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Sample records for bone transport reconstruction

  1. Bone transport for limb reconstruction following severe tibial fractures

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    Julian Fürmetz

    2016-03-01

    Full Text Available A common treatment of tibial defects especially after infections is bone transport via external fixation. We compare complications and outcomes of 25 patients treated with a typical Ilizarov frame or a hybrid system for bone reconstruction of the tibia. Average follow up was 5.1 years. Particular interest was paid to the following criteria: injury type, comorbidities, development of osteitis and outcome of the different therapies. The reason for segmental resection was a second or third grade open tibia fractures in 24 cases and in one case an infection after plate osteosynthesis. Average age of the patients was 41 years (range 19 to 65 years and average defect size 6.6 cm (range 3.0 to 13.4 cm. After a mean time of 113 days 23 tibial defects were reconstructed, so we calculated an average healing index of 44.2 days/cm. Two patients with major comorbidities needed a below knee amputation. The presence of osteitis led to a more complicated course of therapy. In the follow up patients with an Ilizarov frame had better results than patients with hybrid systems. Bone transport using external fixation is suitable for larger defect reconstruction. With significant comorbidities, however, a primary amputation or other methods must be considered.

  2. Bone Transport for Limb Reconstruction Following Severe Tibial Fractures.

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    Fürmetz, Julian; Soo, Chris; Behrendt, Wolf; Thaller, Peter H; Siekmann, Holger; Böhme, Jörg; Josten, Christoph

    2016-03-21

    A common treatment of tibial defects especially after infections is bone transport via external fixation. We compare complications and outcomes of 25 patients treated with a typical Ilizarov frame or a hybrid system for bone reconstruction of the tibia. Average follow up was 5.1 years. Particular interest was paid to the following criteria: injury type, comorbidities, development of osteitis and outcome of the different therapies. The reason for segmental resection was a second or third grade open tibia fractures in 24 cases and in one case an infection after plate osteosynthesis. Average age of the patients was 41 years (range 19 to 65 years) and average defect size 6.6 cm (range 3.0 to 13.4 cm). After a mean time of 113 days 23 tibial defects were reconstructed, so we calculated an average healing index of 44.2 days/cm. Two patients with major comorbidities needed a below knee amputation. The presence of osteitis led to a more complicated course of therapy. In the follow up patients with an Ilizarov frame had better results than patients with hybrid systems. Bone transport using external fixation is suitable for larger defect reconstruction. With significant comorbidities, however, a primary amputation or other methods must be considered. PMID:27114814

  3. Mandibular reconstruction using bone allografts

    International Nuclear Information System (INIS)

    Further understanding of bone healing mechanisms, bone physiology and bone biology, transplantation immunology, and development of Tissue Banking procedures has enabled oral and maxillofacial surgeons to reconstruct even the most difficult bony defects successfully with the preserved allogeneic bone implant. Although it had been known that bone allografts were clinically effective, its application has not been widespread until the reports of Inclan (I 942), Hyatt and Butler (I 950), and Wilson (I 95 1). Tissue Banking provides the surgeon with a readily available, relatively inexpensive, and relatively safe selection of allogeneic bone for clinical use. Now autogenous bone and allogeneic bone implants present a wide variety of surgical options to surgeons, whether used separately or in combination. The surgeons are able to make judicious and fruitful choices, only with a thorough knowledge of the above-mentioned biological principles and skillful techniques. Many kinds of bone grafting techniques have been tried for reconstructing defective osseous tissues of the oral and maxillofacial region, though they have varying degrees of success. The osseous defects which require grafting include those of various size, shape, position, or amount. Unlike autogenous grafts, whose function is to provide osteogenic cells, allografts are purely passive, offering only a matrix for the inductive phase of bone healing. The condition of the recipient bed is of primary importance, because the host must produce all of the essential elements for the bone allograft to become incorporated. Depending on the processing methods of the allogeneic bone, the bone graft materials have different qualities, different healing potentials and different indications. Proper selection of grafts and surgical techniques requires an understanding of graft immunology and the mechanisms of graft healing. The surgeons should know about the biological principles to raise the clinical success rate

  4. Three-Dimensional Evaluation of Mandibular Bone Regenerated By Bone Transport Distraction Osteogenesis

    OpenAIRE

    Kontogiorgos, Elias; Elsalanty, Mohammed E.; Zapata, Uriel; Zakhary, Ibrahim; Nagy, William W; Dechow, Paul C.; Opperman, Lynne A.

    2011-01-01

    The purpose of this study was to evaluate the structure and material properties of native mandibular bone and those of early regenerate bone, produced by bone transport distraction osteogenesis. Ten adult foxhounds were divided into two groups of five animals each. In all animals, a 3- to 4-cm defect was created on one side of the mandible. A bone transport reconstruction plate, consisting of a reconstruction plate with an attached intraoral transport unit, was utilized to stabilize the mandi...

  5. Visualization of postoperative anterior cruciate ligament reconstruction bone tunnels

    OpenAIRE

    Meuffels, Duncan E; Potters, Jan-Willem; Koning, Anton HJ; Brown Jr, Charles H; Verhaar, Jan AN; Reijman, Max

    2011-01-01

    Background and purpose Non-anatomic bone tunnel placement is the most common cause of a failed ACL reconstruction. Accurate and reproducible methods to visualize and document bone tunnel placement are therefore important. We evaluated the reliability of standard radiographs, CT scans, and a 3-dimensional (3D) virtual reality (VR) approach in visualizing and measuring ACL reconstruction bone tunnel placement. Methods 50 consecutive patients who underwent single-bundle ACL reconstructions were ...

  6. Tissue engineering of bone: the reconstructive surgeon's point of view

    OpenAIRE

    Kneser, U; Schaefer, D. J.; Polykandriotis, E; Horch, R E

    2007-01-01

    Bone defects represent a medical and socioeconomic challenge. Different types of biomaterials are applied for reconstructive indications and receive rising interest. However, autologous bone grafts are still considered as the gold standard for reconstruction of extended bone defects. The generation of bioartificial bone tissues may help to overcome the problems related to donor site morbidity and size limitations. Tissue engineering is, according to its historic definition, an “interdisciplin...

  7. FUNCTIONAL OUTCOME OF ARTHROSCOPY ASSISTED ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION USING BONE PATELLAR TENDON BONE AUTOGRAFT

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    Vinod Kumar

    2015-04-01

    Full Text Available INTRODUCTION: The anterior cruciate ligament (ACL is one of the most frequently injured ligaments in the human body. 1 The Anterior Cruciate ligament (ACL is the primary stabilizer of the knee and prevents the knee against anterior translation. 2 It is also important in counteracting rotational and valgus stress. 1 The middle third of the patellar tendon autograft for ACL reconstruction can be readily procured and firmly fixed. 3 It can tolerate the loads produced by an intensive rehabilitation programme. 3 Fixation of bone plugs using interference screws provides sufficient stability to meet the demand of a vigorous postoperative protocol. 3 It remains the gold standard for ACL reconstruction. 3 This study is to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone patellar tendon bone autograft. METHODS: This study was conducted in Kempegowda Institute of Medical Sciences Hospital from November 2012 to April 2014. During this period 20 cases of adult patients with ACL deficient patients were selected according to the inclusion criteria. Study aims to assess the functional outcome of arthroscopy assisted anterior cruciate ligament reconstruction using bone - patellar tendon - bone autograft in terms of range of motion, postoperative knee stability, graft site morbidity and subjective knee functions. RESULTS: Results of our study showed that arthroscopy assisted anterior cruciate ligament reconstruction with bone - patellar tendon - bone autograft could effectively improve knee stability and functions after surgery without any complication. CONCLUSION : Arthroscopy assisted anterior cruciate l igament reconstruction with bone - patellar tendon - bone autograft is an excellent treatment option for anterior cruciate ligament deficient knees. It provides a stable knee and reduces postoperative morbidity and enables early rehabilitation. The functional outcome of arthroscopy assisted anterior

  8. Reconstruction of multiple metacarpal bone defect using segmentated free fibular bone flap: Case report

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    Rahmi Evinc

    2014-04-01

    Full Text Available In this report we present a case of blast injury to hand, including multiple metacarpal bone defect. Bone defects were reconstructed using fibular flap. Structural integrity of metacarpal bones was preserved with good functional results. [Hand Microsurg 2014; 3(1.000: 29-32

  9. Maxillary Tuberosity Reconstruction with Transport Distraction Osteogenesis

    OpenAIRE

    F. Ugurlu; Basel, B.; B. Cem Sener; A. Sertgöz

    2012-01-01

    Severe bone loss due to pathology in the maxillary tuberosity region is a challenging problem both surgically and prosthetically. Large bone grafts have a poor survival rate due to the delicate bony architecture in this area and presence of the maxillary sinus. Our case presentation describes a new technique for reconstructing severe bony defect in the maxillary tuberosity with horizontal distraction osteogenesis in a 45-year-old man. A 4 × 6 × 3 cm cyst was discovered in the left maxillary m...

  10. Reconstruction of saddle nose deformity with calvarial bone graft

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of calvarial bone in the reconstruction of saddle nose deformity. Methods: The cross-sectional study was conducted at the Plastic Surgery Unit of Imam Reza Hospital, Tabriz University of Medical Sciences, Iran, from July 2004 to October 2009. It comprised 19 patients who underwent saddle nose deformity reconstruction with calvarial bone graft. All patients were operated upon under general anaesthesia. They were followed up periodically. Results: The patients followed up for 25 to 61 months for an average period of 39.2+-4.3 months. In 14 (74%) patients the result of the surgical intervention was excellent, while in 5 (26%) it was acceptable. All patients were satisfied and there was not displacement, absorption, distortion or infection of the graft. Conclusion: Calvarial bone graft is a viable option for the reconstruction of saddle nose deformity, especially in severe cases. (author)

  11. Anterior Cruciate Ligament Reconstruction using Bone Patellar Tendon Bone autograft in ACL deficient Knee

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    Navin Kumar Karn

    2015-12-01

    Full Text Available Background & Objectives: Injury to Anterior Cruciate Ligament (ACL reconstruction has increased because of increased interest in sports. There are various grafts used for reconstruction of ACL, for example, Bone Patellar Tendon Bone, Hamstring etc. The study was conducted to evaluate the results of Bone Patellar Tendon Bone graft used for reconstruction of Anterior Cruciate Ligament.Materials & Methods: 40 patients with chronic ACL deficient knee presenting to Neuro Hospital from July 2011 to June 2013 were included in the study. The patients with intraarticular fracture of knee, severe OA knee, local active or suspected infection and systemic disease that might influence the study results were excluded from the study. Bone patellar tendon bone graft was harvested from ipsilateral knee in all the cases. The patient was followed till 2 year with specified programme of rehabilitation. The pain was assessed using VAS and the function of the knee was assessed using Modified WOMAC knee index.Results: The long term satisfactory results in terms of functional stability, symptom relief and return to preinjury level of activity was seen in 32 cases (80%. Two knees got infected out of which one required arthroscopic debridement. Mean visual analogue scale was 8 and modified WOMAC knee score was 3 at 2 year follow up.Conclusion: Bone patellar tendon bone graft is useful in high demand patients and cost effective option with high patient satisfaction rate for reconstruction of ACL.JCMS Nepal. 2015;11(3:12-15.

  12. Composites structures for bone tissue reconstruction

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    Neto, W.; Santos, João [Universidade Federal de São Carlos, Departament of Materials Engineering - Rd. Washington Luis, Km 235, 13565-905, São Carlos-SP (Brazil); Avérous, L.; Schlatter, G.; Bretas, Rosario, E-mail: bretas@ufscar.br [Université de Strasbourg, ECPM-LIPHT - 25 rue Becquerel, 67087, Strasbourg (France)

    2015-05-22

    The search for new biomaterials in the bone reconstitution field is growing continuously as humane life expectation and bone fractures increase. For this purpose, composite materials with biodegradable polymers and hydroxyapatite (HA) have been used. A composite material formed by a film, nanofibers and HA has been made. Both, the films and the non-woven mats of nanofibers were formed by nanocomposites made of butylene adipate-co-terephthalate (PBAT) and HA. The techniques used to produce the films and nanofibers were spin coating and electrospinning, respectively. The composite production and morphology were evaluated. The composite showed an adequate morphology and fibers size to be used as scaffold for cell growth.

  13. Composites structures for bone tissue reconstruction

    Science.gov (United States)

    Neto, W.; Santos, João.; Avérous, L.; Schlatter, G.; Bretas, Rosario.

    2015-05-01

    The search for new biomaterials in the bone reconstitution field is growing continuously as humane life expectation and bone fractures increase. For this purpose, composite materials with biodegradable polymers and hydroxyapatite (HA) have been used. A composite material formed by a film, nanofibers and HA has been made. Both, the films and the non-woven mats of nanofibers were formed by nanocomposites made of butylene adipate-co-terephthalate (PBAT) and HA. The techniques used to produce the films and nanofibers were spin coating and electrospinning, respectively. The composite production and morphology were evaluated. The composite showed an adequate morphology and fibers size to be used as scaffold for cell growth.

  14. Complications of massive allograft reconstruction for bone tumors

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    Abolhasan Borjian

    2006-11-01

    Full Text Available BACKGROUND: Since the evolution of multi-drug chemotherapy and radiotherapy and new sophisticated surgical techniques, limb salvage and reconstruction, rather than amputation, has become the preferred treatment for patients with bone tumors. One option is allograft replacement. Although allograft has several advantages, it is not without complications. This study was performed to observe these complications in a group of patients treated with allograft replacement for bone tumor resection. The purpose was to gain an overview of the factors predisposing to these complications to minimize their occurrence. METHODS: This retrospective study was performed on patients with benign aggressive and malignant bone tumors undergoing limb reconstruction with allograft between 1997 and 2005 in Al-Zahra and Kashani Hospitals in Isfahan, Iran. Data was collected from patient files, clinical notes, radiographs and a recent physical examination. Complications including local recurrence, fracture of allograft, fixation failure, nonunion, infection, skin necrosis and neurological damage were recorded. RESULTS: Sixty patients including 39 males and 21 females were studied. The mean age of patients was 23 ± 11.7 years. The mean follow-up interval was 28.1 ± 12.4 months (mean ± SD. Complications were allograft fracture in 20%, local recurrence in 16%, fixation failure in 11%, nonunion in 6%, infection in 6%, skin necrosis in 6%, and peroneal nerve palsy in 1% of cases. Most local recurrences (60% were those with a mal-performed biopsy. Most allograft fractures occurred when a short plate was used. CONCLUSIONS: Allograft replacement for bone tumors remains a valid option. To avoid complications, biopsy should be done by a trained surgeon in bone oncology. A long plate is recommended for fixation. Sterility and graft processing must be optimal. Autogenous bone graft must be added at host-allograft junction. KEY WORDS: Bone tumors, bone allograft, limb

  15. EPR dose reconstruction for bone-seeking 90Sr

    International Nuclear Information System (INIS)

    The results of the EPR dose reconstruction in calcified tissues of dog injected with 90Sr are presented. It has been established that there is no essential difference in the values of doses absorbed in tooth tissues of teeth in symmetric positions in the mouth, whereas a significant difference occurs in the values of absorbed doses in teeth in non-symmetric positions. In the case of 90Sr internal exposure the dose reconstruction in crown dentine plays an important role. It has been found that its quantity is close to the dose in diaphyseal cortical bone of the femur, dose at the endosteal bone surface and in femural fatty marrow. The fact that these values exceed doses absorbed in tooth enamel points out the predominant contribution of internal exposure. The highest absorbed doses have been observed in metaphyseal trabecular femur bones, tooth alveolar bone walls, and cortical and trabecular vertebra that can be considered as suitable candidates for biomarkers of internal 90Sr exposure for post-mortal autopsy. The satisfactory correlation has been found between the doses reconstructed in calcified dog tissues and the doses measured by EPR in alanine dosimeters fixed in (or nearby) the sites of autopsy of bones/teeth. The experiments provide support for the view that EPR retrospective dosimetry with calcified tissues for internal exposure is unique in providing useful information on the doses obtained

  16. Anterior cruciate ligament reconstruction using the bone-posterior cruciate ligament-bone allograft

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    JIAO Chen; AO Ying-fang; LIU Ping; XIE Xing; LIU Chen; MA Yong

    2013-01-01

    Background AIIografts were widely used in anterior cruciate ligament (ACL) reconstruction for patients with ACL rupture of the knee.This study was to approve the feasibility of bone-posterior cruciate ligament-bone (BPCLB) allograft transplantation in ACL reconstruction.Methods Eight patients underwent ACL reconstructions with BPCLB allografts and were followed up for an average period of 32 months after operation.Results Subjective parameters including Intemational Knee Documentation Committee (IKDC),modified Larson knee ligament,Lysholm,and Tegner rating scales were much improved and side to side KT-2000 arthrometer difference was much less postoperatively.Pivot shift test was negative in all patients.The reconstructed ACL had satisfactory shape and tension.Conclusions BPCLB allograft is an optional choice forACL reconstruction.

  17. Patellar tendon ossification after anterior cruciate ligament reconstruction using bone – patellar tendon – bone autograft

    OpenAIRE

    Camillieri, Gianluca; Di Sanzo, Vincenzo; Ferretti, Matteo; Calderaro, Cosma; Calvisi, Vittorio

    2013-01-01

    Background Among the various complications described in literature, the patellar tendon ossification is an uncommon occurrence in anterior cruciate ligament (ACL) reconstruction using bone – patellar tendon – bone graft (BPTB). The heterotopic ossification is linked to knee traumatism, intramedullary nailing of the tibia and after partial patellectomy, but only two cases of this event linked to ACL surgery have been reported in literature. Case presentation We present a case of a 42-year-old ...

  18. Bone reconstruction of large defects using bone marrow derived autologous stem cells.

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    Lucarelli, Enrico; Donati, Davide; Cenacchi, Annarita; Fornasari, Pier Maria

    2004-04-01

    Bone is a tissue that has the ability to heal itself when fractured. Occasionally, a critical defect can be formed when part of the bone is lost or excised, in this case the bone fails to heal and requires bone reconstruction to prevent a non-union defect. Autogenous cancellous bone is the current gold standard treatment in bone loss. Because the amount of autogenous cancellous bone that can be harvested is limited, the expanding need for bone reconstruction is paired by the growth of interest in the discipline of tissue engineering. Labs worldwide are working to provide the right carrier and the right set of cells that, once retransplanted, will ensure bone repair. Several investigators have focused their attention on a subset of autologous non-hematopoietic stem/progenitor cells contained in the adult bone marrow stroma, referred to as stromal stem cells (SSC), as the appropriate cells to be transplanted. The use of autologous cells is facilitated by less stringent ethical and regulatory issues and does not require the patient to be immunologically suppressed. In pre-clinical and clinical protocols of critical defects in which SSC are employed, two approaches are mainly used: in the first, SSC are derived from bone marrow and directly introduced at the lesion site, in the second, SSC are derived from several sites and are expanded ex vivo before being implanted. Both approaches, equally correct in principle, will have to demonstrate, with definitive evidence of their efficacy, their capability of solving a critical clinical problem such as non-union. In this report we outline the difficulties of working with SSC. PMID:15062758

  19. [Reconstructive surgery in war injuries of the bones and joints].

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    Korzinek, K

    1992-01-01

    The basic problems of bone-and-joint surgery with special emphasis on war injuries and the role of reconstructive surgery in relieving the gravest consequences of war injuries are discussed. Since bone and joint injuries rank high among the war injuries with a share of over 70% including more than 30% of fractures, they pose not only a serious medical and surgical but also a major public health problem. The economic and social consequences of these injuries are further aggravated by the necessity for prolonged treatment and multiple surgical interventions. The basic preconditions which must be fulfilled for bone healing to take place are discussed in the light of the ultimate goal of all therapeutic efforts. i.e. restoration of full functional ability of the injured extremity. The importance of bone fragment immobilization for the process of bone healing is emphasized. Impaired bone healing, resulting from insufficient immobilization or inadequate reposition of bone fragments, is a common problem with war fractures, mainly because of the great forces involved and extensive destruction of bone and all other surrounding tissues. One of the main features of war fractures is delayed bone healing caused by massive circulatory defects in the injured bone. Some special problems attending war injuries, such as pseudarthroses and associated defects, soft tissue infections and defects, may only be effectively solved by cooperation with a plastic-vascular- or neurosurgeon. In one and joint surgery profound understanding of the physiology, pathophysiology and biomechanics of bone healing, knowledge of modern methods of osteosynthesis, skill in the management of bone and other infections as well as knowledge of the latest developments in postoperative care are essential for achieving satisfactory therapeutic results. Availability of various implants and a wide range of surgical instruments is a precondition which needs no further discussion. It is only in this way that the most

  20. Nanostructured Biomaterials for Tissue Engineered Bone Tissue Reconstruction

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    Bressan Eriberto

    2012-01-01

    Full Text Available Bone tissue engineering strategies are emerging as attractive alternatives to autografts and allografts in bone tissue reconstruction, in particular thanks to their association with nanotechnologies. Nanostructured biomaterials, indeed, mimic the extracellular matrix (ECM of the natural bone, creating an artificial microenvironment that promotes cell adhesion, proliferation and differentiation. At the same time, the possibility to easily isolate mesenchymal stem cells (MSCs from different adult tissues together with their multi-lineage differentiation potential makes them an interesting tool in the field of bone tissue engineering. This review gives an overview of the most promising nanostructured biomaterials, used alone or in combination with MSCs, which could in future be employed as bone substitutes. Recent works indicate that composite scaffolds made of ceramics/metals or ceramics/polymers are undoubtedly more effective than the single counterparts in terms of osteoconductivity, osteogenicity and osteoinductivity. A better understanding of the interactions between MSCs and nanostructured biomaterials will surely contribute to the progress of bone tissue engineering.

  1. Vascularized fibula grafts for reconstruction of bone defects after resection of bone sarcomas

    DEFF Research Database (Denmark)

    Petersen, Michael Mørk; Hovgaard, Dorrit; Elberg, Jens Jørgen; Rechnitzer, Catherine; Daugaard, Søren; Muhic, Aida

    2010-01-01

    /3/1) operated on form 2000 to 2006. The bone defects reconstructed were proximal femoral diaphysis and epiphysis (n = 2), humeral diaphysis (n = 2), humeral proximal diaphysis and epiphysis (n = 1), femoral diaphysis (n = 1), ulnar diaphysis (n = 1), and tibial diaphysis (n = 1). One patient with Ewing...

  2. [Bone tissue engineering. Reconstruction of critical sized segmental bone defects in the ovine tibia].

    Science.gov (United States)

    Reichert, J C; Epari, D R; Wullschleger, M E; Berner, A; Saifzadeh, S; Nöth, U; Dickinson, I C; Schuetz, M A; Hutmacher, D W

    2012-04-01

    Well-established therapies for bone defects are restricted to bone grafts which face significant disadvantages (limited availability, donor site morbidity, insufficient integration). Therefore, the objective was to develop an alternative approach investigating the regenerative potential of medical grade polycaprolactone-tricalcium phosphate (mPCL-TCP) and silk-hydroxyapatite (silk-HA) scaffolds.Critical sized ovine tibial defects were created and stabilized. Defects were left untreated, reconstructed with autologous bone grafts (ABG) and mPCL-TCP or silk-HA scaffolds. Animals were observed for 12 weeks. X-ray analysis, torsion testing and quantitative computed tomography (CT) analyses were performed. Radiological analysis confirmed the critical nature of the defects. Full defect bridging occurred in the autograft and partial bridging in the mPCL-TCP group. Only little bone formation was observed with silk-HA scaffolds. Biomechanical testing revealed a higher torsional moment/stiffness (p < 0.05) and CT analysis a significantly higher amount of bone formation for the ABG group when compared to the silk-HA group. No significant difference was determined between the ABG and mPCL-TCP groups. The results of this study suggest that mPCL-TCP scaffolds combined can serve as an alternative to autologous bone grafting in long bone defect regeneration. The combination of mPCL-TCP with osteogenic cells or growth factors represents an attractive means to further enhance bone formation. PMID:22476418

  3. Press-fit Femoral Fixation in ACL Reconstruction using Bone-Patellar Tendon-Bone Graft

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    Kaseb Mohammad Hasan

    2009-05-01

    Full Text Available Bone-patellar tendon auto graft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra-articular hardware we adopt biological fixation with a femoral trapezoidal press-fit fixation. A prospective study was performed on 30 consecutive active people who underwent ACL reconstruction with this technique by two surgeons between september2004 and march2007 (mean follow-up 15.2 months. Results were evaluated by an independent examiner using radiography, subjective and objective evaluation. Assessment using the IKDC knee scoring revealed 92% of the patients with a normal or nearly normal knee joint. Lysholm's score was 63.6(40- 86 preoperatively and 91.88(73-100 at the latest follow up (P < 0.005. No patient complained of instability at latest follow up. The quadriceps muscle showed mild atrophy at 3 and 6 months and at final follow-up. Five Patients complained of anterior knee pain and had a positive kneeling test. We found no graft displacement on follow up radiographs. All cases showed radiological evidence of graft osteointegration at last follow up. Our results show that press-fit fixation of trapezoidal bone graft in femoral tunnel is a simple, reliable, and cost-effective alternative for ACL recon-struction using bone-patellar tendon-bone graft.

  4. A new method of morphological comparison for bony reconstructive surgery: maxillary reconstruction using scapular tip bone

    Science.gov (United States)

    Chan, Harley; Gilbert, Ralph W.; Pagedar, Nitin A.; Daly, Michael J.; Irish, Jonathan C.; Siewerdsen, Jeffrey H.

    2010-02-01

    esthetic appearance is one of the most important factors for reconstructive surgery. The current practice of maxillary reconstruction chooses radial forearm, fibula or iliac rest osteocutaneous to recreate three-dimensional complex structures of the palate and maxilla. However, these bone flaps lack shape similarity to the palate and result in a less satisfactory esthetic. Considering similarity factors and vasculature advantages, reconstructive surgeons recently explored the use of scapular tip myo-osseous free flaps to restore the excised site. We have developed a new method that quantitatively evaluates the morphological similarity of the scapula tip bone and palate based on a diagnostic volumetric computed tomography (CT) image. This quantitative result was further interpreted as a color map that rendered on the surface of a three-dimensional computer model. For surgical planning, this color interpretation could potentially assist the surgeon to maximize the orientation of the bone flaps for best fit of the reconstruction site. With approval from the Research Ethics Board (REB) of the University Health Network, we conducted a retrospective analysis with CT image obtained from 10 patients. Each patient had a CT scans including the maxilla and chest on the same day. Based on this image set, we simulated total, subtotal and hemi palate reconstruction. The procedure of simulation included volume segmentation, conversing the segmented volume to a stereo lithography (STL) model, manual registration, computation of minimum geometric distances and curvature between STL model. Across the 10 patients data, we found the overall root-mean-square (RMS) conformance was 3.71+/- 0.16 mm

  5. Iliotibial band autograft versus bone-patella-tendon-bone autograft, a possible alternative for ACL reconstruction

    DEFF Research Database (Denmark)

    Stensbirk, Frederik; Thorborg, Kristian; Konradsen, Lars; Jørgensen, Uffe; Hölmich, Per

    2014-01-01

    PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi-ligament......PURPOSE: The long-term results after using the iliotibial band autograft (ITB) in anterior cruciate ligament (ACL) reconstruction are not fully known. If equal in quality to conventional methods, the ITB graft could be a useful alternative as a primary graft, in revision surgery or multi......-ligament reconstruction. The purpose is to assess whether the ITB autograft is a long-term reliable alternative to the bone-patella-tendon-bone (BPTB) autograft, using a prospective randomized controlled trial design. METHODS: From 1995 to 1996, sixty patients scheduled for primary ACL reconstruction were included in a...... prospective randomized controlled trial. Three senior knee surgeons, experienced in both types of ACL surgery, performed all the operations. A standardized and supervised rehabilitation programme was used for both groups for 6 months. Thirty patients received the ITB reconstruction, and 30 received the BPTB...

  6. Efficacy of PRP in the Reconstruction of Mandibular Segmental Defects Using Iliac Bone Grafts

    OpenAIRE

    Magesh, D. P. Uma; Kumaravelu, C.; Maheshwari, G. Uma

    2012-01-01

    This retrospective study was conducted to evaluate the role of platelet-rich plasma (PRP) in the reconstruction of segmental mandibular defects using iliac bone grafts. Thirteen patients underwent reconstruction of post-resection segmental defects of the mandible using titanium reconstruction plates, cortico cancellous iliac bone graft. The patients were randomly separated into two groups. One group of the patients received a PRP graft in addition to the iliac bone graft. Post-operative dimen...

  7. Craniofacial reconstruction by transport distraction osteogenesis: corticotomy versus osteotomy--an experimental study.

    Science.gov (United States)

    Kramer, Franz-Josef; Mueller, Michal; Rahmstorf, Meike; Swennen, Gwen; Dempf, Rupert; Schierle, Hannes

    2004-07-01

    Transport osteogenesis is a modified technique of callus distraction appropriate for the reconstruction of extended osseous defects of long or flat bones. The aim of this study was to determine the regenerative potential of this technique related to the degree of mobilization of the transport segment. In 10 adult sheep, critically sized defects of the calvaria were treated by gradual movement of a transport segment consisting of calvarial bone. The transport segments were either corticotomized (n = 5) or osteotomized (n = 5). The latency period was 5 days; the rate of distraction was 1 mm/d, extended for approximately 40 days. The consolidation period was 28 days. Specimens were investigated by conventional radiography, computed tomography scans, immunofluorescence, and histological examination. In both groups, transport osteogenesis resulted in a complete closure of the defect. The volume and thickness of newly formed bone at the defect site did not differ significantly between the groups, nor did the extent of vascularization. Bone formation and remodeling occurred during the entire period of distraction and consolidation. Osteotomized transport segments became smaller during distraction, whereas the volume of corticotomized segments remained relatively constant. In conclusion, transport osteogenesis resulted in reliable closure of extended skull defects in adult organisms; corticotomy and osteotomy of the transport segment led to a similar extent of bone formation. PMID:15213530

  8. A comparative study of calcium sulfate artificial bone graft versus allograft in the reconstruction of bone defect after tumor curettage

    Institute of Scientific and Technical Information of China (English)

    Yang Yongkun; Niu Xiaohui; Zhang Qing; Hao Lin; Ding Yi; Xu Hairong

    2014-01-01

    Background Cavity reconstruction after benign bone tumor removal is varied and controversial.AIIograft is widely used but is associated with complications.New bone substitutes,such as calcium sulfate artificial bone,have been introduced for bone tumor operation.However,the bone healing response of artificial bone has not been compared with allograft bone.We therefore compared calcium sulfate grafts (study group) with bone allografts (control group) for the treatment of benign bone tumors.Methods We retrospectively reviewed 50 patients who underwent calcium sulfate reconstruction and 50 patients who underwent allograft cancellous bone reconstruction.The two groups were well matched.The mean follow-up time of the study group was 19.9 (12-55) months.We investigated bone healing response,complications,and factors affecting bone healing.Results At the last follow-up,84% (42/50) of cases in the study group and 62% (31/50) of cases in the control group had achieved clinical healing (P=0.013).The initial healing rate showed no significant difference between the two groups (100% vs.96%,P=0.153).The mean healing times for calcium sulfate and allograft bone were 9.6 (3-42) months and 13.8 (3-36) months,respectively (P <0.01).Complications in the study group were minor and resolved.Implant volume was a significant factor affecting bone healing.Conclusion The calcium sulfate bone substitute showed a satisfactory healing outcome and safety profile in reconstruction of bone defects after benign bone tumor curettage,especially in smaller cavities.

  9. In Vivo Gait Analysis During Bone Transport.

    Science.gov (United States)

    Mora-Macías, J; Reina-Romo, E; Morgaz, J; Domínguez, J

    2015-09-01

    The load bearing characteristics of the intervened limb over time in vivo are important to know in distraction osteogenesis and bone healing for the characterization of the bone maturation process. Gait analyses were performed for a group of sheep in which bone transport was carried out. The ground reaction force was measured by means of a force platform, and the gait parameters (i.e., the peak, the mean vertical ground reaction force and the impulse) were calculated during the stance phase for each limb. The results showed that these gait parameters decreased in the intervened limb and interestingly increased in the other limbs due to the implantation of the fixator. Additionally, during the process, the gait parameters exponentially approached the values for healthy animals. Corresponding radiographies showed an increasing level of ossification in the callus. This study shows, as a preliminary approach to be confirmed with more experiments, that gait analysis could be used as an alternative method to control distraction osteogenesis or bone healing. For example, these analyses could determine the appropriate time to remove the fixator. Furthermore, gait analysis has advantages over other methods because it provides quantitative data and does not require instrumented fixators. PMID:25650097

  10. Exposed tibial bone after burns: Flap reconstruction versus dermal substitute.

    Science.gov (United States)

    Verbelen, Jozef; Hoeksema, Henk; Pirayesh, Ali; Van Landuyt, Koenraad; Monstrey, Stan

    2016-03-01

    A 44 years old male patient had suffered extensive 3rd degree burns on both legs, undergoing thorough surgical debridement, resulting in both tibias being exposed. Approximately 5 months after the incident he was referred to the Department of Plastic and Reconstructive Surgery of the University Hospital Gent, Belgium, to undergo flap reconstruction. Free flap surgery was performed twice on both lower legs but failed on all four occasions. In between flap surgery, a dermal substitute (Integra(®)) was applied, attempting to cover the exposed tibias with a layer of soft tissue, but also without success. In order to promote the development of granulation tissue over the exposed bone, small holes were drilled in both tibias with removal of the outer layer of the anterior cortex causing the bone to bleed and subsequently negative pressure wound therapy (NPWT) was applied. The limited granulation tissue resulting from this procedure was then covered with a dermal substitute (Glyaderm(®)), consisting of acellular human dermis with an average thickness of 0.25mm. This dermal substitute was combined with a NPWT-dressing, and then served as an extracellular matrix (ECM), guiding the distribution of granulation tissue over the remaining areas of exposed tibial bone. Four days after initial application of Glyaderm(®) combined with NPWT both tibias were almost completely covered with a thin coating of soft tissue. In order to increase the thickness of this soft tissue cover two additional layers of Glyaderm(®) were applied at intervals of approximately 1 week. One week after the last Glyaderm(®) application both wounds were autografted. The combination of an acellular dermal substitute (Glyaderm(®)) with negative pressure wound therapy and skin grafting proved to be an efficient technique to cover a wider area of exposed tibial bone in a patient who was not a candidate for free flap surgery. An overview is also provided of newer and simpler techniques for coverage of

  11. Alendronate reduced peri-tunnel bone loss and enhanced tendon graft to bone tunnel healing in anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    PPY Lui

    2013-01-01

    Full Text Available Peri-tunnel bone loss after anterior cruciate ligament (ACL reconstruction is commonly observed, both clinically and experimentally. We aimed to study the effect and mechanisms of different doses of alendronate in the reduction of peri-tunnel bone loss and promotion of graft-bone tunnel healing in ACL reconstruction. Eighty-four ACL-reconstructed rats were divided into 4 groups. Alendronate at different dosages, or saline, were injected subcutaneously weekly, for 2 or 6 weeks post-reconstruction, for vivaCT (computed tomography imaging, biomechanical tests, histology and immunohistochemistry. Alendronate significantly increased bone mass and density of tissue inside bone tunnels except at the epiphyseal region of tibial tunnel. The femoral tunnel diameter decreased significantly in the mid-dose and high-dose alendronate groups compared to that in the saline group at week 6. Alendronate significantly increased the peri-tunnel bone mass and density along all tunnel regions at week 6. Better graft-bone tunnel integration and intra-tunnel graft integrity were observed in the alendronate groups. The ultimate load was significantly higher in the mid-dose and high-dose alendronate groups at week 2, but not at week 6. There was a reduction in matrix metalloprotein (MMP1, MMP13 and CD68-positive cells at the peri-tunnel region and graft-bone interface in the alendronate-treated group compared to the saline group. Alendronate reduced peri-tunnel bone resorption, increased mineralised tissue inside bone tunnel as well as histologically and biomechanically promoted graft-bone tunnel healing, probably by reducing the expression of MMP1, MMP13 and CD68-positive cells. Alendronate might be used for reducing peri-tunnel bone loss and promoting graft-bone tunnel healing at early stage post-ACL reconstruction.

  12. Morbidity of chin bone transplants used for reconstructing alveolar defects in cleft patients

    NARCIS (Netherlands)

    Booij, A; Raghoebar, GM; Jansma, J; Kalk, WWI; Vissink, A

    2005-01-01

    Objective: The aim of this study was to evaluate the objective and subjective morbidity of symphyseal chin bone harvesting used for reconstruction of alveolar defects in young cleft patients. Design: All patients who had undergone chin bone harvesting for alveolar cleft reconstruction in the period

  13. Reconstruction of the Scapholunate Ligament Using Capitohamate Bone-Ligament-Bone.

    Science.gov (United States)

    Nakamura, Toshiyasu; Abe, Koji; Iwamoto, Takuji; Ochi, Kensuke; Sato, Kazuki

    2015-11-01

    Background The biomechanical properties of the capitohamate (CH) ligament are equivalent to those of the scapholunate (SL) interosseous ligament. We reconstructed the SL ligament using the CH bone-ligament-bone substitute for chronic injury of the SL ligament. Patients and Methods Beginning in 2008, 15 wrists of 14 patients with an average age of 38 years underwent this procedure with a minimum follow-up of 2 years. Thirteen wrists had an SL joint gap more than 3 mm, and two had a complete SL ligament disruption with a severe dorsal intercalated segment instability (DISI) deformity. Kirschner wires (K-wires) were removed 8 weeks after the surgery, then active ROM exercise began. Pain (on visual analog scale [VAS]), wrist motion (angle), radiographic characteristics, such as SL gap (mm) and SL angle, and Modified Mayo Wrist Score (MMWS) were evaluated. Technique The SL joint was reduced by manipulation or with the use of joysticks, then temporary fixed with K-wires. A dorsal trough was then made between the scaphoid and the lunate. The proximal half of the CH ligament was harvested with attached bone from the capitate and hamate (CH bone-ligament-bone), inset into the SL trough, and fixed firmly with 1.2-mm diameter titanium screws in the scaphoid and lunate, respectively. Results The VAS improved from 77 preoperatively to 12 postoperatively. The average wrist extension/flexion was 74°/60°. There was no ossification of the reconstructed SL at the final follow-up. The SL gap improved from an average of 4.8 mm to an average of 2.1 mm, and the SL angle changed from 67° to 55°. The MMWS improved to 82 points postoperatively from a preoperative average of 47 with eight excellent, five good, and two fair results. PMID:26539327

  14. Histological Features and Biocompatibility of Bone and Soft Tissue Substitutes in the Atrophic Alveolar Ridge Reconstruction

    OpenAIRE

    Carlo Maiorana; Mario Beretta; Davide Rancitelli; Giovanni Battista Grossi; Marco Cicciù; Alan Scott Herford

    2016-01-01

    The reconstruction of the atrophic alveolar ridges for implant placement is today a common procedure in dentistry daily practice. The surgical reconstruction provides for the optimization of the supporting bone for the implants and a restoration of the amount of keratinized gingiva for esthetic and functional reasons. In the past, tissue regeneration has been performed with autogenous bone and free gingival or connective tissue grafts. Nowadays, bone substitutes and specific collagen matrix a...

  15. Management of complex long bone nonunions using limb reconstruction system

    Directory of Open Access Journals (Sweden)

    Hiranya Kumar Seenappa

    2013-01-01

    Full Text Available Background: Management of complex nonunions is difficult due to the presence of infection, deformities, shortening and multiple surgeries in the past. Complex nonunions are traditionally managed by Ilizarov fixation. The disadvantages of Ilizarov are poor patient compliance, inconvenience of the frame and difficult frame construction. We conducted a study on 30 long bone complex nonunions treated by the limb reconstruction system (LRS. Materials and Methods: Between April 2009 and September 2012, we treated 30 cases of complex nonunion of long bone with the LRS. 28 were male and 2 females. Average shortening was 5.06 cm and 14 cases presented with infected implants. Initially we managed with implant removal, radical debridement followed by fixation with the LRS. In 16 cases, corticotomy and lengthening was done. The average duration of treatment was 9.68 months. We compressed the fracture site at the rate of 0.25 mm per day for 1-2 weeks and distracted the corticotomy at the rate of 1 mm/day till lengthening was achieved. Result: The union occurred in 89.28% cases and eradication of infection in 91.66% cases. Average lengthening done was 4.57 cm. We had 79% excellent, 11% good and 10% poor bony result and fnctional result was excellent in 40% cases, good in 50% and failure in 10% cases using ASAMI scoring system. Conclusion: LRS is an alternative to the Ilizarov fixation in their management of complex nonunion of long bones. It is less cumbersome to the patient and more surgeon and patient friendly.

  16. Effects of a buried magnetic field on cranial bone reconstruction in rats

    Science.gov (United States)

    de ABREU, Maíra Cavallet; PONZONI, Deise; LANGIE, Renan; ARTUZI, Felipe Ernesto; PURICELLI, Edela

    2016-01-01

    ABSTRACT The understanding of bone repair phenomena is a fundamental part of dentistry and maxillofacial surgery. Objective The present study aimed to evaluate the influence of buried magnetic field stimulation on bone repair in rat calvaria after reconstruction with autogenous bone grafts, synthetic powdered hydroxyapatite, or allogeneic cartilage grafts, with or without exposure to magnetic stimulation. Material and Methods Ninety male Wistar rats were divided into 18 groups of five animals each. Critical bone defects were created in the rats’ calvaria and immediately reconstructed with autogenous bone, powdered synthetic hydroxyapatite or allogeneic cartilage. Magnetic implants were also placed in half the animals. Rats were euthanized for analysis at 15, 30, and 60 postoperative days. Histomorphometric analyses of the quantity of bone repair were performed at all times. Results These analyses showed significant group by postoperative time interactions (p=0.008). Among the rats subjected to autogenous bone reconstruction, those exposed to magnetic stimulation had higher bone fill percentages than those without magnetic implants. Results also showed that the quality of bone repair remained higher in the former group as compared to the latter at 60 postoperative days. Conclusions After 60 postoperative days, bone repair was greater in the group treated with autogenous bone grafts and exposed to a magnetic field, and bone repair was most pronounced in animals treated with autogenous bone grafts, followed by those treated with powdered synthetic hydroxyapatite and allogeneic cartilage grafts. PMID:27119765

  17. A new method of prefabricated vascularized allogenic bone grafts for maxillo-mandibular reconstruction

    International Nuclear Information System (INIS)

    Although there are various applications of allogenic bone grafts, a new technique of prevascularized lyophilized allogenic bone grafting for maxillo-mandibular reconstruction will be presented. Allogenic bone has been made by author's protocol for jaw defects as a powder, chip or block bone type. The author used lyophilized allogenic bone grafts for discontinuity defects as a block bone. In those cases, neovascularization and resorption of the allogenic bone were important factors for success of grafting. To overcome the problems, the author designed the technique of prefabricated vascularization of allogenic bone, which was lyophilized cranium, with an application of bovine BMP or not. Lyophilized cranial bone was designed for the defects and was put into the scalp. After confirming a hot spot via scintigram several months later, vascularized allogenic bone was harvested pedicled on the parietotemporal fascia based on the superficial temporal artery and vein. Vascularized allogenic cranial bone was rotated into the defect and fixed rigidly. Postoperatively, there was no severe resorption and functional disturbance of the mandible. In this technique, BMP seems to be an important role to help osteogenesis and neovascularization. Eight patients underwent prefabricated vascularization of allogenic bone grafts. Among them, four cases of reconstruction in mandibular discontinuity defects and one case of reconstruction in maxillectomy defect underwent this method, which will be presented with good results. This method may be an alternative technique of microvascular free bone graft

  18. Scapular Free Vascularised Bone Flaps for Mandibular Reconstruction: Are Dental Implants Possible?

    Directory of Open Access Journals (Sweden)

    Martin Lanzer

    2015-09-01

    Full Text Available Objectives: Free fibula flap remains the flap of choice for reconstruction of mandibular defects. If free fibula flap is not possible, the subscapular system of flaps is a valid option. In this study, we evaluated the possibility of dental implant placement in patients receiving a scapular free flap for oromandibular reconstruction. Material and Methods: We retrospectively reviewed 10 patients undergoing mandible reconstruction with a subscapular system free-tissue (lateral border of the scapula transfer at the University Hospital Zürich between January 1, 2010 and January 1, 2013. Bone density in cortical and cancellous bone was measured in Hounsfield units (HU. Changes of bone density, height and width were analysed using IBM SPSS Statistics 22. Comparisons of bone dimensions as well as bone density were performed using a chi-square test. Results: Ten patients were included. Implantation was conducted in 50%. However, all patients could have received dental implants considering bone stock. Loss of bone height and width were significant (P < 0.001. There was a statistical significant increase in bone density in cortical (P < 0.001 and cancellous (P = 0.004 bone. Conclusions: Dental implants are possible after scapular free flap reconstruction of oromandibular defects. Bone height and width were reduced, while bone density increased with time.

  19. Histological Features and Biocompatibility of Bone and Soft Tissue Substitutes in the Atrophic Alveolar Ridge Reconstruction

    Directory of Open Access Journals (Sweden)

    Carlo Maiorana

    2016-01-01

    Full Text Available The reconstruction of the atrophic alveolar ridges for implant placement is today a common procedure in dentistry daily practice. The surgical reconstruction provides for the optimization of the supporting bone for the implants and a restoration of the amount of keratinized gingiva for esthetic and functional reasons. In the past, tissue regeneration has been performed with autogenous bone and free gingival or connective tissue grafts. Nowadays, bone substitutes and specific collagen matrix allow for a complete restoration of the atrophic ridge without invasive harvesting procedures. A maxillary reconstruction of an atrophic ridge by means of tissue substitutes and its histological features are then presented.

  20. Histological Features and Biocompatibility of Bone and Soft Tissue Substitutes in the Atrophic Alveolar Ridge Reconstruction.

    Science.gov (United States)

    Maiorana, Carlo; Beretta, Mario; Rancitelli, Davide; Grossi, Giovanni Battista; Cicciù, Marco; Herford, Alan Scott

    2016-01-01

    The reconstruction of the atrophic alveolar ridges for implant placement is today a common procedure in dentistry daily practice. The surgical reconstruction provides for the optimization of the supporting bone for the implants and a restoration of the amount of keratinized gingiva for esthetic and functional reasons. In the past, tissue regeneration has been performed with autogenous bone and free gingival or connective tissue grafts. Nowadays, bone substitutes and specific collagen matrix allow for a complete restoration of the atrophic ridge without invasive harvesting procedures. A maxillary reconstruction of an atrophic ridge by means of tissue substitutes and its histological features are then presented. PMID:27022489

  1. Histological Observation of Regions around Bone Tunnels after Compression of the Bone Tunnel Wall in Ligament Reconstruction

    International Nuclear Information System (INIS)

    The objectives of this study were to investigate the time-course of influence of compression of bone tunnel wall in ligament reconstruction on tissue around the bone tunnel and to histologically examine the mechanism of preventing the complication of bone tunnel dilation, using rabbit tibia. A model in which the femoral origin of the extensor digitorum longus tendon was cut and inserted into a bone tunnel made proximal to the tibia was prepared in the bilateral hind legs of 20 Japanese white rabbits. In each animal, a tunnel was made using a drill only in the right leg, while an undersized bone tunnel was made by drilling and then dilated by compression using a dilator to the same tunnel size as that in the right leg. Animals were sacrificed at 0, 2, 4, 8 and 12 weeks after surgery (4 animals at each time point). Observation of bone tunnels by X-ray radiography showed osteosclerosis in the 2- and 4-week dilation groups. Osteosclerosis appeared as white lines around the bone tunnel on X-ray radiography. This suggests that dilation promotes callus formation in the bone tunnel wall and prevents the complication of bone tunnel enlargement after ligament reconstruction

  2. Assessment of the viability of microvascularized bone grafts after mandibular reconstruction by means of bone SPET and semiquantitative analysis

    International Nuclear Information System (INIS)

    The purpose of this study was to investigate the value of bone scintigraphy including single-photon emission tomography (SPET) and semiquantitative analysis for the assessment of graft viability following microvascularized bone transplantation. We evaluated 60 scintigraphic studies of 36 patients with 39 bone grafts. Thirty-four investigations were performed 6-11 days (early bone scans) and 26 up to 11 months (late bone scans) after mandibular reconstruction. After administration of 550 MBq technetium-99 m methylene diphosphonate, planar scintigrams and a SPET study were performed. The data were reconstructed iteratively. Scans were evaluated visually and semiquantitatively by a region of interest technique using the ratio between transplant and cranium (T/C). Patients with uncomplicated healing showed a T/C ratio >1.0 in early and late bone scans. In cases with necrosis, the T/C ratio was below 1.0 when performing early bone scans. However, in late bone scans, some patients with necrosis showed a slightly increased uptake and a T/C ratio >1.0. The data demonstrate that as early as 6-11 days after mandibular reconstruction, increased tracer uptake proves that the surgery has been successful and indicates a normal healing process. Especially in the early bone scans no false-positive or false-negative results were observed and the T/C ratio clearly differentiated between vital and non-vital bone grafts. At later times false-positive findings could be observed; these were, however, rare because of the significantly higher tracer uptake of the healthy grafts when compared with completely or partially necrotic transplants. (orig.)

