in vivo vertical ground reaction force (5.9% body weight RMS error) and tibia to ground kinematics. The kinematic data from the foot model generally agree with invasive in vivo descriptions of bony motion and provides the most realistic description of bony motion currently available for an in vitro model. These data help to clarify the function of several joints that are difficult to study in vivo; for example, the combined range of motion of the talonavicular, naviculocuneiform, metatarsocuneiform joints provided more sagittal plane mobility (27.4°) than the talotibial joint alone (23.2°). Additionally, the anatomical coordinate systems made it easier to meaningfully determine bone-to-bone motion, describing uniplanar motion as rotation about a single axis rather than about three. The data provided in this study allow for many kinematic interpretations to be made about dynamic foot bone motion, and the methodology presents a means to explore many invasive foot biomechanics questions under near-physiologic conditions.

  13. In vitro integrity of implant external hexagon after application of surgical placement torque simulating implant locking

    Directory of Open Access Journals (Sweden)

    Letícia Resende Davi

    2008-06-01

    Full Text Available The aim of this study was to evaluate the integrity of the external hexagon of an implant system with internal and external hexagons but with prosthetic connection through the external hexagon (Internal Torque, IT in comparison with that of an implant system with external hexagon with mount (External Hexagon, EH. A device was made to measure the rotational freedom angles between implant and abutment hexagons in 10 implants from each group after the application of surgical placement torques of 45, 60 and 80 Ncm simulating implant locking. The distances between the vertices of the external hexagon were also obtained. Rotational freedom data were subjected to ANOVA and Tukey's test (P < .05 showing no significant difference between the angles of the intact implants (EH - 3.31 ± 0.41° and IT - 3.30 ± 0.17° and after application of a 45 Ncm torque (EH - 3.27 ± 0.38° and IT - 3.31 ± 0.22°. However, after application of a 60 Ncm torque there were significant differences (IT - 3.40 ± 0.20° and EH - 4.03 ± 0.54°. After application of a 80 Ncm torque, the IT implant presented values of 3.39 ± 0.21° whereas the EH did not support the torque, suffering deformation of its external hexagon. Within the limits of this study, it can be concluded that the IT implant system may be preferable in clinical situations where implant placement within a certain bone density could generate torques higher than 60 Ncm.

  14. Stiffness matrix representation of hyper-elasticity for surgical simulation and navigation.

    Science.gov (United States)

    Nishiyama, Shuhei; Kuroda, Yoshihiro; Takemura, Haruo

    2015-08-01

    Nowadays, physics-based simulation plays an important role in industries and clinical fields thanks to the outstanding progress of computer technologies and numerical simulation. One of the demands for the applied technology of physics-based simulation, is the surgical simulation of organ tissue not only for surgical training but also for intra-operative navigation. Although linear Finite Element Method (FEM) is capable of real-time simulation, the conventional FEM analysis does not satisfy the accuracy of non-linear response and interactivity at the same time. The aim of this study is to establish the surgical simulation and navigation to consider hyper-elasticity (HE), which represents the organ's non-linear response material better than the conventional linear material. In this paper, we propose a novel method to decompose the stress-strain relationship of HE, and construct the stiffness matrix for real-time and interactive simulation by extending the linear FEM, which is capable of efficient simulation. The experimental results showed that the proposed method is able to simulate non-linear FEM deformation accurately almost equivalent to the existing non-linear FEM analysis by shorter calculation time. In addition, the deformation with the kidney model was demonstrated.

  15. 3D tracking of surgical instruments using a single camera for laparoscopic surgery simulation.

    Science.gov (United States)

    Shin, Sangkyun; Kim, Youngjun; Kwak, Hyunsoo; Lee, Deukhee; Park, Sehyung

    2011-01-01

    Most laparoscopic surgery simulation systems are expensive and complex. To overcome these problems, this study presents a novel three-dimensional tracking method for laparoscopic surgical instruments that uses only a single camera and fiducial markers. The proposed method does not require any mechanical parts to measure the three-dimensional positions/orientations of surgical instruments and the opening angle of graspers. We implemented simple and cost-effective hardware using the proposed method and successfully combined it with virtual simulation software for laparoscopic surgery.

  16. Effect of biphasic calcium phosphate nanocomposite on healing of surgically created alveolar bone defects in beagle dogs

    Science.gov (United States)

    Wang, Lanlei; Guan, Aizhong; Shi, Han; Chen, Yangxi; Liao, Yunmao

    2009-09-01

    The aim of the present study was to investigate the effect of porous biphasic calcium phosphate nanocomposite (nanoBCP) scaffolds bioceramic. Alveolar bone defects were surgically created bilaterally at the buccal aspects of the upper second premolar in fourteen beagle dogs. After root conditioning with ethylenediaminetetraacetate (EDTA), nanoBCP was randomly filled in the defects and nothing was put into the contralaterals as controls. Dogs were killed at the 12th weeks. Histological observations were processed through a light microscopy. The results revealed that a great amount of functional periodontal fissures formed in the defects in the nanoBCP groups while minimal bone took shape in the controls. In this study, nanoBCP has proved to work well as a biocompatible and osteoconductive scaffold material to promote periodontal regeneration effectively.

  17. Denosumab Chemotherapy for Recurrent Giant-Cell Tumor of Bone: A Case Report of Neoadjuvant Use Enabling Complete Surgical Resection

    Directory of Open Access Journals (Sweden)

    Amit Agarwal

    2013-01-01

    Full Text Available Giant-cell tumor of the bone (GCTB is a rare neoplasm that affects young adults. The tumor is generally benign but sometimes can be locally aggressive. There are no standardized approaches to the treatment of GCTB. Recently, the RANKL inhibitor denosumab has shown activity in this tumor type. We present the case of a young female who presented with locally advanced disease and was successfully managed with the neoadjuvant use of denosumab allowing for surgical resection of the tumor that was previously deemed unresectable. Following surgery, the patient is being managed with continued use of denosumab as ‘maintenance,’ and she continues to be free of disease. Our case highlights a novel approach for the management of locally advanced and aggressive giant cell tumor of the bone.

  18. 3D Tracking and Positioning of Surgical Instruments in Virtual Surgery Simulation

    Directory of Open Access Journals (Sweden)

    Zhaoliang Duan

    2011-12-01

    Full Text Available 3D tracking and positioning of surgical instruments is an indispensable part of virtual Surgery training system, because it is the unique interface for trainee to communicate with virtual environment. A suit of 3D tracking and positioning of surgical instruments based on stereoscopic vision is proposed. It can capture spatial movements of simulated surgical instrument in real time, and provide 6 degree of freedom information with the absolute error of less than 1 mm. The experimental results show that the 3D tracking and positioning of surgical instruments is highly accurate, easily operated, and inexpensive. Combining with force sensor and embedded acquisition device, this 3D tracking and positioning method can be used as a measurement platform of physical parameters to realize the measurement of soft tissue parameters.

  19. Surgical simulation: where have we come from? Where are we now? Where are we going?

    Science.gov (United States)

    Munro, Malcolm G

    2012-01-01

    It is now clear to most stakeholders that acquisition of surgical psychomotor skills is best achieved outside of the clinical operating room, in the context of a simulated environment. Endoscopic simulation can be accomplished using simple "box" simulators or video trainers, and virtual reality simulation is now possible using microprocessor-controlled systems. Structured surgical training performed outside of the operating room environment is relatively new to health care, a circumstance different from the process of pilot training, in which simulation has been a mainstay for more than 75 years and in which virtual reality simulation is now the norm. Those charged with surgical education are faced with a dilemma as, while attempting to understand the basic goals of simulation, they are simultaneously faced with choice between relatively inexpensive video trainers and the often prohibitively expensive virtual reality systems. This article explores the history of simulation, reports the results of a modified systematic review of currently available systems and performance, and identifies the gaps in current research and development. It is apparent that available video trainers provide the opportunity for skill development that at present is not surpassed by virtual reality systems. In the future, there will likely be an increasing role for virtual reality; however, challenges remain that include determination of the appropriate metrics and system design, and the fiscal resources necessary for the required hardware and related software development.

  20. Bed capacity and surgical waiting lists: a simulation analysis

    Directory of Open Access Journals (Sweden)

    Manel Antelo

    2015-12-01

    Full Text Available Waiting time for elective surgery is a key problem in the current medical world. This paper aims to reproduce, by a Monte Carlo simulation model, the relationship between hospital capacity, inpatient activity, and surgery waiting list size in teaching hospitals. Inpatient activity is simulated by fitting a Normal distribution to real inpatient activity data, and the effect of the number of beds on inpatient activity is modelled with a linear regression model. Analysis is performed with data of the University Multi-Hospital Complex of Santiago de Compostela (Santiago de Compostela, Spain, by considering two scenarios regarding the elastiticity of demand with bed increase. If demand does not grow with an increase on bed capacity, small changes lead to drastic reductions in the waiting lists. However, if demand grows as bed capacity does, adding additional capacity merely makes waiting lists worse.

  1. Quantitative mandibular and maxillary CT bone densitometry in surgical planning for osseointegrated dental implants

    International Nuclear Information System (INIS)

    Computed tomographic (CT) scanning of the jaw is important in the preoperative evaluation of osseointegrated dental implants. The degree of bone mineralization may have a bearing on the likelihood of successful implantation. A phantom for analysis was scanned prior to CT studies. Measurements were made in 20 patients. Bone density was sampled inferior to normal teeth and in comparable but edentulous regions, in an attempt to define the limits of normal ossification. A wide variation in bone mineral was noted in normal teeth-bearing and in edentulous bone. Three patterns of ossification are identifiable with CT. Bone densitometry may indicate those patients for whom a longer recovery period between implantation and prosthetic placement is advised

  2. New simulation model for bone formation markers in osteoporosis patients treated with once-weekly teriparatide

    Institute of Scientific and Technical Information of China (English)

    Sakae Tanaka; Taiji Adachi; Tatsuhiko Kuroda; Toshitaka Nakamura; Masataka Shiraki; Toshitsugu Sugimoto; Yasuhiro Takeuchi; Mitsuru Saito; John P Bilezikian

    2014-01-01

    Daily 20-mg and once-weekly 56.5-mg teriparatide (parathyroid hormone 1–34) treatment regimens increase bone mineral density (BMD) and prevent fractures, but changes in bone turnover markers differ between the two regimens. The aim of the present study was to explain changes in bone turnover markers using once-weekly teriparatide with a simulation model. Temporary increases in bone formation markers and subsequent decreases were observed during once-weekly teriparatide treatment for 72 weeks. These observations support the hypothesis that repeated weekly teriparatide administration stimulates bone remodeling, replacing old bone with new bone and leading to a reduction in the active remodeling surface. A simulation model was developed based on the iterative remodeling cycle that occurs on residual old bone. An increase in bone formation and a subsequent decrease were observed in the preliminary simulation. For each fitted time point, the predicted value was compared to the absolute values of the bone formation and resorption markers and lumbar BMD. The simulation model strongly matched actual changes in bone turnover markers and BMD. This simulation model indicates increased bone formation marker levels in the early stage and a subsequent decrease. It is therefore concluded that remodeling-based bone formation persisted during the entire treatment period with once-weekly teriparatide.

  3. Pilot study: evaluation of the use of the convergent interview technique in understanding the perception of surgical design and simulation

    OpenAIRE

    Logan, Heather; Wolfaardt, Johan; Boulanger, Pierre; Hodgetts, Bill; Seikaly, Hadi

    2013-01-01

    Background It is important to understand the perceived value of surgical design and simulation (SDS) amongst surgeons, as this will influence its implementation in clinical settings. The purpose of the present study was to examine the application of the convergent interview technique in the field of surgical design and simulation and evaluate whether the technique would uncover new perceptions of virtual surgical planning (VSP) and medical models not discovered by other qualitative case-based...

  4. Modeling the Mechanical Consequences of Age-Related Trabecular Bone Loss by XFEM Simulation

    Science.gov (United States)

    Fan, Ruoxun; Zhang, Xianbin; Liu, Jun; Jia, Zhengbin; Zhu, Dong

    2016-01-01

    The elderly are more likely to suffer from fracture because of age-related trabecular bone loss. Different bone loss locations and patterns have different effects on bone mechanical properties. Extended finite element method (XFEM) can simulate fracture process and was suited to investigate the effects of bone loss on trabecular bone. Age-related bone loss is indicated by trabecular thinning and loss and may occur at low-strain locations or other random sites. Accordingly, several ideal normal and aged trabecular bone models were created based on different bone loss locations and patterns; then, fracture processes from crack initiation to complete failure of these models were observed by XFEM; finally, the effects of different locations and patterns on trabecular bone were compared. Results indicated that bone loss occurring at low-strain locations was more detrimental to trabecular bone than that occurring at other random sites; meanwhile, the decrease in bone strength caused by trabecular loss was higher than that caused by trabecular thinning, and the effects of vertical trabecular loss on mechanical properties were more severe than horizontal trabecular loss. This study provided a numerical method to simulate trabecular bone fracture and distinguished different effects of the possible occurrence of bone loss locations and patterns on trabecular bone.

  5. Modeling the Mechanical Consequences of Age-Related Trabecular Bone Loss by XFEM Simulation.

    Science.gov (United States)

    Fan, Ruoxun; Gong, He; Zhang, Xianbin; Liu, Jun; Jia, Zhengbin; Zhu, Dong

    2016-01-01

    The elderly are more likely to suffer from fracture because of age-related trabecular bone loss. Different bone loss locations and patterns have different effects on bone mechanical properties. Extended finite element method (XFEM) can simulate fracture process and was suited to investigate the effects of bone loss on trabecular bone. Age-related bone loss is indicated by trabecular thinning and loss and may occur at low-strain locations or other random sites. Accordingly, several ideal normal and aged trabecular bone models were created based on different bone loss locations and patterns; then, fracture processes from crack initiation to complete failure of these models were observed by XFEM; finally, the effects of different locations and patterns on trabecular bone were compared. Results indicated that bone loss occurring at low-strain locations was more detrimental to trabecular bone than that occurring at other random sites; meanwhile, the decrease in bone strength caused by trabecular loss was higher than that caused by trabecular thinning, and the effects of vertical trabecular loss on mechanical properties were more severe than horizontal trabecular loss. This study provided a numerical method to simulate trabecular bone fracture and distinguished different effects of the possible occurrence of bone loss locations and patterns on trabecular bone. PMID:27403206

  6. Creation and Global Deployment of a Mobile, Application-Based Cognitive Simulator for Cardiac Surgical Procedures.

    Science.gov (United States)

    Brewer, Zachary E; Ogden, William David; Fann, James I; Burdon, Thomas A; Sheikh, Ahmad Y

    2016-01-01

    Several modern learning frameworks (eg, cognitive apprenticeship, anchored instruction, and situated cognition) posit the utility of nontraditional methods for effective experiential learning. Thus, development of novel educational tools emphasizing the cognitive framework of operative sequences may be of benefit to surgical trainees. We propose the development and global deployment of an effective, mobile cognitive cardiac surgical simulator. In methods, 16 preclinical medical students were assessed. Overall, 4 separate surgical modules (sternotomy, cannulation, decannulation, and sternal closure) were created utilizing the Touch Surgery (London, UK) platform. Modules were made available to download free of charge for use on mobile devices. Usage data were collected over a 6-month period. Educational efficacy of the modules was evaluated by randomizing a cohort of medical students to either module usage or traditional, reading-based self-study, followed by a multiple-choice learning assessment tool. In results, downloads of the simulator achieved global penetrance, with highest usage in the USA, Brazil, Italy, UK, and India. Overall, 5368 unique users conducted a total of 1971 hours of simulation. Evaluation of the medical student cohort revealed significantly higher assessment scores in those randomized to module use versus traditional reading (75% ± 9% vs 61% ± 7%, respectively; P mobile, interactive cognitive simulator for cardiac surgery. Simulators of this type may be effective for the training and assessment of surgical students. We investigated whether an interactive, mobile-computing-based cognitive task simulator for cardiac surgery could be developed, deployed, and validated. Our findings suggest that such simulators may be a useful learning tool. PMID:27568126

  7. Creation and Global Deployment of a Mobile, Application-Based Cognitive Simulator for Cardiac Surgical Procedures.

    Science.gov (United States)

    Brewer, Zachary E; Ogden, William David; Fann, James I; Burdon, Thomas A; Sheikh, Ahmad Y

    2016-01-01

    Several modern learning frameworks (eg, cognitive apprenticeship, anchored instruction, and situated cognition) posit the utility of nontraditional methods for effective experiential learning. Thus, development of novel educational tools emphasizing the cognitive framework of operative sequences may be of benefit to surgical trainees. We propose the development and global deployment of an effective, mobile cognitive cardiac surgical simulator. In methods, 16 preclinical medical students were assessed. Overall, 4 separate surgical modules (sternotomy, cannulation, decannulation, and sternal closure) were created utilizing the Touch Surgery (London, UK) platform. Modules were made available to download free of charge for use on mobile devices. Usage data were collected over a 6-month period. Educational efficacy of the modules was evaluated by randomizing a cohort of medical students to either module usage or traditional, reading-based self-study, followed by a multiple-choice learning assessment tool. In results, downloads of the simulator achieved global penetrance, with highest usage in the USA, Brazil, Italy, UK, and India. Overall, 5368 unique users conducted a total of 1971 hours of simulation. Evaluation of the medical student cohort revealed significantly higher assessment scores in those randomized to module use versus traditional reading (75% ± 9% vs 61% ± 7%, respectively; P mobile, interactive cognitive simulator for cardiac surgery. Simulators of this type may be effective for the training and assessment of surgical students. We investigated whether an interactive, mobile-computing-based cognitive task simulator for cardiac surgery could be developed, deployed, and validated. Our findings suggest that such simulators may be a useful learning tool.

  8. Computer-assisted three-dimensional surgical planning and simulation: 3D virtual osteotomy.

    Science.gov (United States)

    Xia, J; Ip, H H; Samman, N; Wang, D; Kot, C S; Yeung, R W; Tideman, H

    2000-02-01

    A computer-assisted three-dimensional virtual osteotomy system for orthognathic surgery (CAVOS) is presented. The virtual reality workbench is used for surgical planning. The surgeon immerses in a virtual reality environment with stereo eyewear, holds a virtual "scalpel" (3D Mouse) and operates on a "real" patient (3D visualization) to obtain pre-surgical prediction (3D bony segment movements). Virtual surgery on a computer-generated 3D head model is simulated and can be visualized from any arbitrary viewing point in a personal computer system.

  9. Numerical Simulation of the Flow in Vascular Grafts for Surgical Applications

    Science.gov (United States)

    McGah, Patrick; Aliseda, Alberto

    2009-11-01

    Numerical simulation of the human blood vessels, is becoming an important tool in surgical planning and research. Accurate vascular simulations might grant physicians the predictive capability to perform pre-surgical planning. We focus our attention on the implantation of vascular grafts. The high rate of failure of this common vascular interaction is intimately related to the fluid mechanics in the affected region and the subsequent wall tissue remodeling. Here, we will present our current work in developing a methodology for the numerical simulation of vascular grafts which incorporates physiologically realistic geometries and flow boundary conditions. In particular, we seek to correlate the wall shear stress and its spatial (WSSG) and temporal (OSI) variability to wall remodeling as observed in patient specific longitudinal studies. The pulsatility (Remean= 800 , Repeak= 2000, Wo = 2) of the flow gives rise to additional fluid dynamics phenomena such as instability, flow separation, transition, and unsteadiness. Our goal is to describe and evaluate their effect on the wall physiology.

  10. Alveolar corticotomy: a new surgical approach based on bone activation: principle and protocol.

    Science.gov (United States)

    Petitbois, Renaud; Scortecci, Gérard

    2012-12-01

    Alveolar corticotomy has proven effective in shortening orthodontic treatments in adults. A new non-invasive and flapless surgical approach has, however, yielded the same results. This technique, based on prior osteogenic alveoli preparation, entails neither anatomical risk nor post-op pain. The present article describes this new protocol and uses a case report to illustrate it. PMID:23164922

  11. The results of surgical treatment of proximal long segment tracheal stenosis using bilateral hyoid bone cutting with suprahyoid release

    Directory of Open Access Journals (Sweden)

    khadivi E

    2009-10-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Post-intubation tracheal stenosis is a serious problem and surgical resection is the method of choice in long segment tracheal stenosis treatment. The aim of this study was to review the results of surgical treatment of long segment post intubation tracheal stenosis and the role of bilateral hyoid bone cutting in supra- hyoid release technique."n"nMethods: Between 2004 to 2008, 14 patients with proximal long segment tracheal stenosis with resection of more than 40% of trachea length were evaluated regarding surgical technique and post-operative results."n"nResults: The mean age of patients was 22.2±0.4 years. Etiology in all patients were head trauma and prolonged intubation and all patients had tracheostomy at the time of trearment. Average time between surgery and first admission was 4.5±0.5 months. Average length of stenosis and resected segment were 3.6±0.5 and 4.3±0.5cm respectively. Average increased length of trachea after bilateral hyoid bone cutting was 1.1±0.3cm. Postoperative complications occurred in one patient with wound infection, and 4 patients had stenosis recurrence which was treated in 3 patients using multiple dilation. Quality of life 2 years after surgery in 71% of patients were

  12. Tele-surgical simulation system for training in the use of da Vinci surgery.

    Science.gov (United States)

    Suzuki, Shigeyuki; Suzuki, Naoki; Hayashibe, Mitsuhiro; Hattori, Asaki; Konishi, Kozo; Kakeji, Yoshihiro; Hashizume, Makoto

    2005-01-01

    Laparoscopic surgery including robotic surgery allows the surgeon to be able to conduct minimally invasive surgery. A surgeon is required to master difficult skills for this surgery to compensate for the narrow field of view, limitation of work space, and the lack of depth sensation. To counteract these drawbacks, we have been developing a training simulation system that can allow surgeons to practice and master surgical procedures. In addition, our system aims to distribute a simulation program, to provide a means of collaboration between remote hospitals, and to be able to provide a means for guidance from an expert surgeon. In this paper, we would like to show the surgery simulation for da Vinci surgery, in particular a cholecystectomy. The integral parts of this system are a soft tissue model which is created by the sphere-filled method enabling real-time deformations based on a patient's data, force feedback devices known as a PHANToM and the Internet connection. By using this system a surgeon can perform surgical maneuvers such as pushing, grasping, and detachment in real-time manipulation. Moreover, using the broadband communication, we can perform the tele-surgical simulation for training. PMID:15718794

  13. BOTH BONES FOREARM FRACTURES TREATED WITH LC-DCP: A SURGICAL OUTCOME

    OpenAIRE

    Ranganath; Prakash; Ravish; Sumanth

    2014-01-01

    Fractures of the forearm present a unique management problem for years. A forearm fracture involving both bones requires open anatomical reduction with stable fixation.[1] The forearm represents the critical anatomic unit of upper limb, permitting the effect of organ of the upper limb, the hand, to perform multi axial daily activities of living. Historically, the closed management of forearm fractures has been met with frustration in adults and resulted in poor functional ...

  14. Evaluation of 4 mm implants in mandibular edentulous patients with reduced bone height. Surgical preliminary results

    OpenAIRE

    J.L. Calvo-Guirado; M. Mallaun; M. Dard; J.A. López Torres

    2014-01-01

    Aim: Growing evidence has suggested the utility of short dental implants for oral reconstructive procedures in clinical situations of limited vertical bone height. The aim of this short comunication was to evaluate the clinical use of implants < 10 mm in length and to determine short implant-supported prosthesis success in the atrophic jaw. Materials and methods: Six women and three men were recruited for the treatment of edentulous mandibles. A total of 6 implants were inserted in each p...

  15. Evaluation of 4 mm implants in mandibular edentulous patients with reduced bone height. Surgical preliminary results

    Directory of Open Access Journals (Sweden)

    J.L. Calvo-Guirado

    2014-06-01

    Full Text Available Aim: Growing evidence has suggested the utility of short dental implants for oral reconstructive procedures in clinical situations of limited vertical bone height. The aim of this short comunication was to evaluate the clinical use of implants < 10 mm in length and to determine short implant-supported prosthesis success in the atrophic jaw. Materials and methods: Six women and three men were recruited for the treatment of edentulous mandibles. A total of 6 implants were inserted in each patient: two anterior implants of conventional lenght and four posterior 4 mm Titanium Zirconium (TiZr implants. The insertion torque and bone denisty were evaluated. Results: The mean insertion torque for the 4 mm implants was lower than for conventional ones, without any statistical difference. Moreover, most of the patients (88% showed a D2 bone type. Conclusion: The provision of short implant-supported prostheses in patients with atrophic alveolar ridges appears to be a successful treatment option in the short term; however, more scientific evidence is needed for the long term.

  16. Clinical and surgical approach of severe bone fragility fracture: clinical case of 4 fragility fracture in patient with heavy osteoporosis.

    Science.gov (United States)

    Giannotti, Stefano; Bottai, Vanna; Pini, Erica; Dell'osso, Giacomo; De Paola, Gaia; Guido, Giulio

    2013-01-01

    An accurate diagnosis of osteoporosis and a proper treatment are today recognized to be the most important facts for prevention and for a correct arrangement and treatment of fragility fractures. In the text the Authors describe a case of severe osteoporosis aggravated by 2 femur fractures and 2 periprosthetic fractures occurred in 2 months. In such cases the orthopaedic surgeon needs to formulate first a clinical osteoporotic pattern, than its treatment together with a surgery suitable choice, that has to take into consideration of the bone structural characteristics. In the case described one can note that fractures healing occurred thanks to both an improvement in surgical techniques and antiosteoporotic pharmacological support; in the specific case the Authors used strontium ranelate for its osteoinductive capacity. In our opinion is crucial that the treatment used by orthopaedic surgeons is not related only to the "by-hand" treatment but take into consideration both the underlying disease and the possibility of positively affect bone healing with specific drug therapy. PMID:23858312

  17. PEADIATRIC LONG BONES FRACTURE IN LOWER LIMBS TREATED BY TENS (TITANIUM ELASTIC NAILING SYSTEM NAIL: A SURGICAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-08-01

    Full Text Available In the last two decades, there was an increased interest in the operative treatment of pediatric fractures, although debate persisted over its indications. There is a little disagreement concerning the treatment of long bone fractures in children less than 6 years (POP cast and adolescents, older than 16 years (locked intramedullary nailing. 1 Controversy persists regarding the age between 6 to 16 years, with several available options: traction followed by hip Spica, external fixation, flexible, stable intramedullary nails, plate fixation, and locked intramedullary nailing. As no clear guidelines have been available until now despite efforts done initially by French surgeons, later on by European surgeons and recently by the Paediatric Orthopaedic Society of North America (POSNA2Titanium elastic nail (TEN fixation was originally meant as an ideal treatment method for femoral fractures, but was gradually applied to other long bone fractures in children, as it represents a compromise between conservative and surgical therapeutic approaches with satisfactory results and minimal complications3. Hence we have undertaken a prospective study of 30 cases in our institution about the outcome and efficacy of paediatric femoral and tibial diaphyseal fracture between age 6 to 16 years.

  18. Bone loss during simulated weightlessness - Is it glucocorticoid mediated?

    Science.gov (United States)

    Bikle, D. D.; Halloran, B. P.; Cone, C. M.; Morey-Holton, E.

    1985-01-01

    Elevating the hindquarters of a rat by the tail unweights the hind limbs but maintains normal weight-bearing by the forelimbs. This maneuver leads to a decrease in bone mass and calcium content in the unweighted bones (e.g., tibia and L1 vertebra), but not in the normally weighted bones (e.g., humerus and mandible). Potentially, the stress of the maneuver, mediated by increased glucocorticoid production and secretion, could explain the decreased bone formation, rather than the skeletal unweighting per se. To test this possibility, the effects of adrenalectomy on the response of bone to the unweighting of the hind limbs of normal rats were evaluated.

  19. BOTH BONES FOREARM FRACTURES TREATED WITH LC-DCP: A SURGICAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Ranganath

    2014-08-01

    Full Text Available Fractures of the forearm present a unique management problem for years. A forearm fracture involving both bones requires open anatomical reduction with stable fixation.[1] The forearm represents the critical anatomic unit of upper limb, permitting the effect of organ of the upper limb, the hand, to perform multi axial daily activities of living. Historically, the closed management of forearm fractures has been met with frustration in adults and resulted in poor functional outcome, hence perfect fracture reduction and rigid fixation is mandatory and achieved by plating. [2] The number of forearm fractures is increasing faster than the predicted rate due to increasing number of road traffic accidents, increased incidence of violence, rapid industrialization, and various sports activities. Conservative treatment has resulted in malunion, non-union, synostosis and ultimately poor functional outcome. [3] The present study is undertaken to know the functional outcome, advantages and complications of the LC-DCP. Thirty cases of fracture both bones of forearm were selected along the inclusion criteria’s and treated with LC-DCP in Department of Orthopedics, Kempegowda Institute of Medical Sciences, Bangalore

  20. RESULTS OF SURGICAL TREATMENT OF PAEDIATRIC DIAPHYSEAL FRACTURES OF LONG BONES USING INTRAMEDULLARY ELASTIC NAIL

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2015-12-01

    Full Text Available BACKGROUND Among the various methods of treating the long bone fractures in children less than 5yrs (POP cast and adolescents 16yrs (IMN, flexible intramedullary nail has gained importance because of its stability, not violating the physis and less complications and early rehabilitation. Irrespective of mode of treatment, goal shall be to achieve union at fracture site, control length and alignment, minimize the morbidity and complications for patient and their family. MATERIALS AND METHODS A prospective study was conducted on children of both sexes, between the age group of 5-15yrs with diaphyseal fractures of long bones, meeting the inclusion and exclusion criteria during the study period at RRMCH (September 2012 to September 2014. Totally, 30 cases were evaluated clinically and radiologically and followed up at 3, 6, 12, 24 weeks after surgery. Final outcome was assessed using Flynn’s criteria for Tens Scoring System. RESULTS Results of entire, 30 patients were followed up for an average of 6 months, was excellent in 19(63% cases and satisfactory in 11(37% cases and no poor outcome. CONCLUSION Based on this study and result, we found that intramedullary elastic nailing technique is an ideal method for treatment of pediatric femoral and tibial diaphyseal fractures.

  1. Mixed reality orthognathic surgical simulation by entity model manipulation and 3D-image display

    Science.gov (United States)

    Shimonagayoshi, Tatsunari; Aoki, Yoshimitsu; Fushima, Kenji; Kobayashi, Masaru

    2005-12-01

    In orthognathic surgery, the framing of 3D-surgical planning that considers the balance between the front and back positions and the symmetry of the jawbone, as well as the dental occlusion of teeth, is essential. In this study, a support system for orthodontic surgery to visualize the changes in the mandible and the occlusal condition and to determine the optimum position in mandibular osteotomy has been developed. By integrating the operating portion of a tooth model that is to determine the optimum occlusal position by manipulating the entity tooth model and the 3D-CT skeletal images (3D image display portion) that are simultaneously displayed in real-time, the determination of the mandibular position and posture in which the improvement of skeletal morphology and occlusal condition is considered, is possible. The realistic operation of the entity model and the virtual 3D image display enabled the construction of a surgical simulation system that involves augmented reality.

  2. Simulation of carbon dioxide insufflation via a diffuser in an open surgical wound model.

    Science.gov (United States)

    Cater, John E; van der Linden, Jan

    2015-01-01

    Flow within a model surgical opening during insufflation with heated carbon dioxide was studied using computational fluid dynamics. A volume of fluid method was used to simulate the mixture of ambient air and carbon dioxide gas. The negative buoyancy of the carbon dioxide caused it to fill the wound and form a protective layer on the internal surfaces for a range of flow rates, temperatures, and angles of patient inclination. It was observed that the flow remained attached to the surface of the model due to the action of the Coanda effect. A flow rate of 10 L/min was sufficient to maintain a warm carbon dioxide barrier for a moderately sized surgical incision for all likely angles of inclination. PMID:25103346

  3. Does computer-aided surgical simulation improve efficiency in bimaxillary orthognathic surgery?

    Science.gov (United States)

    Schwartz, H C

    2014-05-01

    The purpose of this study was to compare the efficiency of bimaxillary orthognathic surgery using computer-aided surgical simulation (CASS), with cases planned using traditional methods. Total doctor time was used to measure efficiency. While costs vary widely in different localities and in different health schemes, time is a valuable and limited resource everywhere. For this reason, total doctor time is a more useful measure of efficiency than is cost. Even though we use CASS primarily for planning more complex cases at the present time, this study showed an average saving of 60min for each case. In the context of a department that performs 200 bimaxillary cases each year, this would represent a saving of 25 days of doctor time, if applied to every case. It is concluded that CASS offers great potential for improving efficiency when used in the planning of bimaxillary orthognathic surgery. It saves significant doctor time that can be applied to additional surgical work.

  4. FUNCTIONAL OUTCOME OF SURGICAL MANAGEMENT OF FRACTURE BOTH BONES FOREARM IN ADULTS USING LC-DCP

    Directory of Open Access Journals (Sweden)

    Shiva Naik

    2014-09-01

    Full Text Available BACKGROUND: Forearm represent a critical anatomic unit of the upper limb, permitting the effector organ of the upper limb, the hand, to perform multi axial daily activities of living conservative reduction of fracture BBFA results in a poor functional outcome, non-union, mal-union rotational deformity. Hence perfect reduction is essential in maintaining the rotation (supination and pronation. This is achieved by ORIF using LC-DCP. The term LC-DCP stands for a new approach to plate fixation, reduced trauma to bone, preservation of blood supply, avoidance of stress raisers produced at implant removal and improved healing. This study is undertaken to assess the results of diaphyseal fractures of BBFA using LCDCP to study the advantages and its complications. MATERIALS AND METHODS: Patients who are admitted tin Victoria and Bowring & Lady Curzon Hospitals (Bangalore Medical College taken for study after obtaining their consent. This is prospective study from January 2004 to February 2006. RESULTS: This study consists of 20 cases of fracture BBFA. All cases were openly reduced and internally fixed with 3.5 mm LCDCP. Age distribution ranged from 18-65 years with fracture being most common in 2nd and 3rd decade (Average 34.6. Sex distribution out of 20 patients, 17 patients (85% was male and 3 (15% female. Side affected 13 (65% left side and 7 patients (35% right side. Mode of injury RTA 10 (50%, 8 (40% with fall 2 (10% assault. 18 (90% patient s had sound union in less than 6 months, 2 (10% patients had delayed union. Results were evaluated by Andersons scoring system. Using this scoring system we had 17 (85% patients with excellent results. 2 (10% patients with satisfactory results and 1 (5% with unsatisfactory result (radioulnar synostosis. Superficial infection 2 (10% posterior interosseous nerve injury 1 (5% Radioulnar synostosis 1(5%. CONCLUSION: LC-DCP facilitates biological, rigid fixation and early bone union with excellent radiological and

  5. Implantable microelectromechanical sensors for diagnostic monitoring and post-surgical prediction of bone fracture healing.

    Science.gov (United States)

    McGilvray, Kirk C; Unal, Emre; Troyer, Kevin L; Santoni, Brandon G; Palmer, Ross H; Easley, Jeremiah T; Demir, Hilmi Volkan; Puttlitz, Christian M

    2015-10-01

    The relationship between modern clinical diagnostic data, such as from radiographs or computed tomography, and the temporal biomechanical integrity of bone fracture healing has not been well-established. A diagnostic tool that could quantitatively describe the biomechanical stability of the fracture site in order to predict the course of healing would represent a paradigm shift in the way fracture healing is evaluated. This paper describes the development and evaluation of a wireless, biocompatible, implantable, microelectromechanical system (bioMEMS) sensor, and its implementation in a large animal (ovine) model, that utilized both normal and delayed healing variants. The in vivo data indicated that the bioMEMS sensor was capable of detecting statistically significant differences (p-value bioMEMS sensor can be used as a diagnostic tool for detecting the in vivo course of fracture healing in the acute post-treatment period.

  6. Numerical simulations of post-surgical flow and thrombosis in basilar artery aneurysms

    Science.gov (United States)

    Seshadhri, Santhosh; Lawton, Michael; Boussel, Loic; Saloner, David; Rayz, Vitaliy

    2015-11-01

    Surgical treatment of basilar artery aneurysms presents a major challenge since it is crucial to preserve the flow to the vital brainstem perforators branching of the basilar artery. In some cases, basilar aneurysms can be treated by clipping vessels in order to induce flow reduction and aneurysm thrombosis. Patient-specific CFD models can provide guidance to clinicians by simulating postoperative flows resulting from alternative surgeries. Several surgical options were evaluated for four basilar aneurysm patients. Patient-specific models were generated from preoperative MR angiography and MR velocimetry data and modified to simulate different procedures. The Navier-Stokes equations were solved with a finite-volume solver Fluent. Virtual contrast injections were simulated by solving the advection-diffusion equation in order to estimate the flow residence time and determine thrombus-prone regions. The results indicated on procedures that reduce intra-aneurysmal velocities and flow regions which are likely to become thrombosed. Thus CFD modeling can help improve the outcome of surgeries altering the flow in basilar aneurysms.

  7. Outcome of Surgical Treatment for Metastatic Vertebra Bone Tumor in Advanced Lung Cancer

    Directory of Open Access Journals (Sweden)

    Akiko Fukuhara

    2010-03-01

    Full Text Available Background: Spinal metastases of patients with advanced stage lung cancer are an important target for palliative therapy, because their incidence is high, and they often cause severe symptoms and worsen the quality of life. Surgery is one of the most effective treatment options, but the indication of surgery is unclear as the procedure is invasive and patients with spinal metastasis have a rather short life expectancy. Furthermore, there have been few studies that have focused on lung cancer with poor prognosis. Methods: We reviewed all of the cases of lung cancer from January 1999 to July 2007 in the Department of Respiratory Medicine, Kyoto University Hospital, Japan. Thirteen patients with metastatic spinal tumor of lung cancer underwent surgery, and all of them had a poor performance status score (3 or 4. Results: Neurological improvement by at least 1 Frankel grade was seen in 10 of 14 cases (71%. Improvement of the movement capacity was noted in 9 of 14 cases (64%, and pain improvement was noted in 12 of 14 (86%. Median postoperative survival was 5 months (1–25 months. In particular, the group with a good postoperative performance status score (0–2 was shown to have a better median postoperative survival of 13 months. Conclusions: Surgical treatment for symptomatic metastatic spinal tumor of lung cancer can improve quality of life in a substantially high percentage of patients. Surgery should be considered even if preoperative performance status is poor.

  8. Using the Statecharts paradigm for simulation of patient flow in surgical care.

    Science.gov (United States)

    Sobolev, Boris; Harel, David; Vasilakis, Christos; Levy, Adrian

    2008-03-01

    Computer simulation of patient flow has been used extensively to assess the impacts of changes in the management of surgical care. However, little research is available on the utility of existing modeling techniques. The purpose of this paper is to examine the capacity of Statecharts, a system of graphical specification, for constructing a discrete-event simulation model of the perioperative process. The Statecharts specification paradigm was originally developed for representing reactive systems by extending the formalism of finite-state machines through notions of hierarchy, parallelism, and event broadcasting. Hierarchy permits subordination between states so that one state may contain other states. Parallelism permits more than one state to be active at any given time. Broadcasting of events allows one state to detect changes in another state. In the context of the peri-operative process, hierarchy provides the means to describe steps within activities and to cluster related activities, parallelism provides the means to specify concurrent activities, and event broadcasting provides the means to trigger a series of actions in one activity according to transitions that occur in another activity. Combined with hierarchy and parallelism, event broadcasting offers a convenient way to describe the interaction of concurrent activities. We applied the Statecharts formalism to describe the progress of individual patients through surgical care as a series of asynchronous updates in patient records generated in reaction to events produced by parallel finite-state machines representing concurrent clinical and managerial activities. We conclude that Statecharts capture successfully the behavioral aspects of surgical care delivery by specifying permissible chronology of events, conditions, and actions. PMID:18390170

  9. Modelling of the human brain with detailed anatomy for numerical simulation of surgical interventions

    International Nuclear Information System (INIS)

    During the design and simulation process of MEMS medical devices used in neurosurgery, there is a need to build a brain model with detailed anatomy and physical properties incorporated as a platform to conduct numerical analysis. This paper presents a study on constructing a brain model for simulation of medical device interventions during neurosurgery. A brain atlas was utilized to develop a detailed model consisting of multiple structures. Two types of atlas model were generated employing different mesh types and biomechanical properties suited for various applications. The developed model was able to capture the detailed anatomy of the brain and reflect the application-dependant biomechanical behaviour based on material modelling of brain tissue under surgical intervention

  10. An evidence-based laparoscopic simulation curriculum shortens the clinical learning curve and reduces surgical adverse events

    Directory of Open Access Journals (Sweden)

    De Win G

    2016-06-01

    Full Text Available Gunter De Win,1,2 Siska Van Bruwaene,3,4 Jyotsna Kulkarni,5 Ben Van Calster,6 Rajesh Aggarwal,7,8 Christopher Allen,9 Ann Lissens,4 Dirk De Ridder,3 Marc Miserez4,10 1Department of Urology, Antwerp University Hospital, 2Faculty of Health Sciences, University of Antwerp, Antwerp, 3Department of Urology, University Hospitals of KU Leuven, 4Centre for Surgical Technologies, KU Leuven, Leuven, Belgium; 5Kulkarni Endo Surgery Institute, Pune, India; 6Department of Development and Regeneration, KU Leuven, Leuven, Belgium; 7Department of Surgery, Faculty of Medicine, 8Steinberg Centre for Simulation and Interactive Learning, Faculty of Medicine, McGill University, Montreal, QC, Canada; 9School of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA; 10Department of Abdominal Surgery, University Hospitals Leuven, Leuven, Belgium Background: Surgical simulation is becoming increasingly important in surgical education. However, the method of simulation to be incorporated into a surgical curriculum is unclear. We compared the effectiveness of a proficiency-based preclinical simulation training in laparoscopy with conventional surgical training and conventional surgical training interspersed with standard simulation sessions.Materials and methods: In this prospective single-blinded trial, 30 final-year medical students were randomized into three groups, which differed in the way they were exposed to laparoscopic simulation training. The control group received only clinical training during residency, whereas the interval group received clinical training in combination with simulation training. The Center for Surgical Technologies Preclinical Training Program (CST PTP group received a proficiency-based preclinical simulation course during the final year of medical school but was not exposed to any extra simulation training during surgical residency. After 6 months of surgical residency, the influence on the learning curve while performing

  11. Changes in Mechanical Properties of Rat Bones under Simulated Effects of Microgravity and Radiation†

    Science.gov (United States)

    Walker, Azida H.; Perkins, Otis; Mehta, Rahul; Ali, Nawab; Dobretsov, Maxim; Chowdhury, Parimal

    The aim of this study was to determine the changes in elasticity and lattice structure in leg bone of rats which were: 1) under Hind-Limb Suspension (HLS) by tail for 2 weeks and 2) exposed to a total radiation of 10 Grays in 10 days. The animals were sacrificed at the end of 2 weeks and the leg bones were surgically removed, cleaned and fixed with a buffered solution. The mechanical strength of the bone (elastic modulus) was determined from measurement of bending of a bone when under an applied force. Two methodologies were used: i) a 3-point bending technique and ii) classical bending where bending is accomplished keeping one end fixed. Three point bending method used a captive actuator controlled by a programmable IDEA drive. This allowed incremental steps of 0.047 mm for which the force is measured. The data is used to calculate the stress and the strain. In the second method a mirror attached to the free end of the bone allowed a reflected laser beam spot to be tracked. This provided the displacement measurement as stress levels changed. Analysis of stress vs. strain graph together with solution of Euler-Bernoulli equation for a cantilever beam allowed determination of the elastic modulus of the leg bone for (i) control samples, (ii) HLS samples and (iii) HLS samples with radiation effects. To ascertain changes in the bone lattice structure, the bones were cross-sectioned and imaged with a 20 keV beam of electrons in a Scanning Electron Microscope (SEM). A backscattered detector and a secondary electron detector in the SEM provided the images from well-defined parts of the leg bones. Elemental compositions in combination with mechanical properties (elastic modulus and lattice structure) changes indicated weakening of the bones under space-like conditions of microgravity and radiation.

  12. Multiscale approach for bone remodeling simulation based on finite element and neural network computation

    CERN Document Server

    Hambli, Ridha

    2011-01-01

    The aim of this paper is to develop a multiscale hierarchical hybrid model based on finite element analysis and neural network computation to link mesoscopic scale (trabecular network level) and macroscopic (whole bone level) to simulate bone remodelling process. Because whole bone simulation considering the 3D trabecular level is time consuming, the finite element calculation is performed at macroscopic level and a trained neural network are employed as numerical devices for substituting the finite element code needed for the mesoscale prediction. The bone mechanical properties are updated at macroscopic scale depending on the morphological organization at the mesoscopic computed by the trained neural network. The digital image-based modeling technique using m-CT and voxel finite element mesh is used to capture 2 mm3 Representative Volume Elements at mesoscale level in a femur head. The input data for the artificial neural network are a set of bone material parameters, boundary conditions and the applied str...

  13. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery using computer-assisted surgical simulation.

    Science.gov (United States)

    Movahed, Reza; Wolford, Larry M

    2015-02-01

    Combined orthognathic and total joint reconstruction cases can be predictably performed in 1 stage. Use of virtual surgical planning can eliminate a significant time requirement in preparation of concomitant orthognathic and temporomandibular joint (TMJ) prostheses cases. The concomitant TMJ and orthognathic surgery-computer-assisted surgical simulation technique increases the accuracy of combined cases. In order to have flexibility in positioning of the total joint prosthesis, recontouring of the lateral aspect of the rami is advantageous.

  14. Amino acid supplementation alters bone metabolism during simulated weightlessness

    Science.gov (United States)

    Zwart, S. R.; Davis-Street, J. E.; Paddon-Jones, D.; Ferrando, A. A.; Wolfe, R. R.; Smith, S. M.

    2005-01-01

    High-protein and acidogenic diets induce hypercalciuria. Foods or supplements with excess sulfur-containing amino acids increase endogenous sulfuric acid production and therefore have the potential to increase calcium excretion and alter bone metabolism. In this study, effects of an amino acid/carbohydrate supplement on bone resorption were examined during bed rest. Thirteen subjects were divided at random into two groups: a control group (Con, n = 6) and an amino acid-supplemented group (AA, n = 7) who consumed an extra 49.5 g essential amino acids and 90 g carbohydrate per day for 28 days. Urine was collected for n-telopeptide (NTX), deoxypyridinoline (DPD), calcium, and pH determinations. Bone mineral content was determined and potential renal acid load was calculated. Bone-specific alkaline phosphatase was measured in serum samples collected on day 1 (immediately before bed rest) and on day 28. Potential renal acid load was higher in the AA group than in the Con group during bed rest (P < 0.05). For all subjects, during bed rest urinary NTX and DPD concentrations were greater than pre-bed rest levels (P < 0.05). Urinary NTX and DPD tended to be higher in the AA group (P = 0.073 and P = 0.056, respectively). During bed rest, urinary calcium was greater than baseline levels (P < 0.05) in the AA group but not the Con group. Total bone mineral content was lower after bed rest than before bed rest in the AA group but not the Con group (P < 0.05). During bed rest, urinary pH decreased (P < 0.05), and it was lower in the AA group than the Con group. These data suggest that bone resorption increased, without changes in bone formation, in the AA group.

  15. Bone

    Science.gov (United States)

    Helmberger, Thomas K.; Hoffmann, Ralf-Thorsten

    The typical clinical signs in bone tumours are pain, destruction and destabilization, immobilization, neurologic deficits, and finally functional impairment. Primary malignant bone tumours are a rare entity, accounting for about 0.2% of all malignancies. Also benign primary bone tumours are in total rare and mostly asymptomatic. The most common symptomatic benign bone tumour is osteoid osteoma with an incidence of 1:2000.

  16. Addressing gaps in surgical skills training by means of low-cost simulation at Muhimbili University in Tanzania

    Directory of Open Access Journals (Sweden)

    Taché Stephanie

    2009-07-01

    Full Text Available Abstract Background Providing basic surgical and emergency care in rural settings is essential, particularly in Tanzania, where the mortality burden addressable by emergency and surgical interventions has been estimated at 40%. However, the shortages of teaching faculty and insufficient learning resources have hampered the traditionally intensive surgical training apprenticeships. The Muhimbili University of Health and Allied Sciences consequently has experienced suboptimal preparation for graduates practising surgery in the field and a drop in medical graduates willing to become surgeons. To address the decline in circumstances, the first step was to enhance technical skills in general surgery and emergency procedures for senior medical students by designing and implementing a surgical skills practicum using locally developed simulation models. Methods A two-day training course in nine different emergency procedures and surgical skills based on the Canadian Network for International Surgery curriculum was developed. Simulation models for the surgical skills were created with locally available materials. The curriculum was pilot-tested with a cohort of 60 senior medical students who had completed their surgery rotation at Muhimbili University. Two measures were used to evaluate surgical skill performance: Objective Structured Clinical Examinations and surveys of self-perceived performance administered pre- and post-training. Results Thirty-six students participated in the study. Prior to the training, no student was able to correctly perform a surgical hand tie, only one student was able to correctly perform adult intubation and three students were able to correctly scrub, gown and glove. Performance improved after training, demonstrated by Objective Structured Clinical Examination scores that rose from 6/30 to 15/30. Students perceived great benefit from practical skills training. The cost of the training using low-tech simulation was four

  17. Bilateral Temporomandibular Joint Replacement Using Computer-Assisted Surgical Simulation and Three-Dimensional Printing.

    Science.gov (United States)

    Ryu, Jaeyoung; Cho, Jinyong; Kim, Hyeon Min

    2016-07-01

    The dental occlusion is the important reference for replacement of the temporomandibular joint. If a patient does not have normal occlusion, few considerations are needed for temporomandibular joint replacement. The custom-made prosthesis, typically fabricated with a stereolithographic model, is probably the optimized solution currently available. However the ready-made stock from Biomet Microfixation System (Jacksonville, FL) is the only available product, which is authorized by the government ministry in South Korea, for replacement of the temporomandibular joint. This report presents a patient with the problems that were retrognathic "bird face" profile subsequent to severe bilateral condylar resorption and temporomandibular joint ankylosis without enough natural teeth for occlusion. Bilateral temporomandibular joint replacement using the ready-made prosthesis was done by reestablishing the mandibular position with new occlusion and improved facial profile via the virtual surgical planning and stereolithographic model simulation. PMID:27315318

  18. Human maxillary sinus floor elevation as a model for bone regeneration enabling the application of one-step surgical procedures

    NARCIS (Netherlands)

    E. Farre-Guasch; H.J. Prins; J.R. Overman; C.M. ten Bruggenkate; E.A.J.M. Schulten; M.N. Helder; J. Klein-Nulend

    2013-01-01

    Bone loss in the oral and maxillofacial region caused by trauma, tumors, congenital disorders, or degenerative diseases is a health care problem worldwide. To restore (reconstruct) these bone defects, human or animal bone grafts or alloplastic (synthetic) materials have been used. However, several d

  19. Monte Carlo simulation of red bone marrow dose from CT examination

    International Nuclear Information System (INIS)

    To evaluate the methods of calculating red bone marrow dose from CT scan, simulating red bone marrow do ses from different CT scan protocols using different energy can provide the basic dose data for patient radiation protection. Method: Monte Carlo software MCNPX and RPI voxel phantom were used for the simulation, by mass absorption coefficient (MEAC) method, energy including 80 kV, 100 kV, 120 kV and 140 kV of the CT device were simulated, and different CT protocols such as chest scan, abdomen scan and body scan were taken into consideration when simulating the red bone marrow dose (mGy/100 mAs). Results: Under the same other conditions, the larger beam energy caused larger red bone marrow dose, the results of 140 kV was two times larger than that of 80 kV for the same protocol; while under the same beam energy, the difference among different protocol was less than 10%. Conclusion: Under the same conditions, the red bone marrow dose from CT scan depends on beam energy (tube voltage) and total effective mAs; if the total effective mAs was constant, the influence of scan protocol to red bone marrow dose was not much. (authors)

  20. Developing an International Combined Applied Surgical Science and Wet Lab Simulation Course as an Undergraduate Teaching Model

    Directory of Open Access Journals (Sweden)

    Michail Sideris

    2015-01-01

    Full Text Available Background. Essential Skills in the Management of Surgical Cases (ESMSC is an international, animal model-based course. It combines interactive lectures with basic ex vivo stations and more advanced wet lab modules, that is, in vivo dissections and Heart Transplant Surgery on a swine model. Materials and Methods. Forty-nine medical students (male, N=27, female N=22, and mean age = 23.7 years from King’s College London (KCL and Greek Medical Schools attended the course. Participants were assessed with Direct Observation of Procedural Skills (DOPS, as well as Multiple Choice Questions (MCQs. Paired t-test associations were used to evaluate whether there was statistically significant improvement in their performance. Aim. To evaluate the effectiveness of a combined applied surgical science and wet lab simulation course as a teaching model for surgical skills at the undergraduate level. Results. The mean MCQ score was improved by 2.33/32 (P<0.005. Surgical skills competences, as defined by DOPS scores, were improved in a statically significant manner (P<0.005 for all paired t-test correlations. Conclusions. ESMSC seems to be an effective teaching model, which improves the understanding of the surgical approach and the basic surgical skills. In vivo models could be used potentially as a step further in the Undergraduate Surgical Education.

  1. Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery utilizing computer-assisted surgical simulation.

    Science.gov (United States)

    Movahed, Reza; Teschke, Marcus; Wolford, Larry M

    2013-12-01

    Clinicians who address temporomandibular joint (TMJ) pathology and dentofacial deformities surgically can perform the surgery in 1 stage or 2 separate stages. The 2-stage approach requires the patient to undergo 2 separate operations and anesthesia, significantly prolonging the overall treatment. However, performing concomitant TMJ and orthognathic surgery (CTOS) in these cases requires careful treatment planning and surgical proficiency in the 2 surgical areas. This article presents a new treatment protocol for the application of computer-assisted surgical simulation in CTOS cases requiring reconstruction with patient-fitted total joint prostheses. The traditional and new CTOS protocols are described and compared. The new CTOS protocol helps decrease the preoperative workup time and increase the accuracy of model surgery.

  2. The evolution of simulation techniques for dynamic bone tissue engineering in bioreactors.

    Science.gov (United States)

    Vetsch, Jolanda Rita; Müller, Ralph; Hofmann, Sandra

    2015-08-01

    Bone tissue engineering aims to overcome the drawbacks of current bone regeneration techniques in orthopaedics. Bioreactors are widely used in the field of bone tissue engineering, as they help support efficient nutrition of cultured cells with the possible combination of applying mechanical stimuli. Beneficial influencing parameters of in vitro cultures are difficult to find and are mostly determined by trial and error, which is associated with significant time and money spent. Mathematical simulations can support the finding of optimal parameters. Simulations have evolved over the last 20 years from simple analytical models to complex and detailed computational models. They allow researchers to simulate the mechanical as well as the biological environment experienced by cells seeded on scaffolds in a bioreactor. Based on the simulation results, it is possible to give recommendations about specific parameters for bone bioreactor cultures, such as scaffold geometries, scaffold mechanical properties, the level of applied mechanical loading or nutrient concentrations. This article reviews the evolution in simulating various aspects of dynamic bone culture in bioreactors and reveals future research directions.