  3. Selenoprotein P is the essential selenium transporter for bones.

    Science.gov (United States)

    Pietschmann, Nicole; Rijntjes, Eddy; Hoeg, Antonia; Stoedter, Mette; Schweizer, Ulrich; Seemann, Petra; Schomburg, Lutz

    2014-05-01

    Selenium (Se) plays an important role in bone physiology as best reflected by Kashin-Beck disease, an endemic Se-dependent osteoarthritis. Bone development is delayed in children with mutations in SECIS binding protein 2 (SBP2), a central factor for selenoprotein biosynthesis. Circulating selenoprotein P (SePP) is positively associated with bone turnover in humans, yet its function for bone homeostasis is not known. We have analysed murine models of altered Se metabolism. Most of the known selenoprotein genes and factors needed for selenoprotein biosynthesis are expressed in bones. Bone Se is not associated with the mineral but exclusively with the organic matrix. Genetic ablation of Sepp-expression causes a drastic decline in serum (25-fold) but only a mild reduction in bone (2.5-fold) Se concentrations. Cell-specific expression of a SePP transgene in hepatocytes efficiently restores bone Se levels in Sepp-knockout mice. Of the two known SePP receptors, Lrp8 was detected in bones while Lrp2 was absent. Interestingly, Lrp8 mRNA concentrations were strongly increased in bones of Sepp-knockout mice likely in order to counteract the developing Se deficiency. Our data highlight SePP as the essential Se transporter to bones, and suggest a novel feedback mechanism for preferential uptake of Se in Se-deprived bones, thereby contributing to our understanding of hepatic osteodystrophy and the consistent bone phenotype observed in subjects with inherited selenoprotein biosynthesis mutations. PMID:24626785

  4. Bioactive glass-polymer composite for experimental bone reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Aho, A.J.; Tirri, T.; Strandberg, N.; Jaakkola, T.; Naerhi, T.; Kukkonen, J. [Turku Univ. (Finland). Biomaterials Project of Turku; Seppaelae, J.; Rich, J. [Helsinki Univ. of Technology, Espoo (Finland). Dept. of Chemical Engineering

    2001-07-01

    Thermoplastic composite of bioactive glass (S53P4) and copolymer of lactones (Glepron) can be used as liquid, injectable or paste like form, as solid plugs or thin membranes for filling bone defects. This bone substitute is bioactive, osteoconductive and biocompatible resulting in bone bonding contacts between glass granules and bone in defects on the distal femur and ulna of experimental animals. Properties of the material can be adjusted by polymer chemistry. (orig.)

  5. Onlay Rib Bone Graft in Elevation of Reconstructed Auricle: 17 Years of Experience

    Directory of Open Access Journals (Sweden)

    Taehoon Kim

    2013-05-01

    Full Text Available Background  A cartilage wedge block and covering flap are standard procedures for firmelevation of the ear in microtia correction. However, using costal cartilage for elevation ofthe reconstructed auricle can be insufficient, and the fixed cartilage wedge block may beabsorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and usesup fascia, a potential source of reconstruction material. Therefore, we propose an innovativemethod using autologous onlay rib bone graftfor auricular elevation ofmicrotia.Methods  From February 1995 to August 2012, 77 patients received a first stage operationwith a rib cartilage framework graft. In the second stage operation, a small full thickness ofrib bone was harvested through the previous donor scar. The bihalved rib bone was insertedinto the subperiosteal pocket beneath the cartilage framework.Results  The follow-up time ranged from 1 month to 17 years, with a mean of 3 years. Allof the patients sustained the elevation of their ears very well during the follow-up period.Donorsite problems, exceptfor hypertrophic scars,were not observed. Surgery-related complications,specifically skin necrosis, infection, or hematoma, occurred in 4 cases.Conclusions  Onlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate materialthan cartilage, due to the bone-to-bone contact between thebone graft and the temporal bone. Postoperative minor correction of the elevation degree isstraightforward and the skin graft survives better. Therefore, reconstructed auricle elevationusing onlay rib bone graftis a useful and valuablemethod.

  6. Proximal Tibia Fracture After Anterior Cruciate Ligament Reconstruction Using Bone-Patellar Tendon-Bone Autograft: A Case Report

    OpenAIRE

    Voos, James E.; Drakos, Mark C.; Lorich, Dean G.; Fealy, Stephen

    2007-01-01

    The optimal operative management of anterior cruciate ligament (ACL) injury continues to be debated. Many complications can occur, but fracture is often not routinely discussed. We present a complex intra-articular tibia fracture in a patient who had an autologous, ipsilateral bone-patellar-bone ACL reconstruction. While still advocating early, aggressive physical therapy, this case reminds us of the inherent susceptibility to injury in the immediate post-operative period.

  7. Muscle strength after ACL reconstruction with bone tendon-bone patellar autograft tested by Cybex II dynamometer

    OpenAIRE

    Gogus, Abdullah; Taser, Omer; Eralp, Levent

    2004-01-01

    The Cybex II dynamometer is a device which offers isokinetic testing of different body joints and muscle groups, allowing precise, reproducible control of joint range of motion in keeping with specific rehabilitation goals. This system collects torque, work and power data, thus it can be used to identify and quantify functional musculoskeletal deficits. 25 patients with chronic anterolateral knee instability have been treated with ACL reconstruction using bone-tendon-bone patellar autograft a...

  8. Outcome of rail fixator system in reconstructing bone gap

    Directory of Open Access Journals (Sweden)

    Amit Lakhani

    2014-01-01

    Conclusion: All patients well tolerated rail fixator with good functional results and gap reconstruction. Easy application of rail fixator and comfortable distraction procedure suggest rail fixator a good alternative for gap reconstruction of limbs.

  9. Retrospective Reconstructions of Active Bone Marrow Dose-Volume Histograms

    International Nuclear Information System (INIS)

    Purpose: To present a method for calculating dose-volume histograms (DVH's) to the active bone marrow (ABM) of patients who had undergone radiation therapy (RT) and subsequently developed leukemia. Methods and Materials: The study focuses on 15 patients treated between 1961 and 1996. Whole-body RT planning computed tomographic (CT) data were not available. We therefore generated representative whole-body CTs similar to patient anatomy. In addition, we developed a method enabling us to obtain information on the density distribution of ABM all over the skeleton. Dose could then be calculated in a series of points distributed all over the skeleton in such a way that their local density reflected age-specific data for ABM distribution. Dose to particular regions and dose-volume histograms of the entire ABM were estimated for all patients. Results: Depending on patient age, the total number of dose calculation points generated ranged from 1,190,970 to 4,108,524. The average dose to ABM ranged from 0.3 to 16.4 Gy. Dose-volume histograms analysis showed that the median doses (D50%) ranged from 0.06 to 12.8 Gy. We also evaluated the inhomogeneity of individual patient ABM dose distribution according to clinical situation. It was evident that the coefficient of variation of the dose for the whole ABM ranged from 1.0 to 5.7, which means that the standard deviation could be more than 5 times higher than the mean. Conclusions: For patients with available long-term follow-up data, our method provides reconstruction of dose-volume data comparable to detailed dose calculations, which have become standard in modern CT-based 3-dimensional RT planning. Our strategy of using dose-volume histograms offers new perspectives to retrospective epidemiological studies

  10. Retrospective Reconstructions of Active Bone Marrow Dose-Volume Histograms

    Energy Technology Data Exchange (ETDEWEB)

    Veres, Cristina; Allodji, Rodrigue S.; Llanas, Damien; Vu Bezin, Jérémi [Radiation Epidemiology Group, Center for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale, UMR 1018, Villejuif (France); Institut Gustave Roussy, Villejuif (France); University Paris-Sud XI, Villejuif (France); Chavaudra, Jean; Mège, Jean Pierre; Lefkopoulos, Dimitri [Institut Gustave Roussy, Villejuif (France); Quiniou, Eric [Institut National de la Santé et de la Recherche Médicale UMR 759, Orsay (France); Deutsh, Eric [Institut Gustave Roussy, Villejuif (France); Institut National de la Santé et de la Recherche Médicale, UMR 1030, Villejuif (France); Vathaire, Florent de [Radiation Epidemiology Group, Center for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale, UMR 1018, Villejuif (France); Institut Gustave Roussy, Villejuif (France); University Paris-Sud XI, Villejuif (France); Diallo, Ibrahima, E-mail: ibrahim.diallo@gustaveroussy.fr [Radiation Epidemiology Group, Center for Research in Epidemiology and Population Health, Institut National de la Santé et de la Recherche Médicale, UMR 1018, Villejuif (France); Institut Gustave Roussy, Villejuif (France); University Paris-Sud XI, Villejuif (France)

    2014-12-01

    Purpose: To present a method for calculating dose-volume histograms (DVH's) to the active bone marrow (ABM) of patients who had undergone radiation therapy (RT) and subsequently developed leukemia. Methods and Materials: The study focuses on 15 patients treated between 1961 and 1996. Whole-body RT planning computed tomographic (CT) data were not available. We therefore generated representative whole-body CTs similar to patient anatomy. In addition, we developed a method enabling us to obtain information on the density distribution of ABM all over the skeleton. Dose could then be calculated in a series of points distributed all over the skeleton in such a way that their local density reflected age-specific data for ABM distribution. Dose to particular regions and dose-volume histograms of the entire ABM were estimated for all patients. Results: Depending on patient age, the total number of dose calculation points generated ranged from 1,190,970 to 4,108,524. The average dose to ABM ranged from 0.3 to 16.4 Gy. Dose-volume histograms analysis showed that the median doses (D{sub 50%}) ranged from 0.06 to 12.8 Gy. We also evaluated the inhomogeneity of individual patient ABM dose distribution according to clinical situation. It was evident that the coefficient of variation of the dose for the whole ABM ranged from 1.0 to 5.7, which means that the standard deviation could be more than 5 times higher than the mean. Conclusions: For patients with available long-term follow-up data, our method provides reconstruction of dose-volume data comparable to detailed dose calculations, which have become standard in modern CT-based 3-dimensional RT planning. Our strategy of using dose-volume histograms offers new perspectives to retrospective epidemiological studies.

  11. Reconstruction of mandibular defects with autogenous bone grafts: a review of 30 cases

    International Nuclear Information System (INIS)

    Multitudes of options are available for reconstruction of functional and cosmetic defects of the mandible, caused by various ailments. At the present time, autogenous bone grafting is the gold standard by which all other techniques of reconstruction of the mandible can be judged. The purpose of this study was to evaluate the outcome of different osseous reconstruction options using autogenous bone grafts for mandibular reconstruction. Methods: This Interventional study was conducted at Department of Oral and Maxillofacial Surgery, King Edward Medical University/Mayo Hospital Lahore, from January 2008 to July 2009 including one year follow-up. The study was carried out on thirty patients having bony mandibular defects. They were reconstructed with the autogenous bone grafts from different graft donor sites. On post-operative visits they were evaluated for outcome variables. Results: Success rate of autogenous bone grafts in this study was 90%. Only 10% of the cases showed poor results regarding infection, resorption and graft failure. Conclusion: Autogenous bone grafts, non-vascularized or vascularized, are a reliable treatment modality for the reconstruction of the bony mandibular defects with predictable functional and aesthetic outcome. (author)

  12. Guided Self-Generation of Vascularized Neo-Bone for Autologous Reconstruction of Large Mandibular Defects.

    Science.gov (United States)

    Wei, Jiao; Herrler, Tanja; Dai, Chuanchang; Liu, Kai; Han, Dong; Li, Qingfeng

    2016-06-01

    Reconstruction of large mandibular defects is complex and challenging. The authors aimed to individually self-generate a large vascularized bone construct for autologous transplantation without the use of exogenous additives based on the concept of guided self-generation. Using computer-aided design and manufacturing a large size goat mandibular bone was reconstructed in 3 dimensions. Its negative mold printed from hydroxylapatite was temporarily embedded into the costal periosteum along with a contralateral demineralized bone matrix scaffold as control. After 3 months, a mandibular bone construct was obtained and used for autologous transplantation. Osteogenesis and angiogenesis were assessed by real-time imaging, histology, and biomechanical tests during neo-bone formation and up to 6 months after transplantation surgery. A total of 20 animals received implantation of a mandibular bone negative mold along with a contralateral demineralized bone matrix scaffold. Resulting negative mold mandibular bone constructs showed anatomically, histologically, and functionally similar characteristics compared with native controls. Only 1 goat presented partial fibrosis during construct generation with subsequent absorbtion after reconstruction. The absence of exogenous cells, growth factors, and scaffolds facilitated direct translation of this novel concept into clinical application. Further studies are needed to determine functional long-term outcomes and possible extensions to other tissues and organs. PMID:27213741

  13. USE OF CORTICAL STRUCTURAL HOMOLOGOUS BONE GRAFT IN FEMORAL RECONSTRUCTIVE SURGERY

    Science.gov (United States)

    Roos, Milton Valdomiro; Roos, Bruno Dutra; Giora, Taís Stedile Busin; Taglietti, Thiago Martins

    2015-01-01

    To perform a clinical and radiographic assessment of patients undergoing surgical treatment using a cortical structural homologous bone graft for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. Methods: A retrospective study was conducted on 27 patients who underwent surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases) and periprosthetic fractures (15 cases), using a cortical structural homologous bone graft and cemented implants, between June 1999 and February 2008. Of these, 21 fulfilled all the criteria required for this study. The patients underwent pre and postoperative clinical assessments using the Harris Hip Score. Preoperative, immediate postoperative and late postoperative radiographs were also evaluated, with comparisons of fracture consolidation, radiographic signs of graft consolidation, changes to the bone stock and femoral bone quality, and femoral alignment. Results: Nine patients (42.9%) underwent femoral reconstruction following mechanical failure of total hip arthroplasty and 12 cases (57.1%) underwent femoral reconstruction following periprosthetic fracture. Regarding the postoperative clinical classification, the results were considered satisfactory in 85.7% of the cases and unsatisfactory in 14.3%. Radiographic signs of graft consolidation were seen in all cases. There was an increase in bone stock in 90.5% of the hip reconstructions, as measured by the cortical index. Furthermore, the changes to femoral bone quality were considered good in 66.7% of the cases. Conclusion: The use of cortical structural homologous bone grafts for both femoral reconstructive surgery on total hip arthroplasty and periprosthetic fractures is a good treatment option for selected cases, enabling satisfactory clinical and radiographic results. PMID:27026955

  14. Accuracy assessment of 3D bone reconstructions using CT: an intro comparison.

    Science.gov (United States)

    Lalone, Emily A; Willing, Ryan T; Shannon, Hannah L; King, Graham J W; Johnson, James A

    2015-08-01

    Computed tomography provides high contrast imaging of the joint anatomy and is used routinely to reconstruct 3D models of the osseous and cartilage geometry (CT arthrography) for use in the design of orthopedic implants, for computer assisted surgeries and computational dynamic and structural analysis. The objective of this study was to assess the accuracy of bone and cartilage surface model reconstructions by comparing reconstructed geometries with bone digitizations obtained using an optical tracking system. Bone surface digitizations obtained in this study determined the ground truth measure for the underlying geometry. We evaluated the use of a commercially available reconstruction technique using clinical CT scanning protocols using the elbow joint as an example of a surface with complex geometry. To assess the accuracies of the reconstructed models (8 fresh frozen cadaveric specimens) against the ground truth bony digitization-as defined by this study-proximity mapping was used to calculate residual error. The overall mean error was less than 0.4 mm in the cortical region and 0.3 mm in the subchondral region of the bone. Similarly creating 3D cartilage surface models from CT scans using air contrast had a mean error of less than 0.3 mm. Results from this study indicate that clinical CT scanning protocols and commonly used and commercially available reconstruction algorithms can create models which accurately represent the true geometry. PMID:26037323

  15. Reconstruction of Bone Nanostructure using Hierarchically Ordered Polymer Nanofibers

    Science.gov (United States)

    Chen, Xi; Wang, Wenda; Cheng, Shan; Dong, Bin; Li, Christopher

    2013-03-01

    Natural bone is comprised of hydroxyl apatite (HA) crystals periodically templated by collagen fibers with precisely controlled crystal orientation. No synthetic materials can mimic natural bone with controlled mineral orientation and periodicity. Herein we report that this structural challenge can be met using hierarchically ordered nanofiber shish kebabs (NFSKs), constructed via combination of electrospinning polycaprolactone (PCL) and controlled crystallization of PCL- b-poly acrylic acid (PCL- b-PAA). These NFSKs were employed as a template to control the nucleation and growth of hydroxypatite nanocrystals. HA crystals were formed on such templates with controlled orientation and periods. Such a biomimetic structure serves as a promising bone scaffold material for tissue engineering.

  16. Regions of ilium and fibula providing clinically usable bone for mandible reconstruction: "A different approach to bone comparison".

    Science.gov (United States)

    Ghassemi, Alireza; Schreiber, Lovorka; Prescher, Andreas; Modabber, Ali; Nanhekhan, Lloyd

    2016-09-01

    A variety of donor sites are available for mandibular reconstruction. We present here a different way of comparing two commonly-used bone flaps. The lengths of the usable parts in a total of 241 coxal bones, 91 mandibles and 60 fibulas were measured. The mandible was measured from condyle-to-condyle and the harvestable bone length (HBL) and usable (UBL) bone lengths in fibula and ilium were also measured. The bone thickness (BT) in 60 iliac crests was measured in two parallel lines from the anterior superior iliac spine (ASIS) along the iliac crest. The mandible was 32.17 mm shorter in females than in males. The total ilium UBL was 171.12 mm in females and 178.80 mm in males. The mean HBL of the fibula was 22.6 mm shorter in females than in males. However, in some fibulas in both females and males, only 4.2% and 21.1% of the HBL respectively could be used if the ultimate goal was to insert dental implants. We found significant correlations between BT and gender in both fibula and ilium (P≤ 0.05). The ilium offers constant BT throughout the usable bone area with a similar bone length to the fibula. In contrast, the fibula showed variable bone dimensions, so not all of it is clinically usable. This should especially be considered in females when a mandibular reconstruction is planned with the goal of occlusal rehabilitation. Clin. Anat. 29:773-778, 2016. © 2016 Wiley Periodicals, Inc. PMID:27124383

  17. USE OF CORTICAL STRUCTURAL HOMOLOGOUS BONE GRAFT IN FEMORAL RECONSTRUCTIVE SURGERY

    OpenAIRE

    Roos, Milton Valdomiro; Roos, Bruno Dutra; Giora, Taís Stedile Busin; Taglietti, Thiago Martins

    2015-01-01

    To perform a clinical and radiographic assessment of patients undergoing surgical treatment using a cortical structural homologous bone graft for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. Methods: A retrospective study was conducted on 27 patients who underwent surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases) and periprosthetic fractures (15 cases), using a cortical...

  18. Reconstruction of Mandibular Defects Using Nonvascularized Autogenous Bone Graft in Nigerians

    OpenAIRE

    Kizito Chioma Ndukwe; Stephen Babatunde Aregbesola; Innocent Chinedu Ikem; Ugboko, Vincent I; Kehinde Emmanuel Adebiyi; Olawunmi Adedoyin Fatusi; Foluso John Owotade; Ramat Oyebunmi Braimah

    2014-01-01

    Objectives: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile-Ife, Nigeria. Patients and Methods: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife constituted the study sample. Relevant information was retrieved from the patients′ records. This information i...

  19. Freeze dried bone allografts in dental and maxillofacial reconstructive surgery - experience in Malaysia

    International Nuclear Information System (INIS)

    The utilisation of vascularised and free bone autografts remain the goal standard in maxillofacial reconstructive surgery in Malaysia, but the use of freeze dried bone allograft is still widely practiced in many centres with variable results. This study evaluate the effectiveness and clinical efficacy of using radiation sterilised freeze dried bone allografts in oral and maxillofacial reconstructive surgery. The bone grafts were prepared at the Malaysian National Tissue Bank. Seventy eight patients who had undergone oral and Maxillofacial surgical procedures with reconstruction using bone allografts were included in this study. 50 patients were male and 28 patients were female and their age ranged from 14 to 75 years. Forty two patients underwent enucleation of benign cystic lesions in the jaws, 15 patients underwent repair of orbital floor fractures, 6 patients of jaw fractures with partial loss of bone while 8 patients underwent augmentation of depressed cheek bone. Another 4 patients had partial resection of the mandible because of cancer and 3 patients had facial osteotomies. A follow up period of 12 months up to 4 years was carried out. The patients were assessed both clinically and radiologically throughout their follow up visits. Clinical assessment showed no evidence of rejection of the implanted freeze dried allografts. Bone allografts implanted as inlay grafts demonstrated a better clinical performance than onlay grafts and the poorest results were obtained following bridging bony defects in the jaws. Radiation sterilised freeze dried bone allografts produced at the Malaysian National Tissue Bank are bio-compatible, functional, and provide predictable results when applied to selected areas of the facial skeleton

  20. The use of allograft bone in reconstruction of the acetabulum during hip revision arthroplasty

    International Nuclear Information System (INIS)

    We have reviewed 80 patients who underwent an allograft acetabular reconstruction between 1987 and 1995. This group had a mean age of 66 years with a mean follow-up of 5.2 years. A mean preoperative Harris hip score of 32 points was improved to a mean postoperative score of 72 points. There was a 16.5% rerevision rate. Acetabular defects were classified according to the American Academy of Orthopaedic Surgeons system. Subgroup classification categories were analysed and reconstruction methodologies have been devised. This paper deals with the relative indications for the use of morsellised bone, block allografts, anatomic specific allografts and reconstruction shells according to type of acetabular defects

  1. Imaging of limb salvage surgery and pelvic reconstruction following resection of malignant bone tumours

    International Nuclear Information System (INIS)

    Highlights: • Advances in reconstructive orthopaedic techniques now allow for limb salvage and prosthetic reconstruction procedures to be performed on patients who would otherwise be required to undergo debilitating limb amputations for malignant bone tumours. • The resulting post-operative imaging of such cases can be daunting for the radiologist to interpret, particularly in the presence of distorted anatomy and unfamiliar hardware. • This article reviews the indications for limb salvage surgery, prosthetic reconstruction devices involved, expected post-operative imaging findings, as well as the potential hardware related complications that may be encountered in the management of such cases. • By being aware of the various types of reconstructive techniques used in limb salvage surgery as well as the potential complications, the reporting radiologist should possess greater confidence in making an accurate assessment of the expected post-operative imaging findings in the management of such cases. - Abstract: Advances in reconstructive orthopaedic techniques now allow for limb salvage and prosthetic reconstruction procedures to be performed on patients who would otherwise be required to undergo debilitating limb amputations for malignant bone tumours. The resulting post-operative imaging of such cases can be daunting for the radiologist to interpret, particularly in the presence of distorted anatomy and unfamiliar hardware. This article reviews the indications for limb salvage surgery, prosthetic reconstruction devices involved, expected post-operative imaging findings, as well as the potential hardware related complications that may be encountered in the management of such cases

  2. Imaging of limb salvage surgery and pelvic reconstruction following resection of malignant bone tumours

    Energy Technology Data Exchange (ETDEWEB)

    Tan, Tien Jin, E-mail: tien_jin_tan@cgh.com.sg [Department of Radiology, Vancouver General Hospital, Vancouver, BC (Canada); Aljefri, Ahmad M. [Department of Radiology, Vancouver General Hospital, Vancouver, BC (Canada); Clarkson, Paul W.; Masri, Bassam A. [Department of Orthopaedics, University of British Columbia, Vancouver, BC (Canada); Ouellette, Hugue A.; Munk, Peter L.; Mallinson, Paul I. [Department of Radiology, Vancouver General Hospital, Vancouver, BC (Canada)

    2015-09-15

    Highlights: • Advances in reconstructive orthopaedic techniques now allow for limb salvage and prosthetic reconstruction procedures to be performed on patients who would otherwise be required to undergo debilitating limb amputations for malignant bone tumours. • The resulting post-operative imaging of such cases can be daunting for the radiologist to interpret, particularly in the presence of distorted anatomy and unfamiliar hardware. • This article reviews the indications for limb salvage surgery, prosthetic reconstruction devices involved, expected post-operative imaging findings, as well as the potential hardware related complications that may be encountered in the management of such cases. • By being aware of the various types of reconstructive techniques used in limb salvage surgery as well as the potential complications, the reporting radiologist should possess greater confidence in making an accurate assessment of the expected post-operative imaging findings in the management of such cases. - Abstract: Advances in reconstructive orthopaedic techniques now allow for limb salvage and prosthetic reconstruction procedures to be performed on patients who would otherwise be required to undergo debilitating limb amputations for malignant bone tumours. The resulting post-operative imaging of such cases can be daunting for the radiologist to interpret, particularly in the presence of distorted anatomy and unfamiliar hardware. This article reviews the indications for limb salvage surgery, prosthetic reconstruction devices involved, expected post-operative imaging findings, as well as the potential hardware related complications that may be encountered in the management of such cases.

  3. Effect of low-dose CT and iterative reconstruction on trabecular bone microstructure assessment

    Science.gov (United States)

    Kopp, Felix K.; Baum, Thomas; Nasirudin, Radin A.; Mei, Kai; Garcia, Eduardo G.; Burgkart, Rainer; Rummeny, Ernst J.; Bauer, Jan S.; Noël, Peter B.

    2016-03-01

    The trabecular bone microstructure is an important factor in the development of osteoporosis. It is well known that its deterioration is one effect when osteoporosis occurs. Previous research showed that the analysis of trabecular bone microstructure enables more precise diagnoses of osteoporosis compared to a sole measurement of the mineral density. Microstructure parameters are assessed on volumetric images of the bone acquired either with high-resolution magnetic resonance imaging, high-resolution peripheral quantitative computed tomography or high-resolution computed tomography (CT), with only CT being applicable to the spine, which is one of clinically most relevant fracture sites. However, due to the high radiation exposure for imaging the whole spine these measurements are not applicable in current clinical routine. In this work, twelve vertebrae from three different donors were scanned with standard and low radiation dose. Trabecular bone microstructure parameters were assessed for CT images reconstructed with statistical iterative reconstruction (SIR) and analytical filtered backprojection (FBP). The resulting structure parameters were correlated to the biomechanically determined fracture load of each vertebra. Microstructure parameters assessed for low-dose data reconstructed with SIR significantly correlated with fracture loads as well as parameters assessed for standard-dose data reconstructed with FBP. Ideal results were achieved with low to zero regularization strength yielding microstructure parameters not significantly different from those assessed for standard-dose FPB data. Moreover, in comparison to other approaches, superior noise-resolution trade-offs can be found with the proposed methods.

  4. Multiple bone metastases detected 10 years after mastectomy with silicone reconstruction for DCIS and contralateral augmentation

    OpenAIRE

    Mori, Ryutaro; Nagao, Yasuko

    2013-01-01

    Key Clinical Message The patient developed multiple bone metastases following mastectomy with silicone reconstruction and contralateral augmentation for ductal carcinoma in situ (DCIS) of the breast. She was diagnosed with contralateral invasive cancer. Distant metastasis of DCIS is rare, and other metastatic origins must be screened. However, screening of augmented breasts is difficult.

  5. Assessment of rotatory instability after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft

    International Nuclear Information System (INIS)

    Anatomically oriented anterior cruciate ligament (ACL) reconstruction has been advocated recently, but its effect on rotatory instability remains to be cleared objectively. The purpose of this study was to quantitatively evaluate rotatory instability in ACL reconstructed knees with a bone-patellar tendon-bone (BTB) graft using an open MRI system. Eighteen subjects underwent arthroscopic ACL reconstruction with a BTB graft. The tibial tunnel was placed in the center of the ACL footprint. The femoral tunnel was drilled transtibially at the 10:00 to 10:30-o'clock position for the right knees. Subjects were examined using a Slocum anterolateral rotatory instability test in open MRI. Anterior tibial translation was measured at the medial and lateral compartments by evaluating sagittal images. Anterior knee stability was evaluated using the KT-2000 arthrometer. The clinical knee function was assessed with the Lysholm and Tegner scoring scales before and after the surgery. Side-to-side differences of anterolateral tibial translation was 0.1 mm. Side-to-side difference on KT-2000 arthrometer measurement was 1.8 mm. The Lysholm score improved to 96 and the latest Tegner score reached substantially the preinjury level. ACL reconstruction with a BTB graft was successful in restoring rotatory stability as well as anterior stability and knee function. (author)

  6. The use of lyophilised bovine bone xenograft in mandibular reconstructive surgery - an animal experimental surgery

    International Nuclear Information System (INIS)

    The aim of this study is to look at the effectiveness of using lyophillised bovine bone xenograft in mandibular reconstructive surgery. Six adult merino sheep underwent bilateral marginal block resection of the mandible under general anaesthesia. The defect on the right body of mandible was left alone while the similar mandibulectomy defect on the left body of mandible was reconstructed using a cortico-cancellous block of radiosterilised lyophillised bovine bone xenograft which was procured from a calve femur. The bone xenograft was fixed and immobilized using titanium mini plates and screws. All the sheep returned to the controlled grazing ground on the 7th. Postoperative day. One sheep was sacrificed every month and the mandible was retrieved for postmortem gross and microscopical histological examination. Clinical results showed no evidence of tissue rejection in the mandible of the sheep and all the wounds healed well. All sheep showed no problem with normal eating habits. Histological examination showed resorption of the xenograft very early at one month postoperative and xenograft resorption together with new host bone deposition started at 2 months postoperative and maximise at 6 months postoperative. There is also evidence showing that the cancellous portion resorp more than the cortical portion of the xenograft. In conclusion, cortico-cancellous blocks of bovine bone xenograft may be use in mandibular reconstructive surgery giving esthetically acceptable, functional, biocompatible and overall clinically predictable results

  7. Concurrent arthroscopic bicruciate ligament reconstruction using Achilles tendon-bone allografts: experience with 15 cases

    Institute of Scientific and Technical Information of China (English)

    Shi De-hai; CAI Dao-zhang; WANG Kun; RONG Li-min; XU Yi-chun

    2008-01-01

    Objective: To evaluate the clinical outcome of arthroscopically assisted combined anterior and posterior cruciate ligament (ACL/PCL) reconstructions using Achil-les tendon-bone allografts. Methods: Associated meniscus injuries were treated according to established methods prior to ligament recon-structions during arthroscopic surgery. Thirty Achilles ten-don-bone allografts were used to reconstruct torn ACL and PCL in 15 knees. At postoperative follow-up, all knees were graded using the modified IKDC and the Lysholm scoring systems just as done preoperatively. Results were analyzed compared with the contralateral healthy knees. Results: Eleven men and 4 women with a minimum of 3-year follow-up (mean 38 months) were included in the study. Preoperatively, the group ratings by the modified IKDC standards were all severely abnormal. Twelve bicruciate reconstructions were performed in subacute or chronic stage (>3-8 weeks), 3 for acute ligamentous deficien-cies (≤ 3 weeks). The noticeable early complication was transitory local fever combined with joint effusion in one case. At postoperative follow-up, 9 knees were normal, 5 nearly normal and 1 abnormal. On Lysholm score the differ-ence was statistically significant (t- test, P<0.001) before and after operation. Conclusions: Achilles tendon-bone allograft offers an alternative for simultaneous arthroscopic ACL/PCL reconstructions. However, further investigation is needed to eradicate its potential immunogenicity for better use.

  8. Autoclaved Tumor Bone for Skeletal Reconstruction in Paediatric Patients: A Low Cost Alternative in Developing Countries

    Directory of Open Access Journals (Sweden)

    Masood Umer

    2013-01-01

    Full Text Available We reviewed in this series forty patients of pediatric age who underwent resection for malignant tumors of musculoskeletal system followed by biological reconstruction. Our surgical procedure for reconstruction included (1 wide en bloc resection of the tumor; (2 curettage of tumor from the resected bone; (3 autoclaving for 8 minutes (4 bone grafting from the fibula (both vascularized and nonvascularized fibular grafts used; (5 reimplantation of the autoclaved bone into the host bone defect and fixation with plates. Functional evaluation was done using MSTS scoring system. At final followup of at least 18 months (mean 29.2 months, 31 patients had recovered without any complications. Thirty-eight patients successfully achieved a solid bony union between the graft and recipient bone. Three patients had surgical site infection. They were managed with wound debridement and flap coverage of the defect. Local recurrence and nonunion occurred in two patients each. One patient underwent disarticulation at hip due to extensive local disease and one died of metastasis. For patients with non-union, revision procedure with bone graft and compression plates was successfully used. The use of autoclaved tumor grafts provides a limb salvage option that is inexpensive and independent of external resources and is a viable option for musculoskeletal tumor management in developing countries.

  9. Virtopsy -- noninvasive detection of occult bone lesions in postmortem MRI: additional information for traffic accident reconstruction.

    Science.gov (United States)

    Buck, Ursula; Christe, Andreas; Naether, Silvio; Ross, Steffen; Thali, Michael J

    2009-05-01

    In traffic accidents with pedestrians, cyclists or motorcyclists, patterned impact injuries as well as marks on clothes can be matched to the injury-causing vehicle structure in order to reconstruct the accident and identify the vehicle which has hit the person. Therefore, the differentiation of the primary impact injuries from other injuries is of great importance. Impact injuries can be identified on the external injuries of the skin, the injured subcutaneous and fat tissue, as well as the fractured bones. Another sign of impact is a bone bruise. The bone bruise, or occult bone lesion, means a bleeding in the subcortical bone marrow, which is presumed to be the result of micro-fractures of the medullar trabeculae. The aim of this study was to prove that bleeding in the subcortical bone marrow of the deceased can be detected using the postmortem noninvasive magnetic resonance imaging. This is demonstrated in five accident cases, four involving pedestrians and one a cyclist, where bone bruises were detected in different bones as a sign of impact occurring in the same location as the external and soft tissue impact injuries. PMID:19034476

  10. Intercalary bone segment transport in treatment of segmental tibial defects

    International Nuclear Information System (INIS)

    Objective: To evaluate the results and complications of intercalary bone segment transport in the treatment of segmental tibial defects. Design: This is a retrospective analysis of patients with segmental tibial defects who were treated with intercalary bone segment transport method. Place and Duration of Study: The study was carried out at Combined Military Hospital, Rawalpindi from September 1997 to April 2001. Subjects and methods: Thirteen patients were included in the study who had developed tibial defects either due to open fractures with bone loss or subsequent to bone debridement of infected non unions. The mean bone defect was 6.4 cms and there were eight associated soft tissue defects. Locally made unilateral 'Naseer-Awais' (NA) fixator was used for bone segment transport. The distraction was done at the rate of 1mm/day after 7-10 days of osteotomy. The patients were followed-up fortnightly during distraction and monthly thereafter. The mean follow-up duration was 18 months. Results: The mean time in external fixation was 9.4 months. The mean healing index' was 1.47 months/cm. Satisfactory union was achieved in all cases. Six cases (46.2%) required bone grafting at target site and in one of them grafting was required at the level of regeneration as well. All the wounds healed well with no residual infection. There was no residual leg length discrepancy of more than 20 mm nd one angular deformity of more than 5 degrees. The commonest complication encountered was pin track infection seen in 38% of Shanz Screws applied. Loosening occurred in 6.8% of Shanz screws, requiring re-adjustment. Ankle joint contracture with equinus deformity and peroneal nerve paresis occurred in one case each. The functional results were graded as 'good' in seven, 'fair' in four, and 'poor' in two patients. Overall, thirteen patients had 31 (minor/major) complications with a ratio of 2.38 complications per patient. To treat the bone defects and associated complications, a mean of 3

  11. CT scans and 3D reconstructions of Florida manatee (Trichechus manatus latirostris) heads and ear bones.

    Science.gov (United States)

    Chapla, Marie E; Nowacek, Douglas P; Rommel, Sentiel A; Sadler, Valerie M

    2007-06-01

    The auditory anatomy of the Florida manatee (Trichechus manatus latirostris) was investigated using computerized tomography (CT), three-dimensional reconstructions, and traditional dissection of heads removed during necropsy. The densities (kg/m3) of the soft tissues of the head were measured directly using the displacement method and those of the soft tissues and bone were calculated from CT measurements (Hounsfield units). The manatee's fatty tissue was significantly less dense than the other soft tissues within the head (p<0.05). The squamosal bone was significantly less dense than the other bones of the head (p<0.05). Measurements of the ear bones (tympanic, periotic, malleus, incus, and stapes) collected during dissection revealed that the ossicular chain was overly massive for the mass of the tympanoperiotic complex. PMID:17420106

  12. Reconstruction of streamline topology, and percolation models of turbulent transport

    International Nuclear Information System (INIS)

    This paper discusses in detail the percolation models of turbulent diffusion that help establish nontrivial relations among theoretical concepts used in the theories of turbulence, dynamical systems, transport, etc. This approach is particularly important due to the need to describe turbulence in the presence of coherent structures, flow reconstructions, and drift and dissipation effects. In such regimes, the conventional quasilinear description is inconsistent with experimental results, necessitating the search for fundamentally new models and approaches. Most attention is given to the scaling concept, an important and widely used tool among theoreticians and experimentalists. (reviews of topical problems)

  13. Prevalence and influence of tibial tunnel widening after isolated anterior cruciate ligament reconstruction using patella-bone-tendon-bone-graft: long-term follow-up

    OpenAIRE

    Johannes Struewer; Turgay Efe; Thomas Manfred Frangen; Tim Schwarting; Benjamin Buecking; Steffen Ruchholtz; Karl Friedrich Schüttler; Ewgeni Ziring

    2012-01-01

    The aim of the present study was to evaluate incidence, degree and impact of tibial tunnel widening (TW) on patient-reported long-term clinical outcome, knee joint stability and prevalence of osteoarthritis (OA) after isolated anterior cruciate ligament (ACL) reconstruction. On average, 13.5 years after ACL reconstruction via patella-bone-tendon-bone autograft, 73 patients have been re-evaluated. Inclusion criteria consisted of an isolated anterior cruciate ligament rupture and reconstructio...

  14. Use of 3D MR reconstructions in the evaluation of glenoid bone loss: a clinical study

    International Nuclear Information System (INIS)

    To assess the ability of 3D MR shoulder reconstructions to accurately quantify glenoid bone loss in the clinical setting using findings at the time of arthroscopy as the gold standard. Retrospective review of patients with MR shoulder studies that included 3D MR reconstructions (3D MR) produced using an axial Dixon 3D-T1W-FLASH sequence at our institution was conducted with the following inclusion criteria: history of anterior shoulder dislocation, arthroscopy (OR) performed within 6 months of the MRI, and an estimate of glenoid bone loss made in the OR using the bare-spot method. Two musculoskeletal radiologists produced estimates of bone loss along the glenoid width, measured in mm and %, on 3D MR using the best-fit circle method, which were then compared to the OR measurements. There were a total of 15 patients (13 men, two women; mean age, 28, range, 19-51 years). There was no significant difference, on average, between the MRI (mean 3.4 mm/12.6 %; range, 0-30 %) and OR (mean, 12.7 %; range, 0-30 %) measurements of glenoid bone loss (p = 0.767). A 95 % confidence interval for the mean absolute error extended from 0.45-2.21 %, implying that, when averaged over all patients, the true mean absolute error of the MRI measurements relative to the OR measurements is expected to be less than 2.21 %. Inter-reader agreement between the two readers had an IC of 0.92 and CC of 0.90 in terms of percentage of bone loss. 3D MR reconstructions of the shoulder can be used to accurately measure glenoid bone loss. (orig.)

  15. Use of 3D MR reconstructions in the evaluation of glenoid bone loss: a clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Gyftopoulos, Soterios; Beltran, Luis S.; Yemin, Avner; Recht, Michael P. [NYU Langone Medical Center, Department of Radiology, New York, NY (United States); Strauss, Eric; Meislin, Robert; Jazrawi, Laith [NYU Langone Medical Center, Center for Musculoskeletal Care, Department of Orthopaedic Surgery, New York, NY (United States)

    2014-02-15

    To assess the ability of 3D MR shoulder reconstructions to accurately quantify glenoid bone loss in the clinical setting using findings at the time of arthroscopy as the gold standard. Retrospective review of patients with MR shoulder studies that included 3D MR reconstructions (3D MR) produced using an axial Dixon 3D-T1W-FLASH sequence at our institution was conducted with the following inclusion criteria: history of anterior shoulder dislocation, arthroscopy (OR) performed within 6 months of the MRI, and an estimate of glenoid bone loss made in the OR using the bare-spot method. Two musculoskeletal radiologists produced estimates of bone loss along the glenoid width, measured in mm and %, on 3D MR using the best-fit circle method, which were then compared to the OR measurements. There were a total of 15 patients (13 men, two women; mean age, 28, range, 19-51 years). There was no significant difference, on average, between the MRI (mean 3.4 mm/12.6 %; range, 0-30 %) and OR (mean, 12.7 %; range, 0-30 %) measurements of glenoid bone loss (p = 0.767). A 95 % confidence interval for the mean absolute error extended from 0.45-2.21 %, implying that, when averaged over all patients, the true mean absolute error of the MRI measurements relative to the OR measurements is expected to be less than 2.21 %. Inter-reader agreement between the two readers had an IC of 0.92 and CC of 0.90 in terms of percentage of bone loss. 3D MR reconstructions of the shoulder can be used to accurately measure glenoid bone loss. (orig.)

  16. Utility of tricalcium phosphate and osteogenic matrix cellsheet constructs for bone defect reconstruction

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    AIM To determine the effects of transplanting osteogenicmatrix cell sheets and beta-tricalcium phosphate(TCP) constructs on bone formation in bone defects.METHODS: Osteogenic matrix cell sheets were preparedfrom bone marrow stromal cells (BMSCs), anda porous TCP ceramic was used as a scaffold. Threeexperimental groups were prepared, comprised of TCPscaffolds (1) seeded with BMSCs; (2) wrapped withosteogenic matrix cell sheets; or (3) both. Constructswere implanted into a femoral defect model in rats andbone growth was evaluated by radiography, histology,biochemistry, and mechanical testing after 8 wk.RESULTS: In bone defects, constructs implanted withcell sheets showed callus formation with segmental or continuous bone formation at 8 wk, in contrast toTCP seeded with BMSCs, which resulted in bone nonunion.Wrapping TCP constructs with osteogenic matrixcell sheets increased their osteogenic potential andresulting bone formation, compared with conventionalbone tissue engineering TCP scaffolds seeded withBMSCs. The compressive stiffness (mean ± SD) valueswere 225.0 ± 95.7, 30.0 ± 11.5, and 26.3 ± 10.6MPa for BMSC/TCP/Sheet constructs with continuousbone formation, BMSC/TCP/Sheet constructs withsegmental bone formation, and BMSC/TCP constructs,respectively. The compressive stiffness of BMSC/TCP/Sheet constructs with continuous bone formation wassignificantly higher than those with segmental boneformation and BMSC/TCP constructs.CONCLUSION: This technique is an improvementover current methods, such as TCP substitution, andis useful for hard tissue reconstruction and inducingearlier bone union in defects.

  17. Computer-aided planning for zygomatic bone reconstruction in maxillofacial traumatology

    CERN Document Server

    Maubleu, S; Chabanas, M; Payan, Y; Boutault, F; Maubleu, Sylvain; Marecaux, Christophe; Chabanas, Matthieu; Payan, Yohan; Boutault, Franck

    2005-01-01

    An optimal planning procedure has been proposed to define the target position of the zygomatic bone following a fracture of the mid-face skeleton. The protocol has been successfully tested on healthy subjects, and ensures the global symmetry of the face could be obtained after the reconstruction surgery. Now that the planning procedure is available, the next step of this project will be to develop an intra-operative guiding system to help the surgeon to follow the planning. This procedure will mainly rely on the intra-operative registration of the zygomatic bone fragment, and the design of specific surgical ancillaries for cranio-maxillofacial surgery.

  18. Evaluation of cranial bone transport distraction with and without adipose grafting.

    Science.gov (United States)

    Koch, Felix P; Yuhasz, Mikell M; Travieso, Rob; Wong, Kenneth; Clune, James; Zhuang, Zhen W; Van Houten, Joshua; Steinbacher, Derek M

    2014-05-01

    Transport distraction osteogenesis (DO) can be used to autologously reconstitute calvarial defects. The purpose of this study is to histomorphologically interrogate osteogenic formation during cranial transport distraction using a novel device. We also evaluate the effect of fat grafting on the regenerate and soft-tissue stability during distraction. This study was approved by Yale IACUC. Ten male New Zealand white rabbits (3 mo; 3.5 kg) were used (8 treatment, 2 control). A 16 × 16 mm defect was created abutted by a 10 × 16 mm transport disc. The device was fixated anterioposteriorly. Four animals were fat-grafted using 2 mL of subdermal intrascapular fat deposited along the distraction site. Latency (1 d), active distraction (12-14 d) (1.5 mm/d), and consolidation (4 wk) followed. Calcein and xylene orange fluorochromes were injected subcutaneously during and post-distraction to mark sites of bone formation. Following sacrifice, osteogenesis was assessed using microCT, histology, and fluorescence. Treatment animals demonstrated regenerate bone between distracted segments on microCT. MicroCT analysis of non-fat-grafted and fat-grafted animals revealed a mean density of 2271.95 mgHA/ccm and 2254.27 mgHA/ccm (P = 0.967), respectively, and defect bone versus total volume (BV/TV) of 0.0999 and 0.0766 (P = 0.5979), respectively. Controls had minimal reossification. Histologically, mean densities measured 43.63% and 8.19%, respectively. Fluorescence revealed ossification from the callus as well as from dura and periosteum in the cranial defect. Transport distraction is effective to reconstruct critically sized rabbit calvarial defects. Regenerate bone arises predominantly from the callus with contribution from surrounding dura and periosteum. Adipose grafting is well tolerated but does not enhance osseous regeneration. PMID:24820707

  19. A biomechanical assessment of superior shoulder translation after reconstruction of anterior glenoid bone defects: The Latarjet procedure versus allograft reconstruction

    Directory of Open Access Journals (Sweden)

    Ryan M Degen

    2013-01-01

    Full Text Available Background : The coracoacromial ligament (CAL is an important restraint to superior shoulder translation. The effect of CAL release on superior stability following the Latarjet is unknown; therefore, our purpose was to compare the effect of two Latarjet techniques and allograft reconstruction on superior instability. Materials and Methods : Eight cadaveric specimens were tested on a simulator. Superior translation was monitored following an axial force in various glenohumeral rotations (neutral, internal, and external with and without muscle loading. Three intact CAL states were tested (intact specimen, 30% glenoid bone defect, and allograft reconstruction and two CAL deficient states (classic Latarjet (classicLAT and congruent-arc Latarjet (congruentLAT. Results : In neutral without muscle loading, a significant increase in superior translation occurred with the classicLAT as compared to 30% defect (P = 0.046 and allograft conditions (P = 0.041. With muscle loading, the classicLAT (P = 0.005, 0.002 and the congruentLAT (P = 0.018, 0.021 had significantly greater superior translation compared to intact and allograft, respectively. In internal rotation, only loaded tests produced significant results; specifically, classicLAT increased translation compared to all intact CAL states (P 0.05 and no differences (P = 1.0 were found between classicLAT and congruentLAT. Discussion: In most simulations, CAL release with the Latarjet lead to increased superior humeral translation. Conclusion: The choice of technique for glenoid bone loss reconstruction has implications on the magnitude of superior humeral translation. This previously unknown effect requires further study to determine its clinical and kinematic outcomes.

  20. Autograft reconstructions for bone defects in primary total knee replacement in severe varus knees

    Directory of Open Access Journals (Sweden)

    Yatinder Kharbanda

    2014-01-01

    Full Text Available Background: Large posteromedial defects encountered in severe varus knees during primary total knee arthroplasty can be treated by cementoplasty, structural bone grafts or metallic wedges. The option is selected depending upon the size of the defect. We studied the outcome of autograft (structural and impaction bone grafting reconstruction of medial tibial bone defects encountered during primary total knee replacement in severe varus knees. Materials and Methods: Out of 675 primary varus knees operated, bone defects in proximal tibia were encountered in 54 knees. Posteromedial defects involving 25-40% of the tibial condyle cut surface and measuring more than 5 mm in depth were grafted using a structural graft obtained from cut distal femur or proximal tibia in 48 knees. For larger, peripheral uncontained vertical defects in six cases, measuring >25 mm in depth and involving >40% cut surface of proximal tibial condyle, impaction bone grafting with a mesh support was used. Results: Bone grafts incorporated in 54 knees in 6 months. There was no graft collapse or stress fractures, loosening or nonunion. The average followup period was 7.8 years (range 5-10 years. We observed an average postoperative increase in the Knee Society Score from 40 to 90 points. There was improvement in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC scores in terms of pain, stiffness and physical function during activities of daily living. Conclusion: Bone grafting for defects in primary total knee is justified as it is biological, available then and is cost effective besides preserving bone stock for future revisions. Structural grafts should be used in defects >5 mm deep and involving 25-40% of the cut proximal tibial condyle surface. For larger peripheral vertical defects, impaction bone grafting contained in a mesh should be done.

  1. Imaging of vascularized fibular grafts in large bone reconstruction in skeletally immature patients

    International Nuclear Information System (INIS)

    Objective. To describe the imaging findings of vascularized fibular grafts (VFG) in large bone reconstruction in children and teenagers. Design and patients. Fifteen patients aged from 4 to 19 years underwent VFG for bone reconstruction for primary tumors involving bone in 13 cases and for chronic osteomyelitis in 2 cases. Lesions were located in the femur (6 cases), the tibia (6 cases), the humerus, the distal fibula and the ilium. Radiographic follow-up was performed in all patients, radionuclide studies in 12 patients and MRI in 8. Results. Plain films showed a lamellated periosteal reaction on the VFG within 3 weeks following the procedure in all cases. Fusion of VFG and host bone occurred during the first 3 months. Radionuclide uptake of the VFG was seen in all cases but one. MRI showed cortical thickening and conservation of the high signal intensity of fatty marrow on T1-weighted sequences, and periosteal enhancement on dynamic post-contrast studies in all but one of the patients. Conclusion. Radionuclide studies and MRI show the periosteal enhancement and assess the viability of the VFG satisfactorily. However, we feel that plain films may be sufficient to ascertain this viability. (orig.). With 4 figs., 1 tab

  2. Imaging of vascularized fibular grafts in large bone reconstruction in skeletally immature patients

    Energy Technology Data Exchange (ETDEWEB)

    Panuel, M. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France)]|[Department of Radiology, CHU Nord, 13 - Marseille (France)]|[Anthropology Department, Universite de la Mediterranee, Marseille (France); Petit, P. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Jouve, J.L. [Department of Pediatric Orthopedics, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Portier, F. [Department of Radiology, CHU Nord, 13 - Marseille (France); Legre, R. [Department of Plastic Surgery, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Bourliere, B. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France); Devred, P. [Department of Pediatric Radiology, Hopital d`Enfants CHU Timone, 13 - Marseille (France)

    1997-07-07

    Objective. To describe the imaging findings of vascularized fibular grafts (VFG) in large bone reconstruction in children and teenagers. Design and patients. Fifteen patients aged from 4 to 19 years underwent VFG for bone reconstruction for primary tumors involving bone in 13 cases and for chronic osteomyelitis in 2 cases. Lesions were located in the femur (6 cases), the tibia (6 cases), the humerus, the distal fibula and the ilium. Radiographic follow-up was performed in all patients, radionuclide studies in 12 patients and MRI in 8. Results. Plain films showed a lamellated periosteal reaction on the VFG within 3 weeks following the procedure in all cases. Fusion of VFG and host bone occurred during the first 3 months. Radionuclide uptake of the VFG was seen in all cases but one. MRI showed cortical thickening and conservation of the high signal intensity of fatty marrow on T1-weighted sequences, and periosteal enhancement on dynamic post-contrast studies in all but one of the patients. Conclusion. Radionuclide studies and MRI show the periosteal enhancement and assess the viability of the VFG satisfactorily. However, we feel that plain films may be sufficient to ascertain this viability. (orig.). With 4 figs., 1 tab.

  3. FUNCTIONAL OUTCOME OF ACCELERATED REHABILITATION IN ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE PATELLAR TENDON BONE GRAFT A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Hiranyakumar

    2016-03-01

    Full Text Available INTRODUCTION An ideal rehabilitation program post anterior cruciate ligament reconstruction enables an individual to return to pre injury levels at a faster rate with minimal to no risk of reinjury to the graft. Rehabilitation protocols have changed considerably over time in the past. It has become “aggressive”, meaning an intensive rehabilitation which includes greater variety of exercises and sports related training. AIM OF THE STUDY The aim of our study is to assess the outcome of accelerated rehabilitation post anterior cruciate ligament (ACL reconstruction. METHODOLOGY 106 patients were operated by a single surgeon underwent arthroscopic anterior cruciate ligament reconstruction using bone patella tendon bone graft and partial meniscectomy for associated meniscal tear. Patients were put on an accelerated rehabilitation protocol designed in our institute on first post-operative day, under the guidance of a physical therapist in consultation with the operated surgeon. Patients were followed up at 3 weeks, 6 months and 9 months, post onset of rehabilitation, patients were assessed using KT1000 Arthrometer and Lysholm knee scoring system. RESULTS Out of 106 patients, who were selected, 96(91% were males and 10(9% were females. The mean pre-operative Lysholm score was 55.09. Post operatively, while on accelerated rehabilitation program the Lysholm scores were 69.73 at 3 weeks, 89.13 at 6 months and 89.19 at 9 months. In our pre-operative evaluation mean KT 1000 arthrometer score was 10.53 and post-operative at six months was 3.49. At nine months 105 patients had excellent results whereas 1 patient had good result. CONCLUSION Accelerated rehabilitation protocol enables the patient to functionally recover faster to pre injury levels. A rehabilitation protocol for 6 months is sufficient in enabling a patient to get back to pre-injury levels. Functional outcome is the same with or without associated meniscal injuries.

  4. Healing of the proximal bone clock in anterior cruciate ligament reconstruction with bone-patellar-tendon-bone graft - a CT-controlled study

    International Nuclear Information System (INIS)

    Anterior cruciate ligament (ACL) reconstruction with the middle third of the patellar ligament is a widely used method to re-establish knee function after ACL-injury. However, there is still considerable debate about the operative technique and graft fixation The goal of this study was to evaluate ACL-reconstruction with bone-patellar tendon-bone (BPTB) graft and femoral fixation with endobutton clinically as well as to evaluate bone tunnel placement and tunnel morphology with CT and x-ray. 51 patients, who had undergone ACL-reconstruction with BPTB-graft and fixation with Endobutton, were evaluated clinically. In 51 cases standard x-ray films - anterior-posterior (AP) and lateral - and in 50 cases computed tomography (CT) scans were obtained. Femoral tunnel placement was measured with a three-dimensional coordinate system on both x-ray films and CT scans. Tunnel widening and bone block healing where determined with CT on both the femoral and the tibial side. 40 patients had a normal or nearly normal knee function, 6 patients scored abnormal and none of the patients was rated severely abonormal according to the International Knee Documentation Committee (IKDC) form. Tunnel placement could not be determined on plain x-rays in 46 cases on the AP-films and in 8 cases on the lateral films. Average position: AP: 89,8 %, lateral: 38,5 %. On CT-scans the position could be measured in all 50 cases. Average position CT: AP: 90,5 %, lateral: 34,1 %. Tunnel widening on the femoral side was 40 % tunnel widening where obtained. Femoral bone block healing was complete in all cases. This operative technique shows good clinical results, which are comparable to other studies on ACL-reconstruction with BPTB-grafts. Suspensory femoral fixation with Endobutton does not cause any significant tunnel widening as it was reported when using the same fixation but hamstring grafts. Average tunnel position was comparable to other studies. However, CT scans are superior to plain radiographs

  5. Long-term outcome of extensive skull reconstruction using demineralized perforated bone in Siamese twins joined at the skull vertex.

    Science.gov (United States)

    Salyer, K E; Gendler, E; Squier, C A

    1997-05-01

    The successful use of cortical demineralized perforated bone in the treatment of extensive skeletal defects in children is exemplified by this case involving Siamese twins joined at the skull vertex. Four years following extensive skull reconstruction using demineralized perforated bone, an examination revealed successful calvarial reconstruction in one twin. The other twin required additional implants of demineralized perforated bone to fill in defects. However, a histologic examination taken following this additional procedure revealed that these implants neither caused tissue reaction over a 4-year period, nor showed signs of resorption. Bony remodeling and new bone formation were in progress. Compared with other bone substitutes, demineralized perforated bone has proven to be effective in the treatment of large skull defects in children. PMID:9145145

  6. Experimental study of natural hydroxyapatite/chitosan composite on reconstructing bone defects

    Institute of Scientific and Technical Information of China (English)

    Hua Yuan; Ning Chen; XiaoyingLü; Buzhong Zheng

    2008-01-01

    Objective:To study the possibility of natural hydroxyapatite/chitosan composite on repairing bone defects. Methods:We developed a natural hydroxyapatite/chitosan composite that could be molded into any desired shape. The powder component consists of natural hydroxyapatite, which is epurated from bone of pigs. The liquid component consists of malic acid and chitosan. Operations were performed on the left tibias of 15 white rabbits to create two square bone defects. One of the defects was reconstructed with the composite, while the other was not repaired and used as a blank control. Three of the animals were killed at the end of 2 weeks, 4 weeks, 8 weeks, 12 weeks and 16 weeks respectively and implants were evaluated anatomically and histologically. Results:No apparent rejection reaction was found, except for a mild inflammatory infiltration observed 2 weeks after surgery. Fibrous tissue became thinner 2 -8 weeks after surgery and bony connections were detected 12 weeks after surgery. The new bone was the same as the recipient bone by the 16th postoperative week. Conclusion:The hydroxyapatite/chitosan composite has good biocompatibility and osteoconduction. It is a potential repairing material for clinical application.

  7. Enhancement of tendon-to-bone healing after anterior cruciate ligament reconstruction using bone marrow-derived mesenchymal stem cells genetically modified with bFGF/BMP2

    Science.gov (United States)

    Chen, Biao; Li, Bin; Qi, Yong-Jian; Ni, Qu-Bo; Pan, Zheng-Qi; Wang, Hui; Chen, Liao-Bin

    2016-01-01

    Many strategies, including various growth factors and gene transfer, have been used to augment healing after anterior cruciate ligament (ACL) reconstruction. The biological environment regulated by the growth factors during the stage of tendon-bone healing was considered important in controlling the integrating process. The purpose of this study was to evaluate the effects of bone marrow-derived mesenchymal stem cells (BMSCs) genetically modified with bone morphogenetic protein 2 (BMP2) and basic fibroblast growth factor (bFGF) on healing after ACL reconstruction. BMSCs were infected with an adenoviral vector encoding BMP2 (AdBMP2) or bFGF (AdbFGF). Then, the infected BMSCs were surgically implanted into the tendon-bone interface. At 12 weeks postoperatively, the formation of abundant cartilage-like cells, smaller tibial bone tunnel and significantly higher ultimate load and stiffness levels, through histological analysis, micro-computed tomography and biomechanical testing, were observed. In addition, the AdBMP2-plus-AdbFGF group had the smallest bone tunnel and the best mechanical properties among all the groups. The addition of BMP2 or bFGF by gene transfer resulted in better cellularity, new bone formation and higher mechanical property, which contributed to the healing process after ACL reconstruction. Furthermore, the co-application of these two genes was more powerful and efficient than either single gene therapy. PMID:27173013

  8. Free bone graft reconstruction of irradiated facial tissue: Experimental effects of basic fibroblast growth factor stimulation

    International Nuclear Information System (INIS)

    A study was undertaken to evaluate the potential utility of basic fibroblast growth factor in the induction of angiogenesis and osseous healing in bone previously exposed to high doses of irradiation. Thirty New Zealand rabbits were evaluated by introducing basic fibroblast growth factor into irradiated mandibular resection sites either prior to or simultaneous with reconstruction by corticocancellous autografts harvested from the ilium. The fate of the free bone grafts was then evaluated at 90 days postoperatively by microangiographic, histologic, and fluorochrome bone-labeling techniques. Sequestration, necrosis, and failure to heal to recipient osseous margins was observed both clinically and histologically in all nontreated irradiated graft sites as well as those receiving simultaneous angiogenic stimulation at the time of graft placement. No fluorescent activity was seen in these graft groups. In the recipient sites pretreated with basic fibroblast growth factor prior to placement of the graft, healing and reestablishment of mandibular contour occurred in nearly 50 percent of the animals. Active bone formation was evident at cortical margins adjacent to the recipient sites but was absent in the more central cancellous regions of the grafts

  9. Synthesis and characterization of a nanostructured matrix hydroxyapatite ceramic bone reconstruction

    International Nuclear Information System (INIS)

    The nanostructured ceramics have been shown promise as biomaterials for bone reconstruction. Among calcium phosphates, hydroxyapatite Ca/P ratio = 1.67 mol stands out because of its crystallographic similarity with the mineral bone phase and biocompatibility. This work was based on synthesis and characterization of a nanostructured hydroxyapatite for use in reconstituting bone tissue. The synthesis method for obtaining the bioceramic powder occurred at process of dissolution/precipitation, involving CaO solid/liquid and phosphoric acid required for forming the composition of Ca/P = 1.67 mole. The material recovered from the synthesis was calcined at 900 ° C/2h, providing the hydroxyapatite powder nanometer. This was subjected to mechanical fragmentation process in mill attritor, providing a hydroxyapatite with modified surface morphology. The results presented relate to morphological characterization studies (SEM), mineralogical (XRD), chemical (FTIR) and particle size distribution, using the laser particle size analysis method. Such results showed the formation of hydroxyapatite phase and morphology satisfactory for use in reconstituting bone tissue

  10. Reconstruction of mandibular defects using nonvascularized autogenous bone graft in Nigerians

    Directory of Open Access Journals (Sweden)

    Kizito Chioma Ndukwe

    2014-01-01

    Full Text Available Objectives: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile-Ife, Nigeria. Patients and Methods: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife constituted the study sample. Relevant information was retrieved from the patients′ records. This information include patients′ demographics (age and sex as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. Result: There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%. Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients and postoperative wound infection (eight patients were the most common complications recorded. Conclusion: The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care

  11. Hydroxyapatite-doped polycaprolactone nanofiber membrane improves tendon–bone interface healing for anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Han F

    2015-12-01

    Full Text Available Fei Han,1,* Peng Zhang,2,* Yaying Sun,2 Chao Lin,1 Peng Zhao,1 Jiwu Chen2 1Shanghai East Hospital, The Institute for Biomedical Engineering and Nanoscience, Tongji University School of Medicine, Tongji University, 2Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Hamstring tendon autograft is a routine graft for anterior cruciate ligament (ACL reconstruction. However, ways of improving the healing between the tendon and bone is often overlooked in clinical practice. This issue can be addressed by using a biomimetic scaffold. Herein, a biomimetic nanofiber membrane of polycaprolactone/nanohydroxyapatite/collagen (PCL/nHAp/Col is fabricated that mimics the composition of native bone tissue for promoting tendon–bone healing. This membrane has good cytocompatibility, allowing for osteoblast cell adhesion and growth and bone formation. As a result, MC3T3 cells reveal a higher mineralization level in PCL/nHAp/Col membrane compared with PCL membrane alone. Further in vivo studies in ACL reconstruction in a rabbit model shows that PCL/nHAp/Col-wrapped tendon may afford superior tissue integration to nonwrapped tendon in the interface between the tendon and host bone as well as improved mechanical strength. This study shows that PCL/nHAp/Col nanofiber membrane wrapping of autologous tendon is effective for improving tendon healing with host bone in ACL reconstruction. Keywords: nanohydroxyapatite, polycaprolactone, nanofiber, tissue engineering, anterior cruciate ligament reconstruction

  12. Optimal transport by omni-potential flow and cosmological reconstruction

    CERN Document Server

    Frisch, Uriel; Villone, Barbara; Zheligovsky, Vladislav

    2011-01-01

    One of the simplest models used in studying the dynamics of large-scale structure in cosmology, known as the Zeldovich approximation, is equivalent to the three-dimensional inviscid Burgers equation for potential flow. For smooth initial data and sufficiently short times it has the property that the mapping of the positions of fluid particles at any time $t_1$ to their positions at any time $t_2\\ge t_1$ is the gradient of a convex potential, a property we call omni-potentiality. Are there other flows with this property, that are not straightforward generalizations of Zeldovich flows? This is answered in the affirmative in both two and three dimensions. How general are such flows? Using a WKB technique we show that in two dimensions, for sufficiently short times, there are omni-potential flows with arbitrary smooth initial velocity. Mappings with a convex potential are known to be associated with the quadratic-cost optimal transport problem. This has important implications for the problem of reconstructing the...

  13. Performance analysis of model based iterative reconstruction with dictionary learning in transportation security CT

    Science.gov (United States)

    Haneda, Eri; Luo, Jiajia; Can, Ali; Ramani, Sathish; Fu, Lin; De Man, Bruno

    2016-05-01

    In this study, we implement and compare model based iterative reconstruction (MBIR) with dictionary learning (DL) over MBIR with pairwise pixel-difference regularization, in the context of transportation security. DL is a technique of sparse signal representation using an over complete dictionary which has provided promising results in image processing applications including denoising,1 as well as medical CT reconstruction.2 It has been previously reported that DL produces promising results in terms of noise reduction and preservation of structural details, especially for low dose and few-view CT acquisitions.2 A distinguishing feature of transportation security CT is that scanned baggage may contain items with a wide range of material densities. While medical CT typically scans soft tissues, blood with and without contrast agents, and bones, luggage typically contains more high density materials (i.e. metals and glass), which can produce severe distortions such as metal streaking artifacts. Important factors of security CT are the emphasis on image quality such as resolution, contrast, noise level, and CT number accuracy for target detection. While MBIR has shown exemplary performance in the trade-off of noise reduction and resolution preservation, we demonstrate that DL may further improve this trade-off. In this study, we used the KSVD-based DL3 combined with the MBIR cost-minimization framework and compared results to Filtered Back Projection (FBP) and MBIR with pairwise pixel-difference regularization. We performed a parameter analysis to show the image quality impact of each parameter. We also investigated few-view CT acquisitions where DL can show an additional advantage relative to pairwise pixel difference regularization.

  14. Three-dimensional visualization and characterization of bone structure using reconstructed in-vitro μCT images: A pilot study for bone microarchitecture analysis

    International Nuclear Information System (INIS)

    Micro Computed Tomography (μCT) has been largely used to perform micrometer scale imaging of specimens, bone biopsies and small animals for the study of porous or cavity-containing objects. One of its favored applications is for assessing structural properties of bone. In this research, we perform a pilot study to visualize and characterize bone structure of a chicken bone thigh, as well as to delineate its cortical and trabecular bone regions. We utilize an In-Vitro μCT scanner Skyscan 1173 to acquire a three dimensional image data of a chicken bone thigh. The thigh was scanned using X-ray voltage of 45 kV and current of 150 μA. The reconstructed images have spatial resolution of 142.50 μm/pixel. Using image processing and analysis e.i segmentation by thresholding the gray values (which represent the pseudo density) and binarizing the images, we were able to visualize each part of the bone, i.e., the cortical and trabecular regions. Total volume of the bone is 4663.63 mm3, and the surface area of the bone is 7913.42 mm2. The volume of the cortical is approximately 1988.62 mm3 which is nearly 42.64% of the total bone volume. This pilot study has confirmed that the μCT is capable of quantifying 3D bone structural properties and defining its regions separately. For further development, these results can be improved for understanding the pathophysiology of bone abnormality, testing the efficacy of pharmaceutical intervention, or estimating bone biomechanical properties

  15. Three-dimensional visualization and characterization of bone structure using reconstructed in-vitro μCT images: A pilot study for bone microarchitecture analysis

    Energy Technology Data Exchange (ETDEWEB)

    Latief, Fourier Dzar Eljabbar, E-mail: fourier@fi.itb.ac.id [Physics of Earth and Complex Systems, Faculty of Mathematics and Natural Sciences, Institut Teknologi Bandung, Jl. Ganesha 10, Bandung 40132 (Indonesia); Dewi, Dyah Ekashanti Octorina [2Biomedical Engineering Research Division, School of Electrical Engineering and Informatics, Institut Teknologi Bandung, Jl. Ganesha 10, Bandung 40132 (Indonesia); Shari, Mohd Aliff Bin Mohd [Faculty of Electrical Engineering, Universiti Teknologi MARA Malaysia, 40000 Shah Alam, Selangor (Malaysia)

    2014-03-24

    Micro Computed Tomography (μCT) has been largely used to perform micrometer scale imaging of specimens, bone biopsies and small animals for the study of porous or cavity-containing objects. One of its favored applications is for assessing structural properties of bone. In this research, we perform a pilot study to visualize and characterize bone structure of a chicken bone thigh, as well as to delineate its cortical and trabecular bone regions. We utilize an In-Vitro μCT scanner Skyscan 1173 to acquire a three dimensional image data of a chicken bone thigh. The thigh was scanned using X-ray voltage of 45 kV and current of 150 μA. The reconstructed images have spatial resolution of 142.50 μm/pixel. Using image processing and analysis e.i segmentation by thresholding the gray values (which represent the pseudo density) and binarizing the images, we were able to visualize each part of the bone, i.e., the cortical and trabecular regions. Total volume of the bone is 4663.63 mm{sup 3}, and the surface area of the bone is 7913.42 mm{sup 2}. The volume of the cortical is approximately 1988.62 mm{sup 3} which is nearly 42.64% of the total bone volume. This pilot study has confirmed that the μCT is capable of quantifying 3D bone structural properties and defining its regions separately. For further development, these results can be improved for understanding the pathophysiology of bone abnormality, testing the efficacy of pharmaceutical intervention, or estimating bone biomechanical properties.

  16. Dose variation at bone/titanium interfaces using titanium hollow screw osseointegrating reconstruction plates

    International Nuclear Information System (INIS)

    Purpose: To evaluate dose variations at bone/titanium interfaces in an experimental model designed to simulate postoperative radiotherapy in patients with mandibular reconstructions using a titanium hollow-screw osseointegrating reconstruction plate (THORP) system. Materials and Methods: The model consisted of a 25 x 25 x 10 mm3 block of fresh bovine femoral diaphysis, to the surface of which a segment of THORP system reconstruction plate was fixed by means of a solid titanium screw 4 mm in diameter and 10 mm in length. Using specially designed thermoluminescent dosimeters (TLD) 2 mm in diameter and 0.13 mm in thickness, dose measurements were carried out at four distances from the screw axis (0.1, 0.3, 0.6, and 1 mm). 60Co and 6-MV photon beams were used at incidences both perpendicular and parallel ('axial') to the screw axis. Results: For 6-MV X-ray beams incident perpendicular to the screw axis, the maximum dose enhancement (due to backscatter) and the maximum dose reduction (due to attenuation) at the bone/titanium interface were 5% (± 2%) and 6% (± 2%), respectively. The corresponding values for 60Co beams were 6% (± 5%) and 10% (± 5%). For the axial incidences, a maximum dose enhancement of 5-7% was noted for both 6-MV X-rays and 60Co for beams incident on the surface containing the THORP plate segment, whereas beams incident on the opposite surface induced only a very small dose enhancement (2-3%). Conclusion: Using a new experimental model, TLD measurements showed only marginally significant dose variations at bone/titanium interfaces around THORP screws, all measured values being very close to the uncertainty limits (± 5%) associated with the method. For both 60Co and 6-MV beams, dose variations appeared smaller for axial than for perpendicular incidences. Because photon beams used in head and neck cancer treatment are most often directed parallel to the screw axes, these results suggest that failures of prosthetic osseointegration are unlikely to be

  17. 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.

  18. Computer-aided osteotomy design for harvesting autologous bone grafts in reconstructive surgery

    Science.gov (United States)

    Krol, Zdzislaw; Zerfass, Peter; von Rymon-Lipinski, Bartosz; Jansen, Thomas; Hauck, Wolfgang; Zeilhofer, Hans-Florian U.; Sader, Robert; Keeve, Erwin

    2001-05-01

    Autologous grafts serve as the standard grafting material in the treatment of maxillofacial bone tumors, traumatic defects or congenital malformations. The pre-selection of a donor site depends primarily on the morphological fit of the available bone mass and the shape of the part that has to be transplanted. To achieve sufficient incorporation of the autograft into the host bone, precise planning and simulation of the surgical intervention based on 3D CT studies is required. This paper presents a method to identify an optimal donor site by performing an optimization of appropriate similarity measures between donor region and a given transplant. At the initial stage the surgeon has to delineate the osteotomy border lines in the template CT data set and to define a set of constraints for the optimization of appropriate similarity measures between donor region and a given transplant. At the initial stage the surgeon has to delineate the osteotomy border lines in the template CT data set and to define a set of constraints for the optimization task in the donor site CT data set. The following fully automatic optimization stage delivers a set of sub-optimal and optimal donor sites for a given template. All generated solutions can be explored interactively on the computer display using an efficient graphical interface. Reconstructive operations supported by our system were performed on 28 patients. We found that the operation time can be considerably shortened by this approach.

  19. The Influence of Peracetic Acid Sterilization on Tendon Bone Healing of Soft-Tissue Allografts in ACL Reconstruction

    OpenAIRE

    Böhm, Tassilo

    2010-01-01

    Allogenic tissue has become an important graft option for the reconstruction of the anterior cruciate ligament. Recent reports of disease transmission following ACL reconstruction with fresh-frozen non-sterilized allografts have highlighted the need for new sterilization techniques that do not impair the mechanical or biological properties as it was shown for most of the current sterilization techniques. Peracetic acid (PAA) has been successfully used to sterilize bone allografts without thes...

  20. Hybrid technique of cortical bone trajectory and pedicle screwing for minimally invasive spine reconstruction surgery : A technical note

    OpenAIRE

    Takata, Yoichiro; Matsuura, Tetsuya; Higashino, Kosaku; Sakai, Toshinori; Mishiro, Takuya; Suzue, Naoto; Kosaka, Hirofumi; Hamada, Daisuke; Goto, Tomohiro; Nishisho, Toshihiko; Goda, Yuichiro; Sato, Ryosuke(Institute of Particle and Nuclear Studies, High Energy Accelerator Research Organization (KEK), Oho, Tsukuba, 305-0801, Japan); Tsutsui, Takahiko; Tonogai, Ichiro; Tezuka, Fumitake

    2014-01-01

    The pedicle screw (PS) system is widely used for spinal reconstruction. Recently, screw insertion using the cortical bone trajectory (CBT) technique has been reported to provide increased holding strength of the vertebra, even in an osteoporotic spine. CBT is also beneficial due to its low invasiveness. We have been performing hybrid reconstruction with CBT at the cranial level and PS at the caudal level based on the concept of minimal invasiveness. We applied this hybrid technique to 6 cases...

  1. Hydroxyapatite-doped polycaprolactone nanofiber membrane improves tendon-bone interface healing for anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Han, Fei; Zhang, Peng; Sun, Yaying; Lin, Chao; Zhao, Peng; Chen, Jiwu

    2015-01-01

    Hamstring tendon autograft is a routine graft for anterior cruciate ligament (ACL) reconstruction. However, ways of improving the healing between the tendon and bone is often overlooked in clinical practice. This issue can be addressed by using a biomimetic scaffold. Herein, a biomimetic nanofiber membrane of polycaprolactone/nanohydroxyapatite/collagen (PCL/nHAp/Col) is fabricated that mimics the composition of native bone tissue for promoting tendon-bone healing. This membrane has good cytocompatibility, allowing for osteoblast cell adhesion and growth and bone formation. As a result, MC3T3 cells reveal a higher mineralization level in PCL/nHAp/Col membrane compared with PCL membrane alone. Further in vivo studies in ACL reconstruction in a rabbit model shows that PCL/nHAp/Col-wrapped tendon may afford superior tissue integration to nonwrapped tendon in the interface between the tendon and host bone as well as improved mechanical strength. This study shows that PCL/nHAp/Col nanofiber membrane wrapping of autologous tendon is effective for improving tendon healing with host bone in ACL reconstruction. PMID:26677323

  2. Hydroxyapatite-doped polycaprolactone nanofiber membrane improves tendon–bone interface healing for anterior cruciate ligament reconstruction

    Science.gov (United States)

    Han, Fei; Zhang, Peng; Sun, Yaying; Lin, Chao; Zhao, Peng; Chen, Jiwu

    2015-01-01

    Hamstring tendon autograft is a routine graft for anterior cruciate ligament (ACL) reconstruction. However, ways of improving the healing between the tendon and bone is often overlooked in clinical practice. This issue can be addressed by using a biomimetic scaffold. Herein, a biomimetic nanofiber membrane of polycaprolactone/nanohydroxyapatite/collagen (PCL/nHAp/Col) is fabricated that mimics the composition of native bone tissue for promoting tendon–bone healing. This membrane has good cytocompatibility, allowing for osteoblast cell adhesion and growth and bone formation. As a result, MC3T3 cells reveal a higher mineralization level in PCL/nHAp/Col membrane compared with PCL membrane alone. Further in vivo studies in ACL reconstruction in a rabbit model shows that PCL/nHAp/Col-wrapped tendon may afford superior tissue integration to nonwrapped tendon in the interface between the tendon and host bone as well as improved mechanical strength. This study shows that PCL/nHAp/Col nanofiber membrane wrapping of autologous tendon is effective for improving tendon healing with host bone in ACL reconstruction. PMID:26677323

  3. Limb reconstruction with decellularized, non-demineralized bone in a young leporine model

    International Nuclear Information System (INIS)

    Limb salvage from a variety of pathological processes in children is often limited by the unavailability of optimal allograft bone, or an appropriate structural bone substitute. In this study, we sought to examine a practical alternative for pediatric limb repair, based on decellularized, non-demineralized bone grafts, and to determine whether controlled recellularization prior to implantation has any impact on outcome. Growing New Zealand rabbits (n = 12) with a complete, critical-size defect on the left tibiofibula were equally divided into two groups. One group received a decellularized, non-demineralized leporine tibiofibula graft. The other group received an equivalent graft seeded with mesenchymal stem cells labeled with green fluorescent protein (GFP), at a fixed density. Animals were euthanized at comparable time points 3–8 weeks post-implantation. Statistical analysis was by the Student t-test and Fisher’s exact test (P < 0.05). There was no significant difference in the rate of non-union between the two groups, including on 3D micro-CT. Incorporated grafts achieved adequate axial bending rigidity, torsional rigidity, union yield and flexural strength, with no significant differences or unequal variances between the groups. Correspondingly, there were no significant differences in extracellular calcium levels, or alkaline phosphatase activity. Histology confirmed the presence of neobone in both groups, with GFP-positive cells in the recellularized grafts. It was shown that osseous grafts derived from decellularized, non-demineralized bone undergo adequate remodeling in vivo after the repair of critical-size limb defects in a growing leporine model, irrespective of subsequent recellularization. This methodology may become a practical alternative for pediatric limb reconstruction. (paper)

  4. Role of 99mTc-methylene diphosphonate bone scan in the evaluation of the viability of the bone flap in mandibular reconstruction in patients with oromaxillofacial malignancies

    International Nuclear Information System (INIS)

    Osteo-cutaneous flap are commonly used for reconstruction of bone defect after oncology surgery. The success of surgery depends on the viability of the bone flap. Bone scan is a known, but less performed method, to look for viability of bone flaps. We describe a case of 50-year-old lady, presenting with squamous cell carcinoma of left buccal mucosa (cT4N1M0) involving the skin and mandible. She underwent left segmental mandibulectomy and upper alveolectomy with neck dissection, followed by reconstruction using a fibular osteo-cutaneous flap and anterolateral thigh free flap. On postoperative day 10, the intraoral flap showed signs of nonviability. The patient was sent to nuclear medicine for assessment of viability of the free fibula flap. The patient underwent three phase 99mTc-methylene diphosphonate (MDP) bone scan and single-photon emission computerized tomography. Computerized tomography showing good tracer uptake in fibula confirming viability. The case reflects the use of 99mTc-MDP in viability assessment of the bone flap

  5. Combined use of free vascularized bone graft and extracorporeally-irradiated autograft for reconstruction of massive bone and joint defects after resection of malignant tumor

    International Nuclear Information System (INIS)

    Reconstruction of massive bone defect after resection of malignant tumor by irradiated bone graft is reported. But because irradiated bone graft is dead-bone, it poses are many problems such as fracture, infection, and non-union. To resolve these problems, we combined use of the free vascularized bone graft (VBG) and irradiated bone graft (IRBG). We reviewed 10 patients with a, mean age of 28 years old. The locations were one proximal humerus, one shaft of ulna, two acetabular, one distal femur, and five shaft of tibia. One case developed necrosis by venous thrombus, but the other nine cases survived. Two cases developed nonunion, but the other eight cases achieved union. Oncological outcome was nine none eridence of disease (NED) and one dead of disease (DOD). Muskloskeltal tumor society (MTS) score was 84.5% on average (67-100). Three patients with weight-bearing joint reconstruction using IRBG showed osteoarthritic change in the long-term. Combined use of VBG and IRBG provides good functional assessment by compensating each other. If irradiated osteochondral grafts are used for weight-bearing joints, osteoarthritic changes cannot be avoided but clinical outcome is excellent. (author)

  6. Three-dimensional image reconstruction of jaw bone with a personal computer

    International Nuclear Information System (INIS)

    Owing to the rapid development of the computer-assisting systems, the digital data derived from various medical devices have been more useful in diagnosis and treatment planning. Recently 3D-CT system has been widely used, which can offer clear three-dimensional images with high quality in accuracy and reality. The system is not so generalized, however, that the practitioner can utilize it freely by himself at his convenience. In the present study, therefore, three-dimensional reconstruction of the digitalized medical images from CT data was tried using a standard personal computer in order to get concrete information of the internal structure of the body on the practitioner's display readily at any time needed. The sequence CT-images of human mandibles were prepared and converted into the standard image format for PC. The hardware configuration used consists of a NEC PC9821 with Pentium 133 MHz, 64 MB RAM. The software used for the 3D-reconstruction is Scion Image which is based on NIH Image for Macintosh image processing. The 3D-reconstructed model could realistically show a panoramic view of mandible body. At its any part, the shape of the bone surface as well as the anatomical landmarks was well observed. Besides, it could be rotated on the CRT display, and the morphological structure of the mandibles could be spatially examined. The digital image processing developed in this study was also found to be available for other applications such as the multi planer reconstruction and the interior analysis of windowed area. (author)

  7. Reconstructive procedures for segmental resection of bone in giant cell tumors around the knee

    Directory of Open Access Journals (Sweden)

    Aggarwal Aditya

    2007-01-01

    Full Text Available Background: Segmental resection of bone in Giant Cell Tumor (GCT around the knee, in indicated cases, leaves a gap which requires a complex reconstructive procedure. The present study analyzes various reconstructive procedures in terms of morbidity and various complications encountered. Materials and Methods: Thirteen cases (M-six and F-seven; lower end femur-six and upper end tibia -seven of GCT around the knee, radiologically either Campanacci Grade II, Grade II with pathological fracture or Grade III were included. Mean age was 25.6 years (range 19-30 years. Resection arthrodesis with telescoping (shortening over intramedullary nail ( n=5, resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail ( n=3 and resection arthrodesis with intercalary fibular autograft and simultaneous limb lengthening ( n=5 were the procedure performed. Results: Shortening was the major problem following resection arthrodesis with telescoping (shortening over intramedullary nail. Only two patients agreed for subsequent limb lengthening. The rest continued to walk with shortening. Infection was the major problem in all cases of resection arthrodesis with an intercalary allograft threaded over a long intramedullary nail and required multiple drainage procedures. Fusion was achieved after two years in two patients. In the third patient the allograft sequestrated. The patient underwent sequestrectomy, telescoping of fragments and ilizarov fixator application with subsequent limb lengthening. The patient was finally given an ischial weight relieving orthosis, 54 months after the index procedure. After resection arthrodesis with intercalary autograft and simultaneous lengthening the resultant gap (~15cm was partially bridged by intercalary nonvascularized dual fibular strut graft (6-7cm and additional corticocancellous bone graft from ipsilateral patella. Simultaneous limb lengthening with a distal tibial corticotomy was performed on an

  8. Retrospective long-term analysis of bone level changes after horizontal alveolar crest reconstruction with autologous bone grafts harvested from the posterior region of the mandible

    Science.gov (United States)

    2016-01-01

    Purpose The goal of this study was to evaluate the long-term success of horizontal alveolar crest augmentation of the retromolar region of the mandible with particulated bone, as well as factors affecting subsequent peri-implant bone loss. Methods A total of 109 patients (68 female, 41 male) suffering from alveolar ridge deficiencies of the maxilla and mandible were included in this study. All patients were treated with particulated retromolar bone grafts from the mandible prior to the insertion of endosseous dental implants. Mesial and distal peri-implant crestal bone changes were assessed at six time points. Several parameters, including implant survival and the influence of age, gender, localisation of the implant, diameter, covering procedures, and time points of implant placement, were analysed to identify associations with bone level changes using the Mann-Whitney U-test, the Kruskal-Wallis test, and Spearman's rank-order correlation coefficient. Results A total of 164 dental implants were placed in the maxilla (n=97) and in the mandible (n=67). The mean observation period was 105.26±21.58 months after implantation. The overall survival rate was 97.6% after 10 years. Overall, peri-implant bone loss was highest during the first year, but decreased over time. The mean amount of bone loss after 10 years was 2.47 mm mesially and 2.50 mm distally. Bone loss was significantly influenced by implant type and primary stability. Conclusions The use of particulated autologous retromolar bone grafts is a reliable technique for the horizontal reconstruction of local alveolar ridge deficiencies. Our results demonstrate that implants placed in augmented bone demonstrated similar bone level changes compared to implants inserted in non-augmented regions. PMID:27127688

  9. Fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted femoral fractures in dogs: 35 cases (1987-1997)

    International Nuclear Information System (INIS)

    To compare fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted (> 4 fragments) femoral fractures in dogs. Retrospective study. 35 dogs with highly comminuted fractures of the femur. Medical records of all dogs included in this study were reviewed. Dogs had been treated with fragment reconstruction and bone plate application (n = 20) or major fragment alignment and bridging plate fixation (15). Postoperative and follow-up radiographs were evaluated. Operating and hospitalization times, bone alignment, bone healing, and complications were considered. There were no differences in hospitalization times, limb alignment, and complications between dogs with fractures treated with fragment reconstruction and dogs with fractures treated with bridging plate fixation. Dogs with fractures treated with bridging plate fixation had shorter operative times and faster times to radiographic evidence of bone healing. Bridging plate fixation is quicker to perform and results in faster healing than fragment reconstruction and bone plate fixation when used to treat comminuted femoral fractures

  10. Three-Dimensional Upper Lip and Nostril Sill Changes After Cleft Alveolus Reconstruction Using Autologous Bone Grafting Versus Recombinant Human Bone Morphogenetic Protein-2.

    Science.gov (United States)

    Raposo-Amaral, Cassio Eduardo; Denadai, Rafael; Alonso, Nivaldo

    2016-06-01

    Cleft alveolus in patients with unilateral complete cleft lip and palate has been alternatively reconstructed with recombinant human bone morphogenetic protein (rhBMP)-2. However, its effects on upper lip and nostril sill anatomy are not known. Thus, the objective of this investigation was to assess and compare upper lip and nostril sill changes after cleft alveolus reconstruction with autologous bone from the iliac crest region and rhBMP-2. Patients were randomly allocated into 2 groups. In group 1, autologous bone from the iliac crest region was used to fill the cleft alveolus (n = 4), and in group 2, rhBMP-2 was used to fill the cleft alveolus (n = 8). Preoperatively and at one after the surgery, computerized tomography (CT) was performed. Reformatted CT imaging was used to perform cephalometric linear measurements of the upper lip and nostril sill regions. Inter- and intragroup data of the pre and postoperative reformatted CT measurements of the upper lip and nostril sill regions did not show differences (P >0.05) in cutaneous upper lip height and projection, nostril sill elevation, and subnasale projection. There were no significant upper lip and nostril sill anatomical changes after cleft alveolus reconstruction using autologous bone grafting and rhBMP-2. PMID:27244210

  11. Autologously generated tissue-engineered bone flaps for reconstruction of large mandibular defects in an ovine model.

    NARCIS (Netherlands)

    Tatara, A.M.; Kretlow, J.D.; Spicer, P.P.; Lu, S.; Lam, J.; Liu, W.; Cao, Y.; Liu, G.; Jackson, J.D.; Yoo, J.J.; Atala, A.; Beucken, J.J.J.P van den; Jansen, J.A.; Kasper, F.K.; Ho, T.; Demian, N.; Miller, M.J.; Wong, M.E.; Mikos, A.G.

    2015-01-01

    The reconstruction of large craniofacial defects remains a significant clinical challenge. The complex geometry of facial bone and the lack of suitable donor tissue often hinders successful repair. One strategy to address both of these difficulties is the development of an in vivo bioreactor, where

  12. A new bone-ligament-bone autograft from the plantar plates of the toes and its potential use in scapholunate reconstruction: an anatomical study.

    Science.gov (United States)

    Müller, Miriam; Reik, Milena; Sauerbier, Michael; Germann, Günter

    2008-10-01

    The study was performed to investigate a new bone-ligament-bone autograft from the plantar plate of the toes. The anatomic properties of the plantar ligaments and the technical feasibility to harvest a bone-ligament-bone graft were examined to evaluate the potential use of this graft for a suitable reconstruction of the scapholunate (SL) interosseous ligament. The plantar plate of the metatarsophalangeal joints of the second to fifth toe and the proximal interphalangeal joints of the second to fourth toe were examined in 20 cadaver feet (15 fresh and 5 embalmed cadavers) and measurements such as length, thickness, and width were taken. The average length of the plantar ligaments of the proximal interphalangeal joint was 0.63 cm (D3) and 0.62 cm (D4). The length of the plantar plates of the proximal interphalangeal joint of the third and fourth toe was found to be similar to that of the SL ligament. In addition to the measurements, a bone-ligament-bone autograft of the plantar plates of the metatarsophalangeal joint was designed as an SL-ligament substitute and successfully transplanted into cadaveric wrists. This new autograft is intercalated between the scaphoid and lunate and, contrary to all previous methods, not simply superimposed upon them. Length of the plantar plates was considered by the authors as the main criteria for selection of the new bone-ligament-bone graft. The plantar plate of the proximal interphalangeal joint of the third and fourth toe showed a similar length compared with the SL ligament. Therefore, it can be concluded from the data that this bone-ligament-bone graft can be a suitable replacement for the SL ligament. PMID:18812722

  13. A Novel Method of Orbital Floor Reconstruction Using Virtual Planning, 3-Dimensional Printing, and Autologous Bone.

    Science.gov (United States)

    Vehmeijer, Maarten; van Eijnatten, Maureen; Liberton, Niels; Wolff, Jan

    2016-08-01

    Fractures of the orbital floor are often a result of traffic accidents or interpersonal violence. To date, numerous materials and methods have been used to reconstruct the orbital floor. However, simple and cost-effective 3-dimensional (3D) printing technologies for the treatment of orbital floor fractures are still sought. This study describes a simple, precise, cost-effective method of treating orbital fractures using 3D printing technologies in combination with autologous bone. Enophthalmos and diplopia developed in a 64-year-old female patient with an orbital floor fracture. A virtual 3D model of the fracture site was generated from computed tomography images of the patient. The fracture was virtually closed using spline interpolation. Furthermore, a virtual individualized mold of the defect site was created, which was manufactured using an inkjet printer. The tangible mold was subsequently used during surgery to sculpture an individualized autologous orbital floor implant. Virtual reconstruction of the orbital floor and the resulting mold enhanced the overall accuracy and efficiency of the surgical procedure. The sculptured autologous orbital floor implant showed an excellent fit in vivo. The combination of virtual planning and 3D printing offers an accurate and cost-effective treatment method for orbital floor fractures. PMID:27137437

  14. Firm anchoring between a calcium phosphate-hybridized tendon and bone for anterior cruciate ligament reconstruction in a goat model

    Energy Technology Data Exchange (ETDEWEB)

    Mutsuzaki, Hirotaka [Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences, 4669-2 Ami Ami-machi, Inashiki-gun, Ibaraki 300-0394 (Japan); Sakane, Masataka; Ochiai, Naoyuki [Department of Orthopaedic Surgery, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575 (Japan); Hattori, Shinya; Kobayashi, Hisatoshi, E-mail: sakane-m@md.tsukuba.ac.j [Biomaterial Center, National Institute for Materials Science, 1-1 Namiki, Tsukuba, Ibaraki 305-0044 (Japan)

    2009-08-15

    Using an alternative soaking process improved the tendon-bone attachment for a calcium phosphate (CaP)-hybridized tendon graft. We characterized the deposited CaP on and in tendons and analyzed the histology and mechanical properties of the tendon-bone interface in anterior cruciate ligament (ACL) reconstruction in goats. The tendon grafts to be implanted were soaked ten times alternately in a Ca-containing solution and a PO{sub 4}-containing solution for 30 s each. Needlelike CaP nanocrystals including low-crystalline apatite were deposited on and between collagen fibrils from the surface to a depth of 200{mu}m inside the tendon. The structure resembles the extracellular matrix of bone. In animal experiments, the CaP-hybridized tendon directly bonded with newly formed bone at 6 weeks (n = 3), while fibrous bonding was observed in the control (n = 3). The ultimate failure load was not statistically different between the CaP (n = 7) and control (n = 7). However, in the failure mode, all the tendon-bone interfaces were intact in the CaP group, while three of seven specimens were pulled out from bone tunnels in the control. The result suggested that the strength of the tendon-bone interface in the CaP group is superior to that in the control group. Clinically, firm tendon-bone anchoring may lead to good results without the knee instability associated with the loosening of the bone-tendon junction in ACL reconstruction.