  3. Bone

    International Nuclear Information System (INIS)

    Bone scanning provides information on the extent of primary bone tumors, on possible metastatic disease, on the presence of osteomyelitis prior to observation of roentgenographic changes so that earlier therapy is possible, on the presence of collagen diseases, on the presence of fractures not disclosed by x-ray films, and on the evaluation of aseptic necrosis. However, the total effect and contribution of bone scanning to the diagnosis, treatment, and ultimate prognosis of pediatric skeletal diseases is, as yet, unknown. (auth)

  4. Clinical impact of different detection methods for disseminated tumor cells in bone marrow of patients undergoing surgical resection of colorectal liver metastases: a prospective follow-up study

    International Nuclear Information System (INIS)

    Large number of patients with colorectal liver metastasis show recurrent disease after curative surgical resection. Identification of these high-risk patients may guide therapeutic strategies. The aim of this study was to evaluate whether the presence of disseminated tumor cells in bone marrow from patients undergoing surgical resection of colorectal liver metastases can predict clinical outcome. Sixty patients with colorectal liver metastases were planned for a curative resection between 2001 and 2007. All patients underwent bone marrow aspiration before surgery. Detection of tumor cells was performed using immunocytochemical staining for cytokeratin (CK-ICC) combined with automated microscopy or indirectly using reverse transcription-polymerase chain reaction (RT-PCR). Disseminated tumor cells were found in 15 of the 46 patients (33%) using CK-ICC and in 9 of 44 of the patients (20%) using RT-PCR. Patients with negative results for RT-PCR had a significant better disease-free survival after resection of their liver metastases (p = 0.02). This group also showed significant better overall survival (p = 0.002). CK-ICC did not predict a worse clinical outcome. The presence of disseminated tumor cells in bone marrow detected using RT-PCR did predict a worse clinical outcome. The presence of cells detected with CK-ICC did not correlate with poor prognosis

  5. Scanning electron microscope studies of bone samples: Influence of simulated microgravity

    Science.gov (United States)

    Mehta, Rahul; Chowdhury, Parimal; Ali, Nawab

    2007-08-01

    A scanning electron microscope (SEM) with backscatter and secondary electron emission detectors plus a Si(Li) detector for photon yield measurements was used to study bone samples from skull and leg of mice and rats. These animals were either suspended by their tail to induce simulated microgravity, characterized as hind-limb suspension (HLS) or not suspended (control). Analyses of the SEM images and energy dispersive spectrometer (EDS) spectra using Si(Li) detector indicate variation in the lattice structures, and in intensities of the characteristics X-rays, produced from the exposed bone surface due to its interaction with the electron beam. Using Flame software, the X-ray spectra were analyzed and normalized ratios of the elements determined. The elemental analysis indicated a variation in the density of calcium, potassium, and oxygen near the knee joints and near the sutures in the skull bones. The comparison of simulated microgravity subjected samples of the rat skull bones with that of the control samples revealed that in the suture region there was a large increase in the ratio of calcium, and to some degree for phosphorus, suggesting simulated microgravity affects distribution of these elements. Elemental composition for control samples with depth (within the cross section of the leg bones) revealed decrease of oxygen and increase of calcium in the first millimeter of the bone depth after which the relative percentage of elements stayed constant.

  6. Simulated weightlessness and synbiotic diet effects on rat bone mechanical strength

    Science.gov (United States)

    Sarper, Hüseyin; Blanton, Cynthia; DePalma, Jude; Melnykov, Igor V.; Gabaldón, Annette M.

    2014-10-01

    This paper reports results on exposure to simulated weightlessness that leads to a rapid decrease in bone mineral density known as spaceflight osteopenia by evaluating the effectiveness of dietary supplementation with synbiotics to counteract the effects of skeletal unloading. Forty adult male rats were studied under four different conditions in a 2 × 2 factorial design with main effects of diet (synbiotic and control) and weight condition (unloaded and control). Hindlimb unloading was performed at all times for 14 days followed by 14 days of recovery (reambulation). The synbiotic diet contained probiotic strains Lactobacillus acidophilus and Lactococcus lactis lactis and prebiotic fructooligosaccharide. This paper also reports on the development of a desktop three-point bending device to measure the mechanical strength of bones from rats subjected to simulated weightlessness. The importance of quantifying bone resistance to breakage is critical when examining the effectiveness of interventions against osteopenia resulting from skeletal unloading, such as astronauts experience, disuse or disease. Mechanical strength indices provide information beyond measures of bone density and microarchitecture that enhance the overall assessment of a treatment's potency. In this study we used a newly constructed three-point bending device to measure the mechanical strength of femur and tibia bones from hindlimb-unloaded rats fed an experimental synbiotic diet enriched with probiotics and fermentable fiber. Two calculated outputs for each sample were Young's modulus of elasticity and fracture stress. Bone major elements (calcium, magnesium, and phosphorous) were quantified using ICP-MS analysis. Hindlimb unloading was associated with a significant loss of strength in the femur, and with significant reductions in major bone elements. The synbiotic diet did not protect against these unloading effects. Tibia strength and major elements were not reduced by hindlimb unloading, as was

  7. Computer-Aided Simulation of Mastoidectomy

    Institute of Scientific and Technical Information of China (English)

    CHEN He-xin; MA Zhi-chao; Wang Zhang-feng; GUO Jie-bo; WEN Wei-ping; XU Geng

    2008-01-01

    Objective To establish a three-dimensional model of the temporal bone using CT scan images for study of temporal bone structures and simulation of mastoidectomy procedures. Methods CT scan images from 6 individuals (12 temporal bones) were used to reconstruct the Fallopian canal, internal auditory canal, cochlea, semicircular canals, sigmoid sinus, posterior fossa floor and jugular bulb on a computer platform. Their anatomical relations within the temporal bone were restored in the computed model. The same model was used to simulate mastoidectomy procedures. Results The reconstructed computer model provided accurate and clear three-dimensional images of temporal bone structures. Simulation of mastoidectomy using these images provided procedural experiences closely mimicking the real surgical procedure. Conclusion Computeraided three dimensional reconstruction of temporal bone structures using CT scan images is a useful tool in surgical simulation and can aid surgical procedure planning.

  8. Cryosurgery and acrylic cementation as surgical adjuncts in the treatment of aggressive (benign) bone tumors. Analysis of 25 patients below the age of 21.

    Science.gov (United States)

    Malawer, M M; Dunham, W

    1991-01-01

    This article reviews the clinical experience with cryosurgery (use of liquid nitrogen) and acrylic cementation (polymethylmethacrylate; PMMA) in the treatment of aggressive, benign bone sarcomas and the biologic basis of this technique. The results of 25 patients below the age of 21 treated by cryosurgery, with an average follow-up period of 60.8 months, are reported. Three approaches to surgical reconstruction were used: Group 1 (four patients) had cryosurgery with no reconstruction, Group 2 (13 patients) had bone graft reconstruction alone, and Group 3 (eight patients) had composite osteosynthesis with internal fixation, bone graft, and/or PMMA. The overall control rate was 96% (one recurrence). The tumor types were giant-cell tumor, chondroblastoma, aneurysmal bone cyst, and malignant giant-cell tumor. Nineteen lesions involved the lower extremity, and six lesions were located in the upper extremity. There were two secondary fractures (8%), one local flap necrosis, and one synovial fistula. There were no infections. Two epiphyseodeses were performed. The functional results were excellent (83%), good (13%), and fair (4%). The technique of composite osteosynthesis is recommended for all large tumors of the lower extremity. Cryosurgical results compare favorably with those obtained by en bloc resection and demonstrate the ability of cryosurgery to eradicate tumors while avoiding the need for extensive resections and reconstructive procedures. PMID:1984931

  9. Surgical treatment of multifocal giant cell tumor of carpal bones with preservation of wrist function: case report.

    Science.gov (United States)

    Tarng, Yih-Wen; Yang, Shan-Wei; Hsu, Chien-Jen

    2009-02-01

    We report a rare case of multifocal giant cell tumor of bone involving the trapezium, trapezoid, capitate, and scaphoid with soft tissue extension. Following intralesional resection, an autogenous corticocancellous iliac crest bone graft was used to fill the resultant defect and preserve carpal height and radiocarpal motion. Successful union with no recurrence was noted at 1-year follow-up.

  10. Simulation analysis for effects of bone loss on acceleration tolerance of human lumbar vertebra

    Science.gov (United States)

    Ma, Honglei; Zhang, Feng; Zhu, Yu; Xiao, Yanhua; Wazir, Abrar

    2014-02-01

    The purpose of the present study was to analyze and predict the changes in acceleration tolerance of human vertebra as a result of bone loss caused by long-term space flight. A human L3-L4 vertebra FEM model was constructed, in which the cancellous bone was separated, and surrounding ligaments were also taken into account. The simulation results demonstrated that bone loss has more of an effect on the acceleration tolerance in x-direction. The results serve to aid in the creation of new acceleration tolerance standards, ensuring astronauts return home safely after long-term space flight. This study shows that more attention should be focused on the bone degradation of crew members and to create new protective designs for space capsules in the future.

  11. Evaluation of bone remodeling around single dental implants of different lengths: a mechanobiological numerical simulation and validation using clinical data.

    Science.gov (United States)

    Sotto-Maior, Bruno Salles; Mercuri, Emílio Graciliano Ferreira; Senna, Plinio Mendes; Assis, Neuza Maria Souza Picorelli; Francischone, Carlos Eduardo; Del Bel Cury, Altair Antoninha

    2016-01-01

    Algorithmic models have been proposed to explain adaptive behavior of bone to loading; however, these models have not been applied to explain the biomechanics of short dental implants. Purpose of present study was to simulate bone remodeling around single implants of different lengths using mechanoregulatory tissue differentiation model derived from the Stanford theory, using finite elements analysis (FEA) and to validate the theoretical prediction with the clinical findings of crestal bone loss. Loading cycles were applied on 7-, 10-, or 13-mm-long dental implants to simulate daily mastication and bone remodeling was assessed by changes in the strain energy density of bone after a 3, 6, and 12 months of function. Moreover, clinical findings of marginal bone loss in 45 patients rehabilitated with same implant designs used in the simulation (n = 15) were computed to validate the theoretical results. FEA analysis showed that although the bone density values reduced over time in the cortical bone for all groups, bone remodeling was independent of implant length. Clinical data showed a similar pattern of bone resorption compared with the data generated from mathematical analyses, independent of implant length. The results of this study showed that the mechanoregulatory tissue model could be employed in monitoring the morphological changes in bone that is subjected to biomechanical loads. In addition, the implant length did not influence the bone remodeling around single dental implants during the first year of loading. PMID:26249362

  12. Comparison between cone-beam and multislice computed tomography for identification of simulated bone lesions

    Energy Technology Data Exchange (ETDEWEB)

    Gaia, Bruno Felipe [University of Sao Paulo (USP), SP (Brazil). Dental School. Stomatology Dept.; Sales, Marcelo Augusto Oliveira de [University of Paraiba (UFPB), Joao Pessoa, PB (Brazil). Dental School. Dept. of Radiology; Perrella, Andreia; Fenyo-Pereira, Marlene; Cavalcanti, Marcelo Gusmao Paraiso, E-mail: mgpcaval@usp.b [University of Sao Paulo (USP), SP (Brazil). Dental School. Dept. of Radiology

    2011-07-15

    There are many studies that compare the accuracy of multislice (MSCT) and cone beam (CBCT) computed tomography for evaluations in the maxillofacial region. However, further studies comparing both acquisition techniques for the evaluation of simulated mandibular bone lesions are needed. The aim of this study was to compare the accuracy of MSCT and CBCT in the diagnosis of simulated mandibular bone lesions by means of cross sectional images and axial/MPR slices. Lesions with different dimensions, shape and locularity were produced in 15 dry mandibles. The images were obtained following the cross sectional and axial/MPR (Multiplanar Reconstruction) imaging protocols and were interpreted independently. CBCT and MSCT showed similar results in depicting the percentage of cortical bone involvement, with great sensitivity and specificity (p < 0.005). There were no significant intra- or inter-examiner differences between axial/MPR images and cross sectional images with regard to sensitivity and specificity. CBCT showed results similar to those of MSCT for the identification of the number of simulated bone lesions. Cross sectional slices and axial/MPR images presented high accuracy, proving useful for bone lesion diagnosis. (author)

  13. The Mozart effect on task performance in a laparoscopic surgical simulator.

    Science.gov (United States)

    Wiseman, Michael C

    2013-10-01

    The Mozart Effect is a phenomenon whereby certain pieces of music induce temporary enhancement in "spatial temporal reasoning." To determine whether the Mozart Effect can improve surgical performance, 55 male volunteers (mean age = 20.6 years, range = 16-27), novice to surgery, were timed as they completed an activity course on a laparoscopic simulator. Subjects were then randomized for exposure to 1 of 2 musical pieces by Mozart (n = 21) and Dream Theater (n = 19), after which they repeated the course. Following a 15-minute exposure to a nonmusical piece, subjects were exposed to one of the pieces and performed the activity course a third time. An additional group (n = 15) that was not corandomized performed the tasks without any exposure to music. The percent improvements in completion time between 3 successive trials were calculated for each subject and group means compared. In 2 of the tasks, subjects exposed to the Dream Theater piece achieved approximately 30% more improvement (26.7 ± 8.3%) than those exposed to the Mozart piece (20.2 ± 7.8%, P = .021) or to no music (20.4 ± 9.1%, P = .049). Distinct patterns of covariance between baseline performance and subsequent improvement were observed for the different musical conditions and tasks. The data confirm the existence of a Mozart Effect and demonstrate for the first time its practical applicability. Prior exposure to certain pieces may enhance performance in practical skills requiring spatial temporal reasoning.

  14. Adaptive space warping to enhance passive haptics in an arthroscopy surgical simulator.

    Science.gov (United States)

    Spillmann, Jonas; Tuchschmid, Stefan; Harders, Matthias

    2013-04-01

    Passive haptics, also known as tactile augmentation, denotes the use of a physical counterpart to a virtual environment to provide tactile feedback. Employing passive haptics can result in more realistic touch sensations than those from active force feedback, especially for rigid contacts. However, changes in the virtual environment would necessitate modifications of the physical counterparts. In recent work space warping has been proposed as one solution to overcome this limitation. In this technique virtual space is distorted such that a variety of virtual models can be mapped onto one single physical object. In this paper, we propose as an extension adaptive space warping; we show how this technique can be employed in a mixed-reality surgical training simulator in order to map different virtual patients onto one physical anatomical model. We developed methods to warp different organ geometries onto one physical mock-up, to handle different mechanical behaviors of the virtual patients, and to allow interactive modifications of the virtual structures, while the physical counterparts remain unchanged. Various practical examples underline the wide applicability of our approach. To the best of our knowledge this is the first practical usage of such a technique in the specific context of interactive medical training.

  15. Finite element simulation of bone remodelling in human mandible around osseointegrated dental implant

    International Nuclear Information System (INIS)

    Modern dental implant is a biocompatible titanium device surgically placed into a jawbone to support a prosthetic tooth crown in order to replace missing teeth. Implants are superior to conventional prostheses, in both function and long-term predictability. However, placement of an implant changes the normal mechanical environment of jawbone, which causes the bone density to redistribute and adapt to the new environment through a process of remodelling. This study aims to predict the density distribution in human jawbone around osseointegrated dental implant. Based on two popular, yet distinctive theories for bone remodelling, a new remodelling algorithm is proposed. The proposed algorithm is verified by a two-dimensional (2D) plate model. Then, a 2D finite element model of implant and jawbone is studied. The effects of two parameters, viz the reference value of strain energy density (SED) and 'lazy zone' region, on density distribution, are also examined. This study has demonstrated that consideration of the lazy zone, is less important than consideration of the stress and strain (quantified as SED) induced within the bone. Taking into account both 'lazy zone' effect and self-organisational control process, the proposed bone remodelling algorithm has overcome the shortcomings of the two existing theories.

  16. Early Fixation of Cobalt-Chromium Based Alloy Surgical Implants to Bone Using a Tissue-engineering Approach

    Directory of Open Access Journals (Sweden)

    Yasuaki Tohma

    2012-05-01

    Full Text Available To establish the methods of demonstrating early fixation of metal implants to bone, one side of a Cobalt-Chromium (CoCr based alloy implant surface was seeded with rabbit marrow mesenchymal cells and the other side was left unseeded. The mesenchymal cells were further cultured in the presence of ascorbic acid, β-glycerophosphate and dexamethasone, resulting in the appearance of osteoblasts and bone matrix on the implant surface. Thus, we succeeded in generating tissue-engineered bone on one side of the CoCr implant. The CoCr implants were then implanted in rabbit bone defects. Three weeks after the implantation, evaluations of mechanical test, undecalcified histological section and electron microscope analysis were performed. Histological and electron microscope images of the tissue engineered surface exhibited abundant new bone formation. However, newly formed bone tissue was difficult to detect on the side without cell seeding. In the mechanical test, the mean values of pull-out forces were 77.15 N and 44.94 N for the tissue-engineered and non-cell-seeded surfaces, respectively. These findings indicate early bone fixation of the tissue-engineered CoCr surface just three weeks after implantation.

  17. Development of a novel method for surgical implant design optimization through noninvasive assessment of local bone properties.

    Science.gov (United States)

    Schiuma, D; Brianza, S; Tami, A E

    2011-03-01

    A method was developed to improve the design of locking implants by finding the optimal paths for the anchoring elements, based on a high resolution pQCT assessment of local bone mineral density (BMD) distribution and bone micro-architecture (BMA). The method consists of three steps: (1) partial fixation of the implant to the bone and creation of a reference system, (2) implant removal and pQCT scan of the bone, and (3) determination of BMD and BMA of all implant-anchoring locations along the actual and alternative directions. Using a PHILOS plate, the method uncertainty was tested on an artificial humerus bone model. A cadaveric humerus was used to quantify how the uncertainty of the method affects the assessment of bone parameters. BMD and BMA were determined along four possible alternative screw paths as possible criteria for implant optimization. The method is biased by a 0.87 ± 0.12 mm systematic uncertainty and by a 0.44 ± 0.09 mm random uncertainty in locating the virtual screw position. This study shows that this method can be used to find alternative directions for the anchoring elements, which may possess better bone properties. This modification will thus produce an optimized implant design.

  18. Algorithm for planning a double-jaw orthognathic surgery using a computer-aided surgical simulation (CASS) protocol. Part 1: planning sequence.

    Science.gov (United States)

    Xia, J J; Gateno, J; Teichgraeber, J F; Yuan, P; Chen, K-C; Li, J; Zhang, X; Tang, Z; Alfi, D M

    2015-12-01

    The success of craniomaxillofacial (CMF) surgery depends not only on the surgical techniques, but also on an accurate surgical plan. The adoption of computer-aided surgical simulation (CASS) has created a paradigm shift in surgical planning. However, planning an orthognathic operation using CASS differs fundamentally from planning using traditional methods. With this in mind, the Surgical Planning Laboratory of Houston Methodist Research Institute has developed a CASS protocol designed specifically for orthognathic surgery. The purpose of this article is to present an algorithm using virtual tools for planning a double-jaw orthognathic operation. This paper will serve as an operation manual for surgeons wanting to incorporate CASS into their clinical practice.

  19. Implementation of simulation in surgical practice : Minimally invasive surgery has taken the lead: The Dutch experience

    NARCIS (Netherlands)

    Schreuder, Henk W. R.; Oei, Guid; Maas, Mario; Borleffs, Jan C. C.; Schijven, Marlies P.

    2011-01-01

    Minimal invasive techniques are rapidly becoming standard surgical techniques for many surgical procedures. To develop the skills necessary to apply these techniques, box trainers and/or inanimate models may be used, but these trainers lack the possibility of inherent objective classification of res

  20. Implementation of simulation in surgical practice: Minimally invasive surgery has taken the lead: The Dutch experience

    NARCIS (Netherlands)

    H.W.R. Schreuder; G. Oei; M. Maas; J.C.C. Borleffs; M.P. Schijven

    2011-01-01

    Minimal invasive techniques are rapidly becoming standard surgical techniques for many surgical procedures. To develop the skills necessary to apply these techniques, box trainers and/or inanimate models may be used, but these trainers lack the possibility of inherent objective classification of res

  1. Numerical simulation of strain-adaptive bone remodelling in the ankle joint

    Directory of Open Access Journals (Sweden)

    Stukenborg-Colsman Christina

    2011-07-01

    Full Text Available Abstract Background The use of artificial endoprostheses has become a routine procedure for knee and hip joints while ankle arthritis has traditionally been treated by means of arthrodesis. Due to its advantages, the implantation of endoprostheses is constantly increasing. While finite element analyses (FEA of strain-adaptive bone remodelling have been carried out for the hip joint in previous studies, to our knowledge there are no investigations that have considered remodelling processes of the ankle joint. In order to evaluate and optimise new generation implants of the ankle joint, as well as to gain additional knowledge regarding the biomechanics, strain-adaptive bone remodelling has been calculated separately for the tibia and the talus after providing them with an implant. Methods FE models of the bone-implant assembly for both the tibia and the talus have been developed. Bone characteristics such as the density distribution have been applied corresponding to CT scans. A force of 5,200 N, which corresponds to the compression force during normal walking of a person with a weight of 100 kg according to Stauffer et al., has been used in the simulation. The bone adaptation law, previously developed by our research team, has been used for the calculation of the remodelling processes. Results A total bone mass loss of 2% in the tibia and 13% in the talus was calculated. The greater decline of density in the talus is due to its smaller size compared to the relatively large implant dimensions causing remodelling processes in the whole bone tissue. In the tibia, bone remodelling processes are only calculated in areas adjacent to the implant. Thus, a smaller bone mass loss than in the talus can be expected. There is a high agreement between the simulation results in the distal tibia and the literature regarding. Conclusions In this study, strain-adaptive bone remodelling processes are simulated using the FE method. The results contribute to a better

  2. Finite element simulation of cement-bone interface micromechanics: A comparison to experimental results

    NARCIS (Netherlands)

    Janssen, Dennis; Mann, Kenneth A.; Verdonschot, Nico

    2009-01-01

    Recently, experiments were performed to determine the micromechanical behavior of the cement-bone interface under tension-compression loading conditions. These experiments were simulated using finite element analysis (FEA) to test whether the micromechanical response of the interface could be captur

  3. Bone characteristics of 16 wk-old turkeys subjected to different dietary regimens and simulated stress

    Science.gov (United States)

    The effects of a yeast extract (YE) feed supplement and/or vitamin D3 (VD) on the bone properties of 16 wk-old turkeys, transiently subjected to a simulated stress using dexamethasone (Dex), were determined. The turkeys were fed diets with or without YE and/or VD during 6, 11, and 15 wk post hatch, ...

  4. Is suppression of bone formation during simulated weightlessness related to glucocorticoid levels

    Science.gov (United States)

    Morey-Holton, E. R.; Bomalaski, M. D.; Enayati-Gordon, E.; Gonsalves, M. R.; Wronski, T. J.

    1982-01-01

    To investigate the hypothesis that suppression of bone formation in the suspended rat model was the result of increased levels of corticosterone, experiments were performed on young, growing, male rats exposed either to 4 C or suspended for two weeks. Rats suspended on the model system, designed to simulate certain aspects of spaceflight, gained weight at a rate at least equal to control animals but still showed a significant suppression of bone formation within 7 days. Cold-exposed rats gained less weight than their corresponding control group and did not demonstrate any suppression of bone formation. These findings suggest: (1) tail suspension is less stressful than previously used harness systems; (2) suspension in young, rapidly growing rats causes a significant suppression of cortical bone formation; (3) cold exposure does not alter bone formation rate in rats of a similar age and strain to those suspended in this study; and (4) suppression of bone formation provoked by unloading the rear limbs is not due solely to sustained stimulation of the pituitary-adrenal system.

  5. A multiscale modelling of bone ultrastructure elastic proprieties using finite elements simulation and neural network method.

    Science.gov (United States)

    Barkaoui, Abdelwahed; Tlili, Brahim; Vercher-Martínez, Ana; Hambli, Ridha

    2016-10-01

    Bone is a living material with a complex hierarchical structure which entails exceptional mechanical properties, including high fracture toughness, specific stiffness and strength. Bone tissue is essentially composed by two phases distributed in approximately 30-70%: an organic phase (mainly type I collagen and cells) and an inorganic phase (hydroxyapatite-HA-and water). The nanostructure of bone can be represented throughout three scale levels where different repetitive structural units or building blocks are found: at the first level, collagen molecules are arranged in a pentameric structure where mineral crystals grow in specific sites. This primary bone structure constitutes the mineralized collagen microfibril. A structural organization of inter-digitating microfibrils forms the mineralized collagen fibril which represents the second scale level. The third scale level corresponds to the mineralized collagen fibre which is composed by the binding of fibrils. The hierarchical nature of the bone tissue is largely responsible of their significant mechanical properties; consequently, this is a current outstanding research topic. Scarce works in literature correlates the elastic properties in the three scale levels at the bone nanoscale. The main goal of this work is to estimate the elastic properties of the bone tissue in a multiscale approach including a sensitivity analysis of the elastic behaviour at each length scale. This proposal is achieved by means of a novel hybrid multiscale modelling that involves neural network (NN) computations and finite elements method (FEM) analysis. The elastic properties are estimated using a neural network simulation that previously has been trained with the database results of the finite element models. In the results of this work, parametric analysis and averaged elastic constants for each length scale are provided. Likewise, the influence of the elastic constants of the tissue constituents is also depicted. Results highlight

  6. A multiscale modelling of bone ultrastructure elastic proprieties using finite elements simulation and neural network method.

    Science.gov (United States)

    Barkaoui, Abdelwahed; Tlili, Brahim; Vercher-Martínez, Ana; Hambli, Ridha

    2016-10-01

    Bone is a living material with a complex hierarchical structure which entails exceptional mechanical properties, including high fracture toughness, specific stiffness and strength. Bone tissue is essentially composed by two phases distributed in approximately 30-70%: an organic phase (mainly type I collagen and cells) and an inorganic phase (hydroxyapatite-HA-and water). The nanostructure of bone can be represented throughout three scale levels where different repetitive structural units or building blocks are found: at the first level, collagen molecules are arranged in a pentameric structure where mineral crystals grow in specific sites. This primary bone structure constitutes the mineralized collagen microfibril. A structural organization of inter-digitating microfibrils forms the mineralized collagen fibril which represents the second scale level. The third scale level corresponds to the mineralized collagen fibre which is composed by the binding of fibrils. The hierarchical nature of the bone tissue is largely responsible of their significant mechanical properties; consequently, this is a current outstanding research topic. Scarce works in literature correlates the elastic properties in the three scale levels at the bone nanoscale. The main goal of this work is to estimate the elastic properties of the bone tissue in a multiscale approach including a sensitivity analysis of the elastic behaviour at each length scale. This proposal is achieved by means of a novel hybrid multiscale modelling that involves neural network (NN) computations and finite elements method (FEM) analysis. The elastic properties are estimated using a neural network simulation that previously has been trained with the database results of the finite element models. In the results of this work, parametric analysis and averaged elastic constants for each length scale are provided. Likewise, the influence of the elastic constants of the tissue constituents is also depicted. Results highlight

  7. Computer-assisted three-dimensional surgical planing and simulation. 3D soft tissue planning and prediction.

    Science.gov (United States)

    Xia, J; Samman, N; Yeung, R W; Wang, D; Shen, S G; Ip, H H; Tideman, H

    2000-08-01

    The purpose of this paper is to report a new technique for three-dimensional facial soft-tissue-change prediction after simulated orthognathic surgical planning. A scheme for soft tissue deformation, "Computer-assisted three-dimensional virtual reality soft tissue planning and prediction for orthognathic surgery (CASP)", is presented. The surgical planning was based on three-dimensional reconstructed CT visualization. Soft tissue changes were predicted by two newly devised algorithms: Surface Normal-based Model Deformation Algorithm and Ray Projection-based Model Deformation Algorithm. A three-dimensional color facial texture-mapping technique was also used for generating the color photo-realistic facial model. As a final result, a predicted and simulated patient's color facial model can be visualized from arbitrary viewing points.

  8. Aesthetic Surgical Approach for Bone Dehiscence Treatment by Means of Single Implant and Interdental Tissue Regeneration: A Case Report with Five Years of Follow-Up

    Directory of Open Access Journals (Sweden)

    Giorgio Lombardo

    2016-01-01

    Full Text Available The replacement of single anterior teeth by means of endosseous implants implies the achievement of success in restoring both aesthetic and function. However, the presence of wide endoperiodontal lesions can lead to horizontal hard and soft tissues defects after tooth extraction, making it impossible to correctly place an implant in the compromised alveolar socket. Vertical augmentation procedures have been proposed to solve these clinical situations, but the amount of new regenerated bone is still not predictable. Furthermore, bone augmentation can be complicated by the presence of adjacent teeth, especially if they bring with them periodontal defects. Therefore, it is used to restore periodontal health of adjacent teeth before making any augmentation procedures and to wait a certain healing period before placing an implant in vertically augmented sites, otherwise risking to obtain a nonsatisfactory aesthetic result. All of these procedures, however, lead to an expansion of treatment time which should affect patient compliance. For this reason, this case report suggests a surgical technique to perform vertical bone augmentation at a single gap left by a central upper incisor while placing an implant and simultaneously to regenerate the periodontal attachment of an adjacent lateral incisor, without compromising the aesthetic result.

  9. Surgical treatment of giant cell tumors of long bone combined with inserted microwave antennas induced hyperthermia%插入式微波天线阵列诱导高温治疗长骨骨巨细胞瘤

    Institute of Scientific and Technical Information of China (English)

    周勇; 范清宇; 马保安; 张明华; 沈万安

    2003-01-01

    AIM:To evaluate the surgical treatment methods of giant cell tumors (GCT) of long bone in conjunction with inserted microwave antennas induced hyperthermia.METHODS:46 patients, included the surgical procedures,the oncology results,the functions of the limbs and the complications were analyzed.RESULTS:Follow up 3.5 to 9 years (mean 5.5 years).All patients were evaluated according to oncological and orthopaedic criteria.Two tumors were recurred.Orthopaedic function were perfect in 44 patients and were fair in 2.Infection was found in 2 patients.CONCLUSION:The surgical procedure to treat the giant cell tumors of long bone by inserted microwave antennas induced hyperthermia is a definitive surgical method which is safe and confident.

  10. Simulation-based cutaneous surgical-skill training on a chicken-skin bench model in a medical undergraduate program

    Directory of Open Access Journals (Sweden)

    Rafael Denadai

    2013-01-01

    Full Text Available Background: Because of ethical and medico-legal aspects involved in the training of cutaneous surgical skills on living patients, human cadavers and living animals, it is necessary the search for alternative and effective forms of training simulation. Aims: To propose and describe an alternative methodology for teaching and learning the principles of cutaneous surgery in a medical undergraduate program by using a chicken-skin bench model. Materials and Methods: One instructor for every four students, teaching materials on cutaneous surgical skills, chicken trunks, wings, or thighs, a rigid platform support, needled threads, needle holders, surgical blades with scalpel handles, rat-tooth tweezers, scissors, and marking pens were necessary for training simulation. Results: A proposal for simulation-based training on incision, suture, biopsy, and on reconstruction techniques using a chicken-skin bench model distributed in several sessions and with increasing levels of difficultywas structured. Both feedback and objective evaluations always directed to individual students were also outlined. Conclusion: The teaching of a methodology for the principles of cutaneous surgery using a chicken-skin bench model versatile, portable, easy to assemble, and inexpensive is an alternative and complementary option to the armamentarium of methods based on other bench models described.

  11. Evaluation of diabetic foot osteomyelitis using probe to bone test and magnetic resonance imaging and their impact on surgical intervention

    Directory of Open Access Journals (Sweden)

    Fatma Zaiton

    2014-09-01

    Conclusion: PTB test is a simple, minimally invasive, low cost test and can be done at outpatient clinic. Its sensitivity and specificity are good when compared to those of MRI, but when we need to diagnose associated soft tissue infection and planning the surgical management MRI was the image of choice.

  12. Simulated surgical workshops enhance medical school students’ preparation for clinical rotation

    Directory of Open Access Journals (Sweden)

    Patricia Johnson

    2013-02-01

    Full Text Available BackgroundA major focus of the medical school curriculum is to ensure medical students are well prepared prior to entering clinical rotations, which includes the compulsory surgical rotation.AimsThe objective of this research was to design and formally evaluate a set of real-life surgical workshops aimed at better preparing medical students for their clinical rotation in surgery. These workshops would be incorporated into the pre-clinical medical school curriculum.MethodDedicated surgical workshops were introduced into the preclinical component of the Bachelor of Medicine/Bachelor of Surgery (MBBS program at our University in 2009. These workshops encompassed training in the clinical skills needed in the perioperative and wider hospital setting. A survey comprising of eight to nine ranked questions (utilising a five-point Likert Scale as well as three short answer questions was administered to the medical students after they completed their compulsory surgical clinical rotation.ResultsThe overall response rate to the survey evaluating the surgical workshops was 79% (123/155. The mean of the ranked questions ranged from 4.05 to 4.89 which indicated that the students found the workshops useful. When evaluating the short answer questions (via topic coding, additional information was provided that supported and explained the survey findings and also included suggestions for improvements.ConclusionThe findings of the medical student survey demonstrated the value of incorporating dedicated preparatory surgical workshops in the medical school pre-clinical curriculum. However, further research is warranted to determine if this inclusion translated into improved student performance during the clinical surgical rotation.

  13. FEM analysis of drills used in bone surgery

    OpenAIRE

    M. Basiaga; Z. Paszenda

    2009-01-01

    Purpose: The aim of the work was determination of biomechanical analysis of a surgical drill – bone system in simulated conditions of drilling in a bone.Design/methodology/approach: Geometrical model of the selected surgical drill and simulated femur (cortical bone) was worked out in the Inventor Professional 2008. The value geometry of the edge was point angle (2κ1 = 90o and 2κ2 = 120o). Numerical model was prepared in ANSYS Workbench v. 11. Meshing was realized with the use of SOLID 187 ele...

  14. The MAVID heart holder: a demonstration device to anchor cadaver hearts for surgical simulation and practical education.

    Science.gov (United States)

    Mavroudis, Constantine; Idriss, Rachid; Klaus, Kristen E

    2015-12-01

    Performing open heart surgery involves learning challenging techniques and a need for realistic training models to achieve and maintain a high level of surgical skills. The MAVID heart holder is an organ holder primarily designed to hold the heart in its anatomic position for the purpose of surgical simulation and education, thereby closing the gap between surgical performance in the laboratory and in the operating room. The device is simple to use, can be adjusted to organ size, and has the necessary instrumentation to be used with any solid organ. The MAVID heart holder also provides a platform for presentation and assists in advancing the research sphere. The advantage over other existing models is that the MAVID heart holder uses real tissue and does not distort the organ at the attachment sites. Further, it offers superior stability as well as the ability to manipulate the organ during presentation and dissection. Training with the MAVID heart holder has the potential to shorten training time to acquire surgical skills and proficiency before performing these techniques in the operating room and in so doing enhance patient safety.

  15. The MAVID heart holder: a demonstration device to anchor cadaver hearts for surgical simulation and practical education.

    Science.gov (United States)

    Mavroudis, Constantine; Idriss, Rachid; Klaus, Kristen E

    2015-12-01

    Performing open heart surgery involves learning challenging techniques and a need for realistic training models to achieve and maintain a high level of surgical skills. The MAVID heart holder is an organ holder primarily designed to hold the heart in its anatomic position for the purpose of surgical simulation and education, thereby closing the gap between surgical performance in the laboratory and in the operating room. The device is simple to use, can be adjusted to organ size, and has the necessary instrumentation to be used with any solid organ. The MAVID heart holder also provides a platform for presentation and assists in advancing the research sphere. The advantage over other existing models is that the MAVID heart holder uses real tissue and does not distort the organ at the attachment sites. Further, it offers superior stability as well as the ability to manipulate the organ during presentation and dissection. Training with the MAVID heart holder has the potential to shorten training time to acquire surgical skills and proficiency before performing these techniques in the operating room and in so doing enhance patient safety. PMID:26675615

  16. Monte Carlo simulation methods of determining red bone marrow dose from external radiation

    International Nuclear Information System (INIS)

    Objective: To provide evidence for a more reasonable method of determining red bone marrow dose by analyzing and comparing existing simulation methods. Methods: By utilizing Monte Carlo simulation software MCNPX, the absorbed doses of red hone marrow of Rensselaer Polytechnic Institute (RPI) adult female voxel phantom were calculated through 4 different methods: direct energy deposition.dose response function (DRF), King-Spiers factor method and mass-energy absorption coefficient (MEAC). The radiation sources were defined as infinite plate.sources with the energy ranging from 20 keV to 10 MeV, and 23 sources with different energies were simulated in total. The source was placed right next to the front of the RPI model to achieve a homogeneous anteroposterior radiation scenario. The results of different simulated photon energy sources through different methods were compared. Results: When the photon energy was lower than 100 key, the direct energy deposition method gave the highest result while the MEAC and King-Spiers factor methods showed more reasonable results. When the photon energy was higher than 150 keV taking into account of the higher absorption ability of red bone marrow at higher photon energy, the result of the King-Spiers factor method was larger than those of other methods. Conclusions: The King-Spiers factor method might be the most reasonable method to estimate the red bone marrow dose from external radiation. (authors)

  17. Radioactive bone cement for the treatment of spinal metastases: a dosimetric analysis of simulated clinical scenarios

    Science.gov (United States)

    Kaneko, T. S.; Sehgal, V.; Skinner, H. B.; Al-Ghazi, M. S. A. L.; Ramsinghani, N. S.; Marquez Miranda, M.; Keyak, J. H.

    2012-07-01

    Vertebral metastases are a common manifestation of many cancers, potentially leading to vertebral collapse and neurological complications. Conventional treatment often involves percutaneous vertebroplasty/kyphoplasty followed by external beam radiation therapy. As a more convenient alternative, we have introduced radioactive bone cement, i.e. bone cement incorporating a radionuclide. In this study, we used a previously developed Monte Carlo radiation transport modeling method to evaluate dose distributions from phosphorus-32 radioactive cement in simulated clinical scenarios. Isodose curves were generally concentric about the surface of bone cement injected into cadaveric vertebrae, indicating that dose distributions are relatively predictable, thus facilitating treatment planning (cement formulation and dosimetry method are patent pending). Model results indicated that a therapeutic dose could be delivered to tumor/bone within ∼4 mm of the cement surface while maintaining a safe dose to radiosensitive tissue beyond this distance. This therapeutic range should be sufficient to treat target volumes within the vertebral body when tumor ablation or other techniques are used to create a cavity into which the radioactive cement can be injected. With further development, treating spinal metastases with radioactive bone cement may become a clinically useful and convenient alternative to the conventional two-step approach of percutaneous strength restoration followed by radiotherapy.

  18. Computer assisted preoperative planning of bone fracture reduction: Simulation techniques and new trends.

    Science.gov (United States)

    Jiménez-Delgado, Juan J; Paulano-Godino, Félix; PulidoRam-Ramírez, Rubén; Jiménez-Pérez, J Roberto

    2016-05-01

    The development of support systems for surgery significantly increases the likelihood of obtaining satisfactory results. In the case of fracture reduction interventions these systems enable surgery planning, training, monitoring and assessment. They allow improvement of fracture stabilization, a minimizing of health risks and a reduction of surgery time. Planning a bone fracture reduction by means of a computer assisted simulation involves several semiautomatic or automatic steps. The simulation deals with the correct position of osseous fragments and fixation devices for a fracture reduction. Currently, to the best of our knowledge there is no computer assisted methods to plan an entire fracture reduction process. This paper presents an overall scheme of the computer based process for planning a bone fracture reduction, as described above, and details its main steps, the most common proposed techniques and their main shortcomings. In addition, challenges and new trends of this research field are depicted and analyzed.

  19. Planning the Surgical Correction of Spinal Deformities: Toward the Identification of the Biomechanical Principles by Means of Numerical Simulation

    Science.gov (United States)

    Galbusera, Fabio; Bassani, Tito; La Barbera, Luigi; Ottardi, Claudia; Schlager, Benedikt; Brayda-Bruno, Marco; Villa, Tomaso; Wilke, Hans-Joachim

    2015-01-01

    In decades of technical developments after the first surgical corrections of spinal deformities, the set of devices, techniques, and tools available to the surgeons has widened dramatically. Nevertheless, the rate of complications due to mechanical failure of the fixation or the instrumentation remains rather high. Indeed, basic and clinical research about the principles of deformity correction and the optimal surgical strategies (i.e., the choice of the fusion length, the most appropriate instrumentation, and the degree of tolerable correction) did not progress as much as the implantable devices and the surgical techniques. In this work, a software approach for the biomechanical simulation of the correction of patient-specific spinal deformities aimed to the identification of its biomechanical principles is presented. The method is based on three-dimensional reconstructions of the spinal anatomy obtained from biplanar radiographic images. A user-friendly graphical user interface allows for the planning of the desired deformity correction and to simulate the implantation of pedicle screws. Robust meshing of the instrumented spine is provided by using consolidated computational geometry and meshing libraries. Based on a finite element simulation, the program is able to predict the loads and stresses acting in the instrumentation as well as those in the biological tissues. A simple test case (reduction of a low-grade spondylolisthesis at L3–L4) was simulated as a proof of concept, and showed plausible results. Despite the numerous limitations of this approach which will be addressed in future implementations, the preliminary outcome is promising and encourages a wide effort toward its refinement. PMID:26579518

  20. An Evaluation of the Diagnostic Accuracy of the Grade of Preoperative Biopsy Compared to Surgical Excision in Chondrosarcoma of the Long Bones

    Directory of Open Access Journals (Sweden)

    Robert Jennings

    2010-01-01

    Full Text Available Chondrosarcoma is the second most common primary malignant bone tumour. Distinguishing between grades is not necessarily straightforward and may alter the disease management. We evaluated the correlation between histological grading of the preoperative image-guided needle biopsy and the resection specimen of 78 consecutive cases of chondrosarcoma of the femur, humerus, and tibia. In 11 instances, there was a discrepancy in histological grade between the biopsy and surgical specimen. Therefore, there was an 85.9% (67/78 accuracy rate for pre-operative histological grading of chondrosarcoma, based on needle biopsy. However, the accuracy of the diagnostic biopsy to distinguish low-grade from high-grade chondrosarcoma was 93.6% (73/78. We conclude that accurate image-guided biopsy is a very useful adjunct in determining histological grade of chondrosarcoma and the subsequent treatment plan. At present, a multidisciplinary approach, comprising experienced orthopaedic surgeons, radiologists, and pathologists, offers the most reliable means of accurately diagnosing and grading of chondrosarcoma of long bones.

  1. Stereolithography in oral implantology: a comparison of surgical guides.

    Science.gov (United States)

    Sammartino, Gilberto; Della Valle, Antonio; Marenzi, Gaetano; Gerbino, Salvatore; Martorelli, Massimo; di Lauro, Alessandro Espedito; di Lauro, Francesco

    2004-06-01

    This article presents the use of stereolithography in oral implantology. Stereolithography is a new technology that can produce physical models by selectively solidifying an ultraviolet-sensitive liquid resin using a laser beam, reproducing the true maxillary and mandibular anatomic dimensions. With these models, it is possible to fabricate surgical guides that can place the implants in vivo in the same places and same directions as those in the planned computer simulation. A 70-year-old woman, in good health, with severe mandibular bone atrophy was rehabilitated with an over-denture supported by 2 Branemark implants. Two different surgical planning methods were considered: 1) the construction of a surgical guide evaluating clinical aspects, and 2) the surgical guide produced by stereolithographic study. The accuracy of surgical planning can reduce the problems related to bone density and dimensions. Furthermore, the stereolithographic study assured the clinicians of a superior location of fixtures in bone. Surgical planning based on stereolithographic technique is a safe procedure and has many advantages. This technologic advance has biologic and therapeutic benefits because it simplifies anatomic surgical management for improved implant placement.

  2. Effectiveness, usability, and acceptability of haptic-enabled virtual reality and mannequin modality simulators for surgical cricothyroidotomy.

    Science.gov (United States)

    Proctor, Michael D; Campbell-Wynn, Lillian

    2014-03-01

    This research assesses the effectiveness, usability, and acceptability of mannequin and haptic-enabled virtual reality (VR) modality simulators by Army medics in a surgical cricothyroidotomy procedure. Research methods investigate through experimentation surgical task performance, technology acceptance, user recommendation, comparative analysis, and select cognitive task load results. Results indicate that the HapMed mannequin and CricSim VR simulators proved effective by meeting training task performance evaluation requirements. Both systems meet 95% user technology acceptance and 85% user recommendation levels. In conclusion, at those levels, either system may complement, reduce, or replace the use of some alternative training methods such as animals or cadavers. To raise recommendation rates, future research needs to reduce barriers to blending visualization with mannequin modalities and make further refinements within the modalities. One research pathway identified blends a mannequin with stereoscopic visualization and motion parallax, providing correlated, partially transparent visual layers of anatomy and of various medical procedures in virtual overlay with the mannequin. Future research also needs to clarify acceptable degrees of freedom levels by task for haptics VR in light of real-world degrees of freedom requirements. Finally, artificial skin may need research to achieve better replication of human skin on mannequins.

  3. Effects of Zoledronate and Mechanical Loading during Simulated Weightlessness on Bone Structure and Mechanical Properties

    Science.gov (United States)

    Scott, R. T.; Nalavadi, M. O.; Shirazi-Fard, Y.; Castillo, A. B.; Alwood, J. S.

    2016-01-01

    Space flight modulates bone remodeling to favor bone resorption. Current countermeasures include an anti-resorptive drug class, bisphosphonates (BP), and high-force loading regimens. Does the combination of anti-resorptives and high-force exercise during weightlessness have negative effects on the mechanical and structural properties of bone? In this study, we implemented an integrated model to mimic mechanical strain of exercise via cyclical loading (CL) in mice treated with the BP Zoledronate (ZOL) combined with hindlimb unloading (HU). Our working hypothesis is that CL combined with ZOL in the HU model induces additive structural and mechanical changes. Thirty-two C57BL6 mice (male,16 weeks old, n8group) were exposed to 3 weeks of either HU or normal ambulation (NA). Cohorts of mice received one subcutaneous injection of ZOL (45gkg), or saline vehicle, prior to experiment. The right tibia was axially loaded in vivo, 60xday to 9N in compression, repeated 3xweek during HU. During the application of compression, secant stiffness (SEC), a linear estimate of slope of the force displacement curve from rest (0.5N) to max load (9.0N), was calculated for each cycle once per week. Ex vivo CT was conducted on all subjects. For ex vivo mechanical properties, non-CL left femurs underwent 3-point bending. In the proximal tibial metaphysis, HU decreased, CL increased, and ZOL increased the cancellous bone volume to total volume ratio by -26, +21, and +33, respectively. Similar trends held for trabecular thickness and number. Ex vivo left femur mechanical properties revealed HU decreased stiffness (-37),and ZOL mitigated the HU stiffness losses (+78). Data on the ex vivo Ultimate Force followed similar trends. After 3 weeks, HU decreased in vivo SEC (-16). The combination of CL+HU appeared additive in bone structure and mechanical properties. However, when HU + CL + ZOL were combined, ZOL had no additional effect (p0.05) on in vivo SEC. Structural data followed this trend with

  4. The Relationship of Endoscopic Proficiency to Educational Expense for Virtual Reality Simulator Training Amongst Surgical Trainees.

    Science.gov (United States)

    Raque, Jessica; Goble, Adam; Jones, Veronica M; Waldman, Lindsey E; Sutton, Erica

    2015-07-01

    With the introduction of Fundamentals of Endoscopic Surgery, training methods in flexible endoscopy are being augmented with simulation-based curricula. The investment for virtual reality simulators warrants further research into its training advantage. Trainees were randomized into bedside or simulator training groups (BED vs SIM). SIM participated in a proficiency-based virtual reality curriculum. Trainees' endoscopic skills were rated using the Global Assessment of Gastrointestinal Endoscopic Skills (GAGES) in the patient care setting. The number of cases to reach 90 per cent of the maximum GAGES score and calculated costs of training were compared. Nineteen residents participated in the study. There was no difference in the average number of cases required to achieve 90 per cent of the maximum GAGES score for esophagogastroduodenoscopy, 13 (SIM) versus11 (BED) (P = 0.63), or colonoscopy 21 (SIM) versus 4 (BED) (P = 0.34). The average per case cost of training for esophagogastroduodenoscopy was $35.98 (SIM) versus $39.71 (BED) (P = 0.50), not including the depreciation costs associated with the simulator ($715.00 per resident over six years). Use of a simulator appeared to increase the cost of training without accelerating the learning curve or decreasing faculty time spent in instruction. The importance of simulation in endoscopy training will be predicated on more cost-effective simulators.

  5. Three-dimensional computer-assisted surgical simulation and intraoperative navigation in orthognathic surgery: a literature review.

    Science.gov (United States)

    Lin, Hsiu-Hsia; Lo, Lun-Jou

    2015-04-01

    By incorporating three-dimensional (3D) imaging and computer-aided design and manufacturing techniques, 3D computer-assisted technology has been applied widely to provide accurate guidance for assessment and treatment planning in clinical practice. This technology has recently been used in orthognathic surgery to improve surgical planning and outcome. The modality will gradually become popular. This study reviewed the literature concerning the use of computer-assisted techniques in orthognathic surgery including surgical planning, simulation, intraoperative translation of the virtual surgery, and postoperative evaluation. A Medline, PubMed, ProQuest, and ScienceDirect search was performed to find relevant articles with regard to 3D computer-assisted orthognathic surgery in the past 10 years. A total of 460 articles were revealed, out of which 174 were publications addressed the topic of this study. The purpose of this article is to present an overview of the state-of-art methods for 3D computer-assisted technology in orthognathic surgery. From the review we can conclude that the use of computer-assisted technique in orthognathic surgery provides the benefit of optimal functional and aesthetic results, patient satisfaction, precise translation of the treatment plan, and facilitating intraoperative manipulation.

  6. Abortion - surgical

    Science.gov (United States)

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  7. Usefulness of three-dimensional MR images of brain tumors for surgical simulation

    International Nuclear Information System (INIS)

    The purpose of this study was to determine the usefulness of three-dimensional (3D) MR imaging of brain tumors for surgical planning. Sixty-nine patients with various tumors of the brain were included in the present study. Using a volume-rendering (VR) method on an independent workstation, 3D-MR images were obtained with the fast-spoiled gradient recalled acquisition in the steady state (SPGR) sequence after Gd-DTPA administration. VR images could show an exact relationship between the surface of the brain and major vessels. However, in patients with deeply located tumors, VR images did not necessarily provide sufficient information as to the relationship between the tumor and vessels. In combination with a surface-rendering method, 3D-MR imaging could demonstrate the exact relationships among the tumors, major vessels, and surface of the brain. In tumors without contrast enhancement, this method was able to show 3D images of tumors with surrounding structures. For neurosurgeons, 3D-MR images were useful for understanding the surface anatomy and surrounding structures of the tumors prior to surgery. These images were also helpful in explaining the condition of the disease to patients and their families. (author)

  8. Simulation of Surgical Cutting in Deformable Bodies using a Game Engine

    DEFF Research Database (Denmark)

    Jørgensen, Martin Kibsgaard; Kronborg Thomsen, Kasper; Kraus, Martin

    2014-01-01

    . This paper presents a feasibility study for implementing academic methods in a low-cost game engine. Expanding on previous work, a lowcost surgery simulator is implemented to adress these issues. We focus on the implementation of cutting in deformable objects in a game engine. The deformable objects...

  9. Contemporary virtual reality laparoscopy simulators: quicksand or solid grounds for assessing surgical trainees?

    NARCIS (Netherlands)

    A.S. Thijssen; M.P. Schijven

    2010-01-01

    BACKGROUND: A demand for safe, efficient laparoscopic training tools has prompted the introduction of virtual reality (VR) laparoscopic simulators, which might be used for performance assessment. The purpose of this review is to determine the value of VR metrics in laparoscopic skills assessment. DA

  10. High-Speed Burring with and without the Use of Surgical Adjuvants in the Intralesional Management of Giant Cell Tumor of Bone: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Algawahmed, H; Turcotte, Robert; Farrokhyar, F; Ghert, M

    2010-01-01

    Local control rates for Giant Cell Tumor of Bone (GCT) have been reported in a large number of retrospective series. However, there remains a lack of consensus with respect to the need for a surgical adjuvant when intralesional curettage is performed. We have systematically reviewed the literature and identified six studies in which two groups from the same patient cohort were treated with intralesional curettage and high-speed burring with or without a chemical or thermal adjuvant. Studies were evaluated for quality and pooled data was analyzed using the fixed effects model. Data from 387 patients did not indicate improved local control with the use of surgical adjuvants. Given the available data, we conclude that surgical adjuvants are not required when meticulous tumor removal is performed.

  11. High-Speed Burring with and without the Use of Surgical Adjuvants in the Intralesional Management of Giant Cell Tumor of Bone: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    H. Algawahmed

    2010-01-01

    Full Text Available Local control rates for Giant Cell Tumor of Bone (GCT have been reported in a large number of retrospective series. However, there remains a lack of consensus with respect to the need for a surgical adjuvant when intralesional curettage is performed. We have systematically reviewed the literature and identified six studies in which two groups from the same patient cohort were treated with intralesional curettage and high-speed burring with or without a chemical or thermal adjuvant. Studies were evaluated for quality and pooled data was analyzed using the fixed effects model. Data from 387 patients did not indicate improved local control with the use of surgical adjuvants. Given the available data, we conclude that surgical adjuvants are not required when meticulous tumor removal is performed.

  12. Bone graft revascularization strategies

    NARCIS (Netherlands)

    W.F. Willems

    2014-01-01

    Reconstruction of avascular necrotic bone by pedicled bone grafting is a well-known treatment with little basic research supporting its application. A new canine model was used to simulate carpal bone avascular necrosis. Pedicled bone grafting proved to increase bone remodeling and bone blood flow,

  13. WIse-2005: Combined Aerobic and Resistive Exercise May Help Mitigate Bone Loss During 60-D Simulated Microgravity in Women

    Science.gov (United States)

    Smith, Scott M.; Zwart, S. R.; Heer, M. A.; Lee, S. M. C.; Macias, B. R.; Schneider, S. M.; Trappe, S. M.; Hargens, A. R.

    2006-01-01

    Exercise can attenuate bone loss associated with disuse during bed rest (BR), an analog of space flight. Previous studies have examined the efficacy of aerobic or resistive exercise countermeasures, but not in combination. We sought to determine the effect of a combined resistive and aerobic exercise regimen on bone metabolism during BR. After a 20-d ambulatory adaptation to confinement and diet, 16 women participated in a 60-d head-down-tilt BR. Control subjects (CN, n=8) performed no countermeasures. Exercise subjects, (EX, n=8) participated in exercise alternating daily between supine treadmill exercise within lower body negative pressure and resistive fly-wheel exercise (6-d wk(sup -1)). In the last week of BR, bone resorption was greater (p less than 79 plus or minus 44%, mean plus or minus SD) and EX groups (64 50%). N-telopeptide also increased (CN: 51 plus or minus 34%; EX: 43 plus or minus 56%). However, bone-specific alkaline phosphatase, a bone formation marker, tended to be higher in EX (26 plus or minus 18%) than in CN (8 plus or minus 33%) groups. The combination of resistive and aerobic exercise does not prevent bone resorption, but may promote formation, potentially mitigating the net bone loss associated with simulated microgravity. This study was supported by CNES, CSA, ESA, NASA, and NASA grant NNJ04HF71G to ARH. MEDES (French Institute for Space Medicine and Physiology) organized the study.

  14. Development of a Detailed Volumetric Finite Element Model of the Spine to Simulate Surgical Correction of Spinal Deformities

    Directory of Open Access Journals (Sweden)

    Mark Driscoll

    2013-01-01

    Full Text Available A large spectrum of medical devices exists; it aims to correct deformities associated with spinal disorders. The development of a detailed volumetric finite element model of the osteoligamentous spine would serve as a valuable tool to assess, compare, and optimize spinal devices. Thus the purpose of the study was to develop and initiate validation of a detailed osteoligamentous finite element model of the spine with simulated correction from spinal instrumentation. A finite element of the spine from T1 to L5 was developed using properties and geometry from the published literature and patient data. Spinal instrumentation, consisting of segmental translation of a scoliotic spine, was emulated. Postoperative patient and relevant published data of intervertebral disc stress, screw/vertebra pullout forces, and spinal profiles was used to evaluate the models validity. Intervertebral disc and vertebral reaction stresses respected published in vivo, ex vivo, and in silico values. Screw/vertebra reaction forces agreed with accepted pullout threshold values. Cobb angle measurements of spinal deformity following simulated surgical instrumentation corroborated with patient data. This computational biomechanical analysis validated a detailed volumetric spine model. Future studies seek to exploit the model to explore the performance of corrective spinal devices.

  15. The role of simulation in the development of endovascular surgical skills.

    Science.gov (United States)

    Nesbitt, Craig Iain; Birdi, Nikhil; Mafeld, Sebastian; Stansby, Gerrard

    2016-02-01

    Endovascular trainees in the National Health Service still largely rely on the apprentice-apprenticeship model from the late 19th century. As the scope for endovascular therapy increases, due to the rapid innovation, evolution and refinement of technology, so too do patients' therapeutic options. This climate has also opened the door for more novel training adjuncts, to address the gaps that exist in our current endovascular training curriculum. The aim of this paper is to present a succinct overview of endovascular simulation, synthesizing the trials and research behind this rapidly evolving training as well as highlighting areas where further research is required. The authors searched MEDLINE and EMBASE for relevant manuscripts on all aspects of endovascular simulation training. A comprehensive Google search was also undertaken to look for any relevant information on endovascular training courses available and any unpublished work that had been presented at relevant scientific meetings. Papers were categorized into the four models: synthetic, animal, virtual reality and human cadaver, and separate searches for evidence of skill transfer were also undertaken. Authors of novel research projects were contacted for further details of unpublished work and permission granted to report such findings in this manuscript.

  16. Fixation strength analysis of cup to bone material using finite element simulation

    Science.gov (United States)

    Anwar, Iwan Budiwan; Saputra, Eko; Ismail, Rifky; Jamari, J.; van der Heide, Emile

    2016-04-01

    Fixation of acetabular cup to bone material is an important initial stability for artificial hip joint. In general, the fixation in cement less-type acetabular cup uses press-fit and screw methods. These methods can be applied alone or together. Based on literature survey, the additional screw inside of cup is effective; however, it has little effect in whole fixation. Therefore, an acetabular cup with good fixation, easy manufacture and easy installation is required. This paper is aiming at evaluating and proposing a new cup fixation design. To prove the strength of the present cup fixation design, the finite element simulation of three dimensional cup with new fixation design was performed. The present cup design was examined with twist axial and radial rotation. Results showed that the proposed cup design was better than the general version.

  17. Electrical Bioimpedance-Controlled Surgical Instrumentation.

    Science.gov (United States)

    Brendle, Christian; Rein, Benjamin; Niesche, Annegret; Korff, Alexander; Radermacher, Klaus; Misgeld, Berno; Leonhardt, Steffen

    2015-10-01

    A bioimpedance-controlled concept for bone cement milling during revision total hip replacement is presented. Normally, the surgeon manually removes bone cement using a hammer and chisel. However, this procedure is relatively rough and unintended harm may occur to tissue at any time. The proposed bioimpedance-controlled surgical instrumentation improves this process because, for example, most risks associated with bone cement removal are avoided. The electrical bioimpedance measurements enable online process-control by using the milling head as both a cutting tool and measurement electrode at the same time. Furthermore, a novel integrated surgical milling tool is introduced, which allows acquisition of electrical bioimpedance data for online control; these data are used as a process variable. Process identification is based on finite element method simulation and on experimental studies with a rapid control prototyping system. The control loop design includes the identified process model, the characterization of noise as being normally distributed and the filtering, which is necessary for sufficient accuracy ( ±0.5 mm). Also, in a comparative study, noise suppression is investigated in silico with a moving average filter and a Kalman filter. Finally, performance analysis shows that the bioimpedance-controlled surgical instrumentation may also performs effectively at a higher feed rate (e.g., 5 mm/s). PMID:25423656

  18. Mastoidectomy performance assessment of virtual simulation training using final-product analysis

    DEFF Research Database (Denmark)

    Andersen, Steven A W; Cayé-Thomasen, Per; Sørensen, Mads S

    2015-01-01

    OBJECTIVES/HYPOTHESIS: The future development of integrated automatic assessment in temporal bone virtual surgical simulators calls for validation against currently established assessment tools. This study aimed to explore the relationship between mastoidectomy final-product performance assessmen...

  19. See me, touch me, heal me : the role of visuo-spatial ability in virtual anatomical learning and surgical simulator training

    NARCIS (Netherlands)

    Luursema, Jan-Maarten

    2010-01-01

    Medical learning and training are fields in transition. Catalyst in this change is the introduction of digital technology, for example in the form of simulator technology in surgical training, and virtual learning environments in anatomical learning. The primary aim of this thesis is to help underst

  20. Combining Latin Hypercube Designs and Discrete Event Simulation in a Study of a Surgical Unit

    DEFF Research Database (Denmark)

    Dehlendorff, Christian; Andersen, Klaus Kaae; Kulahci, Murat

    Summary form given only:In this article experiments on a discrete event simulation model for an orthopedic surgery are considered. The model is developed as part of a larger project in co-operation with Copenhagen University Hospital in Gentofte. Experiments on the model are performed by using...... and optimization combined with meta-modeling are employed in search for optimal setups. The primary objective in this article is to minimize time spent by the patients in the system. The overall long-term objective for the orthopedic surgery unit is to minimize time lost during the pre- and post operation...... activities for acute and elective surgery as well as dedicated elective surgery....

  1. Evaluation of Veterinary Student Surgical Skills Preparation for Ovariohysterectomy Using Simulators: A Pilot Study.

    Science.gov (United States)

    Read, Emma K; Vallevand, Andrea; Farrell, Robin M

    2016-01-01

    This paper describes the development and evaluation of training intended to enhance students' performance on their first live-animal ovariohysterectomy (OVH). Cognitive task analysis informed a seven-page lab manual, 30-minute video, and 46-item OVH checklist (categorized into nine surgery components and three phases of surgery). We compared two spay simulator models (higher-fidelity silicone versus lower-fidelity cloth and foam). Third-year veterinary students were randomly assigned to a training intervention: lab manual and video only; lab manual, video, and $675 silicone-based model; lab manual, video, and $64 cloth and foam model. We then assessed transfer of training to a live-animal OVH. Chi-square analyses determined statistically significant differences between the interventions on four of nine surgery components, all three phases of surgery, and overall score. Odds ratio analyses indicated that training with a spay model improved the odds of attaining an excellent or good rating on 25 of 46 checklist items, six of nine surgery components, all three phases of surgery, and the overall score. Odds ratio analyses comparing the spay models indicated an advantage for the $675 silicon-based model on only 6 of 46 checklist items, three of nine surgery components, and one phase of surgery. Training with a spay model improved performance when compared to training with a manual and video only. Results suggested that training with a lower-fidelity/cost model might be as effective when compared to a higher-fidelity/cost model. Further research is required to investigate simulator fidelity and costs on transfer of training to the operational environment. PMID:27111005

  2. Numerical simulation on the adaptation of forms in trabecular bone to mechanical disuse and basic multi-cellular unit activation threshold at menopause

    Institute of Scientific and Technical Information of China (English)

    He Gong; Yubo Fan; Ming Zhang

    2008-01-01

    The objective of this paper is to identify the effects of mechanical disuse and basic multi-cellular unit (BMU) activation threshold on the form of trabecular bone during menopause. A bone adaptation model with mechanical-biological factors at BMU level was integrated with finite element analysis to simulate the changes of trabecular bone structure during menopause. Mechanical disuse and changes in the BMU activation threshold were applied to the model for the period from 4 years before to 4 years after menopause.The changes in bone volume fraction, trabecular thickness and fractal dimension of the trabecular structures were used to quantify the changes of trabecular bone in three different cases associated with mechanical disuse and BMU activation threshold. It was found that the changes in the simulated bone volume fraction were highly correlated and consistent with clinical data, and that the trabecular thickness reduced signi-ficantly during menopause and was highly linearly correlated with the bone volume fraction, and that the change trend of fractal dimension of the simulated trabecular structure was in correspondence with clinical observations. The numerical simulation in this paper may help to better understand the relationship between the bone morphology and the mecha- nical, as well as biological environment; and can provide a quantitative computational model and methodology for the numerical simulation of the bone structural morphological changes caused by the mechanical environment, and/or the biological environment.

  3. Influences of traditional Chinese medicine intervention on the bone growth and metabolism of rats with simulated weightlessness

    Institute of Scientific and Technical Information of China (English)

    Jun Zhu

    2013-01-01

    Objective:To probe into the influences ofChinese herbal compound on the growth and metabolism of weight-bearing bones of tail-suspended rats.Methods:Twenty-four maleSD rats were randomly divided into blank control group(eight), tail-suspended control group(eight) and Chinese medicine treatment group(eight) according to their weights.No treatment was done for the blank control group.Double distilled water lavage was performed daily for the tail-suspended control group.On the basis of the tail-suspended rat model, the rats were givenChinese herbal compound lavage every day inChinese medicine treatment group.This compound includes mulberry,Poria cocos and barbary wolfberry,etc.The test cycle was four weeks.The rats were killed after the experiment.The right femoral bone was taken out for the physical measurements, and the left femoral bone was for the three-point bending test.The influences ofChinese herbal compound on femoral bone growth and biomechanical properties of simulated weightlessness rats were observed.Results:(1)After simulated weightlessness(tail-suspension), compared with the blank control group, all the physiological indexes of rat femoral bone decreased in tail-suspended group andChinese medicine treatment group(P<0.05).The strength and rigidity of rat femoral bone decreased in tail-suspended group(P<0.01).The maximum load and rigidity coefficient also decreased with the increasing toughness coefficient in the control group(P<0.01). (2)After the countermeasure ofChinese herbal compound, each biomechanical indexes showed the tendency of increasing inChinese medicine treatment group, and theses indexes were close to those of the blank control group(P<0.05), which indicated that the bone loss caused by simulated weightlessness was improved.Conclusions:Chinese herbal compound for tonifying kidney could effectively prevent the bone loss and have some enhancements on the bone biomechanical properties.

  4. Osteoblastomatosis of bone. A benign, multifocal osteoblastic lesion, distinct from osteoid osteoma and osteoblastoma, radiologically simulating a vascular tumor

    Energy Technology Data Exchange (ETDEWEB)

    Kyriakos, Michael [Washington University School of Medicine, Division of Surgical Pathology, Campus Box 8118, St. Louis, MO (United States); El-Khoury, Georges Y. [University of Iowa, Department of Radiology, Roy J. and Lucille A. Carver School of Medicine, Iowa City, IA (United States); McDonald, Douglas J. [Washington University School of Medicine, Department of Orthopaedic Surgery, St. Louis, MO (United States); Buckwalter, Joseph A. [University of Iowa, Department of Orthopaedics, Roy J. and Lucille A. Carver School of Medicine, Iowa City, IA (United States); Sundaram, Murali [Cleveland Clinic Foundation, Department of Radiology, Cleveland, OH (United States); DeYoung, Barry [University of Iowa, Department of Pathology, School of Medicine, Iowa City, IA (United States); O' Brien, Michael P. [University of Wisconsin Hospital, Department of Radiology, Madison, WI (United States)

    2007-03-15

    Two adult patients are described with multifocal osteolytic lesions radiologically simulating a vascular tumor. One patient had multiple bones involved. Histologically, the individual lesions had the features of the nidus of osteoid osteoma/osteoblastoma. A review of the English language medical literature yielded only one other reported case with similar features. The process is designated as osteoblastomatosis to indicate its bone-forming character, prominent osteoblast proliferation, and multiplicity. The cases are distinguished from multifocal/multicentric osteoid osteoma and osteoblastoma, and from benign and malignant vascular tumors. (orig.)

  5. Bone-like apatite formation on HA/316L stainless steel composite surface in simulated body fluid

    Institute of Scientific and Technical Information of China (English)

    FAN Xin; CHEN Jian; ZOU Jian-peng; WAN Qian; ZHOU Zhong-cheng; RUAN Jian-ming

    2009-01-01

    HA/316L stainless steel(316L SS) biocomposites were prepared by hot-pressing technique. The formation of bone-like apatite on the biocomposite surfaces in simulated body fluid(SBF) was analyzed by digital pH meter, plasma emission spectrometer, scanning electron microscope(SEM) and energy dispersive X-ray energy spectrometer(EDX). The results indicate that the pH value in SBF varies slightly during the immersion. It is a dynamic process of dissolution-precipitation for the formation of apatite on the surface. With prolonging immersion time, Ca and P ion concentrations increase gradually, and then approach equilibrium. The bone-like apatite layer forms on the composites surface, which possesses benign bioactivity and favorable biocompatibility and achieves osseointegration, and can provide firm fixation between HA60/316L SS composite implants and human body bone.

  6. Mid-term study of bone remodeling after femoral cemented stem implantation: comparison between DXA and finite element simulation.

    Science.gov (United States)

    Herrera, Antonio; Rebollo, Sarai; Ibarz, Elena; Mateo, Jesús; Gabarre, Sergio; Gracia, Luis

    2014-01-01

    This five-year prospective study was designed to investigate periprosthetic bone remodeling associated with two cemented stem models, ABG-II (Stryker) and VerSys (Zimmer), randomly implanted in patients older than 75 years. The sample consisted of 64 cases (32, ABG-II; 32, VerSys). Inclusion criterion was diagnosis of osteoarthritis recommended for cemented total hip arthroplasty. Besides clinical study, Finite Element (FE) simulation was used to analyze biomechanical changes caused by hip arthroplasty. Bone Mineral Density (BMD) measurements showed a progressive increase in bone mass throughout the entire follow-up period for both stems, well correlated with FE results except in Gruen zones 4, 5, 6 for ABG-II and in zones 4, 5 for VerSys, denoting that remodeling in those zones does not depend on mechanical factors but rather on biological or physiological ones. PMID:23725926

  7. 88例骨科手术切口感染手术护理要点分析%The nursing essentials for surgical wound infection after bone surgery in 88 patients

    Institute of Scientific and Technical Information of China (English)

    郭汉卿; 谢婉萍

    2012-01-01

    目的 探讨并分析骨科手术后切口的感染情况.方法 2008年3月至2011年3月于我院因骨科就诊并行手术的1884例中发生了感染88例,对其切口类型、患者情况进行问卷调查分类总结,同时,将伤口的感染部分送检区分感染细菌种类.结果 Ⅲ类切口的感染率最高,为2.49%;感染发生在手术的5~8天之间,为61.36%;感染的病原菌以G-杆菌为主,占77.27%.结论 改善手术切口的感染需要提高患者自身的健康卫生知识、加强医护人员对患者的关心及重视和提高院方的控制感染的管理.%Objective To investigate and analyze the occurrence of surgical wound incision after bone surgery.Methods 88 patients who had developed surgical wound infection after bone surgery during the period of March 2008 to March 201 1 were surveyed by questionnaires for types of incision and patient conditions.The infected parts of surgical wound was tested for identifying types of related bacteria.Results Type Ⅲ incision had the highest infection rate of 2.49%.61.36% of the wound infection eccurred 5 to 8 days after bone surgery.G- bacillus was the main pathogenic bacteria,accounting for 77.27%.Conclusions Control of surgical wound infection after bone surgery needs an increase in self knowledge of health,enhancement of patient care from medical staff,and strengthened management of infection control.

  8. An investigation into the feasibility of implementing fractal paradigms to simulate cancellous bone structure.

    Science.gov (United States)

    Haire, T J; Ganney, P S; Langton, C M

    2001-01-01

    Cancellous bone consists of a framework of solid trabeculae interspersed with bone marrow. The structure of the bone tissue framework is highly convoluted and complex, being fractal and statistically self-similar over a limited range of magnifications. To date, the structure of natural cancellous bone tissue has been defined using 2D and 3D imaging, with no facility to modify and control the structure. The potential of four computer-generated paradigms has been reviewed based upon knowledge of other fractal structures and chaotic systems, namely Diffusion Limited Aggregation (DLA), Percolation and Epidemics, Cellular Automata, and a regular Grid with randomly relocated nodes. The resulting structures were compared for their ability to create realistic structures of cancellous bone rather than reflecting growth and form processes. Although the creation of realistic computer-generated cancellous bone structures is difficult, it should not be impossible. Future work considering the combination of fractal and chaotic paradigms is underway. PMID:11328644

  9. Limb Salvage After Bone Cancer

    Science.gov (United States)

    ... Blog Donate Now Select Page Limb Salvage After Bone Cancer Home > Understanding Children’s Cancer > Late Effects of Treatment > Limb Salvage After Bone Cancer Limb salvage is a surgical procedure that replaces ...

  10. Simulated Automobile and Rotary-Wing Aircraft Impacts: Dynamic Neck Response after Surgical Treatment for Cervical Spondylosis

    OpenAIRE

    White, Nicholas Alan

    2014-01-01

    Degeneration of the cervical spine is part of the normal aging process, usually occurring without clinical symptoms. Symptomatic degeneration most often occurs in the lower cervical spine, presenting as axial neck pain, radiculopathy, myelopathy, or any combination of the three. When conservative treatment does not adequately manage these symptoms, surgical intervention may be required. The longstanding surgical treatment for cervical degeneration is arthrodesis achieved through anterior cerv...

  11. The release of gentamicin from acrylic bone cements in a simulated prosthesis-related interfacial gap

    NARCIS (Netherlands)

    Hendriks, JGE; Neut, D; van Horn, [No Value; van der Mei, HC; Busscher, HJ

    2003-01-01

    Gentamicin is added to polymethylmethacrylate bone cements in orthopedics as a measure against infection in total joint arthroplasties. Numerous studies have been published on gentamicin release from bone cements, but none have been able to estimate the local concentrations in the prosthesis-related

  12. A massive chondroblastoma in the proximal humerus simulating malignant bone tumors.

    Science.gov (United States)

    Tonogai, Ichiro; Takahashi, Mitsuhiko; Manabe, Hiroaki; Nishisho, Toshihiko; Iwamoto, Seiji; Takao, Shoichiro; Kagawa, Seiko; Kudo, Eiji; Yasui, Natsuo

    2013-01-01

    Chondroblastoma is a mostly benign bone neoplasm that typically affects the second decade of life and exhibits a lytic lesion in the epiphysis of long bones. We report an extreme case of massive, destructive chondroblastoma of the proximal humerus in a 9-year-old girl. It was difficult to differentiate using imaging information the lesion from malignant bone tumors such as osteosarcoma. Histopathological examination from biopsy proved chondroblastoma. The tumor was resected after preoperative transcatheter embolization. Reconstructive procedure for the proximal humerus was not performed due to the local destruction. The present case demonstrates clinical and radiological differentiations of the massive chondroblastoma from the other lesions and histopathological understandings for this lesion.

  13. Young's modulus and SEM analysis of leg bones exposed to simulated microgravity by hind limb suspension (HLS)

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Niravkumar D.; Mehta, Rahul [Department of Physics and Astronomy, University of Central Arkansas, 201 Donaghey Avenue, Lewis Science Center 171, Conway, AR 72035 (United States); Ali, Nawab [Department of Applied Science, University of Arkansas at Little Rock, 2801 S. University Avenue, Little Rock, AR 72204 (United States); Soulsby, Michael; Chowdhury, Parimal [Department of Physiology and Biophysics, University of Arkansas for Medical Sciences, 4301 W. Markham St., Little Rock, AR 72205 (United States)

    2013-04-19

    The aim of this study was to determine composition of the leg bone tissue of rats that were exposed to simulated microgravity by Hind-Limb Suspension (HLS) by tail for one week. The leg bones were cross sectioned, cleaned of soft tissues, dried and sputter coated, and then placed horizontally on the stage of a Scanning Electron Microscope (SEM) for analysis. Interaction of a 17.5 keV electron beam, incident from the vertical direction on the sample, generated images using two detectors. X-rays emitted from the sample during electron bombardment were measured with an Energy Dispersive Spectroscopy (EDS) feature of SEM using a liquid-nitrogen cooled Si(Li) detector with a resolution of 144 eV at 5.9 keV ({sub 25}Mn K{sub {alpha}} x-ray). K{sub {alpha}}- x-rays from carbon, oxygen, phosphorus and calcium formed the major peaks in the spectrum. Relative percentages of these elements were determined using a software that could also correct for ZAF factors namely Z(atomic number), A(X-ray absorption) and F(characteristic fluorescence). The x-rays from the control groups and from the experimental (HLS) groups were analyzed on well-defined parts (femur, tibia and knee) of the leg bone. The SEM analysis shows that there are definite changes in the hydroxyl or phosphate group of the main component of the bone structure, hydroxyapatite [Ca{sub 10}(PO{sub 4}){sub 6}(OH){sub 2}], due to hind limb suspension. In a separate experiment, entire leg bones (both from HLS and control rats) were subjected to mechanical stress by mean of a variable force. The stress vs. strain graph was fitted with linear and polynomial function, and the parameters reflecting the mechanical strength of the bone, under increasing stress, were calculated. From the slope of the linear part of the graph the Young's modulus for HLS bones were calculated and found to be 2.49 times smaller than those for control bones.

  14. Young's modulus and SEM analysis of leg bones exposed to simulated microgravity by hind limb suspension (HLS)

    Science.gov (United States)

    Patel, Niravkumar D.; Mehta, Rahul; Ali, Nawab; Soulsby, Michael; Chowdhury, Parimal

    2013-04-01

    The aim of this study was to determine composition of the leg bone tissue of rats that were exposed to simulated microgravity by Hind-Limb Suspension (HLS) by tail for one week. The leg bones were cross sectioned, cleaned of soft tissues, dried and sputter coated, and then placed horizontally on the stage of a Scanning Electron Microscope (SEM) for analysis. Interaction of a 17.5 keV electron beam, incident from the vertical direction on the sample, generated images using two detectors. X-rays emitted from the sample during electron bombardment were measured with an Energy Dispersive Spectroscopy (EDS) feature of SEM using a liquid-nitrogen cooled Si(Li) detector with a resolution of 144 eV at 5.9 keV (25Mn Kα x-ray). Kα- x-rays from carbon, oxygen, phosphorus and calcium formed the major peaks in the spectrum. Relative percentages of these elements were determined using a software that could also correct for ZAF factors namely Z(atomic number), A(X-ray absorption) and F(characteristic fluorescence). The x-rays from the control groups and from the experimental (HLS) groups were analyzed on well-defined parts (femur, tibia and knee) of the leg bone. The SEM analysis shows that there are definite changes in the hydroxyl or phosphate group of the main component of the bone structure, hydroxyapatite [Ca10(PO4)6(OH)2], due to hind limb suspension. In a separate experiment, entire leg bones (both from HLS and control rats) were subjected to mechanical stress by mean of a variable force. The stress vs. strain graph was fitted with linear and polynomial function, and the parameters reflecting the mechanical strength of the bone, under increasing stress, were calculated. From the slope of the linear part of the graph the Young's modulus for HLS bones were calculated and found to be 2.49 times smaller than those for control bones.

  15. FEM analysis of drills used in bone surgery

    Directory of Open Access Journals (Sweden)

    M. Basiaga

    2009-04-01

    Full Text Available Purpose: The aim of the work was determination of biomechanical analysis of a surgical drill – bone system in simulated conditions of drilling in a bone.Design/methodology/approach: Geometrical model of the selected surgical drill and simulated femur (cortical bone was worked out in the Inventor Professional 2008. The value geometry of the edge was point angle (2κ1 = 90o and 2κ2 = 120o. Numerical model was prepared in ANSYS Workbench v. 11. Meshing was realized with the use of SOLID 187 elements. Evaluate boundary conditions to numerical analysis imitate phenomena in real system with appropriate accuracy. Drill was loaded with forces in the range F= 100-200 N and torqueT = 0.04 Nm. Calculations were carried out for two kinds of metallic material of the drill.Findings: The effect of numerical analysis was determination of strains and stresses in working part of the drill. Results of analysis indicate diverse values of strains and stresses distribution in working part of the drill depending on its geometry. The maximum values of strains and stresses were obtained for the drill of point angle 2κ1=120o.Research limitations/implications: In order to simulate phenomena in real system, a simplified model of surgical drill – femur system was worked out. The simplifications concerned mostly geometry of a femur. The femur was represented by disc of height h = 10 mm, corresponding with thickness of cortical bone.Originality/value: The numerical analysis of the surgical drill – femur system in simulated conditions of drilling in a bone can be a basis for optimization of cutting edge geometry of surgical tools as well as for selection of their mechanical properties.

  16. The salutary effect of dietary calcium on bone mass in a rat model of simulated weightlessness

    Science.gov (United States)

    Bikle, D. D.; Globus, R.; Halloran, B. P.; Morey-Holton, E.

    1985-01-01

    Whether supplementation of dietary calcium reduces the differences in bone mass of unweighed limbs and normally weighted limbs, and whether parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D (1,25(OH)2D) respond differently to dietary calcium in unweighted animals in comparison with pair-fed controls was studied. The hind limbs of rats were unweighted by a tail suspension method and diets containing 0.1% to 2.4% calcium. After 2 weeks serum calcium, phosphorus, PTH and 1,25(OH)2D intestinal calcium transport were determined and bone mass, ash weight, and calcium in the tibia, L-1 vertebra, and humerus were measured. No significant differences in body weights were observed among the various groups. Suspended rats maintained constant levels of serum calcium and phosphate over the wide range of dietary calcium. Serum PTH and 1,25(OH)2D and intestinal calcium transport fell as dietary calcium was increased. Bone calcium in the tibia and vertebra from suspended rats remained less than that from pair-fed control. It is suggested that although no striking difference between suspended and control animals was observed in response to dieteary calcium, increasing dietary calcium may reduce the negative impact of unloading on the calcium content of the unweighted bones. The salutary effect of high dietary calcium appears to be due to inhibition of bone resorption rather than to stimulation of bone formation.

  17. The Maxillary Sinus Membrane Elevation Procedure: Augmentation of Bone around Dental Implants without Grafts—A Review of a Surgical Technique

    Directory of Open Access Journals (Sweden)

    Christopher Riben

    2012-01-01

    Full Text Available Background. Long-term edentulism may in many cases result in resorption of the alveolar process. The sinus lift procedure aims to create increased bone volume in the maxillary sinus in order to enable installation of dental implants in the region. The method is over 30 years old, and initially autogenous bone grafts were used and later also different bone substitutes. Since 1997, a limited number of studies have explored the possibility of a graftless procedure where the void under the sinus membrane is filled with a blood clot that enables bone formation. Aim. To describe the evolution of the sinus-lift technique and to review the literature related to the technique with a focus on long-term studies related to the graft-less technique. Methods. The electronic database PubMed was searched, and a systematic review was conducted regarding relevant articles. Results. A relatively few long-term studies using the described technique were found. However, the technique was described as reliable considering the outcome of the existing studies. Conclusion. All investigated studies show high implant survival rates for the graftless technique. The technique is considered to be cost-effective, less time-consuming, and related to lower morbidity since no bone harvesting is needed.

  18. Performance of bioactive PMMA-based bone cement under load-bearing conditions: an in vivo evaluation and FE simulation.

    Science.gov (United States)

    Fottner, Andreas; Nies, Berthold; Kitanovic, Denis; Steinbrück, Arnd; Mayer-Wagner, Susanne; Schröder, Christian; Heinemann, Sascha; Pohl, Ulrich; Jansson, Volkmar

    2016-09-01

    In the past, bioactive bone cement was investigated in order to improve the durability of cemented arthroplasties by strengthening the bone-cement interface. As direct bone-cement bonding may theoretically lead to higher stresses within the cement, the question arises, whether polymethylmethacrylate features suitable mechanical properties to withstand altered stress conditions? To answer this question, in vivo experiments and finite element simulations were conducted. Twelve rabbits were divided into two groups examining either bioactive polymethylmethacrylate-based cement with unchanged mechanical properties or commercially available polymethylmethacrylate cement. The cements were tested under load-bearing conditions over a period of 7 months, using a spacer prosthesis cemented into the femur. For the finite element analyses, boundary conditions of the rabbit femur were simulated and analyses were performed with respect to different loading scenarios. Calculations of equivalent stress distributions within the cements were applied, with a completely bonded cement surface for the bioactive cement and with a continuously interfering fibrous tissue layer for the reference cement. The bioactive cement revealed good in vivo bioactivity. In the bioactive cement group two failures (33 %), with complete break-out of the prosthesis occurred, while none in the reference group. Finite element analyses of simulated bioactive cement fixation showed an increase in maximal equivalent stress by 49.2 to 109.4 % compared to the simulation of reference cement. The two failures as well as an increase in calculated equivalent stress highlight the importance of fatigue properties of polymethylmethacrylate in general and especially when developing bioactive cements designated for load-bearing conditions. PMID:27530301

  19. Rapid attachment of adipose stromal cells on resorbable polymeric scaffolds facilitates the one-step surgical procedure for cartilage and bone tissue engineering purposes

    NARCIS (Netherlands)

    W.J. Jurgens; R.J. Kroeze; R.A. Bank; M.J.P.F. Ritt; M.N. Helder

    2011-01-01

    The stromal vascular fraction (SVF) of adipose tissue provides an abundant source of mesenchymal stem cells. For clinical application, it would be beneficial to establish treatments in which SVF is obtained, seeded onto a scaffold, and returned into the patient within a single surgical procedure. In

  20. Rapid Attachment of Adipose Stromal Cells on Resorbable Polymeric Scaffolds Facilitates the One-Step Surgical Procedure for Cartilage and Bone Tissue Engineering Purposes

    NARCIS (Netherlands)

    Jurgens, Wouter J.; Kroeze, Robert Jan; Bank, Ruud A.; Ritt, Marco J. P. F.; Helder, Marco N.

    2011-01-01

    The stromal vascular fraction (SVF) of adipose tissue provides an abundant source of mesenchymal stem cells. For clinical application, it would be beneficial to establish treatments in which SVF is obtained, seeded onto a scaffold, and returned into the patient within a single surgical procedure. In

  1. A Massive Chondroblastoma in the Proximal Humerus Simulating Malignant Bone Tumors

    Directory of Open Access Journals (Sweden)

    Ichiro Tonogai

    2013-01-01

    Full Text Available Chondroblastoma is a mostly benign bone neoplasm that typically affects the second decade of life and exhibits a lytic lesion in the epiphysis of long bones. We report an extreme case of massive, destructive chondroblastoma of the proximal humerus in a 9-year-old girl. It was difficult to differentiate using imaging information the lesion from malignant bone tumors such as osteosarcoma. Histopathological examination from biopsy proved chondroblastoma. The tumor was resected after preoperative transcatheter embolization. Reconstructive procedure for the proximal humerus was not performed due to the local destruction. The present case demonstrates clinical and radiological differentiations of the massive chondroblastoma from the other lesions and histopathological understandings for this lesion.

  2. Individual-specific multi-scale finite element simulation of cortical bone of human proximal femur

    Energy Technology Data Exchange (ETDEWEB)

    Ascenzi, Maria-Grazia, E-mail: mgascenzi@mednet.ucla.edu [UCLA/Orthopaedic Hospital, Department of Orthopaedic Surgery, Rehabilitation Bldg, Room 22-69, 1000 Veteran Avenue, University of California, Los Angeles, CA 90095 (United States); Kawas, Neal P., E-mail: nealkawas@ucla.edu [UCLA/Orthopaedic Hospital, Department of Orthopaedic Surgery, Rehabilitation Bldg, Room 22-69, 1000 Veteran Avenue, University of California, Los Angeles, CA 90095 (United States); Lutz, Andre, E-mail: andre.lutz@hotmail.de [Institute of Biomechanics and Numerical Mechanics, Leibniz University Hannover, 30167 Hannover (Germany); Kardas, Dieter, E-mail: kardas@ibnm.uni-hannover.de [ContiTech Vibration Control, Jaedekamp 30 None, 30419 Hannover (Germany); Nackenhorst, Udo, E-mail: nackenhorst@ibnm.uni-hannover.de [Institute of Biomechanics and Numerical Mechanics, Leibniz University Hannover, 30167 Hannover (Germany); Keyak, Joyce H., E-mail: jhkeyak@uci.edu [Department of Radiological Sciences, Medical Sciences I, Bldg 811, Room B140, University of California, Irvine, CA 92697-5000 (United States)

    2013-07-01

    We present an innovative method to perform multi-scale finite element analyses of the cortical component of the femur using the individual’s (1) computed tomography scan; and (2) a bone specimen obtained in conjunction with orthopedic surgery. The method enables study of micro-structural characteristics regulating strains and stresses under physiological loading conditions. The analysis of the micro-structural scenarios that cause variation of strain and stress is the first step in understanding the elevated strains and stresses in bone tissue, which are indicative of higher likelihood of micro-crack formation in bone, implicated in consequent remodeling or macroscopic bone fracture. Evidence that micro-structure varies with clinical history and contributes in significant, but poorly understood, ways to bone function, motivates the method’s development, as does need for software tools to investigate relationships between macroscopic loading and micro-structure. Three applications – varying region of interest, bone mineral density, and orientation of collagen type I, illustrate the method. We show, in comparison between physiological loading and simple compression of a patient’s femur, that strains computed at the multi-scale model’s micro-level: (i) differ; and (ii) depend on local collagen-apatite orientation and degree of calcification. Our findings confirm the strain concentration role of osteocyte lacunae, important for mechano-transduction. We hypothesize occurrence of micro-crack formation, leading either to remodeling or macroscopic fracture, when the computed strains exceed the elastic range observed in micro-structural testing.

  3. Conseqüências no crescimento de maxila e mandíbula de defeito ósseo cirúrgico no ramo da mandíbula de ratos Consequences on the growth of maxilla and mandible of surgical bone defect on mandibular ramus of rats

    Directory of Open Access Journals (Sweden)

    Lucimar Rodrigues

    2004-10-01

    Full Text Available OBJETIVO: Analisar as conseqüências no crescimento de maxila e mandíbula de defeito ósseo cirúrgico simulando fratura no ramo da mandíbula. MÉTODOS: Foram utilizados 25 ratos Wistar com um mês de idade. Sob anestesia geral e por meio de incisão submandibular. Foi realizada osteotomia vertical no ramo da mandíbula do lado direito com emprego de motor cirúrgico. Após período de dois meses os animais foram sacrificados, os tecidos moles retirados e as hemimandíbulas desarticuladas. Foram realizadas incidências radiográficas axiais para o crânio e laterais para as hemimandíbulas. A seguir, por intermédio de um sistema de computador foram obtidas medidas lineares da maxila e das hemimandíbulas. Foi empregado o teste "t" de Student para verificação da significância da diferença entre os lados experimental e controle. RESULTADOS: A diferença foi significante para a altura do ramo (p=0,010 e comprimento da mandíbula referente ao côndilo (p=0,015 e ao ângulo (pPURPOSE: To analyse the consequences on the growth of maxilla and mandible of a surgical bone defect that simulates a mandibular ramus fracture. METHODS: A group of 25 one-month-old Wistar rats were used in this study. Under general anesthesia, and through a submandibular incision, a vertical osteotomy on the right side of the mandibular ramus was made using a surgical drill. The animals were sacrificed after two months, soft tissues removed, and the mandible disarticulated. The skull was submitted to axial radiograph and the hemimandibles to a lateral radiograph. With these, cephalometric mensurations were made through a computer system, and the obtained values submitted to Student's t-test. RESULTS: The height of the mandibular ramus presented significant difference (p=0,010 as well as the length of mandible, both to the condyle (P=0,015 and the angle (p=0,001. There was no significant difference to the mensurations of the maxilla. CONCLUSION: The consequences of the

  4. Effect of bar cross-section geometry on stress distribution in overdenture-retaining system simulating horizontal misfit and bone loss.

    Science.gov (United States)

    Spazzin, Aloísio Oro; Costa, Ana Rosa; Correr, Américo Bortolazzo; Consani, Rafael Leonardo Xediek; Correr-Sobrinho, Lourenço; dos Santos, Mateus Bertolini Fernandes

    2013-08-01

    This study evaluated the influence of cross-section geometry of the bar framework on the distribution of static stresses in an overdenture-retaining bar system simulating horizontal misfit and bone loss. Three-dimensional FE models were created including two titanium implants and three cross-section geometries (circular, ovoid or Hader) of bar framework placed in the anterior part of a severely resorbed jaw. One model with 1.4-mm vertical loss of the peri-implant tissue was also created. The models set were exported to mechanical simulation software, where horizontal displacement (10, 50 or 100 μm) was applied simulating the settling of the framework, which suffered shrinkage during the laboratory procedures. The bar material used for the bar framework was a cobalt--chromium alloy. For evaluation of bone loss effect, only the 50-μm horizontal misfit was simulated. Data were qualitatively and quantitatively evaluated using von Mises stress for the mechanical part and maximum principal stress and μ-strain for peri-implant bone tissue given by the software. Stresses were concentrated along the bar and in the join between the bar and cylinder. In the peri-implant bone tissue, the μ-strain was higher in the cervical third. Higher stress levels and μ-strain were found for the models using the Hader bar. The bone loss simulated presented considerable increase on maximum principal stresses and μ-strain in the peri-implant bone tissue. In addition, for the amplification of the horizontal misfit, the higher complexity of the bar cross-section geometry and bone loss increases the levels of static stresses in the peri-implant bone tissue. PMID:23791086

  5. Application of bone cement in the posterior approach surgical treatment for metastatic tumor of the thoracolumbar spine%胸腰椎转移瘤后路手术中骨水泥的应用

    Institute of Scientific and Technical Information of China (English)

    毛宁方; 朱晓东; 张晔; 吴云刚; 白玉树; 李明; 石志才

    2009-01-01

    目的:探讨骨水泥在胸腰椎转移瘤后路手术中的应用价值.方法:2004年3月~21208年12月,后方入路手术治疗胸腰椎转移性肿瘤患者26例,原发肿瘤:肺癌9例,乳腺癌7例,肝癌4例,前列腺癌2例,肾癌1例,来源不明3例.病灶累及单节段17例,两节段9例.23例伴不同程度的腰背部疼痛:神经功能按Frankel分级:B级6例,C级7例,D级11例,E级2例.术中采用骨水泥联合椎弓根螺钉重建脊柱稳定性,其中骨水泥填塞15个椎体,骨水泥前方重建9个椎体,骨水泥椎体成形11个椎体,10例合并骨质疏松患者同时采用骨水泥加强椎弓根钉道.结果:术中未发现骨水泥放热效应引起的神经功能受损.24例患者获得完整随访,随访时间3~42个月,平均18.2个月,23例术前有不同程度腰背疼痛者术后疼痛消失6例,缓解14例;术前伴神经功能障碍者17例(77%)获得神经功能改善.随访期间未发现骨水泥下沉、椎节塌陷及向前成角.1例骨水泥填塞术后3个月骨水泥界面出现松动,但未引起神经压迫症状.15例随访期间死亡.结论:在胸腰椎转移性肿瘤后路手术治疗中,根据患者的全身情况、预期寿命、肿瘤类型、转移椎体位置及骨密度,充分利用骨水泥独特的理化特性,进行多种不同方式的应用,可以减小手术创伤,提高生存质量.%Objective:To explore the clinic effects of the bone cement utilized in the posterior approach surgical treatment of the thoracic and lumbar spinal metastatic tumor.Method:26 patients with the thoracolumbar spinal metastatic tumors who underwent posterior approach surgical treatment from March 2004 to December 2008 were reviewed retrospectively.There were lung carcinoma in 9 cases, breast carcinoma in 7 cases, hepato-carcinoma in 4 cases,prostate carcinoma in 2 cages,kidney carcinoma in 1 case,and 3 cases with unknown origin.Tumor involved single vertebral body in 17 cases,two vertebral bodies in 9 cases.23

  6. Simulation of the mechanical behavior of a HIP implant. Implant fixed to bone by cementation under arbitrary load

    Energy Technology Data Exchange (ETDEWEB)

    Oldani, C R [Materials Department - FCEFyN - Universidad Nacional de Cordoba, Av.Velez Sarsfield 1611 (5016) Cordoba (Argentina); Dominguez, A A [INTI Cordoba, Av. Velez Sarsfield 1561 (5016) Cordoba (Argentina)

    2007-11-15

    In a previous work a finite elements model was constructed to simulate a fatigue assay according to the norm IRAM 9422-3. Three materials were studied, two of them are the most used in this type of implant (Stainless steel 3161 and alloy T16A14V) and the third was a new developed titanium alloy (Ti35Nb7Zr5Ta). Static loads were applied to the model according to the highest requirements of the norm and the stress - strain distribution were determined. In this study a simplified analysis of the material's fatigue was done according to the previous work. The best behavior of the titanium alloys vs. the stainless steel was evident. With the objective of studying the behavior of both: the implant and the femur bone, new finite elements models were realized, in which the presence of the bone was considered. Inside the bone, the femoral component of the implant was placed in a similar way of a cemented prosthesis in a total hip arthroplasty. The advantage of the titanium implant related to the stainless steel one, was very clear.

  7. Simulation of the mechanical behavior of a HIP implant. Implant fixed to bone by cementation under arbitrary load

    Science.gov (United States)

    Oldani, C. R.; Dominguez, A. A.

    2007-11-01

    In a previous work a finite elements model was constructed to simulate a fatigue assay according to the norm IRAM 9422-3. Three materials were studied, two of them are the most used in this type of implant (Stainless steel 3161 and alloy T16A14V) and the third was a new developed titanium alloy (Ti35Nb7Zr5Ta). Static loads were applied to the model according to the highest requirements of the norm and the stress - strain distribution were determined. In this study a simplified analysis of the material's fatigue was done according to the previous work. The best behavior of the titanium alloys vs. the stainless steel was evident. With the objective of studying the behavior of both: the implant and the femur bone, new finite elements models were realized, in which the presence of the bone was considered. Inside the bone, the femoral component of the implant was placed in a similar way of a cemented prosthesis in a total hip arthroplasty. The advantage of the titanium implant related to the stainless steel one, was very clear.

  8. Radioisotopic evaluation of bone repair after experimental surgical trauma Avaliação radiofarmacológica do reparo ósseo após trauma cirúrgico padronizado

    Directory of Open Access Journals (Sweden)

    Ana Cristina Breithaupt-Faloppa

    2004-03-01

    Full Text Available BACKGROUND: Scientific approach of the bone reaction after surgical procedures provides valuable information on methods and techniques. The purpose of this study was to follow this process using a radioisotope marker of bone remodelling. MATERIAL AND METHODS: Two bone cavities were created (one for every tibia in adult Wistar male rats using a 0.5 mm spherical burr; left tibial cavities were filled with bovine freeze-dried bone; the right ones were left unfilled for control. Scintigrams were done with sodium methylene diphosphonate (MDP labelled with radioactive pertechnetate (99mTcO4- to evaluate the inflammatory response and the local osteoblastic activity. The evolution of bone repair was additionally evaluated by light microscopy. RESULTS: Our results have shown that the highest bone activity was recorded between the 7th and the 14th day after surgery. The morphological analysis confirmed the results obtained with radioisotope analysis and did not reveal significant differences regarding the evolution of bone repair between the filled and the unfilled defects. CONCLUSION: We confirmed that 99mTc -MDP is a valuable tool to study bone repair, as it was able to show subtle alterations of bone activity even in lesions as small as those created herein (0.5 mm wide, 0.5 mm deep.Este trabalho objetivou estudar a evolução temporal do processo de reparo ósseo em tíbia de rato, após trauma cirúrgico padronizado. A incorporação do radiofármaco 99mTc-MDP na região afetada foi tomada como medida indireta da intensidade de reação tecidual; foi feito também acompanhamento histológico do processo de reparo. Foram realizadas cirurgias nas duas tíbias de 72 animais divididos em 2 grupos, sendo sacrificados em diferentes dias pós-operatórios (1, 3, 7, 14, 21 e 28 dias p.o.. As cavidades criadas nas tíbias esquerdas foram preenchidas com osso liofilizado bovino, e as direitas serviram como controle (não preenchidas. Grupos paralelos de

  9. Difference in the Surgical Outcome of Unilateral Cleft Lip and Palate Patients with and without Pre-Alveolar Bone Graft Orthodontic Treatment

    Science.gov (United States)

    Chang, Chun-Shin; Wallace, Christopher Glenn; Hsiao, Yen-Chang; Chiu, Yu-Ting; Pai, Betty Chien-Jung; Chen, I-Ju; Liao, Yu-Fang; Liou, Eric Jen-Wein; Chen, Philip Kuo-Ting; Chen, Jyh-Ping; Noordhoff, M. Samuel

    2016-01-01

    Presurgical orthodontic treatment before secondary alveolar bone grafting (SABG) is widely performed for cleft lip/palate patients. However, no randomized controlled trial has been published comparing SABG outcomes in patients with, and without, presurgical orthodontic treatment. This randomized, prospective, single-blinded trial was conducted between January 2012 and April 2015 to compare ABG volumes 6 months postoperatively between patients with and without presurgical orthodontic treatment. Twenty-four patients were enrolled and randomized and 22 patients completed follow-up. Patients who had presurgical orthodontics before SABG had significantly improved inclination (p < 0.001) and rotation (p < 0.001) of the central incisor adjacent to the defect, significantly improved ABG fill volume (0.81 ± 0.26 cm3 at 6 months compared to 0.59 ± 0.22 cm3; p < 0.05) and less residual alveolar bone defect (0.31 ± 0.08 cm3 at 6 months compared to s 0.55 ± 0.14 cm3; p < 0.001) compared to patients who did not have presurgical orthodontic treatment. In conclusion, orthodontic treatment combined with SABG results in superior bone volume when compared with conventional SABG alone. PMID:27041697

  10. Surgical treatment of the osteoporotic spine with bone cement-injectable cannulated pedicle screw fixation: technical description and preliminary application in 43 patients

    Directory of Open Access Journals (Sweden)

    Fei Dai

    2015-02-01

    Full Text Available OBJECTIVES: To describe a new approach for the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws. METHODS: Between June 2010 and February 2013, 43 patients with degenerative spinal disease and osteoporosis (T-score <-2.5 underwent lumbar fusion using cement-injectable cannulated pedicle screws. Clinical outcomes were evaluated using a Visual Analog Scale and the Oswestry Disability Index. Patients were given radiographic follow-up examinations after 3, 6, and 12 months and once per year thereafter. RESULTS: All patients were followed for a mean of 15.7±5.6 months (range, 6 to 35 months. The Visual Analog Scale and Oswestry Disability Index scores showed a significant reduction in back pain (p = 0.018 and an improvement in lower extremity function (p = 0.025 in patients who underwent lumbar fusion using the novel screw. Intraoperative cement leakage occurred in four patients, but no neurological complications were observed. Radiological observation indicated no loosening or pulling out of the novel screw, and bone fusion was excellent. CONCLUSIONS: The described polymethylmethacrylate augmentation technique using bone cement-injectable cannulated pedicle screws can reduce pain and improve spinal dysfunction in osteoporotic patients undergoing osteoporotic spine surgery.

  11. Investigating the Influence of Hand Dominance on Postural Sway During Traditional and Simulated Laparoscopic Surgical Skills Practice.

    Science.gov (United States)

    White, Anthony; Huang, Chun-Kai; Oleynikov, Dmitry; Siu, Ka-Chun

    2016-01-01

    This study examined how hand dominance could influence postural sway during laparoscopic skills practice. Ten inexperienced medical trainees performed a peg transfer task using the Fundamentals of Laparoscopic Surgery (FLS) training box and the virtual reality (VR) trainer. Surface electromyographic recordings of upper and lower limb muscles were taken, while the postural sway was measured by a pressure mapping system. Skills performance using the non-dominant hand required more muscle effort and increased more postural sway. Compared with the FLS training box, training with VR decreased the use of muscle effort and could reduce the influence of hand dominance on the overall postural sway during laparoscopic surgical skills practice. PMID:27046621

  12. The Impact of Simulated and Real Microgravity on Bone Cells and Mesenchymal Stem Cells

    Directory of Open Access Journals (Sweden)

    Claudia Ulbrich

    2014-01-01

    machine (RPM, the 2D-clinostat, or the NASA-developed rotating wall vessel bioreactor (RWV to create tissue from bone, tumor, and mesenchymal stem cells. To understand the development of 3D structures, in vitro experiments using s-µg devices can provide valuable information about modulations in signal-transduction, cell adhesion, or extracellular matrix induced by altered gravity conditions. These systems also facilitate the analysis of the impact of growth factors, hormones, or drugs on these tissue-like constructs. Progress has been made in bone tissue engineering using the RWV, and multicellular tumor spheroids (MCTS, formed in both r- and s-µg, have been reported and were analyzed in depth. Currently, these MCTS are available for drug testing and proteomic investigations. This review provides an overview of the influence of µg on the aforementioned cells and an outlook for future perspectives in tissue engineering.

  13. Surgical selection of traumatic tibia tubular bone defect of different clinical cla ssification%不同临床分型创伤性胫骨管状骨缺损的手术选择分析

    Institute of Scientific and Technical Information of China (English)

    孟仕坤

    2016-01-01

    Objective:To study the surgical selection of traumatic tibia tubular bone defect of different clinical classification.Mte h-ods:85 cases of patients with traumatic tibia tubular bone defect and admitted into the hospital during May 2012 to August 2014 were se-lected as the research objects.According to the length of the tibia tubular bone defect, they were divided into three clinical classification groups:39 cases of type I (4-6cm), 25 cases of type II (6-9cm)and 21 cases of type III ( >9cm)., monosegment osteotomy tele-port, double-segment osteotomy transport and ipsilateral vascularized fibula grafts in Ilizarov technique combined with Ilizarov external fixator fixation surgical therapy were performed respectively in the three groups.The bone healing time, the time with external fixation and the degree indexes of limb function recovery after operation in the three groups of different clinical classification were observed.The cura-tive effect of surgical treatment of different clinical classification was analyzed.Results:The three groups of different clinical classification achieved significant efficacy.The time of type I bone healing was the longest which was 9.4 months while of type III was 5.6 months which was the shortest.The fixation time of Ilizarov external fixator in type II was the shortest which was 10.5months while in type III was the longest which was 181. months.After operation, the function recovery of the diseased limbs in the three groups reached the normal levels. Because the three groups of different clinical classification were different in the pathogenetic condition, the number of cases,the choice of surgical operation, they can not be statistically compared.Conclus ion:The curative effect of hree kinds of surgical treatment for treating traumatic tibia tubular bone defect of different clinical classification was significant, which was of significant clinical value.%目的:研究不同临床分型创伤性胫骨管状骨缺损的手术选择

  14. Micro-scale finite element modeling of ultrasound propagation in aluminum trabecular bone-mimicking phantoms: A comparison between numerical simulation and experimental results.

    Science.gov (United States)

    Vafaeian, B; Le, L H; Tran, T N H T; El-Rich, M; El-Bialy, T; Adeeb, S

    2016-05-01

    The present study investigated the accuracy of micro-scale finite element modeling for simulating broadband ultrasound propagation in water-saturated trabecular bone-mimicking phantoms. To this end, five commercially manufactured aluminum foam samples as trabecular bone-mimicking phantoms were utilized for ultrasonic immersion through-transmission experiments. Based on micro-computed tomography images of the same physical samples, three-dimensional high-resolution computational samples were generated to be implemented in the micro-scale finite element models. The finite element models employed the standard Galerkin finite element method (FEM) in time domain to simulate the ultrasonic experiments. The numerical simulations did not include energy dissipative mechanisms of ultrasonic attenuation; however, they expectedly simulated reflection, refraction, scattering, and wave mode conversion. The accuracy of the finite element simulations were evaluated by comparing the simulated ultrasonic attenuation and velocity with the experimental data. The maximum and the average relative errors between the experimental and simulated attenuation coefficients in the frequency range of 0.6-1.4 MHz were 17% and 6% respectively. Moreover, the simulations closely predicted the time-of-flight based velocities and the phase velocities of ultrasound with maximum relative errors of 20 m/s and 11 m/s respectively. The results of this study strongly suggest that micro-scale finite element modeling can effectively simulate broadband ultrasound propagation in water-saturated trabecular bone-mimicking structures.

  15. 3D Rapid Prototyping for Otolaryngology-Head and Neck Surgery: Applications in Image-Guidance, Surgical Simulation and Patient-Specific Modeling.

    Directory of Open Access Journals (Sweden)

    Harley H L Chan

    Full Text Available The aim of this study was to demonstrate the role of advanced fabrication technology across a broad spectrum of head and neck surgical procedures, including applications in endoscopic sinus surgery, skull base surgery, and maxillofacial reconstruction. The initial case studies demonstrated three applications of rapid prototyping technology are in head and neck surgery: i a mono-material paranasal sinus phantom for endoscopy training ii a multi-material skull base simulator and iii 3D patient-specific mandible templates. Digital processing of these phantoms is based on real patient or cadaveric 3D images such as CT or MRI data. Three endoscopic sinus surgeons examined the realism of the endoscopist training phantom. One experienced endoscopic skull base surgeon conducted advanced sinus procedures on the high-fidelity multi-material skull base simulator. Ten patients participated in a prospective clinical study examining patient-specific modeling for mandibular reconstructive surgery. Qualitative feedback to assess the realism of the endoscopy training phantom and high-fidelity multi-material phantom was acquired. Conformance comparisons using assessments from the blinded reconstructive surgeons measured the geometric performance between intra-operative and pre-operative reconstruction mandible plates. Both the endoscopy training phantom and the high-fidelity multi-material phantom received positive feedback on the realistic structure of the phantom models. Results suggested further improvement on the soft tissue structure of the phantom models is necessary. In the patient-specific mandible template study, the pre-operative plates were judged by two blinded surgeons as providing optimal conformance in 7 out of 10 cases. No statistical differences were found in plate fabrication time and conformance, with pre-operative plating providing the advantage of reducing time spent in the operation room. The applicability of common model design and

  16. 外科手术联合自体骨髓干细胞动员治疗大鼠脑缺血%Surgical operation combined with autologous bone marrow stem cell mobilization to treat ischemic cerebrovascular diseases in rats

    Institute of Scientific and Technical Information of China (English)

    张圣旭; 步星耀; 程培训; 刘猛; 姜金豆; 李志营; 张峰

    2011-01-01

    BACKGROUND: Studies have shown that stem cell therapy can promote recovery of brain function, and stem cells combined with surgical intervention can be more effective in improving the prognosis.OBJECTIVE: To explore the effect and mechanism of surgical operation combined with autologous bone marrow stem cell mobilization in treatment of cerebral ischemia.METHODS: Male Sprague-Dawley rats were used to produce rat cerebral ischemia models using suture method and then divided into four groups. We used surgery, recombinant human granulocyte colony stimulating factor (rhG-CSF) and rhGM-CSF mobilization of autologous bone marrow stem cell therapy respectively.RESULTS AND CONCLUSION: In the surgery combined with autologous bone marrow stem cell mobilization group, the neurological deficit score, cerebral infarction area and the number of apoptosis were significantly lower than those in the control group, surgery group and bone marrow stem cell mobilization group (P < 0.01); Histopathology examination showed that BrdU, BDNF positive cells and angiogenesis were much more than those in the other three groups (P < 0.05). The surgery combined with autologous bone marrow stem cell mobilization can reduce the size of cerebral infarction, inhibit cell apoptosis, promote nerve regeneration and repair, and then improve brain function.%背景:研究表明干细胞治疗能够促进脑功能恢复,联合外科干预能更有效地改善预后.目的:分析外科手术联合自体骨髓干细胞动员治疗脑缺血的疗效和机制.方法:用线栓法制作SD大鼠脑缺血模型后随机分为4组:对照组不干预,其他3组分别行外科手术、重组人粒细胞集落刺激因子和粒/巨噬细胞集落刺激因子动员自体骨髓干细胞治疗或联合治疗.结果与结论:外科手术联合自体骨髓干细胞动员组大鼠的神经功能缺损评分、缺血坏死面积和细胞凋亡数明显低于对照组、外科手术组和自体骨髓干细胞动员组(P<0

  17. Changes in functional construction of bone in rats under conditions of simulated increased gravity.

    Science.gov (United States)

    Amtmann, E.; Oyama, J.