  15. BIOMECHANICAL STUDY OF TRANSCORTICAL OR TRANSTRABECULAR BONE FIXATION OF PATELLAR TENDON GRAFT WITH BIOABSORBABLE PINS IN ACL RECONSTRUCTION IN SHEEP

    Science.gov (United States)

    Albano, Mauro Batista; Borges, Paulo César; Namba, Mario Massatomo; da Silva, João Luiz Vieira; de Assis Pereira Filho, Francisco; Filho, Edmar Stieven; Matias, Jorge Eduardo Fouto

    2015-01-01

    Objective: To determine the initial resistance of fixation using the Rigid Fix® system, and compare it with traditional fixation methods using metal interference screws; and to evaluate the resistance of the fixation with the rigid fix system when the rotational position of the bone block is altered in the interior of the femoral tunnel. Methods: forty ovine knee specimens (stifle joints) were submitted to anterior cruciate ligament reconstruction (ACL) using a bone-tendon-bone graft. In twenty specimens, the Rigid Fix method was used; this group was subdivided into two groups: ten knees the pins transfixed only the spongious area of the bone block, and ten for fixation passing through the layer of cortical bone. In the twenty remaining specimens, the graft was fixed with 9mm metal interference screws. Results: comparison of the RIGIDFIX® method with the metal interference screw fixation method did not show any statistically significant differences in terms of maximum load and rigidity; also, there were no statistically significant differences when the rotational position of the bone block was altered inside the femoral tunnel. For these evaluations, a level of significance of p < 0.017 was considered. Conclusion: fixation of the bone-tendon-bone graft with 2 bioabsorbable pines, regardless of the rotational position inside the femoral tunnel, gave a comparable fixation in terms of initial resistance to the metal interference screw, in this experimental model. PMID:27027081

  16. ACL reconstruction - discharge

    Science.gov (United States)

    Anterior cruciate ligament reconstruction - discharge; ACL reconstruction - discharge ... had surgery to reconstruct your anterior cruciate ligament (ACL). The surgeon drilled holes in the bones of ...

  17. X-ray micro-diffraction analysis of reconstructed bone at Zr prosthetic surface with sub-micrometre spatial resolution

    International Nuclear Information System (INIS)

    The purpose of the present investigation is to demonstrate the power of the x-ray micro-diffraction technique in biological studies. In particular the reported experiment concerns the study of the interface between a Zr prosthetic device implanted in a rat femur and the newly-formed bone, with a spatial resolution of 0.5 μm. The obtained results give interesting information on the Zr deformation and on the crystallographic phase, the grain size and the orientation of the new bone. Moreover the study reveals a marked difference in the structure of the reconstructed bone with respect to the native bone, which cannot be appreciated with other techniques. (note)

  18. Biomechanical competence of six different bone screws for reconstructive surgery in three different transplants: Fibular, iliac crest, scapular and artificial bone.

    Science.gov (United States)

    Pietsch, Arnold P; Raith, Stefan; Ode, Jan-Eric; Teichmann, Jan; Lethaus, Bernd; Möhlhenrich, Stephan C; Hölzle, Frank; Duda, Georg N; Steiner, Timm

    2016-06-01

    The goal of this study was to determine a combination of screw and transplantation type that offers optimal primary stability for reconstructive surgery. Fibular, iliac crest, and scapular transplants were tested along with artificial bone substrate. Six different kinds of bone screws (Medartis(©)) were compared, each type utilized with one of six specimens from human transplants (n = 6). Controlled screw-in-tests were performed and the required torque was protocolled. Subsequently, pull-out-tests were executed to determine the retention forces. The artificial bone substitute material showed significantly higher retention forces than real bone samples. The self-drilling screws achieved the significantly highest retention values in the synthetic bone substitute material. Cancellous screws achieved the highest retention in the fibular transplants, while self-drilling and cancellous screws demonstrated better retention than cortical screws in the iliac crest. In the scapular graft, no significant differences were found between the screw types. In comparison to the human transplant types, the cortical screws showed the significantly highest values in the fibula and the lowest values in the iliac crest. The best retention was found in the combination of cancellous screws with fibular graft (514.8 N + -252.3 N). For the flat bones (i.e., scapular and illiac crest) we recommend the cancellous screws. PMID:27107477

  19. Long-term outcome of free fibula osteocutaneous flap and massive allograft in the reconstruction of long bone defect.

    Science.gov (United States)

    Halim, Ahmad Sukari; Chai, Siew Cheng; Wan Ismail, Wan Faisham; Wan Azman, Wan Sulaiman; Mat Saad, Arman Zaharil; Wan, Zulmi

    2015-12-01

    Reconstruction of massive bone defects in bone tumors with allografts has been shown to have significant complications including infection, delayed or nonunion of allograft, and allograft fracture. Resection compounded with soft tissue defects requires skin coverage. A composite osteocutaneous free fibula offers an optimal solution where the allografts can be augmented mechanically and achieve biological incorporation. Following resection, the cutaneous component of the free osteocutaneous fibula flaps covers the massive soft tissue defect. In this retrospective study, the long-term outcome of 12 patients, who underwent single-stage limb reconstruction with massive allograft and free fibula osteocutaneous flaps instead of free fibula osteal flaps only, was evaluated. This study included 12 consecutive patients who had primary bone tumors and had follow-up for a minimum of 24 months. The mean age at the time of surgery was 19.8 years. A total of eight patients had primary malignant bone tumors (five osteosarcomas, two chondrosarcomas and one synovial sarcoma), and four patients had benign bone tumors (two giant-cell tumors, one aneurysmal bone cyst, and one neurofibromatosis). The mean follow-up for the 12 patients was 63 months (range 24-124 months). Out of the 10 patients, nine underwent lower-limb reconstruction and ambulated with partial weight bearing and full weight bearing at an average of 4.2 months and 8.2 months, respectively. In conclusion, augmentation of a massive allograft with free fibula osteocutaneous flap is an excellent alternative for reducing the long-term complication of massive allograft and concurrently addresses the soft tissue coverage. PMID:26420474

  20. Stem cell therapy: a promising biological strategy for tendon-bone healing after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Hao, Zi-Chen; Wang, Shan-Zheng; Zhang, Xue-Jun; Lu, Jun

    2016-04-01

    Tendon-bone healing after anterior cruciate ligament (ACL) reconstruction is a complex process, impacting significantly on patients' prognosis. Natural tendon-bone healing usually results in fibrous scar tissue, which is of inferior quality compared to native attachment. In addition, the early formed fibrous attachment after surgery is often not reliable to support functional rehabilitation, which may lead to graft failure or unsatisfied function of the knee joint. Thus, strategies to promote tendon-bone healing are crucial for prompt and satisfactory functional recovery. Recently, a variety of biological approaches, including active substances, gene transfer, tissue engineering and stem cells, have been proposed and applied to enhance tendon-bone healing. Among these, stem cell therapy has been shown to have promising prospects and draws increasing attention. From commonly investigated bone marrow-derived mesenchymal stem cells (bMSCs) to emerging ACL-derived CD34+ stem cells, multiple stem cell types have been proven to be effective in accelerating tendon-bone healing. This review describes the current understanding of tendon-bone healing and summarizes the current status of related stem cell therapy. Future limitations and perspectives are also discussed. PMID:26929145

  1. Autologously generated tissue-engineered bone flaps for reconstruction of large mandibular defects in an ovine model.

    Science.gov (United States)

    Tatara, Alexander M; Kretlow, James D; Spicer, Patrick P; Lu, Steven; Lam, Johnny; Liu, Wei; Cao, Yilin; Liu, Guangpeng; Jackson, John D; Yoo, James J; Atala, Anthony; van den Beucken, Jeroen J J P; Jansen, John A; Kasper, F Kurtis; Ho, Tang; Demian, Nagi; Miller, Michael John; Wong, Mark E; Mikos, Antonios G

    2015-05-01

    The reconstruction of large craniofacial defects remains a significant clinical challenge. The complex geometry of facial bone and the lack of suitable donor tissue often hinders successful repair. One strategy to address both of these difficulties is the development of an in vivo bioreactor, where a tissue flap of suitable geometry can be orthotopically grown within the same patient requiring reconstruction. Our group has previously designed such an approach using tissue chambers filled with morcellized bone autograft as a scaffold to autologously generate tissue with a predefined geometry. However, this approach still required donor tissue for filling the tissue chamber. With the recent advances in biodegradable synthetic bone graft materials, it may be possible to minimize this donor tissue by replacing it with synthetic ceramic particles. In addition, these flaps have not previously been transferred to a mandibular defect. In this study, we demonstrate the feasibility of transferring an autologously generated tissue-engineered vascularized bone flap to a mandibular defect in an ovine model, using either morcellized autograft or synthetic bone graft as scaffold material. PMID:25603924

  2. Image reconstruction in diffuse optical tomography using the coupled radiative transport-diffusion model

    International Nuclear Information System (INIS)

    The coupled radiative transport-diffusion model can be used as light transport model in situations in which the diffusion equation is not a valid approximation everywhere in the domain. In the coupled model, light propagation is modelled with the radiative transport equation in sub-domains in which the approximations of the diffusion equation are not valid, such as within low-scattering regions, and the diffusion approximation is used elsewhere in the domain. In this paper, an image reconstruction method for diffuse optical tomography based on using the coupled radiative transport-diffusion model is developed. In the approach, absorption and scattering distributions are estimated by minimising a regularised least-squares error between the measured data and solution of the coupled model. The approach is tested with simulations. Reconstructions from different cases including domains with low-scattering regions are shown. The results show that the coupled radiative transport-diffusion model can be utilised in image reconstruction problem of diffuse optical tomography and that it produces as good quality reconstructions as the full radiative transport equation also in the presence of low-scattering regions.

  3. Reconstructing Ancient Egyptian Diet through Bone Elemental Analysis Using LIBS (Qubbet el Hawa Cemetery

    Directory of Open Access Journals (Sweden)

    Ghada Darwish Al-Khafif

    2015-01-01

    Full Text Available One of the most important advantages of LIBS that make it suitable for the analysis of archeological materials is that it is a quasi-nondestructive technique. Archeological mandibles excavated from Qubbet el Hawa Cemetery, Aswan, were subjected to elemental analysis in order to reconstruct the dietary patterns of the middle class of the Aswan population throughout three successive eras: the First Intermediate Period (FIP, the Middle Kingdom (MK, and the Second Intermediate Period (SIP. The bone Sr/Ca and Ba/Ca ratios were significantly correlated, so the Sr/Ca ratios are considered to represent the ante-mortem values. It was suggested that the significantly low FIP Sr/Ca compared to that of both the MK and the SIP was attributed to the consumption of unusual sorts of food and imported cereals during years of famine, while the MK Sr/Ca was considered to represent the amelioration of climatic, social, economic, and political conditions in this era of state socialism. The SIP Sr/Ca, which is nearly the same as that of the MK, was considered to be the reflection of the continuity of the individualism respect and state socialism and a reflection of agriculture conditions amelioration under the reign of the 17th Dynasty in Upper Egypt.

  4. Osteointegration of soft tissue grafts within the bone tunnels in anterior cruciate ligament reconstruction can be enhanced

    OpenAIRE

    Kuang, GM; Yau, WP; Lu, WW; Chiu, KY

    2010-01-01

    Anterior cruciate ligament reconstruction with a soft tissue autograft (hamstring autograft) has grown in popularity in the last 10 years. However, the issues of a relatively long healing time and an inferior histological healing result in terms of Sharpey-like fibers connection in soft tissue grafts are still unsolved. To obtain a promising outcome in the long run, prompt osteointegration of the tendon graft within the bone tunnel is essential. In recent decades, numerous methods have been r...

  5. Reconstruction of advanced bone defect associated with severely compromised maxillary anterior teeth in aggressive periodontitis: a case report

    OpenAIRE

    Kamil, Wisam; Al Bayati, Lina; Hussin, Akbar S.; Hassan, Haszelini

    2015-01-01

    Introduction Aggressive periodontitis is characterized by a rapid rate of attachment loss and bone resorption. Regenerative therapy offers reconstruction of the periodontium; however, certain advanced cases with a questionable prognosis might remain a challenge. We report a successful intervention outcome of a challenging case in the aesthetic zone of a patient with aggressive periodontitis. Case presentation A 34-year-old systemically healthy Malay woman was referred to the Periodontics Spec...

  6. Free deep circumflex iliac artery vascularised bone flap for reconstruction of the distal radius: planning with CT angiography.

    Science.gov (United States)

    Ting, Jeannette W C; Rozen, Warren M; Leong, James; Crock, John

    2010-01-01

    Distal radius fractures in the younger population are often comminuted and intra-articular, which can increase the complexity of their management. In addition, these patients tend to place high demands on their wrists, and the prevention of functional arthritis necessitates excellent anatomical reduction. Complicated cases such as these are often limited in their management options. We present a complex case of distal radius fracture and bone loss in which initial therapy with nonvascularized bone graft failed, and osteomyelitis was a further complicating factor. With the aid of preoperative planning with computed tomographic angiography (CTA), a deep circumflex iliac artery (DCIA) bone flap was able to be assessed as a reconstructive option. The use of preoperative CTA, the first description of such imaging in this role, was able to delineate the bone to be harvested, confirm its vascular supply, and plan flap harvest. The use of a vascularized bone flap in this setting was thus undertaken and was able to provide an autologous anatomical support for the wrist while reducing the risk of recurrent infection and still preserving internal fixation. This unique application of the free DCIA bone flap was potentiated by CTA, achieving complete healing and good functional outcomes. PMID:20017201

  7. Clinical study of reconstructing the medial malleolus with free grafting of fibular head composite tendon bone flap

    Institute of Scientific and Technical Information of China (English)

    WU Shui-pei

    2008-01-01

    Objective: To explore new surgical procedure for repairing and reconstructing medial malleolus and soft tissue defect.Methods: According to the size of medial malleolus and composite soft tissue defect, vascular fibular head composite tendon bone flap free grafting using anterior tibial recurrent vessel as the perforating branch was designed to reconstruct the medial malleolar saddle and triangular ligament, and composite back broadest muscle flap free grafting was designed to repair the medical malleolar wound surface. From January 2000 to December 2006, the technique was used in 5 male patients who were injured by machine or in traffic accidents, causing bone and soft tissue defect. The size of wound surface ranged from 19 cm×12 cm to 24 cm×12 cm.Results: The wound surface was healed at the first stage in 4 cases, and the other case had infection and was cured in 6 months with anti infection therapy. Postoperative follow-ups from 6 months to 6 years showed that grafted bones and free cutaneous flaps were healed well, malleolar joints were stable, joint movement was normal, and the appearance was satisfactory. The overall outcome was good.Conclusion: Fibular head composite tendon bone flap free grafting is effective for repairing medical malleolar defect.

  8. Long-term bone tissue reaction to polyethylene oxide/polybutylene terephthalate copolymer (Polyactive) in metacarpophalangeal joint reconstruction.

    Science.gov (United States)

    Waris, Eero; Ashammakhi, Nureddin; Lehtimäki, Mauri; Tulamo, Riitta-Mari; Törmälä, Pertti; Kellomäki, Minna; Konttinen, Yrjö T

    2008-06-01

    The poly-L/D-lactide 96/4 joint scaffolds are used to engineer fibrous tissue joints in situ for the reconstruction of metacarpophalangeal joints. In this experimental study, a supplementary elastomeric stem made of Polyactive 1000PEO70PBT30 (a segmented block copolymer of polyethylene oxide and polybutylene terephtalate with 70/30 PEO/PBT ratio) was used to anchor the joint scaffold in the arthroplasty space. Eleven resected fifth metacarpophalangeal joints of minipig were reconstructed and evaluated radiologically and histologically for 3 years. Plain joint scaffold and Swanson silicone implant arthroplasties (11 of each) in metacarpophalangeal joints of minipig served as controls. Altogether fore limbs of eighteen minipigs were operated for the study. Deleterious tissue reaction with dramatic signs of osteolysis and inflammatory foreign-body reaction was observed around the Polyactive stems. The mean maximum diameter of the osteolytic stem cavity was statistically wider when compared to the mean maximum diameter of Swanson implant group during the first postoperative year. Numerous osteoclasts were found at the margins of the osteolytic areas. No direct bone contact could be seen. At 1 year osteoblastic regeneration and formation of new trabecular bone followed. Finally the foreign-body reaction settled, but the adjoining bones were at this stage highly sclerotic and composed of coarse trabeculae. In contrary to previous in vivo studies suggesting biocompatibility, osteoconductivity and capability to bond to bone, Polyactive 1000PEO70PBT30 stem in this setting caused massive osteolytic lesions and foreign-body reactions. PMID:18336902

  9. Effective Transport Properties of the Reconstructed Porous Catalyst Carriers

    Czech Academy of Sciences Publication Activity Database

    Salejová, G.; Kosek, J.; Nevoral, V.; Šolcová, Olga; Schneider, Petr

    Praha: Process Engineering Publisher, 2004, s. 102. ISBN 80-86059-40-5. [International Congress of Chemical and Process Engineering CHISA 2004 /16./. Praha (CZ), 22.08.2004-26.08.2004] R&D Projects: GA ČR GA104/02/0325; GA ČR GD104/03/H141 Institutional research plan: CEZ:AV0Z4072921 Keywords : transport * porous catalysts carriers Subject RIV: CF - Physical ; Theoretical Chemistry

  10. Reconstructing the transport history of pebbles on Mars

    OpenAIRE

    Szabó, Tímea; Domokos, Gábor; Grotzinger, John P.; Jerolmack, Douglas J.

    2015-01-01

    The discovery of remarkably rounded pebbles by the rover Curiosity, within an exhumed alluvial fan complex in Gale Crater, presents some of the most compelling evidence yet for sustained fluvial activity on Mars. While rounding is known to result from abrasion by inter-particle collisions, geologic interpretations of sediment shape have been qualitative. Here we show how quantitative information on the transport distance of river pebbles can be extracted from their shape alone, using a combin...

  11. Probing the electronic transport on the reconstructed Au/Ge(001 surface

    Directory of Open Access Journals (Sweden)

    Franciszek Krok

    2014-09-01

    Full Text Available By using scanning tunnelling potentiometry we characterized the lateral variation of the electrochemical potential µec on the gold-induced Ge(001-c(8 × 2-Au surface reconstruction while a lateral current flows through the sample. On the reconstruction and across domain boundaries we find that µec shows a constant gradient as a function of the position between the contacts. In addition, nanoscale Au clusters on the surface do not show an electronic coupling to the gold-induced surface reconstruction. In combination with high resolution scanning electron microscopy and transmission electron microscopy, we conclude that an additional transport channel buried about 2 nm underneath the surface represents a major transport channel for electrons.

  12. Visualization of postoperative anterior cruciate ligament reconstruction bone tunnels: Reliability of standard radiographs, CT scans, and 3D virtual reality images

    NARCIS (Netherlands)

    D.E. Meuffels (Duncan); J.W. Potters (Jan Willem); A.H.J. Koning (Anton); C.H. Brown Jr Jr. (Charles); J.A.N. Verhaar (Jan); M. Reijman (Max)

    2011-01-01

    textabstractBackground and purpose: Non-anatomic bone tunnel placement is the most common cause of a failed ACL reconstruction. Accurate and reproducible methods to visualize and document bone tunnel placement are therefore important. We evaluated the reliability of standard radiographs, CT scans, a

  13. Bone grafting and one-stage revision of THR - biological reconstruction and effective antimicrobial treatment using antibiotic impregnated allograft bone.

    Science.gov (United States)

    Winkler, Heinz

    2012-01-01

    Infection of a total hip replacement (THR) is considered one of the most serious complications in orthopaedic surgery. Problems derive from the presence of biofilms with inherent resistance to usual antibiotic treatment and bone defects resulting from infection induced osteolysis. Discussions on the choice of treatment mainly focus on the chance of eradicating the infection in either one or more stages. The advantages of only one operation with regard to patients' satisfaction, functional results and economical burden are evident. However, the fear of re-infection usually leads surgeons to multiple stage procedures, mostly using antibiotic loaded spacers in the interval. Spacers have no effect on biofilms and are associated with a high rate of complications such as breakage or dislocation. Cemented revisions show several disadvantages like reduction of biomechanical properties through added antibiotics, inferior long term results, difficulties of removal in case of recurrence etc. Uncemented implants appear more advantageous but are at risk of becoming colonised by remaining biofilm fragments. To overcome this risk higher local concentrations of antibiotics are needed. Allograft bone may be impregnated with high loads of antibiotics using special incubation techniques, resulting in an antibiotic bone compound (ABC). ABC provides local concentrations exceeding those of cement by more than a 100-fold and efficient release is prolonged for several weeks. At the same time it is likely to restore bone stock, which is usually compromised after removal of an infected endoprosthesis. Based on these considerations new protocols for one-stage exchange of infected THR have been established. Bone voids may be filled with ABC, uncemented implants may be fixed in original healthy bone. Recent studies indicate an overall success rate of more than 90% with one operation, without any adverse side effects. Incorporation of allografts appears as after grafting with unimpregnated bone

  14. Reconstruction of the Midfoot Using a Free Vascularized Fibular Graft After En Bloc Excision for Giant Cell Tumor of the Tarsal Bones: A Case Report.

    Science.gov (United States)

    Hara, Hitomi; Kawamoto, Teruya; Onishi, Yasuo; Fujioka, Hiroyuki; Nishida, Kotaro; Kuroda, Ryosuke; Kurosaka, Masahiro; Akisue, Toshihiro

    2016-01-01

    We report the case of a 32-year-old Japanese female with a giant cell tumor of bone involving multiple midfoot bones. Giant cell tumors of bone account for approximately 5% of all primary bone tumors and most often arise at the ends of long bones. The small bones, such as those of the hands and feet, are rare sites for giant cell tumors. Giant cell tumors of the small bones tend to exhibit more aggressive clinical behavior than those of the long bones. The present patient underwent en bloc tumor excision involving multiple tarsals and metatarsals. We reconstructed the longitudinal arch of the foot with a free vascularized fibular graft. At the 2-year follow-up visit, bony union had been achieved, with no tumor recurrence. PMID:26213165

  15. Reconstruction of transports through the Strait of Gibraltar from limited observations

    Science.gov (United States)

    Jordà, G.; Sánchez-Román, A.; Gomis, D.

    2016-04-01

    Observing the water transports through the Strait of Gibraltar is a difficult task. Here we present a methodology aimed to obtain the inflow, outflow and net transport of water from the limited set of available observations, currently consisting of an upward looking ADCP deployed at Espartel sill, two tide gauges located at each side of the Strait and radars monitoring the surface velocities. More precisely, we reconstruct the velocity field over a vertical section across the Strait using a reduced order optimal interpolation technique fed with the spatial covariance patterns deduced from high resolution numerical simulations. As a first step we carry out some sensitivity experiments with synthetic data that demonstrate the high potential of the approach. The reconstruction methodology can reproduce very satisfactorily the variability of the transports with estimated correlations for the inflow, outflow and net over 0.9 in all the cases and estimated RMS errors of 0.03, 0.08 and 0.05 Sv, respectively. However, we have also found that the reconstruction is sensible to bias problems, mostly due to the sensitivity of the method to the differences between the statistics of the actual and modeled velocity profiles. The sensitivity experiments have been used to tune the parameters of the method and a reconstruction of actual monthly transports has been performed for the period 2004-2010 along with an estimate of the associated uncertainty. This reconstruction provides for the first time a multiannual time series of the inflow and the net transports solely based on in situ observations. Therefore it can be used as an independent estimate for the validation of numerical models and surface freshwater fluxes in the Mediterranean.

  16. Effect of erythropoietin on the glucose transport of rat erythrocytes and bone marrow cells

    International Nuclear Information System (INIS)

    The effect of Ep on radioactive glucose and methyl-alpha-D-glucoside transport by rat erythrocytes and bone marrow cells were studied. There is initial linearity followed by saturation kinetics of [14C]glucose transport by the erythrocytes of starved and starved plus Ep-treated rats at different concentrations of glucose. Starvation caused slight inhibition of glucose transport which increased markedly on Ep administration to starved rats. Normal animals failed to show any significant change in glucose transport after Ep treatment. Methyl-alpha-D-glucoside inhibited the Ep-stimulated glucose transport significantly. Ep also stimulated the transport of radioactive methyl-alpha-D-glucoside which was competitively inhibited in presence of D-glucose. Glucose transport in erythrocytes was found to be sensitive to metabolic inhibitors like azide and DNP. A sulfhydryl reagent and ouabain also inhibited the transport process. Ep stimulated glucose and methyl-alpha-D-glucoside transport in the bone marrow cells of starved rats. The sugar analog competitively inhibited the glucose transport in bone marrow cells and vice versa

  17. Experience of using vascularized bone grafts in reconstructive surgery of the upper limbs

    Science.gov (United States)

    Atamanov, E. A.; Keosyan, V. T.; Bryukhanov, A. V.; Tsaregorodtseva, E. M.; Danilov, A. V.

    2015-11-01

    The article describes the results of treatment patients with defects and diseases of bone tissue using bone grafting with vascularized bone grafts from different areas of the body. The results of treatment of 27 patients with bone tissue defects of the upper extremities are demonstrated. 16 of patients had scaphoid nonunion. 2 cases of nonunion were reported: one scaphoid nonunion due to unstable osteosynthesis and one lunate fragmentation nonunion in patient with late stage Kienbock`s disease. Vascularized bone graft from distal radius was used in both cases. We had two cases of delayed union at 18 months in surgical treatment of scaphoid. 2 patients had metacarpal bone defect, 1 patient with radius bone defect, 2 patients with SLAC (scapholunate advanced collapse), 2 patients with bone defect of the humerus, 1 patient with bone defect of the ulna. In all cases we used vascularized bone crafts from various anatomical areas. We achieved union in all other cases. The study shows high efficiency of upper extremity bone defect replacement methods.

  18. A biomechanical assessment of superior shoulder translation after reconstruction of anterior glenoid bone defects: The Latarjet procedure versus allograft reconstruction

    OpenAIRE

    Degen, Ryan M; Giles, Joshua W.; Harm W Boons; Litchfield, Robert B.; Johnson, James A.; Athwal, George S.

    2013-01-01

    Background : The coracoacromial ligament (CAL) is an important restraint to superior shoulder translation. The effect of CAL release on superior stability following the Latarjet is unknown; therefore, our purpose was to compare the effect of two Latarjet techniques and allograft reconstruction on superior instability. Materials and Methods : Eight cadaveric specimens were tested on a simulator. Superior translation was monitored following an axial force in various glenohumeral rotations (...

  19. Surface reconstructions and transport of epitaxial PtLuSb (001) thin films grown by MBE

    Science.gov (United States)

    Patel, Sahil J.; Logan, John A.; Harrington, Sean D.; Schultz, Brian D.; Palmstrøm, Chris J.

    2016-02-01

    This work presents the surface reconstructions and transport properties of the topological insulator PtLuSb grown on Al0.1In0.9Sb/GaAs (001). Two stable surface reconstructions, (1×3) and c(2×2), were observed on PtLuSb (001) surfaces. Antimony-dimerization was determined to be the nature of the (1×3) surface reconstruction as evidenced by chemical binding energy shifts in the antimony 4d core-level for surface bonding components. The two surface reconstructions were studied as a function of Sb4 overpressure and substrate temperature to create a reconstruction phase diagram. From this reconstruction phase diagram, a growth window from 320 °C to 380 °C using an antimony overpressure was identified. Within this window, the highest quality films were grown at a growth temperature of 380 °C. These films exhibited lower p-type carrier concentrations as well as relatively high hole mobilities.

  20. Hybrid light transport model based bioluminescence tomography reconstruction for early gastric cancer detection

    Science.gov (United States)

    Chen, Xueli; Liang, Jimin; Hu, Hao; Qu, Xiaochao; Yang, Defu; Chen, Duofang; Zhu, Shouping; Tian, Jie

    2012-03-01

    Gastric cancer is the second cause of cancer-related death in the world, and it remains difficult to cure because it has been in late-stage once that is found. Early gastric cancer detection becomes an effective approach to decrease the gastric cancer mortality. Bioluminescence tomography (BLT) has been applied to detect early liver cancer and prostate cancer metastasis. However, the gastric cancer commonly originates from the gastric mucosa and grows outwards. The bioluminescent light will pass through a non-scattering region constructed by gastric pouch when it transports in tissues. Thus, the current BLT reconstruction algorithms based on the approximation model of radiative transfer equation are not optimal to handle this problem. To address the gastric cancer specific problem, this paper presents a novel reconstruction algorithm that uses a hybrid light transport model to describe the bioluminescent light propagation in tissues. The radiosity theory integrated with the diffusion equation to form the hybrid light transport model is utilized to describe light propagation in the non-scattering region. After the finite element discretization, the hybrid light transport model is converted into a minimization problem which fuses an l1 norm based regularization term to reveal the sparsity of bioluminescent source distribution. The performance of the reconstruction algorithm is first demonstrated with a digital mouse based simulation with the reconstruction error less than 1mm. An in situ gastric cancer-bearing nude mouse based experiment is then conducted. The primary result reveals the ability of the novel BLT reconstruction algorithm in early gastric cancer detection.

  1. Reconstrucción del maxilar superior mediante transporte del proceso alveolar: Presentación de un caso Reconstruction of the maxilla by means of transport of the alveolar process: A case report

    Directory of Open Access Journals (Sweden)

    A. Bilbao

    2006-02-01

    Full Text Available La osteogénesis mediante distracción aplicada a la reconstrucción del proceso alveolar es una técnica sobradamente contrastada en la literatura, al igual que la utilización del transporte óseo en la reconstrucción de defectos segmentarios mandibulares. Presentamos en este artículo un caso de reconstrucción de un defecto segmentario del maxilar superior mediante transporte de proceso alveolar y su posterior rehabilitación protésica implantosoportada. Mostramos tanto la técnica quirúrgica como el manejo de del vector de distracción utilizando elásticos de ortodoncia y tornillos de bloqueo intermaxilar.Osteogenesis by means of distraction applied to the reconstruction of the alveolar process is a well-documented technique in the literature, as is the use of bone transport in the reconstruction of mandibular segment defects. In the present article we report on a case of reconstruction of a segment defect in the maxilla using the alveolar transport process, and on the subsequent rehabilitation by means of an implant-supported prosthesis. Both the surgical technique and the handling of the distraction vector using orthodontic bands and inter-maxillary fixation screws are shown.

  2. A meta-analysis of hamstring autografts versus bone-patellar tendon-bone autografts for reconstruction of the anterior cruciate ligament.

    Science.gov (United States)

    Li, ShuZhen; Su, Wei; Zhao, Jinmin; Xu, Yinglong; Bo, Zhandong; Ding, Xiaofei; Wei, Qingjun

    2011-10-01

    The objective of this study was to evaluate the effectiveness of hamstring (HT) autografts versus bone-patellar tendon-bone (BPTB) autografts for reconstruction of the anterior cruciate ligament (ACL). We searched the Cochrane Library, MEDLINE, EMBASE and the Chinese Biomedicine Database (CBM) for published randomised clinical trials (RCTs) relevant to ACL reconstruction comparing HT and BPTB autografts. Data analyses were performed with Cochrane Collaboration's RevMan 5.0. A total of 23 reports of 19 randomised controlled trials (RCTs) (1643 patients) met the inclusion criteria. Outcomes favouring BPTB autografts were found in terms of KT-1000 arithmometer values, negative rates of Lachman tests and negative rates of Pivot tests. Outcome measures that favoured HT autografts included anterior knee pain, kneeling pain and extension loss. There was no statistical difference of postoperative graft failure. Overall, postoperative complications of the knee joint were lower for HT autografts than for BPTB autografts, and BPTB autografts were superior to HT autografts in resuming stability of the knee joint, but four-strand HT combined with application of the modern endobutton HT graft-fixation technique could increase knee-joint stability. PMID:20850327

  3. Prevalence and influence of tibial tunnel widening after isolated anterior cruciate ligament reconstruction using patella-bone-tendon-bone-graft: long-term follow-up

    Directory of Open Access Journals (Sweden)

    Johannes Struewer

    2012-06-01

    Full Text Available The aim of the present study was to evaluate incidence, degree and impact of tibial tunnel widening (TW on patient-reported long-term clinical outcome, knee joint stability and prevalence of osteoarthritis (OA after isolated anterior cruciate ligament (ACL reconstruction. On average, 13.5 years after ACL reconstruction via patella-bone-tendon-bone autograft, 73 patients have been re-evaluated. Inclusion criteria consisted of an isolated anterior cruciate ligament rupture and reconstruction, a minimum of 10-year follow-up and no previous anterior cruciate ligament repair or associated intra-articular lesions. Clinical evaluation was performed via the International Knee Documentation Committee (IKDC score and the Tegner and Lysholm scores. Instrumental anterior laxity testing was carried out with the KT-1000™ arthrometer. The degree of degenerative changes and the prevalence of osteoarthritis were assessed with the Kellgren-Lawrence score. Tibial tunnel enlargement was radiographically evaluated on both antero-posterior and lateral views under establishment of 4 degrees of tibial tunnel widening by measuring the actual tunnel diameters in mm on the sclerotic margins of the inserted tunnels on 3 different points (T1-T3. Afterwards, a conversion of the absolute values in mm into a 4 staged ratio, based on the comparison to the results of the initial drill-width, should provide a better quantification and statistical analysis. Evaluation was performed postoperatively as well as on 2 year follow-up and 13 years after ACL reconstruction. Minimum follow-up was 10 years. 75% of patients were graded A or B according to IKDC score. The mean Lysholm score was 90.2 ± 4.8 (25-100. Radiological assessment on long-term follow-up showed in 45% a grade I, in 24% a grade II, in 17% a grade III and in additional 12% a grade IV enlargement of the tibial tunnel. No evident progression of TW was found in comparison to the 2 year results. Radiological evaluation

  4. Prevalence and influence of tibial tunnel widening after isolated anterior cruciate ligament reconstruction using patella-bone-tendon-bone-graft: long-term follow-up.

    Science.gov (United States)

    Struewer, Johannes; Efe, Turgay; Frangen, Thomas Manfred; Schwarting, Tim; Buecking, Benjamin; Ruchholtz, Steffen; Schüttler, Karl Friedrich; Ziring, Ewgeni

    2012-05-01

    The aim of the present study was to evaluate incidence, degree and impact of tibial tunnel widening (TW) on patient-reported long-term clinical outcome, knee joint stability and prevalence of osteoarthritis (OA) after isolated anterior cruciate ligament (ACL) reconstruction. On average, 13.5 years after ACL reconstruction via patella-bone-tendon-bone autograft, 73 patients have been re-evaluated. Inclusion criteria consisted of an isolated anterior cruciate ligament rupture and reconstruction, a minimum of 10-year follow-up and no previous anterior cruciate ligament repair or associated intra-articular lesions. Clinical evaluation was performed via the International Knee Documentation Committee (IKDC) score and the Tegner and Lysholm scores. Instrumental anterior laxity testing was carried out with the KT-1000™ arthrometer. The degree of degenerative changes and the prevalence of osteoarthritis were assessed with the Kellgren-Lawrence score. Tibial tunnel enlargement was radiographically evaluated on both antero-posterior and lateral views under establishment of 4 degrees of tibial tunnel widening by measuring the actual tunnel diameters in mm on the sclerotic margins of the inserted tunnels on 3 different points (T1-T3). Afterwards, a conversion of the absolute values in mm into a 4 staged ratio, based on the comparison to the results of the initial drill-width, should provide a better quantification and statistical analysis. Evaluation was performed postoperatively as well as on 2 year follow-up and 13 years after ACL reconstruction. Minimum follow-up was 10 years. 75% of patients were graded A or B according to IKDC score. The mean Lysholm score was 90.2±4.8 (25-100). Radiological assessment on long-term follow-up showed in 45% a grade I, in 24% a grade II, in 17% a grade III and in additional 12% a grade IV enlargement of the tibial tunnel. No evident progression of TW was found in comparison to the 2 year results. Radiological evaluation revealed

  5. Rehabilitation of Patients Following Autogenic Bone-Patellar Tendon-Bone ACL Reconstruction: A 20-Year Perspective

    OpenAIRE

    De Carlo, Mark S.; McDivitt, Ryan

    2006-01-01

    Rehabilitation of patients following anterior cruciate ligament (ACL) reconstruction has undergone remarkable improvements over the past two decades. During this time, ACL research has been at the forefront of many orthopaedic and sports physical therapy clinics. With over 20 years of ACL rehabilitation experience (senior author) and prior collaboration with accelerated ACL rehabilitation pioneer K. Donald Shelbourne, the authors wish to present a unique perspective on the evolution of ACL re...

  6. Tratamento da falha óssea parcial pelo transporte ósseo parietal Partial bone defect treatment using parietal bone transportation

    Directory of Open Access Journals (Sweden)

    Fabio Lucas Rodrigues

    2005-01-01

    Full Text Available OBJETIVO: Descrever a técnica de transporte ósseo parietal para tratamento de falha óssea parcial, e descrever o resultado clínico e radiográfico de uma série de pacientes tratados por esta técnica. CASUÍSTICA E MÉTODO: tratamos nove pacientes portadores de lesão óssea parcial, sendo seis localizada na tíbia e três no fêmur. Todos apresentavam lesão infectada, acompanhada de pseudo-artrose. O procedimento iniciou-se com estabilização do segmento ósseo com fixador externo, seguido de corticotomia parietal, em osso sadio adjacente à falha, para criar o fragmento que foi transportado. Este fragmento foi transfixado por fios olivados, que conectados às hastes sulcadas permitiam o transporte ósseo. Em dois pacientes os fragmentos utilizados eram de osso adjacente (fíbula, transportados para a tíbia em direção da tíbia. A latência, velocidade e ritmo de distração foram os preconizados por Ilizarov. RESULTADOS: a infecção e a pseudo-artrose foram curadas em todos os casos, com preenchimento da falha óssea. As complicações encontradas foram infecção nos orifícios dos fios na pele e regenerado hipotrófico. CONCLUSÃO: o tratamento da falha óssea parcial pelo transporte ósseo parietal determinou solução do processo infeccioso, com consolidação da pseudo-artrose e preenchimento da falha óssea.OBJECTIVE: This study describes the bone transportation technique for partial bone defect, and shows clinical and radiological results of a series of patients treated by using this method. MATERIAL AND METHODS: Nine patients with partial bone defect were treated (six tibia and three femur. Every patient had infection and nonunion. The initial procedure was to stabilize the bone, followed by a partial corticotomy on the healthy bone adjacent to the defect, in order to create a fragment to be distracted. This fragment was fixed by olive wires, which were conected to the thread rod. We used fibula transport for tibial lateral

  7. Enhancement of Tendon–Bone Healing for Anterior Cruciate Ligament (ACL Reconstruction Using Bone Marrow-Derived Mesenchymal Stem Cells Infected with BMP-2

    Directory of Open Access Journals (Sweden)

    Shiyi Chen

    2012-10-01

    Full Text Available At present, due to the growing attention focused on the issue of tendon–bone healing, we carried out an animal study of the use of genetic intervention combined with cell transplantation for the promotion of this process. Here, the efficacy of bone marrow stromal cells infected with bone morphogenetic protein-2 (BMP-2 on tendon–bone healing was determined. A eukaryotic expression vector containing the BMP-2 gene was constructed and bone marrow-derived mesenchymal stem cells (bMSCs were infected with a lentivirus. Next, we examined the viability of the infected cells and the mRNA and protein levels of BMP-2-infected bMSCs. Gastrocnemius tendons, gastrocnemius tendons wrapped by bMSCs infected with the control virus (bMSCs+Lv-Control, and gastrocnemius tendons wrapped by bMSCs infected with the recombinant BMP-2 virus (bMSCs+Lv-BMP-2 were used to reconstruct the anterior cruciate ligament (ACL in New Zealand white rabbits. Specimens from each group were harvested four and eight weeks postoperatively and evaluated using biomechanical and histological methods. The bMSCs were infected with the lentivirus at an efficiency close to 100%. The BMP-2 mRNA and protein levels in bMSCs were significantly increased after lentiviral infection. The bMSCs and BMP-2-infected bMSCs on the gastrocnemius tendon improved the biomechanical properties of the graft in the bone tunnel; specifically, bMSCs infected with BMP-2 had a positive effect on tendon–bone healing. In the four-week and eight-week groups, bMSCs+Lv-BMP-2 group exhibited significantly higher maximum loads of 29.3 ± 7.4 N and 45.5 ± 11.9 N, respectively, compared with the control group (19.9 ± 6.4 N and 21.9 ± 4.9 N (P = 0.041 and P = 0.001, respectively. In the eight-week groups, the stiffness of the bMSCs+Lv-BMP-2 group (32.5 ± 7.3 was significantly higher than that of the bMSCs+Lv-Control group (22.8 ± 7.4 or control groups (12.4 ± 6.0 (p = 0.036 and 0.001, respectively. Based on the

  8. In Vivo Study of Ligament-Bone Healing after Anterior Cruciate Ligament Reconstruction Using Autologous Tendons with Mesenchymal Stem Cells Affinity Peptide Conjugated Electrospun Nanofibrous Scaffold

    Directory of Open Access Journals (Sweden)

    Jingxian Zhu

    2013-01-01

    Full Text Available Electrospinning nanofibrous scaffold was commonly used in tissue regeneration recently. Nanofibers with specific topological characteristics were reported to be able to induce osteogenic differentiation of MSCs. In this in vivo study, autologous tendon grafts with lattice-like nanofibrous scaffold wrapping at two ends of autologous tendon were used to promote early stage of ligament-bone healing after rabbit ACL reconstruction. To utilize native MSCs from bone marrow, an MSCs specific affinity peptide E7 was conjugated to nanofibrous meshes. After 3 months, H-E assessment and specific staining of collagen type I, II, and III showed direct ligament-bone insertion with typical four zones (bone, calcified fibrocartilage, fibrocartilage, and ligament in bioactive scaffold reconstruction group. Diameters of bone tunnel were smaller in nanofibrous scaffold conjugated E7 peptide group than those in control group. The failure load of substitution complex also indicated a stronger ligament-bone insertion healing using bioactive scaffold. In conclusion, lattice-like nanofibrous scaffold with specific MSCs affinity peptide has great potential in promoting early stage of ligament-bone healing after ACL reconstruction.

  9. Mid-foot reconstruction following involvement of five bones by giant cell tumor

    Energy Technology Data Exchange (ETDEWEB)

    Szendroei, M.; Antal, I.; Perlaky, G. [Dept. of Orthopaedics, Semmelweis Univ., Budapest (Hungary)

    2000-11-01

    We report on a patient who had giant cell tumor involving multiple bones of the mid-foot. The tumor originated from the navicular bone, but also destroyed the cuboid, and all cuneiform bones. This unusual presentation of giant cell tumor presented a therapeutic challenge for the surgeons. The patient was treated with en bloc resection and the bony defect replaced with a massive iliac crest graft which united within 9 months and has remained stable for 7 years without local recurrence, and with excellent function of the foot. (orig.)

  10. Mid-foot reconstruction following involvement of five bones by giant cell tumor

    International Nuclear Information System (INIS)

    We report on a patient who had giant cell tumor involving multiple bones of the mid-foot. The tumor originated from the navicular bone, but also destroyed the cuboid, and all cuneiform bones. This unusual presentation of giant cell tumor presented a therapeutic challenge for the surgeons. The patient was treated with en bloc resection and the bony defect replaced with a massive iliac crest graft which united within 9 months and has remained stable for 7 years without local recurrence, and with excellent function of the foot. (orig.)

  11. Characterization, Reconstruction and Transport Properties of Vosges Sandstones Caractérisation, reconstruction et propriétés de transport des grès des Vosges

    OpenAIRE

    Moulu J.-C.; Kalaydjian F.; Tsakiroglou C. D.; Burganos V. N.; Payatakes A. C.; Yao J; Thovert J.-F.; Adler P.-M.

    2006-01-01

    A thorough study of Vosges sandstone samples is presented in this work. First, the geometry of these porous media is analyzed using serial thin sections. Then, random numerical samples are reconstructed according to the measured statistical geometrical parameters. Finally, the macroscopic transport properties are determined from the numerical solutions in the reconstructed samples of the local equations governing the corresponding transport phenomena and compared to available experimental dat...

  12. Analysis of Complications after Reconstruction of Bone Defects Involving Complete Mandibular Resection Using Finite Element Modelling

    OpenAIRE

    Markwardt, Jutta; Pfeifer, Günther; Eckelt, Uwe; Reitemeier, Bernd

    2014-01-01

    Background: In a retrospective study, risk factors for complications after the bridging of mandibular defects using reconstruction plates were reviewed. Especially the loosening of the plate-screw-mandible complex should be analyzed with a finite element model in order to reduce plate complications in future. Patients and Methods: We examined 60 patients who underwent a treatment with reconstruction plates after tumor resection during a period of 10 years. The problem of screw loosening was a...

  13. Facial reconstruction with a bone-anchored prosthesis following destructive cancer surgery

    Science.gov (United States)

    MELLO, MONICA C.P.; PIRAS, JOAQUIM AUGUSTO OLIVEIRA; TAKIMOTO, ROBERTO M.; CERVANTES, ONIVALDO; ABRAÃO, MÁRCIO; DIB, LUCIANO L.

    2012-01-01

    Reconstruction of craniofacial defects following cancer surgery may be performed using several techniques and materials. This case report describes surgery for a large tumor, as well as the rehabilitation process which involved a craniofacial prosthesis covering the whole defect of the anterior brain, orbit, mid-face and hard palate. The results suggest that a craniofacial prosthesis anchored on titanium implants is a viable alternative as a retention system, and also a good alternative to other reconstructive surgeries. PMID:23205082

  14. The Value of SPECT/CT in Monitoring Prefabricated Tissue-Engineered Bone and Orthotopic rhBMP-2 Implants for Mandibular Reconstruction.

    Directory of Open Access Journals (Sweden)

    Miao Zhou

    Full Text Available Bone tissue engineering shows good prospects for mandibular reconstruction. In recent studies, prefabricated tissue-engineered bone (PTEB by recombinant human bone morphogenetic proteins (rhBMPs applied in vivo has found to be an effective alternative for autologous bone grafts. However, the optimal time to transfer PTEB for mandibular reconstruction is still not elucidated. Thus, here in an animal experiment of rhesus monkey, the suitable transferring time for PTEB to reconstruct mandibular defects was evaluated by 99mTc-MDP SPECT/CT, and its value in monitoring orthotopic rhBMP-2 implants for mandibular reconstruction was also evaluated. The result of SPECT/CT showed higher 99mTc-MDP uptake, indicating osteoinductivity, in rhBMP-2 incorporated demineralized freeze-dried bone allograft (DFDBA and coralline hydroxyapatite (CHA implants than those without BMP stimulation. 99mTc-MDP uptake of rhBMP-2 implant peaked at 8 weeks following implantation while CT showed the density of these implants increased after 13 weeks' prefabrication. Histology confirmed that mandibular defects were repaired successfully with PTEB or orthotopically rhBMP-2 incorporated CHA implants, in accordance with SPECT/CT findings. Collectively, data shows 99mTc-MDP SPECT/CT is a sensitive and noninvasive tool to monitor osteoinductivity and bone regeneration of PTEB and orthotopic implants. The PTEB achieved peak osteoinductivity and bone density at 8 to 13 weeks following ectopic implantation, which would serve as a recommendable time frame for its transfer to mandibular reconstruction.

  15. MR imaging findings of patellar tendon after anterior cruciate ligament reconstruction with bone-tendon-bone autograft

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hyoung; Kim, Hyoung Rae; Kim, Baek Hyun; Seol, Hae Young; Cha, In ho; Im, Hong Cheol [College of Medicine, Korea Univ., Seoul (Korea, Republic of); Kim, Hyoung Seuk [College of Medicine, Inje Univ., Kimhae (Korea, Republic of); Lee, Chang Hee [College of Medicine, Konkuk Univ., Seoul (Korea, Republic of)

    2002-01-01

    To evaluate the postoperative changes occurring in the patellar tendon after reconstruction of the anterior cruciate ligament (ACL) using the central one-third of the patellar tendon together with patellar and tibial bony plugs. Ten patients with ACL injury underwent sagittal and coronal T1- weighted MR imaging of both postoperative and normal knee joints. In all cases, reconstruction of the ACL was performed using the central one-third of the patellar tendon, together with patellar and tibial bony plugs. During the follow-up period of 6-27 months, patient were clinically stable. We compared the length, signal intensity and contour of both patellar tendons, as seen on MR images. No defects was found in harvested patellar tendons, and MR images showed high signal intensity within harvested tendons in six of the ten patients. In seven of ten, patellar tendons had irregular margins and were poorly delineated from adjacent tissue. The mean length of patellar tendons was 44.2 {+-}2.0 mm in normal knee and 43.9 {+-}3.1 mm in postoperative knee, while their mean thickness in postoperative knee, measured at mid-portion averaged 4.3{+-}1.2 mm. There were no statistically significant differences (p>0.05). The greatest mean thickness of patellar tendon was 6.9 {+-}1.2 mm and 4.3 {+-}0.5 mm in normal and postoperative knee, respectively. Thus, on average, postoperative patellar tendon was 161% thickner than normal tendon (p<0.05). In clinically stable patients, patellar tendons after graft harvesting had a higher signal intensity, worse-defined margins and a greater thickness than normal. We suggest that these are the normal postoperative findings.

  16. MR imaging findings of patellar tendon after anterior cruciate ligament reconstruction with bone-tendon-bone autograft

    International Nuclear Information System (INIS)

    To evaluate the postoperative changes occurring in the patellar tendon after reconstruction of the anterior cruciate ligament (ACL) using the central one-third of the patellar tendon together with patellar and tibial bony plugs. Ten patients with ACL injury underwent sagittal and coronal T1- weighted MR imaging of both postoperative and normal knee joints. In all cases, reconstruction of the ACL was performed using the central one-third of the patellar tendon, together with patellar and tibial bony plugs. During the follow-up period of 6-27 months, patient were clinically stable. We compared the length, signal intensity and contour of both patellar tendons, as seen on MR images. No defects was found in harvested patellar tendons, and MR images showed high signal intensity within harvested tendons in six of the ten patients. In seven of ten, patellar tendons had irregular margins and were poorly delineated from adjacent tissue. The mean length of patellar tendons was 44.2 ±2.0 mm in normal knee and 43.9 ±3.1 mm in postoperative knee, while their mean thickness in postoperative knee, measured at mid-portion averaged 4.3±1.2 mm. There were no statistically significant differences (p>0.05). The greatest mean thickness of patellar tendon was 6.9 ±1.2 mm and 4.3 ±0.5 mm in normal and postoperative knee, respectively. Thus, on average, postoperative patellar tendon was 161% thickner than normal tendon (p<0.05). In clinically stable patients, patellar tendons after graft harvesting had a higher signal intensity, worse-defined margins and a greater thickness than normal. We suggest that these are the normal postoperative findings

  17. SU-E-T-143: Effect of X-Ray and Cone Beam CT Reconstruction Parameters On Estimation of Bone Volume of Mice Used in Aging Research

    Energy Technology Data Exchange (ETDEWEB)

    Russ, M; Pang, M; Troen, B; Rudin, S; Ionita, C [University at Buffalo, Buffalo, NY (United States)

    2014-06-01

    Purpose: To investigate the variations in bone volume calculations in mice involved in aging research when changing cone beam micro-CT x-ray and reconstruction parameters. Methods: Mouse spines were placed on an indexed turn table that rotated 0.5° per projection and imaged by a self-built micro CT machine containing a CCD-based high-resolution x-ray detector. After the full 360° rotation data set of object images was obtained, a standard filtered back-projection cone beam reconstruction was performed. Four different kVp's between 40–70 kVp in 10kVp increments were selected. For each kVp two mAs settings were used. Each acquisition was reconstructed using two voxel sizes (12 and 25μm) and two step angles, 0.5° and 1°, respectively. A LabView program was written to determine the total bone volume contained in the mouse's total spine volume (bone plus gaps) as a measure of spine health. First, the user selected the desired 512×512 reconstruction to view the whole spine volume which was then used to select a gray-level threshold that allowed for viewing of the bone structure, then another threshold to include gaps. The program returned bone volume, bone × gap volume, and their ratio, BVF. Results: The calculated bone volume fractions were compared as a function of tube potential. Cases with 25μm slice thickness showed trials with lower kVp's had greater image contrast, which resulted in higher calculated bone volume fractions. Cases with 12μm reconstructed slice thickness were significantly noisier, and showed no clear maximum BVF. Conclusion: Using the projection images and reconstructions acquired from the micro CT, it can be shown that the micro-CT x-ray and reconstruction parameters significantly affect the total bone volume calculations. When comparing mice cohorts treated with different therapies researchers need to be aware of such details and use volumes which were acquired and processed in identical conditions.

  18. Accuracy of computer-aided geometric three-dimensional reconstruction of the human petrous bone based on serial unstained celloidin sections

    OpenAIRE

    WEI, XIAN-FENG; Zhang, Xiao-Yang; Yuan, Wu; Li, Yun-Sheng

    2015-01-01

    The aim of this study was to present a comprehensive three-dimensional (3D) morphology of the petrous bone with computer image-processing technology, which could be beneficial for the teaching of anatomy and for surgical procedures. The unstained celloidin sections of human temporal bone were digitized with high resolution and quality, and then processed with Amira® software to include alignment, segmentation and reconstruction. The integral structure of the human inner ear was presented with...

  19. Rubidium transport in irradiated vitamin-E-deficient bone marrow cells

    Energy Technology Data Exchange (ETDEWEB)

    Altman, K.I.; Muehlensiepen, H.; Wolters, R.; Muzik, O.; Feinendegen, L.E. (Forschungszentrum Juelich GmbH (Germany). Inst. fuer Medizin)

    1993-01-01

    We showed previously that the Rb[sup +] transport rate in bone marrow cells (BMC) of vitamin-E-deficient mice is significantly lower than that in BMC of euvitaminotic mice. It is now evident that 4 h after whole-body, low-dose (0.01-1.0 Gy) gamma-irradiation of avitaminotic mice, there is an increase in the rate of Rb[sup +] transport. This increase is quite pronounced, exceeding at all dose levels the rate of Rb[sup +] transport in euvitaminotic mice exposed to the same radiation dose. (orig.).

  20. Bone Anchor Fixation in Abdominal Wall Reconstruction: A Useful Adjunct in Suprapubic and Para-iliac Hernia Repair.

    Science.gov (United States)

    Blair, Laurel J; Cox, Tiffany C; Huntington, Ciara R; Ross, Samuel W; Kneisl, Jeffrey S; Augenstein, Vedra A; Heniford, B Todd

    2015-07-01

    Suprapubic hernias, parailiac or flank hernias, and lumbar hernias are difficult to repair and are associated with high-recurrence rates owing to difficulty in obtaining substantive overlap and especially mesh fixation due to bone being a margin of the hernia. Orthopedic suture anchors used for ligament reconstruction have been used to attach prosthetic material to bony surfaces and can be used in the repair of these hernias where suture fixation was impossible. A prospective, single institution study of ventral hernia repairs involving bone anchor mesh fixation was performed. Demographics, operative details, and outcomes data were collected. Twenty patients were identified, with a mean age 53 (range: 35-70 years) and mean body mass index 28.4 kg/m(2) (range 21-38). Ten lumbar, seven suprapubic, and three parailiac hernias were studied. The majority were recurrent hernias (n = 13), with one to seven previously failed repairs. The mean hernia defect size was very large (270 cm(2); range: 56-832 cm(2)) with average mesh size of 1090 cm(2) (range 224-3640 cm(2)). Both Mitek GII (Depuy, Raynham, MA) and JuggerKnot 2.9-mm (Biomet, Biomedical Instruments, Warsaw, IN) anchors were used, with an average of four anchors/case (range: 1-16). Mean operative time was 218 minutes (120-495). There were three minor complications, no operative mortality, and no recurrences during an average follow-up of 24 months. Pelvic bone anchors permit mesh fixation in high-recurrence areas not amenable to traditional suture fixation. The ability to safely and effectively use bone anchor fixation is an essential tool in complex open ventral hernia repair. PMID:26140889

  1. Mass-conservative reconstruction of Galerkin velocity fields for transport simulations

    Science.gov (United States)

    Scudeler, C.; Putti, M.; Paniconi, C.

    2016-08-01

    Accurate calculation of mass-conservative velocity fields from numerical solutions of Richards' equation is central to reliable surface-subsurface flow and transport modeling, for example in long-term tracer simulations to determine catchment residence time distributions. In this study we assess the performance of a local Larson-Niklasson (LN) post-processing procedure for reconstructing mass-conservative velocities from a linear (P1) Galerkin finite element solution of Richards' equation. This approach, originally proposed for a-posteriori error estimation, modifies the standard finite element velocities by imposing local conservation on element patches. The resulting reconstructed flow field is characterized by continuous fluxes on element edges that can be efficiently used to drive a second order finite volume advective transport model. Through a series of tests of increasing complexity that compare results from the LN scheme to those using velocity fields derived directly from the P1 Galerkin solution, we show that a locally mass-conservative velocity field is necessary to obtain accurate transport results. We also show that the accuracy of the LN reconstruction procedure is comparable to that of the inherently conservative mixed finite element approach, taken as a reference solution, but that the LN scheme has much lower computational costs. The numerical tests examine steady and unsteady, saturated and variably saturated, and homogeneous and heterogeneous cases along with initial and boundary conditions that include dry soil infiltration, alternating solute and water injection, and seepage face outflow. Typical problems that arise with velocities derived from P1 Galerkin solutions include outgoing solute flux from no-flow boundaries, solute entrapment in zones of low hydraulic conductivity, and occurrences of anomalous sources and sinks. In addition to inducing significant mass balance errors, such manifestations often lead to oscillations in concentration

  2. Acetabular reconstruction with human and bovine freeze-dried bone grafts and a reinforcement device

    Directory of Open Access Journals (Sweden)

    Ricardo Rosito

    2008-01-01

    Full Text Available BACKGROUND: This is a cohort trial (1997-2005 of 49 patients submitted to an acetabular component revision of a total hip arthroplasty, using impacted human and bovine freeze-dried cancellous bone grafts (H&FDBG and a reinforcement device. OBJECTIVE: To compare clinical/radiographic graft incorporation capability between cancellous bone grafts. PATIENTS/METHODS: There were two groups: I (n=26 receiving human grafts and II (n=25 receiving bovine grafts. The average follow-up times were 55 and 49 months, respectively. Clinical analysis was based on the Merle d'Aubigné and Postel score, and the radiographic analysis involved an established score based on Conn's et al. criteria for radiographic bone incorporation. RESULTS: No clinical/radiographic differences were found between the groups and both showed an overall rate of 88.5% and 76% of graft incorporation (p=0.424. CONCLUSION: The results presented here are comparable to those in the literature with the use of deep-FG. Therefore, cancellous bone grafts can be safely and adequately used in acetabular component revision in total hip arthroplasty.

  3. Acetabular Reconstruction with Human and Bovine Freeze- Dried Bone Grafts and a Reinforcement Device

    Science.gov (United States)

    Rosito, Ricardo; Galia, Carlos Roberto; Macedo, Carlos Alberto Souza; Moreira, Luis Fernando; Quaresma, Lourdes Maria Araújo C.; Palma, Humberto Moreira

    2008-01-01

    BACKGROUND This is a cohort trial (1997–2005) of 49 patients submitted to an acetabular component revision of a total hip arthroplasty, using impacted human and bovine freeze-dried cancellous bone grafts (H&FDBG) and a reinforcement device. OBJECTIVE To compare clinical/radiographic graft incorporation capability between cancellous bone grafts. PATIENTS/METHODS There were two groups: I (n=26) receiving human grafts and II (n=25) receiving bovine grafts. The average follow-up times were 55 and 49 months, respectively. Clinical analysis was based on the Merle d’Aubigné and Postel score, and the radiographic analysis involved an established score based on Conn’s et al. criteria for radiographic bone incorporation. RESULTS No clinical/radiographic differences were found between the groups and both showed an overall rate of 88.5% and 76% of graft incorporation (p=0.424). CONCLUSION The results presented here are comparable to those in the literature with the use of deep-FG. Therefore, cancellous bone grafts can be safely and adequately used in acetabular component revision in total hip arthroplasty. PMID:18719763

  4. Characterization and three-dimensional reconstruction of synthetic bone model foams

    International Nuclear Information System (INIS)

    Sawbones© open-cell foams with different porosity grades are being used as synthetic bone-like models for in vitro mechanical and infiltration experiments. However, a comprehensive characterization of these foams is not available and there is a lack of reliable information about them. For this reason two of these foams (Refs. 1522-505 and -507) have been characterized at the micro architectural level by scanning electron microscopy, computed tomography and image data analysis. BoneJ open software and ImageJ open software were used to obtain the characteristic histomorphometric parameters and the three dimensional virtual models of the foams. The results showed that both foams, while having different macro porosities, appeared undistinguishable at the micro scale. Moreover, the micro structural features resembled those of osteoporotic rather than healthy trabecular bone. It is concluded that Sawbones© foams behave reasonably as synthetic bone-like models. Consequently, their use is recommended for in vitro comparison purposes of both mechanical and infiltration testing performed in real vertebra. Finally, the virtual models obtained, which are available under request, can favour comparisons between future self-similar in vitro experiments and computer simulations. - Highlights: • Sawbones© model foams have been scanned by μ-CT. • Histomorphometric indices and 3D virtual models have been obtained. • The results will be of use to understand biocement vertebra infiltration studies

  5. Characterization and three-dimensional reconstruction of synthetic bone model foams

    Energy Technology Data Exchange (ETDEWEB)

    Gómez, S. [Interdepartment Research Group for the Applied Scientific Collaboration (IRGASC), Division of Biomaterials and Bioengineering, Technical University of Catalonia (UPC), Avda. Diagonal 647, E-08028 Barcelona (Spain); Vlad, M.D. [Interdepartment Research Group for the Applied Scientific Collaboration (IRGASC), Division of Biomaterials and Bioengineering, Technical University of Catalonia (UPC), Avda. Diagonal 647, E-08028 Barcelona (Spain); Faculty of Medical Bioengineering, “Gr. T. Popa” University of Medicine and Pharmacy, Str. Kogalniceanu 9-13, 700454 Iasi (Romania); López, J. [Interdepartment Research Group for the Applied Scientific Collaboration (IRGASC), Division of Biomaterials and Bioengineering, Technical University of Catalonia (UPC), Avda. Diagonal 647, E-08028 Barcelona (Spain); Navarro, M. [Centre de Biotecnologia Animal i de Teràpia Gènica (CBATEG), Departament de Sanitat i d' Anatomia Animals, Universitat Autònoma de Barcelona, E-08193 Bellaterra, Cerdanyola del Vallès (Spain); Fernández, E., E-mail: enrique.fernandez@upc.edu [Interdepartment Research Group for the Applied Scientific Collaboration (IRGASC), Division of Biomaterials and Bioengineering, Technical University of Catalonia (UPC), Avda. Diagonal 647, E-08028 Barcelona (Spain)

    2013-08-01

    Sawbones© open-cell foams with different porosity grades are being used as synthetic bone-like models for in vitro mechanical and infiltration experiments. However, a comprehensive characterization of these foams is not available and there is a lack of reliable information about them. For this reason two of these foams (Refs. 1522-505 and -507) have been characterized at the micro architectural level by scanning electron microscopy, computed tomography and image data analysis. BoneJ open software and ImageJ open software were used to obtain the characteristic histomorphometric parameters and the three dimensional virtual models of the foams. The results showed that both foams, while having different macro porosities, appeared undistinguishable at the micro scale. Moreover, the micro structural features resembled those of osteoporotic rather than healthy trabecular bone. It is concluded that Sawbones© foams behave reasonably as synthetic bone-like models. Consequently, their use is recommended for in vitro comparison purposes of both mechanical and infiltration testing performed in real vertebra. Finally, the virtual models obtained, which are available under request, can favour comparisons between future self-similar in vitro experiments and computer simulations. - Highlights: • Sawbones© model foams have been scanned by μ-CT. • Histomorphometric indices and 3D virtual models have been obtained. • The results will be of use to understand biocement vertebra infiltration studies.

  6. The mechanical and biological studies of calcium phosphate cement-fibrin glue for bone reconstruction of rabbit femoral defects

    Directory of Open Access Journals (Sweden)

    Dong J

    2013-03-01

    Full Text Available Jingjing Dong,1,* Geng Cui,2,* Long Bi,1,* Jie Li,3 Wei Lei11Institute of Orthopedics, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, People’s Republic of China; 2Institute of Orthopedics, General Hospital of PLA, Beijing, People’s Republic of China; 3Institute of Gynecology and Obstetrics, General Hospital of PLA, Beijing, People’s Republic of China*These authors contributed equally to this workAbstract: In order to improve the mechanical and biological properties of calcium phosphate cement (CPC, nanometer-biomaterial for bone reconstruction in the rabbit femoral defect model, fibrin glue (FG, the natural product, purified from the blood was introduced at three different ratios. The CPC powder and the FG solution were mixed, respectively, at the powder/liquid (P/L ratios (g/mL of 1:1, 3:1, and 5:1 (g/mL, and pure CPC was used as a control. After being implanted into the femoral defect in rabbit, the healing process was evaluated by micro-computed tomography scan, biomechanical testing, and histological examination. By micro-computed tomography analysis, the P/L ratio of 1:1 (g/mL group indicated the largest quantity of new bone formation at 4 weeks, 8 weeks, and 12 weeks after implantation, respectively. Bone volume per trabecular volume of the 1:1 group was highest in the four groups, which was 1.45% ± 0.42%, 7.35% ± 1.45%, and 29.10% ± 1.67% at 4 weeks, 8 weeks, and 12 weeks after the operation, respectively. In the biomechanical tests, the compressive strength and the elastic modulus of the three CPC–FG groups were much higher than those of the pure CPC group at the determined time point (P < 0.05. The histological evaluation also showed the best osseointegration in the 1:1 group at 4 weeks, 8 weeks, and 12 weeks after the operation, respectively. In the 1:1 group, the bone grew into the pore of the cement in the laminar arrangement and connected with the cement tightly at the 12th week after the operation

  7. Effect of a combination of local flap and sequential compression-distraction osteogenesis in the reconstruction of post-traumatic tibial bone and soft tissue defects

    Institute of Scientific and Technical Information of China (English)

    HU Xiao-hua; HUANG Lei; CHEN Zhong; DU Wei-li; WANG Cheng; SHEN Yu-ming

    2013-01-01

    Background Treatment of extensive post-traumatic composite bone and soft tissue defects remains a complicated therapeutic problem and a challenge for surgeons.We investigated the application of local flaps and Ilizarov osteogenesis in the reestablishment of severe combined defects of tibial bone and soft tissue.Methods Sixteen patients with bone and soft tissue defects were included.The mean age of the patients was 31.5 years.The average time from injury to initial surgery was 14.4 weeks.The average soft tissue and bone defect sizes were 92.9cm2 and 8.7 cm,respectively.Local flaps were created to reconstruct the soft tissue defects.The Ilizarov external fixator or the Orthofix Limb Reconstruction System was used to reconstruct bony defects using delayed distraction osteogenesis.Results Two myocutaneous flaps and 14 reverse island flaps were applied.All transferred flaps survived.Fifteen patients healed with equal leg length,and one healed with a residual leg-length discrepancy of 1.5 cm.One patient with an Ilizarov external fixator developed ankle joint stiffening and a pin-track infection that was successfully treated with oral antibiotics.No patient developed pin loosening.All patients walked without assistance.Fifteen patients returned to their work,and one lost her job.The results were evaluated using the Paley bone and functional assessment scores.The bone assessment results were excellent in 14 and good in two patients.Functional assessment scores were excellent in 13,good in two,and fair in one patient.Conclusion The combination of local flaps and sequential distraction osteogenesis can be used for successful reconstruction of defects of incorporated bone and soft tissue.

  8. 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)

  9. Dietary reconstruction and reservoir correction of 14C dates on bones from pagan and early Christian graves in Iceland

    DEFF Research Database (Denmark)

    Sveinbjörnsdóttir, Árný E; Heinemeier, Jan; Arneborg, Jette;

    2010-01-01

    between the excavation site and the seashore. We have radiocarbon dated 47 of these skeletons and used the carbon isotopic composition (?13C) to estimate and correct for the marine reservoir effect (the 14C difference between terrestrial and mixed marine organisms). The reservoir-corrected ages lie in the...... range of AD 780?1270 (68.2% probability). Reservoir age corrections were checked by comparing 14C dates of a horse (terrestrial diet), a dog (highly marine diet), and a human (mixed diet) from the same burial. The range in measured marine protein percentage in individual diet is from about 10% up to 55...... AD 1211. Using our dietary reconstruction, his bones were about 17% marine, which is within the range of human skeletons from the same area, and the reservoir-corrected calibrated 14C age of the skeleton is in accord with the historical date....

  10. Accuracy of fibular sectioning and insertion into a rapid-prototyped bone plate, for mandibular reconstruction using CAD-CAM technology.

    Science.gov (United States)

    Ciocca, Leonardo; Marchetti, Claudio; Mazzoni, Simona; Baldissara, Paolo; Gatto, Maria Rosaria Antonella; Cipriani, Riccardo; Scotti, Roberto; Tarsitano, Achille

    2015-01-01

    Modern techniques of mandibular reconstruction, such as CAD-CAM technology and rapid prototyping, offer new means by which reconstructive surgery can be planned to optimise aesthetic outcomes and prosthetic rehabilitation. The high degree of accuracy afforded by these approaches is principally attributable to high-precision fibular sectioning and insertion of the bone into a customised bone plate. CAD-CAM mandibular reconstruction procedures using vascularised bone free-flap transfers were performed on 10 patients with benign or malignant neoplasms. Five were not treated with the aid of CAD-CAM technology, and served as the control group. Five were scheduled for maxillofacial surgery using surgical cutting guides and customised bone plates. A generalised linear model for linear measures was used to compare the accuracy of reconstruction between the two groups. A difference, even though not significant, in the lateral shift of the mesial and distal positions of the fibular units was evident between groups. CAD-CAM-generated fibular surgical guides afford improved accuracy when used to restore native anatomy, especially in the context of mandibular arch restoration, and both operating room time and related costs are reduced during fibular sectioning. PMID:25434288

  11. Clinical Usefulness of Mandibular Reconstruction Using Custom-Made Titanium Mesh Tray and Autogenous Particulate Cancellous Bone and Marrow Harvested From Tibia and/or Ilia.

    Science.gov (United States)

    Yamada, Hiroyuki; Nakaoka, Kazutoshi; Sonoyama, Tomoo; Kumagai, Kenichi; Ikawa, Tomoko; Shigeta, Yuko; Harada, Naohiko; Kawamura, Noboru; Ogawa, Takumi; Hamada, Yoshiki

    2016-05-01

    The objective of this study was to evaluate usefulness of mandibular reconstructions using custom-made titanium mesh (Ti-mesh) tray and particulate cancellous bone and marrow (PCBM). Consecutive 21 patients who underwent mandibular reconstruction were enrolled in this study. They were 13 men and 8 women (mean age, 52.0 years). Virtual reality simulation was performed using computer software based on the preoperative computed tomography data. A 3-dimensional skull model was constructed using 3-dimensional printer. A tray was custom-made from Ti-mesh sheet bent to adapt to the model. After PCBM harvesting from posterior ilia and/or proximal tibia, the tray was fixed to the host bone. New bone formation and configuration of the reconstructed mandible were assessed radiologically. Complications were recorded in each patient during the follow-up period. Patients' satisfaction with postoperative facial contour was evaluated using visual analog scale (VAS score, range, 0-100). In 16 of 21 patients, excellent new bone formation was recognized and expected results were radiologically achieved. In 5 patients, new bone formation was insufficient. Causes of insufficient bone formation included postoperative infection in 2 patients, Ti-mesh tray fracture in 2 patients, and local recurrence of lower gingival cancer in 1 patient. To prevent a tray fracture, a double-layered Ti-mesh tray was useful. Mean VAS score on patients' satisfaction was 77.1. Our results comprehensively suggest that mandibular reconstruction using custom-made Ti-mesh tray and PCBM is clinically useful. PMID:27092909

  12. Atmospheric transport and dispersion modeling for the Hanford Environmental Dose Reconstruction Project

    International Nuclear Information System (INIS)

    Radiation doses that may have resulted from operations at the Hanford Site are being estimated in the Hanford Environmental Dose Reconstruction (HEDR) Project. One of the project subtasks, atmospheric transport, is responsible for estimating the transport, diffusion and deposition of radionuclides released to the atmosphere. This report discusses modeling transport and diffusion in the atmospheric pathway. It is divided into three major sections. The first section of the report presents the atmospheric modeling approach selected following discussion with the Technical Steering Panel that directs the HEDR Project. In addition, the section discusses the selection of the MESOI/MESORAD suite of atmospheric dispersion models that form the basis for initial calculations and future model development. The second section of the report describes alternative modeling approaches that were considered. Emphasis is placed on the family of plume and puff models that are based on Gaussian solution to the diffusion equations. The final portion of the section describes the performance of various models. The third section of the report discusses factors that bear on the selection of an atmospheric transport modeling approach for HEDR. These factors, which include the physical setting of the Hanford Site and the available meteorological data, serve as constraints on model selection. Five appendices are included in the report. 39 refs., 4 figs., 2 tabs

  13. Management of traumatic tibial diaphyseal bone defect by “induced-membrane technique”

    OpenAIRE

    Gaurav Gupta; Sohail Ahmad; Mohd. Zahid; Khan, A H.; M K A Sherwani; Abdul Qayyum Khan

    2016-01-01

    Background: Gap nonunion of long bones is a challenging problem, due to the limitation of conventional reconstructive techniques more so if associated with infection and soft tissue defect. Treatment options such as autograft with non-vascularized fibula and cancellous bone graft, vascularized bone graft, and bone transportation are highly demanding on the part of surgeons and hospital setups and have many drawbacks. This study aims to analyze the outcome of patients with wide diaphyseal bone...

  14. Evaluation of iterative reconstruction method and attenuation correction on brain dopamine transporter SPECT using anthropomorphic striatal phantom

    OpenAIRE

    Akira Maebatake; Ayaka Imamura; Yui Kodera; Yasuo Yamashita; Kazuhiko Himuro; Shingo Baba; Kenta Miwa; Masayuki Sasaki

    2016-01-01

    Objective(s): The aim of this study was to determine the optimal reconstruction parameters for iterative reconstruction in different devices and collimators for dopamine transporter (DaT) single-photon emission computed tomography (SPECT). The results were compared between filtered back projection (FBP) and different attenuation correction (AC) methods.Methods: An anthropomorphic striatal phantom was filled with 123I solutions at different striatum-to-background radioactivity ratios. Data wer...

  15. Reconstruction of Frontal Bone With Custom-Made Prosthesis Using Rapid Prototyping.

    Science.gov (United States)

    Florentino, Vinícius Gabriel Barros; Mendonça, Diego Santiago de; Bezerra, Ariel Valente; Silva, Leonardo de Freitas; Pontes, Rafael Figueirêdo; Melo, Carlos Vinícius Mota de; Mello, Manoel de Jesus Rodrigues; de Aguiar, Andréa Silvia Walter

    2016-06-01

    Frontal bone fracture treatment is still an issue of research in craniofacial surgery and neurosurgery. The aims of the treatment are to reduce the complication risks and to keep the aesthetic of the face. Before the management of this fracture type, it is necessary to consider the permanence or not of the frontal sinus function. Rapid prototyping has been an aid tool on planning and simulation of the surgical procedure, improving the diagnostic quality and the implant manufacture, beyond reducing the operative time. Among the used materials on treatment of these fractures, titanium mesh shows large versatility and ease of handling. Poly(methyl methacrylate) has been used in defects of partial thickness or irregularities on cranial surface. The aim of this study is to report a case of a patient presenting sequelae of large fracture of anterior wall of frontal bone, treated by a titanium mesh associated with the customized poly(methyl methacrylate) implant from the rapid prototyping. It could be concluded that the use of this technique showed itself effective on patient treatment, and rapid prototyping demonstrated being a valuable tool showing predictable and satisfactory results. PMID:27285896

  16. A novel technique for impaction bone grafting in acetabular reconstruction of revision total hip arthroplasty using an ex vivo compaction device

    International Nuclear Information System (INIS)

    Impaction bone grafting allows restoration of the acetabular bone stock in revision hip arthroplasty. The success of this technique depends largely on achieving adequate initial stability of the component. To obtain well-compacted, well-graded allograft aggregates, we developed an ex vivo compaction device to apply it in revision total hip arthroplasty on the acetabular side, and characterized mechanical properties and putative osteoconductivity of allograft aggregates. Morselized allograft bone chips were compacted ex vivo using the creep technique and subsequent impaction technique to form the bone aggregates. Impaction allograft reconstruction of the acetabulum using an ex vivo compaction device was performed on eight hips. The mechanical properties and three-dimensional micro-CT-based structural characteristics of the bone aggregates were investigated. In clinical practice, this technique offered good reproducibility in reconstructing the cavity and the segmental defects of the acetabulum, with no migration and no loosening of the component. In vitro analysis showed that the aggregates generated from 25 g fresh-frozen bone chips gained compression stiffness of 13.5-15.4 MPa under uniaxial consolidation strain. The recoil of the aggregates after compaction was 2.6-3.9%. The compression stiffness and the recoil did not differ significantly from those measured using a variety of proportions of large- and small-sized bone chips. Micro-CT-based structural analysis revealed average pore sizes of 268-299 μm and average throat diameter of pores in the bone aggregates of more than 100 μm. These sizes are desirable for osteoconduction, although large interconnected pores of more than 500 μm were detectable in association with the proportion of large-sized bone chips. Cement penetration into the aggregates was related to the proportion of large-sized bone chips. This study introduces the value of an ex vivo compaction device in bone graft compaction in clinical

  17. Transport simulation and image reconstruction for fast-neutron detection of explosives and narcotics

    Energy Technology Data Exchange (ETDEWEB)

    Micklich, B.J.; Fink, C.L.; Sagalovsky, L.

    1995-07-01

    Fast-neutron inspection techniques show considerable promise for explosive and narcotics detection. A key advantage of using fast neutrons is their sensitivity to low-Z elements (carbon, nitrogen, and oxygen), which are the primary constituents of these materials. We are currently investigating two interrogation methods in detail: Fast-Neutron Transmission Spectroscopy (FNTS) and Pulsed Fast-Neutron Analysis (PFNA). FNTS is being studied for explosives and narcotics detection in luggage and small containers for which the transmission ratio is greater than about 0.01. The Monte-Carlo radiation transport code MCNP is being used to simulate neutron transmission through a series of phantoms for a few (3-5) projection angles and modest (2 cm) resolution. Areal densities along projection rays are unfolded from the transmission data. Elemental abundances are obtained for individual voxels by tomographic reconstruction, and these reconstructed elemental images are combined to provide indications of the presence or absence of explosives or narcotics. PFNA techniques are being investigated for detection of narcotics in cargo containers because of the good penetration of the fast neutrons and the low attenuation of the resulting high-energy gamma-ray signatures. Analytic models and Monte-Carlo simulations are being used to explore the range of capabilities of PFNA techniques and to provide insight into systems engineering issues. Results of studies from both FNTS and PFNA techniques are presented.

  18. No red cell alloimmunization or change of clinical outcome after using fresh frozen cancellous allograft bone for acetabular reconstruction in revision hip arthroplasty: a follow up study

    Directory of Open Access Journals (Sweden)

    Mittag Falk

    2012-09-01

    Full Text Available Abstract Background Possible immunization to blood group or other antigens and subsequent inhibition of remodeling or incorporation after use of untreated human bone allograft was described previously. This study presents the immunological, clinical and radiological results of 30 patients with acetabular revisions using fresh frozen non-irradiated bone allograft. Methods AB0-incompatible (donor-recipient bone transplantation was performed in 22 cases, Rh(D incompatible transplantation in 6 cases. The mean follow up of 23 months included measuring Harris hip score and radiological examination with evaluation of remodeling of the bone graft, implant migration and heterotopic ossification. In addition, all patients were screened for alloimmunization to Rh blood group antigens. Results Compared to the whole study group, there were no differences in clinical or radiological measurements for the groups with AB0- or Rh(D-incompatible bone transplantation. The mean Harris Hip Score was 80.6. X-rays confirmed total remodeling of all allografts with no acetabular loosening. At follow up, blood tests revealed no alloimmunization to Rh blood group donor antigens. Conclusions The use of fresh frozen non-irradiated bone allograft in acetabular revision is a reliable supplement to reconstruction. The risk of alloimmunization to donor-blood group antigens after AB0- or Rh-incompatible allograft transplantation with a negative long-term influence on bone-remodeling or the clinical outcome is negligible.

  19. Early reconstruction of bone defect created after initial surgery of a large keratocystic odontogenic tumor: A case report

    Directory of Open Access Journals (Sweden)

    Matijević Stevo

    2013-01-01

    Full Text Available Introduction. Keratocystic odontogenic tumor (KCOT is defined as a benign cystic neoplasm of the jaws of odontogenic origin with a high rate of recurrence. The most lesions occur in the posterior part of the mandible. Treatment of KCOT remains controversial, but the goals of treatment should involve eliminating the potential for recurrence while minimizing surgical morbidity. However, another significant therapeutic problem related to the management of KCOT is an adequate and early reconstruction of the existing jaw defect, as well as appropriate aesthetic and functional rehabilitation of a patient, especially in cases of a very large destruction of the jaws bone. Case report. We presented a 65-year-old female patient with very large KCOT of the mandible. Orthopantomographic radiography showed a very large elliptical multilocular radiolucency, located on the right side of the mandible body and the ascending ramus of the mandible, with radiographic evidence of cortical perforation at the anterior border of the mandibular ramus and the superior border of the alveolar part of the mandible. The surgical treatment included two phases. In the first phase, the tumor was removed by enucleation and additional use of Carnoy solution, performing peripheral ostectomy and excision of the affected overlying mucosa, while in the second phase, restorative surgery of the existing mandibular defect was performed 6 months later. Postoperatively, we did not register any of postoperative complications, nor recurrence within 2 years of the follow-up. Conclusion. Adequate and early reconstruction of the existing jaw defect and appropriate aesthetic and functional rehabilitation of the patient should be the primary goal in the treatment of KCOT, having in mind the need for a long-term post-surgical follow-up.

  20. Evaluation of Medial Acetabular Wall Bone Stock in Patients with Developmental Dysplasia of the Hip Using a Helical Computed Tomography Multiplanar Reconstruction Technique

    Energy Technology Data Exchange (ETDEWEB)

    Rui Yu Liu; Kun Zheng Wang; Chun Sheng Wang; Xiao Qian Dang; Zhi Qin Tong (Second Hospital Affiliated to the Medical College of Xi' an Jiaotong Univ., Xi' an Shaanxi (China))

    2009-08-15

    Background: The technique of medialization has been used to reconstruct acetabula at the level of true acetabula in total hip arthroplasty (THA) in patients with developmental dysplasia of the hip (DDH). Appreciation of the bone stock in the medial acetabular wall is significant for making an optimal acetabular reconstruction plan and avoiding complications. Purpose: To evaluate the bone stock of the medial acetabular wall and its relation to the degree of subluxation in patients with DDH using computed tomography (CT). Material and Methods: Helical CT scans of 27 hips were obtained from 21 patients with osteoarthritis secondary to DDH who were scheduled for total hip arthroplasty. Eleven hips belonged to Crowe class I, while 16 hips belonged to Crowe class II/III. The raw CT data were reprocessed in various planes by scrolling multiplanar reformation (MPR). Acetabular opening, depth, and medial bone stock, as indicated by the minimum thickness of the medial acetabular wall, were measured in the transverse reformed MPR plane. Results: The minimum thicknesses of the medial acetabular wall in Crowe-I and Crowe-II/III hips were 3.8+-2.1 mm and 7.1+-3.1 mm, respectively, with statistically significant differences between the groups (P<0.05). Furthermore, the bone stock in the medial acetabular wall correlated with the degree of subluxation (R=0.69) and the acetabular depth (R= ;- ;0.71). Conclusion: There was significantly more bone stock in the medial acetabular wall in patients with higher-degree subluxation than there was in the less-severe class. This difference should be taken into consideration when reconstructing acetabula in THA in patients with DDH using the technique of medialization

  1. COMPARATIVE STUDY OF INTRA OSSEOUS WIRING, MINIPLATE OSTEOSYNTHESIS AND RECONSTRUCTION PLATE WITH BONE GRAFT IN THE METHOD OF TREATMENT FOR MANDIBULAR FRACTURE

    Directory of Open Access Journals (Sweden)

    Asok Kumar

    2015-08-01

    Full Text Available The mandible or lower jaw is one of the most commonly encountered maxillo facial fractures in our clinical practice. Un - displaced, single and closed fractures are usually managed by closed method with maxillo - mandibular fixation (MMF. Displaced open and multiple fractures are treated by open reduction and internal fixation (ORIF. Displaced, open and multiple fractures are treated by ORIF by various methods like intraosseus wiring, miniplate osteosynthesis an d reconstruction plate with bone graft. Present study is done to evaluate these three methods of ORIF and their post - operative outcome. Our study material comprises 72 cases of isolated mandibular fracture of adult patient. All these patients are treated b y ORIF by either of the three above methods. These patients are divided into three groups. Group A includes 18 cases treated by intra osseous wiring and post - operative maxillo mandibular immobilization for 4 weeks. Group B includes 38 cases treated with si ngle or double miniplate and no post - operative immobilization. Group C includes 11 cases treated by reconstruction plate with bone graft along with miniplate in patients having bone loss or gap fractures. The surgical outcome based on parameters such as ma locclusion, intra oral exposure of plate, wound dehiscence, delayed union, plate fracture, non - union and sensory deficit are compared at 4 - 6 weeks after operation among the three groups and patients are followed up every three months interval. The results are statistically analysed and it is concluded that the use of miniplate gives better result in comparison to intra osseous wiring. In cases of bone loss or gap fracture reconstruction plate and bone graft along with miniplate are effective

  2. A novel silk–TCP–PEEK construct for anterior cruciate ligament reconstruction: an off-the shelf alternative to a bone–tendon–bone autograft

    International Nuclear Information System (INIS)

    Bone–tendon–bone autograft represents a gold-standard for anterior cruciate ligament (ACL) reconstruction but at the cost of a secondary surgical site that can be accompanied by functional impairment and discomfort. Although numerous in vitro and in vivo studies have investigated tissue engineering alternatives to autografting, the achievement of a functional histological transition between soft and hard tissue has remained elusive. To bridge this gap we developed and tested a novel multiphase scaffold of silk, tricalcium phosphate (TCP) and polyether ether ketone for ACL reconstruction. We present in vitro biomechanical tests demonstrating that the construct recapitulates native ACL function under typical physiological loads. A pilot in vivo experiment in two pigs with a three-month follow-up showed a robust histological transition between regenerated fibrous tissue and the margins of the bone tunnel, with histological features similar to the native ACL to bone insertion. These histological observations suggest that the construct was stably anchored until TCP incorporation to the host tissues. On the strength of these preliminary results, we conclude that the described approach may offer a promising alternative to autograft for ACL reconstruction. This study thus provides proof for a concept that warrants further development. (paper)

  3. Regional Atmospheric Transport Code for Hanford Emission Tracking (RATCHET). Hanford Environmental Dose Reconstruction Project

    Energy Technology Data Exchange (ETDEWEB)

    Ramsdell, J.V. Jr.; Simonen, C.A.; Burk, K.W.

    1994-02-01

    The purpose of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate radiation doses that individuals may have received from operations at the Hanford Site since 1944. This report deals specifically with the atmospheric transport model, Regional Atmospheric Transport Code for Hanford Emission Tracking (RATCHET). RATCHET is a major rework of the MESOILT2 model used in the first phase of the HEDR Project; only the bookkeeping framework escaped major changes. Changes to the code include (1) significant changes in the representation of atmospheric processes and (2) incorporation of Monte Carlo methods for representing uncertainty in input data, model parameters, and coefficients. To a large extent, the revisions to the model are based on recommendations of a peer working group that met in March 1991. Technical bases for other portions of the atmospheric transport model are addressed in two other documents. This report has three major sections: a description of the model, a user`s guide, and a programmer`s guide. These sections discuss RATCHET from three different perspectives. The first provides a technical description of the code with emphasis on details such as the representation of the model domain, the data required by the model, and the equations used to make the model calculations. The technical description is followed by a user`s guide to the model with emphasis on running the code. The user`s guide contains information about the model input and output. The third section is a programmer`s guide to the code. It discusses the hardware and software required to run the code. The programmer`s guide also discusses program structure and each of the program elements.

  4. Management of infected non-union tibia by intercalary bone transport

    International Nuclear Information System (INIS)

    To evaluate the efficacy of ilizarov ring fixator in treating infected non-union tibia by intercalary bone transport. Sixteen patients, all males, aged 20-60 years (mean 32 years), with infected non-union tibia (Lax/Cierney Type IV Osteomyelitis); the commonest cause being open fracture and the commonest site being lower 1/3rd. In infected non-union of tibia with draining sinus, wound swab was sent for culture and sensitivity, and sinogram done. Debridement and sequestrectomy was done, leaving behind a gap ranging from 2-8 cms (mean 4.5 cms) and ilizarov ring fixator, a transport assembly, applied. A navigation wire was passed through medial malleolus, irrigation system set up and the wound closed in a single layer. Proximal metaphyseal corticotomy was done. Irrigation with 2-3 litres of normal saline with appropriate antibiotic was continued for five days. On the 5th day irrigation system was removed and the transport started. Patients remained on partial weight bearing till soft tissue healing occured. Transport took place over the navigation wire at the rate of 1mm/day till docking achieved. Full weight bearing was allowed after soft tissue healing; knee and ankle physiotherapy was started from day one. Navigation wire was removed after 2-3 weeks of docking. Follow up ranged from 12-27 months (mean 16 months). Union was achieved at the docking site in all the cases at the time of frame removal i.e. 8-13 months. The duration of union at docking site ranged from 3.5 months to 6 months (mean 4.5 months). Two patients needed bone graft at the docking site. The regenerate was broken in one case due to fall which was treated in cast. All the patients were satisfied except a 60 years old who had severe osteoarthritis of knee. Pin tract infection occurred on and off in all the patients; appropriate antibiotic was given. The infection subsided in all the cases except two in whom debridement was followed by application of a local flap. Intercalary bone transport by

  5. Inverse modelling-based reconstruction of the Chernobyl source term available for long-range transport

    Directory of Open Access Journals (Sweden)

    X. Davoine

    2007-01-01

    Full Text Available The reconstruction of the Chernobyl accident source term has been previously carried out using core inventories, but also back and forth confrontations between model simulations and activity concentration or deposited activity measurements. The approach presented in this paper is based on inverse modelling techniques. It relies both on the activity concentration measurements and on the adjoint of a chemistry-transport model. The location of the release is assumed to be known, and one is looking for a source term available for long-range transport that depends both on time and altitude. The method relies on the maximum entropy on the mean principle and exploits source positivity. The inversion results are mainly sensitive to two tuning parameters, a mass scale and the scale of the prior errors in the inversion. To overcome this hardship, we resort to the statistical L-curve method to estimate balanced values for these two parameters. Once this is done, many of the retrieved features of the source are robust within a reasonable range of parameter values. Our results favour the acknowledged three-step scenario, with a strong initial release (26 to 27 April, followed by a weak emission period of four days (28 April–1 May and again a release, longer but less intense than the initial one (2 May–6 May. The retrieved quantities of iodine-131, caesium-134 and caesium-137 that have been released are in good agreement with the latest reported estimations. Yet, a stronger apportionment of the total released activity is ascribed to the first period and less to the third one. Finer chronological details are obtained, such as a sequence of eruptive episodes in the first two days, likely related to the modulation of the boundary layer diurnal cycle. In addition, the first two-day release surges are found to have effectively reached an altitude up to the top of the domain (5000 m.

  6. Biomechanical characteristics of regenerated cortical bone in the canine mandible

    OpenAIRE

    Zapata, Uriel; Opperman, Lynne A.; Kontogiorgos, Elias; Elsalanty, Mohammed E.; Dechow, Paul C.

    2011-01-01

    To test the mechanical properties of regenerate cortical bone created using Mandibular Bone Transport (MBT) distraction, five adult male American foxhound dogs underwent unilateral distraction of the mandible with a novel MBT device placed to linearly repair a 30-35 mm bone defect. The animals were sacrificed 12 weeks after the beginning of the consolidation period. Fourteen cylindrical specimens were taken from the inner (lingual) and outer (buccal) plates of the reconstructed mandible and 2...

  7. Fully automated, high speed, tomographic phase object reconstruction using the transport of intensity equation in transmission and reflection configurations.

    Science.gov (United States)

    Nguyen, Thanh; Nehmetallah, George; Tran, Dat; Darudi, Ahmad; Soltani, Peyman

    2015-12-10

    While traditional transport of intensity equation (TIE) based phase retrieval of a phase object is performed through axial translation of the CCD, in this work a tunable lens TIE is employed in both transmission and reflection configurations. These configurations are extended to a 360° tomographic 3D reconstruction through multiple illuminations from different angles by a custom fabricated rotating assembly of the phase object. Synchronization circuitry is developed to control the CCD camera and the Arduino board, which in its turn controls the tunable lens and the stepper motor to automate the tomographic reconstruction process. Finally, a MATLAB based user friendly graphical user interface is developed to control the whole system and perform tomographic reconstruction using both multiplicative and inverse radon based techniques. PMID:26836869

  8. The strain at bone-implant interface determines the effect of spinopelvic reconstruction following total sacrectomy: a strain gauge analysis in various spinopelvic constructs.

    Directory of Open Access Journals (Sweden)

    Yan Yu

    Full Text Available PURPOSE: There is still some controversy regarding the optimal biomechanical concept for spinopelvic stabilization following total sacrectomy for malignancy. Strains at specific anatomical sites at pelvis/sacrum and implants interfaces have been poorly investigated. Herein, we compared and analyzed the strains applied at key points at the bone-implant interface in four different spinopelvic constructs following total sacrectomy; consequently, we defined a balanced architecture for spinopelvic fusion in that situation. METHODS: Six human cadaveric specimens, from second lumbar vertebra to proximal femur, were used to compare the partial strains at specific sites in a total sacrectomy model. Test constructs included: (1 intact pelvis (control, (2 sacral-rod reconstruction (SRR, (3 bilateral fibular flap reconstruction (BFFR, (4 four-rods reconstruction (FRR, and (5 improved compound reconstruction (ICR. Strains were measured by bonded strain gauges onto the surface of three specific sites (pubic rami, arcuate lines, and posterior spinal rods under a 500 N axial load. RESULTS: ICR caused lower strains at specific sites and, moreover, on stress distribution and symmetry, compared to the other three constructs. Strains at pubic rami and arcuate lines following BFFR were lower than those following SRR, but higher at the posterior spinal rod construct. The different modes of strain distribution reflected different patient's parameter-related conditions. FRR model showed the highest strains at all sites because of the lack of an anterior bracing frame. CONCLUSIONS: The findings of this investigation suggest that both anterior bracing frame and the four-rods load dispersion provide significant load sharing. Additionally, these two constructs decrease the peak strains at bone-implant interface, thus determining the theoretical surgical technique to achieve optimal stress dispersion and balance for spinopelvic reconstruction in early postoperative period

  9. Evaluation of Short Term Outcomes of Transportal Femoral Cross Pin Fixation in Anterior Cruciate Ligament Reconstruction

    OpenAIRE

    Zehir, Sinan; Şahin, Ercan; Çalbıyık, Murat; Kalem, Mahmut; İpek, Deniz; Songür, Murat

    2014-01-01

    Objectives: Many fixation techniques are currently in use for femoral side graft fixation at ACL reconstruction surgery. Short term success following ACL reconstruction highly depends on fixation strength of the graft. In this study we report short term results of anterior cruciate ligament reconstruction using double hamstring tendon autograft using double cross pin for femoral tunnel fixation. Methods: Between years 2009 and 2013, 51 male adult anterior cruciate ligament injury cases treate...