    1973-01-01

    An investigation was conducted to determine experimentally whether femur bones are altered in cross-sectional area or cross-sectional shape by chronic centrifugation at different G-levels in conformance to Wolff's law. It was found that the centrifuged animals exhibit on the average smaller body masses, femur lengths and femur cross sections, as compared to their corresponding age controls. The mean inhibitory effect of chronic centrifugation upon body and femur growth can be measured in a shortcut approximation by calculating the decrease of body masses and femoral dimensions on a percentage basis.

  18. Surgical Assisting

    Science.gov (United States)

    ... specific training over and above a degree in science, nursing, physician assisting, or another health profession. Prerequisites . Recommended eligibility requirements for admission into a surgical assisting program are: Bachelor of Science degree (or higher) Associate degree in an allied ...

  19. Evolution of surgical skills training

    OpenAIRE

    Roberts, Kurt E.; Bell, Robert L.; Duffy, Andrew J

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients.

  20. Bone cysts: unicameral and aneurysmal bone cyst.

    Science.gov (United States)

    Mascard, E; Gomez-Brouchet, A; Lambot, K

    2015-02-01

    Simple and aneurysmal bone cysts are benign lytic bone lesions, usually encountered in children and adolescents. Simple bone cyst is a cystic, fluid-filled lesion, which may be unicameral (UBC) or partially separated. UBC can involve all bones, but usually the long bone metaphysis and otherwise primarily the proximal humerus and proximal femur. The classic aneurysmal bone cyst (ABC) is an expansive and hemorrhagic tumor, usually showing characteristic translocation. About 30% of ABCs are secondary, without translocation; they occur in reaction to another, usually benign, bone lesion. ABCs are metaphyseal, excentric, bulging, fluid-filled and multicameral, and may develop in all bones of the skeleton. On MRI, the fluid level is evocative. It is mandatory to distinguish ABC from UBC, as prognosis and treatment are different. UBCs resolve spontaneously between adolescence and adulthood; the main concern is the risk of pathologic fracture. Treatment in non-threatening forms consists in intracystic injection of methylprednisolone. When there is a risk of fracture, especially of the femoral neck, surgery with curettage, filling with bone substitute or graft and osteosynthesis may be required. ABCs are potentially more aggressive, with a risk of bone destruction. Diagnosis must systematically be confirmed by biopsy, identifying soft-tissue parts, as telangiectatic sarcoma can mimic ABC. Intra-lesional sclerotherapy with alcohol is an effective treatment. In spinal ABC and in aggressive lesions with a risk of fracture, surgical treatment should be preferred, possibly after preoperative embolization. The risk of malignant transformation is very low, except in case of radiation therapy.

  1. The acquisition and retention of urinary catheterisation skills using surgical simulator devices: teaching method or student traits

    OpenAIRE

    Waters, Peadar S.; McVeigh, Terri; Kelly, Brian D; Flaherty, Gerard T; Devitt, Dara; Barry, Kevin; Kerin, Michael J.

    2014-01-01

    Background The acquisition of procedural skills is an essential component of learning for medical trainees. The objective of this study was to assess which teaching method of performing urinary catheterisation is associated with most efficient procedural skill acquisition and retention. We evaluated factors affecting acquisition and retention of skills when using simulators as adjuncts to medical training. Methods Forty-two second year medical students were taught urinary catheter insertion u...

  2. Bone tumor

    Science.gov (United States)

    Tumor - bone; Bone cancer; Primary bone tumor; Secondary bone tumor ... The cause of bone tumors is unknown. They often occur in areas of the bone that grow rapidly. Possible causes include: Genetic defects ...

  3. Bone graft substitutes and bone morphogenetic proteins for osteoporotic fractures: What is the evidence?

    NARCIS (Netherlands)

    E.M.M. van Lieshout (Esther); V. Alt (Volker)

    2016-01-01

    textabstractDespite improvements in implants and surgical techniques, osteoporotic fractures remain challenging to treat. Among other major risk factors, decreased expression of morphogenetic proteins has been identified for impaired fracture healing in osteoporosis. Bone grafts or bone graft substi

  4. 关于老龄患者的骨外科护理体会%Experience of Surgical Nursing on Aged Patients of Bone

    Institute of Scientific and Technical Information of China (English)

    吴畏

    2015-01-01

    ObjectiveHow to ensure the safety of older patients with nursing of orthopedics at present, we summarizes some suitable method by investigation.Methods Investigate the different requirements in the preoperative and postoperative for a certain number of patients, and the physiological and psychological nursing methods on patients with different function to study.Results After care, in the two aspects of psychological and physiological, health level was greatly improved.Conclusion Nursing care of bone surgery for aged patients not only has the pursuit of quality in the hardware facilities, but also has the pursuit of quality in software facilities efforts.%目的:在当前的骨科护理中,如何确保年龄比较大的患者的安全性,我们通过一些调查,总结了一些比较合适的方法。方法调查一定数量的患者在术前术后护理中的不同要求,以及生理心理护理方法对患者的不同作用来研究。结果经过护理后,患者的心理和生理两方面的健康水平都有了较大的改善。结论对老龄患者的骨外科方面的护理,既要在硬件设施上追求质量,也要在软件设施方面下功夫。

  5. Medium-Term Function of a 3D Printed TCP/HA Structure as a New Osteoconductive Scaffold for Vertical Bone Augmentation: A Simulation by BMP-2 Activation

    Directory of Open Access Journals (Sweden)

    Mira Moussa

    2015-04-01

    Full Text Available Introduction: A 3D-printed construct made of orthogonally layered strands of tricalcium phosphate (TCP and hydroxyapatite has recently become available. The material provides excellent osteoconductivity. We simulated a medium-term experiment in a sheep calvarial model by priming the blocks with BMP-2. Vertical bone growth/maturation and material resorption were evaluated. Materials and methods: Titanium hemispherical caps were filled with either bare- or BMP-2 primed constructs and placed onto the calvaria of adult sheep (n = 8. Histomorphometry was performed after 8 and 16 weeks. Results: After 8 weeks, relative to bare constructs, BMP-2 stimulation led to a two-fold increase in bone volume (Bare: 22% ± 2.1%; BMP-2 primed: 50% ± 3% and a 3-fold decrease in substitute volume (Bare: 47% ± 5%; BMP-2 primed: 18% ± 2%. These rates were still observed at 16 weeks. The new bone grew and matured to a haversian-like structure while the substitute material resorbed via cell- and chemical-mediation. Conclusion: By priming the 3D construct with BMP-2, bone metabolism was physiologically accelerated, that is, enhancing vertical bone growth and maturation as well as material bioresorption. The scaffolding function of the block was maintained, leaving time for the bone to grow and mature to a haversian-like structure. In parallel, the material resorbed via cell-mediated and chemical processes. These promising results must be confirmed in clinical tests.

  6. Evolution of surgical skills training

    Institute of Scientific and Technical Information of China (English)

    Kurt E Roberts; Robert L Bell; Andrew J Duffy

    2006-01-01

    Surgical training is changing: one hundred years of tradition is being challenged by legal and ethical concerns for patient safety, work hours restrictions, the cost of operating room time, and complications. Surgical simulation and skills training offers an opportunity to teach and practice advanced skills outside of the operating room environment before attempting them on living patients.Simulation training can be as straight forward as using real instruments and video equipment to manipulate simulated "tissue" in a box trainer. More advanced,virtual reality simulators are now available and ready for widespread use. Early systems have demonstrated their effectiveness and discriminative ability. Newer systems enable the development of comprehensive curricula and full procedural simulations.The Accreditation Council of Graduate Medical Education's (ACGME) has mandated the development of novel methods of training and evaluation. Surgical organizations are calling for methods to ensure the maintenance of skills, advance surgical training, and to credential surgeons as technically competent.Simulators in their current form have been demonstrated to improve the operating room performance of surgical residents. Development of standardized training curricula remains an urgent and important agenda, particularly for minimal invasive surgery.An innovative and progressive approach, borrowing experiences from the field of aviation, can provide the foundation for the next century of surgical training,ensuring the quality of the product. As the technology develops, the way we practice will continue to evolve, to the benefit of physicians and patients.

  7. The impact of simulated and real microgravity on bone cells and mesenchymal stem cells

    NARCIS (Netherlands)

    C. Ulbrich; M. Wehland; J. Pietsch; G. Aleshcheva; P. Wise; J. van Loon; N. Magnusson; M. Infanger; J. Grosse; C. Eilles; A. Sudaresan; D. Grimm

    2014-01-01

    How microgravity affects the biology of human cells and the formation of 3D cell cultures in real and simulated microgravity (r- and s- ) is currently a hot topic in biomedicine. In r- and s- , various cell types were found to form 3D structures. This review will focus on the current knowledge of ti

  8. A study of murine bone marrow cells cultured in bioreactors which create an environment which simulated microgravity

    Science.gov (United States)

    Lawless, Brother Desales

    1990-01-01

    Previous research indicated that mouse bone marrow cells could be grown in conditions of simulated microgravity. This environment was created in rotating bioreactor vessels. On three attempts mouse cells were grown successfully in the vessels. The cells reached a stage where the concentrations were doubling daily. Phenotypic analysis using a panel of monoclonal antibodies indicated that the cell were hematopoietic pluripotent stem cells. One unsuccessful attempt was made to reestablish the immune system in immunocompromised mice using these cells. Since last summer, several unsuccessful attempts were made to duplicate these results. It was determined by electron microscopy that the cells successfully grown in 1989 contained virus particles. It was suggested that these virally parasitized cells had been immortalized. The work of this summer is a continuation of efforts to grow mouse bone marrow in these vessels. A number of variations of the protocol were introduced. Certified pathogen free mice were used in the repeat experiments. In some attempts the medium of last summer was used; in others Dexture Culture Medium containing Iscove's Medium supplemented with 20 percent horse serum and 10-6 M hydrocortisone. Efforts this summer were directed solely to repeating the work of last summer. Plans were made for investigations if stem cells were isolated. Immortalization of the undifferentiated stem cell would be attempted by transfection with an oncogenic vector. Selective differentiation would be induced in the stem cell line by growing it with known growth factors and immune response modulators. Interest is in identifying any surface antigens unique to stem cells that would help in their characterization. Another goal was to search for markers on stem cells that would distinguish them from stem cells committed to a particular lineage. If the undifferentiated hematopoietic stem cell was obtained, the pathways that would terminally convert it to myeloid, lyphoid

  9. Stereo morphology of temporal bone and ear

    Institute of Scientific and Technical Information of China (English)

    戴朴; 刘阳; 姜泗长; 方耀云; 王今; 杨伟炎

    2004-01-01

    Background The temporal bone has the most complicated anatomic feature among the whole human body, which always challenges otolaryngologists. This study was to study three-dimensional (3D) morphology of the temporal bone and the ear by means of a computer image processing technique, for the purpose of providing a 3D image to help in pathological, diagnostic and surgical procedures. Methods Forty sets of temporal bone celloidin serial sections with reference points were prepared and the contours of selected structures and reference points were entered into a graphics programme. The technique of computer-aided 3D reconstruction was applied to obtain 3D images and parameters of the temporal bones and the ears. Stereo views of the ossicles (n=5), the facial nerves (n=11), the posterior tympanic sinuses (n=11), the posterior ampullary nerves (n=4), the endolymphatic ducts and sacs (n=5), and the bony and membranous labyrinth (n=1) were reconstructed. Results Three-dimensional images, including the cochlea, the ossicles, the nerves, the tendons and the endolymphatic fluid system in the temporal bone, were obtained. Stereo picture pairs and 3D parameters of spatial dimensions, angle and volume for these reconstructed structures were calculated. The arrangement of the ossicles, spatial relationship of the bony and membranous labyrinth, the whole course of the facial nerves, the endolymphatic sac and posterior tympanic cavity were clearly observable. Stereo picture pairs made the spatial relationships among the above-mentioned structures much clearer. The operation of the posterior ampullary nerve transection was designed and simulated on the graphic computer based on 3D anatomic investigations. Conclusion The technique of computer-aided 3D reconstruction provides a new tool to observe the morphology of the temporal bone and thus may allow design and study of new surgical approaches.

  10. Bone tumors: Nursing care

    International Nuclear Information System (INIS)

    Bone tumors represent approximately 5% of childhood malignancies. osteosarcoma is the primary malignant bone tumor, accounting for 60% of cancer with peak incidence in the 2nd decade of life. Ewing's sarcoma is the second most common bone cancer with peak at a slightly younger age. This presentation discusses similarities and differences in the diagnosis and treatment of these two malignancies. Diagnostic procedures include plain radiographs, CT and MRI of the primary site, plain x-ray and CT of the chest, bone scan, and biopsy of the primary tumor. For patients diagnosed with Ewing's sarcoma, a bone marrow aspirate and biopsy will also be required. Our current approach to the treatment of bone tumors includes preoperative combination chemotherapy and en bloc surgical removal of the tumor followed by postoperative chemotherapy. In the case of Ewing's sarcoma, radiation therapy may be employed in addition to surgery, if margins are questionable of instead of surgery, if the tumor is not resectable

  11. Malignant transformation of a unicameral bone cyst in a cat.

    Science.gov (United States)

    Berger, Björn; Brühschwein, Andreas; Eddicks, Lina; Meyer-Lindenberg, Andrea

    2016-04-01

    A unicameral bone cyst in the proximal humerus of a 3-year-old Norwegian forest cat was diagnosed by dynamic contrast-enhanced magnetic resonance imaging, surgical exploration, and histopathology. Surgical curettage and incorporation of bone cement led to full recovery. An osteosarcoma developed at the surgical site 17 months later. Thoracic radiographs showed pulmonary lesions consistent with metastasis. PMID:27041754

  12. Simulating the Lunar Environment: Partial Weightbearing and High-LET Radiation-Induce Bone Loss and Increase Sclerostin-Positive Osteocytes.

    Science.gov (United States)

    Macias, B R; Lima, F; Swift, J M; Shirazi-Fard, Y; Greene, E S; Allen, M R; Fluckey, J; Hogan, H A; Braby, L; Wang, Suojin; Bloomfield, S A

    2016-09-01

    Exploration missions to the Moon or Mars will expose astronauts to galactic cosmic radiation and low gravitational fields. Exposure to reduced weightbearing and radiation independently result in bone loss. However, no data exist regarding the skeletal consequences of combining low-dose, high-linear energy transfer (LET) radiation and partial weightbearing. We hypothesized that simulated galactic cosmic radiation would exacerbate bone loss in animals held at one-sixth body weight (G/6) without radiation exposure. Female BALB/cByJ four-month-old mice were randomly assigned to one of the following treatment groups: 1 gravity (1G) control; 1G with radiation; G/6 control; and G/6 with radiation. Mice were exposed to either silicon-28 or X-ray radiation. (28)Si radiation (300 MeV/nucleon) was administered at acute doses of 0 (sham), 0.17 and 0.5 Gy, or in three fractionated doses of 0.17 Gy each over seven days. X radiation (250 kV) was administered at acute doses of 0 (sham), 0.17, 0.5 and 1 Gy, or in three fractionated doses of 0.33 Gy each over 14 days. Bones were harvested 21 days after the first exposure. Acute 1 Gy X-ray irradiation during G/6, and acute or fractionated 0.5 Gy (28)Si irradiation during 1G resulted in significantly lower cancellous mass [percentage bone volume/total volume (%BV/TV), by microcomputed tomography]. In addition, G/6 significantly reduced %BV/TV compared to 1G controls. When acute X-ray irradiation was combined with G/6, distal femur %BV/TV was significantly lower compared to G/6 control. Fractionated X-ray irradiation during G/6 protected against radiation-induced losses in %BV/TV and trabecular number, while fractionated (28)Si irradiation during 1G exacerbated the effects compared to single-dose exposure. Impaired bone formation capacity, measured by percentage mineralizing surface, can partially explain the lower cortical bone thickness. Moreover, both partial weightbearing and (28)Si-ion exposure contribute to a higher proportion of

  13. Curative effect of bone transport for infectious large segmental bone defect after surgical treatment for tibial fracture%骨搬移术治疗胫骨骨折术后感染性大段骨缺损的疗效分析

    Institute of Scientific and Technical Information of China (English)

    郝光亮; 张贵春; 曹学成

    2014-01-01

    背景:胫骨骨折术后感染性大段骨缺损的发生率高,治疗困难,效果不理想。目前,骨缺损修复方法包括皮瓣覆盖+自体骨移植术、异体骨或异种骨移植、带血供腓骨移植、骨延长和骨搬移术。  目的:探讨骨搬移术治疗胫骨骨折术后感染性大段骨缺损的疗效。  方法:选取2010年9月至2014年9月收治的胫骨骨折术后感染性大段骨缺损患者40例,男24例,女16例;年龄18~64岁,平均(42.8±12.1)岁。将患者随机分成两组各20例,一组采用Orthofix单臂外固定延长架截骨延长,另一组采用Ilizarov环形外固定延长架截骨延长,术后随访对比两组患者的手术时间、手术出血量、HHS膝关节功能评分、Baird-Jackson踝关节功能评分。  结果:Orthofix单臂外固定延长架的手术时间较短、手术出血量较少,与Ilizarov环形外固定延长架比较均有统计学差异(P<0.05)。两组患者的术后HHS膝关节功能评分、Baird-Jackson踝关节功能评分均较术前有明显提高(P<0.01)。  结论:骨搬移术治疗胫骨骨折术后感染性大段骨缺损的疗效佳,可较好地改善患者的膝关节和踝关节功能。其中Or-thofix单臂外固定延长架能减少手术创伤,安全性较高,但骨搬运过程中容易发生延长骨成角和偏移;Ilizarov环形外固定延长架的术中应用置入较多钢针,移动时可造成部分皮瓣坏死和血管损伤,应避免在皮瓣覆盖创面的胫骨大段骨缺损患者中使用。%Background:There are high incidences of infectious large segmental bone defect after surgical treatment for tibial fracture, and it is very difficult to be cured. At present, there are a few of methods for repairing bone defect, such as skin flap cover-age plus autogenous bone transplantation, allograft bone or xenogeneic bone transplantation, vascularized fibular graft, bone lengthening and bone

  14. Computer-assisted preoperative simulation for positioning of plate fixation in Lefort I osteotomy: A case report.

    Science.gov (United States)

    Suenaga, Hideyuki; Taniguchi, Asako; Yonenaga, Kazumichi; Hoshi, Kazuto; Takato, Tsuyoshi

    2016-06-01

    Computed tomography images are used for three-dimensional planning in orthognathic surgery. This facilitates the actual surgery by simulating the surgical scenario. We performed a computer-assisted virtual orthognathic surgical procedure using optically scanned three-dimensional (3D) data and real computed tomography data on a personal computer. It helped maxillary bone movement and positioning and the titanium plate temporary fixation and positioning. This simulated the surgical procedure, which made the procedure easy, and we could perform precise actual surgery and could forecast the postsurgery outcome. This simulation method promises great potential in orthognathic surgery to help surgeons plan and perform operative procedures more precisely.

  15. Pterion: An anatomical variation and surgical landmark

    Directory of Open Access Journals (Sweden)

    Prashant E Natekar

    2011-01-01

    Full Text Available Introduction : The frontal and the parietal bones superiorly and the greater wing of the sphenoid and the squamous temporal inferiorly of one side meet at an H-shaped sutural junction termed the pterion. This is an important anatomical and anthropological landmark as it overlies both the anterior branch of middle meningeal artery and the lateral fissure of the cerebral hemisphere. The knowledge of sutural joints between frontal, parietal, sphenoid and temporal bones at pterion is clinically, radiologically and surgically important during surgical interventions involving burr hole surgeries. Materials and Methods : Study performed on 150 dry temporal bones. The pterion, and its sutural articulations with frontal, parietal, sphenoid and temporal bones and also anatomical variations, if any, were studied. Results : Four types of pterion, i.e. sphenoparietal, frontotemporal, stellate and epipteric, were observed. Conclusions : The knowledge of the variations of pterion and its surgical anatomy, in Indian population are important for surgeons operating in the fieldThe present study will also contribute additional information of skull bone fractures in infancy and early childhood, which may be associated with large intersutural bones giving false appearance of fracture radiologically and also during surgical interventions involving burr hole surgeries, as their extensions may lead to continuation of fracture lines.

  16. BROWN TUMOR OF THE FACIAL BONES

    Directory of Open Access Journals (Sweden)

    Violeta Trandafir

    2010-11-01

    Full Text Available Brown tumor arises as a direct result of the effect of parathyroid hormone on bone tissue in some patients with hyperparathyroidism. The lesion localizes in areas of intense bone resorbtion, and the bone defect becomes filled with fibroblastic tissue that can deform the bone and simulate a neoplastic process. Brown tumors can affect the mandible, maxilla, clavicle, ribs and pelvic bones. Most patients with hyperparathyroidism are asymptomatic. Skeletal changes may represent the first manifestations of the disease. Radiologically, brown tumor in the jaws presents as a well-defined radiolucent osteolytic lesion, making it hard to differentiate it from other maxillary expansive lesions that can present with a similar imaging. Brown tumors exhibit no pathognomonic histologic changes. Differentiating between a brown tumor and other giant-cell tumors may be very difficult, even with histology. A final diagnosis can be defined only by evaluating the radiological findings with histopathological, laboratory and clinical data. At present, brown tumor is considered as a reparative cellular process rather than a real neoplasia. This phenomenon is considered as pathognomonic of hyperparathyroidism secondary to renal failure, especially in patients on long-term hemodialysis. The initial treatment of brown tumor involves control of hyperparathyroidism, regardless of whether it is primary or secondary. The clinical management of brown tumor aims primarily to reduce the elevated parathyroid hormone levels by pharmacological treatment. Surgical treatment is reserved to nonresponders or to patients with painful symptomatology or alteration of normal function. Brown tumor can recur if hyperparathyroidism persists or recurs.

  17. Decomposition of two-component ultrasound pulses in cancellous bone using modified least squares prony method--phantom experiment and simulation.

    Science.gov (United States)

    Wear, Keith A

    2010-02-01

    Porous media such as cancellous bone often support the simultaneous propagation of two compressional waves. When small bone samples are interrogated in through-transmission with broadband sources, these two waves often overlap in time. The modified least-squares Prony's (MLSP) method was tested for decomposing a 500 kHz-center-frequency signal containing two overlapping components: one passing through a polycarbonate plate (to produce the "fast" wave) and another passing through a cancellous-bone-mimicking phantom (to produce the "slow" wave). The MLSP method yielded estimates of attenuation slopes accurate to within 7% (polycarbonate plate) and 2% (cancellous bone phantom). The MLSP method yielded estimates of phase velocities accurate to within 1.5% (both media). The MLSP method was also tested on simulated data generated using attenuation slopes and phase velocities corresponding to bovine cancellous bone. Throughout broad ranges of signal-to-noise ratio (SNR), the MLSP method yielded estimates of attenuation slope that were accurate to within 1.0% and estimates of phase velocity that were accurate to within 4.3% (fast wave) and 1.3% (slow wave).

  18. A Digital Model to Simulate Effects of Bone Architecture Variations on Texture at Spatial Resolutions of CT, HR-pQCT, and μCT Scanners

    Directory of Open Access Journals (Sweden)

    T. Lowitz

    2014-01-01

    Full Text Available The quantification of changes in the trabecular bone structure induced by musculoskeletal diseases like osteoarthritis, osteoporosis, rheumatoid arthritis, and others by means of a texture analysis is a valuable tool which is expected to improve the diagnosis and monitoring of a disease. The reaction of texture parameters on different alterations in the architecture of the fine trabecular network and inherent imaging factors such as spatial resolution or image noise has to be understood in detail to ensure an accurate and reliable determination of the current bone state. Therefore, a digital model for the quantitative analysis of cancellous bone structures was developed. Five parameters were used for texture analysis: entropy, global and local inhomogeneity, local anisotropy, and variogram slope. Various generic structural changes of cancellous bone were simulated for different spatial resolutions. Additionally, the dependence of the texture parameters on tissue mineralization and noise was investigated. The present work explains changes in texture parameter outcomes based on structural changes originating from structure modifications and reveals that a texture analysis could provide useful information for a trabecular bone analysis even at resolutions below the dimensions of single trabeculae.

  19. Bone Biopsy

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Bone Biopsy Bone biopsy uses a needle and imaging guidance ... limitations of Bone Biopsy? What is a Bone Biopsy? A bone biopsy is an image-guided procedure ...

  20. Bone Diseases

    Science.gov (United States)

    ... avoid smoking and drinking too much alcohol. Bone diseases can make bones easy to break. Different kinds ... break Osteogenesis imperfecta makes your bones brittle Paget's disease of bone makes them weak Bones can also ...

  1. Primary implant stability in a bone model simulating clinical situations for the posterior maxilla: an in vitro study

    Science.gov (United States)

    2016-01-01

    Purpose The aim of this study was to determine the influence of anatomical conditions on primary stability in the models simulating posterior maxilla. Methods Polyurethane blocks were designed to simulate monocortical (M) and bicortical (B) conditions. Each condition had four subgroups measuring 3 mm (M3, B3), 5 mm (M5, B5), 8 mm (M8, B8), and 12 mm (M12, B12) in residual bone height (RBH). After implant placement, the implant stability quotient (ISQ), Periotest value (PTV), insertion torque (IT), and reverse torque (RT) were measured. Two-factor ANOVA (two cortical conditions×four RBHs) and additional analyses for simple main effects were performed. Results A significant interaction between cortical condition and RBH was demonstrated for all methods measuring stability with two-factor ANOVA. In the analyses for simple main effects, ISQ and PTV were statistically higher in the bicortical groups than the corresponding monocortical groups, respectively. In the monocortical group, ISQ and PTV showed a statistically significant rise with increasing RBH. Measurements of IT and RT showed a similar tendency, measuring highest in the M3 group, followed by the M8, the M5, and the M12 groups. In the bicortical group, all variables showed a similar tendency, with different degrees of rise and decline. The B8 group showed the highest values, followed by the B12, the B5, and the B3 groups. The highest coefficient was demonstrated between ISQ and PTV. Conclusions Primary stability was enhanced by the presence of bicortex and increased RBH, which may be better demonstrated by ISQ and PTV than by IT and RT. PMID:27588215

  2. Endotoxins in surgical instruments of hip arthroplasty

    Directory of Open Access Journals (Sweden)

    Vania Regina Goveia

    2016-06-01

    Full Text Available Abstract OBJECTIVE To investigate endotoxins in sterilized surgical instruments used in hip arthroplasties. METHOD A descriptive exploratory study conducted in a public teaching hospital. Six types of surgical instruments were selected, namely: acetabulum rasp, femoral rasp, femoral head remover, chisel box, flexible bone reamer and femoral head test. The selection was based on the analysis of the difficulty in removing bone and blood residues during cleaning. The sample was made up of 60 surgical instruments, which were tested for endotoxins in three different stages. The EndosafeTM Gel-Clot LAL (Limulus Amebocyte Lysate method was used. RESULT There was consistent gel formation with positive analysis in eight instruments, corresponding to 13.3%, being four femoral rasps and four bone reamers. CONCLUSION Endotoxins in quantity ≥0.125 UE/mL were detected in 13.3% of the instruments tested.

  3. Maxillary sinus floor augmentation on humans: Packing simulations and 8 months histomorphometric comparative study of anorganic bone matrix and β-tricalcium phosphate particles as grafting materials

    OpenAIRE

    Martinez, A; Franco, J.; Saiz, E.; Guitian, F.

    2010-01-01

    The present study compares the behaviour of an anorganic bone matrix material and a synthetic β-Tricalcium phosphate employed as grafting materials in a sinus floor augmentation two step protocol in humans. In order to estimate the initial occupation level for the two materials, an ‘in vitro’ simulation has been performed to analyse macroporosity created due to particle packing in terms of porosity and interparticle distances. Grafting in the sinus floor augmentation was performed by filling ...

  4. Towards Safe Robotic Surgical Systems

    DEFF Research Database (Denmark)

    Sloth, Christoffer; Wisniewski, Rafael

    2015-01-01

    A proof of safety is paramount for an autonomous robotic surgical system to ensure that it does not cause trauma to patients. However, a proof of safety is rarely constructed, as surgical systems are too complex to be dealt with by most formal verification methods. In this paper, we design...... a controller for motion compensation in beating-heart surgery, and prove that it is safe, i.e., the surgical tool is kept within an allowable distance and orientation of the heart. We solve the problem by simultaneously finding a control law and a barrier function. The motion compensation system is simulated...

  5. Fixation of non-cemented total hip arthroplasty femoral components in a simulated proximal bone defect model.

    Science.gov (United States)

    Sangiorgio, Sophia N; Ebramzadeh, Edward; Knutsen, Ashleen R; Borkowski, Sean L; Kalma, Jeremy J; Bengs, Benjamin C

    2013-10-01

    An accelerated sequential proximal femoral bone loss model was used to measure the initial stability of three noncemented femoral stem designs: fully porous-coated, proximally porous-coated, and dual-tapered, diaphyseal press-fit (N=18). Only dual-tapered, diaphyseal press-fit stems remained stable with as much as 105 mm of bone loss, with average cyclic micromotion remaining below 25 μm in ML and below 10 μm in AP planes. In contrast, with proximally coated and fully coated stem designs with circular or oval cross-sections, 60mm of bone loss, resulting in lower than 10 cm of diaphyseal bone contact length, led to gross instability, increasing average cyclic micromotions to greater than 100 μm prior to failure. Therefore, the results provide support for using a dual-tapered stem in revision cases with proximal bone loss. PMID:23523487

  6. Application of surgical simulation system to the teaching of orthognathic surgery%手术虚拟系统在正颌外科教学中的应用

    Institute of Scientific and Technical Information of China (English)

    于洪波; 代杰文; 于德栋; 沈国芳

    2014-01-01

    Orthognathic surgical procedure is relatively complex and poses high requirements for accuracy and minimal invasion .However , the means of surgical teaching and training is limited .Because of its special advantages , virtual reality ( VR ) technology plays an important role in the teaching of orthognathic surgery .This paper describes the value and significance of surgical simulation and operation training.Based on the application of surgical simulation in orthognathic surgery , the paper illustrates the role, advantages and application prospects of VR technology to orthognathic surgery teaching .%治疗牙颌面畸形的正颌手术操作相对复杂,对精度及微创的要求较高。而其手术教学及操作培训的手段有限。虚拟现实技术以其独有的优势,在正颌外科教学中具有重要意义。该文介绍了手术虚拟及操作培训的价值及意义,并结合虚拟现实技术在正颌外科的应用实例,阐述了其在正颌外科教学中的作用、优势及其应用前景。

  7. Phantom studies using a high-resolution CT for ex-vivo imaging of degradable magnesium implants and simulated peri-implant bone formation in rabbit tibiae

    International Nuclear Information System (INIS)

    Purpose: Evaluation of the suitability of the high-resolution CT XtremeCT for ex vivo imaging of degradable magnesium implants with simulated peri-implant bone formation in rabbit tibiae and development of a method for calibrating the mass concentration of a magnesium alloy in an implant volume. Materials and Methods: Using specially designed phantoms, degradable magnesium implants of the alloys LAE442, ZEK100, AX30 and MgCa 0.8 %, without coating and with peri-implant bone formation simulated by a coating, as well as rabbit tibiae were scanned. CT numbers and the contrast-to-noise-ratio (CNR) of the studied materials were determined. The visual distinction between implant and coating was evaluated. To calibrate the implant density, exemplary LAE442 pins with different mass concentrations were scanned using a specially constructed phantom. Subsequently, CT numbers corresponding to the appropriate mass concentration were determined. Results: The implants, coating and substantia corticalis showed a similar density. Visual distinction between coating and implant was strongly dependent on the respective magnesium alloy and chosen scan parameter. A CNR of at least 0.2 was required for a distinction between implant and coating. For the mass concentration, a high CT number linearity (R2 = 0.99) throughout the measuring range (1811 - 1273 mg/cm3 LAE442) was found. Conclusion: As expected, the XtremeCT is primarily suitable for the imaging of bone tissue and implants. Good visual distinction of peri-implant bone formation on magnesium implants in an ex vivo phantom model ranges from possible to difficult depending on the bone density and alloy composition. (orig.)

  8. Bone cysts: unicameral and aneurysmal bone cyst.

    Science.gov (United States)

    Mascard, E; Gomez-Brouchet, A; Lambot, K

    2015-02-01

    Simple and aneurysmal bone cysts are benign lytic bone lesions, usually encountered in children and adolescents. Simple bone cyst is a cystic, fluid-filled lesion, which may be unicameral (UBC) or partially separated. UBC can involve all bones, but usually the long bone metaphysis and otherwise primarily the proximal humerus and proximal femur. The classic aneurysmal bone cyst (ABC) is an expansive and hemorrhagic tumor, usually showing characteristic translocation. About 30% of ABCs are secondary, without translocation; they occur in reaction to another, usually benign, bone lesion. ABCs are metaphyseal, excentric, bulging, fluid-filled and multicameral, and may develop in all bones of the skeleton. On MRI, the fluid level is evocative. It is mandatory to distinguish ABC from UBC, as prognosis and treatment are different. UBCs resolve spontaneously between adolescence and adulthood; the main concern is the risk of pathologic fracture. Treatment in non-threatening forms consists in intracystic injection of methylprednisolone. When there is a risk of fracture, especially of the femoral neck, surgery with curettage, filling with bone substitute or graft and osteosynthesis may be required. ABCs are potentially more aggressive, with a risk of bone destruction. Diagnosis must systematically be confirmed by biopsy, identifying soft-tissue parts, as telangiectatic sarcoma can mimic ABC. Intra-lesional sclerotherapy with alcohol is an effective treatment. In spinal ABC and in aggressive lesions with a risk of fracture, surgical treatment should be preferred, possibly after preoperative embolization. The risk of malignant transformation is very low, except in case of radiation therapy. PMID:25579825

  9. SURGICAL NUTRITION

    Directory of Open Access Journals (Sweden)

    Danny Kurniawan Darianto

    2015-07-01

    Full Text Available A patient undergoing surgery faces great physiologic and psychologic stress. so nutritional demands are greatly increased during this period and deficiencies can easily develop. If these deficiencies are allowed to develop and are not in screening, serious malnutrition and clinical problem can occur. Therefore careful attention must be given to a patient's nutritional status in preparation of surgery, as well as to the individual nutritional needs. If these needs are met, complications are less likely developing. Natural resources provide for rapid recovery. Proper nutrition can speed healing in surgical patients with major trauma, severe malnutition, burns, and other severe illnesses. New techniques for tube feeding, intravenous nutrition for patients with serious weight loss due to gastrointestinal disorders, and use of supplements can hasten wound healing and shorten recovery times.

  10. Uncemented Total Hip Replacement Stem Loosening after Long Term Compressive Stress Application: A Simulated FEA Study of Cortical Bone Remodeling

    Science.gov (United States)

    Jung, Duk-Young; Tsutsumi, Sadami; Nakai, Ryusuke; Ikeuchi, Ken; Sekel, Ron

    The purpose of this study is to predict with the use of FEA, the differing predisposition to cortical bone resorption and subsequent distal migration of an un-cemented femoral hip replacement stem subjected to long term biomechanical high compressive stresses, while varying the load angles, the material properties of the stem, and the stem length. A two-dimensional hip model was constructed to estimate the minimum principle stresses (P3) and migration magnitudes. Bone remodeling at the interface between the bone and the prosthesis was performed by comparison of the local compressive stress to physiological stress values governing bone resorption. With respect to load angles, migrations of the hip prosthesis did not occur with load angles between 63° and 74° load angle in relation to the longitudinal axis of the bony femur, as the compressive stress generated on the cortical bone was under the criteria threshold for bone resorption (-50MPa). In addition, the magnitude of migration (17%decrease) was relatively more sensitive to changes in stem length than those (92%decrease) of changes of material properties. In conclusion, using an FEA model for bone remodeling, based on the high compressive stresses exerted on distal cortical bone, it is possible to estimate migration magnitudes of cementless hip prostheses in the long term. The load angles have been shown to be an important parameter affecting the migration magnitudes and furthermore, it can be demonstrated that the stiffer materials and reduction of stem length can decrease the migration of cementless hip prosthesis in the long term.

  11. Educational value of virtual reality skill in the surgical anatomy of petrous bone%虚拟现实技术在岩骨手术解剖教学中的作用

    Institute of Scientific and Technical Information of China (English)

    赵亚群; 汤可; 周敬安

    2012-01-01

    背景:岩骨解剖形态和空间构筑关系复杂,手术教学难度大.计算机虚拟现实技术因其高效、直观、交互性等优点,用于岩骨手术解剖教学开发潜力巨大.目的:评估虚拟现实技术建立岩骨三维解剖模型在岩骨手术教学中的价值.方法:1例非颅底病变患者头颅CT Dicom格式数据导入虚拟现实工作站进行三维重建,利用工作站中的图像处理软件提取岩骨表面和内部解剖结构图像,构建岩骨三维解剖模型.选取志愿者40名随机分为2组,每组20名,受试组安排阅读教科书结合虚拟影像模型观察,对照组仅安排阅读教科书.在学习后1,2周分别进行相关解剖知识笔试和图谱标识测试.结果与结论:岩骨虚拟现实解剖模型可视化效果良好.学习后1周测试,受试组解剖知识笔试和图谱标识成绩高于对照组,差异有显著性意义(P 0.05),受试组图谱标识成绩高于对照组,差异有显著性意义(P 0.05). However, the illustration marking score of examined group was significantly higher than that of control group, and there was significant difference of illustration marking score between two groups (P < 0.05). The virtual reality three-dimensional model has good advantages in the surgical education of petrous bone.

  12. Bone Grafts

    Science.gov (United States)

    ... repair and rebuild diseased bones in your hips, knees, spine, and sometimes other bones and joints. Grafts can also repair bone loss caused by some types of fractures or cancers. Once your body accepts the bone ...

  13. Bone within a bone

    Energy Technology Data Exchange (ETDEWEB)

    Williams, H.J.; Davies, A.M. E-mail: wendy.turner@roh.nhs.uk; Chapman, S

    2004-02-01

    The 'bone within a bone' appearance is a well-recognized radiological term with a variety of causes. It is important to recognize this appearance and also to be aware of the differential diagnosis. A number of common conditions infrequently cause this appearance. Other causes are rare and some remain primarily of historical interest, as they are no longer encountered in clinical practice. In this review we illustrate some of the conditions that can give the bone within a bone appearance and discuss the physiological and pathological aetiology of each where known.

  14. 肱骨近段锁定板结合植骨治疗肱骨外科颈Ⅱ、Ⅲ型骨折疗效观察%Clinical Observation of Locking Proximal Humerus Plate Combining Bone Graft in Treating Humerus Surgical Neck Fracture (NearⅡ,Ⅲ)

    Institute of Scientific and Technical Information of China (English)

    李家德; 陈榆; 钟永祥; 林晓; 辛伟光; 付新美; 吴永辉; 黄杨; 颜灵松

    2011-01-01

    Objective To evaluate the clinical results of open reduction and internal fixation combining bone graft in the treatment of humerus surgical neck fracture (NeerⅡ, Ⅲ). Methods Twenty-one cases of humerus surgical neck fractures (Neer Ⅱ: 5 cases; Neer Ⅲ: 16 cases) were treated by locking proximal humerus plate combining bone grafting. Results All patients were followed for more than 6 months on average, all of the fractures were healed and got satisfactory results of shoulder functional recovery. The results were excellent and good in 18 cases, the good rate was 85.7%. Conclusion Locking proximal humerus plate fracture fragments combining bone graft is conductive to the fracture healing and shoulder functional recovery. It is an effective method in the treatment of humerus surgical neck fracture (Near Ⅱ, Ⅲ ).%目的 评价切开复位内固定加植骨治疗肱骨外科颈Ⅱ、Ⅲ型骨折的疗效.方法 采用肱骨近段锁定板结合植骨治疗肱骨外科颈骨折21例,根据Neer分型,Ⅱ型5例,Ⅲ型16例;其中二部分骨折5例,三部分骨折10例,四部分骨折6例.结果 所有病例均随访6个月以上,骨折全部愈合,肩关节功能恢复满意,优良率85.7%.结论 肱骨近段锁定板结合植骨有利于骨折断端愈合、肩关节功能的恢复,是治疗肱骨外科颈Ⅱ、Ⅲ型骨折的有效方法.

  15. Surgical disaster in temporomandibular joint: Case report

    Directory of Open Access Journals (Sweden)

    Guilherme Machado De Carvalho

    2014-07-01

    Conclusion: Since there is no corrective treatment for this type of injuries, the craniomaxillofacial surgeon and other professionals who carry out interventions of this nature need perfect knowledge of the anatomy of the temporal bone and lateral skull base, taking into account the risk of surgical disasters like the one here reported.

  16. Effects of bone materials on the screw pull-out strength in human spine.

    Science.gov (United States)

    Zhang, Qing Hang; Tan, Soon Huat; Chou, Siaw Meng

    2006-10-01

    A three-dimensional finite element model simulating the threaded connections including detailed helix curve for the bone and surgical screw was constructed. Validation of the FE model was conducted by comparing the predicted screw pull-out strength in different foam materials against experimental study. The FE model was then further analyzed to investigate the interaction of bone material and purchase length on the screw pull-out strength. The results show that failure of the connection was due to bone shearing which occurred along a cylindrical surface determined by the outer perimeter of the screw. The cortical shell resists around 50% of the pull-out strength for a screw of 4mm in major diameter and 22 mm in length. The effects of purchase length on the pull-out strength were different for different bone material. It is the bone material that determines the stability of the inserted surgical screw. The significance of the purchase length on the pull-out strength of cortical screw will be much lower than that in cancellous bone screw. PMID:16414303

  17. CT pre-operative planning of a new semi-implantable bone conduction hearing device

    Energy Technology Data Exchange (ETDEWEB)

    Law, Eric K.C.; Bhatia, Kunwar S.S. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Hong Kong, SAR (China); Tsang, Willis S.S.; Tong, Michael C.F. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Otorhinolaryngology, Head and Neck Surgery, Hong Kong, SAR (China); Shi, Lin [The Chinese University of Hong Kong, Department of Medicine and Therapeutics, Hong Kong, SAR (China); The Chinese University of Hong Kong, Chow Yuk Ho Technology Center for Innovative Medicine, Hong Kong, SAR (China)

    2016-06-15

    Accommodating a novel semi-implantable bone conduction hearing device within the temporal bone presents challenges for surgical planning. This study describes the utility of CT in pre-operative assessment of such an implant. Retrospective review of pre-operative CT, clinical and surgical records of 16 adults considered for device implantation. Radiological suitability was assessed on CT using 3D simulation software. Antero-posterior (AP) dimensions of the mastoid bone and minimum skull thickness were measured. CT planning results were correlated with operative records. Eight and five candidates were suitable for device placement in the transmastoid and retrosigmoid positions, respectively, and three were radiologically unsuitable. The mean AP diameter of the mastoid cavity was 14.6 mm for the transmastoid group and 4.6 mm for the retrosigmoid group (p < 0.05). Contracted mastoid and/or prior surgery were predisposing factors for unsuitability. Four transmastoid and five retrosigmoid positions required sigmoid sinus/dural depression and/or use of lifts due to insufficient bone capacity. A high proportion of patients being considered have contracted or operated mastoids, which reduces the feasibility of the transmastoid approach. This finding combined with the complex temporal bone geometry illustrates the importance of careful CT evaluation using 3D software for precise device simulation. (orig.)

  18. Previous exposure to simulated microgravity does not exacerbate bone loss during subsequent exposure in the proximal tibia of adult rats.

    Science.gov (United States)

    Shirazi-Fard, Yasaman; Anthony, Rachel A; Kwaczala, Andrea T; Judex, Stefan; Bloomfield, Susan A; Hogan, Harry A

    2013-10-01

    Extended periods of inactivity cause severe bone loss and concomitant deterioration of the musculoskeletal system. Considerable research has been aimed at better understanding the mechanisms and consequences of bone loss due to unloading and the associated effects on strength and fracture risk. One factor that has not been studied extensively but is of great interest, particularly for human spaceflight, is how multiple or repeated exposures to unloading and reloading affect the skeleton. Space agencies worldwide anticipate increased usage of repeat-flier crewmembers, and major thrust of research has focused on better understanding of microgravity effects on loss of bone density at weightbearing skeletal sites; however there is limited data available on repeat microgravity exposure. The adult hindlimb unloaded (HU) rat model was used to determine how an initial unloading cycle will affect a subsequent exposure to disuse and recovery thereafter. Animals underwent 28 days of HU starting at 6 months of age followed by 56 days of recovery, and then another 28 days of HU with 56 days of recovery. In vivo longitudinal pQCT was used to quantify bone morphological changes, and ex vivo μCT was used to quantify trabecular microarchitecture and cortical shell geometry at the proximal tibia metaphysis (PTM). The mechanical properties of trabecular bone were examined by the reduced platen compression mechanical test. The hypothesis that the initial HU exposure will mitigate decrements in bone mass and density for the second HU exposure was supported as pre- to post-HU declines in total BMC, total vBMD, and cortical area by in vivo pQCT at the proximal tibia metaphysis were milder for the second HU (and not significant) compared to an age-matched single HU (3% vs. 6%, 2% vs. 6%, and 2% vs. 6%, respectively). In contrast, the hypothesis was not supported at the microarchitectural level as losses in BV/TV and Tb.Th. were similar during 2nd HU exposure and age-matched single HU

  19. Surgical tools and medical devices

    CERN Document Server

    Jackson, Mark

    2016-01-01

    This new edition presents information and knowledge on the field of biomedical devices and surgical tools. The authors look at the interactions between nanotechnology, nanomaterials, design, modeling, and tools for surgical and dental applications, as well as how nanostructured surfaces can be created for the purposes of improving cell adhesion between medical devices and the human body. Each original chapter is revised in this second edition and describes developments in coatings for heart valves, stents, hip and knee joints, cardiovascular devices, orthodontic applications, and regenerative materials such as bone substitutes. There are also 8 new chapters that address: Microvascular anastomoses Inhaler devices used for pulmonary delivery of medical aerosols Surface modification of interference screws Biomechanics of the mandible (a detailed case study) Safety and medical devices The synthesis of nanostructured material Delivery of anticancer molecules using carbon nanotubes Nano and micro coatings for medic...

  20. Simulated bone remodeling around two types of osseointegrated implants for direct fixation of upper-leg prostheses

    NARCIS (Netherlands)

    Tomaszewski, P.K.; Verdonschot, N.; Bulstra, S.K.; Rietman, J.S.; Verkerke, G.J.

    2012-01-01

    Direct attachment of an upper leg prosthesis to the skeletal system by a percutaneous implant is an alternative solution to the traditional socket fixation. In this study, we investigated long-term periprosthetic bone changes around two types of fixation implants using two different initial conditio

  1. Measurements of simulated periodontal bone defects in inverted digital image and film-based radiograph: an in vitro study

    Energy Technology Data Exchange (ETDEWEB)

    Molon, Rafael Scaf; Morais Camillo, Juliana Aparecida Najarro Dearo; Ferreira, Mauricio Goncalves; Loffredo, Leonor Castro Monteiro; Scaf, Gulnara [Araraquara Dental School, Universidade Estadual Paulista, Sao Paulo (Brazil); Sakakura, Celso Eduardo [Barretos Dental School, Barretos Educational Fundation, Sao Paulo (Brazil)

    2012-09-15

    This study was performed to compare the inverted digital images and film-based images of dry pig mandibles to measure the periodontal bone defect depth. Forty 2-wall bone defects were made in the proximal region of the premolar in the dry pig mandibles. The digital and conventional radiographs were taken using a Schick sensor and Kodak F-speed intraoral film. Image manipulation (inversion) was performed using Adobe Photoshop 7.0 software. Four trained examiners made all of the radiographic measurements in millimeters a total of three times from the cementoenamel junction to the most apical extension of the bone loss with both types of images: inverted digital and film. The measurements were also made in dry mandibles using a periodontal probe and digital caliper. The Student's t-test was used to compare the depth measurements obtained from the two types of images and direct visual measurement in the dry mandibles. A significance level of 0.05 for a 95% confidence interval was used for each comparison. There was a significant difference between depth measurements in the inverted digital images and direct visual measurements (p>|t|=0.0039), with means of 6.29 mm (IC{sub 95%}:6.04-6.54) and 6.79 mm (IC{sub 95%}:6.45-7.11), respectively. There was a non-significant difference between the film-based radiographs and direct visual measurements (p>|t|=0.4950), with means of 6.64 mm(IC{sub 95%}:6.40-6.89) and 6.79 mm(IC{sub 95%}:6.45-7.11), respectively. The periodontal bone defect measurements in the inverted digital images were inferior to film-based radiographs, underestimating the amount of bone loss.

  2. Assessment of the risk factors for impending fractures following radiotherapy for long bone metastases using CT scan-based virtual simulation: a retrospective study

    International Nuclear Information System (INIS)

    Radiotherapy for long bone metastases (RTLB) can be complicated by fractures, which considerably increase morbidity and mortality. The aim of this study was to analyze the risk factors for impending fractures following radiotherapy for long bone metastases (RTLB) using CT scan-based virtual simulation. Forty-seven (47) patients were treated with RTLB (18 lung, 11 breast, 10 prostate and 8 other cancers) for a period of 18 months. Two doctors analyzed the CT images prior to radiation therapy. The impending fractures were then monitored and the correlation between bone scan parameters and fracture occurrence was analyzed. The male gender ratio was 0.57 and the mean age 62.8 (33–93) years. The average size of the metastatic lesions was 32 (8–87) x 2 (6–81) x 52 (7–408) mm with cortical involvement (CI) in 66% of cases. The site was in the upper third of the bone in 92% of cases (28 femoral, 17 humeral and two tibial). Ten fractures occurred: two during RTLB, seven after one month and one after 6.6 months. The fractured lesions measured 48 (17–87) x 34 (12–66) x 76 (38–408) mm. The predictive parameters for fracture were osteolytic (39% vs. 10%; p = 0.02) and permeative lesions (42% vs. 0%; p < 0.0005), a Mirels score ≥9 (42% vs. 0%; p < 0.0005), circumferential CI ≥30% (71% vs. 0%, p < 0.00001), CI ≥45 mm in height (67% vs. 0%, p < 0.00001) and CI in thickness =100% (40% vs. 0%; p = 0.0008). In the multivariate analysis, circumferential CI ≥30% was the only predictive parameter for fracture (p = 0.00035; OR = 62; CI 95%: 6.5-595). Overall survival was 91% and 40% at one month and twelve months respectively. Prophylactic primary fixation surgery should always be considered when the circumferential CI ≥30%

  3. Curved Beam Computed Tomography based Structural Rigidity Analysis of Bones with Simulated Lytic Defect: A Comparative Study with Finite Element Analysis

    Science.gov (United States)

    Oftadeh, R.; Karimi, Z.; Villa-Camacho, J.; Tanck, E.; Verdonschot, N.; Goebel, R.; Snyder, B. D.; Hashemi, H. N.; Vaziri, A.; Nazarian, A.

    2016-09-01

    In this paper, a CT based structural rigidity analysis (CTRA) method that incorporates bone intrinsic local curvature is introduced to assess the compressive failure load of human femur with simulated lytic defects. The proposed CTRA is based on a three dimensional curved beam theory to obtain critical stresses within the human femur model. To test the proposed method, ten human cadaveric femurs with and without simulated defects were mechanically tested under axial compression to failure. Quantitative computed tomography images were acquired from the samples, and CTRA and finite element analysis were performed to obtain the failure load as well as rigidities in both straight and curved cross sections. Experimental results were compared to the results obtained from FEA and CTRA. The failure loads predicated by curved beam CTRA and FEA are in agreement with experimental results. The results also show that the proposed method is an efficient and reliable method to find both the location and magnitude of failure load. Moreover, the results show that the proposed curved CTRA outperforms the regular straight beam CTRA, which ignores the bone intrinsic curvature and can be used as a useful tool in clinical practices.

  4. Curved Beam Computed Tomography based Structural Rigidity Analysis of Bones with Simulated Lytic Defect: A Comparative Study with Finite Element Analysis.

    Science.gov (United States)

    Oftadeh, R; Karimi, Z; Villa-Camacho, J; Tanck, E; Verdonschot, N; Goebel, R; Snyder, B D; Hashemi, H N; Vaziri, A; Nazarian, A

    2016-01-01

    In this paper, a CT based structural rigidity analysis (CTRA) method that incorporates bone intrinsic local curvature is introduced to assess the compressive failure load of human femur with simulated lytic defects. The proposed CTRA is based on a three dimensional curved beam theory to obtain critical stresses within the human femur model. To test the proposed method, ten human cadaveric femurs with and without simulated defects were mechanically tested under axial compression to failure. Quantitative computed tomography images were acquired from the samples, and CTRA and finite element analysis were performed to obtain the failure load as well as rigidities in both straight and curved cross sections. Experimental results were compared to the results obtained from FEA and CTRA. The failure loads predicated by curved beam CTRA and FEA are in agreement with experimental results. The results also show that the proposed method is an efficient and reliable method to find both the location and magnitude of failure load. Moreover, the results show that the proposed curved CTRA outperforms the regular straight beam CTRA, which ignores the bone intrinsic curvature and can be used as a useful tool in clinical practices. PMID:27585495

  5. WISE-2005: supine treadmill exercise within lower body negative pressure and flywheel resistive exercise as a countermeasure to bed rest-induced bone loss in women during 60-day simulated microgravity.

    Science.gov (United States)

    Smith, Scott M; Zwart, Sara R; Heer, Martina; Lee, Stuart M C; Baecker, Natalie; Meuche, Sabine; Macias, Brandon R; Shackelford, Linda C; Schneider, Suzanne; Hargens, Alan R

    2008-03-01

    Bone loss associated with disuse during bed rest (BR), an analog of space flight, can be attenuated by exercise. In previous studies, the efficacy of either aerobic or resistive exercise countermeasures has been examined separately. We hypothesized that a regimen of combined resistive and aerobic exercise during BR would prevent bone resorption and promote bone formation. After a 20-day ambulatory adaptation to controlled confinement and diet, 16 women participated in a 60-day, 6 degrees head-down-tilt BR and were assigned randomly to one of the two groups. Control subjects (CON, n=8) performed no countermeasure. Exercise subjects (EX, n=8) participated in an exercise program during BR, alternating between supine treadmill exercise within lower body negative pressure (3-4 d wk(-1)) and flywheel resistive exercise (2-3 d wk(-1)). By the last week of BR, excretion of helical peptide (CON, 79%+/-44 increase; EX, 64%+/-50, mean+/-SD) and N-terminal cross-linking telopeptide (CON, 51%+/-34; EX, 43%+/-56), markers of bone resorption, were greater than they were before BR in both groups (P<0.05). However, serum concentrations of the bone formation marker procollagen type I N propeptide were greater in EX than CON throughout and after bed rest (P<0.05), while concentrations of the bone formation marker bone alkaline phosphatase tended to be greater in EX than CON. Dual-energy X-ray absorptiometry results indicated that the exercise treatment significantly (P<0.05) attenuated loss of hip and leg bone mineral density in EX compared to CON. The combination of resistive and aerobic exercise did not prevent bone resorption but did promote bone formation, and helped mitigate the net bone loss associated with simulated microgravity. PMID:18249055

  6. Electronic surgical record management.

    Science.gov (United States)

    Rockman, Justin

    2010-01-01

    This paper explores the challenges surgical practices face in coordinating surgeries and how the electronic surgical record management (ESRM) approach to surgical coordination can solve these problems and improve efficiency. Surgical practices continue to experience costly inefficiencies when managing surgical coordination. Application software like practice management and electronic health record systems have enabled practices to "go digital" for their administrative, financial, and clinical data. However, surgical coordination is still a manual and labor-intensive process. Surgical practices need to create a central and secure record of their surgeries. When surgical data are inputted once only and stored in a central repository, the data are transformed into active information that can be outputted to any form, letter, calendar, or report. ESRM is a new approach to surgical coordination. It enables surgical practices to automate and streamline their processes, reduce costs, and ensure that patients receive the best possible care. PMID:20480775

  7. 根形骨块onlay移植治疗上颌前牙种植术所需的牙槽骨骨量不足%Restoration of anterior maxillar bone deficiency by simulated root-type bone graft onlay for dental implan-tation

    Institute of Scientific and Technical Information of China (English)

    张健; 杨晶; 朱甄慧; 王庆福; 王文慧

    2012-01-01

    目的:研究根形骨块移植治疗上颌骨前部骨量不足的效果.方法:通过对7例患者前牙区的26个牙位进行根形植骨术,重建牙槽骨的形态后植入种植体,术后随访时间平均10个月.结果:重建的牙槽骨唇侧丰满,骨面根形逼真,种植体无松动,无脱落,唇侧牙龈无退缩.结论:根形植骨术是治疗上颌多颗前牙缺失伴水平向骨量不足的有效手段.%Objective: To study the effects of simulated root- type bone graft onlay in the restoration of anterior maxilla bone deficiency for dental implantation. Methods: Restoration of anterior maxilla alveolar bone deficience was performed in 7 patients with 26 missing teeth by root-type bone graft,followed by dental implantation. 10 month follow-up was conducted. Results: A significant increase in the alveolar bone dimensions was achieved,labial alveolar bone presented root type. No implant was loosening or dropping,and there was no labial gingival recession. Conclusion: Root- type bone graft is effective in the restoration of anterior maxillar bone deficiency for dental implantation.