  10. Evaluation of a radiation transport modeling method for radioactive bone cement

    Energy Technology Data Exchange (ETDEWEB)

    Kaneko, T S [Department of Radiological Sciences, B170 Med Sci I, University of California, Irvine, CA 92697 (United States); Sehgal, V; Al-Ghazi, M S A L; Ramisinghani, N S [Department of Radiation Oncology, University of California Irvine Medical Center, Orange, CA 92868 (United States); Skinner, H B [St Jude Heritage Medical Group, Fullerton, CA 92835 (United States); Keyak, J H [Departments of Radiological Sciences, Biomedical Engineering, and Mechanical Engineering, University of California, Irvine, CA 92697 (United States)], E-mail: tkaneko@uci.edu

    2010-05-07

    Spinal metastases are a common and serious manifestation of cancer, and are often treated with vertebroplasty/kyphoplasty followed by external beam radiation therapy (EBRT). As an alternative, we have introduced radioactive bone cement, i.e. bone cement incorporated with a radionuclide. In this study, we present a Monte Carlo radiation transport modeling method to calculate dose distributions within vertebrae containing radioactive cement. Model accuracy was evaluated by comparing model-predicted depth-dose curves to those measured experimentally in eight cadaveric vertebrae using radiochromic film. The high-gradient regions of the depth-dose curves differed by radial distances of 0.3-0.9 mm, an improvement over EBRT dosimetry accuracy. The low-gradient regions differed by 0.033-0.055 Gy/h/mCi, which may be important in situations involving prior spinal cord irradiation. Using a more rigorous evaluation of model accuracy, four models predicted the measured dose distribution within the experimental uncertainty, as represented by the 95% confidence interval of the measured log-linear depth-dose curve. The remaining four models required modification to account for marrow lost from the vertebrae during specimen preparation. However, the accuracy of the modified model results indicated that, when this source of uncertainty is accounted for, this modeling method can be used to predict dose distributions in vertebrae containing radioactive cement.

  11. Experimental study on mechanical and biomechanical reconstruction of bone defect of long bone near joint%长骨近关节端骨缺损的力学和生物力学结构重建

    Institute of Scientific and Technical Information of China (English)

    胡春明; 张伟; 苏云; 王成学; 徐莘香; 卢宝顺

    2005-01-01

    reconstruction methods.DESIGN: A completely randomized experiment with self-control and mutual control.SETTING: Laboratory for Experimental Animals, First Hospital of Jilin University.MATERIALS: Twelve healthy adult hybrid dogs, 5 males and 7 females weighing 12 to 18 kg, were recruited.METHODS: The bone defects near joints were established in upper femoral condyle in the 12 dogs, which were reconstructed by 3 operation styles: only filling with bone cement, filling with bone cement + autogenous ilium bone graft, and filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate. There was one dog in each method. The specimens were harvested at the end of weeks 3, 6, 12and 24, respectively, after operation. One week before specimens were harvested the fluorescent labeling was prepared; we conducted vascular perfusion of disulphine blue before the animals were executed.MAIN OUTCOME MEASURES: A series of examinations were carried out, including X-ray film, biomechanical test, intravascular perfusion and tetracycline fluorescent labeling. The bone healing, blood supply recovery and biomechanics were observed in the three groups.RESULTS: The 12 dogs all entered the result analysis. ① Results of Xray examination: Two cases of fracture occurred in experimental side at 6and 12 weeks in group Ⅰ; one case of fracture occurred in experimental side at 6 weeks in group Ⅱ. No fracture happened in group Ⅲ. ② Bone stiffness assayed with biomechanics: It decreased in experimental side as compared to control side by 67% and 70% in group Ⅰ; 66%, 76% and 46% in group Ⅱ; and 8% in group Ⅲ. ③ Specimen observation after operation: Bone formation, callus, and blood supply recovery were significantly better in group Ⅲ than in groups Ⅰ and Ⅱ at all stages.CONCLUSION: The third operation, filling with bone cement + autogenous ilium bone graft + fixation with L-trapezoid compression plate, is an ideal method of bone reconstruction. It can

  12. Outcome of revision total knee arthroplasty with the use of trabecular metal cone for reconstruction of severe bone loss at the proximal tibia

    DEFF Research Database (Denmark)

    Jensen, Claus L; Olsen, Nikolaj Winther; Schrøder, Henrik M; Petersen, Michael M

    2014-01-01

    technology (TMT) cones for the reconstruction of tibial bone loss at the time of rTKA. METHODS: Thirty-six patients had rTKA with the use of a TMT Cone. Bone loss was classified according to the AORI classification and 25% of the patients suffered from T3 AORI defects and 75% of the patients from T2 AORI...... from 42 to 77 points (p<0.0005) and 19 to 63 points (p<0.0005) respectively. Twenty-seven patients (follow-up 44 months (range 12-72 months)) showed no signs of radiological loosening of rTKA components. CONCLUSION: Based on our study, it was concluded that the use of TMT Cones provided an effective...

  13. Bolt from the Blue: A Large Foreign Body in the Maxillary Antrum Necessitating Delayed Primary Reconstruction with Split Cranial Bone Graft.

    Science.gov (United States)

    Sharma, Ramesh K; Vemula, Guru Karna; John, Jerry R

    2016-09-01

    We report an unusual case of a large metallic foreign body embedded in the maxillary antrum leading to extensive bony destruction of the mid-face following a road side accident in a 12-year-old boy. There was extensive bony loss that necessitated reconstruction for both aesthetic and functional reasons. The same was accomplished by using split cranial bone graft in a delayed primary manner after a gap of 7 days following initial debridement. There was primary healing with good aesthetic and functional results. PMID:27516840

  14. Experimental evaluation of the 'transport-of-intensity' equation for magnetic phase reconstruction in Lorentz transmission electron microscopy.

    Science.gov (United States)

    Kohn, Amit; Habibi, Avihay; Mayo, Martin

    2016-01-01

    The 'transport-of-intensity' equation (TIE) is a general phase reconstruction methodology that can be applied to Lorentz transmission electron microscopy (TEM) through the use of Fresnel-contrast (defocused) images. We present an experimental study to test the application of the TIE for quantitative magnetic mapping in Lorentz TEM without aberration correction by examining sub-micrometer sized Ni80Fe20 (Permalloy) elements. For a JEOL JEM 2100F adapted for Lorentz microscopy, we find that quantitative magnetic phase reconstructions are possible for defoci distances ranging between approximately 200 μm and 800 μm. The lower limit originates from competing sources of image intensity variations in Fresnel-contrast images, namely structural defects and diffraction contrast. The upper defocus limit is due to a numerical error in the estimation of the intensity derivative based on three images. For magnetic domains, we show quantitative reconstructions of the product of the magnetic induction vector and thickness in element sizes down to approximately 100 nm in lateral size and 5 nm thick resulting in a minimal detection of 5Tnm. Three types of magnetic structures are tested in terms of phase reconstruction: vortex cores, domain walls, and element edges. We quantify vortex core structures at a diameter of 12 nm while the structures of domain walls and element edges are characterized qualitatively. Finally, we show by image simulations that the conclusions of this experimental study are relevant to other Lorentz TEM in which spherical aberration and defocus are dominant aberrations. PMID:26452194

  15. Enhanced reconstruction of long bone architecture by a growth factor mutant combining positive features of GDF-5 and BMP-2.

    Science.gov (United States)

    Kleinschmidt, Kerstin; Ploeger, Frank; Nickel, Joachim; Glockenmeier, Julia; Kunz, Pierre; Richter, Wiltrud

    2013-08-01

    Non healing bone defects remain a worldwide health problem and still only few osteoinductive growth factors are available for clinical use in bone regeneration. By introducing BMP-2 residues into growth and differentiation factor (GDF)-5 we recently produced a mutant GDF-5 protein BB-1 which enhanced heterotopic bone formation in mice. Designed to combine positive features of GDF-5 and BMP-2, we suspected that this new growth factor variant may improve long bone healing compared to the parent molecules and intended to unravel functional mechanisms behind its action. BB-1 acquired an increased binding affinity to the BMP-IA receptor, mediated enhanced osteogenic induction of human mesenchymal stem cells versus GDF-5 and higher VEGF secretion than BMP-2 in vitro. Rabbit radius defects treated with a BB-1-coated collagen carrier healed earlier and with increased bone volume compared to BMP-2 and GDF-5 according to in vivo micro-CT follow-up. While BMP-2 callus often remained spongy, BB-1 supported earlier corticalis and marrow cavity formation, showing no pseudojoint persistence like with GDF-5. Thus, by combining positive angiogenic and osteogenic features of GDF-5 and BMP-2, only BB-1 restored a natural bone architecture within 12 weeks, rendering this promising growth factor variant especially promising for long bone regeneration. PMID:23680368

  16. The use of a modular titanium endoprosthesis in skeletal reconstructions after bone tumor resections: method presentation and analysis of 37 cases

    Directory of Open Access Journals (Sweden)

    Croci Alberto Tesconi

    2000-01-01

    Full Text Available We analyzed 37 patients who underwent segmental wide resection of bone tumors and reconstruction with a modular titanium endoprosthesis at the Orthopaedic Oncology Group, between 1992 and 1998. Twelve patients were male and 25 were female, with a mean age of 30 years (9 - 81. The mean follow-up was 14 months (2 - 48. The diagnoses were: osteosarcoma (14 cases, metastatic carcinoma (10, Ewing's sarcoma (4, giant cell tumor (4, malignant fibrous histiocytoma (3, chondrosarcoma (1, and aneurysmal bone cyst (1. Eleven articulated total knee, 8 partial proximal femur with bipolar acetabulum, 8 partial proximal humerus, 3 total femur, 2 partial proximal tibia, 2 diaphyseal femur, 2 diaphyseal humerus, and 1 total proximal femur with cementless acetabulum endoprosthesis implant procedures were done. The complications related to the procedure included: infection (5 cases, dislocation (3, module loosening (1, and ulnar nerve paresthesia (1. We used the following criteria for the clinical evaluation: presence of pain, range of motion, reconstruction stability, surgical and oncologic complications, and patient acceptance. The results were good in 56.8% of the cases, regular in 32.4% and poor in 10.8%.

  17. Reconstrucción alveolar de maxilar atrófico con injerto de calota craneal: A propósito de dos casos Alveolar bone reconstruction of atrophic maxilla with calvarial bone graft: Two case reports

    Directory of Open Access Journals (Sweden)

    A. Modelo Pérez

    2009-12-01

    Full Text Available La atrofia alveolar del maxilar superior es un reto difícil de solventar en la práctica clínica para la rehabilitación dental sobre implantes. Existen varios métodos de reconstrucción con dicha finalidad. Aunque la elección del método depende de varios factores, de los más importantes son la cantidad de hueso remanente y los deseos del paciente. Presentamos dos casos en los que hemos efectuado la rehabilitación prostodóncica sobre implantes MG Osseous, no removible en uno y removible en el otro. Previa a la colocación de los implantes se llevó a cabo la reconstrucción alveolar con injerto óseo de calota craneal.The alveolar atrophy of superior maxilla is a difficult challenge to resolve in clinical practice for the dental rehabilitation on implants. There are several methods of reconstruction with this purpose. Although the election of the method depends on several factors, most importantly the amount of bone surplus and the desires patient´s. We presented/displayed two cases in which we have carried out the prosthodontist rehabilitation on implants MG Osseous, nonremovable in one and removable in the other. Previous to the positioning of the implants alveolar reconstruction was carried out with calvarial bone graft.

  18. Long Term Behavior of Pedicled Vascularized Fibular Grafts in Reconstruction of Middle and Distal Tibia after Resection of Malignant Bone Tumors

    International Nuclear Information System (INIS)

    Objectives: The aim of this study was to evaluate the long term behavior of pedicled vascualrized fibula graft in reconstruction of middle and distal tibia defects following malignant tumor resection with particular emphasis on success in limb salvage and the specific late related complications. Patients and Methods: Between 1997 and 2006, 16 patients having malignant bone tumors of the middle tibia (10 cases) and distal tibia (6 cases) were candidate for wide resection of their tumors and reconstruction of the bony defect by ipsilateral vascularized pedicled fibular graft based on the peroneal vessels. There were 9 males and 7 females with a mean age of 13 years at time of surgery (range 11-23 years). Mean follow up period was 52 months (range 32 -110 months). Fixation was done by cast in 14 cases and by plate and screws in 2 patients. According to the Enneking staging system (1), 9 patients had stage IIB and 7 had stage IIA. Bony union and hypertrophy were assessed radio graphically on regular basis. Hypertrophy was estimated in a percentage. Functional limb results were also reported according to MSTS functional scores [2]. Results: The mean length of bony gap bridged was 14 cm (range of 11.0-16.0 cm) and the mean length of fibula harvested was 15.5 cm (range 12-17 cm). Ninety seven percent of patients (15 cases) healed primarily at a mean time of 4.8 months (range 3.5-6 months). Hypertrophy was evident in all patients and ranged from 60 to 210% (mean 91%). Increase in size of the hypertrophied fibula beyond the recipient bone was noticed in three cases (18.7%) and we relate this to weight-bearing forces and not to the size of the recipient bone. The mean time of the fibula to double its size (10 cases) was 21 months (range 18-31 months). Young patients developed full hypertrophy earlier than older patients. Complication rate was low. One patient had non union at the proximal end of the fibulotibial junction and two patients had stress fracture of the fibula

  19. Palaeodiet reconstruction in a woman with probable celiac disease: a stable isotope analysis of bone remains from the archaeological site of Cosa (Italy).

    Science.gov (United States)

    Scorrano, Gabriele; Brilli, Mauro; Martínez-Labarga, Cristina; Giustini, Francesca; Pacciani, Elsa; Chilleri, Filberto; Scaldaferri, Franco; Gasbarrini, Antonio; Gasbarrini, Giovanni; Rickards, Olga

    2014-07-01

    Stable isotope analysis in the reconstruction of human palaeodiets can yield clues to early human subsistence strategies, origins and history of farming and pastoralist societies, and intra- and intergroup social differentiation. In the last 10 years, the method has been extended to the pathological investigation. Stable isotope analysis to better understand a diet-related disease: celiac disease in ancient human bones was carried out. To do this, we analyzed the nitrogen and carbon isotopic composition of human (n = 37) and faunal (n = 8) bone remains from the archaeological site of Cosa at Ansedonia, on the Tyrrhenian coast near Orbetello (Tuscany), including the skeletal remains of a young woman (late 1st century-early 2nd century Common Era [CE]) with morphological and genetic features suggestive of celiac disease. We compared the young woman's isotopic data with those of other individuals recovered at the same site but from two later time periods (6th century CE; 11-12th century CE) and with literature data from other Italian archaeological sites dating to the same period. Her collagen δ(13) C and δ(15) N values differed from those of the samples at the same site, and from most but not all of the contemporary sites. Although the woman's diet appears distinct, chronic malnutrition resulting from severe malabsorption of essential nutrients due to celiac disease may have affected the isotopic composition of her bone collagen. PMID:24706415

  20. Characterization, Reconstruction and Transport Properties of Vosges Sandstones Caractérisation, reconstruction et propriétés de transport des grès des Vosges

    Directory of Open Access Journals (Sweden)

    Moulu J.-C.

    2006-11-01

    Full Text Available A thorough study of Vosges sandstone samples is presented in this work. First, the geometry of these porous media is analyzed using serial thin sections. Then, random numerical samples are reconstructed according to the measured statistical geometrical parameters. Finally, the macroscopic transport properties are determined from the numerical solutions in the reconstructed samples of the local equations governing the corresponding transport phenomena and compared to available experimental data. Mercury intrusion in the simulated media is modelled and pore size distribution results are compared with those obtained from serial tomography. Dans cet article, nous présentons une étude approfondie d'échantillons de grès des Vosges. La géométrie de ces milieux est analysée en utilisant des coupes sériées. Puis des échantillons aléatoires sont reconstruits en accord avec les propriétés géométriques statistiques mesurées. Enfin, les propriétés macroscopiques de transport sont déduites des solutions numériques dans les échantillons reconstruits des équations locales qui régissent les transports correspondants, et elles sont comparées aux mesures disponibles. La pénétration de mercure dans les échantillons est modélisée et les résultats relatifs aux distributions de pores sont comparés à ceux obtenus sur les coupes sériées.

  1. Vacancy Defect Reconstruction and its Effect on Electron Transport in Si-C Nanotubes

    Directory of Open Access Journals (Sweden)

    S. Choudhary

    2011-01-01

    Full Text Available We investigate the vacancy defect reconstruction and its effect on I-V characteristics in a (4, 0 zigzag and (5, 5 armchair silicon-carbide nanotubes (SiCNTs by applying self consistent non-equilibrium Green’s function formalism in combination with the density-functional theory to a two probe molecular junction constructed from SiCNTs. The results show that single vacancies and di-vacancies in SiCNTs have different reconstructions. A single vacancy when optimized, reconstructs into a 5-1DB configuration in both zigzag and armchair SiCNTs, and a di-vacancy reconstructs into a 5-8-5 configuration in zigzag and into a 5-2DB configuration in armchair SiCNTs. Introduction of vacancy increases the band gap of (4, 0 metallic SiCNT and decreases the bandgap of (5, 5 semiconducting SiCNT, bias voltage dependent current characteristic show reduction in overall current in metallic SiCNT and an increase in overall current in semiconducting SiCNT.

  2. Modeling fluorescence recovery after photobleaching in loaded bone: potential applications in measuring fluid and solute transport in the osteocytic lacunar-canalicular system.

    Science.gov (United States)

    Zhou, Xiaozhou; Novotny, John E; Wang, Liyun

    2008-12-01

    Solute transport through the bone lacunar-canalicular system is essential for osteocyte viability and function, and it can be measured using fluorescence recovery after photobleaching (FRAP). The mathematical model developed here aims to analyze solute transport during FRAP in mechanically loaded bone. Combining both whole bone-level poroelasticity and cellular-level solute transport, we found that load-induced solute transport during FRAP is characterized by an exponential recovery rate, which is determined by the dimensionless Strouhal (St) number that characterizes the oscillation effects over the mean flows, and that significant transport occurs only for St values below a threshold, when the solute stroke displacement exceeds the distance between the source and sink (the canalicular length). This threshold mechanism explains the general flow behaviors such as increasing transport with increasing magnitude and decreasing frequency. Mechanical loading is predicted to enhance transport of all tracers relative to diffusion, with the greatest enhancement for medium-sized tracers and less enhancement for small and large tracers. This study provides guidelines for future FRAP experiments, based on which the model can be used to quantify bone permeability, solute-matrix interaction, and flow velocities. These studies should provide insights into bone adaptation and metabolism, and help to treat various bone diseases and conditions. PMID:18810639

  3. Reconstruction of 131I radioactive contamination in Ukraine caused by the Chernobyl accident using atmospheric transport modelling

    International Nuclear Information System (INIS)

    The evaluation of 131I air and ground contamination field formation in the territory of Ukraine was made using the model of atmospheric transport LEDI (Lagrangian-Eulerian DIffusion model). The 131I atmospheric transport over the territory of Ukraine was simulated during the first 12 days after the accident (from 26 April to 7 May 1986) using real aerological information and rain measurement network data. The airborne 131I concentration and ground deposition fields were calculated as the database for subsequent thyroid dose reconstruction for inhabitants of radioactive contaminated regions. The small-scale deposition field variability is assessed using data of 137Cs detailed measurements in the territory of Ukraine. The obtained results are compared with available data of radioiodine daily deposition measurements made at the network of meteorological stations in Ukraine and data of the assessments of 131I soil contamination obtained from the 129I measurements

  4. Reconstruction of (131)I radioactive contamination in Ukraine caused by the Chernobyl accident using atmospheric transport modelling.

    Science.gov (United States)

    Talerko, Nikolai

    2005-01-01

    The evaluation of (131)I air and ground contamination field formation in the territory of Ukraine was made using the model of atmospheric transport LEDI (Lagrangian-Eulerian DIffusion model). The (131)I atmospheric transport over the territory of Ukraine was simulated during the first 12 days after the accident (from 26 April to 7 May 1986) using real aerological information and rain measurement network data. The airborne (131)I concentration and ground deposition fields were calculated as the database for subsequent thyroid dose reconstruction for inhabitants of radioactive contaminated regions. The small-scale deposition field variability is assessed using data of (137)Cs detailed measurements in the territory of Ukraine. The obtained results are compared with available data of radioiodine daily deposition measurements made at the network of meteorological stations in Ukraine and data of the assessments of (131)I soil contamination obtained from the (129)I measurements. PMID:16024139

  5. Arthroscopic reconstruction of the posterior cruciate ligament. MR studies for bone tunnel positioning and comparison with physical findings

    International Nuclear Information System (INIS)

    The success of arthroscopic cruciate ligament construction depends on several factors., such as patient selection, current surgical execution and postoperative rehabilitation. Technical considerations include graft choice, positioning, fixations, intercondylar notch enlargement, and new ligament tensioning. Graft acceptance is effected by all these factors. Tunnel position is of great importance both for bio mechanical reasons and optimal function of the new ligament, and to avoid stress, friction, abnormal strain, and/or damage to the reconstructed ligament. Many orthopedic and radiographic literature studies discuss the exact site of anterior cruciate ligament insertion for the best possible anatomical reconstruction, In contrast, the debate over the insertional area and anatomical landmarks is open for the posterior cruciate ligament (PCL), because of the difficult execution of this type of reconstruction and the smaller number of candidate

  6. Bone transportion by composite external fixator on refractory chronic osteomyelitis of femur%组合式外固定架骨搬运术治疗难治性股骨慢性骨髓炎疗效评价

    Institute of Scientific and Technical Information of China (English)

    海国栋; 张春雷

    2014-01-01

    Objective To evaluate the clinical effect of bone transport by composite external fixator on chronic osteomyelitis of femur. Methods Thirteen patients with bone defect of femur after chronic osteomyelitis were treated by bone transport with composite external fixator. The mean length of the bone defect was 8. 7 cm. Results All patients were followed up for 21-32 months. The bone lengthening area grew well,the length of callus distraction was 6. 8~14. 5 cm,and the mean radiographic con-solidation index was 19. 7 d/cm. According to the Paley’s criteria,the healing effect of 10 cases was excellent,and that of the rest 3 cases was good. The functional recovery of 9 cases was excellent,and that of the rest 4 cases was good. Conclusion Bone trans-port by composite external fixator is a reliable method in the reconstruction of bone defect caused by chronic osteomyelitis.%目的:评价应用组合式外固定架骨搬运术治疗股骨慢性骨髓炎的临床疗效。方法应用组合式外固定架骨搬运技术治疗13例股骨慢性骨髓炎清除后骨缺损,平均骨缺损长度8.7 cm。结果随访21~32个月,骨缺损接触并全部愈合,骨延长区骨生长满意,切口一期愈合,窦道和骨外露消失。骨延长6.8~14.5 cm,平均外固定指数19.7 d/cm。依据Paley 的评定标准进行骨愈合评定,优为11例,良为2例;功能评定优为9例,良为4例。结论组合式外固定架骨搬运术是治疗难治性股骨慢性骨髓炎可靠方法。

  7. Transport Properties of Stochastically Reconstructed Porous Media with Improved Pore Connectivity

    Czech Academy of Sciences Publication Activity Database

    Čapek, P.; Hejtmánek, Vladimír; Kolafa, J.; Brabec, Libor

    2011-01-01

    Roč. 88, č. 1 (2011), s. 87-106. ISSN 0169-3913 R&D Projects: GA ČR GA203/09/1353; GA ČR GA203/05/0347 Institutional research plan: CEZ:AV0Z40720504; CEZ:AV0Z40400503 Keywords : viscous flow * simulated annealing * stochastic reconstruction Subject RIV: CI - Industrial Chemistry, Chemical Engineering Impact factor: 1.811, year: 2011

  8. Correção da falha óssea femoral e tibial pelo método do transporte ósseo de Ilizarov Femoral and tibial bone loss correction using Ilizarov's bone transport

    Directory of Open Access Journals (Sweden)

    Celso Herminio Ferraz Picado

    2000-12-01

    pacientes ficaram satisfeitos com o resultado do tratamento. Concluímos que a resposta biológica ao transporte ósseo é formidável, com a formação do regenerado reparando grandes falhas ósseas. Entretanto, consideramos que o aparelho circular externo preconizado por Ilizarov traz consigo diversas complicações principalmente relacionadas a presença dos fios transfixantes, causando sofrimento para os pacientes, principalmente quando instalados no fêmur.Eleven patients carrying diaphyseal bone fissure secondary to ressection of infected bone segments, 5 in the femur and 6 in the tibia, submitted to the Ilizarov bone transport technique were retrospectively analyzed. In the group of patients with femoral lesion the bone fissure varied from 7 cm to 12 cm, and in two there was a 2 cm shortening of the limb. In the group with tibial lesion the bone fissure varied from 2.5 cm to 10 cm, with limb shortening in two patients, respectively 1.5 cm and 2 cm. The mean follow-up period since the end of the treatment until evaluation was 49 months for the femoral lesion patients and 28.3 months for the tibial lesion patients. The femoral transports were bifocal and the tibial transports were bifocal in 4 patients and trifocal in 2. In all, patients formation of regenerate occurred. Consolidation of the target focus was naturally obtained in 7 patients; one patient needed bone grafting to obtain the focus consolidation. In three patients the nonunion of the target focus demanded modification of the treatment method with the external circular fixator withdrawal. In all the patients infection adjacent to the wires was observed. There was rupture of the wires in all assemblies made in the thigh. All the wires lost the tension initially imposed to them. Two patients submitted to femoral transport evolved with septic arthritis of the knee. Mobility of the knee was severely impaired in the patients submitted to femoral transport, and the same was observed in relation to the ankle of

  9. Evaluation of Iterative Reconstruction Method and Attenuation Correction in Brain Dopamine Transporter SPECT Using an Anthropomorphic Striatal Phantom

    Science.gov (United States)

    Maebatake, Akira; Imamura, Ayaka; Kodera, Yui; Yamashita, Yasuo; Himuro, Kazuhiko; Baba, Shingo; Miwa, Kenta; Sasaki, Masayuki

    2016-01-01

    Objective(s): The aim of this study was to determine the optimal reconstruction parameters for iterative reconstruction in different devices and collimators for dopamine transporter (DaT) single-photon emission computed tomography (SPECT). The results were compared between filtered back projection (FBP) and different attenuation correction (AC) methods. Methods: An anthropomorphic striatal phantom was filled with 123I solutions at different striatum-to-background radioactivity ratios. Data were acquired using two SPECT/CT devices, equipped with a low-to-medium-energy general-purpose collimator (cameras A-1 and B-1) and a low-energy high-resolution (LEHR) collimator (cameras A-2 and B-2). The SPECT images were once reconstructed by FBP using Chang’s AC and once by ordered subset expectation maximization (OSEM) using both CTAC and Chang’s AC; moreover, scatter correction was performed. OSEM on cameras A-1 and A-2 included resolution recovery (RR). The images were analyzed, using the specific binding ratio (SBR). Regions of interest for the background were placed on both frontal and occipital regions. Results: The optimal number of iterations and subsets was 10i10s on camera A-1, 10i5s on camera A-2, and 7i6s on cameras B-1 and B-2. The optimal full width at half maximum of the Gaussian filter was 2.5 times the pixel size. In the comparison between FBP and OSEM, the quality was superior on OSEM-reconstructed images, although edge artifacts were observed in cameras A-1 and A-2. The SBR recovery of OSEM was higher than that of FBP on cameras A-1 and A-2, while no significant difference was detected on cameras B-1 and B-2. Good linearity of SBR was observed in all cameras. In the comparison between Chang’s AC and CTAC, a significant correlation was observed on all cameras. The difference in the background region influenced SBR differently in Chang’s AC and CTAC on cameras A-1 and B-1. Conclusion: Iterative reconstruction improved image quality on all cameras

  10. Hydroxyapatite-doped polycaprolactone nanofiber membrane improves tendon–bone interface healing for anterior cruciate ligament reconstruction

    OpenAIRE

    Han F; Zhang P; Sun YY; Lin C.; Zhao P; Chen JW

    2015-01-01

    Fei Han,1,* Peng Zhang,2,* Yaying Sun,2 Chao Lin,1 Peng Zhao,1 Jiwu Chen2 1Shanghai East Hospital, The Institute for Biomedical Engineering and Nanoscience, Tongji University School of Medicine, Tongji University, 2Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Hamstring tendon autograft is a routine graft for anterior cruciate ligament (ACL) reconstruction. However,...

  11. Oxygen isotope composition of North American bobcat (Lynx rufus) and puma (Puma concolor) bone phosphate: implications for provenance and climate reconstruction.

    Science.gov (United States)

    Pietsch, Stephanie J; Tütken, Thomas

    2016-01-01

    Feline carnivores are threatened by illegal wildlife trade. Tracing the provenance of unknown felid tissues via stable isotope analysis could provide important information in wildlife crime investigations. The oxygen isotope composition of mammalian skeletal phosphate (δ(18)Op) is widely applied to trace the origin of animal remains and to reconstruct migratory patterns in palaeontological, archaeological, ecological and wildlife forensic applications. Teeth and bones of terrestrial mammals form at constant body temperature in isotope equilibrium with body water, which is predominantly controlled by ingested meteoric water (δ(18)Ow) that varies systematically with latitude, altitude and climate. Here we analysed δ(18)Op of 106 North American puma and bobcat bones of known geographic origin to establish the first δ(18)Op-δ(18)Ow regression for feline carnivores: δ(18)Op = 0.40(±0.04) * δ(18)Ow + 20.10(±0.40) (R(2) = 0.46, n = 106). This was compared with those from their respective prey species (deer and rabbit), a canid carnivore (fox) and other placental mammals. Effects of species, sex and relative humidity on the feline δ(18)Op-δ(18)Ow correlation were analysed and additional intra-individual tissue comparisons (hair δ(18)Oh vs. bone δ(18)Op) were performed for some bobcat individuals. Bobcats and pumas exhibited only a moderate δ(18)Op-δ(18)Ow correlation, which differed from canid carnivores and other placental mammals. However, feline δ(18)Op values revealed a moderate relation with δ(18)Ow, which lacks for the δ(18)Oh of hair from the same bobcat individuals. This indicates a difference in oxygen isotope routing from body water to bioapatite and hair. Most herbivores and omnivores track δ(18)Ow in their bioapatite δ(18)Op values much better, whereas δ(18)Op and especially δ(18)Oh values of feline carnivores are less precise proxies for meteoric water δ(18)Ow values and thus for provenance determination in wildlife

  12. COMPARATIVE STUDY OF CLINICAL OUTCOME OF ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION BONE PATELLAR TENDON BONE GRAFT V/S HAMSTRING GRAFT

    Directory of Open Access Journals (Sweden)

    Priyank

    2015-08-01

    fulfilling the predetermined inclusion and exclusion criteria were included in the study. STATISTICAL METHODS : Intergroup comparison was analysed by K - Independent sample t test. Intragroup comparison was analysed by Paired t - test. RESULTS : Patients were divided into two groups and treated with using Bone - patellar tendon - bone graft and Hamstring graft respectively. Mean age group of patients was 29.16 yrs. (range 16 - 51yrs and 30.88 yrs. (range 19 - 48yrs in group A and B respectively we found the incidence of ACL injury in 15 - 44 years age group to be greater than twice the general population. A mean delay in surgery of 4.66 months (range 2 - 12 months since the time of injury in group A and 4.46 months (range 2 - 7 months in group B was observed. Subjective IKDC evaluation was done at the end of 12 months. Ther e was no difference in both the groups in the terms of effusion, passive motion, knee compartment findings, ligament examination, X - ray findings. Functional test and IKDC grade of both the groups showed statistically very highly significant improvement. Ho wever, there was statistically very high Harvest site pathology in group A. CONCLUSION : We found that there is statistically no significant difference in the overall clinical outcome between hamstring autograft with transfix and bone - patellar tendon bone autograft with interference screw except that the patellar tendon group had a greater tendency of having donor site morbidity compared to the hamstring tendon group.

  13. Reconstruction with fascia lata allograft of the posterior vertebra elements after resection for aneurysmal bone cyst in a child.

    Science.gov (United States)

    Errani, Costantino; Schuster, Sergio; Biagini, Roberto; Casadei, Roberto; De Paolis, Massimiliano; Bertoni, Franco; Boriani, Stefano; Mercuri, Mario

    2007-09-01

    We report a case of ABC in a child where, after resection of the posterior spinal column of L1, we did a biological reconstruction using a posterior tension band with a segment of fascia lata allograft in tension between T12 and L2. After the long term follow up, X-ray and MRI controls showed a satisfactory alignment of the spine and no local recurrence. The patient now has no sign of spinal instability or deviation, with no kind of discomfort or pain, and has a normal life. In our experience this biological tension band interferes minimally with the growth of the spine, and has a less number of complications in comparison with other more aggressive methods and so is a good option for restoring the stability in young patients with benign spinal tumors that arises on the posterior column without having any kind of potential deviations. PMID:17426986

  14. Reconstruction with fascia lata allograft of the posterior vertebra elements after resection for aneurysmal bone cyst in a child

    Science.gov (United States)

    Schuster, Sergio; Biagini, Roberto; Casadei, Roberto; De Paolis, Massimiliano; Bertoni, Franco; Boriani, Stefano; Mercuri, Mario

    2007-01-01

    We report a case of ABC in a child where, after resection of the posterior spinal column of L1, we did a biological reconstruction using a posterior tension band with a segment of fascia lata allograft in tension between T12 and L2. After the long term follow up, X-ray and MRI controls showed a satisfactory alignment of the spine and no local recurrence. The patient now has no sign of spinal instability or deviation, with no kind of discomfort or pain, and has a normal life. In our experience this biological tension band interferes minimally with the growth of the spine, and has a less number of complications in comparison with other more aggressive methods and so is a good option for restoring the stability in young patients with benign spinal tumors that arises on the posterior column without having any kind of potential deviations. PMID:17426986

  15. Role of Magnesium Transporter Subtype 1 (MagT1) in the Osteogenic Differentiation of Rat Bone Marrow Stem Cells.

    Science.gov (United States)

    Zheng, Jianmao; Mao, Xueli; Ling, Junqi; Chen, Chanchan; Zhang, Wen

    2016-05-01

    In the present study, we investigated the role of magnesium transporter subtype 1 (MagT1), a selective Mg transporter protein, in the osteogenic differentiation of rat bone marrow stem cells (rBMSCs). Osteogenic differentiation was monitored by the expressions of alkaline phosphatase (ALP), osteocalcin (OCN), collagen-1 (COL-1) and runt-related transcription factor 2 (RUNX2), and extracellular matrix mineralization of rBMSCs. The expression of MagT1 increased with osteogenic differentiation of rBMSCs, suggesting the importance of intracellular Mg homeostasis to cell differentiation. Alteration of intracellular Mg homeostasis by culture condition with low extracellular Mg significantly reduced the osteogenic differentiation markers ALP, OCN, COL-1, and RUNX2 gene expressions. MagT1 knockdown during the differentiation period also reduced osteogenic differentiation and the extent of matrix mineralization of rBMSCs. In conclusion, our results indicate that Mg and MagT1 play an important role in osteogenic differentiation of rBMSCs and may be involved in the bone regeneration. PMID:26358767

  16. Long-term bone loss after renal transportation. Comparison of immunosuppressive regimens

    International Nuclear Information System (INIS)

    Serial measurements of serum and urine markers of bone metabolism and of forearm bone density (BMD) by dual photon absorptiometry were performed in 22 patients undergoing renal transplantation in 1986. Patients were randomised to immunosuppression with (1) cyclosporin alone (CsA group, n = 10), (2) cyclosporin for 3 months followed by azathioprine-prednisone (CsA/AzP group, n = 3) or (3) long-term azathioprine-prednisone (LT AzP group, n = 9). As no reduction in bone mineral density (BMD) was noted in the first 6 months, groups 2 and 3 were considered together (AzP group, n = 12). Mean±SEM BMD fell by 19±2% at 36 months (n = 19,m p<0.01), with similar reductions seen in the CsA and AzP groups. At 60 months, BMD of the AzP group was 25±3% below baseline (p<0.01), while the CsA group were only 5±4% belov baseline (p = NS vs baseline, p<0.05 vs AzP group). The degree of reduction in BMD over 5 years correlated with total glucocorticoid dose (r = 0.63, p<0.05), but not with biochemical markers of bone turnover. Serum alkaline phosphatase fell post-transplant in patients treated with AzP, but not in the CsA group. These results demonstrate significant loss of forearm bone mineral with long-term follow-up after renal transplantation, but suggest that patients treated with cyclosporin monotherapy may be at lower risk of this complication. (au) (15 refs.)

  17. Long-term bone loss after renal transportation. Comparison of immunosuppressive regimens

    Energy Technology Data Exchange (ETDEWEB)

    Menzies, B.; Rigby, R.; Hawley, CJ.M.; Hardie, I.R. [Princess Alexandra Hospital, Renal Transplant Unit, Woolloongabba (Australia); McIntyre, H.D. [Mater Adult Hospital, Department of Medicine, South Brisbane (Australia); Perry-Keene, D.A. [Royal Brisbane Hospital, Department of Endocrinology, Herston, Queensland (Australia)

    1995-02-01

    Serial measurements of serum and urine markers of bone metabolism and of forearm bone density (BMD) by dual photon absorptiometry were performed in 22 patients undergoing renal transplantation in 1986. Patients were randomised to immunosuppression with (1) cyclosporin alone (CsA group, n = 10), (2) cyclosporin for 3 months followed by azathioprine-prednisone (CsA/AzP group, n = 3) or (3) long-term azathioprine-prednisone (LT AzP group, n = 9). As no reduction in bone mineral density (BMD) was noted in the first 6 months, groups 2 and 3 were considered together (AzP group, n = 12). Mean{+-}SEM BMD fell by 19{+-}2% at 36 months (n = 19,m p<0.01), with similar reductions seen in the CsA and AzP groups. At 60 months, BMD of the AzP group was 25{+-}3% below baseline (p<0.01), while the CsA group were only 5{+-}4% belov baseline (p = NS vs baseline, p<0.05 vs AzP group). The degree of reduction in BMD over 5 years correlated with total glucocorticoid dose (r = 0.63, p<0.05), but not with biochemical markers of bone turnover. Serum alkaline phosphatase fell post-transplant in patients treated with AzP, but not in the CsA group. These results demonstrate significant loss of forearm bone mineral with long-term follow-up after renal transplantation, but suggest that patients treated with cyclosporin monotherapy may be at lower risk of this complication. (au) (15 refs.).

  18. Autologous transplantation of CD34(+) bone marrow derived mononuclear cells in management of non-reconstructable critical lower limb ischemia.

    Science.gov (United States)

    Ismail, Ahmed M; Abdou, Said M; Aty, Hassan Abdel; Kamhawy, Adel H; Elhinedy, Mohammed; Elwageh, Mohammed; Taha, Atef; Ezzat, Amal; Salem, Hoda A; Youssif, Said; Salem, Mohamed L

    2016-08-01

    Patients with a decrease in limb perfusion with a potential threat to limb viability manifested by ischemic rest pain, ischemic ulcers, and/or gangrene are considered to have critical limb ischemia (CLI). Because of this generally poor outcome, there is a strong need for attempting any procedure to save the affected limb. The aim of this work is to evaluate the possibility to use stem cell therapy as a treatment option for patients with chronic critical lower limb ischemia with no distal run off. This study includes 20 patients with chronic critical lower limb ischemia with no distal run off who are unsuitable for vascular or endovascular option. These patients underwent stem cell therapy (SCT) by autologous transplantation of bone marrow derived mononuclear cells. 55 % of patients treated with SCT showed improvement of the rest pain after the first month, 60 % continued improvement of the rest pain after 6 months, 75 % after 1 year and 80 % after 2 years and continued without any deterioration till the third year. Limb salvage rate after STC was 80 % after the first year till the end of the second and third years. SCT can result in angiogenesis in patients with no-option CLI, providing a foundation for the application of this therapy to leg ischemia. PMID:25511801

  19. Engineered allogeneic chondrocyte pellet for reconstruction of fibrocartilage zone at bone-tendon junction--a preliminary histological observation.

    Science.gov (United States)

    Wong, Margaret W N; Qin, Lin; Tai, Jenny K O; Lee, Simon K M; Leung, K S; Chan, K M

    2004-08-15

    This study examined histologically the potential of using allogeneic cultured chondrocyte pellet (CCP) in enhancing bone-tendon junction (BTJ) healing using a rabbit partial patellectomy model. Chondrocytes isolated from the cartilaginous ribs of 6-week-old New Zealand white rabbits were cultured for 14 days to form CCP. Partial patellectomy was performed on 30 18-week-old rabbits. After removal of the distal third patella, the BTJ gap was repaired surgically with or without CCP interposition. Four samples of patella-patellar tendon complexes (PPTC) for each group were harvested each at 8, 12, and 16 weeks; and two additional PPTC for each group were harvested at 2, 4, and 6 weeks for early observation of fibrocartilage zone regeneration, histologically. Results showed that CCP interposition demonstrated earlier structural integration at the BTJ after 8, 12, and 16 weeks of healing, and formation of a fibrocartilage zone like structure, compared with control specimens. In addition, no immune rejection was observed in CCP experimental group. The results suggested that CCP had a stimulatory effect on BTJ healing. This bioengineering approach might have potential clinical application in treatment of difficult BTJ healing. However, systemic histomorphometric, immunological tests, and biomechanical evaluations are needed before any clinical trials. PMID:15264320

  20. The effect of CT dose on glenohumeral joint congruency measurements using 3D reconstructed patient-specific bone models

    International Nuclear Information System (INIS)

    The study of joint congruency at the glenohumeral joint of the shoulder using computed tomography (CT) and three-dimensional (3D) reconstructions of joint surfaces is an area of significant clinical interest. However, ionizing radiation delivered to patients during CT examinations is much higher than other types of radiological imaging. The shoulder represents a significant challenge for this modality as it is adjacent to the thyroid gland and breast tissue. The objective of this study was to determine the optimal CT scanning techniques that would minimize radiation dose while accurately quantifying joint congruency of the shoulder. The results suggest that only one-tenth of the standard applied total current (mA) and a pitch ratio of 1.375:1 was necessary to produce joint congruency values consistent with that of the higher dose scans. Using the CT scanning techniques examined in this study, the effective dose applied to the shoulder to quantify joint congruency was reduced by 88.9% compared to standard clinical CT imaging techniques.

  1. Evaluation of transport conditions for autologous bone marrow-derived mesenchymal stromal cells for therapeutic application in horses.

    Science.gov (United States)

    Espina, Miguel; Jülke, Henriette; Brehm, Walter; Ribitsch, Iris; Winter, Karsten; Delling, Uta

    2016-01-01

    Background. Mesenchymal stromal cells (MSCs) are increasingly used for clinical applications in equine patients. For MSC isolation and expansion, a laboratory step is mandatory, after which the cells are sent back to the attending veterinarian. Preserving the biological properties of MSCs during this transport is paramount. The goal of the study was to compare transport-related parameters (transport container, media, temperature, time, cell concentration) that potentially influence characteristics of culture expanded equine MSCs. Methods. The study was arranged in three parts comparing (I) five different transport containers (cryotube, two types of plastic syringes, glass syringe, CellSeal), (II) seven different transport media, four temperatures (4 °C vs. room temperature; -20 °C vs. -80 °C), four time frames (24 h vs. 48 h; 48 h vs. 72 h), and (III) three MSC concentrations (5 × 10(6), 10 × 10(6), 20 × 10(6) MSC/ml). Cell viability (Trypan Blue exclusion; percent and total number viable cell), proliferation and trilineage differentiation capacity were assessed for each test condition. Further, the recovered volume of the suspension was determined in part I. Each condition was evaluated using samples of six horses (n = 6) and differentiation protocols were performed in duplicates. Results. In part I of the study, no significant differences in any of the parameters were found when comparing transport containers at room temperature. The glass syringe was selected for all subsequent evaluations (highest recoverable volume of cell suspension and cell viability). In part II, media, temperatures, or time frames had also no significant influence on cell viability, likely due to the large number of comparisons and small sample size. Highest cell viability was observed using autologous bone marrow supernatant as transport medium, and "transport" at 4 °C for 24 h (70.6% vs. control group 75.3%); this was not significant. Contrary, viability was unacceptably low

  2. Development of a transportable neutron activation analysis system to quantify manganese in bone in vivo: feasibility and methodology

    International Nuclear Information System (INIS)

    This study was conducted to investigate the methodology and feasibility of developing a transportable neutron activation analysis (NAA) system to quantify manganese (Mn) in bone using a portable deuterium–deuterium (DD) neutron generator as the neutron source. Since a DD neutron generator was not available in our laboratory, a deuterium–tritium (DT) neutron generator was used to obtain experimental data and validate the results from Monte Carlo (MC) simulations. After validation, MC simulations using a DD generator as the neutron source were then conducted. Different types of moderators and reflectors were simulated, and the optimal thicknesses for the moderator and reflector were determined. To estimate the detection limit (DL) of the system, and to observe the interference of the magnesium (Mg) γ line at 844 keV to the Mn γ line at 847 keV, three hand phantoms with Mn concentrations of 30 parts per million (ppm), 150 ppm, and 500 ppm were made and irradiated by the DT generator system. The Mn signals in these phantoms were then measured using a 50% high-efficiency high-purity germanium (HPGe) detector. The DL was calculated to be about 4.4 ppm for the chosen irradiation, decay, and measurement time. This was calculated to be equivalent to a DL of about 3.3 ppm for the DD generator system. To achieve this DL with one 50% high-efficiency HPGe detector, the dose to the hand was simulated to be about 37 mSv, with the total body equivalent dose being about 23µSv. In conclusion, it is feasible to develop a transportable NAA system to quantify Mn in bone in vivo with an acceptable radiation exposure to the subject. (paper)

  3. Effect of Dietary Nutrient Density on Small Intestinal Phosphate Transport and Bone Mineralization of Broilers during the Growing Period

    Science.gov (United States)

    Miao, Zhiqiang; Song, Zhigang; Yang, Yu; Tian, Wenxia; Guo, Yuming

    2016-01-01

    A 2 × 4 factorial experiment was conducted to determine the effects of dietary nutrient density on growth performance, small intestinal epithelial phosphate transporter expression, and bone mineralization of broiler chicks fed with diets with different nutrient densities and nonphytate phosphorus (NPP) levels. The broilers were fed with the same starter diets from 0 to 21 days of age. In the grower phase (day 22 to 42), the broilers were randomly divided into eight groups according to body weight. Relatively high dietary nutrient density (HDND) and low dietary nutrient density (LDND) diets were assigned metabolic energy (ME) values of 3,150 and 2,950 kcal/kg, respectively. Crude protein and essential amino acid levels were maintained in the same proportion as ME to prepare the two diet types. NPP levels were 0.25%, 0.30%, 0.35%, and 0.40% of the diets. Results showed that a HDND diet significantly increased the body weight gain (BWG) of broilers and significantly decreased the feed conversion ratio and NPP consumed per BWG. HDND significantly decreased tibial P content of the broilers. Conversely, mRNA expression of NaPi-IIb and protein expression of calbindin were significantly increased in the intestine of broilers fed a HDND diet. HDND also increased vitamin D receptor (VDR) expression, especially at a relatively low dietary NPP level (0.25%). The mRNA expression of NaPi-IIa in the kidneys was significantly increased at a relatively low dietary NPP level (0.25%) to maintain P balance. Tibial P, calcium, and ash content were significantly decreased, as were calbindin and VDR expression levels in the intestine at a low NPP level. Therefore, HDND improved the growth rate of broilers and increased the expression of phosphate and calcium transporter in the small intestine, but adversely affected bone mineralization. PMID:27100791

  4. 关节镜下自体、异体骨-髌腱-骨与半腱肌腱3种重建后交叉韧带方法的比较%A comparative study on arthroscopic posterior cruciate ligament reconstruction using bone-patellar tendon-bone allograft, bone-patellar tendon-bone autograft and semitendinosus tendon autograft

    Institute of Scientific and Technical Information of China (English)

    郑小飞; 黄华扬; 张余; 李凭跃; 尹庆水

    2009-01-01

    现为胫骨隧道外口持续果酱样液体流出,经换药、激素或消炎痛治疗后痊愈.结论:关节镜下自体、异体骨-髌腱-骨与半腱肌腱移植重建后交叉韧带均取得满意的结果,并且疗效相似.%BACKGROUND: There are many methods for posterior cruciate ligament (PCL) reconstruction, which is involved in many graft materials, but few studies aim to compare the differences in outcomes of different grafts for PCL reconstruction. OBJECTIVE: To compare the clinical results of arthroscopic PLC reconstruction with bone-patellar tendon-bone (B-PT-B) autograft, B-TP-B allograft and semitendinosus tendon autograft. DESIGN, TIME AND SETTING: A retrospective case analysis was completed in the Department of Orthopedics, Guangzhou General Hospital of Guangzhou Area Military Command of Chinese PLA from January 2000 to September 2005. MATERIALS: Totally 76 patients underwent arthroscopic PLC reconstruction from January 2000 to September 2005, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. METHODS: A retrospective analysis was performed in 76 patients underwent arthroscopic PCL reconstruction, with the use of B-TP-B autograft in 21 patients, B-TP-B allograft in 27 patients, semitendinosus tendon autograft in 28 patients. Postoperative body temperature was examined duration hospitalization. The follow-up parameters included International Knee Documentation Committee (IKDC) scores, Lysholm knee joint scores, and KT-1000 evaluation.MAIN OUTCOME MEASURES: ①Range of motion. ②joint stability: posterior draw test and KT-1000 test. ③overall function of knee: IKDC scores and Lysholm scores; ④complications and side effect. RESULTS: The time of follow-up visit was 26-79 months. Differences were no statistically significant among the IKDC scores, Lysholm scores, KT-1000 side-side difference, the positive rate of posterior draw test in three groups of patients with PCL

  5. Quantitative Proteomics-Based Reconstruction and Identification of Metabolic Pathways and Membrane Transport Proteins Related to Sugar Accumulation in Developing Fruits of Pear (Pyrus communis).