  8. Surgical innovation as sui generis surgical research.

    Science.gov (United States)

    Lotz, Mianna

    2013-12-01

    Successful innovative 'leaps' in surgical technique have the potential to contribute exponentially to surgical advancement, and thereby to improved health outcomes for patients. Such innovative leaps often occur relatively spontaneously, without substantial forethought, planning, or preparation. This feature of surgical innovation raises special challenges for ensuring sufficient evaluation and regulatory oversight of new interventions that have not been the subject of controlled investigatory exploration and review. It is this feature in particular that makes early-stage surgical innovation especially resistant to classification as 'research', with all of the attendant methodological and ethical obligations--of planning, regulation, monitoring, reporting, and publication--associated with such a classification. This paper proposes conceptual and ethical grounds for a restricted definition according to which innovation in surgical technique is classified as a form of sui generis surgical 'research', where the explicit goal of adopting such a definition is to bring about needed improvements in knowledge transfer and thereby benefit current and future patients.

  9. Biology and augmentation of tendon-bone insertion repair

    OpenAIRE

    Lui PPY; Zhang P; KM, Chan; Qin L

    2010-01-01

    Abstract Surgical reattachment of tendon and bone such as in rotator cuff repair, patellar-patella tendon repair and anterior cruciate ligament (ACL) reconstruction often fails due to the failure of regeneration of the specialized tissue ("enthesis") which connects tendon to bone. Tendon-to-bone healing taking place between inhomogenous tissues is a slow process compared to healing within homogenous tissue, such as tendon to tendon or bone to bone healing. Therefore special attention must be ...

  10. Surgical Simulation of Extradural Anterior Clinoidectomy through the Trans-superior Orbital Fissure Approach Using a Dissectable Three-dimensional Skull Base Model with Artificial Cavernous Sinus

    OpenAIRE

    Mori, Kentaro; Yamamoto, Takuji; NAKAO, Yasuaki; Esaki, Takanori

    2010-01-01

    Extradural anterior clinoidectomy via the trans-superior orbital fissure (SOF) approach can provide extensive exposure of the anterior clinoid process and safe drilling under direct view. This technique requires peeling of the dura propria of the temporal lobe from the lateral wall of the SOF. Therefore, cadaveric dissection is mandatory to acquire surgical technique. However, chances for cadaveric dissection are limited. We propose modification of our three-dimensional (3-D) skull base model...

  11. Real-time in situ three-dimensional integral videography and surgical navigation using augmented reality: a pilot study.

    Science.gov (United States)

    Suenaga, Hideyuki; Hoang Tran, Huy; Liao, Hongen; Masamune, Ken; Dohi, Takeyoshi; Hoshi, Kazuto; Mori, Yoshiyuki; Takato, Tsuyoshi

    2013-06-01

    To evaluate the feasibility and accuracy of a three-dimensional augmented reality system incorporating integral videography for imaging oral and maxillofacial regions, based on preoperative computed tomography data. Three-dimensional surface models of the jawbones, based on the computed tomography data, were used to create the integral videography images of a subject's maxillofacial area. The three-dimensional augmented reality system (integral videography display, computed tomography, a position tracker and a computer) was used to generate a three-dimensional overlay that was projected on the surgical site via a half-silvered mirror. Thereafter, a feasibility study was performed on a volunteer. The accuracy of this system was verified on a solid model while simulating bone resection. Positional registration was attained by identifying and tracking the patient/surgical instrument's position. Thus, integral videography images of jawbones, teeth and the surgical tool were superimposed in the correct position. Stereoscopic images viewed from various angles were accurately displayed. Change in the viewing angle did not negatively affect the surgeon's ability to simultaneously observe the three-dimensional images and the patient, without special glasses. The difference in three-dimensional position of each measuring point on the solid model and augmented reality navigation was almost negligible (augmented reality system was highly accurate and effective for surgical navigation and for overlaying a three-dimensional computed tomography image on a patient's surgical area, enabling the surgeon to understand the positional relationship between the preoperative image and the actual surgical site, with the naked eye.

  12. Porous surface modified bioactive bone cement for enhanced bone bonding.

    Directory of Open Access Journals (Sweden)

    Qiang He

    Full Text Available BACKGROUND: Polymethylmethacrylate bone cement cannot provide an adhesive chemical bonding to form a stable cement-bone interface. Bioactive bone cements show bone bonding ability, but their clinical application is limited because bone resorption is observed after implantation. Porous polymethylmethacrylate can be achieved with the addition of carboxymethylcellulose, alginate and gelatin microparticles to promote bone ingrowth, but the mechanical properties are too low to be used in orthopedic applications. Bone ingrowth into cement could decrease the possibility of bone resorption and promote the formation of a stable interface. However, scarce literature is reported on bioactive bone cements that allow bone ingrowth. In this paper, we reported a porous surface modified bioactive bone cement with desired mechanical properties, which could allow for bone ingrowth. MATERIALS AND METHODS: The porous surface modified bioactive bone cement was evaluated to determine its handling characteristics, mechanical properties and behavior in a simulated body fluid. The in vitro cellular responses of the samples were also investigated in terms of cell attachment, proliferation, and osteoblastic differentiation. Furthermore, bone ingrowth was examined in a rabbit femoral condyle defect model by using micro-CT imaging and histological analysis. The strength of the implant-bone interface was also investigated by push-out tests. RESULTS: The modified bone cement with a low content of bioactive fillers resulted in proper handling characteristics and adequate mechanical properties, but slightly affected its bioactivity. Moreover, the degree of attachment, proliferation and osteogenic differentiation of preosteoblast cells was also increased. The results of the push-out test revealed that higher interfacial bonding strength was achieved with the modified bone cement because of the formation of the apatite layer and the osseointegration after implantation in the bony

  13. Treatment of the benign bone tumors including femoral neck lesion using compression hip screw and synthetic bone graft

    OpenAIRE

    Nakamura Tomoki; Matsumine Akihiko; Asanuma Kunihiro; Matsubara Takao; Sudo Akihiro

    2015-01-01

    Purpose: The proximal femur is one of the most common locations for benign bone tumors and tumor like conditions. We describe the clinical outcomes of the surgical treatment of benign lesions of the proximal femur including femoral neck using compression hip screw and synthetic bone graft. Methods: Thirteen patients with benign bone tumors or tumor like conditions of the proximal femur including femoral neck were surgically treated. Their average age at the time of presentatio...

  14. 术前正畸联合可吸收胶原生物膜用于牙槽突裂植骨修复30例分析%Analysis of 30 patients with pre-surgical orthodontics and application of absorbable collagen bio-membrane on alveolar clefe bone grafting

    Institute of Scientific and Technical Information of China (English)

    李志强; 黄诺蓓; 艾伟健; 刘曙光

    2013-01-01

    目的 探讨术前正畸联合术中应用可吸收胶原生物膜对单侧牙槽突裂植骨效果的影响.方法 选择牙弓狭窄、上颌前牙舌倾或扭转、牙槽突裂隙不规则、难以进行牙槽突裂檀骨术的单侧完全性牙槽突裂患者30例,年龄9 ~13岁,先进行植骨前正畸治疗,再应用髂骨松质骨加可吸收胶原生物膜覆盖行植骨修复,术后定期拍X线片检查,观察植骨效果.牙槽骨高度评价标准采用Bergland标准进行,术后观察期为1~3年.结果 30例患者术后成骨情况Ⅰ型11例,Ⅱ型17例,植骨成功率达93.3%.结论 对于上颌牙弓狭窄、牙槽突裂隙不规则、牙颌畸形严重的牙槽突裂患者,建议先行植骨前正畸治疗,植骨术中联合应用可吸收胶原生物膜可有效提高植骨成功率.%Objective To discuss the effect of bone grafting in patients with unilateral alveolar cleft,treated by presurgical orthodontics and secondary alveolar bone grafting surgery with absorbable collagen bio-membrane,in order to improve the success rate of graft.Methods Thirty complete unilateral alveolar cleft patients,aged 9-13 years,with collapsed upper arch or severe malpositioned upper incisors were selected.The patients received pre-surgical orthodontics before secondary alveolar bone grafting used ilium and absorbable bio-membrane.The observation period was 1-3 years and X-ray was taken regularly.Bergland criteria were used to evaluate the alveolar bone height.Results Pre-surgical orthodontics expanded the collapsed upper arch to benefit the secondary alveolar bone grafting with absorbable collagen bio-membrane,and the success rate of graft was improved to 93.3%.Conclusion It is worth popularizing that patients with collapsed upper arch or severe mal-positioned upper incisors should receive pre-surgical orthodontics and then secondary alveolar bone graft surgery with absorbable collagen bio-membrane.

  15. Clinical Analysis on Locking Plate Combining Bone Grafting in Treating with Fracture of Surgical Neck of Humerus%锁定钢板联合植骨治疗老年性肱骨外科颈骨折临床分析

    Institute of Scientific and Technical Information of China (English)

    张坤和; 黄黎; 王理德

    2014-01-01

    Objective To explore clinical efficacy of locking plate combining bone grafting in treating the senile with fracture of surgical neck of humerus and to provide references for future clinical treatment. Methods 180 patients with fracture of surgical neck of humerus admitted by this Hospital were selected as research subjects, who were divided into the research group and the control group on different treatment methods with 90 cases in each group. The patients in the research group underwent locking plate combining bone grafting treatment, and patients in the control group underwent locking plate treatment. Results The comparison and difference between intra-operative duration and postoperative healing time of patients in two groups were statistically significant (P <0.05).Conclusions The locking plate combining bone grafting in treating the senile with fracture of surgical neck of humerus delivers remarkable clinical efficacy, and patients are greatly recovered.%目的:探究钢板联合植骨治疗老年肱骨外科颈骨折的临床效果,为后期临床治疗提供参考。方法选取我院收入的肱骨骨折患者180例为研究对象,根据治疗方式的不同分为研究组与对照组各90例。研究组行锁定钢板联合植骨治疗,对照组行锁定钢板治疗。结果两组患者在手术及术后愈合时间比较,差异具有统计学意义(P<0.05)。结论锁定钢板联合植骨治疗老年性肱骨外科颈骨折的临床效果显著,患者恢复好。

  16. Clinicopathological study of surgically treated osteoradionecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Ohishi, Shin-ichiro [Kurume Univ., Fukuoka (Japan). School of Medicine

    2001-01-01

    To evaluate prognostic factors affecting surgically treated osteoradionecrosis (ORN) of the mandible, 13 patients with mandibular bone necrosis caused by irradiation for head and neck cancer were examined chlinicopathologically. The subjects were included 12 men and 1 woman, with a mean age of 65.3 years at surgery. The mean total dose of irradiation was 61.6 Gy. The clinical stage according to Epstein et al. (1987) was IIB in 1 patient, IIIA in 4, and IIIB in 8. The mandible was resected 10 mm or more from the lesion. Delayed healing was found in two patients, and three had recurrence of necrosis of the remaining bone. Patients whose mandibular periosteum had been resected previously who received mandibular reconstruction had a poor outcome. Pathological changes, such as stenosis of the inferior alveolar artery, fibrosis of bone marrow, and low osteocyte density in cortical bone, were found in all resected mandibles. Among them, mandibles lacking sequestra and bone remodeling had poor viability. Therefore, the periosteal blood supply should be conserved and surgical interventions, particularly heat, must be minimized to avoid recurrence of ORN. (author)

  17. Evaluation of Qualitative Changes in Simulated Periodontal Ligament and Alveolar Bone Using a Noncontact Electromagnetic Vibration Device with a Laser Displacement Sensor.

    Science.gov (United States)

    Kobayashi, Hiroshi; Hayashi, Makoto; Yamaoka, Masaru; Yasukawa, Takuya; Ibi, Haruna; Ogiso, Bunnai

    2016-01-01

    Evaluating periodontal tissue condition is an important diagnostic parameter in periodontal disease. Noncontact electromagnetic vibration device (NEVD) was previously developed to monitor this condition using mechanical parameters. However, this system requires accelerometer on the target tooth. This study assessed application of laser displacement sensor (LDS) to NEVD without accelerometer using experimental tooth models. Tooth models consisted of cylindrical rod, a tissue conditioner, and polyurethane or polyurethane foam to simulate tooth, periodontal ligament, and alveolar bone, respectively. Tissue conditioner was prepared by mixing various volumes of liquid with powder. Mechanical parameters (resonant frequency, elastic modulus, and coefficient of viscosity) were assessed using NEVD with the following methods: Group A, measurement with accelerometer; Group B, measurement with LDS in the presence of accelerometer; and Group C, measurement with LDS in the absence of accelerometer. Mechanical parameters significantly decreased with increasing liquid volume. Significant differences were also observed between the polyurethane and polyurethane foam models. Meanwhile, no statistically significant differences were observed between Groups A and B; however, most mechanical parameters in Group C were significantly larger and more distinguishable than those of Groups A and B. LDS could measure mechanical parameters more accurately and clearly distinguished the different periodontal ligament and alveolar bone conditions. PMID:27274995

  18. Evaluation of Qualitative Changes in Simulated Periodontal Ligament and Alveolar Bone Using a Noncontact Electromagnetic Vibration Device with a Laser Displacement Sensor

    Directory of Open Access Journals (Sweden)

    Hiroshi Kobayashi

    2016-01-01

    Full Text Available Evaluating periodontal tissue condition is an important diagnostic parameter in periodontal disease. Noncontact electromagnetic vibration device (NEVD was previously developed to monitor this condition using mechanical parameters. However, this system requires accelerometer on the target tooth. This study assessed application of laser displacement sensor (LDS to NEVD without accelerometer using experimental tooth models. Tooth models consisted of cylindrical rod, a tissue conditioner, and polyurethane or polyurethane foam to simulate tooth, periodontal ligament, and alveolar bone, respectively. Tissue conditioner was prepared by mixing various volumes of liquid with powder. Mechanical parameters (resonant frequency, elastic modulus, and coefficient of viscosity were assessed using NEVD with the following methods: Group A, measurement with accelerometer; Group B, measurement with LDS in the presence of accelerometer; and Group C, measurement with LDS in the absence of accelerometer. Mechanical parameters significantly decreased with increasing liquid volume. Significant differences were also observed between the polyurethane and polyurethane foam models. Meanwhile, no statistically significant differences were observed between Groups A and B; however, most mechanical parameters in Group C were significantly larger and more distinguishable than those of Groups A and B. LDS could measure mechanical parameters more accurately and clearly distinguished the different periodontal ligament and alveolar bone conditions.

  19. Evaluation of Qualitative Changes in Simulated Periodontal Ligament and Alveolar Bone Using a Noncontact Electromagnetic Vibration Device with a Laser Displacement Sensor

    Science.gov (United States)

    Kobayashi, Hiroshi; Hayashi, Makoto; Yamaoka, Masaru; Yasukawa, Takuya; Ibi, Haruna; Ogiso, Bunnai

    2016-01-01

    Evaluating periodontal tissue condition is an important diagnostic parameter in periodontal disease. Noncontact electromagnetic vibration device (NEVD) was previously developed to monitor this condition using mechanical parameters. However, this system requires accelerometer on the target tooth. This study assessed application of laser displacement sensor (LDS) to NEVD without accelerometer using experimental tooth models. Tooth models consisted of cylindrical rod, a tissue conditioner, and polyurethane or polyurethane foam to simulate tooth, periodontal ligament, and alveolar bone, respectively. Tissue conditioner was prepared by mixing various volumes of liquid with powder. Mechanical parameters (resonant frequency, elastic modulus, and coefficient of viscosity) were assessed using NEVD with the following methods: Group A, measurement with accelerometer; Group B, measurement with LDS in the presence of accelerometer; and Group C, measurement with LDS in the absence of accelerometer. Mechanical parameters significantly decreased with increasing liquid volume. Significant differences were also observed between the polyurethane and polyurethane foam models. Meanwhile, no statistically significant differences were observed between Groups A and B; however, most mechanical parameters in Group C were significantly larger and more distinguishable than those of Groups A and B. LDS could measure mechanical parameters more accurately and clearly distinguished the different periodontal ligament and alveolar bone conditions. PMID:27274995

  20. Abortion - surgical - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000658.htm Abortion - surgical - aftercare To use the sharing features on ... please enable JavaScript. You have had a surgical abortion. This is a procedure that ends pregnancy by ...

  1. Optimizing surgical f

    Directory of Open Access Journals (Sweden)

    Sabry Mohamed Amin

    2016-07-01

    Conclusions: In our study both dexmedetomidine and esmolol were effective in reducing MABP, and lowering the heart rate providing dry surgical field and ensured good surgical condition during cochlear implant surgery in pediatric patients.

  2. Urogynecologic Surgical Mesh Implants

    Science.gov (United States)

    ... be used for urogynecologic procedures, including repair of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). It is ... associated with surgical mesh for transvaginal repair of pelvic organ prolapse 513(e) Proposed Order for Reclassification of Surgical ...

  3. Biochemical changes on the repair of surgical bone defects grafted with biphasic synthetic micro-granular HA + β-tricalcium phosphate induced by laser and LED phototherapies assessed by Raman spectroscopy

    Science.gov (United States)

    Pinheiro, Antonio Luiz B.; Soares, Luiz Guilherme P.; Marques, Aparecida Maria C.; Silveira, Landulfo

    2016-03-01

    This work aimed the assessment of the biochemical changes during bone mineralization induced by laser and LED irradiation in an animal model of bone repair using a spectral model based on Raman spectroscopy. Six groups were studied: Clot, Laser (λ780 nm, 70 mW), LED (λ850 nm +/- 10 nm, 150 mW), Biomaterial (biphasic synthetic microgranular hydroxyapatite (HA) + β-tricalcium phosphate), Laser + Biomaterial and LED + Biomaterial. When indicated, defects were further irradiated at 48 h interval during 2 wks, 20 J/cm2 per session. At 15th and 30th days, femurs were dissected and spectra of the defects were collected. Raman spectra were submitted to a model to estimate the relative amount of collagen, phosphate HA and carbonate HA, by using spectra of pure collagen, biomaterial and basal bone, respectively. At 15th days, the use of biomaterial associated to phototherapy reduced the collagen formation, whereas the amount of carbonate HA was not different in all groups. The phosphate HA was higher in the groups that received biomaterial grafts. At 30th days, it was observed an increase of collagen for the group Laser + Biomaterial, and a reduction in the carbonate HA for the LED + Biomaterial. The phosphate HA was higher for the groups LED + Biomaterial and Laser + Biomaterial, while decreased for the group Biomaterial. These results indicated that the use of Laser and LED phototherapies improved the repair of bone defects grafted with the biomaterial by increasing the collagen deposition and phosphate HA.

  4. Bone Densitometry (Bone Density Scan)

    Science.gov (United States)

    ... of DXA Bone Densitometry? What is a Bone Density Scan (DXA)? Bone density scanning, also called dual-energy x-ray absorptiometry ( ... is today's established standard for measuring bone mineral density (BMD). An x-ray (radiograph) is a noninvasive ...

  5. 骨髓腔注射骨髓间充质干细胞防治模拟失重大鼠的骨质疏松%Preventive and therapeutic effects of intra-bone marrow cavity injection of bone mesenchymal stem cells on osteoporosis in rats subjected to simulated weightlessness

    Institute of Scientific and Technical Information of China (English)

    吴礼凤; 孙平; 麦燕兴; 刘海明; 徐艳花; 杨锐; 黄震

    2012-01-01

    背景:模拟失重条件下自身骨髓间充质干细胞的增殖受到抑制,并且向成骨细胞分化的能力减弱,造成骨量减少与骨微结构的破坏,最终导致骨质疏松.目的:观察同种异体骨髓间充质干细胞骨髓腔注射对模拟失重大鼠胫骨骨密度和骨组织微结构的影响.方法:将雄性SD大鼠随机分为自由活动对照组、尾吊模拟失重组、细胞治疗组(尾吊模拟失重同时给予双侧胫骨骨髓腔注射成骨诱导的同种异体BMSCs细胞).结果与结论:与自由活动对照组相比,尾吊模拟失重组胫骨骨密度、骨小梁面积百分比、骨小梁数量和厚度均显著降低(P < 0.01),骨小梁分离度显著增加(P < 0.01).与尾吊模拟失重组相比,细胞治疗组中胫骨骨密度、骨小梁面积百分比、骨小梁数量和厚度均显著增加(P < 0.01),骨小梁分离度显著降低(P < 0.01).说明骨髓腔注射能够增加模拟失重大鼠骨密度,改善骨超微结构,减缓骨量丢失,有效防治骨质疏松.%BACKGROUND: Simulated weightlessness can inhibit the proliferation of bone marrow mesenchymal stem cells and their differentiation towards osteoblasts, which leads to osteoporosis characterized by low bone mass and microarchitectural deterioration of bone tissue.OBJECTIVE: To study the effects of intra-bone marrow cavity injection of allogeneic bone mesenchymal stem cells (BMSCs) on the bone mineral density and microarchitecture of the tibias in rats subjected to simulated weightlessness.METHODS: Male SD rats were randomly divided into three groups: normal control group, tail-suspended simulated weightlessness group, and treatment group. The bilateral tibias were subjected to intra-bone marrow cavity injection of allogeneic BMSCs while giving the tail-suspended simulated weightlessness.RESULTS AND CONCLUSION: Compared with the normal control group, the bone mineral density, percentage of trabecular area, trabecular number and trabecular thickness

  6. Surgical history of ancient China: Part 2.

    Science.gov (United States)

    Fu, Louis

    2010-03-01

    In this second part of ancient Chinese surgical history, the practice of bone setting in China began around 3000 years ago. Throughout this period, significant progress was made, some highlights of which are cited. These methods, comparable with Western orthopaedic technique, are still being practised today. In conclusion, the possible reasons for the lack of advancement in operative surgery are discussed, within context of the cultural, social and religious background of ancient China.

  7. Low Bone Density

    Science.gov (United States)

    ... Density Exam/Testing › Low Bone Density Low Bone Density Low bone density is when your bone density ... people with normal bone density. Detecting Low Bone Density A bone density test will determine whether you ...

  8. Inca bones at asterion

    Directory of Open Access Journals (Sweden)

    Prashant E Natekar

    2014-01-01

    Full Text Available Background: Surgical approach towards asterion has to be done with caution as many surgeons are unfamiliar with the anatomical variations. The asterion corresponds to the site of the posterolateral (mastoid fontanelle of the neonatal skull which closes at the end of the first year. Inca bones provide information as markers for various diseases, and can mislead in the diagnosis of fractures. Observation and Results: 150 dry skull bones from the Department of Anatomy at Goa Medical College, India and other neighboring medical colleges by examining the asterion, and its sutural articulations with parietal, temporal and occipital bones and also anatomical variations if any in adults. Discussion: The anatomical landmarks selected must be reliable and above all easy to identify. Bony structures are more suitable than soft tissue or cartilaginous landmarks because of their rigid and reliable location. Presence of these bones provides false impressions of fractures or the fractures may be interpreted for inca bones especially in the region of asterion either radiologically or clinically which may lead to complications during burr hole surgeries.

  9. Computerized geometric features of carpal bone for bone age estimation

    Institute of Scientific and Technical Information of China (English)

    Chi-Wen Hsieh; Tai-Lang Jong; Yi-Hong Chou; Chui-Mei Tiu

    2007-01-01

    Background Bone age development is one of the significant indicators depicting the growth status of children.However, bone age assessment is an heuristic and tedious work for pediatricians. We developed a computerized bone age estimation system based on the analysis of geometric features of carpal bones.Methods The geometric features of carpals were extracted and analyzed to judge the bone age of children by computerized shape and area description. Four classifiers, linear, nearest neighbor, back-propagation neural network,and radial basis function neural network, were adopted to categorize bone age. Principal component and discriminate analyses were employed to improve assorting accuracy.Results The hand X-ray films of 465 boys and 444 girls served as our database. The features were extracted from carpal bone images, including shape, area, and sequence. The proposed normalization area ratio method was effective in bone age classification by simulation. Besides, features statistics showed similar results between the standard of the Greulich and Pyle atlas and our database.Conclusions The bone area has a higher discriminating power to judge bone age. The ossification sequence of trapezium and trapezoid bones between Taiwanese and the atlas of the GP method is quite different. These results also indicate that carpal bone assessment with classification of neural networks can be correct and practical.

  10. Computer-Assisted Technique for Surgical Tooth Extraction

    Directory of Open Access Journals (Sweden)

    Hosamuddin Hamza

    2016-01-01

    Full Text Available Introduction. Surgical tooth extraction is a common procedure in dentistry. However, numerous extraction cases show a high level of difficulty in practice. This difficulty is usually related to inadequate visualization, improper instrumentation, or other factors related to the targeted tooth (e.g., ankyloses or presence of bony undercut. Methods. In this work, the author presents a new technique for surgical tooth extraction based on 3D imaging, computer planning, and a new concept of computer-assisted manufacturing. Results. The outcome of this work is a surgical guide made by 3D printing of plastics and CNC of metals (hybrid outcome. In addition, the conventional surgical cutting tools (surgical burs are modified with a number of stoppers adjusted to avoid any excessive drilling that could harm bone or other vital structures. Conclusion. The present outcome could provide a minimally invasive technique to overcome the routine complications facing dental surgeons in surgical extraction procedures.

  11. Surgical endodontic management of infected lateral canals of maxillary incisors

    Science.gov (United States)

    2015-01-01

    This case report presents surgical endodontic management outcomes of maxillary incisors that were infected via the lateral canals. Two cases are presented in which endodontically-treated maxillary central incisors had sustained lateral canal infections. A surgical endodontic treatment was performed on both teeth. Flap elevation revealed vertical bone destruction along the root surface and infected lateral canals, and microscopy revealed that the lateral canals were the origin of the lesions. After the infected lateral canals were surgically managed, both teeth were asymptomatic and labial fistulas were resolved. There were no clinical or radiographic signs of surgical endodontic management failure at follow-up visits. This case report highlights the clinical significance and surgical endodontic management of infected lateral canal of maxillary incisor. It is important to be aware of root canal anatomy variability in maxillary incisors. Maxillary central incisors infected via the lateral canal can be successfully managed by surgical endodontic treatment. PMID:25671217

  12. Surgical Vision: Google Glass and Surgery.

    Science.gov (United States)

    Chang, Johnny Yau Cheung; Tsui, Lok Yee; Yeung, Keith Siu Kay; Yip, Stefanie Wai Ying; Leung, Gilberto Ka Kit

    2016-08-01

    Google Glass is, in essence, a smartphone in the form of a pair of spectacles. It has a display system, a bone conduction "speaker," video camera, and connectivity via WiFi or Bluetooth technologies. It can also be controlled by voice command. Seizing Google Glass' capabilities as windows of opportunity, surgeons have been the first group of doctors trying to incorporate the technology into their daily practices. Experiences from different groups have demonstrated Google Glass' potential in improving perioperative care, intraoperative communication and documentation, surgical outcome as well as surgical training. On the other hand, the device has technical limitations, notably suboptimal image qualities and a short battery life. Its operational functions also bring forth concerns on the protection of patient privacy. Nonetheless, the technological advances that this device embodies hold promises in surgical innovations. Further studies are required, and surgeons should explore, investigate, and embrace similar technologies with keen and informed anticipation. PMID:27146972

  13. Surgical Vision: Google Glass and Surgery.

    Science.gov (United States)

    Chang, Johnny Yau Cheung; Tsui, Lok Yee; Yeung, Keith Siu Kay; Yip, Stefanie Wai Ying; Leung, Gilberto Ka Kit

    2016-08-01

    Google Glass is, in essence, a smartphone in the form of a pair of spectacles. It has a display system, a bone conduction "speaker," video camera, and connectivity via WiFi or Bluetooth technologies. It can also be controlled by voice command. Seizing Google Glass' capabilities as windows of opportunity, surgeons have been the first group of doctors trying to incorporate the technology into their daily practices. Experiences from different groups have demonstrated Google Glass' potential in improving perioperative care, intraoperative communication and documentation, surgical outcome as well as surgical training. On the other hand, the device has technical limitations, notably suboptimal image qualities and a short battery life. Its operational functions also bring forth concerns on the protection of patient privacy. Nonetheless, the technological advances that this device embodies hold promises in surgical innovations. Further studies are required, and surgeons should explore, investigate, and embrace similar technologies with keen and informed anticipation.

  14. Surgical dislocation of the hip in patients with femoroacetabular impingement: Surgical techniques and our experience

    Directory of Open Access Journals (Sweden)

    Mladenović Marko

    2015-01-01

    Full Text Available Background/Aim. Arthrosis of the hip is the most common cause of a hip joint disorders. The aim of this study was to present our experience in the application of a safe surgical dislocation of the hip in patients with minor morphological changes in the hip joint, which, through the mechanism of femoroacetabular impingement, cause damage to the acetabular labrum and adjacent cartilage as an early sign of the hip arthrosis. Methods. We have operated 51 patients with different morphological bone changes in the hip area and resultant soft tissue damage of the acetabular labrum and its adjacent cartilage. Surgical technique that we applied in this group of patients, was adapted to our needs and capabilities and it was minimaly modified compared to the original procedure. Results. The surgical technique presented in this paper, proved to be a good method of treatment of bone and soft tissue pathomorphological changes of the hip in patients with femoroacetabular impingement. We had no cases with avascular necrosis of the femoral head, and two patients had nonunion of the greater trochanter, 9 patients developed paraarticular ossification, without subjective symptoms, while 3 patients suffered from postoperative pain in the groin during more energetic physical activities. Conclusion. Utilization of our partly modified surgical technique of controlled and safe dislocation of the hip can solve all the bone and soft tissue problems in patients with femoroacetibular impingement to stop already developed osteoarthritis of the hip or to prevent mild form of it.

  15. Simulations

    CERN Document Server

    Ngada, N M

    2015-01-01

    The complexity and cost of building and running high-power electrical systems make the use of simulations unavoidable. The simulations available today provide great understanding about how systems really operate. This paper helps the reader to gain an insight into simulation in the field of power converters for particle accelerators. Starting with the definition and basic principles of simulation, two simulation types, as well as their leading tools, are presented: analog and numerical simulations. Some practical applications of each simulation type are also considered. The final conclusion then summarizes the main important items to keep in mind before opting for a simulation tool or before performing a simulation.

  16. Virtual Temporal Bone Anatomy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Background The Visible Human Project(VHP) initiated by the U.S. National Library of Medicine has drawn much attention and interests from around the world. The Visible Chinese Human (VCH) project has started in China. The current study aims at acquiring a feasible virtual methodology for reconstructing the temporal bone of the Chinese population, which may provide an accurate 3-D model of important temporal bone structures that can be used in teaching and patient care for medical scientists and clinicians. Methods A series of sectional images of the temporal bone were generated from section slices of a female cadaver head. On each sectional image, SOIs (structures of interest) were segmented by carefully defining their contours and filling their areas with certain gray scale values. The processed volume data were then inducted into the 3D Slicer software(developed by the Surgical Planning Lab at Brigham and Women's Hospital and the MIT AI Lab) for resegmentation and generation of a set of tagged images of the SOIs. 3D surface models of SOIs were then reconstructed from these images. Results The temporal bone and structures in the temporal bone, including the tympanic cavity, mastoid cells, sigmoid sinus and internal carotid artery, were successfully reconstructed. The orientation of and spatial relationship among these structures were easily visualized in the reconstructed surface models. Conclusion The 3D Slicer software can be used for 3-dimensional visualization of anatomic structures in the temporal bone, which will greatly facilitate the advance of knowledge and techniques critical for studying and treating disorders involving the temporal bone.

  17. [Palliative surgery for bone metastases].

    Science.gov (United States)

    Oetiker, R F; Meier, G; Hefti, F; Bereiter, H

    2001-12-01

    Advances in the treatment of patients who have bone metastases are an issue of high importance to the orthopaedic surgeon. Early diagnosis requires knowledge of the pathogenesis of bone metastases. A primary route of metastatic cells is via Batson's vertebral vein plexus. An understanding of the pathophysiology enables the surgeon to plan effective treatment. As many patients continue to survive for prolonged periods following the detection of bone metastases, it is important to plan treatment that relieves pain and is functional. In long bones non-operative treatment with radiotherapy, patient education to avoid excessive torsional loads and systemic chemotherapy or hormonal therapy as well as diphosphonates are utilized for small lesions with less than 25 percent of the cortical diameter. The indications for surgical treatment include lesions with elevated fracture risk according to Mirels score. Special emphasis is led on the surgical treatment of spinal metastasis. Early and effective treatment improves the remaining quality of life in patients with metastatic bone disease. However a firm knowledge of the pathogenesis and pathophysiology helps the clinician in making an early diagnosis. Nevertheless the orthopaedic surgeon must recognize the need to approach management of these patients from a multidisciplinary perspective in cooperation with the oncologist, radiotherapist, rehabilitation medicine specialist, radiologist, and pathologist. The cooperation among all members of the team will assure the best possible care for the patient who has metastatic bone disease. PMID:11797537

  18. Haptic Modeling and Rendering Based on Neurofuzzy Rules for Surgical Cutting Simulation%手术切割模拟中基于模糊规则的触觉建模及绘制

    Institute of Scientific and Technical Information of China (English)

    宋卫国; 原魁; 付玉锦

    2006-01-01

    This paper combines image processing with 3D magnetic tracking method to develop a scalpel for haptic simulation in surgical cutting. First, a cutting parameter acquisition setup is presented and the performance is validated from soft tissue cutting. Then, based on the acquired input-output data pairs, a method for fuzzy system modeling is presented, that is, after partitioning each input space equally and giving the premises and the total number of fuzzy rules, the consequent parameters and the fuzzy membership functions (MF) of the input variables are learned and optimized via a neurofuzzy modeling technique. Finally, a haptic scalpel implemented with the established cutting model is described. Preliminary results show the feasibility of the haptic display system for real-time interaction.

  19. Bone Cancer

    Science.gov (United States)

    ... cancer. Surgery is often the main treatment for bone cancer. Other treatments may include amputation, chemotherapy, and radiation therapy. Because bone cancer can come back after treatment, regular follow-up visits are important. NIH: National ...

  20. 耳周复合带蒂软组织瓣在鼻咽癌放疗后颞骨骨坏死手术治疗中的应用%The application of local composite vascularized fascia flaps in the surgical treatment of diffused osteoradionecrosis of temporal bone in cases with nasopharyngeal carcinoma after radiotherapy

    Institute of Scientific and Technical Information of China (English)

    许耀东; 区永康; 郑亿庆; 陈穗俊; 吴树浓; 何晓峥; 纪树芳; 郭晓娟

    2008-01-01

    Objective To investigate the value of the local composite vascularized fascia flaps in the surgical treatment of osteoradionecresis(ORN)of temporal bone in cases with nasopharyngeal carcinoma(NPC)after radiotheraphy.Methods Eight NPC patients with ORN of temporal bone accepted radical mastoidectomy and obliteration with local composite veuscularized fascia flaps including palva flap,temporalis fascia flap and skin flap of external acoustic meatus.Results Five ears(62.5%)achieved dry ear.Two ears(25%)still had infection and granulation tissue in the operating cavities,but the symptoms relieved and the esrs were without re-sequestration.One ear(12.5%)needed regular cleaning for the operating cavity because of neciosis of the fascia flaps and re-sequestration.Conclusion The surgical treatment for diffused ORN of temporal bone is difficult.Obliteration with local composite vascularized fascia flaps is an effective method in order to get dry ear and prevent from re-sequestration after radical mastoidectomy.%目的 探讨耳周复合带蒂软组织瓣乳突术腔转移填塞在NPC放疗后颞骨放射性骨坏死手术治疗中的应用价值.方法 对8例NPC放疗后颞骨放射性骨坏死的患者行乳突根治术,同期采用耳后Palva辨、带蒂颞肌筋膜瓣及外耳道皮瓣复合转移乳突术腔填塞.结果 5耳(62.5%)获得干耳.无死骨再形成;2耳(25%)症状改善,术腔仍有感染及局限肉芽组织生长,无死骨再形成;1耳(12.5%)术腔填塞筋膜局部坏死及局灶游离死骨形成,定期换药.结论 NPC放疗后颞骨骨坏死治疗困难,应用耳周复合带蒂软组织瓣转移术腔填塞术是乳突根治术后获得干耳、预防死骨再形成等术腔问题的有效技术方法.

  1. 鼻内镜下鼻骨骨折伴外伤性鼻中隔偏曲同期手术治疗可行性分析%Feasibility of simultaneous surgical treatment on nasal bone fracture and traumatic deviation of nasal septum under endoscope

    Institute of Scientific and Technical Information of China (English)

    孟新宇; 刘明秋

    2013-01-01

    Objective It is to approach the feasibility of simultaneous surgical treatment in nasal bone fracture and traumatic deflection of nasal septum under endoscopic. Methods 26 patients with nasal bone fracture and traumatic deflection of nasal septum were randomly divided into two groups, the patients were treated by modified nasal septum correction in control group and septoplasty in observation group. Clinical index, clinical efficacy and quality of life changes of the two groups were observed and compared. Results In observation group, the quality of life was better than that of control group ( P <0.05 ), and the total effective rate was higher than that of control group ( P <0.05 ). Conclusion For nasal bone fracture associated with traumatic deflection of nasal septum, simultaneous surgical treatment is feasible in early period after injury, but plasty is requisite for nasal septum correction. While take the modified nasal septum correction, the complications will be happened because do not pay attention to fine operation.%目的 探讨鼻内镜下鼻骨骨折伴外伤性鼻中隔偏曲同期手术治疗的可行性.方法 将26例鼻骨骨折并外伤性鼻中隔偏曲患者随机分为2组,对照组给予改良鼻中隔黏膜下矫正术,观察组采取鼻中隔成形术,对比2组的临床指标、临床疗效及生活质量变化.结果 观察组患者的生活质量显著优于对照组(P均<0.05),且总有效率显著高于对照组(P<0.05).结论 鼻骨骨折伴有外伤性鼻中隔偏曲时,伤后早期可行同期手术,但鼻中隔矫正需采取成形术;若采取改良鼻中隔黏膜下矫正术,可能因操作不精细发生并发症.

  2. Preoperative Guidance Optimization of Surgical Robot Based on Simulation%基于仿真的外科手术机器人术前引导优化

    Institute of Scientific and Technical Information of China (English)

    闫志远; 杜志江; 吴冬梅

    2014-01-01

    A method to complete the setup of the surgical robot is presented, which can guarantee the dexterity, acces-sibility, visibility. And a virtual reality system is established to assist the surgeon to pose the robot before operation. The incision placement and the arm position are obtained by particle swarm optimization algorithm. The method not only can effectively complete setup optimization of the robot in an operation space, but also can reflect the internal difference of the operation space by dividing the operation space and assigning the subspaces with weights. Global isotropy index and cooperation ability are put forward, and their weighted average based on space division are used as objective functions to reflect the single-arm and three-arm cooperation performances of the robot respectively. Hence, the method can intuitively guide surgeons to complete the complex preoperative arrangement, taking into account the performance of the surgical robot and the internal difference of the operation space. Experiments show that compared with the method without weights, the dexterity of the three arms are all better, and cooperation capability index of the three arms increases by 25%∼30%, and it can give priority to important regions of the operation space.%给出一种保证术中较高灵巧度、可达性和可视化指标的手术机器人布置方法,建立一个能够辅助医生完成手术机器人术前布置的虚拟现实系统。基于粒子群优化算法提出了引导手术切口布置和机器人摆位的方法,该方法不仅能够有效完成针对某一手术空间的摆位优化,还通过手术空间划分并赋予权值的方法来反映手术空间内部差异,在空间分割的基础上提出加权平均的全域各向同性和多臂协同性两个目标函数,分别反映机器人系统的单臂性能和三臂协作能力。该方法可以在兼顾手术机器人性能和手术空间内部差异的前提下直观地引导医生完

  3. Manual of Surgical Instruments

    Directory of Open Access Journals (Sweden)

    Olga Lidia Sánchez Sarría

    2014-10-01

    Full Text Available Surgical instruments are the group of tools used in surgical procedures. They are very expensive and sophisticated. Consequently, a standardized and meticulous care is essential; they should go through the decontamination, cleaning and sterilization process. These instruments are designed in order to provide surgeons with tools that help them to perform a basic surgical procedure; there are multiple variations and the design depends on their function. This paper aims at showing all surgical instruments that can be used in an operating room during surgery and are not generally included in the medical literature.

  4. Computational biomechanics of bone's responses to dental prostheses - osseointegration, remodeling and resorption

    Science.gov (United States)

    Li, Wei; Rungsiyakull, Chaiy; Field, Clarice; Lin, Daniel; Zhang, Leo; Li, Qing; Swain, Michael

    2010-06-01

    Clinical and experimental studies showed that human bone has the ability to remodel itself to better adapt to its biomechanical environment by changing both its material properties and geometry. As a consequence of the rapid development and extensive applications of major dental restorations such as implantation and fixed partial denture (FPD), the effect of bone remodeling on the success of a dental restorative surgery is becoming critical for prosthetic design and pre-surgical assessment. This paper aims to provide a computational biomechanics framework to address dental bone's responses as a result of dental restoration. It explored three important issues of resorption, apposition and osseointegration in terms of remodeling simulation. The published remodeling data in long bones were regulated to drive the computational remodeling prediction for the dental bones by correlating the results to clinical data. It is anticipated that the study will provide a more predictive model of dental bone response and help develop a new design methodology for patient-specific dental prosthetic restoration.

  5. Disc degeneration: current surgical options

    Directory of Open Access Journals (Sweden)

    C Schizas

    2010-10-01

    Full Text Available Chronic low back pain attributed to lumbar disc degeneration poses a serious challenge to physicians. Surgery may be indicated in selected cases following failure of appropriate conservative treatment. For decades, the only surgical option has been spinal fusion, but its results have been inconsistent. Some prospective trials show superiority over usual conservative measures while others fail to demonstrate its advantages. In an effort to improve results of fusion and to decrease the incidence of adjacent segment degeneration, total disc replacement techniques have been introduced and studied extensively. Short-term results have shown superiority over some fusion techniques. Mid-term results however tend to show that this approach yields results equivalent to those of spinal fusion. Nucleus replacement has gained some popularity initially, but evidence on its efficacy is scarce. Dynamic stabilisation, a technique involving less rigid implants than in spinal fusion and performed without the need for bone grafting, represents another surgical option. Evidence again is lacking on its superiority over other surgical strategies and conservative measures. Insertion of interspinous devices posteriorly, aiming at redistributing loads and relieving pain, has been used as an adjunct to disc removal surgery for disc herniation. To date however, there is no clear evidence on their efficacy. Minimally invasive intradiscal thermocoagulation techniques have also been tried, but evidence of their effectiveness is questioned. Surgery using novel biological solutions may be the future of discogenic pain treatment. Collaboration between clinicians and basic scientists in this multidisciplinary field will undoubtedly shape the future of treating symptomatic disc degeneration.

  6. Surgical ethics and the challenge of surgical innovation.

    Science.gov (United States)

    Angelos, Peter

    2014-12-01

    Surgical ethics as a specific discipline is relatively new to many. Surgical ethics focuses on the ethical issues that are particularly important to the care of surgical patients. Informed consent for surgical procedures, the level of responsibility that surgeons feel for their patients' outcomes, and the management of surgical innovation are specific issues that are important in surgical ethics and are different from other areas of medicine. The future of surgical progress is dependent on surgical innovation, yet the nature of surgical innovation raises specific concerns that challenge the professionalism of surgeons. These concerns will be considered in the following pages.

  7. Virtual reality simulation training of mastoidectomy - studies on novice performance.

    Science.gov (United States)

    Andersen, Steven Arild Wuyts

    2016-08-01

    Virtual reality (VR) simulation-based training is increasingly used in surgical technical skills training including in temporal bone surgery. The potential of VR simulation in enabling high-quality surgical training is great and VR simulation allows high-stakes and complex procedures such as mastoidectomy to be trained repeatedly, independent of patients and surgical tutors, outside traditional learning environments such as the OR or the temporal bone lab, and with fewer of the constraints of traditional training. This thesis aims to increase the evidence-base of VR simulation training of mastoidectomy and, by studying the final-product performances of novices, investigates the transfer of skills to the current gold-standard training modality of cadaveric dissection, the effect of different practice conditions and simulator-integrated tutoring on performance and retention of skills, and the role of directed, self-regulated learning. Technical skills in mastoidectomy were transferable from the VR simulation environment to cadaveric dissection with significant improvement in performance after directed, self-regulated training in the VR temporal bone simulator. Distributed practice led to a better learning outcome and more consolidated skills than massed practice and also resulted in a more consistent performance after three months of non-practice. Simulator-integrated tutoring accelerated the initial learning curve but also caused over-reliance on tutoring, which resulted in a drop in performance when the simulator-integrated tutor-function was discontinued. The learning curves were highly individual but often plateaued early and at an inadequate level, which related to issues concerning both the procedure and the VR simulator, over-reliance on the tutor function and poor self-assessment skills. Future simulator-integrated automated assessment could potentially resolve some of these issues and provide trainees with both feedback during the procedure and immediate

  8. Virtual reality simulation training of mastoidectomy - studies on novice performance.

    Science.gov (United States)

    Andersen, Steven Arild Wuyts

    2016-08-01

    Virtual reality (VR) simulation-based training is increasingly used in surgical technical skills training including in temporal bone surgery. The potential of VR simulation in enabling high-quality surgical training is great and VR simulation allows high-stakes and complex procedures such as mastoidectomy to be trained repeatedly, independent of patients and surgical tutors, outside traditional learning environments such as the OR or the temporal bone lab, and with fewer of the constraints of traditional training. This thesis aims to increase the evidence-base of VR simulation training of mastoidectomy and, by studying the final-product performances of novices, investigates the transfer of skills to the current gold-standard training modality of cadaveric dissection, the effect of different practice conditions and simulator-integrated tutoring on performance and retention of skills, and the role of directed, self-regulated learning. Technical skills in mastoidectomy were transferable from the VR simulation environment to cadaveric dissection with significant improvement in performance after directed, self-regulated training in the VR temporal bone simulator. Distributed practice led to a better learning outcome and more consolidated skills than massed practice and also resulted in a more consistent performance after three months of non-practice. Simulator-integrated tutoring accelerated the initial learning curve but also caused over-reliance on tutoring, which resulted in a drop in performance when the simulator-integrated tutor-function was discontinued. The learning curves were highly individual but often plateaued early and at an inadequate level, which related to issues concerning both the procedure and the VR simulator, over-reliance on the tutor function and poor self-assessment skills. Future simulator-integrated automated assessment could potentially resolve some of these issues and provide trainees with both feedback during the procedure and immediate

  9. Computer-Assisted Orthognathic Surgery for Patients with Cleft Lip/Palate: From Traditional Planning to Three-Dimensional Surgical Simulation

    Science.gov (United States)

    Lonic, Daniel; Pai, Betty Chien-Jung; Yamaguchi, Kazuaki; Chortrakarnkij, Peerasak; Lin, Hsiu-Hsia; Lo, Lun-Jou

    2016-01-01

    Background Although conventional two-dimensional (2D) methods for orthognathic surgery planning are still popular, the use of three-dimensional (3D) simulation is steadily increasing. In facial asymmetry cases such as in cleft lip/palate patients, the additional information can dramatically improve planning accuracy and outcome. The purpose of this study is to investigate which parameters are changed most frequently in transferring a traditional 2D plan to 3D simulation, and what planning parameters can be better adjusted by this method. Patients and Methods This prospective study enrolled 30 consecutive patients with cleft lip and/or cleft palate (mean age 18.6±2.9 years, range 15 to 32 years). All patients received two-jaw single-splint orthognathic surgery. 2D orthodontic surgery plans were transferred into a 3D setting. Severe bony collisions in the ramus area after 2D plan transfer were noted. The position of the maxillo-mandibular complex was evaluated and eventually adjusted. Position changes of roll, midline, pitch, yaw, genioplasty and their frequency within the patient group were recorded as an alternation of the initial 2D plan. Patients were divided in groups of no change from the original 2D plan and changes in one, two, three and four of the aforementioned parameters as well as subgroups of unilateral, bilateral cleft lip/palate and isolated cleft palate cases. Postoperative OQLQ scores were obtained for 20 patients who finished orthodontic treatment. Results 83.3% of 2D plans were modified, mostly concerning yaw (63.3%) and midline (36.7%) adjustments. Yaw adjustments had the highest mean values in total and in all subgroups. Severe bony collisions as a result of 2D planning were seen in 46.7% of patients. Possible asymmetry was regularly foreseen and corrected in the 3D simulation. Conclusion Based on our findings, 3D simulation renders important information for accurate planning in complex cleft lip/palate cases involving facial asymmetry that is

  10. Computer-Assisted Orthognathic Surgery for Patients with Cleft Lip/Palate: From Traditional Planning to Three-Dimensional Surgical Simulation.

    Directory of Open Access Journals (Sweden)

    Daniel Lonic

    Full Text Available Although conventional two-dimensional (2D methods for orthognathic surgery planning are still popular, the use of three-dimensional (3D simulation is steadily increasing. In facial asymmetry cases such as in cleft lip/palate patients, the additional information can dramatically improve planning accuracy and outcome. The purpose of this study is to investigate which parameters are changed most frequently in transferring a traditional 2D plan to 3D simulation, and what planning parameters can be better adjusted by this method.This prospective study enrolled 30 consecutive patients with cleft lip and/or cleft palate (mean age 18.6±2.9 years, range 15 to 32 years. All patients received two-jaw single-splint orthognathic surgery. 2D orthodontic surgery plans were transferred into a 3D setting. Severe bony collisions in the ramus area after 2D plan transfer were noted. The position of the maxillo-mandibular complex was evaluated and eventually adjusted. Position changes of roll, midline, pitch, yaw, genioplasty and their frequency within the patient group were recorded as an alternation of the initial 2D plan. Patients were divided in groups of no change from the original 2D plan and changes in one, two, three and four of the aforementioned parameters as well as subgroups of unilateral, bilateral cleft lip/palate and isolated cleft palate cases. Postoperative OQLQ scores were obtained for 20 patients who finished orthodontic treatment.83.3% of 2D plans were modified, mostly concerning yaw (63.3% and midline (36.7% adjustments. Yaw adjustments had the highest mean values in total and in all subgroups. Severe bony collisions as a result of 2D planning were seen in 46.7% of patients. Possible asymmetry was regularly foreseen and corrected in the 3D simulation.Based on our findings, 3D simulation renders important information for accurate planning in complex cleft lip/palate cases involving facial asymmetry that is regularly missed in conventional 2D

  11. Characterization of aerosols produced by surgical procedures

    Energy Technology Data Exchange (ETDEWEB)

    Yeh, H.C.; Muggenburg, B.A.; Lundgren, D.L.; Guilmette, R.A.; Snipes, M.B.; Jones, R.K. [Inhalation Toxicology Research Institute, Albuquerque, NM (United States); Turner, R.S. [Lovelace Health Systems, Albuquerque, NM (United States)

    1994-07-01

    In many surgeries, especially orthopedic procedures, power tools such as saws and drills are used. These tools may produce aerosolized blood and other biological material from bone and soft tissues. Surgical lasers and electrocautery tools can also produce aerosols when tissues are vaporized and condensed. Studies have been reported in the literature concerning production of aerosols during surgery, and some of these aerosols may contain infectious material. Garden et al. (1988) reported the presence of papilloma virus DNA in the fumes produced from laser surgery, but the infectivity of the aerosol was not assessed. Moon and Nininger (1989) measured the size distribution and production rate of emissions from laser surgery and found that particles were generally less than 0.5 {mu}m diameter. More recently there has been concern expressed over the production of aerosolized blood during surgical procedures that require power tools. In an in vitro study, the production of an aerosol containing the human immunodeficiency virus (HIV) was reported when power tools were used to cut tissues with blood infected with HIV. Another study measured the size distribution of blood aerosols produced by surgical power tools and found blood-containing particles in a number of size ranges. Health care workers are anxious and concerned about whether surgically produced aerosols are inspirable and can contain viable pathogens such as HIV. Other pathogens such as hepatitis B virus (HBV) are also of concern. The Occupational Safety and Health funded a project at the National Institute for Inhalation Toxicology Research Institute to assess the extent of aerosolization of blood and other tissues during surgical procedures. This document reports details of the experimental and sampling approach, methods, analyses, and results on potential production of blood-associated aerosols from surgical procedures in the laboratory and in the hospital surgical suite.

  12. 手术模拟器培训眼科青年医师显微手术技能的观察研究%Application effect of surgical simulator to improve the microsurgical skills in junior ophthalmologist

    Institute of Scientific and Technical Information of China (English)

    吴航; 戴惟葭; 董莹; 刘大川

    2015-01-01

    目的::利用眼科显微手术模拟器提高眼科青年医师白内障显微手术能力的量化观察。方法:眼科青年医师进行经过理论授课、模拟器训练及动物眼球操作,模拟器对学员完成白内障手术操作各项步骤行综合打分,并对学员培训前后完成白内障手术模拟器综合得分结果进行分析。结果:学员通过理论授课阶段后在模拟器完成白内障手术操作测试评分平均75.91±6.53分,再经过模拟器反复训练阶段后模拟器给予的测试评分平均85.57±4.64分,这两阶段学习后学员在模拟器上完成白内障手术操作的综合测试评分对比具有显著统计学差异(P<0.01),第三阶段学员经过动物眼球实际操作后,在模拟器上完成白内障手术的测试评分平均89.77±7.61分,与动物眼球操作前仅进行模拟器操作训练测试评分相比较具有统计学差异(P<0.05)。结论:利用眼科显微手术模拟器进行短期培训可显著提高眼科医师白内障手术能力,但长期效果及实际临床手术能力有待进一步观察。%AlM: To discuss the application effect of surgical simulator to improve the microsurgical skills in junior ophthalmologist. METHODS: Lecture teaching, training in surgical simulator and operation in animal eyes were received in all these ophthalmologists. Results of the ability of operation in cataract surgery after this training were analyzed. RESULTS: After taught theory, students completed cataract surgical procedures on simulator and the mean test score was 75. 91 ± 6. 53 points. After trained on simulator repeatedly, the mean test score was 85. 57±4. 64 points. There was statistically significant difference ( P<0. 01) . During the third stage of practicing on animal eyes, the score was 89. 77 ± 7. 61 points, there was statistically significant difference compared with former two stages (P<0. 05).CONCLUSlON: Comprehensive training can improve microsurgical

  13. Recognizing surgical patterns

    NARCIS (Netherlands)

    Bouarfa, L.

    2012-01-01

    In the Netherlands, each year over 1700 patients die from preventable surgical errors. Numerous initiatives to improve surgical practice have had some impact, but problems persist. Despite the introduction of checklists and protocols, patient safety in surgery remains a continuing challenge. This is

  14. Surgical medical record

    DEFF Research Database (Denmark)

    Bulow, S.

    2008-01-01

    A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15......A medical record is presented on the basis of selected linguistic pearls collected over the years from surgical case records Udgivelsesdato: 2008/12/15...

  15. 数字化三维手术模拟在正颌外科专科医师培训中的应用%Application of digital three-dimensional surgical simulation system in specialist training of orthognathic surgery

    Institute of Scientific and Technical Information of China (English)

    沈末伦; 王旭东

    2016-01-01

    牙颌面畸形患者面部形态异常和咬合功能障碍常较严重,需要采用正颌—正畸联合治疗的方法进行矫正。治疗牙颌面畸形的正颌手术术野狭小、操作复杂、风险较大,其手术教学和操作培训手段有限,限制了此类技术的推广应用。文章介绍了将数字化三维手术设计与模拟系统应用于正颌外科专科医师培训,可取得良好的手术教学效果。实践表明,通过手术虚拟操作,可使受训医师加深对牙颌面畸形和正颌外科手术的理解。%Patients with dento-maxillofacial deformities often suffer relatively severe facial anomalies and occlusal dysfunction, which need to be corrected with combined orthodontic and orthognathic treatment.Orthognathic surgery is very complicated with narrow operative field and relatively high risk.The means of orthognathic surgery teaching and operation training are limited,which restricts the promotion of orthognathic surgical technology.In this study,a digital three-dimensional surgical design and simulation system was applied to specialist training of orthognathic surgery with satisfactory results.Practice proves that through virtual operation training,the trained surgeons obtained a deeper understanding of dento-maxillofacial deformities and orthognathic surgery.

  16. Accuracy of a newly developed cone-beam computerized tomography-aided surgical guidance system for dental implant placement: an ex vivo study.

    Science.gov (United States)

    Murat, Sema; Kamburoğlu, Kivanç; Özen, Tuncer

    2012-12-01

    The aim of the present study was to measure the accuracy of the cone-beam computerized tomography (CBCT)- aided StentCad Beyond surgical guidance system and to compare bone-supported and tooth/bone-supported guidance by using this system in dental implant placement ex vivo. Five cadaver mandibles were scanned using an Iluma CBCT scanner. After scanning, DICOM slices were transferred to the StentCad Beyond implant simulation software, which was used for preoperative implant planning. Using the StentCad Beyond guidance system, 9 implant drills were inserted using a bone-supported guidance system and 11 using a tooth/bone-supported guidance system. Mandibles were scanned again and these data were transferred to the StentCad Beyond software. Pre- and postoperative information was superimposed using the Rhinoceros version 4 software program, and deviations between planned and actual drill positions were calculated for each implant. In addition, differences between bone-supported and tooth/bone-supported guidance systems were analyzed by t-test, with a significance level of P .05); however, statistically significant differences between groups were found in mean horizontal coronal deviation (P = .016) and mean horizontal apical deviation (P = .047). The StentCad Beyond system was found to be a reliable guide for placing implants ex vivo.

  17. [Bone diseases].

    Science.gov (United States)

    Uebelhart, Brigitte; Rizzoli, René

    2016-01-13

    Calcium intake shows a small impact on bone mineral density and fracture risk. Denosumab is a more potent inhibitor of bone resorption than zoledronate. Abaloparatide, PTHrP analog, increases bone mineral density and decreases fracture incidence. Teriparatide could be delivered via a transdermic device. Romosozumab and odanacatib improve calculated bone strength. Sequential or combined treatments with denosumab and teriparatide could be of interest, but not denosumab followed by teriparatide. Fibrous dysplasia, Paget disease and hypophosphatasia are updated, as well as atypical femoral fracture and osteonecrosis of the jaw. PMID:26946704

  18. Multiscale Surgical Telerobots

    Energy Technology Data Exchange (ETDEWEB)

    Miles, R R; Seward, K P; Benett, W J; Tendick, F; Bentley, L; Stephan, P L

    2002-01-23

    A project was undertaken to improve robotic surgical tools for telerobotic minimally invasive surgery. The major objectives were to reduce the size of the tools to permit new surgical procedures in confined spaces such as the heart and to improve control of surgical tools by locating positional sensors and actuators at the end effector rather than external to the patient as is currently the state of the technology. A new compact end-effector with wrist-like flexibility was designed. Positional sensors based on MEMS microfabrication techniques were designed.

  19. Local recurrence, rate and sites of metastases, and time to relapse as a function of treatment regimen, size of primary and surgical history in 62 patients presenting with non-metastatic Ewing's sarcoma of the pelvic bones

    International Nuclear Information System (INIS)

    This report reviews the experience of 62 patients who presented between 1972 and 1978 with non-metastatic Ewing's sarcoma of the pelvis and were entered on IESS I. Seventeen patients (27%) developed a local recurrence, 38 patients (61%) demonstrated metastases and 21 (34%) neither. In the dose range 4000 rad to 6000 rad no dose response could be detected for local control of tumor. Forty-six patients (74%) had a biopsy or exploratory surgery only, 5 patients (8%) had an incomplete resection and 11 patients (18%) has a complete resection of their tumor. In the 46 patients having a biopsy only, 13 developed a local recurrence (28%) as compared to 2 of 11 patients undergoing a complete resection (18%). The most common sites for metastases were lung in 19 patients (31%) and bone in 23 patients (37%). No significant difference was noted in the frequency of overall metastases or metastases to any site between those patients receiving one of the three treatment regimens used in IESS I: VAC and Adriamycin (regime I), VAC alone (regimen II) and VAC plus bilateral pulmonary irradiation (regimen III). At a median follow-up of 135 weeks no significant difference in median survival could be detected in patients with pelvic primaries between regimens I, II and III. The possible reasons for the poor prognosis of pelvic primary patients are discussed together with treatment policies that might improve the survival of this group of patients

  20. Acrylic Bone Cements Modified with Starch

    OpenAIRE

    Krilova, V; Vītiņš, V

    2010-01-01

    The successful result of restorative and replacement surgical operation depends significantly on properties of used bone cement. Acrylic bone cements are usually based on methylmethacrylate polymer, while monomer polymerization begins after mixing of components in mixing device and terminates in living tissue. Polymerization of methylmethacrylate is exothermic process, and temperature increase might cause tissue necrosis with concomitant implant aseptic loosening. Developed non-ionogenic and ...

  1. Chondroblastoma of the navicular bone.

    Science.gov (United States)

    Li, Xiao Na; Peng, Zhi Gang; Zhao, Jing Pin; Zhang, Ze Kun

    2014-12-01

    This is a case report of a 24-year-old man who presented with increased pain and firm swelling of the right foot after a minor twisting injury. Radiography, computed tomography (CT) and magnetic resonance imaging (MRI) findings showed ancillary information that was helpful for surgical treatment. The final diagnosis was confirmed as chondroblastoma of the navicular bone based on the pathology report. The navicularbone is a very rare site in the foot, where we should pay attention to chondroblastoma.

  2. Chondroblastoma of the navicular bone.

    Science.gov (United States)

    Li, Xiao Na; Peng, Zhi Gang; Zhao, Jing Pin; Zhang, Ze Kun

    2014-12-01

    This is a case report of a 24-year-old man who presented with increased pain and firm swelling of the right foot after a minor twisting injury. Radiography, computed tomography (CT) and magnetic resonance imaging (MRI) findings showed ancillary information that was helpful for surgical treatment. The final diagnosis was confirmed as chondroblastoma of the navicular bone based on the pathology report. The navicularbone is a very rare site in the foot, where we should pay attention to chondroblastoma. PMID:25780542

  3. Chondroblastoma of the Navicular Bone

    OpenAIRE

    Li, Xiao Na; Peng, Zhi Gang; Zhao, Jing Pin; Zhang, Ze Kun

    2014-01-01

    This is a case report of a 24-year-old man who presented with increased pain and firm swelling of the right foot after a minor twisting injury. Radiography, computed tomography (CT) and magnetic resonance imaging (MRI) findings showed ancillary information that was helpful for surgical treatment. The final diagnosis was confirmed as chondroblastoma of the navicular bone based on the pathology report. The navicularbone is a very rare site in the foot, where we should pay attention to chondrobl...

  4. Management of Temporal Bone Trauma

    OpenAIRE

    Patel, Alpen; Groppo, Eli

    2010-01-01

    The temporal bones are paired structures located on the lateral aspects of the skull and contribute to the skull base. Trauma is usually the result of blunt head injury and can result in damage to the brain and meninges, the middle and internal ear, and the facial nerve. Complications can include intracranial hemorrhage, cerebral contusion, CSF leak and meningitis, hearing loss, vertigo, and facial paralysis. To prevent these complications, diagnosis followed by appropriate medical and surgic...

  5. Three-dimensional finite element simulation of surgical correction for Lenke 2 type adolescent idiopathic scoliosis%Lenke2型特发性脊柱侧凸三维矫形手术的有限元模拟

    Institute of Scientific and Technical Information of China (English)

    刘祥胜; 吴冰; 魏显招; 吴大江; 杨宗德; 易红蕾; 王传锋; 董有海; 李明

    2012-01-01

    Objective To simulate different anterior and posterior correction strategies using finite element model of Lenke 2 type adolescent idiopathic scoliosis(AlS), in an effort to seek the optimal surgical protocol. Methods The finite element model of Lenke 2 type AIS was established and used to simulate five surgical strategies. The effectiveness and shoulder balance parameters were compared among different surgical approaches. Results The coronary proximal thoracic(PT) Cobb angle and corrective rates of the five surgical strategies were 21. 5(44. 8%), 26.5(32. 1%), 28. 1(27.9%), 34. 1(12.5%), and 32(17. 9%). The corrective rates for the main thoracic curves were not significantly different among the five strategies, and the physiological sagittal configuration was maintained. Postoperative radiographic shoulder balance parameters were increased for all five surgical protocols. Except for strategy A(posterior fusion from T2 to T11 ), other four strategy achieved the following outcomes! coracoid height difference>9 mm, elavical angle>2. 5° and clavicular tilt angle difference>4. 5° . Conclusion Simulation of posterior correction and fusion to T2 including both thoracic curve can achieve excellent three-dimensional shoulder imbalance slight to moderate degrees.%目的 利用建立的Lenke 2型青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)三维有限元模型,分别仿真模拟前路、后路手术矫形操作,探讨其最佳手术方案.方法 建立Lenke 2型AIS的有限元模型,分别模拟前路和后路共5种不同的矫形方案,比较不同手术方案的矫形效果和双肩平衡参数的变化.结果 5种不同矫形方案有限元模拟术后的上胸弯冠状面Cobb角和矫形率分别为:21.5(44.8%)、26.5(32.1%)、28.1(27.9%)、34.1(12.5%)、32(17.9%),各矫形方案的主胸弯矫正率无明显差别.胸椎矢状面生理后凸得以维持.5种矫形方案术后各双肩平衡影像学参数较术前有所升高,除方

  6. Technetium bone scanning as an aid in the diagnosis of atypical acute osteomyelitis in children

    Energy Technology Data Exchange (ETDEWEB)

    Letts, R.M.; Afifi, A.; Sutherland, J.B.

    1975-06-01

    Technetium bone scanning is a simple, safe and accurate method for the diagnosis of acute osteomyelitis in children whose presenting clinical findings are atypical of bone infection. Bone scanning was effective in the localization of the exact site of osteomyelitis, thus facilitating needle aspiration as well as subsequent surgical decompression. Technetium bone scanning is a diagnostic technique for determining bone infection in children who are unable to communicate adequately or in those whose signs have been modified by previous inadequate antibacterial therapy.

  7. Ambulatory Surgical Measures - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  8. Ambulatory Surgical Measures - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  9. Ambulatory Surgical Measures - Facility

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Ambulatory Surgical Center Quality Reporting (ASCQR) Program seeks to make care safer and more efficient through quality reporting. ASCs eligible for this...

  10. Surgical Critical Care Initiative

    Data.gov (United States)

    Federal Laboratory Consortium — The Surgical Critical Care Initiative (SC2i) is a USU research program established in October 2013 to develop, translate, and validate biology-driven critical care....

  11. Talking Bones.

    Science.gov (United States)

    Johnson, Jaclyn; Kassing, Sharon

    2002-01-01

    Describes cooperation with the Saint Louis Zoo to provide opportunities for elementary school students to learn about bones, how animals move, what they eat, and how much they grow. Uses biofacts which include bones, skulls, and other parts to make the laboratory a hands-on experience for students. (YDS)

  12. Bone Markers

    Science.gov (United States)

    ... bone turnover: C-telopeptide (C-terminal telopeptide of type 1 collagen (CTx)) – a marker for bone resorption. It is ... resorption include: N-telopeptide (N-terminal telopeptide of type 1 collagen (NTx)) – a peptide fragment from the amino terminal ...

  13. MODELADO, SIMULACIÓN Y CONTROL DEL ROBOT PARA CIRUGÍA LAPAROSCÓPICA 'LAPBOT' MODELING, SIMULATION AND CONTROL OF SURGICAL LAPAROSCOPIC ROBOT 'LAPBOT'

    Directory of Open Access Journals (Sweden)

    Sergio Alexander Salinas

    2009-12-01

    Full Text Available Este artículo presenta el modelado matemático y estructural, la simulación por computador y el control por par calculado del robot para cirugía laparoscópica ‘LapBot’, que ha sido desarrollado en el Grupo de Investigación de Automática Industrial de la Universidad del Cauca, Colombia. Inicialmente se muestra un resumen de los principales robots utilizados como asistentes para cirugías de laparoscopia en el mundo, y de cómo tratan ellos el problema del paso por la incisión practicada en la cavidad abdominal. Con base en lo anterior se describen los requerimientos que deben cumplir los robots de este tipo y a partir de éstos se diseña el robot LapBot. Se muestra el modelo cinemático y dinámico del robot LapBot, así como el modelo de la restricción espacial que representa el punto de incisión abdominal. Se implementa una estrategia de control basada en el modelo del robot (control por par calculado. Diversas trayectorias en un plano y en un espacio de tres dimensiones son utilizadas para validar tanto el modelo como el controlador.This paper presents the mathematical and structural model, simulation and computed torque control of the LapBot robot, developed by the Group of Investigation of Industrial Automatics, of the University of Cauca, Colombia. First, a summary of the principal surgery assistant robots of the world is presented, and how they solve the problem of passing through the incision into the abdominal cavity. Based on this, the conditions that must be fulfilled by the robots of this type is exposed, and from these conditions the LapBot robot is designed. Its kinematics and dynamics model is shown, as well as the mathematical spatial restriction that incision represents. A control strategy based on the model (computed torque control is implemented. Several trajectories defined in a plane and in a three dimensions space are used to validate the model and the control.

  14. Bone densitometry

    DEFF Research Database (Denmark)

    Ravn, Pernille; Alexandersen, P; Møllgaard, A

    1999-01-01

    The bisphosphonates have been introduced as alternatives to hormone replacement therapy (HRT) for the treatment and prevention of postmenopausal osteoporosis. The expected increasing application in at clinical practice demands cost-effective and easily handled methods to monitor the effect on bone....... The weak response at the distal forearm during antiresorptive treatment has restricted the use of bone densitometry at this region. We describe a new model for bone densitometry at the distal forearm, by which the response obtained is comparable to the response in other regions where bone densitometry...... is much more expensive and technically complicated. By computerized iteration of single X-ray absorptiometry forearm scans we defined a region with 65% trabecular bone. The region was analyzed in randomized, double-masked, placebo- controlled trials: a 2-year trial with alendronate (n = 69), a 1-year...

  15. Personalized Guides for Registration in Surgical Navigation.

    Science.gov (United States)

    Dickinson, Andrew W L; Rasquinha, Brian J; Rudan, John F; Ellis, Randy E

    2016-01-01

    Personalized guides are increasingly used in orthopedic procedures but do not provide for intraoperative re-planning. This work presents a tracked guide that used physical registration to provide an anatomy-to-tracking coordinate frame transformation for surgical navigation. In a study using seven femoral models derived from clinical CT scans used for hip resurfacing, a guide characterization FRE of 0.4°±0.2°, drill-path drill-path angular TRE of 0.9°±0.4° and a positional TRE of 1.2mm±0.4mm were found; these values are comparable to conventional optical tracking accuracy. This novel use of a tracked guide may be particularly applicable to procedures that require a small surgical exposure, or when operating on anatomical regions with small bones that are difficult to track or reliably register. PMID:27046560

  16. [Surgical treatment of extensive craniofacial juvenile angiofibromas].

    Science.gov (United States)

    Cherekaev, V A; Gol'bin, D A; Kapitanov, D N; Belov, A I; Arustamian, S R; Gromova, V V; Imaev, A A

    2009-01-01

    Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumor occurring almost exclusively in adolescent and young adult males. The tumor is characterized by slow progression, aggressive growth, high vascularization and increased rate of persistence and recurrence. From 2000 till 2008 29 consecutive male patients with JNA Fisch grade III and IV (intracranial extradural or intradural extension) were operated in Burdenko Neurosurgical Institute (Moscow, Russia). Most patients received different kinds of treatment before admission to the Institute. All patients underwent surgical resection using predominantly orbitozygomatic approach. Preoperative endovascular embolization was applied. Total removal was achieved in 86% of cases. Postoperative complications included osteomyelitis of the bone flap (4 cases), nasal CSF leak (1 case) etc. Recurrences were observed in 3 patients, all of them underwent repeated surgeries. 4 cases are presented (3 patients with Fisch grade IV tumor and 1 with grade III). Surgical treatment is the basic tactics in management of extensive JNAs. The authors recommend to use orbitozygomatic approach and endoscopic assistance.

  17. Surgical Management of Significant Maxillary Anterior Vertical Ridge Defects.

    Science.gov (United States)

    Urban, Istvan A; Monje, Alberto; Nevins, Myron; Nevins, Marc L; Lozada, Jamie L; Wang, Hom-Lay

    2016-01-01

    Severe vertical ridge deficiency in the anterior maxilla represents one of the most challenging scenarios in bone regeneration. Under ideal circumstances, guided bone regeneration in combination with soft tissue management has shown predictable esthetic and functional outcomes. Success largely relies on primary wound closure during and after the surgical procedure. Surgical sites present different challenges that need to be considered when designing the flap. The goal of this article is to propose a classification of flap designs that considers vestibular depth and scar formation around the periosteum when performing vertical ridge augmentation in the atrophic anterior maxilla. The four clinical conditions proposed under this classification are (1) shallow vestibule with healthy periosteum, (2) deep vestibule with healthy periosteum, (3) shallow vestibule with scarred periosteum, and (4) deep vestibule with scarred periosteum. The classification will allow clinicians to achieve tension-free closure and more predictable vertical bone gain.

  18. Surgical-prosthetic treatment of large mandibular cysts

    Directory of Open Access Journals (Sweden)

    Džambas Ljubiša D.

    2003-01-01

    Full Text Available This paper presents a combined surgical-prosthetic procedure of reconstructing mandibular bone defect in a 53 year old patient, following enucleation of a mandibular cyst (Cystectomy Partsch II. After a thorough diagnostic evaluation, a surgical procedure was planned with the particular attention to the nature of the disease, patient’s condition, size and extension of the cyst, tissue loss, and the possibilities of prosthetic management of a mandibular bone defect with partial postresection dental prosthesis. It is of great importance to point to the significance of teamwork of a maxillofacial surgeon and a specialist in prosthodontics. This kind of cooperation provided very effective and less risky soft tissue, as well as bone tissue regeneration (osteogenesis. The patient’s recovery was fast, and he could return to his daily activities and work without significant changes regarding quality of life after surgery and prosthetic treatment.

  19. Real-time in situ three-dimensional integral videography and surgical navigation using augmented reality:a pilot study

    Institute of Scientific and Technical Information of China (English)

    Hideyuki Suenaga; Huy Hoang Tran; Hongen Liao; Ken Masamune; Takeyoshi Dohi; Kazuto Hoshi; Yoshiyuki Mori; Tsuyoshi Takato

    2013-01-01

    To evaluate the feasibility and accuracy of a three-dimensional augmented reality system incorporating integral videography for imaging oral and maxillofacial regions, based on preoperative computed tomography data. Three-dimensional surface models of the jawbones, based on the computed tomography data, were used to create the integral videography images of a subject’s maxillofacial area. The three-dimensional augmented reality system (integral videography display, computed tomography, a position tracker and a computer) was used to generate a three-dimensional overlay that was projected on the surgical site via a half-silvered mirror. Thereafter, a feasibility study was performed on a volunteer. The accuracy of this system was verified on a solid model while simulating bone resection. Positional registration was attained by identifying and tracking the patient/surgical instrument’s position. Thus, integral videography images of jawbones, teeth and the surgical tool were superimposed in the correct position. Stereoscopic images viewed from various angles were accurately displayed. Change in the viewing angle did not negatively affect the surgeon’s ability to simultaneously observe the three-dimensional images and the patient, without special glasses. The difference in three-dimensional position of each measuring point on the solid model and augmented reality navigation was almost negligible (,1 mm);this indicates that the system was highly accurate. This augmented reality system was highly accurate and effective for surgical navigation and for overlaying a three-dimensional computed tomography image on a patient’s surgical area, enabling the surgeon to understand the positional relationship between the preoperative image and the actual surgical site, with the naked eye.

  20. Surgical treatment of tibial avulsion fracture at the posterior ligament- to- bone insertion site%手术治疗后交叉韧带胫骨止点撕脱性骨折

    Institute of Scientific and Technical Information of China (English)

    陈红峰; 王东明; 徐明勇

    2012-01-01

    Objective To study the clinical effect of the medial knee after surgical fixation of posterior cruciate ligament surgery tibial avulsion fracture. Methods Fifteen cases of cruciate ligament tibial avulsion fractures were performed with knee down "L-shaped" incision and anatomic fracture reduction was fixed with hollow screws and anchors. Patients were followed up for 6 months. Data regarding fractures, healing and joint stability, and range were collected. The recovery of knee function was assessed by Lysholm scale for knee function. Results All patients were cured after 8 to 13 weeks with no displacement. After 6 months, 2 cases of posteriordrawer test was weakly positive. There was 1 case with mild knee flexion limitation, but no knee extension limitation was observed. Lysholmknee score was (92 ± 2. 4) points. Conclusion Knee medial approach with a line of hollow screw and anchor screw fixation of posterior cruciate ligament tibial avulsion fracture is simple, safe, effective and reliable.%目的 探讨膝关节后内侧入路手术内固定治疗手术后交叉韧带胫骨止点撕脱性骨折的临床效果.方法 对15例交叉韧带胫骨止点撕脱性骨折患者行膝后倒“L”形小切口显露,解剖复位骨折,予以中空螺钉及带线锚钉内固定.术后随访6个月,收集骨折复位、愈合及关节稳定性、活动度以及Lysholm膝关节功能评分标准评估膝关节功能恢复情况.结果 术后8~13周均骨性愈合,未见位移.术后6个月,有2例后抽屉试验弱阳性,1例轻度屈膝受限,无伸膝受限,Lysholm膝关节功能评分( 92.0±2.4)分.结论 膝后内侧入路中空螺钉及带线锚钉内固定治疗后交叉韧带胫骨止点撕脱性骨折操作简单、安全、效果可靠.

  1. Lisfranc Injury Imaging and Surgical Management.

    Science.gov (United States)

    Llopis, Eva; Carrascoso, Javier; Iriarte, Inigo; Serrano, Mariano de Prado; Cerezal, Luis

    2016-04-01

    The Lisfranc joint is composed of the cuneiform bones and the cuboid and metatarsal bases, united by a synovial capsule and ligamentous complex. Familiarity with the anatomy is essential for image planning and for understanding injury patterns. The more important structures are the Lisfranc ligament and the plantar ligaments that can be visualized with MR, although careful attention to technique and orientation of scan planes is required for accuracy. A combination of conventional radiographs, computed tomography, and MR allow precise diagnosis of Lisfranc fractures, fracture dislocation, and subtle Lisfranc injuries to guide clinical management and surgical planning. PMID:27336449

  2. Stress fracture of the navicular bone. Nine cases in athletes.

    Science.gov (United States)

    Hulkko, A; Orava, S; Peltokallio, P; Tulikoura, I; Walden, M

    1985-12-01

    Nine cases of stress fractures of the tarsal navicular bone were treated in athletes. The diagnosis was made with radiographs and bone scan within 6 months. Only two patients were treated surgically. The only poor result was seen in a patient in whom the fracture was only explored. PMID:4090953

  3. Nonviral gene transfer strategies to promote bone regeneration.

    Science.gov (United States)

    Im, Gun-Il

    2013-10-01

    Despite the inherent ability of bone to regenerate itself, there are a number of clinical situations in which complete bone regeneration fails to occur. In view of shortcomings of conventional treatment, gene therapy may have a place in cases of critical-size bone loss that cannot be properly treated with current medical or surgical treatment. The purpose of this review is to provide an overview of gene therapy in general, nonviral techniques of gene transfer including physical and chemical methods, RNA-based therapy, therapeutic genes to be transferred for bone regeneration, route of application including ex vivo application, and direct gene therapy approaches to regenerate bone.

  4. Ultrasonic bone removal with the Sonopet Omni: a new instrument for orbital and lacrimal surgery.

    Science.gov (United States)

    Sivak-Callcott, Jennifer A; Linberg, John V; Patel, Sarit

    2005-11-01

    We used a new instrument that ultrasonically removes bone (Sonopet Omni, model UST-2001 Ultrasonic Surgical Aspirator) in 13 orbital decompressions and 6 dacryocystorhinostomies. We noted no surgical complications of ocular or soft tissue damage, infection, inflammation, or visual loss. Visualization, manipulation, ease of use, and speed were far superior with the Sonopet ultrasonic bone curette compared with drills or rongeurs. The Sonopet Omni is an outstanding innovation in technology for bone removal in surgery. PMID:16286624

  5. Surgical management of ectrodactyly in a dog

    Directory of Open Access Journals (Sweden)

    Márcio Poletto Ferreira

    2016-04-01

    Full Text Available Ectrodactyly is the term used to designate cases in which soft and bone tissue separation within the distal region of the thoracic limbs is present. It is observed in particular below the metacarpal bones and extending to the radius and ulna. In addition, it can often be associated with ipsilateral elbow luxation. We describe a case of ectrodactyly in a 3-month-old mongrel dog, where bone and soft tissue separation occurred between the third and fourth digits, extending proximally to the carpal region. We identified shortening of the ulna without elbow luxation. The dog was subjected to a surgical procedure comprising bone and soft tissue reconstruction and ulnar diaphyseal osteotomy, which was fixed using a Steinmann pin in the intramedullary canal, maintaining a distance of 1 cm between the two ulnar fragments. Two distal phalanges were removed because it was not possible to reposition them anatomically in the limb. The dog walked with mild lameness nine months after surgery.

  6. Excised Abdominoplasty Material as a Systematic Plastic Surgical Training Model

    Directory of Open Access Journals (Sweden)

    M. Erol Demirseren

    2012-01-01

    Full Text Available Achieving a level of technical skill and confidence in surgical operations is the main goal of plastic surgical training. Operating rooms were accepted as the practical teaching venues of the traditional apprenticeship model. However, increased patient population, time, and ethical and legal considerations made preoperation room practical work a must for plastic surgical training. There are several plastic surgical teaching models and simulators which are very useful in preoperation room practical training and the evaluation of plastic surgery residents. The full thickness skin with its vascular network excised in abdominoplasty procedures is an easily obtainable real human tissue which could be used as a training model in plastic surgery.

  7. Simulation

    DEFF Research Database (Denmark)

    Gould, Derek A; Chalmers, Nicholas; Johnson, Sheena J;

    2012-01-01

    Recognition of the many limitations of traditional apprenticeship training is driving new approaches to learning medical procedural skills. Among simulation technologies and methods available today, computer-based systems are topical and bring the benefits of automated, repeatable, and reliable...... performance assessments. Human factors research is central to simulator model development that is relevant to real-world imaging-guided interventional tasks and to the credentialing programs in which it would be used....

  8. A MULTI-SITE SHEEP MODEL FOR CANCELLOUS BONE HEALING

    OpenAIRE

    MatthewhenryPelletier

    2014-01-01

    Appropriate, well characterized bone defect animal models remain essential for preclinical research. This pilot study demonstrates a relevant animal model for cancellous bone defect healing. Three different defect diameters (8, 11, 14mm) of fixed depth (25mm) were compared in both skeletally immature (18 month old) and aged sheep (5 year old). In each animal, four defects were surgically created and placed in the cancellous bone of the medial distal femoral and proximal tibial epiphyses bi...

  9. Fenestration of bone flap during decompressive craniotomy for subdural hematoma

    OpenAIRE

    Ha Son Nguyen; Ninh Doan; Christopher Wolfla; Glen Pollock

    2016-01-01

    Background: Persistent/recurrent extra-axial hemorrhage may occur after decompression of a subdural hematoma (SDH) followed by an immediate replacement of bone flap. A fenestration of the bone flap may encourage extra-axial fluid absorption; however, the literature has not explored this technique. Methods: Forty-four consecutive patients who underwent surgical decompression of SDH with immediate replacement of bone flap were divided into two groups: Fenestration (F), n = 33, and no fenest...

  10. Your Bones

    Science.gov (United States)

    ... a fall! If you play sports like football, soccer, lacrosse, or ice hockey, always wear all the ... to strengthen your bones is through exercise like running, jumping, dancing, and playing sports. Take these steps ...

  11. Assessment of bone vascularity in the anterior mandible using laser Doppler flowmetry.

    NARCIS (Netherlands)

    Verdonck, H.W.; Meijer, G.J.; Kessler, P.; Nieman, F.H.; Baat, C. de; Stoelinga, P.J.W.

    2009-01-01

    OBJECTIVES: In irradiated bone, a method assessing vascularity of intended implant recipient bone would be of clinical significance in preventing early implant loss and in reducing the risk of osteoradionecrosis due to surgical oral implant insertion. At present, assessing bone vascularity clinicall

  12. Surgical management of presbyopia

    Directory of Open Access Journals (Sweden)

    Torricelli AA

    2012-09-01

    Full Text Available André AM Torricelli, Jackson B Junior, Marcony R Santhiago, Samir J BecharaDivision of Ophthalmology, University of São Paulo Medical School, São Paulo, BrazilAbstract: Presbyopia, the gradual loss of accommodation that becomes clinically significant during the fifth decade of life, is a physiologic inevitability. Different technologies are being pursued to achieve surgical correction of this disability; however, a number of limitations have prevented widespread acceptance of surgical presbyopia correction, such as optical and visual distortion, induced corneal ectasia, haze, anisometropy with monovision, regression of effect, decline in uncorrected distance vision, and the inherent risks with invasive techniques, limiting the development of an ideal solution. The correction of the presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. The purpose of this paper is to provide an update about current procedures available for presbyopia correction, their advantages, and disadvantages.Keywords: presbyopia, surgical correction, treatment

  13. Bone defect animal models for testing efficacy of bone substitute biomaterials

    Directory of Open Access Journals (Sweden)

    Ye Li

    2015-07-01

    Full Text Available Large bone defects are serious complications that are most commonly caused by extensive trauma, tumour, infection, or congenital musculoskeletal disorders. If nonunion occurs, implantation for repairing bone defects with biomaterials developed as a defect filler, which can promote bone regeneration, is essential. In order to evaluate biomaterials to be developed as bone substitutes for bone defect repair, it is essential to establish clinically relevant in vitro and in vivo testing models for investigating their biocompatibility, mechanical properties, degradation, and interactional with culture medium or host tissues. The results of the in vitro experiment contribute significantly to the evaluation of direct cell response to the substitute biomaterial, and the in vivo tests constitute a step midway between in vitro tests and human clinical trials. Therefore, it is essential to develop or adopt a suitable in vivo bone defect animal model for testing bone substitutes for defect repair. This review aimed at introducing and discussing the most available and commonly used bone defect animal models for testing specific substitute biomaterials. Additionally, we reviewed surgical protocols for establishing relevant preclinical bone defect models with various animal species and the evaluation methodologies of the bone regeneration process after the implantation of bone substitute biomaterials. This review provides an important reference for preclinical studies in translational orthopaedics.

  14. Temporal response of bone to unloading

    International Nuclear Information System (INIS)

    A model of weightlessness in which the hindlimbs of rats are elevated by their tails at a 40 degrees angle to unload the hindlimbs while maintaining normal weight bearing on the forelimbs has been used to simulate certain conditions of space flight. When we used this model in growing rats, we found that growth in bone weight ceased by 1 week in the hindlimbs and lumbar vertebrae, whereas growth in bone weight in the forelimbs and cervical vertebrae remained unaffected. Within 2 weeks, however, the accretion of bone weight in the hindlimbs and lumbar vertebrae returned to normal despite continued skeletal unloading. Since bone weight in the growing rat is primarily determined by bone formation (bone resorption is modest), we investigated the effects of selective skeletal unloading on bone formation during 2 weeks of hindlimb elevation using radioisotope incorporation (with 45Ca and [3H]proline) and histomorphometry (with tetracycline labeling). The studies using radioisotope incorporation showed that bone formation was inhibited by the fifth day of skeletal unloading. By the 10th to 12th day, bone formation had returned toward normal. In comparison with cortical bone, cancellous bone (lumbar vertebrae and proximal tibiae) incorporated more 45Ca and [3H]proline (indicating greater metabolic activity) and had a greater absolute response to skeletal unloading. The results of these studies were confirmed by histomorphometric measurements of bone formation using triple tetracycline labeling. We conclude that this model of simulated weightlessness results in an initial inhibition of bone formation in the unloaded bones. This temporary cessation of bone formation is followed by a cessation in the accretion of bone weight, which then resumes at a normal rate by 14 days despite continued skeletal unloading

  15. Temporal response of bone to unloading

    Energy Technology Data Exchange (ETDEWEB)

    Globus, R.K.; Bikle, D.D.; Morey-Holton, E.

    1986-02-01

    A model of weightlessness in which the hindlimbs of rats are elevated by their tails at a 40 degrees angle to unload the hindlimbs while maintaining normal weight bearing on the forelimbs has been used to simulate certain conditions of space flight. When we used this model in growing rats, we found that growth in bone weight ceased by 1 week in the hindlimbs and lumbar vertebrae, whereas growth in bone weight in the forelimbs and cervical vertebrae remained unaffected. Within 2 weeks, however, the accretion of bone weight in the hindlimbs and lumbar vertebrae returned to normal despite continued skeletal unloading. Since bone weight in the growing rat is primarily determined by bone formation (bone resorption is modest), we investigated the effects of selective skeletal unloading on bone formation during 2 weeks of hindlimb elevation using radioisotope incorporation (with /sup 45/Ca and (/sup 3/H)proline) and histomorphometry (with tetracycline labeling). The studies using radioisotope incorporation showed that bone formation was inhibited by the fifth day of skeletal unloading. By the 10th to 12th day, bone formation had returned toward normal. In comparison with cortical bone, cancellous bone (lumbar vertebrae and proximal tibiae) incorporated more /sup 45/Ca and (/sup 3/H)proline (indicating greater metabolic activity) and had a greater absolute response to skeletal unloading. The results of these studies were confirmed by histomorphometric measurements of bone formation using triple tetracycline labeling. We conclude that this model of simulated weightlessness results in an initial inhibition of bone formation in the unloaded bones. This temporary cessation of bone formation is followed by a cessation in the accretion of bone weight, which then resumes at a normal rate by 14 days despite continued skeletal unloading.

  16. Osteobiology: newest bone organ topics and the platelet-rich plasma treatment.

    Directory of Open Access Journals (Sweden)

    Ananias García Cardona

    2007-11-01

    Full Text Available The bone is a dynamic tissue taht provides mechanical support, physical protection, storage site for minerals, and enables genesis movement. The bone biology (osteobiology is regulated by the balance betqeen osteoblastic formation and osteoclatic resorption. the skeletal bone homeostasis is influenced by components of the bone marrow organ, neuroendocrine system and hemato-inmmune system. The purpose of this review is to describe the biodynamic of the bone organ, and actual terapeutics with platelet-rich plasma in guide bone regeneration, a co-surgical method employed to increase the quantity and quality of the bone.

  17. The advantage of the three dimensional computed tomographic (3 D-CT for ensuring accurate bone incision in sagittal split ramus osteotomy

    Directory of Open Access Journals (Sweden)

    Coen Pramono D

    2005-03-01

    Full Text Available Functional and aesthetic dysgnathia surgery requires accurate pre-surgical planning, including the surgical technique to be used related with the difference of anatomical structures amongst individuals. Programs that simulate the surgery become increasingly important. This can be mediated by using a surgical model, conventional x-rays as panoramic, cephalometric projections and another sophisticated method such as a three dimensional computed tomography (3 D-CT. A patient who had undergone double jaw surgeries with difficult anatomical landmarks was presented. In this case the mandible foramens were seen highly relatively related to the sigmoid notches. Therefore, ensuring the bone incisions in sagittal split was presumed to be difficult. A 3D-CT was made and considered to be very helpful in supporting the pre-operative diagnostic.

  18. [Orthognathic surgery: corrective bone operations].

    Science.gov (United States)

    Reuther, J

    2000-05-01

    The article reviews the history of orthognathic surgery from the middle of the last century up to the present. Initially, mandibular osteotomies were only performed in cases of severe malformations. But during the last century a precise and standardized procedure for correction of the mandible was established. Multiple modifications allowed control of small fragments, functionally stable osteosynthesis, and finally a precise positioning of the condyle. In 1955 Obwegeser and Trauner introduced the sagittal split osteotomy by an intraoral approach. It was the final breakthrough for orthognathic surgery as a standard treatment for corrections of the mandible. Surgery of the maxilla dates back to the nineteenth century. B. von Langenbeck from Berlin is said to have performed the first Le Fort I osteotomy in 1859. After minor changes, Wassmund corrected a posttraumatic malocclusion by a Le Fort I osteotomy in 1927. But it was Axhausen who risked the total mobilization of the maxilla in 1934. By additional modifications and further refinements, Obwegeser paved the way for this approach to become a standard procedure in maxillofacial surgery. Tessier mobilized the whole midface by a Le Fort III osteotomy and showed new perspectives in the correction of severe malformations of the facial bones, creating the basis of modern craniofacial surgery. While the last 150 years were distinguished by the creation and standardization of surgical methods, the present focus lies on precise treatment planning and the consideration of functional aspects of the whole stomatognathic system. To date, 3D visualization by CT scans, stereolithographic models, and computer-aided treatment planning and simulation allow surgery of complex cases and accurate predictions of soft tissue changes.

  19. Remoción de terceros molares mandibulares con asistencia endoscópica: Nota técnica de un nuevo procedimiento quirúrgico para prevenir lesiones del NAI y formación de defectos óseos Removal of mandibular third molars with endoscopic approach: Technical note of a new surgical procedure to avoid IAN damage and bone defect formation

    Directory of Open Access Journals (Sweden)

    R Fuentes

    2012-08-01

    , preserving the buccal and lingual walls through direct and magnified visualization of the surgical site, adaptable to the patient’s movements during the surgery. In this report, we present a new and minimally invasive procedure through endoscopic assistance for bone conservation in the removal of third molars at risk of inferior alveolar nerve injury.

  20. Simulation

    CERN Document Server

    Ross, Sheldon

    2006-01-01

    Ross's Simulation, Fourth Edition introduces aspiring and practicing actuaries, engineers, computer scientists and others to the practical aspects of constructing computerized simulation studies to analyze and interpret real phenomena. Readers learn to apply results of these analyses to problems in a wide variety of fields to obtain effective, accurate solutions and make predictions about future outcomes. This text explains how a computer can be used to generate random numbers, and how to use these random numbers to generate the behavior of a stochastic model over time. It presents the statist

  1. Surgical virtual reality - highlights in developing a high performance surgical haptic device.

    Science.gov (United States)

    Custură-Crăciun, D; Cochior, D; Constantinoiu, S; Neagu, C

    2013-01-01

    Just like simulators are a standard in aviation and aerospace sciences, we expect for surgical simulators to soon become a standard in medical applications. These will correctly instruct future doctors in surgical techniques without there being a need for hands on patient instruction. Using virtual reality by digitally transposing surgical procedures changes surgery in are volutionary manner by offering possibilities for implementing new, much more efficient, learning methods, by allowing the practice of new surgical techniques and by improving surgeon abilities and skills. Perfecting haptic devices has opened the door to a series of opportunities in the fields of research,industry, nuclear science and medicine. Concepts purely theoretical at first, such as telerobotics, telepresence or telerepresentation,have become a practical reality as calculus techniques, telecommunications and haptic devices evolved,virtual reality taking a new leap. In the field of surgery barrier sand controversies still remain, regarding implementation and generalization of surgical virtual simulators. These obstacles remain connected to the high costs of this yet fully sufficiently developed technology, especially in the domain of haptic devices. PMID:24331310

  2. Surgical virtual reality - highlights in developing a high performance surgical haptic device.

    Science.gov (United States)

    Custură-Crăciun, D; Cochior, D; Constantinoiu, S; Neagu, C

    2013-01-01

    Just like simulators are a standard in aviation and aerospace sciences, we expect for surgical simulators to soon become a standard in medical applications. These will correctly instruct future doctors in surgical techniques without there being a need for hands on patient instruction. Using virtual reality by digitally transposing surgical procedures changes surgery in are volutionary manner by offering possibilities for implementing new, much more efficient, learning methods, by allowing the practice of new surgical techniques and by improving surgeon abilities and skills. Perfecting haptic devices has opened the door to a series of opportunities in the fields of research,industry, nuclear science and medicine. Concepts purely theoretical at first, such as telerobotics, telepresence or telerepresentation,have become a practical reality as calculus techniques, telecommunications and haptic devices evolved,virtual reality taking a new leap. In the field of surgery barrier sand controversies still remain, regarding implementation and generalization of surgical virtual simulators. These obstacles remain connected to the high costs of this yet fully sufficiently developed technology, especially in the domain of haptic devices.

  3. 后路一期病灶清除结合内固定治疗多节段脊柱结核%Surgical Treatment with Posterior Pedicle Screw Fixation,Focal Cleaning,Titanium Mesh and Bone Graft Fusion for Multi-segmental Spinal Tuberculosis

    Institute of Scientific and Technical Information of China (English)

    杨启远; 冯敬; 杨雯栋; 罗小丽; 李英博; 雷超; 冯志; 赖显金

    2016-01-01

    Objective To study the clinical effect of Surgical treatment with posterior pedicle screw fixation,focal clean-ing,titanium mesh and bone graft fusion for multi-segmental spinal tuberculosis. Methods The clinical data from 16 patients with multi-segmental spinal tuberculosis from January 2009 to December 2014 were retrospectively analyzed. There were 7 males and 9 females,ranging in age from 19 to 56 years with an average of 36. 5 years old. 2 vertebral bodies involved in 6 ca-ses,3 vertebral bodies in 7 cases,4 vertebral bodies in 2 eases,and 5 vertebral bodies in 1case. Among these cases,there were 9 cases of thoracic vertebra,5 cases of thoracolumbar vertebra,2 cases of lumbar vertebra. The kyphosis angel of diseased seg-ments was 28° to 53°,37. 6° in average. According to the Frankel classification before operation,there were Frankel A in 0 case,Frankel B in 1 cases,Frankel C in 2 cases,Frankel D in 6 cases,Frankel E in 7 cases. After intensive anti-tuberculosis medication(HRSZ)for 2 to 4 weeks before operation,all patients were treated with posterior pedicle screw fixation,focal clean-ing,titanium mesh and bone graft fusion. After operation,the anti-tuberculosis medication was continued for 12 ~ 18 months. Results The operation time ranged from 160 mins to 290 mins,215 mins in average. The blood loss ranged from 400 to 1 800 mL,780 mL in average. All the cases were followed up for 6 months to 2 years with the average of 1 year and 7 months. 1 cases was complicated with CSF leakage. No wound infection and sinus tract formation were noted. All the cases showed excellent bone graft fusion,all internal fixation had good position without looseness,displacement and breakage. The Mean kyphosis angle was 28. 2°(range,8°to 27°)after operation,with an average correction rate of 75% . Neurologic status of all patients with pre-opertative neurologic deficit was :1 with grade B recovered to grade C;2 with grade C,1 recovered to grade D and 1 recovered to grade E;6

  4. Phosphate-induced metal stabilization: Use of apatite and bone char for the removal of soluble radionuclides in authentic and simulated DOE groundwater

    International Nuclear Information System (INIS)

    The apatite group of minerals is a family of calcium phosphate phases. Apatite is the principal component of bone tissue, and it also occurs naturally as mineral deposits in the geosphere. Bone char is calcined (coked) animal bone, containing activated carbon as well as calcium phosphate mineral phases. Apatite IItrademark is a more reactive form of apatite, supplied by UFA Ventures, Inc., at a cost of approximately 1/4 that of commercial bone char. Apatite is shown to be effective for the removal of select heavy metal impurities in groundwater. Previous investigations have demonstrated that apatite is an effective medium for the stabilization of soluble lead, cadmium, and zinc from mine waste leachate by the formation of highly insoluble precipitate phases. The performance of bone char and apatite II are compared with other candidate sorption media (including granular activated carbon and anion exchange resin) for the removal of soluble uranyl ion in synthetic DOE Site groundwater supplemented with varying levels of interfering nitrate ion. Apatite II has a greater affinity for U(VI), especially in the presence of nitrate ion, as evidenced by a larger value for the conditional distribution coefficient (Kd) in batch test experiments. Contact of uranyl nitrate solution with apatite II is shown to produce highly insoluble mineral phases of the autunite group (calcium uranyl phosphate hydrates). Apatite II is also demonstrated to be moderately effective for the removal of soluble radioactive isotopes of strontium, but not cesium, when these ions are supplemented into authentic DOE Site groundwater

  5. 前外侧和外侧联合入路的股骨颈肿瘤刮除植骨及内固定术%Surgical technique of combined anterior-lateral and lateral approach in the management of bone tumor of femoral neck

    Institute of Scientific and Technical Information of China (English)

    伦登兴; 胡永成; 黄洪超; 夏群; 苗军; 于金虎

    2011-01-01

    Objective To explore surgical procedure of combined anterior-lateral and lateral approach for the treatment of bone tumors of femoral neck. Methods Forty patients with bone tumors of femoral neck treated in Tianjin Hospital were included from July 2005 to August 2009. Of the patients, 12 who were treated with curettage and bone graft through combined anterior-lateral and lateral incision were analyzed in this study. There were 7 males and 5 females with an average age of 34 years ranging from 17 to 68 years. 4 patients were diagnosed as chondroblastoma, 2 giant cell tumor, 3 fibrous dysplasia, and 3 single bone cysts. 7 patients suffered from pathologic fractures, and 5 had presented thin cortical bone because of tumor involvement. There were 1 tumor located in H1 zone, 4 in H2 zone and 7 in H1,2 zone according to ISOLS femoral neck classification. All patients were treated by curettage and bone graft via anterior-lateral approach, 10 cases underwent internal fixation with anatomical plate, and 2 cases with canulated screws with lateral approach. Results The follow-up time ranged from 10 to 68 months with an average of 35 months.Pain disappeared in all patients, and there were not recurrence of tumor, pathologic fractures and avascular necrosis. One case had complained of lateral femoral skin numbness which may be caused by injures of femoral lateral nerves. One case had difficulties in the valgus of hip joint. The mean MSTS score was 29.2 points ranging from 27 to 30 points. Conclusion Anterior approaches of "SP" incision is helpful to thorough curettage which decrease the risk of recurrence due to good visualization and intemal fixation is easy to perform via lateral approaches. The result suggested that combined anterior-lateral "SP" and lateral incision is liable option in treatment of bone tumors of femoral neck.%目的 探讨前外侧和外侧联合入路肿瘤刮除植骨重建治疗股骨颈骨肿瘤的疗效.方法 2005年7月至2009年8月采用前外侧

  6. Anxiety in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Jensen, Asger Lundorff;

    2012-01-01

    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... Skills); both courses were offered in multiple classes (with a total of 171 students in 2009 and 156 students in 2010). All classes in 2009 participated in the SSL stage of the Basic Surgical Skills course before performing live-animal surgery, and one class (28 students) in 2010 did not. Two validated...

  7. Surgical infections with Mycoplasma

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Prag, Jørgen Brorson; Jensen, J S;

    1997-01-01

    Mycoplasma hominis and Ureaplasma urealyticum are common inhabitants of the human genital tract. Evidence for an aetiological role in pyelonephritis, pelvic inflammatory disease, post-abortion and post-partum fever has been presented. There are sporadic reports of Mycoplasma causing serious extra...... extragenital infection such as septicemia, septic arthritis, neonatal meningitis and encephalitis. We review 38 cases of surgical infections with Mycoplasma....

  8. Surgical wound care

    Science.gov (United States)

    ... F for more than 4 hours Alternate Names Surgical incision care; Open wound care Images Proper hand washing References Lynn PB. Cleaning a wound and applying a dry, sterile dressing. In: Lynn PB. Taylor’s Handbook of Nursing Skills . Philadelphia, PA: Lippincott Williams and Wilkins, Wolters ...

  9. Ancient Egyptian surgical heritage.

    Science.gov (United States)

    Saber, Aly

    2010-12-01

    Egyptian medicine influenced the medicine of neighboring cultures, including the culture of ancient Greece. From Greece, its influence spread onward, thereby affecting Western civilization significantly. The oldest extant Egyptian medical texts are six papyri: The Edwin Smith Surgical Papyrus and the Ebers Medical Papyrus are famous. PMID:21208098

  10. Bone marrow transplant

    Science.gov (United States)

    Transplant - bone marrow; Stem cell transplant; Hematopoietic stem cell transplant; Reduced intensity nonmyeloablative transplant; Mini transplant; Allogenic bone marrow transplant; Autologous bone marrow transplant; Umbilical ...

  11. Mesenchymal Stem Cells as a Potent Cell Source for Bone Regeneration

    Directory of Open Access Journals (Sweden)

    Elham Zomorodian

    2012-01-01

    Full Text Available While small bone defects heal spontaneously, large bone defects need surgical intervention for bone transplantation. Autologous bone grafts are the best and safest strategy for bone repair. An alternative method is to use allogenic bone graft. Both methods have limitations, particularly when bone defects are of a critical size. In these cases, bone constructs created by tissue engineering technologies are of utmost importance. Cells are one main component in the manufacture of bone construct. A few cell types, including embryonic stem cells (ESCs, adult osteoblast, and adult stem cells, can be used for this purpose. Mesenchymal stem cells (MSCs, as adult stem cells, possess characteristics that make them good candidate for bone repair. This paper discusses different aspects of MSCs that render them an appropriate cell type for clinical use to promote bone regeneration.

  12. Bone mineral content and bone metabolism in young adults with severe periodontitis

    DEFF Research Database (Denmark)

    Wowern von, N.; Westergaard, J.; Kollerup, G.

    2001-01-01

    Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis......Bone loss, bone markers, bone metabolism, bone mineral content, osteoporosis, severe periodontitis...

  13. Successful surgical excision of primary right atrial angiosarcoma

    Directory of Open Access Journals (Sweden)

    van der Horst Iwan CC

    2011-04-01

    Full Text Available Abstract Primary cardiac angiosarcoma is a rare and aggressive tumor with a high incidence of metastatic spread (up to 89% at the time of diagnosis, which restricts the indication for surgical resection to a small number of patients. We report the case of a 50-year old Caucasian woman with non-metastatic primary right atrial angiosarcoma, who underwent successful surgical excision of the tumor (with curative intent and reconstruction of the right atrium with a porcine pericardial patch. However, after a symptom-free survival of five months the patient presented with bone and liver metastases without evidence of local tumor recurrence.

  14. [Bone transplant].

    Science.gov (United States)

    San Julián, M; Valentí, A

    2006-01-01

    We describe the methodology of the Bone and Soft Tissue Bank, from extraction and storage until use. Since the year 1986, with the creation of the Bone Bank in the University Clinic of Navarra, more than 3,000 grafts have been used for very different types of surgery. Bone grafts can be classified into cortical and spongy; the former are principally used in surgery to save tumour patients, in large post-traumatic reconstructions and in replacement surgery where there are massive bone defects and a structural support is required. The spongy grafts are the most used due to their numerous indications; they are especially useful in filling cavities that require a significant quantity of graft when the autograft is insufficient, or as a complement. They are also of special help in treating fractures when there is bone loss and in the treatment of delays in consolidation and pseudoarthrosis in little vascularized and atrophic zones. They are also used in prosthetic surgery against the presence of cavity type defects. Allografts of soft tissues are specially recognised in multiple ligament injuries that require reconstructions. Nowadays, the most utilised are those employed in surgery of the anterior cruciate ligament although they can be used for filling any ligament or tendon defect. The principal difficulties of the cortical allografts are in the consolidation of the ends with the bone itself and in tumour surgery, given that these are patients immunodepressed by the treatment, the incidence of infection is increased with respect to spongy grafts and soft tissues, which is irrelevant. In short, the increasingly widespread use of allografts is an essential therapeutic weapon in orthopaedic surgery and traumatology. It must be used by expert hands.

  15. [Bone transplant].

    Science.gov (United States)

    San Julián, M; Valentí, A

    2006-01-01

    We describe the methodology of the Bone and Soft Tissue Bank, from extraction and storage until use. Since the year 1986, with the creation of the Bone Bank in the University Clinic of Navarra, more than 3,000 grafts have been used for very different types of surgery. Bone grafts can be classified into cortical and spongy; the former are principally used in surgery to save tumour patients, in large post-traumatic reconstructions and in replacement surgery where there are massive bone defects and a structural support is required. The spongy grafts are the most used due to their numerous indications; they are especially useful in filling cavities that require a significant quantity of graft when the autograft is insufficient, or as a complement. They are also of special help in treating fractures when there is bone loss and in the treatment of delays in consolidation and pseudoarthrosis in little vascularized and atrophic zones. They are also used in prosthetic surgery against the presence of cavity type defects. Allografts of soft tissues are specially recognised in multiple ligament injuries that require reconstructions. Nowadays, the most utilised are those employed in surgery of the anterior cruciate ligament although they can be used for filling any ligament or tendon defect. The principal difficulties of the cortical allografts are in the consolidation of the ends with the bone itself and in tumour surgery, given that these are patients immunodepressed by the treatment, the incidence of infection is increased with respect to spongy grafts and soft tissues, which is irrelevant. In short, the increasingly widespread use of allografts is an essential therapeutic weapon in orthopaedic surgery and traumatology. It must be used by expert hands. PMID:16998521

  16. What Is Bone?

    Science.gov (United States)

    ... by your browser. Home Bone Basics What Is Bone? Publication available in: PDF (57 KB) Related Resources ... Men, and Osteoporosis Osteoporosis Prevention For Your Information Bone Remodeling Throughout life, bone is constantly renewed through ...

  17. Calcium and bones

    Science.gov (United States)

    Bone strength and calcium ... calcium (as well as phosphorus) to make healthy bones. Bones are the main storage site of calcium in ... your body does not absorb enough calcium, your bones can get weak or will not grow properly. ...

  18. Facts about Broken Bones

    Science.gov (United States)

    ... White House Lunch Recipes The Facts About Broken Bones KidsHealth > For Kids > The Facts About Broken Bones ... through the skin . continue What Happens When a Bone Breaks? It hurts to break a bone! It's ...