    Science.gov (United States)

    Reuscher, Stefan; Fukao, Yoichiro; Morimoto, Reina; Otagaki, Shungo; Oikawa, Akira; Isuzugawa, Kanji; Shiratake, Katsuhiro

    2016-03-01

    During their 6 month development, pear (Pyrus communis) fruits undergo drastic changes in their morphology and their chemical composition. To gain a better understanding of the metabolic pathways and transport processes active during fruit development, we performed a time-course analysis using mass spectrometry (MS)-based protein identification and quantification of fruit flesh tissues. After pre-fractionation of the samples, 2,841 proteins were identified. A principal component analysis (PCA) separated the samples from seven developmental stages into three distinct clusters representing the early, mid and late developmental phase. Over-representation analysis of proteins characteristic of each developmental phase revealed both expected and novel biological processes relevant at each phase. A high abundance of aquaporins was detected in samples from fruits in the cell expansion stage. We were able quantitatively to reconstruct basic metabolic pathways such as the tricarboxylic acid (TCA) cycle, which indicates sufficient coverage to reconstruct other metabolic pathways. Most of the enzymes that presumably contribute to sugar accumulation in pear fruits could be identified. Our data indicate that invertases do not play a major role in the sugar conversions in developing pear fruits. Rather, sucrose might be broken down by sucrose synthases. Further focusing on sugar transporters, we identified several putative sugar transporters from diverse families which showed developmental regulation. In conclusion, our data set comprehensively describes the proteome of developing pear fruits and provides novel insights about sugar accumulation as well as candidate genes for key reactions and transport steps. PMID:26755692

  6. ''Black Bone'' MRI: a potential alternative to CT with three-dimensional reconstruction of the craniofacial skeleton in the diagnosis of craniosynostosis

    International Nuclear Information System (INIS)

    To determine the potential of novel gradient echo parameters, ''Black Bone'' MRI as an alternative to CT in the identification of normal and prematurely fused cranial sutures both in 2D and 3D imaging. Thirteen children with a clinical diagnosis of craniosynostosis underwent ''Black Bone'' MRI in addition to routine cranial CT. ''Black Bone'' datasets were compared to CT and clinical findings. ''Black Bone'' imaging was subsequently used to develop 3D reformats of the craniofacial skeleton to enhance further visualisation of the cranial sutures. Patent cranial sutures were consistently identified on ''Black Bone'' MRI as areas of increased signal intensity. In children with craniosynostosis the affected suture was absent, whilst the remaining patent sutures could be visualised, consistent with CT and clinical findings. Segmentation of the ''Black Bone'' MRI datasets was successful with both threshold and volume rendering techniques. The cranial sutures, where patent, could be visualised throughout their path. Patent cranial sutures appear as areas of increased signal intensity on ''Black Bone'' MRI distinct from the cranial bone, demonstrating considerable clinical potential as a non-ionising alternative to CT in the diagnosis of craniosynostosis. (orig.)

  7. ''Black Bone'' MRI: a potential alternative to CT with three-dimensional reconstruction of the craniofacial skeleton in the diagnosis of craniosynostosis

    Energy Technology Data Exchange (ETDEWEB)

    Eley, Karen A. [University of Oxford, John Radcliffe Hospital, Nuffield Department of Surgical Sciences, Oxford (United Kingdom); University of Cambridge, Addenbrookes Hospital, Department of Radiology, Cambridge (United Kingdom); Watt-Smith, Stephen R. [University of Oxford, John Radcliffe Hospital, Nuffield Department of Surgical Sciences, Oxford (United Kingdom); University College London, Eastman Dental Institute, London (United Kingdom); Sheerin, Fintan [University of Oxford, John Radcliffe Hospital, Nuffield Department of Surgical Sciences, Oxford (United Kingdom); Oxford University Hospitals NHS Trust, Oxford (United Kingdom); Golding, Stephen J. [University of Oxford, John Radcliffe Hospital, Nuffield Department of Surgical Sciences, Oxford (United Kingdom)

    2014-10-15

    To determine the potential of novel gradient echo parameters, ''Black Bone'' MRI as an alternative to CT in the identification of normal and prematurely fused cranial sutures both in 2D and 3D imaging. Thirteen children with a clinical diagnosis of craniosynostosis underwent ''Black Bone'' MRI in addition to routine cranial CT. ''Black Bone'' datasets were compared to CT and clinical findings. ''Black Bone'' imaging was subsequently used to develop 3D reformats of the craniofacial skeleton to enhance further visualisation of the cranial sutures. Patent cranial sutures were consistently identified on ''Black Bone'' MRI as areas of increased signal intensity. In children with craniosynostosis the affected suture was absent, whilst the remaining patent sutures could be visualised, consistent with CT and clinical findings. Segmentation of the ''Black Bone'' MRI datasets was successful with both threshold and volume rendering techniques. The cranial sutures, where patent, could be visualised throughout their path. Patent cranial sutures appear as areas of increased signal intensity on ''Black Bone'' MRI distinct from the cranial bone, demonstrating considerable clinical potential as a non-ionising alternative to CT in the diagnosis of craniosynostosis. (orig.)

  8. Mandibular defect reconstruction using three-dimensional polycaprolactone scaffold in combination with platelet-rich plasma and recombinant human bone morphogenetic protein-2: de novo synthesis of bone in a single case.

    Science.gov (United States)

    Schuckert, Karl-Heinz; Jopp, Stefan; Teoh, Swee-Hin

    2009-03-01

    This publication describes the clinical case of a 71-year-old female patient. Using polycaprolactone (PCL) scaffold, platelet-rich plasma (PRP) and recombinant human bone morphogenetic protein-2 (rhBMP-2), a critical-sized defect in the anterior mandible was regenerated using de novo-grown bone. A bacterial infection had caused a periimplantitis in two dental implants leading to a large destruction in the anterior mandible. Both implants were removed under antibiotic prophylaxis. A PCL scaffold was prepared especially for this clinical case. In a second procedure with antibiotic prophylaxis, the bony defect was reopened. The PCL scaffold was fitted and charged with PRP and rhBMP-2 (1.2 mg). After complication-free wound healing, the radiological control demonstrated de novo-grown bone in the anterior mandible 6 months postoperatively. Dental implants were inserted in a third operation. A bone biopsy of the newly grown bone, as well as of the bordering local bone, was taken and histologically examined. The bone samples were identical and presented vital laminar bone. PMID:18767969

  9. Comparison of transtibial and transportal techniques in drilling femoral tunnels during anterior cruciate ligament reconstruction using 3D-CAD models

    Directory of Open Access Journals (Sweden)

    Tashiro Y

    2014-04-01

    Full Text Available Yasutaka Tashiro,1 Ken Okazaki,1 Munenori Uemura,2 Kazutaka Toyoda,2 Kanji Osaki,1 Hirokazu Matsubara,1 Makoto Hashizume,2 Yukihide Iwamoto1 1Department of Orthopaedic Surgery, 2Department of Advanced Medical Initiatives, Kyushu University Hospital, Fukuoka, Japan Purpose: The purpose of this study was to assess the differences in bone tunnel apertures between the trans-accessory medial portal (trans-AMP technique and the transtibial (TT technique in double-bundle anterior cruciate ligament reconstruction. The extent of ovalization and the frequency of overlap of the two tunnel apertures were compared. Methods: The simulation of femoral tunnel drilling with the TT and the trans-AMP techniques was performed using three-dimensional computer aided design models from two volunteers. The incidence angle of drilling against the intercondylar wall, the femoral tunnel position, the ovalization, and the overlap were analyzed. The aperture and location of the tunnels were also examined in real anterior cruciate ligament reconstruction cases (n=36. Results: The surgical simulation showed that a lower drill incident angle induced by the TT technique made the apertures of two tunnels more ovalized, located anteromedial tunnels in a shallower position to prevent posterior wall blow out, and led to a higher frequency of tunnel overlap. The trans-AMP group had tunnel places within the footprint and had less ovalization and overlap. The results of analysis for tunnels in the clinical cases were consistent with results from the surgical simulation. Conclusion: In the TT technique, the shallow anteromedial tunnel location and more ovalized tunnel aperture can lead to a higher frequency of tunnel overlap. Compared with the TT technique, the trans-AMP technique was more useful in preparing femoral tunnels anatomically and avoiding tunnel ovalization and overlapping in double-bundle anterior cruciate ligament reconstruction. Keywords: anterior cruciate ligament

  10. 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 ...

  11. Bone Grafts

    Science.gov (United States)

    A bone graft transplants bone tissue. Surgeons use bone grafts to 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 ...

  12. Current knowledge and perspectives for the use of platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) in oral and maxillofacial surgery part 2: Bone graft, implant and reconstructive surgery.

    Science.gov (United States)

    Simonpieri, Alain; Del Corso, Marco; Vervelle, Alain; Jimbo, Ryo; Inchingolo, Francesco; Sammartino, Gilberto; Dohan Ehrenfest, David M

    2012-06-01

    Platelet concentrates for surgical use are innovative tools of regenerative medicine, and were widely tested in oral and maxillofacial surgery. Unfortunately, the literature on the topic is contradictory and the published data are difficult to sort and interpret. In bone graft, implant and reconstructive surgery, the literature is particularly dense about the use of the various forms of Platelet-Rich Plasma (PRP) - Pure Platelet-Rich Plasma (P-PRP) or Leukocyte- and Platelet-Rich Plasma (L-PRP) - but still limited about Platelet-Rich Fibrin (PRF) subfamilies. In this second article, we describe and discuss the current published knowledge about the use of PRP and PRF during implant placement (particularly as surface treatment for the stimulation of osseointegration), the treatment of peri-implant bone defects (after peri-implantitis, during implantation in an insufficient bone volume or during immediate post-extraction or post-avulsion implantation), the sinuslift procedures and various complex implant-supported treatments. Other potential applications of the platelet concentrates are also highlighted in maxillofacial reconstructive surgery, for the treatment of patients using bisphosphonates, anticoagulants or with post-tumoral irradiated maxilla. Finally, we particularly insist on the perspectives in this field, through the description and illustration of the use of L-PRF (Leukocyte- and Platelet-Rich Fibrin) clots and membranes during the regeneration of peri-implant bone defects, during the sinus-lift procedure and during complex implant-supported rehabilitations. The use of L-PRF allowed to define a new therapeutic concept called the Natural Bone Regeneration (NBR) for the reconstruction of the alveolar ridges at the gingival and bone levels. As it is illustrated in this article, the NBR principles allow to push away some technical limits of global implant-supported rehabilitations, particularly when combined with other powerful biotechnological tools

  13. Anterior cruciate ligament reconstruction

    International Nuclear Information System (INIS)

    This paper determines the efficacy of MR imaging in evaluation of the anterior cruciate ligament (ACL) following reconstructive surgery. Forty-three MR examinations were performed in 33 patients who had undergone previous arthroscopic ACL reconstruction with patellar bone-tendon- bone autografts (postoperative period, 1-24 months; mean, 5.2 months). Of the 40 studies performed in clinically stable knees (30 patients), MR demonstrated a well-defined, signal void ACL graft in 36. Of the three studies performed in three patients with clinical ACL laxity or suspected tear, the neoligament was of intermediate definition in one and nondiscernible in the other two. As in the native knee, buckling of the PCL was suggestive of ACL insufficiency. Bone tunnel placement, patellar tendon changes, and joint effusions were also evaluated

  14. 组织工程骨材料在运动性骨缺损修复中的评价%Evaluation of materials of bone tissue engineering in athletic bone defects reconstruction

    Institute of Scientific and Technical Information of China (English)

    李华

    2011-01-01

    目的:评价组织工程化人工骨材料的性能和应用,找合理的骨缺损修复材料.方法:以"组织工程,缺损,工骨,米材料" 为中文关键词;以"tissue engineering,bone defect,artificial bone,biological degradation"为英文关键词,用计算机检索1993-01/2009-10相关文章.纳入与有关组织工程相关的文章;排除重复研究或Meta分析类文章.以30篇文献为主,点进行了讨论组织工程纳米级人工骨材料的种类及其性能.结果:可生物降解并具有生物活性的组织工程人工骨材料可作为一种较理想的支架材料应用于骨缺损修复组织工程.修复效果相当或接近自体骨,源充足,无免疫排斥反应,避免取自体骨给患者带来的痛苦和并发症,影响运动员重返赛场,动员患者乐于接受.复合材料人工骨在解除运动员患者的后顾之忧的同时,带来巨大的社会效益.基于纳米羟基磷灰石复合重组人骨形态发生蛋白2制成的支架,但具有理想的生物相容性、生物降解性和较高的亲和性,且能提高了骨诱导活性,够促进新骨的形成.可生物降解并具有生物活性的组织工程人工骨材料在临床使用的初步情况表明,人体生物相容性良好,免疫排斥反应,合情况良好.结论:骨缺损是常见的运动损伤,直为运动损伤研究热点.组织工程化骨缺损修复的研究近年来发展迅速,运动损伤骨缺损修复带来了契机.组织工程复合材料可以发挥不同材料的优势,补单一材料的不足,一种比较理想的支架材料.%OBJECTIVE: To evaluate the disposition and application of tissue-engineered artificial bone materials, in order to find a reasonable repair material for bone defect.METHODS: Taking "tissue engineering, bone defect, artificial bone, nanomaterials" in Chinese, and "tissue engineering, bone defect, artificial bone, biological degradation" in English as search terms, the articles between January 1993 and October 2009were

  15. Management of traumatic tibial diaphyseal bone defect by “induced-membrane technique”

    Science.gov (United States)

    Gupta, Gaurav; Ahmad, Sohail; Mohd. Zahid; Khan, A H; Sherwani, M K A; Khan, Abdul Qayyum

    2016-01-01

    Background: Gap nonunion of long bones is a challenging problem, due to the limitation of conventional reconstructive techniques more so if associated with infection and soft tissue defect. Treatment options such as autograft with non-vascularized fibula and cancellous bone graft, vascularized bone graft, and bone transportation are highly demanding on the part of surgeons and hospital setups and have many drawbacks. This study aims to analyze the outcome of patients with wide diaphyseal bone gap treated with induced-membrane technique (Masquelet technique). Materials and Methods: This study included 9 patients (7 males and 2 females), all with tibial bone-gap. Eight of the 9 patients were infected and in 3 patients there was associated large soft tissue defect requiring flap cover. This technique is two-stage procedure. Stage I surgery included debridement, fracture stabilization, application of spacer between bone ends, and soft tissue reconstruction. Stage II surgery included removal of spacer with preservation of induced membrane formed at spacer surface and filling the bone-gap with morselized iliac crest bone-graft within the membrane sleeve. Average bone-gap of 5.2 cm was treated. The spacer was always found to be encapsulated by a thick glistening membrane which did not collapse after its removal. All patients were followed up for an average period of 21.5 months. Results: Serial Radiographs showed regular uptake of autograft and thus consolidation within themselves in the region of bone gap and also with host bone. Bone-union was documented in all patients and all patients are walking full weight-bearing without support. Conclusions: The study highlights that the technique provide effective and practical management for difficult gap nonunion. It does not require specialized equipment, investigations, and surgery. Thus, it provides a reasonable alternative to the developing infrastructures and is a reliable and reproducible technique. PMID:27293290

  16. Uso de enxerto ósseo homólogo estrutural cortical em cirurgias de reconstrução femoral Use of cortical structural homologous bone graft in femoral reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Milton Valdomiro Roos

    2010-01-01

    periprotéticas é uma boa opção de tratamento em casos selecionados, permitindo resultados clínicos e radiográficos satisfatórios.OBJECTIVE: To perform a clinical and radiographic assessment of patients submitted to cortical structural homologous bone graftsurgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty and periprosthetic fractures. METHODS: A retrospective study with 27 patients submitted to surgical treatment for femoral reconstruction following mechanical failure of total hip arthroplasty (12 cases and periprosthetic fractures (15 cases, using cortical structural homologous bone graft and cemented implants, in the period of June 1999 to February 2008 was performed. Of these, 21 fulfilled the criteria required for this study. Patients were submitted to a pre and postoperative clinical assessment according to Harris Hip Score. Pre-operative, immediate and late postoperative radiographs were also evaluated by comparing fracture consolidation, radiographic signs of graft integration, changes in bone stock and femoral bone quality, as well as femoral alignment. RESULTS: Nine patients (42.9% were submitted to femoral reconstruction following mechanical failure of total hip arthroplasty. The other 12 cases (57.1%, were submitted to femoral reconstruction following periprosthetic fracture. Results were considered satisfactory in 85.7% and unsatisfactory in 14.3% of cases. Radiographic signs of graft integration to the host's bone were seen in all cases. There was an increase of bone stock in 90.5% of hip reconstructions, according to cortical index measurement. Furthermore, changes in femoral bone quality were considered good in 66.7% of cases. CONCLUSION: The use of cortical structural homologous bone grafts for both femoral reconstructive surgeries of total hip arthroplasty and periprosthetic fractures is a good treatment option for selected cases, allowing for satisfactory clinical and radiographic results.

  17. Accuracy and benefits of 3D bone surface modelling: a comparison of two methods of surface data acquisition reconstructed by laser scanning and computed tomography outputs

    Czech Academy of Sciences Publication Activity Database

    Brzobohatá, Hana; Prokop, J.; Horák, M.; Jančárek, A.; Velemínská, J.

    2012-01-01

    Roč. 36, č. 3 (2012), s. 801-806. ISSN 0350-6134 Grant ostatní: GA UK(CZ) 613012 Keywords : frontal bone * three-dimensional imaging * laser scanning * surface registration Subject RIV: AC - Archeology, Anthropology, Ethnology Impact factor: 0.414, year: 2012

  18. Pitfalls in comparing modern hair and fossil bone collagen C and N isotopic data to reconstruct ancient diets: a case study with cave bears (Ursus spelaeus).

    Science.gov (United States)

    Bocherens, Hervé; Grandal-d'Anglade, Aurora; Hobson, Keith A

    2014-01-01

    Stable isotope analyses provide one of the few means to evaluate diet of extinct taxa. However, interpreting isotope data from bone collagen of extinct animals based on isotopic patterns in different tissues of modern animal proxies is precarious. For example, three corrections are needed before making comparisons of recent hair and ancient bone collagen: calibration of carbon-13 variations in atmospheric CO2, different isotopic discrimination between diet-hair keratin and diet-bone collagen, and time averaging of bone collagen versus short-term record in hair keratin. Recently, Robu et al. [Isotopic evidence for dietary flexibility among European Late Pleistocene cave bears (Ursus spelaeus). Can J Zool. 2013;91:227-234] published an article comparing extant carbon (δ(13)C) and nitrogen (δ(15)N) stable isotopic data of European cave bear bone collagen with those of Yellowstone Park grizzly bear hair in order to test the prevailing assumption of a largely vegetarian diet among cave bears. The authors concluded that cave bears were carnivores. This work is unfortunately unfounded as the authors failed to consider the necessary corrections listed above. When these corrections are applied to the Romanian cave bears, these individuals can be then interpreted without involving consumption of high trophic-level food, and environmental changes are probably the reason for the unusual isotopic composition of these cave bears in comparison with other European cave bears, rather than a change of diet. We caution researchers to pay careful attention to these factors when interpreting feeding ecology of extinct fauna using stable isotope techniques. PMID:24588112

  19. The BoneXpert method for automated determination of skeletal maturity

    DEFF Research Database (Denmark)

    Thodberg, Hans Henrik; Kreiborg, Sven; Juul, Anders;

    2009-01-01

    bone morphology or very poor image quality. From the methodological point of view, BoneXpert contains the following innovations: 1) a generative model (active appearance model) for the bone reconstruction; 2) the prediction of bone age from shape, intensity, and texture scores derived from principal...... 15 bones automatically and then computes "intrinsic" bone ages for each of 13 bones (radius, ulna, and 11 short bones). Finally, it transforms the intrinsic bone ages into Greulich Pyle (GP) or Tanner Whitehouse (TW) bone age. The bone reconstruction method automatically rejects images with abnormal...... component analysis; 3) the consensus bone age concept that defines bone age of each bone as the best estimate of the bone age of the other bones in the hand; 4) a common bone age model for males and females; and 5) the unified modelling of TW and GP bone age. BoneXpert is developed on 1559 images. It is...

  20. Spectral nodal method with hybrid angular quadrature and analytical reconstruction for one-speed transport problem in discrete ordinates and slab geometry

    International Nuclear Information System (INIS)

    In typical lattice cells where a highly absorbing, small fuel element is embedded in the moderator, large weakly absorbing medium, high-order transport methods become unnecessary. In this work we describe the hybrid discrete ordinates (SN) method for energy one-group slab lattice calculations using fine-mesh and coarse-mesh methods with a spatial reconstruction scheme. This hybrid SN method combines the convenience of a low-order SN method in the moderator with a high-order SN method in the fuel. The idea is based on the fact that in weakly absorbing media whose physical size is several neutron mean free paths in extent, even the S-2 method (P-1 approximation) leads to an accurate result. We review the use of special fuel-moderator interface conditions with the fine-grid DD method and the coarse-grid SGF nodal method with spatial reconstruction scheme to calculate the one-group neutron flux distributions and the thermal disadvantage factor. (author)

  1. 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 ...

  2. The use of transport and diffusion equations in the three-dimensional reconstruction of computerized tomographic images

    Energy Technology Data Exchange (ETDEWEB)

    Pires, Sandrerley Ramos, E-mail: sandrerley@eee.ufg.br [Escola de Engenharia Eletrica e de Computacao - EEEC, Universidade Federal de Goias - UFG, Goiania, GO (Brazil); Flores, Edna Lucia; Pires, Dulcineia Goncalves F.; Carrijo, Gilberto Arantes; Veiga, Antonio Claudio Paschoarelli [Faculdade de Engenharia Eletrica - FEELT, Universidade Federal de Uberlandia - UFU, Uberlandia, MG (Brazil); Barcelos, Celia Aparecida Z. [Faculdade de Matematica, Universidade Federal de Uberlandia - UFU, Uberlandia, MG (Brazil)

    2012-09-15

    The visualization of a computerized tomographic (TC) exam in 3D increases the quality of the medical diagnosis and, consequently, the success probability in the treatment. To obtain a high quality image it is necessary to obtain slices which are close to one another. Motivated towards the goal of reaching an improved balance between quantity of slices and visualization quality, this research work presents a digital inpainting technique of 3D interpolation for CT slices used in the visualization of human body structures. The inpainting is carried out via non-linear partial differential equations (PDE). The PDE's have been used, in the image-processing context to fill in the damaged regions in a digital 2D image. Inspired by this idea, this article proposes an interpolation method for the filling in of the empty regions between the CT slices. To do it, considering the high similarity between two consecutive real slice, the first step of the proposed method is to create the virtual slices. The virtual slices contain all similarity between the intercalated slices and, when there are not similarities between real slices, the virtual slices will contain indefinite portions. In the second step of the proposed method, the created virtual slices will be used together with the real slices images, in the reconstruction of the structure in three dimensions, mapped onto the exam. The proposed method is capable of reconstructing the curvatures of the patient's internal structures without using slices that are close to one another. The experiments carried out show the proposed method's efficiency. (author)

  3. Treatment of open tibial fracture with bone defect caused by high velocity missiles: A case report

    Directory of Open Access Journals (Sweden)

    Golubović Zoran

    2013-01-01

    Full Text Available Introduction .Tibia fracture caused by high velocity missiles is mostly comminuted and followed by bone defect which makes their healing process extremely difficult and prone to numerous complications. Case Outline. A 34-year-old male was wounded at close range by a semi-automatic gun missile. He was wounded in the distal area of the left tibia and suffered a massive defect of the bone and soft tissue. After the primary treatment of the wound, the fracture was stabilized with an external fixator type Mitkovic, with convergent orientation of the pins. The wound in the medial region of the tibia was closed with the secondary stitch, whereas the wound in the lateral area was closed with the skin transplant after Thiersch. Due to massive bone defect in the area of the rifle-missile wound six months after injury, a medical team placed a reconstructive external skeletal fixator type Mitkovic and performed corticotomy in the proximal metaphyseal area of the tibia. By the method of bone transport (distractive osteogenesis, the bone defect of the tibia was replaced. After the fracture healing seven months from the secondary surgery, the fixator was removed and the patient was referred to physical therapy. Conclusion. Surgical treatment of wounds, external fixation, performing necessary debridement, adequate antibiotic treatment and soft and bone tissue reconstruction are essential in achieving good results in patients with the open tibial fracture with bone defect caused by high velocity missiles. Reconstruction of bone defect can be successfully treated by reconstructive external fixator Mitkovic. [Projekat Ministarstva nauke Republike Srbije, br. III 41017 i br. III 41004

  4. A new variant of scaphoid reconstruction: Treatment of scaphoid non-union with avascular bone interponate and high compression screw (Synthes

    Directory of Open Access Journals (Sweden)

    Eder, Christian

    2015-08-01

    Full Text Available Scaphoid fractures as frequently overseen injuries often result in scaphoid non-unions, that need to be treated to prevent carpal collapse and secondary cartilage damage. Vital bone tissue and compression of fracture and bone graft ends seem to be crucial in for ossification and final bone healing. In the present study we compare our results using a high compression screw (HCS Synthes to results in the literature using different kinds of internal fixation including compression screws of various types. We present 22 patients with scaphoid non-unions treated with a bone graft and a HCS Synthes. We evaluated our post-operative results. The Manchester-Modified Disability of the Shoulder, Arm and Hand–Score (M-Dash imposed with an average of 29.8 points (MD=29 / SD=9.46 / MIN=18 / MAX=48. None of the re-evaluated patients sorrowed for pain in rest. Five patients stated pain (ranging from 4 to 8 on numeric analogue scale after heavy burden (e.g. boxing, weight lifting.In exploring the range of motion of the operated hand we deliver the following results: dorsal extension: average 72.73° (MD=80° / SD=17.23° / MIN=30° / MAX=85°, flexion: average 73.64° (MD=80° / SD=8.97° / MIN=60° / MAX=80°, ulnar deviation: average 39.09°, (MD=40° / SD=2.02° / MIN=35° / MAX=40°, radial deviation: average 29.09°, (MD=30° / SD=3.01° / MIN=20° / MAX=30°. Additionally a performance testing was conducted: fist clenching sign: complete without pain in 100%, pinch grip: complete in 100%, moderate pain in n=1 (8.33%, opposition digitus manus I–V complete in 100%, moderate pain n=2 (16.67%. Three patients with persisting fracture gap had a scaphoid bone fractured in the proximal third; one patient even with a very small proximal fragment. One persisting non-union was localized in the middle third (period between injury and operation = . In conclusion, our patients showed better healing rates compared to results presented in the literature. Non

  5. Reconstruction of 131I radioactive contamination dynamics in belarus due to Chernobyl accident using atmospheric transport modelling

    International Nuclear Information System (INIS)

    The calculations of 131I radioactive contamination in the 3 most contaminated regions of Belarus are carried out using the Lagrangian-Eulerian atmospheric transport LEDI model. Verification of the obtained results is made on the base of 131I activity measurements in soil of 534 settlements in Belarus during the initial period of the accident. The input of radionuclides wet deposition processes due to rains and fogs has been evaluated in the period of radioactivity releases from the Chornobyl NPP.

  6. A novel intramedullary callus distraction system for the treatment of femoral bone defects.

    Science.gov (United States)

    Horas, Konstantin; Schnettler, Reinhard; Maier, Gerrit; Horas, Uwe

    2016-08-01

    An intramedullary device has some advantages over external fixation in callus distraction for bone defect reconstruction. There are difficulties controlling motorized intramedullary devices and monitoring the distraction rate which may lead to poor results. The aim of this study was to design a fully implantable and non-motorized simple distraction nail for the treatment of bone defects. The fully implantable device comprises a tube-in-tube system and a wire pulling mechanism for callus distraction. For the treatment of femoral bone defects, a traction wire, attached to the device at one end, is fixed to the tibial tubercle at its other end. Flexion of the knee joint over a predetermined angle generates a traction force on the wire triggering bone segment transport. This callus distraction system was implanted into the femur of four human cadavers (total 8 femora), and bone segment transport was conducted over 60-mm defects with radiographic monitoring. All bone segments were transported reliably to the docking site. From these preliminary results, we conclude that this callus distraction system offers an alternative to the current intramedullary systems for the treatment of bone defects. PMID:27221258

  7. Unfavourable results in thumb reconstruction

    Directory of Open Access Journals (Sweden)

    Samir M Kumta

    2013-01-01

    Full Text Available The history of thumb reconstruction parallels the history of hand surgery. The attributes that make the thumb unique, and that the reconstructive surgeon must assess and try to restore when reconstructing a thumb, are: Position, stability, strength, length, motion, sensibility and appearance. Deficiency in any of these attributes can reduce the utility of the reconstructed thumb. A detailed assessment of the patient and his requirements needs to be performed before embarking on a thumb reconstruction. Most unsatisfactory results can be attributed to wrong choice of procedure. Component defects of the thumb are commonly treated by tissue from adjacent fingers, hand or forearm. With refinements in microsurgery, the foot has become a major source of tissue for component replacement in the thumb. Bone lengthening, osteoplastic reconstruction, pollicisation, and toe to hand transfers are the commonest methods of thumb reconstruction. Unfavourable results can be classified as functional and aesthetic. Some are common to all types of procedures. However each type of reconstruction has its own unique set of problems. Meticulous planning and execution is essential to give an aesthetic and functionally useful thumb. Secondary surgeries like tendon transfers, bone grafting, debulking, arthrodesis, may be required to correct deficiencies in the reconstruction. Attention needs to be paid to the donor site as well.

  8. Bone X-Ray (Radiography)

    Medline Plus

    Full Text Available ... be more useful in identifying bone and joint injuries (e.g., meniscal and ligament tears in the knee, rotator cuff and labrum tears in the shoulder) and in imaging of the spine (because both the bones and the spinal cord can ... suspected spine injury or other complicated injuries, 3-D reconstructed CT ...

  9. Evaluation of transport conditions for autologous bone marrow-derived mesenchymal stromal cells for therapeutic application in horses

    OpenAIRE

    Espina, Miguel; Jülke, Henriette; Brehm, Walter; Ribitsch, Iris; Winter, Karsten; Delling, Uta

    2016-01-01

    Background. Mesenchymal stromal cells (MSCs) are increasingly used for clinical applications in equine patients. For MSC isolation and expansion, a laboratory step is mandatory, after which the cells are sent back to the attending veterinarian. Preserving the biological properties of MSCs during this transport is paramount. The goal of the study was to compare transport-related parameters (transport container, media, temperature, time, cell concentration) that potentially influence characteri...

  10. 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.

  11. 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 ...

  12. Transport

    International Nuclear Information System (INIS)

    Transport is one of the major causes of environmental damage in Austria. Energy consumption, pollutants emissions, noise emissions, use of surfaces, sealing of surfaces, dissection of ecosystems and impact on landscape are the most significant environmental impacts caused by it. An overview of the transport development of passengers and freight in Austria is presented. Especially the energy consumption growth, carbon dioxide and nitrogen oxide emissions by type of transport, and the emissions development (HC, particle and carbon monoxide) of goods and passengers transport are analyzed covering the years 1980 - 1999. The health cost resulting from transport-related air pollution in Austria is given and measures to be taken for an effective control of the transport sector are mentioned. Figs. 8, Table 1. (nevyjel)

  13. Intermittent negative pressure affects tendon-bone healing after anterior cruciate ligament reconstruction%间歇性负压干预前交叉韧带重建后的腱-骨愈合

    Institute of Scientific and Technical Information of China (English)

    孙正明; 凌鸣; 冯伟楼; 董向辉; 刘时璋; 易智

    2013-01-01

    背景:间歇性负压被证实可以促进软组织修复及骨愈合,但其对交叉韧带重建后腱-骨愈合的影响尚未见报道。  目的:观察间歇性负压对兔前交叉韧带重建后腱-骨愈合及肌腱移植物生物力学的影响。  方法:取24只新西兰大白兔制备自体半腱肌前交叉韧带重建模型,随机取一侧后腿作为负压侧,负压侧关节通过引流管接微型负压吸引器,并维持低强度、间歇性负压;对侧后腿作为对照,接普通引流管。5d后两侧同时拔除吸引管。造模后6周,取关节液检测白细胞介素1β的表达水平;取股骨-韧带-胫骨复合体行肌腱移植物拉力测定和腱-骨界面组织学观察。  结果与结论:1只兔关节感染,最终23只兔进入结果分析。拉力测定结果显示,负压组完全断裂所需拉力显著大于对照组(P OBJECTIVE:To research the effect of intermittent negative pressure on tendon-bone healing after anterior cruciate ligament reconstruction and on the biomechanics of tendon grafts. METHODS:A total of 24 New Zealand white rabbits were randomly selected to establish the models of anterior cruciate ligament reconstruction of autogenous semitendinosus. The hind leg of one side was selected randomly as the negative pressure group, and the joint of the negative pressure side was connected with the micro-negative pressure aspirator through drainage tube and maintained a low-intensity and intermittent negative pressure;the contralateral hind leg was as the control and connected with ordinary drainage tube. Drainage tubes of both sides were removed at the same time after 5 days. At 6 weeks after modeling, the joint fluid was drawn to detect the expression levels of interleukin-1β;femur-ligament-tibia complex was used for tension measurement of tendon graft, and histological observation of tendon-bone interface. RESULTS AND CONCLUSION:One rabbit had joint infection, and final y 23

  14. Effect of duration of exposure to RaCl2 and a radium apatite from freshwater mussels on intestinal transport and bone deposition of radium

    International Nuclear Information System (INIS)

    Natural leaching of uranium ore bodies can result in 226Ra pollution of adjacent waterways and consequent incorporation of radium into the food chain. Mining has the potential to augment this effect. In the Magela flood plain, Northern Territory, the freshwater mussel (Velesunio angasi) concentrates radium in its tissues as a phosphate compound. The availability of mussel radium for uptake and tissue incorporation was assessed relative to radium chloride using rats. The results were compared for jejunal transport (in situ in vivo, ligated segment using anaesthetised animals) and feed trial experiments. In addition, the influence of age and duration of dosage (hours in the case of the jejunal transport and weeks in the feed trial studies) were investigated. Mussel radium transport across the jejunum of adults and juveniles (<0.3%) was very small when compared to radium chloride (50% injected dose). The amount of mussel radium available for intestinal uptake in the feed trials was also low (<0.5%) but significant when compared to the uptake of radium chloride (< 1.5%). Incorporation of mussel radium into bone was less than that of radium chloride (p=0.0001) for both adults and juveniles. Extrapolation of the data from the animal model to humans suggests that eating these mussels carries with it only a low risk of exceeding the Annual Limit of Intake (ALI) set for members of the public, even in juveniles

  15. Effect of duration of exposure to RaCl{sub 2} and a radium apatite from freshwater mussels on intestinal transport and bone deposition of radium

    Energy Technology Data Exchange (ETDEWEB)

    Domel, R.U. [Australian Nuclear Science and Technology Organsiation, Lucas Heights, NSW (Australia). Environment Division; Beal, A.M. [University of New South Wales, NSW (Australia). Biological Science

    1997-10-01

    Natural leaching of uranium ore bodies can result in {sup 226}Ra pollution of adjacent waterways and consequent incorporation of radium into the food chain. Mining has the potential to augment this effect. In the Magela flood plain, Northern Territory, the freshwater mussel (Velesunio angasi) concentrates radium in its tissues as a phosphate compound. The availability of mussel radium for uptake and tissue incorporation was assessed relative to radium chloride using rats. The results were compared for jejunal transport (in situ in vivo, ligated segment using anaesthetised animals) and feed trial experiments. In addition, the influence of age and duration of dosage (hours in the case of the jejunal transport and weeks in the feed trial studies) were investigated. Mussel radium transport across the jejunum of adults and juveniles (<0.3%) was very small when compared to radium chloride (50% injected dose). The amount of mussel radium available for intestinal uptake in the feed trials was also low (<0.5%) but significant when compared to the uptake of radium chloride (< 1.5%). Incorporation of mussel radium into bone was less than that of radium chloride (p=0.0001) for both adults and juveniles. Extrapolation of the data from the animal model to humans suggests that eating these mussels carries with it only a low risk of exceeding the Annual Limit of Intake (ALI) set for members of the public, even in juveniles 18 refs., 5 figs.

  16. Supporting screws combined with bone cement filling for reconstructing tibial bone defect in knee arthroplasty%支撑螺钉结合骨水泥填充重建膝关节置换术中胫骨平台骨缺损

    Institute of Scientific and Technical Information of China (English)

    黄海; 张喜才

    2014-01-01

    Objective To observe the clinical effect of supporting screws combined with bone cement filling on reconstructing tibial bone defect in knee arthroplasty.Methods Thirty-one patients (47 lateral tibial plateau structural bone defect) underwent total knee replacement.After conventional tibial osteotomy,2 or 3 pieces of supporting screws were screwed according to bone defect area,and bone cement was pressurely filled,and then the tibial prosthesis was installed.The knee rehabilitation training was strengthened and the effect was regular followed up after the operation.Results Thirty-one patients were followed up for 1-5 years,average 2.8 years.The pain of the knee completely disappeared after operation,and the stability and function of the knee were good.The KSS knee score were 87 to 95 points,an average of 92.4 points,which were significantly improved after operation (t =6.41,P < 0.01).In the last follow-up through X-ray examination,there were no prosthesis loosening or signs of infection,no bone cement filling zone interface lucency or supporting screw loosening,displacement or other complications.Conclusions Supporting screws combined with bone cement filling technique can effectively resolve the tibial knee replacement of large bone defects,and the short-term curative effect is satisfactory.So it is one of the ideal methods for senile patients.%目的 观察支撑螺钉结合骨水泥填充重建膝关节置换术中胫骨平台骨缺损的临床疗效.方法 对31例47侧重度胫骨平台结构性骨缺损患者行全膝关节置换术,常规胫骨平台截骨,截骨后根据骨缺损面积,拧入2~3枚支撑螺钉,加压填充骨水泥,安置胫骨骨水泥假体.术后加强膝关节功能康复训练并定期随访疗效.结果 31例患者术后随访1~5年,平均2.8年,术后疼痛完全消失,膝关节稳定性及功能均良好.膝关节KSS评分87~95分,平均92.4分,较术前显著改善(t=6.41,P<0.01).术后末次随访复查X线片未见

  17. A new double bone-double bundle patellar tendon-bone graft model: A calf model study

    OpenAIRE

    Öztürk, Hayati; Öztemur, Zekeriya; Bulut, Okay; Tezeren, Seyfi Gündüz

    2011-01-01

    AbstractThe aim of this study is to improve a new graft model for anatomic double bundle Anterior Crucial Ligament reconstruction (ACL). The aim of ACL reconstruction is to reproduce the functions of the native ACL. An anatomic double bundle ACL reconstruction utilizes two separate grafts to replace the Anterior Medial (AM) and Posterior Lateral (PL) bundles of the ACL. Bone-Patellar Tendon-Bone (BPTB) Graft was harvested from calf knee. Patellar tendon and distal bone were split as longitudi...

  18. Definitive Management of Open Tibia Fractures Using Limb Reconstruction System

    Science.gov (United States)

    Patil, Mahantesh Yellangouda; Gupta, Srinath Myadam; Agarwal, Saumya; Chandarana, Vishal

    2016-01-01

    Introduction Open fractures are treated as surgical emergency and early administration of intravenous antibiotic coupled with early irrigation and debridement decreases the infection rate dramatically. Limb Reconstruction System (LRS) is a unilateral rail system which consists of Shanz pins, rail rods and sliding clamps. It is specifically designed to enable the surgeon to perform simple and effective surgery as it offers rigid fixation of fracture fragments, allowing early weight bearing and reduces economic burden. Aim To determine the efficacy of Limb Reconstruction System for treatment of compound tibia fractures. Materials and Methods A prospective study was carried out where in 54 cases out of 412 compound tibia fractures having Modified Gustilo Anderson Type IIIA and IIIB with a mean age of 42±5 years were treated using LRS over a period of 26 months. Limb reconstruction system was used in acute docking mode or with corticotomy and bone transport was done depending upon the bone loss. The soft tissue condition was assessed and split thickness skin grafting and flap repairs were done as per the need. Clinical and radiological assessment was done at every follow-up. Bony and functional assessment was done by Association for the Study and Application of the Methods of Illizarov (ASAMI) criteria. Results Among 54 patients, bony results as per ASAMI score were excellent in 36, good in 14, fair in 2 and poor in 2 patients. Functional results were excellent in 43, good in 7, fair in 4 patients. The average fracture union time was 8 months. Post-surgery patient satisfaction was excellent since fixation allowed weight bearing immediately. Average hospital stay was 7 days and financial burden was reduced by 40% as compared to multi staged surgery. The average time of return to work was 20 days. Conclusion LRS is an easy, simple and definitive surgical procedure that allows immediate full weight bearing walking. It reduces hospital stay, is cost effective with

  19. Clinical study of prosthetic gingival reconstruction in vertical bone defect patients%垂直骨量不足时种植修复体的牙龈补偿处理及其效果研究

    Institute of Scientific and Technical Information of China (English)

    邸萍; 林野; 李健慧; 邱立新; 崔宏燕

    2011-01-01

    目的 探讨和评估垂直骨量不足的种植修复患者采用牙龈色材料进行牙龈补偿修复的临床效果、技术要点及应用价值.方法 2002年2月至2011年1月采用牙龈瓷或牙龈色树脂对北京大学口腔医学院·口腔医院口腔种植中心垂直骨量不足患者31例(男性22例、女性9例)的种植修复体进行了牙龈补偿修复处理.31例中牙列缺失12例、牙列缺损19例,共有152件种植体支持固定修复体.对种植体存留率、修复体质量及美学、软组织变化、牙龈状态等进行观察和评价.患者追踪3~108个月,平均31.5个月.结果 本研究观察期内152枚种植体存留率100%,修复体总体评估可接受率96.8%.结论 具有适应证的垂直骨量不足患者种植修复时牙龈补偿处理方法临床可行、无外科创伤、美观效果可接受、患者满意度高.%Objective To evaluate the preliminary clinical results of prosthetic gingival reconstruction in vertical bone defect patients.Methods The study included 31 partial or edentulous patients (male 22,female 9) with 152 implants supporting fixed prostheses from February 2002 to January 2011 in Peking University School and Hospital of Stomatology.The implant-supported fixed prostheses with artificial gingival material to compensate for vertical defect were delivery after implant healing period.At time of prostheses delivery,a panoramic radiograph was taken.The results were evaluated according to California Dental Association by two prosthodontists.Clinical observation included survival of the implants,integrity of the restoration,complication of prosthesis and degree of satisfaction of the patients.Results A total of 152 implants supported fixed prostheses with artificial gingival materials to compensate vertical bone defect were delivered.No implants lost,and the survival rate was 100% during the follow-up period.The sore of acceptance of prosthesis was 96.8%.All patients were satisfied with

  20. Metaphyseal bone loss in revision knee arthroplasty.

    Science.gov (United States)

    Ponzio, Danielle Y; Austin, Matthew S

    2015-12-01

    The etiology of bone loss encountered during revision total knee arthroplasty (TKA) is often multifactorial and can include stress shielding, osteolysis, osteonecrosis, infection, mechanical loss due to a grossly loose implant, and iatrogenic loss at the time of implant resection. Selection of the reconstructive technique(s) to manage bone deficiency is determined by the location and magnitude of bone loss, ligament integrity, surgeon experience, and patient factors including the potential for additional revision, functional demand, and comorbidities. Smaller, contained defects are reliably managed with bone graft, cement augmented with screw fixation, or modular augments. Large metaphyseal defects require more extensive reconstruction such as impaction bone grafting with or without mesh augmentation, prosthetic augmentation, use of bulk structural allografts, or use of metaphyseal cones or sleeves. While each technique has advantages and disadvantages, the most optimal method for reconstruction of large metaphyseal bone defects during revision TKA is not clearly established. PMID:26362647

  1. Canal Wall Reconstruction Mastoidectomy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To investigate the advantages of canal wall reconstruction (CWR) mastoidectomy, a single-stage technique for cholesteatoma removal and posterior external canal wall reconstruction, over the open and closed procedures in terms of cholesteatoma recurrence. Methods: Between June 2002 and December 2005, 38 patients (40 ears) with cholesteatoma were admited to Sun Yat-Sen Memorial Hospital and received surgical treatments. Of these patients, 25 were male with ages ranging between 11 and 60 years (mean = 31.6 years) and 13 were female with ages ranging between 20 and 65 years (mean = 38.8 years). Canal wall reconstruction (CWR)mastoidectomy was performed in 31 ears and canal wall down (CWD) mastoidectomy in 9 ears. Concha cartilage was used for ear canal wall reconstruction in 22 of the 31 CWR procedures and cortical mastoid bone was used in the remaining 9 cases. Results At 0.5 to 4 years follow up, all but one patients remained free of signs of cholesteatoma recurrence, i.e., no retraction pocket or cholesteatoma matrix. One patient, a smoker, needed revision surgery due to cholesteatoma recurrence 1.5 year after the initial operation. The recurrence rate was therefore 3.2% (1/31). Cholesteatoma recurrence was monitored using postoperative CT scans whenever possible. In the case that needed a revision procedure, a retraction pocket was identified by otoendoscopy in the pars flacida area that eventually evolved into a cholesteatoma. A pocket extending to the epitympanum filled with cholesteatoma matrix was confirmed during the revision operation, A decision to perform a modified mastoidectomy was made as the patient refused to quit smoking. The mean air-bone gap in pure tone threshold was 45 dB before surgery and 25 dB after (p < 0.05). There was no difference between using concha cartilage and cortical mastoid bone for the reconstruction regarding air-bone gap improvement, CT findings and otoendoscopic results. Conclusion CWR mastoidectomy can be used for

  2. Bone Cancer

    Science.gov (United States)

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another ... more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 and ...

  3. Bone Cancer

    Science.gov (United States)

    Cancer that starts in a bone is uncommon. Cancer that has spread to the bone from another part of the body is more common. There are three types of bone cancer: Osteosarcoma - occurs most often between ages 10 ...