  19. Bone biopsy (image)

    Science.gov (United States)

    A bone biopsy is performed by making a small incision into the skin. A biopsy needle retrieves a sample of bone and it ... examination. The most common reasons for bone lesion biopsy are to distinguish between benign and malignant bone ...

  20. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... is sent to a lab for examination. Bone biopsy may also be done under general anesthesia to ... remove the bone can be done if the biopsy exam shows that there is an abnormal growth ...

  1. Pressurization of bioactive bone cement in vitro.

    Science.gov (United States)

    Fujita, H; Iida, H; Kawanabe, K; Okada, Y; Oka, M; Masuda, T; Kitamura, Y; Nakamura, T

    1999-01-01

    We have developed a bioactive bone cement consisting of MgO-CaO-SiO2-P2O5-CaF2 glass-ceramic powder (AW glass-ceramic powder), silica glass powder as an inorganic filler, and bisphenol-a-glycidyl methacrylate (bis-GMA) based resin as an organic matrix. The efficacy of this bioactive bone cement was investigated by evaluating its pressurization in a 5-mm hole and small pores using a simulated acetabular cavity. Two types of acetabular components were used (flanged and unflanged sockets) and a commercially available polymethylmethacrylate (PMMA) bone cement (CMW 1 Radiopaque Bone Cement) was selected as a comparative control. Bioactive bone cement exerted greater intrusion volume in 5-mm holes than PMMA bone cement in both the flanged and unflanged sockets 10 minutes after pressurization (p anchor holes than PMMA bone cement.

  2. Hepatic surgical anatomy.

    Science.gov (United States)

    Skandalakis, John E; Skandalakis, Lee J; Skandalakis, Panajiotis N; Mirilas, Petros

    2004-04-01

    The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

  3. Histological changes in the bone structure induced at 12 weeks by experimental administration of bisphosphonates

    OpenAIRE

    ALMAŞAN, Horea Artimoniu; BACIUT, MIHAELA; ALMAŞAN, Oana Cristina; Bran, Simion; BACIUT, GRIGORE

    2013-01-01

    Histological changes in bone structure were induced at 12 weeks by experimental administration of bisphosphonates, which have been associated with osteonecrosis of the jaws. The purpose of this study was to determine the effect of local administration of bisphosphonate on bone formation in rats. Surgically created bone defects were evaluated at 12 weeks by histological examination after bisphosphonate administration. Fifteen Wistar rats that underwent surgery to create a bone defect at the ri...

  4. Louis Pasteur surgical revolution.

    Science.gov (United States)

    Toledo-Pereyra, Luis H

    2009-01-01

    Louis Pasteur (1822-1895) is considered the most notable medical scientist of his time and perhaps one of the most distinguished of all times in the history of medicine. From Dole in France to Paris, from a student of crystals to "living ferments," and from chemistry to biology and medicine, Pasteur changed the world for the benefit of humanity. The genius of Pasteur dealt with the most pressing issues of his time, basing the germ theory on the effects that microorganisms had on fermentation and putrefaction of organic matter, which gave birth to the science of bacteriology. Many other difficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacular results seen with the treatment of rabies. Surgery was no exception to the scientific conquests of Pasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister that were based on the germ theory of the disease, which had been derived from the germ theory of fermentation and putrefaction discovered by Pasteur. The acceptance of these principles represented the surgical revolution brought on by the science of Pasteur, a revolution that is now accepted in our daily care of surgical patients.

  5. The temporal response of bone to unloading

    Science.gov (United States)

    Globus, R. K.; Bikle, D. D.; Morey-Holton, E.

    1984-01-01

    Rats were suspended by their tails with the forelimbs bearing the weight load to simulate the weightlessness of space flight. Growth in bone mass ceased by 1 week in the hindlimbs and lumbar vertebrae in growing rats, while growth in the forelimbs and cervical vertebrae remained unaffected. The effects of selective skeletal unloading on bone formation during 2 weeks of suspension was investigated using radio iostope incorporation (with Ca-45 and H-3 proline) and histomorphometry (with tetracycline labeling). The results of these studies were confirmed by histomorphometric measurements of bone formation using triple tetracycline labeling. This model of simulated weightlessness results in an initial inhibition of bone formation in the unloaded bones. This temporary cessation of bone formation is followed in the accretion of bone mass, which then resumes at a normal rate by 14 days, despite continued skeletal unloading. This cycle of inhibition and resumption of bone formation has profound implication for understanding bone dynamics durng space flight, immobilization, or bed rest and offers an opportunity to study the hormonal and mechanical factors that regulate bone formation.

  6. [Contemporary management of bone tumors at Semmelweis University].

    Science.gov (United States)

    Szendrői, Miklós; Antal, Imre; Kiss, János; Perlaky, Tamás; Szalay, Krisztián

    2014-06-01

    The incidence of bone tumors is low therefore it is highly recommended to treat patients in specialized centers. In the late 70ies a bone tumor registry was initiated at the Department of Orthopedics of the Semmelweis University followed by the development of a specialized diagnostic unit and a bone cancer center. Several novel surgical procedures have been introduced, including the extremity-sparing surgery, leading to a significant improvement of the patients survival. This is fully supported by a specialized bone cancer oncoteam of experts. The 6000-sized registry and biobank now allows the development of translational research in this orphan tumor type. PMID:25010756

  7. Clinical anatomy of greater petrosal nerve and its surgical importance

    OpenAIRE

    Prashant E Natekar; Fatima M De Souza

    2013-01-01

    Background: Surgical approach towards greater petrosal nerve has to be done with caution as many surgeons are unfamiliar with the anatomy of the facial nerve. The anatomical landmarks selected must be reliable and above all easy to identify for identification of the greater petrosal nerve so as to avoid injury to the structures in the middle cranial fossa. Observation and Results: The present study is carried out on 100 temporal bones by examining the following measurements of the right and t...

  8. Three different surgical techniques of crown lengthening: A comparative study

    Directory of Open Access Journals (Sweden)

    Ramya Nethravathy

    2013-01-01

    Full Text Available Introduction: A short clinical crown may lead to poor retention form thereby leading to improper tooth preparation. Surgical crown lengthening procedure is done to increase the clinical crown length without violating the biologic width. Several techniques have been proposed for clinical crown lengthening which includes gingivectomy, apically displaced flap with or without resective osseous surgery, and surgical extrusion using periotome. Objective: The aim of this paper is to compare clinically the three different surgical techniques of crown lengthening procedures. Materials and Methods: Fifteen patients who reported to the department of Periodontology, were included in the study. Patients were randomly divided into three groups, which include patients who underwent gingivectomy (Group A, apically repositioned flap (Group B and surgical extrusion using periotome (Group C. Clinical measurements such as clinical crown length, gingival zenith, interdental papilla height were taken at baseline and at 3 rd month post-operatively. Results: Clinical and radiographic evaluation at 3 rd month suggest that surgical extrusion technique offers several advantages over the other conventional surgical techniques such as preservation of the interproximal papilla, gingival margin position and no marginal bone loss. Conclusions: This technique can be used to successfully treat a grossly damaged crown structure as a result of tooth fracture, dental caries and iatrogenic factors especially in the anterior region, where esthetics is of great concern.

  9. Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones

    Directory of Open Access Journals (Sweden)

    Rubenbauer Bianka

    2009-12-01

    Full Text Available Abstract Background Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF as well as augmentation with autologous-bone-grafting. However, there is morbidity associated with the bone-graft donor site and some patients offer limited quantity or quality of autologous-bone graft material. Since allogene bone-grafts are introduced on the market, this comparative study aims to evaluate healing characteristics of ununited bones treated with ORIF combined with either iliac-crest-autologous-bone-grafting (ICABG or demineralized-bone-matrix (DBM. Methods and results From 2000 to 2006 out of sixty-two consecutive patients with non-unions presenting at our Level I Trauma Center, twenty patients had ununited diaphyseal fractures of long bones and were treated by ORIF combined either by ICABG- (n = 10 or DBM-augmentation (n = 10. At the time of index-operation, patients of the DBM-group had a higher level of comorbidity (ASA-value: p = 0.014. Mean duration of follow-up was 56.6 months (ICABG-group and 41.2 months (DBM-group. All patients were clinically and radiographically assessed and adverse effects related to bone grafting were documented. The results showed that two non-unions augmented with ICABG failed osseous healing (20% whereas all non-unions grafted by DBM showed successful consolidation during the first year after the index operation (p = 0.146. No early complications were documented in both groups but two patients of the ICABG-group suffered long-term problems at the donor site (20% (p = 0.146. Pain intensity were comparable in both groups (p = 0.326. However, patients treated with DBM were more satisfied with the surgical procedure (p = 0.031. Conclusion With the use of DBM, the costs for augmentation of the non-union-site are more expensive compared to ICABG (calculated difference: 160

  10. Dem Bones: Forensic Resurrection of a Skeleton.

    Science.gov (United States)

    Bruce, Alease

    2001-01-01

    Presents an activity for students to determine the sex and age of an individual from a collection of bones. Simulates some of the actual procedures conducted in a forensic anthropologist's lab, examining and identifying bones through a series of lab activities. (Author/ASK)

  11. Histomorphological evaluation of Compound bone of Granulated Ricinus in bone regeneration in rabbits

    International Nuclear Information System (INIS)

    Histological evaluation is an effective method in the behavioral description of the qualitative and quantitative implanted materials. The research validated the performance of Compound bone of Granulated Ricinus on bone regeneration with the histomorphological analysis results. Were selected 30 rabbits, females, divided into 3 groups of 10 animals (G1, G2, G3) with a postoperative time of 45, 70 and 120 days respectively. Each animal is undergone 2 bone lesions in the ilium, one implemented in the material: Compound bone of Granulated Ricinus and the other for control. After the euthanasia, the iliac bone was removed, identified and subjected to histological procedure. The evaluation histological, histomorphological results were interpreted and described by quantitative and qualitative analysis based facts verified in the three experimental groups evaluating the rate of absorption of the material in the tissue regeneration, based on the neo-bone formation. The histomorphologic results classified as a material biocompatible and biologically active. Action in regeneration by bone resorption occurs slowly and gradually. Knowing the time and rate of absorption and neo-formation bone biomaterial, which can be determined in the bone segment applicable in the clinical surgical area.

  12. Bone SPECT/CT detection of a sequestrum in chronic-infected nonunion of the tibia

    DEFF Research Database (Denmark)

    Madsen, Jan L

    2008-01-01

    Abstract: Sequestra are dead pieces of bone most often seen in long bones affected with prior or current infection. In addition to antibiotic therapy, chronic osteomyelitis with sequestration requires surgical debridement for cure. The author presents a case of tibial fracture associated with chr......Abstract: Sequestra are dead pieces of bone most often seen in long bones affected with prior or current infection. In addition to antibiotic therapy, chronic osteomyelitis with sequestration requires surgical debridement for cure. The author presents a case of tibial fracture associated...

  13. The retained surgical sponge.

    Science.gov (United States)

    Kaiser, C W; Friedman, S; Spurling, K P; Slowick, T; Kaiser, H A

    1996-01-01

    OBJECTIVE. A review was performed to investigate the frequency of occurrence and outcome of patients who have retained surgical sponges. METHODS. Closed case records from the files of the Medical Professional Mutual Insurance Company (ProMutual, Boston, MA) involving a claim of retained surgical sponges were reviewed for a 7-year period. RESULTS. Retained sponges occurred in 40 patients, comprising 48% of all closed claims for retained foreign bodies. A falsely correct sponge count after an abdominal procedure was documented in 76% of these claims. Ten percent of claims involved vaginal deliveries and minor non-body cavity procedures, for which no sponge count was performed. Total indemnity payments were $2,072,319, and defense costs were $572,079. In three cases, the surgeon was deemed responsible by the court despite the nursing staff's admitting liability and evidence presented that the surgeon complied completely with the standard of care. A wide range of indemnity payments was made despite a remarkable similarity of outcome in the patients studied. CONCLUSIONS. Despite the rarity of the reporting of a retained surgical sponge, this occurrence appears to be encountered more commonly than generally is appreciated. Operating teams should ensure that sponges be counted for all vaginal and any incisional procedures at risk for retaining a sponge. In addition, the surgeon should not unquestioningly accept correct count reports, but should develop the habit of performing a brief but thorough routine postprocedure wound/body cavity exploration before wound closure. The strikingly similar outcome for most patients would argue for a standardized indemnity payment being made without the need for adversarial legal procedures. PMID:8678622

  14. An algorithm for automatic surface labeling of planar surgical resections

    International Nuclear Information System (INIS)

    Three dimensional (3D) preoperative planning and navigation in bone tumor resections have been used in the last five years with good results. The purpose of this study is to develop a method capable of detecting and labeling the nearly planar surface generated by the cutting saw in the surgical specimen taken off the patient during the resection procedure. This surface area labeling is fundamental to track the path that the cutting saw took during the surgery and compare it to the planned cutting plane. The algorithm presented here works by using a 3D reconstruction of the surgical specimen computed tomography (CT) scan, registered against the 3D reconstruction of the preoperative patient CT scan, and the cutting plane defined during surgical planning. The results show a high labeling accuracy (a matching mean of 98.5%) and a non significant accuracy variation for a range of distance and angle offsets.

  15. Chondroblastoma of the sphenoid bone

    Directory of Open Access Journals (Sweden)

    Patrocíni, Tomas Gomes

    2008-12-01

    Full Text Available Introduction: Chondroblastoma is an uncommon cartilaginous benign neoplasm, highly destructive, which specifically appears in the epiphysis of long bones in young patients. Its occurrence is extremely rare in the cranial base, normally occurring in the temporal bone. Objective: To describe a rare case in a patient presenting with a sphenoid bone chondroblastoma that invaded the middle cranial cavity, submitted to a successful surgical resection, without recurrence after 2 years. Case Report: W.J.S, 37 years old, male, forwarded to the otorhinolaryngology service with persistent and strong otalgia for 3 months. He had normal otoscopy and without visible tumorations. The computerized tomography confirmed tumor mass in the left infra-temporal cavity, invading the middle cranial cavity. The biopsy suggested giant cells tumor. After wide resection by frontal approach via orbitozygomatic osteotomy. During the surgery, we confirmed tomographic statements and didn't find temporal bone involvement. The histopathological exam confirmed chondroblastoma. After 18 months after the surgery, he doesn't present with complaints, without motor, sensitive deficits or of cranial nerves and without recurrence tomographic signals. Conclusion: The importance of differential diagnosis of chondroblastoma is remarkable in the cranial base lesions and its therapeutic approach, whose objective must always be the major possible resection with the maximum function conservation.

  16. [Intraoperative crisis and surgical Apgar score].

    Science.gov (United States)

    Oshiro, Masakatsu; Sugahara, Kazuhiro

    2014-03-01

    Intraoperative crisis is an inevitable event to anesthesiologists. The crisis requires effective and coordinated management once it happened but it is difficult to manage the crises properly under extreme stressful situation. Recently, it is reported that the use of surgical crisis checklists is associated with significant improvement in the management of operating-room crises in a high-fidelity simulation study. Careful preoperative evaluation, proper intraoperative management and using intraoperative crisis checklists will be needed for safer perioperative care in the future. Postoperative complication is a serious public health problem. It reduces the quality of life of patients and raises medical cost. Careful management of surgical patients is required according to their postoperative condition for preventing postoperative complications. A 10-point surgical Apgar score, calculated from intraoperative estimated blood loss, lowest mean arterial pressure, and lowest heart rate, is a simple and available scoring system for predicting postoperative complications. It undoubtedly predicts higher than average risk of postoperative complications and death within 30 days of surgery. Surgical Apgar score is a bridge between proper intraoperative and postoperative care. Anesthesiologists should make effort to reduce the postoperative complication and this score is a tool for it.

  17. Bacterial migration through punctured surgical gloves under real surgical conditions

    OpenAIRE

    Heidecke Claus-Dieter; Assadian Ojan; Stanislawski Natalie; Goerdt Anna-Maria; Hübner Nils-Olaf; Kramer Axel; Partecke Lars

    2010-01-01

    Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag met...

  18. A virtual reality interface for pre-planning of surgical operations based on a customized model of the patient

    Science.gov (United States)

    Witkowski, Marcin; Lenar, Janusz; Sitnik, Robert; Verdonschot, Nico

    2012-03-01

    We present a human-computer interface that enables the operator to plan a surgical procedure on the musculoskeletal (MS) model of the patient's lower limbs, send the modified model to the bio-mechanical analysis module, and export the scenario parameters to the surgical navigation system. The interface provides the operator with tools for: importing customized MS model of the patient, cutting bones and manipulating/removal of bony fragments, repositioning muscle insertion points, muscle removal and placing implants. After planning the operator exports the modified MS model for bio-mechanical analysis of the functional outcome. If the simulation result is satisfactory the exported scenario data may be directly used during the actual surgery. The advantages of the developed interface are the possibility of installing it in various hardware configurations and coherent operation regardless of the devices used. The hardware configurations proposed to be used with the interface are: (a) a standard computer keyboard and mouse, and a 2-D display, (b) a touch screen as a single device for both input and output, or (c) a 3-D display and a haptic device for natural manipulation of 3-D objects. The interface may be utilized in two main fields. Experienced surgeons may use it to simulate their intervention plans and prepare input data for a surgical navigation system while student or novice surgeons can use it for simulating results of their hypothetical procedure. The interface has been developed in the TLEMsafe project (www.tlemsafe.eu) funded by the European Commission FP7 program.

  19. Lumbopelvic fixation: a surgical alternative for lumbar stability

    Directory of Open Access Journals (Sweden)

    Gabriel Virgilio Ortiz García

    2014-09-01

    Full Text Available OBJECTIVE: Lumbopelvic fixation is a valid surgical option to achieving great stability in cases where it is particularly demanded, such as in patients with poor quality bone, degenerative scoliosis, and revision surgeries with modern materials and techniques. It enables simple integration of the iliopelvic systems with the rest of the spinal structure, maintaining hemorrhagia at acceptable levels, as well as surgery time. METHODS: We analyzed a case series of 15 patients of our center, who required major construction and/or presented poor quality bone. RESULTS: A total of 15 patients was studied, of which 12 (80% were women and three (20%, men. Nine (60% of these were revision surgeries, maintaining a surgery time of 5 hours (±1 h, with average blood loss of 1380 ml (±178 ml. All the patients received six to eight transpedicular screws, including iliac screws, and in all cases, a bone graft was inserted. CONCLUSION: Lumbopelvic fixation in patients with characteristics associated with osteopenia and osteoporosis, and in major instrumentations, particularly revision surgeries, three-dimensional correction is achieved, constructing a strong, stable pelvic base that is very useful, in patients with fragile surgical anatomy, for changes of implant or extensive decompression, provided the arthrodesis technique is adequate and with the insertion of a sufficient bone graft, and obviously, taking care to maintain the sagittal balance.

  20. Surgical treatments for osteoarthritis.

    Science.gov (United States)

    de l'Escalopier, Nicolas; Anract, Philippe; Biau, David

    2016-06-01

    There are two main surgical treatments for osteoarthritis: conservative treatments, where the damaged cartilage is left in place, and radical treatments, where the cartilage is replaced by an artificial endoprosthesis; this latter procedure is termed joint arthroplasty. These treatments are only offered to symptomatic patients. Arthrodesis is yet another surgical intervention in cases of osteoarthritis. It will sacrifice the joint's articular function and is performed on small osteoarthritic joints, such as wrists and ankles, for instance. Osteoarthritis symptoms are usually the consequence of an imbalance between the load applied to a joint and the surface available to support that load. Therefore, conservative treatments will either tend to decrease the load exerted on the joint, such as in a tibial valgus osteotomy for instance, or to improve the articular surface supporting that load. Sometimes, both can be provided at the same time; the peri-acetabular osteotomy for hip dysplasia is an example of such a procedure. Conservative treatments are usually offered to young patients in order to delay, if not avoid, the need for a joint prosthesis. They are usually performed before osteoarthritis appears or at an early stage. Joint arthroplasties have overwhelmingly excellent functional results and today's research is directed towards providing rapid recovery, very long-term stability, and the assurance of a good functionality in extreme conditions. However, complications with joint arthroplasties can be serious with little, if any, reasonable salvage solution. Therefore, these procedures are offered to patients who have failed adequate medical treatment measures. PMID:27185463

  1. Field Surgical Intervention of Bovine Actinomycosis

    Directory of Open Access Journals (Sweden)

    U. Farooq*, A. Qayyum, H. A. Samad, H. R. Chaudhry and N. Ahmad1

    2010-10-01

    Full Text Available Actinomycosis, or lumpy jaw, is an important cause of economic losses in livestock because of its widespread occurrence and poor response to the routine clinical treatment. The present study describes a typical case of bovine actinomycosis in a seven-month pregnant Sahiwal heifer with a hard swelling on the middle of the maxilla bone at the level of the central molar teeth. Tentative diagnosis was made through clinical signs. After maturation of the swelling, the area was incised under local anesthesia and debridement of the wound was achieved by sharp surgical debridement and mechanical debridement. Pus, having the appearance of sulphur granules, was completely removed from the excised cavity, which was closed by applying mattress sutures. Adjunct therapy of broad-spectrum antibiotic was administered intramuscularly for five days as a post-operative measure. Catamnesis revealed that the healing was complete in 15 days with no recurrence and untoward consequences.

  2. CLINICAL ANALYSIS AND SURGICAL RESULTS IN SARCOMA

    Directory of Open Access Journals (Sweden)

    Basavaraju

    2016-02-01

    Full Text Available INTRODUCTION Sarcomas are quite rare with only 15,000 new cases per year in the United States. Sarcomas therefore represent about one percent of the 1.5 million new cancer diagnoses in that country each year. Sarcoma can be defined as cancer whose cells originate from the cells of mesenchymal origin. The bones, cartilages, muscles are a few examples to be mentioned. This is in contrast to a malignant tumour originating from epithelial cells, which are termed carcinoma. AIMS AND OBJECTIVES 1. To clinically analyze the sarcomas. 2. To analyze the surgical outcome of this disease. The survival of the patient depends on the extent of metastasis and the primary identification. The study forms a base for further studies. So atleast it could be diagnosed earlier and treated to the full extent.

  3. Augmentation of tendon-to-bone healing.

    Science.gov (United States)

    Atesok, Kivanc; Fu, Freddie H; Wolf, Megan R; Ochi, Mitsuo; Jazrawi, Laith M; Doral, M Nedim; Lubowitz, James H; Rodeo, Scott A

    2014-03-19

    Tendon-to-bone healing is vital to the ultimate success of the various surgical procedures performed to repair injured tendons. Achieving tendon-to-bone healing that is functionally and biologically similar to native anatomy can be challenging because of the limited regeneration capacity of the tendon-bone interface. Orthopaedic basic-science research strategies aiming to augment tendon-to-bone healing include the use of osteoinductive growth factors, platelet-rich plasma, gene therapy, enveloping the grafts with periosteum, osteoconductive materials, cell-based therapies, biodegradable scaffolds, and biomimetic patches. Low-intensity pulsed ultrasound and extracorporeal shockwave treatment may affect tendon-to-bone healing by means of mechanical forces that stimulate biological cascades at the insertion site. Application of various loading methods and immobilization times influence the stress forces acting on the recently repaired tendon-to-bone attachment, which eventually may change the biological dynamics of the interface. Other approaches, such as the use of coated sutures and interference screws, aim to deliver biological factors while achieving mechanical stability by means of various fixators. Controlled Level-I human trials are required to confirm the promising results from in vitro or animal research studies elucidating the mechanisms underlying tendon-to-bone healing and to translate these results into clinical practice. PMID:24647509

  4. Evaluation of trabecular bone patterns on dental radiographic images: influence of cortical bone

    Science.gov (United States)

    Amouriq, Yves; Evenou, Pierre; Arlicot, Aurore; Normand, Nicolas; Layrolle, Pierre; Weiss, Pierre; Guédon, Jean-Pierre

    2010-03-01

    For some authors trabecular bone is highly visible in intraoral radiographs. For other authors, the observed intrabony trabecular pattern is a representation of only the endosteal surface of cortical bone, not of intermedullary striae. The purpose of this preliminary study was to investigate the true anatomical structures that are visible in routine dental radiographs and classically denoted trabecular bone. This is a major point for bone texture analysis on radiographs. Computed radiography (CR) images of dog mandible section in molar region were compared with simulations calculated from high-resolution micro-CT volumes. Calculated simulations were obtained using the Mojette Transform. By digitally editing the CT volume, the simulations were separated into trabecular and cortical components into a region of interest. Different images were compared and correlated, some bone micro-architecture parameters calculated. A high correlation was found between computed radiographs and calculated simulations from micro-CT. The Mojette transform was successful to obtain high quality images. Cortical bone did not contribute to change in a major way simulated images. These first results imply that intrabony trabecular pattern observed on radiographs can not only be a representation of the cortical bone endosteal surface and that trabecular bone is highly visible in intraoral radiographs.

  5. Surgical treatment of extensive complex odontoma in the mandible by corticotomy. A case report.

    Science.gov (United States)

    Nogueira, A S; Gonçales, E S; Gonçales, A G B; Thiegui-Neto, V; Nogueira, C B P; Nogueira, A; Medeiros, R

    2013-09-01

    Odontomas represent the most prevalent odontogenic tumors in the jaw. The treatment of choice is surgical removal, usually performed by conventional techniques involving ostectomies to expose the tumor. In this paper, the authors describe, through the report of a case of complex odontoma located in the mandibular angle, a more conservative surgical technique called corticotomy, in which the bone removed for access to the tumor (buccal cortical) is repositioned and fixed by titanium plates of 1.5 mm. PMID:24126599

  6. Surgical treatment of extensive complex odontoma in the mandible by corticotomy. A case report.

    Science.gov (United States)

    Nogueira, A S; Gonçales, E S; Gonçales, A G B; Thiegui-Neto, V; Nogueira, C B P; Nogueira, A; Medeiros, R

    2013-09-01

    Odontomas represent the most prevalent odontogenic tumors in the jaw. The treatment of choice is surgical removal, usually performed by conventional techniques involving ostectomies to expose the tumor. In this paper, the authors describe, through the report of a case of complex odontoma located in the mandibular angle, a more conservative surgical technique called corticotomy, in which the bone removed for access to the tumor (buccal cortical) is repositioned and fixed by titanium plates of 1.5 mm.

  7. Surgical scar revision: An overview

    Directory of Open Access Journals (Sweden)

    Shilpa Garg

    2014-01-01

    Full Text Available Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.

  8. Connecting mechanics and bone cell activities in the bone remodeling process: an integrated finite element modeling.

    Science.gov (United States)

    Hambli, Ridha

    2014-01-01

    Bone adaptation occurs as a response to external loadings and involves bone resorption by osteoclasts followed by the formation of new bone by osteoblasts. It is directly triggered by the transduction phase by osteocytes embedded within the bone matrix. The bone remodeling process is governed by the interactions between osteoblasts and osteoclasts through the expression of several autocrine and paracrine factors that control bone cell populations and their relative rate of differentiation and proliferation. A review of the literature shows that despite the progress in bone remodeling simulation using the finite element (FE) method, there is still a lack of predictive models that explicitly consider the interaction between osteoblasts and osteoclasts combined with the mechanical response of bone. The current study attempts to develop an FE model to describe the bone remodeling process, taking into consideration the activities of osteoclasts and osteoblasts. The mechanical behavior of bone is described by taking into account the bone material fatigue damage accumulation and mineralization. A coupled strain-damage stimulus function is proposed, which controls the level of autocrine and paracrine factors. The cellular behavior is based on Komarova et al.'s (2003) dynamic law, which describes the autocrine and paracrine interactions between osteoblasts and osteoclasts and computes cell population dynamics and changes in bone mass at a discrete site of bone remodeling. Therefore, when an external mechanical stress is applied, bone formation and resorption is governed by cells dynamic rather than adaptive elasticity approaches. The proposed FE model has been implemented in the FE code Abaqus (UMAT routine). An example of human proximal femur is investigated using the model developed. The model was able to predict final human proximal femur adaptation similar to the patterns observed in a human proximal femur. The results obtained reveal complex spatio-temporal bone

  9. Osteoclasts prefer aged bone

    DEFF Research Database (Denmark)

    Henriksen, K; Leeming, Diana Julie; Byrjalsen, I;

    2007-01-01

    We investigated whether the age of the bones endogenously exerts control over the bone resorption ability of the osteoclasts, and found that osteoclasts preferentially develop and resorb bone on aged bone. These findings indicate that the bone matrix itself plays a role in targeted remodeling...

  10. Surgical Safety Checklists : an Update

    OpenAIRE

    BERGS, J.; Hellings, Johan; CLEEMPUT, Irina; SIMONS, Pascale; ZUREL, Ozhan; Vertriest, Sonja; Vandijck, Dominique

    2014-01-01

    Surgical safety checklists aim to improve patient safety by prompting the attention of the surgical team towards critical steps during the operation. The checklist's items are aimed to improve compliance with proven interventions, and to facilitate multidisciplinary communication and teamwork. Based on the current literature, corroborated by systematic reviews and meta-analysis, surgical safety checklists have a positive impact on communication and reduce postoperative complications including...

  11. [A rapid prototype fabrication method of dental splint based on 3D simulation and technology].

    Science.gov (United States)

    Lin, Yanping; Chen, Xiaojun; Zhang, Shilei; Wang, Chengtao

    2006-04-01

    The conventional design and fabrication of the dental splint (in orthognathic surgery) is based on the preoperative planning and model surgery so this process is of low precision and efficiency. In order to solve the problems and be up to the trend of computer-assisted surgery, we have developed a novel method to design and fabricate the dental splint--computer-generated dental splint, which is based on three-dimensional model simulation and rapid prototype technology. After the surgical planning and simulation of 3D model, we can modify the model to be superior in chewing action (functional) and overall facial appearance (aesthetic). Then, through the Boolean operation of the dental splint blank and the maxillofacial bone model the model of dental splint is formed. At last, the dental splint model is fabricated through rapid prototype machine and applied in clinic. The result indicates that, with the use of this method, the surgical precision and efficiency are improved.

  12. The effects of bone density and crestal cortical bone thickness on micromotion and peri-implant bone strain distribution in an immediately loaded implant: a nonlinear finite element analysis

    Science.gov (United States)

    2016-01-01

    Purpose This study investigated the effects of bone density and crestal cortical bone thickness at the implant-placement site on micromotion (relative displacement between the implant and bone) and the peri-implant bone strain distribution under immediate-loading conditions. Methods A three-dimensional finite element model of the posterior mandible with an implant was constructed. Various bone parameters were simulated, including low or high cancellous bone density, low or high crestal cortical bone density, and crestal cortical bone thicknesses ranging from 0.5 to 2.5 mm. Delayed- and immediate-loading conditions were simulated. A buccolingual oblique load of 200 N was applied to the top of the abutment. Results The maximum extent of micromotion was approximately 100 μm in the low-density cancellous bone models, whereas it was under 30 μm in the high-density cancellous bone models. Crestal cortical bone thickness significantly affected the maximum micromotion in the low-density cancellous bone models. The minimum principal strain in the peri-implant cortical bone was affected by the density of the crestal cortical bone and cancellous bone to the same degree for both delayed and immediate loading. In the low-density cancellous bone models under immediate loading, the minimum principal strain in the peri-implant cortical bone decreased with an increase in crestal cortical bone thickness. Conclusions Cancellous bone density may be a critical factor for avoiding excessive micromotion in immediately loaded implants. Crestal cortical bone thickness significantly affected the maximum extent of micromotion and peri-implant bone strain in simulations of low-density cancellous bone under immediate loading. PMID:27382504

  13. Multiple verification in computational modeling of bone pathologies

    CERN Document Server

    Liò, Pietro; Paoletti, Nicola; 10.4204/EPTCS.67.8

    2011-01-01

    We introduce a model checking approach to diagnose the emerging of bone pathologies. The implementation of a new model of bone remodeling in PRISM has led to an interesting characterization of osteoporosis as a defective bone remodeling dynamics with respect to other bone pathologies. Our approach allows to derive three types of model checking-based diagnostic estimators. The first diagnostic measure focuses on the level of bone mineral density, which is currently used in medical practice. In addition, we have introduced a novel diagnostic estimator which uses the full patient clinical record, here simulated using the modeling framework. This estimator detects rapid (months) negative changes in bone mineral density. Independently of the actual bone mineral density, when the decrease occurs rapidly it is important to alarm the patient and monitor him/her more closely to detect insurgence of other bone co-morbidities. A third estimator takes into account the variance of the bone density, which could address the...

  14. Bone repair: Effects of physical exercise and LPS systemic exposition.

    Science.gov (United States)

    Nogueira, Jonatas E; Branco, Luiz G S; Issa, João Paulo M

    2016-08-01

    Bone repair can be facilitated by grafting, biochemical and physical stimulation. Conversely, it may be delayed lipopolysaccharide (LPS). Physical exercise exerts beneficial effects on the bone, but its effect on bone repair is not known. We investigated the effect of exercise on the LPS action on bone healing through bone densitometry, quantitative histological analysis for bone formation rate and immunohistochemical markers in sedentary and exercised animals. Rats ran on the treadmill for four weeks. After training the rats were submitted to a surgical procedure (bone defect in the right tibia) and 24h after the surgery LPS was administered at a dose of 100μg/kg i.p., whereas the control rats received a saline injection (1ml/kg, i.p.). Right tibias were obtained for analysis after 10days during which rats were not submitted to physical training. Physical exercise had a positive effect on bone repair, increasing bone mineral density, bone mineral content, bone formation rate, type I collagen and osteocalcin expression. These parameters were not affected by systemic administration of LPS. Our data indicate that physical exercise has an important osteogenic effect, which is maintained during acute systemic inflammation induced by exposure to a single dose of LPS. PMID:27319388

  15. Neuronavigation. Principles. Surgical technique.

    Science.gov (United States)

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques. PMID:20108488

  16. Neuronavigation. Principles. Surgical technique.

    Science.gov (United States)

    Ivanov, Marcel; Ciurea, Alexandru Vlad

    2009-01-01

    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques.

  17. Mechanical characterization of bone anchors used with a bone-attached, parallel robot for skull surgery.

    Science.gov (United States)

    Kobler, Jan-Philipp; Prielozny, Lenka; Lexow, G Jakob; Rau, Thomas S; Majdani, Omid; Ortmaier, Tobias

    2015-05-01

    Bone-attached robots and microstereotactic frames, intended for deep brain stimulation and minimally invasive cochlear implantation, typically attach to a patient's skull via bone anchors. A rigid and reliable link between such devices and the skull is mandatory in order to fulfill the high accuracy demands of minimally invasive procedures while maintaining patient safety. In this paper, a method is presented to experimentally characterize the mechanical properties of the anchor-bone linkage. A custom-built universal testing machine is used to measure the pullout strength as well as the spring constants of bone anchors seated in four different bone substitutes as well as in human cranial bone. Furthermore, the angles at which forces act on the bone anchors are varied to simulate realistic conditions. Based on the experimental results, a substitute material that has mechanical properties similar to those of cranial bone is identified. The results further reveal that the pullout strength of the investigated anchor design is sufficient with respect to the proposed application. However, both the measured load capacity as well as the spring constants vary depending on the load angles. Based on these findings, an alternative bone anchor design is presented and experimentally validated. Furthermore, the results serve as a basis for stiffness simulation and optimization of bone-attached microstereotactic frames. PMID:25771430

  18. Bone marrow aspiration

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003658.htm Bone marrow aspiration To use the sharing features on this page, please enable JavaScript. Bone marrow is the soft tissue inside bones that helps ...

  19. Bone marrow biopsy

    Science.gov (United States)

    Biopsy - bone marrow ... A bone marrow biopsy may be done in the health care provider's office or in a hospital. The sample may be taken from the pelvic or breast bone. Sometimes, other areas are used. Marrow is removed ...

  20. Diaphyseal chondroblastoma in a long bone: first report

    Energy Technology Data Exchange (ETDEWEB)

    Azorin, D.; Gonzalez-Mediero, I.; Colmenero, I.; Prada, I. de [Hospital Infantil Universitario Nino Jesus, Service of Anatomic Pathology, Madrid (Spain); Lopez-Barea, F. [Hospital Universitario La Paz, Department of Anatomic Pathology, Madrid (Spain)

    2006-01-01

    Chondroblastoma is a rare benign bone tumor typically located in the epiphysis. We describe the first case of chondroblastoma arising in the diaphysis of a long bone. The patient was a 13-year-old girl who presented with pain over her right thigh. Radiographs showed a lytic lesion in the diaphysis of her right femur. A core biopsy and a subsequent surgical resection were performed. (orig.)

  1. Brodie's abscess of the cuboid bone: a case report.

    Science.gov (United States)

    Bagatur, A Erdem; Zorer, Gazi

    2003-03-01

    The case of a patient with Brodie's abscess of the cuboid bone and who presented with a painful and swollen right foot is described. The patient was treated successfully by surgical evacuation of the abscess and with antibiotics. To the authors' knowledge, Brodie's abscess of the cuboid bone has not been reported previously. The clinical presentation and diagnostic difficulties which may be encountered are discussed.

  2. Biology and augmentation of tendon-bone insertion repair

    Directory of Open Access Journals (Sweden)

    Lui PPY

    2010-08-01

    Full Text Available Abstract Surgical reattachment of tendon and bone such as in rotator cuff repair, patellar-patella tendon repair and anterior cruciate ligament (ACL reconstruction often fails due to the failure of regeneration of the specialized tissue ("enthesis" which connects tendon to bone. Tendon-to-bone healing taking place between inhomogenous tissues is a slow process compared to healing within homogenous tissue, such as tendon to tendon or bone to bone healing. Therefore special attention must be paid to augment tendon to bone insertion (TBI healing. Apart from surgical fixation, biological and biophysical interventions have been studied aiming at regeneration of TBI healing complex, especially the regeneration of interpositioned fibrocartilage and new bone at the healing junction. This paper described the biology and the factors influencing TBI healing using patella-patellar tendon (PPT healing and tendon graft to bone tunnel healing in ACL reconstruction as examples. Recent development in the improvement of TBI healing and directions for future studies were also reviewed and discussed.

  3. Bone Replacement Materials and Techniques Used for Achieving Vertical Alveolar Bone Augmentation

    Directory of Open Access Journals (Sweden)

    Zeeshan Sheikh

    2015-05-01

    Full Text Available Alveolar bone augmentation in vertical dimension remains the holy grail of periodontal tissue engineering. Successful dental implant placement for restoration of edentulous sites depends on the quality and quantity of alveolar bone available in all spatial dimensions. There are several surgical techniques used alone or in combination with natural or synthetic graft materials to achieve vertical alveolar bone augmentation. While continuously improving surgical techniques combined with the use of auto- or allografts provide the most predictable clinical outcomes, their success often depends on the status of recipient tissues. The morbidity associated with donor sites for auto-grafts makes these techniques less appealing to both patients and clinicians. New developments in material sciences offer a range of synthetic replacements for natural grafts to address the shortcoming of a second surgical site and relatively high resorption rates. This narrative review focuses on existing techniques, natural tissues and synthetic biomaterials commonly used to achieve vertical bone height gain in order to successfully restore edentulous ridges with implant-supported prostheses.

  4. Anorexia Nervosa and Bone

    OpenAIRE

    Misra, Madhusmita; Klibanski, Anne

    2014-01-01

    Anorexia nervosa (AN) is a condition of severe low weight that is associated with low bone mass, impaired bone structure and reduced bone strength, all of which contribute to increased fracture risk., Adolescents with AN have decreased rates of bone accrual compared with normal-weight controls, raising addition concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, hormonal alterations secondary to nutritional factors...

  5. Arthroscopic treatment of glenoid bone loss.

    Science.gov (United States)

    Taverna, Ettore; Garavaglia, Guido; Ufenast, Henri; D'Ambrosi, Riccardo

    2016-02-01

    Recurrent anterior instability of the glenohumeral joint has long been an arduous problem to solve surgically, owing to its difficulty to the need to restore both osseous and dynamic constraints in the unstable shoulder. Biomechanical studies have indicated that glenoid bone loss shortens the safe arc through which the glenoid can resist axial forces; in these cases, a soft tissue repair alone may be insufficient to maintain stability. Clinical studies have confirmed that major bone loss is associated with an unfavourable outcome. The benefits of using arthroscopic procedures for surgical stabilization of the shoulder include smaller incisions and less soft tissue dissection, better access for repair and, potentially, the maximum respect for the undamaged anatomical structures. The biggest disadvantage of arthroscopic procedures until recently was the inability to successfully treat a significant bone defect. Over the last 10 years, several new arthroscopic techniques have been developed, providing new surgical options for successfully treating soft tissues and bony lesions in anterior-inferior glenohumeral instability. Level of evidence V. PMID:26658567

  6. Surgical innovations in canine gonadectomy

    NARCIS (Netherlands)

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated n

  7. Bone marrow transplant - discharge

    Science.gov (United States)

    Transplant - bone marrow - discharge; Stem cell transplant - discharge; Hematopoietic stem cell transplant - discharge; Reduced intensity; Non-myeloablative transplant - discharge; Mini transplant - discharge; Allogenic bone marrow transplant - discharge; ...

  8. Histological evaluation of the influence of magnetic field application in autogenous bone grafts in rats

    Directory of Open Access Journals (Sweden)

    Ponzoni Deise

    2009-01-01

    Full Text Available Abstract Background Bone grafts are widely used in oral and maxillofacial reconstruction. The influence of electromagnetic fields and magnets on the endogenous stimulation of target tissues has been investigated. This work aimed to assess the quality of bone healing in surgical cavities filled with autogenous bone grafts, under the influence of a permanent magnetic field produced by in vivo buried devices. Methods Metal devices consisting of commercially pure martensitic stainless steel washers and titanium screws were employed. Thirty male Wistar rats were divided into 3 experimental and 3 control groups. A surgical bone cavity was produced on the right femur, and a bone graft was collected and placed in each hole. Two metallic washers, magnetized in the experimental group but not in the control group, were attached on the borders of the cavity. Results The animals were sacrificed on postoperative days 15, 45 and 60. The histological analysis of control and experimental samples showed adequate integration of the bone grafts, with intense bone neoformation. On days 45 and 60, a continued influence of the magnetic field on the surgical cavity and on the bone graft was observed in samples from the experimental group. Conclusion The results showed intense bone neoformation in the experimental group as compared to control animals. The intense extra-cortical bone neoformation observed suggests that the osteoconductor condition of the graft may be more susceptible to stimulation, when submitted to a magnetic field.

  9. Bone wax as a cause of a foreign body granuloma in a cranial defect: a case report.

    Science.gov (United States)

    Wolvius, E B; van der Wal, K G H

    2003-12-01

    Bone wax was used to stop bleeding of the diploic vessels after harvesting cranial bone for reconstruction of an orbital floor defect. After five months a fistula in the overlying skin of the donor site appeared and was eventually surgically explored. Remnants of bone wax and surrounding inflammatory tissue were removed and the fistula was excised. Histological examination revealed a foreign body granuloma. The use of bone wax and possible alternative local haemostatic agents and their complications are discussed.

  10. Bone Flap Technique for Impacted Teeth Extraction and Bone Cysts Removal.

    Science.gov (United States)

    Saponaro, Gianmarco; Pelo, Sandro; De Angelis, Paolo; Forcione, Mario; D'Amato, Giuseppe; Moro, Alessandro

    2016-06-01

    The treatment of cystic lesions and the extraction of impacted third molars are 2 of the most common procedures in oral and maxillofacial surgery. The surgical treatment of cysts of the jaws can consist of a cystectomy, a cystotomy, or a staged combination of the 2 procedures. The surgical techniques developed for the extraction of impacted third molars are: coronectomy, orthodontic extraction, and surgery using intraoral or extraoral methods. There are various complications related to both surgical treatments. With regards to these complications, authors' department has developed a new surgical technique based on a previously described technique, which provides better support to the mucoperiosteal flap and improves bone regeneration after healing. Additionally, authors' goal was to reduce the risk of nerve injury, which has been achieved thanks to a direct visualization of the inferior alveolar nerve as well as cystic lesion or the dental element. The surgical procedure described produces major advantages over the traditional alternatives, despite needing a longer operation. This technique is particularly useful in the treatment of cystic lesions that have caused considerable bone loss. It can also be utilized for cysts or impacted dental elements strictly linked to the inferior alveolar nerve. PMID:27171951

  11. An intramembranous ossification model for the in silico analysis of bone tissue formation in tooth extraction sites.

    Science.gov (United States)

    Corredor-Gómez, Jennifer Paola; Rueda-Ramírez, Andrés Mauricio; Gamboa-Márquez, Miguel Alejandro; Torres-Rodríguez, Carolina; Cortés-Rodríguez, Carlos Julio

    2016-07-21

    The accurate modeling of biological processes allows us to predict the spatiotemporal behavior of living tissues by computer-aided (in silico) testing, a useful tool for the development of medical strategies, avoiding the expenses and potential ethical implications of in vivo experimentation. A model for bone healing in mouth would be useful for selecting proper surgical techniques in dental procedures. In this paper, the formulation and implementation of a model for Intramembranous Ossification is presented aiming to describe the complex process of bone tissue formation in tooth extraction sites. The model consists in a mathematical description of the mechanisms in which different types of cells interact, synthesize and degrade extracellular matrices under the influence of biochemical factors. Special attention is given to angiogenesis, oxygen-dependent effects and growth factor-induced apoptosis of fibroblasts. Furthermore, considering the depth-dependent vascularization of mandibular bone and its influence on bone healing, a functional description of the cell distribution on the severed periodontal ligament (PDL) is proposed. The developed model was implemented using the finite element method (FEM) and successfully validated by simulating an animal in vivo experiment on dogs reported in the literature. A good fit between model outcome and experimental data was obtained with a mean absolute error of 3.04%. The mathematical framework presented here may represent an important tool for the design of future in vitro and in vivo tests, as well as a precedent for future in silico studies on osseointegration and mechanobiology. PMID:27113783

  12. Development and characterization of an injectable dextrin-based hydrogel for bone regeneration

    OpenAIRE

    Dina M. Silva; Daniella L. Morgado; Delair, T; David, L; Rouif, S.; López-Lacomba, J. L.; A C Maurício; Santos, J. D.; Gama, F. M.

    2014-01-01

    Bone is a dynamic, highly vascularized tissue that remodels itself continuously over an individual ́s lifetime. It plays several important roles in maintaining homeostasis of the body systems [ 1 , 2 ] . However, this regenerative capac ity is limited and, as in the case of large bone defects, where the template for an orchestrated regeneration is absent, surgical proce dures are needed [ 2...

  13. An injectable calcium phosphate cement for the local delivery of paclitaxel to bone

    NARCIS (Netherlands)

    Lopez-Heredia, M.A.; Kamphuis, G.J.; Thune, P.C.; Oner, F.C.; Jansen, J.A.; Walboomers, X.F.

    2011-01-01

    Bone metastases are usually treated by surgical removal, fixation and chemotherapeutic treatment. Bone cement is used to fill the resection voids. The aim of this study was to develop a local drug delivery system using a calcium phosphate cement (CPC) as carrier for chemotherapeutic agents. CPC cons

  14. LAPAROSCOPIC SURGICAL TRAINING. A THREE STAGES MODE

    Directory of Open Access Journals (Sweden)

    R. Moldovanu

    2013-03-01

    Full Text Available The classic “Halstedian” apprenticeship model for surgical training takes place into the operating theater under the strict coordination of a senior surgeon. The development of minimally invasive surgery (MIS rapidly revealed that this apprenticeship model is insufficient to successful fulfill the well known three stages of training of Rasmussen model – skill-based behavior (SBB, rule-based behavior (RBB and knowledge-based behavior (KBB – due to ethical, medico-legal and economic considerations and a specific training using different methods (theoretical and hands-on courses using simulators, animal models and web resources is mandatory. However it isn’t a worldwide accepted laparoscopic training curriculum. We present our experience with different types of teaching methods; in this way we retrospectively reviewed our experience in laparoscopic education, presenting data using Rasmussen model, as a dynamic three stages model: 1 first stage (the beginning, from 1993 until 1995, our staff acquired SBB, RBB and KBB for basic MIS procedures: cholecystectomy, appendectomy, surgical ablation of ovarian cysts; 2 the second stage, from 1996 until 1999, characterized by continuous training of our surgical staff until the achievement of the KBB level for basic MIS procedures and training for other operations (laparoscopic treatment of the groin hernias, eso-gastric and bariatric surgery and the teaching of the residents and the surgeons from Moldova region to achieve SBB and RBB for basic MIS procedures; 3 the third stage, from 2000 until present characterized by a continuous improvement of the surgical teams’ laparoscopic skills for different procedures, and developing a modern curricula for laparoscopic education. CONCLUSIONS: There is no universal method for laparoscopic training. Our experience demonstrates good results using a combination of training methods which allowed acquiring: SBB (Basic skills using virtual reality (VR simulators

  15. Silver Nanoparticles in Alveolar Bone Surgery Devices

    Directory of Open Access Journals (Sweden)

    Stefano Sivolella

    2012-01-01

    Full Text Available Silver (Ag ions have well-known antimicrobial properties and have been applied as nanostrategies in many medical and surgical fields, including dentistry. The use of silver nanoparticles (Ag NPs may be an option for reducing bacterial adhesion to dental implant surfaces and preventing biofilm formation, containing the risk of peri-implant infections. Modifying the structure or surface of bone grafts and membranes with Ag NPs may also prevent the risk of contamination and infection that are common when alveolar bone augmentation techniques are used. On the other hand, Ag NPs have revealed some toxic effects on cells in vitro and in vivo in animal studies. In this setting, the aim of the present paper is to summarize the principle behind Ag NP-based devices and their clinical applications in alveolar bone and dental implant surgery.

  16. ANEURYSMAL BONE CYST OF THE CLAVICLE IN CHILDREN (CLINICAL CASES AND TREATMENT

    Directory of Open Access Journals (Sweden)

    Тимур Фаизович Зубаиров

    2014-09-01

    Full Text Available The purpose. To examine the results of the treatment of children with aneurysmal cyst of the clavicle. Material and methods. The results of examination and treatment of patients aged 16 and 17 years with a diagnosis of aneurysmal cyst of the clavicle. All patients underwent surgical treatment with the ABC stage delimitation. We used a surgical technique, which consists in open removement of the abnormal tissue with replacement of the bone defect with bone-plastic material or autogenous bone from the iliac crest. Conclusions. The method of treatment of aneurysmal bone cyst of the clavicle must be individualized depending on the location, aggressiveness and extent of the lesion. The use bone-plastic material or autogenous bone from the iliac crest restore the structural integrity of a compromised clavicle gives good results in the observation period of up to 2 years.

  17. Technetium bone scintigraphy in the diagnosis of osteomyelitis in children

    International Nuclear Information System (INIS)

    In a 5 1/2-year retrospective study of hospitalized children with osteomyelitis who had technetium bone scans, we found that 32 of 38 (84%) had increased radionuclide uptake, 4 (11%) had normal uptake and 2 (5%) had decreased uptake. The two patients with decreased uptake had a stormy course with extensive bone destruction and pathologic fractures in spite of prolonged courses of antibiotic therapy. Decreased uptake on bone scan in patients with clinical evidence of osteomyelitis could indicate a poor prognosis and early surgical drainage is indicated in order to decrease morbidity

  18. Assessment of functional displacement of bone marrow by osteoplastic metastases from prostatic carcinoma with bone marrow scintigraphy

    International Nuclear Information System (INIS)

    The detailed examination of the skeleton in prostate cancer has become more critical since surgical treatment requires the non-evidence of bone metastases. The data of 30 patients have been evaluated. All patients had a bone scan and a bone marrow scintigraphy with [99mTc[-anti-NCA95. In this study we compared the degree of bone marrow displacement with the extent of metastatic deposits identified on the bone scan. Six patients showing the criterias of a superscan (maximal avidity of the osteotrope radiatracer) had as a correlate a complete displacement of the hematopoesis in the bone marrow scintigraphy and an increased activity in liver and spleen. The degree of the peripheral extension correlated strongly with the decrease of the haemoglobin in blood samples. The grading was based upon the number of metastatic deposits identified on the scan (0=no metastases; 1≤6 metastases; 2=multiple metastases; 3=superscan). In 28 of 30 patients (93%) we found corresponding results in both the bone scan and the bone marrow scintigraphy. The bone marrow scintigraphy is a sensitive method in the detection of metastatic disease and gives additional information about the extent of bone marrow displacement by osteoplastic metastases. (orig.)

  19. In vitro experiment of the modular orthopedic plate based on Nitinol, used for human radius bone fractures.

    Science.gov (United States)

    Tarniţă, Daniela; Tarniţă, D N; Hacman, L; Copiluş, C; Berceanu, C

    2010-01-01

    Shape memory alloys (SMAs) and in particular Ni-Ti alloys are commonly used in bioengineering applications as they join important qualities as resistance to corrosion, biocompatibility, fatigue resistance, MR compatibility, kink resistance with two unique thermo-mechanical behaviors: the shape memory effect and the pseudoelastic effect. They allow Ni-Ti devices to undergo large mechanically induced deformations and then to recover the original shape by thermal loading or simply by mechanical unloading. Diaphyseal fractures of the radius and ulna present specific problems not encountered in the treatment of fractures of the shafts of other long bones. The adaptive modular implants based on smart materials represent a superior solution in the osteosynthesis of the fractured bones over the conventional implants known so far. To realize the model of the implant module we used SolidWorks software. The small sizes of the modules enable the surgeon to make small incisions, using surgical techniques minimally invasive, having the following advantages: reduction of soft tissues destruction; eliminating intra-operator infections; reduction of blood losses; the reduction of infection risk; the reduction of the healing time. Numerical simulations of the virtual modular implant are realized using Visual Nastran software. The stress diagrams, the displacements diagram and the strain diagram are obtained. An in vitro experiment is made, simulating the osteosynthesis of a transverse diaphyseal fracture of human radius bone. The kinematical parameters diagrams of the staple are obtained, using SIMI Motion video capture system. The experimental diagram force-displacement is obtained. PMID:20495750

  20. Bone grafting: An overview

    Directory of Open Access Journals (Sweden)

    D. O. Joshi

    2010-08-01

    Full Text Available Bone grafting is the process by which bone is transferred from a source (donor to site (recipient. Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of

  1. Surgical Skills Beyond Scientific Management

    Science.gov (United States)

    Whitfield, Nicholas

    2015-01-01

    During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel’s attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel–Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice. PMID:26090737

  2. Bone scan in rheumatology

    International Nuclear Information System (INIS)

    In this chapter a revision is made concerning different uses of bone scan in rheumatic diseases. These include reflex sympathetic dystrophy, osteomyelitis, spondyloarthropaties, metabolic bone diseases, avascular bone necrosis and bone injuries due to sports. There is as well some comments concerning pediatric pathology and orthopedics. (authors). 19 refs., 9 figs

  3. Bone Marrow Transplantation

    Science.gov (United States)

    Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains immature cells, called stem cells. The ... platelets, which help the blood to clot. A bone marrow transplant is a procedure that replaces a ...

  4. Bone grafts in dentistry

    Directory of Open Access Journals (Sweden)

    Prasanna Kumar

    2013-01-01

    Full Text Available Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation.

  5. Radiology trainer. Surgical ambulance. 2. rev. and enl. ed.; Roentgen-Trainer. Chirurgische Ambulanz

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, Ole [Wedau-Kliniken Duisburg (Germany). Klinik fuer Unfallchirurgie; Ruchholtz, Steffen [Universitaetsklinikum Giessen und Marburg GmbH, Marburg (Germany). Klinik fuer Unfall-, Hand- und Wiederherstellungschirurgie; Siemann, Holger [LVR Klinikum Essen (Germany); Barkhausen, Joerg [Universitaetsklinikum Schleswig-Holstein, Luebeck (Germany). Klinik fuer Radiologie und Nuklearmedizin

    2013-08-01

    The radiology trainer for surgical ambulance includes informative X-ray imaging examples for the following issues: zygoma, nasal bone, spinal cord, clavicle, shoulder, upper arms, elbow, forearms, wrist, hand, phalanx, thorax, sternum, pelvis, abdomen, hips, femur, knee, lower leg, ankle, feet.

  6. Reliability of clinically relevant 3D foot bone angles from quantitative computed tomography

    OpenAIRE

    Gutekunst, David J; Liu, Lu; Ju, Tao; Prior, Fred W.; Sinacore, David R

    2013-01-01

    Background Surgical treatment and clinical management of foot pathology requires accurate, reliable assessment of foot deformities. Foot and ankle deformities are multi-planar and therefore difficult to quantify by standard radiographs. Three-dimensional (3D) imaging modalities have been used to define bone orientations using inertial axes based on bone shape, but these inertial axes can fail to mimic established bone angles used in orthopaedics and clinical biomechanics. To provide improved ...

  7. Aneurysmal bone cyst of the mandibular condyle with condylar neck fracture

    International Nuclear Information System (INIS)

    Aneurysmal bone cyst (ABC) is relatively rare, non-neoplastic expansible lesion of bone. The case of a 15-year-old male with a ABC of the left mandibular condyle is presented. Panoramic radiograph showed a unilocular radiolucency with thinned coritces and a subcondylar fracture which was due to the trauma. Computed tomography (CT) revealed expansible lesion which had similar attenuation soft tissue. The patient was treated surgically including iliac crestal bone graft.

  8. Advanced BMP Gene Therapies for Temporal and Spatial Control of Bone Regeneration

    OpenAIRE

    Wilson, C.G.; Martín-Saavedra, F.M.; Vilaboa, N.; Franceschi, R.T.

    2013-01-01

    Spatial and temporal patterns of bone morphogenetic protein (BMP) signaling are crucial to the assembly of appropriately positioned and shaped bones of the face and head. This review advances the hypothesis that reconstitution of such patterns with cutting-edge gene therapies will transform the clinical management of craniofacial bone defects attributed to trauma, disease, or surgical resection. Gradients in BMP signaling within developing limbs and orofacial primordia regulate proliferation ...

  9. Simulation in shoulder surgery.

    Science.gov (United States)

    Colaço, Henry B; Tennent, Duncan

    2016-10-01

    Simulation is a rapidly developing field in medical education. There is a growing need for trainee surgeons to acquire surgical skills in a cost-effective learning environment to improve patient safety and compensate for a reduction in training time and operative experience. Although simulation is not a replacement for traditional models of surgical training, and robust assessment metrics need to be validated before widespread use for accreditation, it is a useful adjunct that may ultimately lead to improving surgical outcomes for our patients. PMID:27660662

  10. Surgical induction of metacarpal synostosis for treatment of ectrodactyly in a dog.

    Science.gov (United States)

    Pisoni, L; Del Magno, S; Cinti, F; Dalpozzo, B; Bellei, E; Cloriti, E; Joechler, M

    2014-01-01

    Ectrodactyly is a rare developmental anomaly of the distal part of the forelimb. It is characterized by the presence of an abnormal longitudinal soft tissue and osseous separation or cleft between the digits and the metacarpal bones. It can be associated with hypoplasia, aplasia and malformation of one or more bones of the antebrachium, carpus, metacarpus and digits. Unilateral ectrodactyly and moderate lameness were diagnosed in a young female dog. The dog was treated surgically with reconstruction of soft tissues and stabilization of the metacarpal bones by two nylon cerclage sutures. After three years a mild residual lameness was present. Radiographic signs of synostosis between the metacarpal bones II, III and IV with presence of a cleft between carpal bones II and III were observed. PMID:24569849

  11. Evidence-based surgical wound care on surgical wound infection.

    Science.gov (United States)

    Reilly, Jaqueline

    2002-09-01

    Surgical wound infection is an important outcome indicator in the postoperative period. A 3-year prospective cohort epidemiological study of 2202 surgical patients from seven surgical wards across two hospitals was carried out using gold standard surveillance methodology. This involved following patients up as inpatients and postdischarge surveillance to 30 days by an independent observer. The results led to the development of a mathematical model for risk of clean, elective surgical wound infection. Risk of surgical wound infection was increased by smoking, higher body mass index, presence of malignancy, haematoma formation, increasing numbers of people in theatre, adherent dressing usage, and higher times to suture removal (P<0.05). The results show that this type of surveillance is an effective way of collecting accurate data on wound infection rates. It was noted that patient care practices affected the surgical wound infection rate and the surveillance was used to facilitate the adoption of evidence-based practice, through recommendations for clean surgery, to reduce the risk from extrinsic risk factors for wound infection. As a result of the implementation of this evidence-based practice there was a significant reduction (P<0.05) in the clean wound infection rate.

  12. Effects of Two Types of Anorganic Bovine Bone on Bone Regeneration: A Histological and Histomorphometric Study of Rabbit Calvaria

    OpenAIRE

    Mojgan Paknejad; Amir Reza Rokn; Siamak Yaghobee; Pantea Moradinejad; Mohadeseh Heidari; Ali Mehrfard

    2014-01-01

    Objective: The purpose of this study was to evaluate the efficacy of two types of bone substitutes, Bio-Oss and NuOss, for repair of bone defects. Materials and Methods: This study was performed on the calvaria of 14 New Zealand rabbits. The 6mm critical size defect (CSD) models of bone regeneration were used. Three CSDs were created in each surgical site. The first defect was filled with NuOss, the second one with Bio-Oss and the third one remained unfilled as the control. After healing peri...

  13. Bone Health and Osteoporosis.

    Science.gov (United States)

    Lupsa, Beatrice C; Insogna, Karl

    2015-09-01

    Osteoporosis is characterized by low bone mass and microarchitectural deterioration of bone tissue leading to decreased bone strength and an increased risk of low-energy fractures. Central dual-energy X-ray absorptiometry measurements are the gold standard for determining bone mineral density. Bone loss is an inevitable consequence of the decrease in estrogen levels during and following menopause, but additional risk factors for bone loss can also contribute to osteoporosis in older women. A well-balanced diet, exercise, and smoking cessation are key to maintaining bone health as women age. Pharmacologic agents should be recommended in patients at high risk for fracture.

  14. Surgical manipulation compromises leukocyte mobilisation responses and inflammation after experimental cerebral ischaemia in mice

    Directory of Open Access Journals (Sweden)

    Adam eDenes

    2014-01-01

    Full Text Available Acute brain injury results in peripheral inflammatory changes, although the impact of these processes on neuronal death and neuroinflammation is currently unclear. To facilitate the translation of experimental studies to clinical benefit, it is vital to characterize the mechanisms by which acute brain injury induces peripheral inflammatory changes, and how these are affected by surgical manipulation in experimental models. Here we show that in mice, even mild surgical manipulation of extracranial tissues induced marked granulocyte mobilisation (300% and systemic induction of cytokines. However, intracranial changes induced by craniotomy, or subsequent induction of focal cerebral ischaemia were required to induce egress of CXCR2-positive granulocytes from the bone marrow. CXCR2 blockade resulted in reduced mobilisation of granulocytes from the bone marrow, caused an unexpected increase in circulating granulocytes, but failed to effect brain injury induced by cerebral ischaemia. We also demonstrate that isoflurane anaesthesia interferes with circulating leukocyte responses, which could contribute to the reported vascular and neuroprotective effects of isoflurane. In addition, no immunosuppression develops in the bone marrow after experimental stroke. Thus, experimental models of cerebral ischaemia are compromised by surgery and anaesthesia in proportion to the severity of surgical stress and overall tissue injury. Understanding the inherent confounding effects of surgical manipulation and development of new models of cerebral ischaemia with minimal surgical intervention could facilitate better understanding of interactions between inflammation and brain injury.

  15. BONE IN OSTEOPETROSIS

    Directory of Open Access Journals (Sweden)

    Ramkumar

    2014-04-01

    Full Text Available Osteopetrosis, a generalized developmental bone disease due to genetic disturbances, characterized by failure of bone re sorption and continuous bone formation making the bone hard, dense and brittle. Bones of intramembranous ossification and enchondrial ossification are affected genetically and symmetrically. During the process of disease the excess bone formation obliterates the cranial foramina and presses the optic, auditory and facial nerves resulting in defective vision, impaired hearing and facial paralysis. The bone formation in osteopetrosis affects bone marrow function leading to severe anemia and deficient of blood cells. The bone devoid of blood supply due to compression of blood vessels by excess formation of bone are prone to osteomyelitic changes with suppuration and pathological fracture if exposed to infection. Though the condition is chronic progressive, it produces changes leading to fatal condition, it should be studied thoroughly by everyone and hence this article presents a classical case of osteopetrosis with detailed description and discussion for the benefit of readers

  16. Composite bone models in orthopaedic surgery research and education.

    Science.gov (United States)

    Elfar, John; Menorca, Ron Martin Garcia; Reed, Jeffrey Douglas; Stanbury, Spencer

    2014-02-01

    Composite bone models are increasingly used in orthopaedic biomechanics research and surgical education-applications that traditionally relied on cadavers. Cadaver bones are suboptimal for many reasons, including issues of cost, availability, preservation, and inconsistency between specimens. Further, cadaver samples disproportionately represent the elderly, whose bone quality may not be representative of the greater orthopaedic population. The current fourth-generation composite bone models provide an accurate reproduction of the biomechanical properties of human bone when placed under bending, axial, and torsional loads. The combination of glass fiber and epoxy resin components into a single phase has enabled manufacturing by injection molding. The high level of anatomic fidelity of the cadaver-based molds and negligible shrinkage properties of the epoxy resin results in a process that allows for excellent definition of anatomic detail in the cortical wall and optimized consistency of features between models. Recent biomechanical studies of composites have validated their use as a suitable substitute for cadaver specimens. PMID:24486757

  17. Bone-Cement: The new medical quick fix

    Directory of Open Access Journals (Sweden)

    Dinesh Bhatia

    2010-01-01

    Full Text Available Bone Cement is being widely used in vertebroplasty, a minimally invasive surgical procedure to treat spinal frac-tures and collapsed vertebrae. It is being labeled as a concrete success in medical field. It is being used to treat fractures due to osteoporosis, menopause, steroids, hyperthyroidism and chronic obstructive pulmonary diseases. In this technique a needle with bone cement (PMMA, polymethylmethacrylate is injected into the collapsed verte-bra after administering local anesthesia to patient. It solidifies within few minutes and provides support to damaged bone resulting in relief to the patient. It also prevents the movement between different parts of the broken bone. Hence it requires a short hospital stay for the patient and the procedure can be performed with much ease and at significant lower costs. Patient can resume normal activity within a day or so. Bone cement is now being referred to as the quick medical fix material for early repair of fractures.

  18. Surgical Procedures for Vestibular Dysfunction

    Science.gov (United States)

    ... Rated Nonprofit! Volunteer. Donate. Review. Surgical Procedures for Vestibular Dysfunction When is surgery necessary? When medical treatment ... organ (cochlea) is also sacrificed with this procedure. Vestibular nerve section A vestibular nerve section is a ...

  19. Aesthetic Surgical Crown Lengthening Procedure

    Directory of Open Access Journals (Sweden)

    Pablo Santos de Oliveira

    2015-01-01

    Full Text Available The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey, crown lengthening is the most habitual surgical periodontal treatment.

  20. Aesthetic Surgical Crown Lengthening Procedure.

    Science.gov (United States)

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A; Shibli, Jamil A; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment.

  1. Undernutriton and surgical site infection

    OpenAIRE

    Weimann, Arved

    2007-01-01

    There is strong evidence for the impact of nutritional status and nutritional intervention on surgical morbidity with special regard to surgical site infectious complications. Aiming on the decrease of length of hospital stay in surgery, the identification of nutritional risk patients and candidates for preoperative nutritional support has to be realized in an outpatient setting. This has to be established by improvement of health care networking. Whenever possible, nutritional support should...

  2. Surgical checklists: the human factor

    OpenAIRE

    O’Connor, Paul; Reddin, Catriona; O’Sullivan, Michael; O’Duffy, Fergal; Keogh, Ivan

    2013-01-01

    Background Surgical checklists has been shown to improve patient safety and teamwork in the operating theatre. However, despite the known benefits of the use of checklists in surgery, in some cases the practical implementation has been found to be less than universal. A questionnaire methodology was used to quantitatively evaluate the attitudes of theatre staff towards a modified version of the World Health Organisation (WHO) surgical checklist with relation to: beliefs about levels of compli...

  3. Surgical treatment for liver cancer

    Institute of Scientific and Technical Information of China (English)

    Nicole; C; Tsim; Adam; E; Frampton; Nagy; A; Habib; Long; R; Jiao

    2010-01-01

    Primary liver cancer is amongst the commonest tumors worldwide,particularly in parts of the developing world,and is increasing in incidence. Over the past three decades,surgical hepatic resection has evolved from a high risk,resource intensive procedure with limited application,to a safe and commonly performed operation with a range of indications. This article reviews the approach to surgical resection for malignancies such as hepatocellular cancer,metastatic liver de-posits and neuroendocrine tumors. Surv...

  4. Innovation in pediatric surgical education.

    Science.gov (United States)

    Clifton, Matthew S; Wulkan, Mark L

    2015-06-01

    Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees.

  5. Blepharoplasty and periorbital surgical rejuvenation

    OpenAIRE

    Milind Naik

    2013-01-01

    The periorbital region forms the epicenter of facial aging changes and receives highest attention from physicians and patients. The concern about visual function, clubbed with the need for hidden incisions, makes the periocular region a highly specialized surgical area, most appropriately handled by an ophthalmic plastic surgeon. The article provides an overview of cosmetic eyelid and facial surgery in the periocular region. Common aesthetic surgical procedures as well as ocular side-effects ...

  6. Surgical treatment of primary hyperparathyroidism

    DEFF Research Database (Denmark)

    Brasso, K; Karstrup, S; Lundby, C M;

    1994-01-01

    One hundred and two patients with primary hyperparathyroidism underwent a total of 108 bilateral neck explorations with attempted identification and biopsy of all four glands. Hypercalcaemia was surgically eliminated in 97 of 102 patients (95%). Of the remaining hypercalcaemic patients one.......9%). Permanent paralysis of the recurrent nerve occurred in three patients (2.9%). Twenty-one patients developed other postoperative complications from which they all recovered without sequelae. No postoperative deaths occurred. Our results show that surgical treatment of primary hyperparathyroidism...

  7. Surgical innovations in canine gonadectomy

    OpenAIRE

    Van Goethem, Bart

    2016-01-01

    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated negative consequences (lengthy placement, impaired wound healing around bulky knots, and the effect of unsightly knots on cosmetics). A study in 9 dogs found that celiotomy closure was easily achiev...

  8. Screw-bone finite element models for screw pullout simulation%螺钉-骨抗拔出力试验有限元模型的建立与验证

    Institute of Scientific and Technical Information of China (English)

    严亚波; 裴国献; 桑宏勋; 马真胜; 雷伟

    2013-01-01

    Objective To establish screw-bone finite element (FE) models for screw pullout simulation.Methods A pedicle screw model with a diameter of 6.5 mm,a model of screw-low density porous foam and a model of screw-high density porous foam were established and validated against the published data.Next,a screw-bone model was established and imported into the ANSYS software for FE simulation to study the dynamic bone responses during screw pullout according to the criteria set by American Association for Testing Materials (ASTM).A velocity loading of 0.01 mm/s with a maximum displacement of 2.7 mm was applied on the screw.For validation,the screw-foam models with 2 different densities were used for comparison of the pullout forces with the experimental data published.Results In validation,the predicted pullout forces were 2028.8 N in the high density foam model and 607.0 N in the low density foam model,respectively.They were in good agreement with the data of Hashemi et al.(2132.5 ± 119.3 N and 688.2 ±91.4 N,respectively).The load-displacement curves in the FE models were similar to the published (1.8 mm versus 1.5mm).In the simulation of screw pullout,the areas around the crew changed in volume in the process of pullout.Conclusion The dynamic screw-bone FE model established and validated by the present study can be used in simulation of pullout of pedicle screws to study mechanical bone responses to the pullout.%目的 建立螺钉-骨抗拔出力试验的动态有限元模型,模拟螺钉的拔出过程. 方法 基于螺钉的国标尺寸,建立直径为6.5 mm的椎弓根螺钉模型,并建立对应骨组织的高密度和低密度多孔泡沫三维模型进行验证,最后建立螺钉-骨模型研究螺钉拔出过程中骨骼的动态响应.在Ansys中对三维模型进行网格划分,并按照美国材料试验协会(ASTM)标准对螺钉进行拔出力加载分析.拔出方向为轴向拔出,拔出速度为0.01 mm/s.建立模型后,对模型进行加载计算并与

  9. Modification of the technique of osteotomy for surgical maxillary expansion

    Directory of Open Access Journals (Sweden)

    João Luis Carlini

    2015-10-01

    Full Text Available Surgically assisted maxillary expansion is a technique used to correct transverse maxillary deficiency, which is a dentofacial anomaly related to the decrease of the upper arch over the lower arch. It is applied to patients in their late teens and adults due to skeletal maturity, causing obliteration of the intermaxillary suture, which requires orthodontic procedure, associated with surgery. The purpose of this study is to report the clinical case of a patient admitted for surgical maxillary expansion through the modified technique and point out the possible advantages, such as aesthetics maintenence, long-term stability, faster return to orthodontic treatment, and improved bone healing. However, there are some contraindications when the patient presents severe crowding, roots of the canine and lateral incisor are converging and in patients who will undergo to protraction with facial mask.

  10. Surgical Intervention for Instability of the Craniovertebral Junction.

    Science.gov (United States)

    Takayasu, Masakazu; Aoyama, Masahiro; Joko, Masahiro; Takeuchi, Mikinobu

    2016-08-15

    Surgical approaches for stabilizing the craniovertebral junction (CVJ) are classified as either anterior or posterior approaches. Among the anterior approaches, the established method is anterior odontoid screw fixation. Posterior approaches are classified as either atlanto-axial fixation or occipito-cervical (O-C) fixation. Spinal instrumentation using anchor screws and rods has become a popular method for posterior cervical fixation. Because this method achieves greater stability and higher success rates for fusion without the risk of sublaminar wiring, it has become a substitute for previous methods that used bone grafting and wiring. Several types of anchor screws are available, including C1/2 transarticular, C1 lateral mass, C2 pedicle, and translaminar screws. Appropriate anchor screws should be selected according to characteristics such as technical feasibility, safety, and strength. With these stronger anchor screws, shorter fixation has become possible. The present review discusses the current status of surgical interventions for stabilizing the CVJ. PMID:27041630

  11. Surgical Management of Compound Odontoma Associated with Unerupted Tooth.

    Science.gov (United States)

    Pacifici, Andrea; Carbone, Daniele; Marini, Roberta; Pacifici, Luciano

    2015-01-01

    Odontomas represent the most common type of odontogenic benign jaws tumors among patients younger than 20 years of age. These tumors are composed of enamel, dentine, cementum, and pulp tissue. According to the World Health Organization classification, two distinct types of odontomas are acknowledged: complex and compound odontoma. In complex odontomas, all dental tissues are formed, but appeared without an organized structure. In compound odontomas, all dental tissues are arranged in numerous tooth-like structures known as denticles. Compound odontomas are often associated with impacted adjacent permanent teeth and their surgical removal represents the best therapeutic option. A case of a 20-year-old male patient with a compound odontoma-associated of impacted maxillary canine is presented. A minimally invasive surgical technique is adopted to remove the least amount of bone tissue as far as possible.

  12. Surgical Management of Compound Odontoma Associated with Unerupted Tooth

    Directory of Open Access Journals (Sweden)

    Andrea Pacifici

    2015-01-01

    Full Text Available Odontomas represent the most common type of odontogenic benign jaws tumors among patients younger than 20 years of age. These tumors are composed of enamel, dentine, cementum, and pulp tissue. According to the World Health Organization classification, two distinct types of odontomas are acknowledged: complex and compound odontoma. In complex odontomas, all dental tissues are formed, but appeared without an organized structure. In compound odontomas, all dental tissues are arranged in numerous tooth-like structures known as denticles. Compound odontomas are often associated with impacted adjacent permanent teeth and their surgical removal represents the best therapeutic option. A case of a 20-year-old male patient with a compound odontoma-associated of impacted maxillary canine is presented. A minimally invasive surgical technique is adopted to remove the least amount of bone tissue as far as possible.

  13. The anatomic coracoclavicular ligament reconstruction: surgical technique and indications.

    Science.gov (United States)

    Carofino, Brad C; Mazzocca, Augustus D

    2010-03-01

    The anatomic coracoclavicular ligament reconstruction (ACCR) is a surgical procedure to address acriomioclavicular joint instability. The coracoclavicular ligaments are reconstructed using a semitendinosus allograft passed beneath the coracoid and through bone tunnels in the clavicle. The graft is secured with interference screw fixation, and the acromioclavicular joint is retained. Here we describe the authors' surgical technique, indications, and rehabilitation protocol. Also, a preliminary case series of seventeen patients is presented. Patients demonstrated significant improvement in pain levels and function. The mean ASES score increased from 52 preoperatively to 92. The Constant Murley rose from 66.6 to 94.7. There were three failures in this series, and two required revision surgery. PMID:20188267

  14. Bacterial migration through punctured surgical gloves under real surgical conditions

    Directory of Open Access Journals (Sweden)

    Heidecke Claus-Dieter

    2010-07-01

    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  15. Characterization of aerosols produced by surgical procedures: A summary

    International Nuclear Information System (INIS)

    In many types of surgery, especially orthopedic procedures, power tools such as saws and drills are used. These tools can impart considerable energy in disrupting tissue and may produce aerosolized blood and material from bone and other tissues. Surgical lasers and electrocautery tools can also produce aerosols due to vaporization of blood and tissues. A number of studies have been reported concerning production of aerosols during surgery, and some of the aerosols produced may contain infectious materials. Health care workers have expressed concern and questions pertaining to the occupational transmission of blood-borne pathogens including the human immunodeficiency virus (HIV) and hepatitis B virus (HBV) via blood aerosols during surgery. Little or no data existed characterizing the aerosols produced performing surgical procedures. Because of this lack of data, the National Institute for Occupational Safety and Health funded a project at ITRI to assess the extent of aerosolization of blood and other tissues during surgical procedures in the laboratory and in a hospital surgical suite

  16. [Atraumatic bone expansion: Interest of piezo-surgery, conicals expanders and immediate implantation combination].

    Science.gov (United States)

    Iraqui, O; Lakhssassi, N; Berrada, S; Merzouk, N

    2016-06-01

    The durability of dental implants depends on the presence of a 1mm coating bone sheath all around the fixture. Therefore, bone resorption represents a challenge for the practitioner. Bone expansion is a surgical technique that allows the management of horizontal bone atrophy. Cortical bone splitting allows for an enlargement of the residual crest by displacement of the vestibular bone flap. The immediate placement of implants secures the widening and allows for a 97% survival rate. However, bone expansion is hard to undertake in sites with high bone density. Furthermore, the use of traditional instruments increases patient's stress and the risk for an interruptive fracture during bone displacement. Non-traumatic bone expansion is one solution to this problem. The combination of piezo-surgery and conical expanders allows for a secured displacement of the selected bone flap as well as an immediate implant placement, avoiding the risk of slipping, overheating, or fracture, all within an undeniable operative comfort. Non-traumatic bone expansion is a reliable, reproducible, conservative, and economical in time and cost procedure. We describe our atraumatic bone expension and immediate implant placement technique in high bone density sites and illustrate it by a clinical case.

  17. [Atraumatic bone expansion: Interest of piezo-surgery, conicals expanders and immediate implantation combination].

    Science.gov (United States)

    Iraqui, O; Lakhssassi, N; Berrada, S; Merzouk, N

    2016-06-01

    The durability of dental implants depends on the presence of a 1mm coating bone sheath all around the fixture. Therefore, bone resorption represents a challenge for the practitioner. Bone expansion is a surgical technique that allows the management of horizontal bone atrophy. Cortical bone splitting allows for an enlargement of the residual crest by displacement of the vestibular bone flap. The immediate placement of implants secures the widening and allows for a 97% survival rate. However, bone expansion is hard to undertake in sites with high bone density. Furthermore, the use of traditional instruments increases patient's stress and the risk for an interruptive fracture during bone displacement. Non-traumatic bone expansion is one solution to this problem. The combination of piezo-surgery and conical expanders allows for a secured displacement of the selected bone flap as well as an immediate implant placement, avoiding the risk of slipping, overheating, or fracture, all within an undeniable operative comfort. Non-traumatic bone expansion is a reliable, reproducible, conservative, and economical in time and cost procedure. We describe our atraumatic bone expension and immediate implant placement technique in high bone density sites and illustrate it by a clinical case. PMID:27185205

  18. Anatomy-based registration of CT-scan and intraoperative X-ray images for guiding a surgical robot.

    Science.gov (United States)

    Guéziec, A; Kazanzides, P; Williamson, B; Taylor, R H

    1998-10-01

    We describe new methods for rigid registration of a preoperative computed tomography (CT)-scan image to a set of intraoperative X-ray fluoroscopic images, for guiding a surgical robot to its trajectory planned from CT. Our goal is to perform the registration, i.e., compute a rotation and translation of one data set with respect to the other to within a prescribed accuracy, based upon bony anatomy only, without external fiducial markers. With respect to previous approaches, the following aspects are new: 1) we correct the geometric distortion in fluoroscopic images and calibrate them directly with respect to the robot by affixing to it a new calibration device designed as a radiolucent rod with embedded metallic markers, and by moving the device along two planes, while radiographs are being acquired at regular intervals; 2) the registration uses an algorithm for computing the best transformation between a set of lines in three space, the (intraoperative) X-ray paths, and a set of points on the surface of the bone (imaged preoperatively), in a statistically robust fashion, using the Cayley parameterization of a rotation; and 3) to find corresponding sets of points to the X-ray paths on the surfaces, our new approach consists of extracting the surface apparent contours for a given viewpoint, as a set of closed three-dimensional nonplanar curves, before registering the apparent contours to X-ray paths. Aside from algorithms, there are a number of major technical difficulties associated with engineering a clinically viable system using anatomy and image-based registration. To detect and solve them, we have so far conducted two experiments with the surgical robot in an operating room (OR), using CT and fluoroscopic image data of a cadaver bone, and attempting to faithfully simulate clinical conditions. Such experiments indicate that intraoperative X-ray-based registration is a promising alternative to marker-based registration for clinical use with our proposed method.

  19. Giant aneurysmal bone cyst of the mandible with unusual presentation.

    Science.gov (United States)

    Capote-Moreno, Ana; Acero, Julio; García-Recuero, Ignacio; Ruiz, Julián; Serrano, Rosario; de Paz, Víctor

    2009-03-01

    Aneurysmal bone cysts are rare benign lesions of bone tissue, infrequent in craneofacial skeleton with regard to other structures like long bones or the spine. They are composed of sinusoidal and vascular spaces blood-filled and surrounded by fibrous tissue septa. We present a case of a 29-year-old Caucasian male with a big swelling in the left mandible associated to pain and rapid growth. He referred previous extraction of the left inferior third molar. On the X-ray study, an expansive multilocular and high vascularized bony lesion within the mandibular angle was observed. It produced expansion and destruction of lingual and buccal cortex. An incisional biopsy was performed showing a fibrous tissue with blood-filled spaces lesion suggestive of an aneurysmal bone cyst. After selective embolization of the tumour, surgical resection was done with curettage and immediate reconstruction of the defect with an anterior iliac crest graft. Aneurysmal bone cysts are non-neoplastic but locally aggressive tumours with occasional rapid growth that may be differentiated from other multilocular process like ameloblastoma, ossifying fibroma, epithelial cyst, giant cell granuloma and sarcomas. Treatment of choice consists on conservative surgical excision of the mass with curettage or enucleation. When resection creates a big defect, primary surgical reconstruction is recommended.

  20. Stress Distribution on Short Implants at Maxillary Posterior Alveolar Bone Model With Different Bone-to-Implant Contact Ratio: Finite Element Analysis.

    Science.gov (United States)

    Yazicioglu, Duygu; Bayram, Burak; Oguz, Yener; Cinar, Duygu; Uckan, Sina

    2016-02-01

    The aim of this study was to evaluate the stress distribution of the short dental implants and bone-to-implant contact ratios in the posterior maxilla using 3-dimensional (3D) finite element models. Two different 3D maxillary posterior bone segments were modeled. Group 1 was composed of a bone segment consisting of cortical bone and type IV cancellous bone with 100% bone-to-implant contact. Group 2 was composed of a bone segment consisting of cortical bone and type IV cancellous bone including spherical bone design and homogenous tubular hollow spaced structures with 30% spherical porosities and 70% bone-to-implant contact ratio. Four-millimeter-diameter and 5-mm-height dental implants were assumed to be osseointegrated and placed at the center of the segments. Lateral occlusal bite force (300 N) was applied at a 25° inclination to the implants long axis. The maximum von Mises stresses in cortical and cancellous bones and implant-abutment complex were calculated. The von Mises stress values on the implants and the cancellous bone around the implants of the 70% bone-to-implant contact group were almost 3 times higher compared with the values of the 100% bone-to-implant contact group. For clinical reality, use of the 70% model for finite element analysis simulation of the posterior maxilla region better represents real alveolar bone and the increased stress and strain distributions evaluated on the cortical and cancellous bone around the dental implants.

  1. Stress Distribution on Short Implants at Maxillary Posterior Alveolar Bone Model With Different Bone-to-Implant Contact Ratio: Finite Element Analysis.

    Science.gov (United States)

    Yazicioglu, Duygu; Bayram, Burak; Oguz, Yener; Cinar, Duygu; Uckan, Sina

    2016-02-01

    The aim of this study was to evaluate the stress distribution of the short dental implants and bone-to-implant contact ratios in the posterior maxilla using 3-dimensional (3D) finite element models. Two different 3D maxillary posterior bone segments were modeled. Group 1 was composed of a bone segment consisting of cortical bone and type IV cancellous bone with 100% bone-to-implant contact. Group 2 was composed of a bone segment consisting of cortical bone and type IV cancellous bone including spherical bone design and homogenous tubular hollow spaced structures with 30% spherical porosities and 70% bone-to-implant contact ratio. Four-millimeter-diameter and 5-mm-height dental implants were assumed to be osseointegrated and placed at the center of the segments. Lateral occlusal bite force (300 N) was applied at a 25° inclination to the implants long axis. The maximum von Mises stresses in cortical and cancellous bones and implant-abutment complex were calculated. The von Mises stress values on the implants and the cancellous bone around the implants of the 70% bone-to-implant contact group were almost 3 times higher compared with the values of the 100% bone-to-implant contact group. For clinical reality, use of the 70% model for finite element analysis simulation of the posterior maxilla region better represents real alveolar bone and the increased stress and strain distributions evaluated on the cortical and cancellous bone around the dental implants. PMID:26867093

  2. A projective surgical navigation system for cancer resection

    Science.gov (United States)

    Gan, Qi; Shao, Pengfei; Wang, Dong; Ye, Jian; Zhang, Zeshu; Wang, Xinrui; Xu, Ronald

    2016-03-01

    Near infrared (NIR) fluorescence imaging technique can provide precise and real-time information about tumor location during a cancer resection surgery. However, many intraoperative fluorescence imaging systems are based on wearable devices or stand-alone displays, leading to distraction of the surgeons and suboptimal outcome. To overcome these limitations, we design a projective fluorescence imaging system for surgical navigation. The system consists of a LED excitation light source, a monochromatic CCD camera, a host computer, a mini projector and a CMOS camera. A software program is written by C++ to call OpenCV functions for calibrating and correcting fluorescence images captured by the CCD camera upon excitation illumination of the LED source. The images are projected back to the surgical field by the mini projector. Imaging performance of this projective navigation system is characterized in a tumor simulating phantom. Image-guided surgical resection is demonstrated in an ex-vivo chicken tissue model. In all the experiments, the projected images by the projector match well with the locations of fluorescence emission. Our experimental results indicate that the proposed projective navigation system can be a powerful tool for pre-operative surgical planning, intraoperative surgical guidance, and postoperative assessment of surgical outcome. We have integrated the optoelectronic elements into a compact and miniaturized system in preparation for further clinical validation.

  3. [Motor nerves of the face. Surgical and radiologic anatomy of facial paralysis and their surgical repair].

    Science.gov (United States)

    Vacher, C; Cyna-Gorse, F

    2015-10-01

    Motor innervation of the face depends on the facial nerve for the mobility of the face, on the mandibular nerve, third branch of the trigeminal nerve, which gives the motor innervation of the masticator muscles, and the hypoglossal nerve for the tongue. In case of facial paralysis, the most common palliative surgical techniques are the lengthening temporalis myoplasty (the temporal is innervated by the mandibular nerve) and the hypoglossal-facial anastomosis. The aim of this work is to describe the surgical anatomy of these three nerves and the radiologic anatomy of the facial nerve inside the temporal bone. Then the facial nerve penetrates inside the parotid gland giving a plexus. Four branches of the facial nerve leave the parotid gland: they are called temporal, zygomatic, buccal and marginal which give innervation to the cutaneous muscles of the face. Mandibular nerve gives three branches to the temporal muscles: the anterior, intermediate and posterior deep temporal nerves which penetrate inside the deep aspect of the temporal muscle in front of the infratemporal line. The hypoglossal nerve is only the motor nerve to the tongue. The ansa cervicalis, which is coming from the superficial cervical plexus and joins the hypoglossal nerve in the submandibular area is giving the motor innervation to subhyoid muscles and to the geniohyoid muscle.

  4. Outcome of surgical treatment of type IV capitellum frac-

    Directory of Open Access Journals (Sweden)

    Singh Ajay Pal

    2012-08-01

    Full Text Available 【Abstract】 Objective: Fractures of the capitellum and trochlea constitute less than 1% of all elbow fractures and a shear fracture involving the capitellum and extending medially into most of the trochlea is rarely reported. Type IV capitellum fracture is still controversial in regard to its ra-diographic appearance, surgical approach and osteosynthesis. We report 10 cases of type IV capitellum fracture with a view to elucidating its clinical features and treatment outcome. Methods: We treated 10 patients of type IV capitellum fracture with a mean age of 32 years. A uniform surgical approach and postoperative rehabilitation were followed. Results: Nine patients presented to us after a mean of 4 days of injury and one patient was nonunion after 6 months of injury who had been treated conservatively by a bone setter. Double arc sign was absent in 6 cases. Intraopera-tively 6 capitellotrochlear fragments were devoid of soft Chin J Traumatol 2012;15(4:201-205 DOI: 10.3760/cma.j.issn.1008-1275.2012.04.002 Punjab Civil Medical Services-I Mukerian, Punjab, In-dia (Singh AP Department of Orthopaedics, UCMS & GTB Hospital, Delhi, India (Dhammi IK and Garg V Swami Premanand Hospital, Mukerian, Punjab, India (Singh AP *Corresponding author: Tel: 98-72069734, Email: docajaypal@gmail.com C oronal shear fractures of distal end of humeral articular surface involve the capitellum and trochlea. These fractures are difficult to assess accurately on plain radiographs and the limited amount of subchondral bone available for stable internal fixation makes the operative treatment equally difficult. 1 Joint stiffness, instability and osteoarthrosis are complications resulting from treatment failures. 2 The major classification systems are proposed by Bryan and Dubberley et al. 3,4 Type IV fracture is a fracture involving the capitellum and extends to more than lateral half of the trochlea. 1 We report an analysis of ten cases of type IV capi-tissue attachments. By

  5. Surgical versus non-surgical treatment of congenital hyperinsulinism.

    Science.gov (United States)

    Mazor-Aronovitch, Kineret; Landau, Heddy; Gillis, David

    2009-03-01

    Congenital hyperinsulinism is a functional disorder of insulin secretion. In its diffuse severe form, it is traditionally treated with over 95% pancreatectomy. However, even after this procedure normoglycemia is not always achieved. Non-surgical therapy with frequent or continuous feeding, medication and close monitoring is another alternative. In this review we compare the two approaches to this condition focusing on early complications, diabetes, neurological outcome and home management issues. Early complications of pancreatectomy include mechanical, metabolic and infectious complications. Non-surgical interventions can be complicated by unwarranted effects of medications and of invasive procedures. Diabetes occurs with both approaches but much less frequently and years later with non-surgical treatment. Regarding neurodevelopmental outcome, most data come from heterogeneous groups. Nevertheless, it appears that outcome is not adversely affected by avoiding surgery. Home management is far more difficult for the non-surgical form. When the non-surgical approach is successful in achieving normoglycemia and parents are highly motivated, this mode of therapy should be considered.

  6. Preoperative embolization of primary bone tumors: A case control study

    Science.gov (United States)

    Jha, Roushan; Sharma, Raju; Rastogi, Shishir; Khan, Shah Alam; Jayaswal, Arvind; Gamanagatti, Shivanand

    2016-01-01

    AIM: To study the safety and effectiveness of preoperative embolization of primary bone tumors in relation to intraoperative blood loss, intraoperative blood transfusion volume and surgical time. METHODS: Thirty-three patients underwent preoperative embolization of primary tumors of extremities, hip or vertebrae before resection and stabilization. The primary osseous tumors included giant cell tumors, aneurysmal bone cyst, osteoblastoma, chondroblastoma and chondrosarcoma. Twenty-six patients were included for the statistical analysis (embolization group) as they were operated within 0-48 h within preoperative embolization. A control group (non-embolization group, n = 28) with bone tumor having similar histological diagnosis and operated without embolization was retrieved from hospital record for statistical comparison. RESULTS: The mean intraoperative blood loss was 1300 mL (250-2900 mL), the mean intraoperative blood transfusion was 700 mL (0-1400 mL) and the mean surgical time was 221 ± 76.7 min for embolization group (group I, n = 26). Non-embolization group (group II, n = 28), the mean intraoperative blood loss was 1800 mL (800-6000 mL), the mean intraoperative blood transfusion was 1400 mL (700-8400 mL) and the mean surgical time was 250 ± 69.7 min. On comparison, statistically significant (P < 0.001) difference was found between embolisation group and non-embolisation group for the amount of blood loss and requirement of blood transfusion. There was no statistical difference between the two groups for the surgical time. No patients developed any angiography or embolization related complications. CONCLUSION: Preoperative embolization of bone tumors is a safe and effective adjunct to the surgical management of primary bone tumors that leads to reduction in intraoperative blood loss and blood transfusion volume. PMID:27158424

  7. Final Report for completed IPP Project: Development of Plasma Ablation for Soft Tissue and Bone Surgery

    International Nuclear Information System (INIS)

    ArthroCare is a medical device company that develops, manufactures, and markets an advanced surgical tool, a plasma electro-surgical system for cutting and removing tissue. The hand-held electrical discharge device produces plasma in a biocompatible conductive fluid and tissue to which it is applied during surgery. Its products allow surgeons to operate with increased precision and accuracy, limiting damage to surrounding tissue thereby reducing pain and speeding recovery for the patient. In the past, the design of ArthfoCare's plasma wands has been an empirical undertaking. One goal of this R and D program was to put the phenomena involved on a sound scientific footing, allowing optimization of existing plasma based electro-surgery system technology, and the design and manufacture of new and improved kinds of scalpels, in particular for the surgical cutting of bone. Another important related goal of the program was to develop, through an experimental approach, new plasma wand approaches to the cutting ('shaving') of hard bone tissue. The goals of the CRADA were accomplished - computer models were used to predict important parameters of the plasma discharge and the bone environment, and several different approaches to bone-shaving were developed and demonstrated. The primary goal of the project was to develop and demonstrate an atmospheric-pressure plasma tool that is suitable for surgical use for shaving bone in humans. This goal was accomplished, in fact with several different alternative plasma approaches. High bone ablation speeds were measured. The use of probes ('plasma wand' - the surgical tool) with moving active electrodes was also explored, and there are advantages to this method. Another important feature is that the newly-exposed bone surface have only a very thin necrosis layer; this feature was demonstrated. This CRADA has greatly advanced our understanding of bone removal by atmospheric pressure plasmas in liquid, and puts ArthroCare in a good

  8. 模拟失重对大鼠承重骨骨髓基质细胞数量及体外成骨能力的影响%Effects of simulated weightlessness on bone marrow stromal cell count and osteogentic capacity of weight bearing bone in rats

    Institute of Scientific and Technical Information of China (English)

    付崇建; 郁冰冰; 杨连甲; 曹新生; 张立藩

    2007-01-01

    of simulated weightlessness on bone marrow stromal cell count and osteogentic capacity of weight bearing bone in rats so as to reveal the mechanism of bone loss.DESIGN : Randomized pairing and controlled study.SETTING: College of Aerospace Medicine and Department of Pathology of Stomatology College, the Fourth Military Medical University of Chinese PLA.MATERIALS: A total of 20 adult healthy male SD rats were selected in this study. At the beginning of experiment, rats based on their body mass were randomly divided into control group and suspension group with 10 in each group. Alkaline phosphatase kit was provided by Beijing Zhongsheng Bioengineering High-technological Company.METHODS: The experiment was carried out in the Department of Pathology, Collage of Stomatology, the Fourth Military Medical University of Chinese PLA from November 1999 to July 2000. Rats were randomly divided into tail suspension group and control group with 10 in each group. Rats in the tail suspension group were given tail suspension for 28 days. Their heads maintained 30° low position, and their hindlimbs freely suspended and were not given weight loading. While, rats in the control group were fed normally. At the end of experiment, bone marrow stromal cells were obtained from femur for primary and transferring cultures.MAIN OUTCOME MEASURES: Cell counting and methylthianolyldiphenyl-tetrazolium bromide (MTT) assay were used to draw growth curve of cells in primary and transferring cultures and to measure activity of alkaline phosphatase and forming quantity of mineralized nodules in vitro.RESULTS : ① Activity of alkaline phosphatase: Activity of alkaline phosphatase of cells in the primary and transferring cultures in the suspension group was lower than that in the control group, and there was significant difference between them (P<0.05). ② Forming quantity of mineralized nodules: Forming quantity of mineralized nodules in the suspension group was less than that in the control group

  9. Wear investigations of tools used in bone surgery

    Directory of Open Access Journals (Sweden)

    J. Marciniak

    2007-01-01

    Full Text Available Purpose: The main aim of the work was evaluation of wear rate of surgical drills used in orthopaedic procedureswith the use of plate bone stabilizers.Design/methodology/approach: The authors proposed a wear evaluation methodology of surgical drill edges.The drill wear was evaluated on the basis of measurement of point angle (2 κ and wear land (VBB i VBBmax.The measurements were recorded for preselected number of holes n drilled in a bovine femur. Furthermore,structure investigations and hardness tests of surgical drills were performed.Findings: The investigations revealed diverse wear of the surgical drills. The main mechanism was the wear ofthe chamfered corner and chisel edge of the drills.Research limitations/implications: The improvement of service life of surgical drills can be achieved by thecorrect selection of heat treatment parameters, ensuring the desired geometry of edge and deposition of layerwhich ensure the significant increase of cutting edge hardness.Originality/value: The proposed methodology applied for surgical drills is an effective way of service lifeestimation. The quality of surgical tools influences the safety and the effectiveness of surgical procedures withthe use of plate stabilizers.

  10. Stationary surgical smoke evacuation systems.

    Science.gov (United States)

    2001-03-01

    Two types of systems are available for evacuating the surgical smoke created by electrosurgery and laser surgery: portable and stationary surgical smoke evacuation systems. While portable systems dominate the market today, stationary systems are an alternative worth considering--even though they are still in their infancy, with fewer than 90 systems installed to date. Stationary systems represent a major commitment on the part of the healthcare facility. Several system components must be installed as part of the physical plant (for instance, within the walls), making the system a permanent fixture in the surgical suite. Installation of these systems is often carried out during building construction or major renovation--although the systems can be cost-effective even if no renovations are planned. For this Evaluation, we tested three stationary systems. All three are adequate to capture surgical smoke and evacuate it from the operating room. These systems are easy to use, are quietter than their portable counterparts, and require minimal user maintenance. They represent an excellent option for most hospitals actively evacuating surgical smoke. In this article, we discuss the factors to consider when selecting from among these systems. We also offer guidance on choosing between stationary systems and portable ones. PMID:11321758

  11. Development of electrospun bone-mimetic matrices for bone regenerative applications

    Science.gov (United States)

    Phipps, Matthew Christopher

    Although bone has a dramatic capacity for regeneration, certain injuries and procedures present defects that are unable to heal properly, requiring surgical intervention to induce and support osteoregeneration. Our research group has hypothesized that the development of a biodegradable material that mimics the natural composition and architecture of bone extracellular matrix has the potential to provide therapeutic benefit to these patients. Utilizing a process known as electrospinning, our lab has developed a bone-mimetic matrix (BMM) consisting of composite nanofibers of the mechanically sta-ble polymer polycaprolactone (PCL), and the natural bone matrix molecules type-I colla-gen and hydroxyapatite nanocrystals (HA). We herein show that BMMs supported great-er adhesion, proliferation, and integrin activation of mesenchymal stem cells (MSCs), the multipotent bone-progenitor cells within bone marrow and the periosteum, in comparison to electrospun PCL alone. These cellular responses, which are essential early steps in the process of bone regeneration, highlight the benefits of presenting cells with natural bone molecules. Subsequently, evaluation of new bone formation in a rat cortical tibia defect showed that BMMs are highly osteoconductive. However, these studies also revealed the inability of endogenous cells to migrate within electrospun matrices due to the inherently small pore sizes. To address this limitation, which will negatively impact the rate of scaf-fold-to-bone turnover and inhibit vascularization, sacrificial fibers were added to the ma-trix. The removal of these fibers after fabrication resulted in BMMs with larger pores, leading to increased infiltration of MSCs and endogenous bone cells. Lastly, we evaluat-ed the potential of our matrices to stimulate the recruitment of MSCs, a vital step in bone healing, through the sustained delivery of platelet derived growth factor-BB (PDGF-BB). BMMs were found to adsorb and subsequently release greater

  12. [Bone formation and corticotomy-induced accelerated bone remodeling: can alveolar corticotomy induce bone formation?].

    Science.gov (United States)

    Moreau, Nathan; Charrier, Jean-Baptiste

    2015-03-01

    Current orthodontic treatments must answer an increasing demand for faster yet as efficient treatments, especially in adult patients. These past years, the amelioration of orthodontic, anesthetic and orthognathic surgery techniques have allowed considerable improvement of orthodontico-surgical treatments and of adult orthodontic treatments. Alveolar corticotomy (an example of such techniques) accelerates orthodontic tooth movements by local modifications of bone metabolism, inducing a transient osteopenia. This osteopenia allows greater tooth movements than conventional techniques. Whereas there is a growing understanding of the underlying biological mechanisms of alveolar corticotomies, there is little data regarding the osteogenic potential of such technique. In the present article, we review the literature pertaining to alveolar corticotomies and their underlying biological mechanisms and present a clinical case underlining the osteogenic potential of the technique. PMID:25888047

  13. Mechanical performance of disposable surgical needle holders.

    Science.gov (United States)

    Francis, E H; Towler, M A; Moody, F P; McGregor, W; Himel, H N; Rodeheaver, G T; Edlich, R F

    1992-01-01

    The mechanical performance of disposable Webster surgical needle holders supplied by three different surgical instrument companies was determined by recording the forces (clamping moment) applied by the different needle holder jaws to curved surgical needles. This investigation demonstrated that there was a large variability in the mechanical performance of the disposable needle holders supplied by each surgical instrument company. In addition, the mechanical performance of the disposable needle holder of each surgical instrument company was distinctly different.

  14. Using Natural Stable Calcium Isotopes to Rapidly Assess Changes in Bone Mineral Balance Using a Bed Rest Model to Induce Bone Loss

    Science.gov (United States)

    Morgan, J. L. L.; Skulan, J. L.; Gordon, G. E.; Smith, Scott M.; Romaniello, S. J.; Anbar, A. D.

    2012-01-01

    Metabolic bone diseases like osteoporosis result from the disruption of normal bone mineral balance (BMB) resulting in bone loss. During spaceflight astronauts lose substantial bone. Bed rest provides an analog to simulate some of the effects of spaceflight; including bone and calcium loss and provides the opportunity to evaluate new methods to monitor BMB in healthy individuals undergoing environmentally induced-bone loss. Previous research showed that natural variations in the Ca isotope ratio occur because bone formation depletes soft tissue of light Ca isotopes while bone resorption releases that isotopically light Ca back into soft tissue (Skulan et al, 2007). Using a bed rest model, we demonstrate that the Ca isotope ratio of urine shifts in a direction consistent with bone loss after just 7 days of bed rest, long before detectable changes in bone mineral density (BMD) occur. The Ca isotope variations tracks changes observed in urinary N-teleopeptide, a bone resorption biomarker. Bone specific alkaline phosphatase, a bone formation biomarker, is unchanged. The established relationship between Ca isotopes and BMB can be used to quantitatively translate the changes in the Ca isotope ratio to changes in BMD using a simple mathematical model. This model predicts that subjects lost 0.25 0.07% ( SD) of their bone mass from day 7 to day 30 of bed rest. Given the rapid signal observed using Ca isotope measurements and the potential to quantitatively assess bone loss; this technique is well suited to study the short-term dynamics of bone metabolism.

  15. Stem and progenitor cells: advancing bone tissue engineering.

    Science.gov (United States)

    Tevlin, R; Walmsley, G G; Marecic, O; Hu, Michael S; Wan, D C; Longaker, M T

    2016-04-01

    Unlike many other postnatal tissues, bone can regenerate and repair itself; nevertheless, this capacity can be overcome. Traditionally, surgical reconstructive strategies have implemented autologous, allogeneic, and prosthetic materials. Autologous bone--the best option--is limited in supply and also mandates an additional surgical procedure. In regenerative tissue engineering, there are myriad issues to consider in the creation of a functional, implantable replacement tissue. Importantly, there must exist an easily accessible, abundant cell source with the capacity to express the phenotype of the desired tissue, and a biocompatible scaffold to deliver the cells to the damaged region. A literature review was performed using PubMed; peer-reviewed publications were screened for relevance in order to identify key advances in stem and progenitor cell contribution to the field of bone tissue engineering. In this review, we briefly introduce various adult stem cells implemented in bone tissue engineering such as mesenchymal stem cells (including bone marrow- and adipose-derived stem cells), endothelial progenitor cells, and induced pluripotent stem cells. We then discuss numerous advances associated with their application and subsequently focus on technological advances in the field, before addressing key regenerative strategies currently used in clinical practice. Stem and progenitor cell implementation in bone tissue engineering strategies have the ability to make a major impact on regenerative medicine and reduce patient morbidity. As the field of regenerative medicine endeavors to harness the body's own cells for treatment, scientific innovation has led to great advances in stem cell-based therapies in the past decade.

  16. Development of Marjolin's ulcer following successful surgical treatment of chronic sacral pressure sore

    DEFF Research Database (Denmark)

    Knudsen, M.A.; Biering-Sørensen, Fin

    2008-01-01

    STUDY DESIGN: Case report. OBJECTIVE: Report of an unusual case, where a Marjolin's ulcer that developed 2.5 years after surgical excision and successful closure. SETTING: Department of Plastic and Reconstructive Surgery and Burn Unit and the Clinic for Spinal Cord Injuries, Copenhagen University...... tomography, and magnetic resonance imaging scans revealed a soft tissue process over the sacral and coccygeal bones and massive destruction of these bony structures. The patient died 11 months later, despite surgical and radiation treatment. CONCLUSION: The present case is unusual because, in spite...... of surgical excision and successful closure of the wound, the patient developed Marjolin's ulcer 2.5 years later. Yet it illustrates the primary importance of preventing the development pressure sores, of aggressive (surgical) therapy with healing when they do arise and of taking frequent biopsies...

  17. Application of student-subjected high simulation scene simulation teaching in the teaching of surgical nursing%以学生为主体的高仿真情景模拟教学在外科护理教学中的应用

    Institute of Scientific and Technical Information of China (English)

    陈英

    2016-01-01

    Objective: To explore the application of the students as the main body in the teaching mode of scene simulation in surgical nursing teaching. Methods: Certain class (68 persons) of nursing specialty in 2013 of Nanyang Medical College in Henan Province were designed by SimMan integrated system model, which provided the students with the corresponding nursing care, and then organized class discussion. Results: The students of high school teaching in the overall recognition of the attitude, the value of its application value of the 3 were "teaching to promote me to become active learners", "I was encouraged to participate in classroom teaching", "in the clinical teaching process, the atmosphere is harmonious", the results of the semi structure interview, the application of SimMan integrated system model of the teaching method in a certain extent, mobilize the students to participate in the initiative and improve the students' teamwork spirit, confidence and work ability. Conclusion: With the SimMan model to simulate the teaching method of the students as the main body, it is beneficial to improve the students' comprehensive ability, and deepen the knowledge of the related diseases, and cultivate the clinical thinking ability.%目的:探讨以学生为主体进行情景模拟教学模式在外科护理教学中的应用。方法:选择河南省南阳医学高等专科学校护理专业2013级某班(68例)采用SimMan综合系统模型设计情景,让学生根据不同“病情”提供相应护理,而后组织课堂讨论,教学结束后对学生进行问卷调查和半结构访谈评价教学效果。结果:学生对高仿真模拟人教学总体持认可态度,对其应用价值认可度最高的3项分别为“教学促使我成为积极主动的学习者”“我被鼓励参与课堂教学”“在临床教学过程中,气氛很和谐”;半结构访谈结果发现,应用SimMan综合系统模型的情景模拟教

  18. How Is Bone Cancer Diagnosed?

    Science.gov (United States)

    ... with bone cancer. Accurate diagnosis of a bone tumor often depends on combining information about its location (what bone is affected and even which part of the bone is involved), appearance on x-rays, and appearance under a microscope. ...

  19. Attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopic analysis of regenerated bone

    Science.gov (United States)

    Benetti, Carolina; Kazarain, Sergei G.; Alves, Marco A. V.; Blay, Alberto; Correa, Luciana; Zezell, Denise M.

    2014-03-01

    The cutting of bone is routinely required in medical procedures, especially in dental applications. In such cases, bone regeneration and new bone quality can determine the success of the treatment. This study investigated the main spectral differences of undamaged and healed bone using the ATR-FTIR spectroscopy technique. Three rabbits were submitted to a surgical procedure; a small piece of bone (3x3 mm2) was removed from both sides of their jaws using a high speed drill. After 15 days, the rabbits were euthanized and the jaws were removed. A bone slice was cut from each side of the jaw containing regions of undamaged and newly formed bone, resulting in six samples which were polished for spectroscopic comparison. The samples were analyzed by FTIR spectroscopy using a diamond ATR accessory. Spectral characteristics were compared and particular attention was paid to the proportion of phosphate to amide I bands and the width of the phosphate band. The results show that the ratio of phosphate to amide I is smaller in new bone tissue than in the undamaged bone, indicating a higher organic content in the newly formed bone. The analysis of the width of the phosphate band suggests a crystallinity difference between both tissues, since the width was higher in the new bone than in the natural bone. These results suggest that the differences observed in bone aging processes by FTIR spectroscopic can be applied to the study of healing processes.

  20. Emotions in veterinary surgical students

    DEFF Research Database (Denmark)

    Langebæk, Rikke; Eika, Berit; Pedersen, Lene Tanggaard;

    2012-01-01

    A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources ...... and enhance positive emotions and engagement, thereby improving students' learning.......A surgical educational environment is potentially stressful and can negatively affect students' learning. The aim of the present study was to investigate the emotions experienced by veterinary students in relation to their first encounter with live-animal surgery and to identify possible sources...... of positive and negative emotions, respectively. During a Basic Surgical Skills course, 155 veterinary fourth-year students completed a survey. Of these, 26 students additionally participated in individual semi-structured interviews. The results of the study show that students often experienced a combination...