  4. Bone Diseases

    Science.gov (United States)

    Your bones help you move, give you shape and support your body. They are living tissues that rebuild constantly ... childhood and your teens, your body adds new bone faster than it removes old bone. After about ...

  5. Correção da falha óssea femoral e tibial pelo método do transporte ósseo de Ilizarov Femoral and tibial bone loss correction using Ilizarov's bone transport

    OpenAIRE

    Celso Herminio Ferraz Picado; Cleber Antonio Jansen Paccola; Eugenio Freire Andrade Filho

    2000-01-01

    Analisamos retrospectivamente 11 pacientes submetidos à técnica do transporte ósseo de Ilizarov, todos portadores de falha óssea diafisária secundária a ressecção de segmentos ósseos infectados, 5 localizadas no fêmur e 6 na tíbia. No grupo de pacientes com lesão femoral a falha óssea variou de 7cm a 12 cm, em dois destes pacientes havia encurtamento do membro de 2 cm. No grupo com lesão tibial a falha óssea variou de 2,5cm a 10cm, com encurtamento do membro em dois pacientes de 1,5cm e 2 cm ...

  6. Three-dimensional reconstruction of entire vertebral bodies

    DEFF Research Database (Denmark)

    Odgaard, A.; Andersen, K.; Ullerup, R.; Frich, Lars Henrik; Melsen, F.

    1994-01-01

    This paper describes a technique for 3-D reconstruction of large cancellous bone regions. The output is a 3-D array describing the original cancellous bone region, and the output can be used for any kind of measurement of the bone architecture. The technique was developed as a tool for researchers...

  7. Evidence-Based ACL Reconstruction

    Directory of Open Access Journals (Sweden)

    E. Carlos RODRIGUEZ-MERCHAN

    2015-01-01

    Full Text Available There is controversy in the literature regarding a number of topics related to anterior cruciate ligament (ACLreconstruction. The purpose of this article is to answer the following questions: 1 Bone patellar tendon bone (BPTB reconstruction or hamstring reconstruction (HR; 2 Double bundle or single bundle; 3 Allograft or authograft; 4 Early or late reconstruction; 5 Rate of return to sports after ACL reconstruction; 6 Rate of osteoarthritis after ACL reconstruction. A Cochrane Library and PubMed (MEDLINE search of systematic reviews and meta-analysis related to ACL reconstruction was performed. The key words were: ACL reconstruction, systematic reviews and meta-analysis. The main criteria for selection were that the articles were systematic reviews and meta-analysesfocused on the aforementioned questions. Sixty-nine articles were found, but only 26 were selected and reviewed because they had a high grade (I-II of evidence. BPTB-R was associated with better postoperative knee stability but with a higher rate of morbidity. However, the results of both procedures in terms of functional outcome in the long-term were similar. The double-bundle ACL reconstruction technique showed better outcomes in rotational laxity, although functional recovery was similar between single-bundle and double-bundle. Autograft yielded better results than allograft. There was no difference between early and delayed reconstruction. 82% of patients were able to return to some kind of sport participation. 28% of patients presented radiological signs of osteoarthritis with a follow-up of minimum 10 years.

  8. Penile reconstruction

    OpenAIRE

    Garaffa, Giulio; Sansalone, Salvatore; Ralph, David J.

    2012-01-01

    During the most recent years, a variety of new techniques of penile reconstruction have been described in the literature. This paper focuses on the most recent advances in male genital reconstruction after trauma, excision of benign and malignant disease, in gender reassignment surgery and aphallia with emphasis on surgical technique, cosmetic and functional outcome.

  9. Penile reconstruction

    Institute of Scientific and Technical Information of China (English)

    Giulio Garaffa; Salvatore Sansalone; David J Ralph

    2013-01-01

    During the most recent years,a variety of new techniques of penile reconstruction have been described in the literature.This paper focuses on the most recent advances in male genital reconstruction after trauma,excision of benign and malignant disease,in gender reassignment surgery and aphallia with emphasis on surgical technique,cosmetic and functional outcome.

  10. 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 ...

  11. Bone tissue engineering : state of the art and future trends

    OpenAIRE

    Salgado, A. J.; Coutinho, O. P.; Reis, R.L.

    2004-01-01

    Although several major progresses have been introduced in the field of bone regenerative medicine during the years, current therapies, such as bone grafts, still have many limitations. Moreover, and in spite of the fact that material science technology has resulted in clear improvements in the field of bone substitution medicine, no adequate bone substitute has been developed and hence large bone defects/injuries still represent a major challenge for orthopaedic and reconstructive surgeons. I...

  12. 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 ...

  13. Fracture of the patella after the anterior cruciate ligament reconstruction

    OpenAIRE

    Milović Milan; Bojat Veselin; Kovačev Nemanja; Rašović Predrag; Milankov Miroslav

    2012-01-01

    Introduction. Fracture of the patella, after harvesting the central third of the patellar tendon for a bone-tendon-bone autograft, is a rare complication. Material and Methods. We made 1714 reconstructions of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and 7 patients had fracture of the patella (0.42%). The fracture was immediately recognized in the patients with vertical non-displaced patellar fracture and the broken screw osteosynthesis was ca...

  14. Climate Reconstructions

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA Paleoclimatology Program archives reconstructions of past climatic conditions derived from paleoclimate proxies, in addition to the Program's large...

  15. Titanium template for scaphoid reconstruction.

    Science.gov (United States)

    Haefeli, M; Schaefer, D J; Schumacher, R; Müller-Gerbl, M; Honigmann, P

    2015-06-01

    Reconstruction of a non-united scaphoid with a humpback deformity involves resection of the non-union followed by bone grafting and fixation of the fragments. Intraoperative control of the reconstruction is difficult owing to the complex three-dimensional shape of the scaphoid and the other carpal bones overlying the scaphoid on lateral radiographs. We developed a titanium template that fits exactly to the surfaces of the proximal and distal scaphoid poles to define their position relative to each other after resection of the non-union. The templates were designed on three-dimensional computed tomography reconstructions and manufactured using selective laser melting technology. Ten conserved human wrists were used to simulate the reconstruction. The achieved precision measured as the deviation of the surface of the reconstructed scaphoid from its virtual counterpart was good in five cases (maximal difference 1.5 mm), moderate in one case (maximal difference 3 mm) and inadequate in four cases (difference more than 3 mm). The main problems were attributed to the template design and can be avoided by improved pre-operative planning, as shown in a clinical case. PMID:25167978

  16. Laryngopharyngeal reconstruction

    OpenAIRE

    Kazi, Rehan A

    2006-01-01

    There is a high incidence of hypopharyngeal cancer is our country due to the habits of tobacco and alcohol. Moreover these cases are often detected in the late stages thereby making the issue of reconstruction very tedious and unpredictable. There are a number of options for laryngopharyngeal reconstruction available now including the use of microvascular flaps depending upon the patient’s fitness, motivation, technical expertise, size and extent of the defect. This article reviews the differ...

  17. Biomaterials for craniofacial reconstruction

    Directory of Open Access Journals (Sweden)

    Neumann, Andreas

    2009-01-01

    Full Text Available Biomaterials for reconstruction of bony defects of the skull comprise of osteosynthetic materials applied after osteotomies or traumatic fractures and materials to fill bony defects which result from malformation, trauma or tumor resections. Other applications concern functional augmentations for dental implants or aesthetic augmentations in the facial region.For ostheosynthesis, mini- and microplates made from titanium alloys provide major advantages concerning biocompatibility, stability and individual fitting to the implant bed. The necessity of removing asymptomatic plates and screws after fracture healing is still a controversial issue. Risks and costs of secondary surgery for removal face a low rate of complications (due to corrosion products when the material remains in situ. Resorbable osteosynthesis systems have similar mechanical stability and are especially useful in the growing skull.The huge variety of biomaterials for the reconstruction of bony defects makes it difficult to decide which material is adequate for which indication and for which site. The optimal biomaterial that meets every requirement (e.g. biocompatibility, stability, intraoperative fitting, product safety, low costs etc. does not exist. The different material types are (autogenic bone and many alloplastics such as metals (mainly titanium, ceramics, plastics and composites. Future developments aim to improve physical and biological properties, especially regarding surface interactions. To date, tissue engineered bone is far from routine clinical application.

  18. “Basket weave technique” for medial patellofemoral ligament reconstruction: Clinical outcome of a prospective study

    Directory of Open Access Journals (Sweden)

    Pranjal S Kodkani

    2016-01-01

    Conclusion: This new method of MPFL reconstruction gives excellent results. It avoids complications related to bone tunneling and implants. It is a safe, effective, reliable and reproducible technique.

  19. Temperature effect (300-1500K) on the infrared photon transport inside an X-ray microtomographic reconstructed porous silica glass

    International Nuclear Information System (INIS)

    A Monte Carlo Ray Tracing program has been developed to predict the thermal radiative properties of an X-ray microtomographic reconstructed silica glass containing gas bubbles, for a large domain of wavelength (1-25μm) and for a large domain of temperature (300-1500K). The main input of the program is the complex optical index of the corresponding homogeneous silica glass. Validity of the model is checked by comparing a simulated normal spectral emittance, obtained on the reconstructed glass, with the experimental one recorded at T=1300K

  20. 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 ...

  1. Laryngeal reconstruction by complex hyoid bone flap after frontal partial laryngectomy%复合舌骨瓣悬吊修复额侧部分喉缺损的临床研究

    Institute of Scientific and Technical Information of China (English)

    欧阳电; 杨安奎; 张诠; 陈文宽; 宋明; 李浩; 刘巍巍; 刘学奎; 陈艳峰

    2013-01-01

    Objective To describe a new flap technique,the combined hyoid bone and thyrohyoid membrane flap,for laryngeal reconstruction after tumor resection,and to evaluate clinical outcome.Methods Six patients requiring frontal partial laryngectomy for cancer were enrolled between September 2008 and August 2012.Results Nasogastric feeding was given in the first 24 hours after surgery.The median times of swallowing batter,drinking water and removal of the nasogastric tubes were 2.6,5.5 and 6.3 days respectively.All patients had good respiratory function,no dyspnea or dysphagia postoperatively.Voice quality was satisfactory.There were no deaths.The median of survival time was 29.5 months,ranging from 14 to 47 months.Only one case subsequently underwent total laryngectomy due to disease recurrence in the paraglottic space,no evidence of tumor recurrence in other cases.Conclusions The combined musclepedicle hyoid bone and thyrohyoid membrane flap is a reliable for one-stage repair of laryngotracheal defects and voice quality,swallowing function and ventilation after the procedure were favorable.%目的 报道用复合舌骨瓣悬吊修复额侧部分喉缺损,并且探讨术后喉功能和肿瘤预后情况.方法 分析2008年9月至2012年8月中山大学肿瘤防治中心头颈科运用该技术治疗6例患者的临床资料.结果 患者均在术后24 h内进行鼻饲营养,进食糊状物、喝水和拔出鼻饲营养管的中位数时间分别是2.6,5.5和6.3d.未发生误吸和吸人性肺炎等严重不良事件.发声效果还是令人满意的.呼吸功能良好,无喉狭窄发生.第2例患者术后8个月声门旁间隙复发因而进行了喉全切除,其余病例均无瘤生存至今.中位生存时间是29.5个月(14 ~ 47个月).结论 复合舌骨瓣悬吊术可以一期修复额侧喉软骨和喉黏膜缺损,可以重建喉的吞咽、呼吸和发音功能.

  2. Osteogenic Matrix Cell Sheets Facilitate Osteogenesis in Irradiated Rat Bone

    Directory of Open Access Journals (Sweden)

    Yoshinobu Uchihara

    2015-01-01

    Full Text Available Reconstruction of large bone defects after resection of malignant musculoskeletal tumors is a significant challenge in orthopedic surgery. Extracorporeal autogenous irradiated bone grafting is a treatment option for bone reconstruction. However, nonunion often occurs because the osteogenic capacity is lost by irradiation. In the present study, we established an autogenous irradiated bone graft model in the rat femur to assess whether osteogenic matrix cell sheets improve osteogenesis of the irradiated bone. Osteogenic matrix cell sheets were prepared from bone marrow-derived stromal cells and co-transplanted with irradiated bone. X-ray images at 4 weeks after transplantation showed bridging callus formation around the irradiated bone. Micro-computed tomography images at 12 weeks postoperatively showed abundant callus formation in the whole circumference of the irradiated bone. Histology showed bone union between the irradiated bone and host femur. Mechanical testing showed that the failure force at the irradiated bone site was significantly higher than in the control group. Our study indicates that osteogenic matrix cell sheet transplantation might be a powerful method to facilitate osteogenesis in irradiated bones, which may become a treatment option for reconstruction of bone defects after resection of malignant musculoskeletal tumors.

  3. Bone tumor

    Science.gov (United States)

    ... physical exam. Tests that may be done include: Alkaline phosphatase blood level Bone biopsy Bone scan Chest x- ... also affect the results of the following tests: Alkaline phosphatase isoenzyme Blood calcium level Parathyroid hormone Blood phosphorus ...

  4. 二处截骨骨搬运治疗胫骨干大段感染性骨缺损合并软组织缺损的再认识%Bifocal corticotomy and bone transport for large segmental defects of the infected tibia and soft tissue

    Institute of Scientific and Technical Information of China (English)

    徐永清; 朱跃良; 范新宇; 林玮; 何晓清; 李阳; 王毅

    2015-01-01

    .After debridement,the tibia was fixated with Ilizarov external fixator.Bifocal corticotomy was performed on the proximal and distal tibial metaphyses simultaneously.The transporting speeds for proximal and distal tibial segment were 1 mm/d and 0.6 mm/d initially,and lowered to 0.5 ~ 0.6 mm/d later until the 2 bone segments connected.The bone transport lasted for 40 to 150 days,averaging 69.6 days.Results The patients were followed up for 12 to 72 months (average,26.6 months).The soft tissue wound healed uneventfully and the bone defects were reconstructed.Of the 25 cases,22 obtained primary bone union.Nonunion of the bone segments occurred in one,wound infection and osteogenesis imperfect in bone lengthening area occurred in one,and cut and pull-out of K-wires in the osteoporotic tibial ends occurred in one.These complications were treated accordingly before bone union was achieved.The other complications were also treated accordingly,including serious pin tract infection in 2 cases,re-fracture after removal of the external fixator in one,and shift of the tibial alignment in 2 cases.Conclusions Bifocal corticotomy can decrease bone transport time for large segmental defects of the tibia and soft tissue.During the long treatment period,a surgeon must pay much attention to the technical details and management of complications.

  5. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  6. Effects of 25-(OH)D3 on fecal Ca and P excretion, bone mineralization, Ca and P transporter mRNA expression and performance in growing female pigs.

    Science.gov (United States)

    Regassa, Alemu; Adhikari, Roshan; Nyachoti, Charles M; Kim, Woo Kyun

    2015-01-01

    A study was conducted to examine the effects of 25-hydroxyvitamin D3 (25-(OH)D3) on fecal Ca and P excretion, bone mineralization, performance and the mRNA expression of intestinal transporter genes in growing female pigs. Sixty-day old gilts (n = 24) with an average initial BW of 23.13 ± 1.49 kg were randomly allocated to a control diet (diet 1) containing wheat/corn/soybean meal and 150 IU kg(-1) of Vitamin D3, diet 1 + 50 μg of 25-(OH)D3 kg(-1) (diet 2) and diet 1 + 100 μg of 25-(OH)D3 kg(-1) (diet 3). The pigs were housed in an individual pen and had ad libitum access to feed and water for 42 days, and BWG and feed intake were measured weekly. Measures of bone mineralization and expression of Ca and P transporters mRNA were analyzed using Dual Energy X-Ray Absortiometry (DEXA) and quantitative real-time polymerase chain reaction (qRT-PCR), respectively. Data were analyzed using GLM procedure of the Statistical Analysis System (SAS Institute version 9.2). Fecal Ca and P concentration were significantly reduced (P ≤ 0.05) in pigs fed diets 2 and 3 compared with the control diet. Supplementation of 25-(OH)D3 did not significantly improve bone mineralization, animal performance and intestinal transporters mRNA expression except for SLC34A1, a sodium-dependent phosphate transporter 1. In conclusion, supplementation of 25-(OH)D3 in swine nutrition may not improve animal performance but has the potential to reduce environmental pollution by increasing dietary Ca and P retention while reducing their excretion. PMID:25714461

  7. Project Reconstruct.

    Science.gov (United States)

    Helisek, Harriet; Pratt, Donald

    1994-01-01

    Presents a project in which students monitor their use of trash, input and analyze information via a database and computerized graphs, and "reconstruct" extinct or endangered animals from recyclable materials. The activity was done with second-grade students over a period of three to four weeks. (PR)

  8. Vaginal reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Lesavoy, M.A.

    1985-05-01

    Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients.

  9. Vaginal reconstruction

    International Nuclear Information System (INIS)

    Vaginal reconstruction can be an uncomplicated and straightforward procedure when attention to detail is maintained. The Abbe-McIndoe procedure of lining the neovaginal canal with split-thickness skin grafts has become standard. The use of the inflatable Heyer-Schulte vaginal stent provides comfort to the patient and ease to the surgeon in maintaining approximation of the skin graft. For large vaginal and perineal defects, myocutaneous flaps such as the gracilis island have been extremely useful for correction of radiation-damaged tissue of the perineum or for the reconstruction of large ablative defects. Minimal morbidity and scarring ensue because the donor site can be closed primarily. With all vaginal reconstruction, a compliant patient is a necessity. The patient must wear a vaginal obturator for a minimum of 3 to 6 months postoperatively and is encouraged to use intercourse as an excellent obturator. In general, vaginal reconstruction can be an extremely gratifying procedure for both the functional and emotional well-being of patients

  10. Comparing calvarial transport distraction with and without radiation and fat grafting.

    Science.gov (United States)

    Yuhasz, Mikell M; Koch, Felix P; Kwiatkowski, Anna; Young, Calvin; Clune, James; Travieso, Rob; Wong, Kenneth; Van Houten, Joshua; Steinbacher, Derek M

    2014-10-01

    The purpose of this study is to: a) assess transport distraction to reconstruct cranial defects in radiated and non-radiated fields b) examine adipose grafting's effect on the bony regenerate and overlying wound, and c) elucidate sources of bone formation during transport distraction osteogenesis. Twenty-three male New Zealand white rabbits (3 months; 3.5 kg) were used, 10 non-irradiated and 13 irradiated (17 treatment, 6 control) with a one-time fraction of 35 Gy. A 16 × 16 mm defect was abutted by a 10 × 16 mm transport disc 5 weeks after irradiation, and 11 animals were fat grafted at the distraction site. Latency (1 day), distraction (1.5 mm/day), and consolidation (4 weeks) followed. Fluorochromes were injected subcutaneously and microCT, fluorescence, and histology assessed. In distracted animals without fat grafting, bone density measured 701.87 mgHA/ccm and 2271.95 mgHA/ccm in irradiated and non-irradiated animals. In distracted animals with fat grafting, bone density measured 703.23 mgHA/ccm and 2254.27 mgHA/ccm in irradiated and non-irradiated animals. Fluorescence revealed ossification emanating from the dura, periosteum, and transport segment with decreased formation in irradiated animals. Transport distraction is possible for cranial reconstruction in irradiated fields but short-term osseous fill is significantly diminished. Adipose grafting enhances wound healing in previously irradiated fields but does not enhance ossification. PMID:24864072

  11. Quantitative evaluation of regularized phase retrieval algorithms on bone scaffolds seeded with bone cells.

    Science.gov (United States)

    Weber, L; Langer, M; Tavella, S; Ruggiu, A; Peyrin, F

    2016-05-01

    In the field of regenerative medicine, there has been a growing interest in studying the combination of bone scaffolds and cells that can maximize newly formed bone. In-line phase-contrast x-ray tomography was used to image porous bone scaffolds (Skelite(©)), seeded with bone forming cells. This technique allows the quantification of both mineralized and soft tissue, unlike with classical x-ray micro-computed tomography. Phase contrast images were acquired at four distances. The reconstruction is typically performed in two successive steps: phase retrieval and tomographic reconstruction. In this work, different regularization methods were applied to the phase retrieval process. The application of a priori terms for heterogeneous objects enables quantitative 3D imaging of not only bone morphology, mineralization, and soft tissue formation, but also cells trapped in the pre-bone matrix. A statistical study was performed to derive statistically significant information on the different culture conditions. PMID:27054380

  12. Quantitative evaluation of regularized phase retrieval algorithms on bone scaffolds seeded with bone cells

    Science.gov (United States)

    Weber, L.; Langer, M.; Tavella, S.; Ruggiu, A.; Peyrin, F.

    2016-05-01

    In the field of regenerative medicine, there has been a growing interest in studying the combination of bone scaffolds and cells that can maximize newly formed bone. In-line phase-contrast x-ray tomography was used to image porous bone scaffolds (Skelite©), seeded with bone forming cells. This technique allows the quantification of both mineralized and soft tissue, unlike with classical x-ray micro-computed tomography. Phase contrast images were acquired at four distances. The reconstruction is typically performed in two successive steps: phase retrieval and tomographic reconstruction. In this work, different regularization methods were applied to the phase retrieval process. The application of a priori terms for heterogeneous objects enables quantitative 3D imaging of not only bone morphology, mineralization, and soft tissue formation, but also cells trapped in the pre-bone matrix. A statistical study was performed to derive statistically significant information on the different culture conditions.

  13. Bone regeneration in surgically created defects filled with autogenous bone: an epifluorescence microscopy analysis in rats

    OpenAIRE

    Marcos Heidy Guskuma; Eduardo Hochuli-Vieira; Flávia Priscila Pereira; Idelmo Rangel-Garcia Junior; Roberta Okamoto; Tetuo Okamoto; Osvaldo Magro Filho

    2010-01-01

    Although the search for the ideal bone substitute has been the focus of a large number of studies, autogenous bone is still the gold standard for the filling of defects caused by pathologies and traumas, and mainly, for alveolar ridge reconstruction, allowing the titanium implants installation. OBJECTIVES: The aim of this study was to evaluate the dynamics of autogenous bone graft incorporation process to surgically created defects in rat calvaria, using epifluorescence microscopy. MATERIAL A...

  14. Three-Dimensional Virtual Bone Bank System Workflow for Structural Bone Allograft Selection: A Technical Report

    OpenAIRE

    Ritacco, Lucas Eduardo; Farfalli, German Luis; Milano, Federico Edgardo; Ayerza, Miguel Angel; Muscolo, Domingo Luis; Aponte-Tinao, Luis

    2013-01-01

    Structural bone allograft has been used in bone defect reconstruction during the last fifty years with acceptable results. However, allograft selection methods were based on 2-dimensional templates using X-rays. Thanks to preoperative planning platforms, three-dimensional (3D) CT-derived bone models were used to define size and shape comparison between host and donor. The purpose of this study was to describe the workflow of this virtual technique in order to explain how to choose the best al...

  15. CT-based three-dimensional reconstruction navigation technique assisted pedicle screw placement in lumbar and sacral bone%腰骶骨椎弓根螺钉置入内固定:CT三维重建虚拟导航的辅助

    Institute of Scientific and Technical Information of China (English)

    陈晓明; 陈前芬; 肖增明; 宗少晖

    2015-01-01

      结果与结论:共置入腰骶椎椎弓根螺钉1088枚,其中1068枚螺钉位置为Ⅰ级,置钉准确率达98.2%。152例获得随访,随访时间12个月,无内固定物移位、断裂等并发症。术前CT三维重建虚拟导航技术能为腰骶骨椎弓根螺钉内固定提供三维立体的解剖信息,制定最优置钉计划,使置钉更加精确安全,从而提高整体的修复质量。%BACKGROUND:Pedicle screw fixation techniques have been widely used in the treatment of lumbar and sacral disease, such as trauma, deformity, tumor and degeneration. How to improve the accuracy of screw placement is a hot topic. CT-based three-dimensional reconstruction navigation technique provides real-time, multi-perspective, three-dimensional visualization of lumbar and sacral anatomy, and surgeons can perform the pedicle screw insertion procedures confidently with increase of accuracy and safety. OBJECTIVE:To study the clinical value of CT-based three-dimensional reconstruction navigation technique in the application of lumbar and sacral pedicle screw placement. METHODS:A total of 203 patients with lumbar and sacral diseases, including lumbar fracture, lumbar spondylolysis and lumbar spinal stenosis, were recruited from Department of Spine&Osteopathy, the First Affiliated Hospital of Guangxi Medical University between July 2008 and November 2014. Patients received pedicle screw placement in lumbar and sacral bone under the guidance of CT-based three-dimensional reconstruction navigation. Postoperative X-ray films and three-dimensional CT scan of lumbar bone were routinely examined in each patient. The accuracy of pedicle screw insertion was evaluated with postoperative CT scan according to Andrew classification. RESULTS AND CONCLUSION:A total of 1 088 screws were inserted in the lumbar and sacral bone. The accuracy of pedicle screw insertion was rated as grade I in 1 068 screws (98.2%) according to postoperative CT scan. 152 cases were fol owed

  16. Finite element analysis of total hip replacement with structural bone graft for acetabulum reconstruction in dysplasia of hip%成人髋臼发育不良伴骨关节炎行髋臼结构性植骨重建关节置换术的力学分析

    Institute of Scientific and Technical Information of China (English)

    许杰; 马若凡; 蔡志清; 李登

    2014-01-01

    Objective To study the stress distribution in the acetabular cup-bone interface affected by the structural bone graft for the acetabulum reconstruction during the total hip replacement (THR) in treating the dysplasia of hip by using the three dimensional (3D) finite element analysis. Methods The acetabulumm of the hip with dysplasia was scanned by CT.The computer simulation technology was used to reconstruct the three-dimensional (3D) model of the pelvic from CT scan picture in order to observe the dysplasia of the hip.The structural bone graft for reconstruction of the acetabulum reconstruction in THR was simulated.Then the pelvis and acetabular cup models were meshed.The mechanical analysis tool was used to analyze the 3D model, and the stress data in the acetabular cup-bone interface was achieved.After the statistical analysis of the experimental results, the structural bone graft affecting the stress distribution in the acetabular cup-bone interface was observed.Results The structural bone graft augmented the deficient acetabulum and improved the bone-bed inclusion of the cup during THR in treating the dysplasia of the hip, which leaded to greater contact area and smaller stress per unit area. The structural autograft which covered the anterior-lateral part of the cup bore greater stress.Conclusion The acetabular reconstruction with the structural bone graft improves the bone-bed inclusion of the cup during THR in treating the dysplasia of the hip.The stress deconcentration due to the larger contact area could benefit the stability of the cup.The coverage of the cup by the graft should not be too much, otherwise, the great stress on the structural bone graft would increase the risk of loosening.%目的:利用三维有限元力学分析方法,研究髋关节发育不良患者髋臼外上缘结构性植骨重建髋臼、增加臼杯假体包容对髋臼假体-骨界面间的应力分布情况的影响。方法选取髋关节发育不良患者的骨盆为

  17. Radio Reconstructions

    OpenAIRE

    Bulley, James; Jones, Daniel

    2013-01-01

    Radio Reconstructions is a sound installation which use indeterminate radio broadcasts as its raw material. Each piece is structured by a notated score, which controls its rhythm, dynamics and melodic contour over time. The audio elements used to enact this score are selected in real-time from unknown radio transmissions, by an autonomous software system which is continuously scanning the radio waves in search of similar fragments of audio. Using a technique known as audio mosaicing, hund...

  18. Bones of the Earth

    Directory of Open Access Journals (Sweden)

    Jose Miguel Correa

    2014-06-01

    Full Text Available The film Bones of the Earth (Riglin, Cunninham & Correa, 2014 is an experience in collective inquiry and visual creation based on arts-based research. Starting from the meeting of different subjectivities and through dialogue, planning, shooting and editing, an audiovisual text that reconstructs a reflexive process of collective creation is built. A sense of community, on-going inquiry, connections and social commitment inform the creative process. As a result, the video’s nearly five intense minutes are a metaphor for the search for personal meaning, connection with nature and intersubjective positioning in a world that undergoes constant change.

  19. [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

  20. Reconstruction de la surface de Fermi dans l'etat normal d'un supraconducteur a haute Tc: Une etude du transport electrique en champ magnetique intense

    Science.gov (United States)

    Le Boeuf, David

    Des mesures de resistance longitudinale et de resistance de Hall en champ magnetique intense transverse (perpendiculaire aux plans CuO2) ont ete effectuees au sein de monocristaux de YBa2Cu3Oy (YBCO) demacles, ordonnes et de grande purete, afin d'etudier l'etat fondamental des supraconducteurs a haute Tc dans le regime sous-dope. Cette etude a ete realisee en fonction du dopage et de l'orientation du courant d'excitation J par rapport a l'axe orthorhombique b de la structure cristalline. Les mesures en champ magnetique intense revelent par suppression de la supraconductivite des oscillations magnetiques des resistances longitudinale et de Hall dans YBa2Cu 3O6.51 et YBa2Cu4O8. La conformite du comportement de ces oscillations quantiques au formalisme de Lifshitz-Kosevich, apporte la preuve de l'existence d'une surface de Fermi fermee a caractere quasi-2D, abritant des quasiparticules coherentes respectant la statistique de Fermi-Dirac, dans la phase pseudogap d'YBCO. La faible frequence des oscillations quantiques, combinee avec l'etude de la partie monotone de la resistance de Hall en fonction de la temperature indique que la surface de Fermi d'YBCO sous-dope comprend une petite poche de Fermi occupee par des porteurs de charge negative. Cette particularite de la surface de Fermi dans le regime sous-dope incompatible avec les calculs de structure de bande est en fort contraste avec la structure electronique presente dans le regime surdope. Cette observation implique ainsi l'existence d'un point critique quantique dans le diagramme de phase d'YBCO, au voisinage duquel la surface de Fermi doit subir une reconstruction induite par l'etablissement d'une brisure de la symetrie de translation du reseau cristallin sous-jacent. Enfin, l'etude en fonction du dopage de la resistance de Hall et de la resistance longitudinale en champ magnetique intense suggere qu'un ordre du type onde de densite (DW) est responsable de la reconstruction de la surface de Fermi. L'analogie de

  1. Allograft in bone tumour surgery

    International Nuclear Information System (INIS)

    In the last twenty years, there has been a vast improvement in the prognosis of primary malignant tumours of bone. This is due to many factors including early detection, staging and classification of tumours as a result of better staining and imaging techniques, better surgical technology, e.g. endoprosthesis and most importantly adjuvant treatment with cytotoxic drugs. As a result of long term survival, amputation of limb has more or less been replaced by limb salvage surgery. This procedure consists of two parts. Primary objective is of course complete removal of the tumour by adequate soft tissue cover and secondarily by reconstruction of the locomotor system, If possible with retention of the function of the limb. These procedures include endo-prosthetic replacement or arthroplasty and arthrodesis using autologus grafts, allograft or combination. With the development of bone banks and assured safety of preserved bones, reconstructive limb salvage surgery using massive allograft is gradually replacing prosthetic implants. The advantages include replacement of articular surfaces, incorporation of the graft to the host bone, attachment of bone tissue and increased probably permanent survival. Allograft can be used for intercalary replacement, osteo-articular arthroplasty arthrodesis or filling large cavities. Inherent complication of massive allograft are disease transmission, infection, delayed and non-union, pathological fractures, mechanical failure and joint destruction. Several limb salvage procedures using allografts have been carried out in our institution with one failure due to infection. Paucity of available allograft has restricted more such procedures to be carried out

  2. Reconstrucción craneofacial compleja: malla de titanio, hueso autólogo preservado en óxido de etileno y reconstrucciones tridimensionales en polimetilmetacrilato (HTR-PMI Complex craneofacial reconstruction: titanium mesh, autologous bone preserved in ethylene oxide and tridimensional polimetilmetacrilate implants (HTR-PMI

    Directory of Open Access Journals (Sweden)

    G. Flores-Lima

    2010-03-01

    Full Text Available La evolución de la Cirugía Craneofacial se inicio con Jean Paul Tessier, quien en 1967 preconizó el uso de injertos autólogos de hueso fresco en gran cantidad para cubrir extensas brechas óseas en la corrección de disóstosis craneofacial. Recientemente, diferentes tipos de reconstrucción utilizando hueso autólogo preservado en oxido de etileno y materiales como el polimetilmetacrilato poroso confeccionado a medida, han permitido también la corrección de grandes defectos óseos craneofaciales. Presentamos nuestra experiencia inicial en el uso de estas técnicas a través de un análisis retrospectivo sobre 21 pacientes operados por un equipo multidisciplinario entre Enero del 2007 y Marzo del 2009 en el Hospital Militar, Centro Panamericano de Ojos y Hospital de Diagnóstico de El Salvador, en los que se utilizaron formas alternativas pera reconstrucción de calota craneana, piso de órbita, fosa craneal anterior, área órbito-cigomática y maxilar superior. No registramos casos de infección o retirada de material de osteosíntesis aloplástico o de los injertos autólogos, ni hubo fístulas. Si se presentó una úlcera postraumática en una zona de unión de tejido desvitalizado, que se resolvió con tratamiento conservador. Los resultados estéticos obtenidos fueron de aceptables a buenos. Como conclusión, el equipo multidisciplinario, la combinación de técnicas quirúrgicas y el uso de material protésico para la reconstrucción craneofacial compleja ha dado como resultado avances significativos desde el punto de vista funcional y estético ante lesiones que involucran esta compleja área anatómica.The evolution of craniofacial surgery began with Jean Paul Tessier, who in 1967 supported the use of fresh autologous bone to cover bone defects in the craniofacial area. Recently different types of reconstructions using autologous bone preserved in ethylene oxide and advanced custom-made polimetacrilate implants that have allowed

  3. The effect of bone marrow aspirate, bone graft and collagen composites on fixation of bone implants

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    2007-01-01

     Introduction: Replacement of extensive local bone loss especially in revision joint arthroplasties is a significant clinical challenge. Autogenous and allogenic cancellous bone grafts have been the gold standard in reconstructive orthopaedic surgery, but it is well known that there is morbidity...... associated with harvesting of autogenous bone graft and limitations in the quantity of bone available. Disadvantages of allograft include the risk of bacterial or viral contamination and non union as well as the potential risk of disease transmission. Alternative options are attractive and continue to be...... sought. Hydroxyapatite and collagen composites have the potential in mimicking and replacing skeletal bones. Aim: This study attempted to determine the effect of hydroxyapatite/collagen composites in the fixation of bone implants. The composites used in this study is produced by Institute of Science and...

  4. 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)

  5. 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 ...

  6. Alpha-tricalcium phosphate cement in the reconstruction of bone defects in rats Cimento de alfa-tricálcio-fosfato na reconstrução de defeitos ósseos em ratos

    Directory of Open Access Journals (Sweden)

    João Gabriel Souza Pinto

    2011-04-01

    Full Text Available PURPOSE: To evaluate the ability of a mixture of α-TCP and autogenous bone (AB vs. α-TCP alone and AB alone to promote new bone formation and tissue repair in bone defects. METHODS: Bone defects surgically created in 15 male Wistar rats were divided into four groups: Group I (AB, Group II (α-TCP, Group III (α-TCP+AB assessed by light microscopy, and Group IV (α-TCP+AB assessed by scanning electron microscopy. Bone repair findings were assessed at 30, 60, and 120 days postoperatively. RESULTS: The histological findings obtained in Groups I (p=0.459, II (p=0.368, and III (p=0.459 and at 30 days (p=0.717, 60 days (p=0.717, and 120 days (p=0.779 did not show statistically significant differences. Scanning electron microscopy revealed direct contact between the α-TCP+AB implant and the bone tissue at 120 days. CONCLUSION: The α-TCP implant is effective alternative bone substitutes for the treatment of critical size bone defects.OBJETIVO: Avaliar a capacidade da mistura de α-TCP e osso autógeno (OA Vs somente α-TCP e somente OA em promover a neoformação óssea e reparo tecidual em defeitos ósseos. MÉTODOS: Foram criados cirurgicamente defeitos ósseos em 15 ratos Wistar machos, distribuídos em quatro grupos: Grupo I (OA, Grupo II (α-TCP, Grupo III (α-TCP + OA avaliado por microscopia de luz e Grupo IV (α-TCP + OA avaliado por microscopia eletrônica de varredura. Os resultados da reparação óssea foram avaliados em 30, 60 e 120 dias. RESULTADOS:os achados histológicos obtidos nos grupos I (p = 0,459, II (p = 0,368 e III (p = 0,459 e aos 30 dias (p = 0,717, 60 dias (p = 0,717, e 120 dias (p = 0,779 não apresentaram diferenças estatisticamente significativas. A análise por microscopia eletrônica de varredura revelou contacto direto entre o implante de α-TCP + AO e o tecido ósseo aos 120 dias. CONCLUSÃO: O implante de α-TCP é alternativa eficaz como substitutos ósseos para o tratamento de defeitos ósseos de tamanho crítico.

  7. 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...

  8. Bone metabolism during pregnancy.

    Science.gov (United States)

    Salles, Jean Pierre

    2016-06-01

    During pregnancy, mineral concentrations, of calcium and phosphorus in particular, are maintained at a high level in fetal blood so that the developing skeleton may accrete adequate mineral content. The placenta actively transports minerals for this purpose. Maternal intestinal absorption increases in order to meet the fetal demand for calcium, which is only partly dependent on calcitriol. Mineral regulation is essentially dependent on parathyroid hormone (PTH) and PTH-related protein (PTHrP). The calcium-sensing receptor (CaSR) regulates PTH and PTHrP production. If calcium intake is insufficient, the maternal skeleton will undergo resorption due to PTHrP. After birth, a switch from fetal to neonatal homeostasis occurs through increase in PTH and calcitriol, and developmental adaptation of the kidneys and intestines with bone turnover contributing additional mineral to the circulation. Calcium absorption becomes progressively active and dependent on calcitriol. The postnatal skeleton can transiently present with osteoposis but adequate mineral diet usually allows full restoration. Cases of primary osteoporosis must be identified. Loss of trabecular mineral content occurs during lactation in order to provide calcium to the newborn. This programmed bone loss is dependent on a "brain-breast-bone" circuit. The physiological bone resorption during reproduction does not normally cause fractures or persistent osteoporosis. Women who experience fracture are likely to have other causes of bone loss. PMID:27157104

  9. Biofabrication of bone tissue: approaches, challenges and translation for bone regeneration.

    Science.gov (United States)

    Tang, Daniel; Tare, Rahul S; Yang, Liang-Yo; Williams, David F; Ou, Keng-Liang; Oreffo, Richard O C

    2016-03-01

    The rising incidence of bone disorders has resulted in the need for more effective therapies to meet this demand, exacerbated by an increasing ageing population. Bone tissue engineering is seen as a means of developing alternatives to conventional bone grafts for repairing or reconstructing bone defects by combining biomaterials, cells and signalling factors. However, skeletal tissue engineering has not yet achieved full translation into clinical practice as a consequence of several challenges. The use of additive manufacturing techniques for bone biofabrication is seen as a potential solution, with its inherent capability for reproducibility, accuracy and customisation of scaffolds as well as cell and signalling factor delivery. This review highlights the current research in bone biofabrication, the necessary factors for successful bone biofabrication, in addition to the current limitations affecting biofabrication, some of which are a consequence of the limitations of the additive manufacturing technology itself. PMID:26803405

  10. Tracheal reconstructions.

    Science.gov (United States)

    Srikrishna, S V; Shekar, P S; Shetty, N

    1998-12-01

    Surgical reconstruction of the trachea is a relatively complex procedure. We had 20 cases of tracheal stenosis. We have a modest experience of 16 tracheal reconstructions for acquired tracheal stenosis. Two patients underwent laser treatment while another two died before any intervention. The majority of these cases were a result of prolonged ventilation (14 cases), following organophosphorous poisoning (11 cases), Guillain-Barré syndrome, bullet injury, fat embolism and surprisingly only one tumor, a case of mucoepidermoid carcinoma, who had a very unusual presentation. There were 12 males and 4 females in this series, age ranging from 12-35 years. The duration of ventilation ranged from 1-21 days and the interval from decannulation to development of stridor was between 5-34 days. Six of them were approached by the cervical route, 5 by thoracotomy and cervical approach, 2 via median sternotomy and 3 by thoracotomy alone. Five of them required an additional laryngeal drop and 1 required pericardiotomy and release of pulmonary veins to gain additional length. The excised segments of trachea measured 3 to 5 cms in length. All were end to end anastomosis with interrupted Vicryl sutures. We have had no experience with stents or prosthetic tubes. Three patients developed anastomotic leaks which were controlled conservatively. Almost all of them required postoperative tracheo-bronchial suctioning with fibreoptic bronchoscope. We had one death in this series due to sepsis. PMID:9914459

  11. A novel 3D template for mandible and maxilla reconstruction: Rapid prototyping using stereolithography

    OpenAIRE

    Samir Kumta; Monica Kumta; Leena Jain; Shrirang Purohit; Rani Ummul

    2015-01-01

    Introduction: Replication of the exact three-dimensional (3D) structure of the maxilla and mandible is now a priority whilst attempting reconstruction of these bones to attain a complete functional and aesthetic rehabilitation. We hereby present the process of rapid prototyping using stereolithography to produce templates for modelling bone grafts and implants for maxilla/mandible reconstructions, its applications in tumour/trauma, and outcomes for primary and secondary reconstruction. Materi...

  12. Efficacy of rhBMP-2 loaded PCL/PLGA/β-TCP guided bone regeneration membrane fabricated by 3D printing technology for reconstruction of calvaria defects in rabbit

    International Nuclear Information System (INIS)

    We successfully fabricated a three-dimensional (3D) printing-based PCL/PLGA/β-TCP guided bone regeneration (GBR) membrane that slowly released rhBMP-2. To impregnate the GBR membrane with intact rhBMP-2, collagen solution encapsulating rhBMP-2 (5 µg ml−1) was infused into pores of a PCL/PLGA/β-TCP membrane constructed using a 3D printing system with four dispensing heads. In a release profile test, sustained release of rhBMP-2 was observed for up to 28 d. To investigate the efficacy of the GBR membrane on bone regeneration, PCL/PLGA/β-TCP membranes with or without rhBMP-2 were implanted in an 8 mm calvaria defect of rabbits. Bone formation was evaluated at weeks 4 and 8 histologically and histomorphometrically. A space making ability of the GBR membrane was successfully maintained in both groups, and significantly more new bone was formed at post-implantation weeks 4 and 8 by rhBMP-2 loaded GBR membranes. Interestingly, implantation with rhBMP-2 loaded GBR membranes led to almost entire healing of calvaria defects within 8 weeks. (paper)

  13. A quantification strategy for missing bone mass in case of osteolytic bone lesions

    International Nuclear Information System (INIS)

    ratiovr/vm of the reconstructed bone volume vr and the healthy model bone volume vm is 1.07, which indicates a good reconstruction of the modified bone. Conclusions: The qualitative and quantitative comparison of manual and semi-automated segmentation results have shown that comparing a modified bone structure with a healthy model can be used to identify and measure missing bone mass in a reproducible way

  14. A quantification strategy for missing bone mass in case of osteolytic bone lesions

    Energy Technology Data Exchange (ETDEWEB)

    Fränzle, Andrea, E-mail: a.fraenzle@dkfz.de; Giske, Kristina [Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Bretschi, Maren; Bäuerle, Tobias [Department of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Hillengass, Jens [Department of Internal Medicine V, University of Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Bendl, Rolf [Medical Informatics, Heilbronn University, Max-Planck-Strasse 39, 74081 Heilbronn, Germany and Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)

    2013-12-15

    ratiov{sub r}/v{sub m} of the reconstructed bone volume v{sub r} and the healthy model bone volume v{sub m} is 1.07, which indicates a good reconstruction of the modified bone. Conclusions: The qualitative and quantitative comparison of manual and semi-automated segmentation results have shown that comparing a modified bone structure with a healthy model can be used to identify and measure missing bone mass in a reproducible way.

  15. Anterior and middle skull base reconstruction after tumor resection

    Institute of Scientific and Technical Information of China (English)

    WANG Bo; WU Sheng-tian; LI Zhi; LIU Pi-nan

    2010-01-01

    Background Surgical management of skull base tumors is still challenging today due to its sophisticated operation procedure. Surgeons who specialize in skull base surgery are making endeavor to promote the outcome of patients with skull base tumor. A reliable skull base reconstruction after tumor resection is of paramount importance in avoiding life-threatening complications, such as cerebrospinal fluid leakage and intracranial infection. This study aimed at investigating the indication, operation approach and operation technique of anterior and middle skull base reconstruction.Methods A retrospective analysis was carried out on 44 patients who underwent anterior and middle skull base reconstruction in the Department of Neurosurgery at Beijing Tiantan Hospital between March 2005 and March 2008. Different surgical approaches were selected according to the different regions involved by the tumor. Microsurgery was carried out for tumor resection and combined endoscopic surgery was performed in some cases. According to the different locations and sizes of various defects after tumor resection, an individualized skull base soft tissue reconstruction was carried out for each case with artificial materials, pedicled flaps, free autologous tissue, and free vascularized muscle flaps, separately. A skull base bone reconstruction was carried out in some cases simultaneously.Results Soft tissue reconstruction was performed in all 44 cases with a fascia lata repair in 9 cases, a free vascularized muscle flap in 1 case, a pedicled muscle flap in 14 cases, and a pedicled periosteal flap in 20 cases. Skull base bone reconstruction was performed on 10 cases simultaneously. The materials for bone reconstruction included titanium mesh, free autogenous bone, and a Medpor implant. The result of skull base reconstruction was satisfactory in all patients. Postoperative early-stage complications occurred in 10 cases with full recovery after conventional treatment.Conclusions The specific

  16. Effect of negative pressure on vascularization of tendon-bone interface after reconstruction of anterior cruciate ligament in rabbits%负压对兔前交叉韧带重建术后腱-骨界面血管化影响的研究

    Institute of Scientific and Technical Information of China (English)

    孙正明; 凌鸣; 冯伟楼; 董向辉; 刘时璋; 易智

    2013-01-01

    Objective To explore the effect of intermittent negative pressure on vascularization of tendon-bone interface after reconstruction of anterior cruciate ligament in rabbits.Methods One side of hind legs in 24 New Zealand white rabbits were randomly chosen as negative pressure group,and its contralateral hind leg was chosen as control.The anterior cruciate ligament model was reconstructed with autogenous semitendinosus of rabbit.Joint at the negative pressure side was placed with drainage tube connecting the micro-negative pressure aspirator for maintaining a low-intensity,intermittent negative pressure.Control side was placed with ordinary drainage tube.Drainage tubes of both sides were removed at 5 d after operation.After 6 weeks,femur-ligament-tibia complex was obtained to determine tendon graft tension,observe the blood vessels of the tendon-bone interface and detect the expression of VEGF.Results Twenty-three rabbits were included in the study,and one rabbit was excluded because of joint infections.Rally measurement results showed that the maximum load breakage of tendon graft was significantly greater in negative pressure group than that in control group (P < 0.05).Histological studies of tendon-bone interface found that the number of blood vessels was significantly more in negative pressure group than that in control group (P < 0.01).Immunohistochemistry showed that expression of VEGF was higher in negative pressure group than that in control group (P < 0.01).Conclusion Intermittent negative pressure may promote tendon-bone healing by increasing the vascularization of the tendon-bone interface after reconstruction of anterior cruciate ligament in rabbits.%目的 研究间歇性负压对兔前交叉韧带(anterior cruciate ligament,ACL)重建后腱-骨血管化的影响.方法 24只新西兰大白兔,随机取负压侧后腿,对侧后腿为对照.采用兔自体半腱肌重建前交叉韧带模型,负压侧关节通过引流管接微型负压吸引器,

  17. Reconstrucción del maxilar superior mediante transporte del proceso alveolar: Presentación de un caso Reconstruction of the maxilla by means of transport of the alveolar process: A case report

    OpenAIRE

    Bilbao, A.; Cobo, R.; Hernández, M.; Rocha, R.; J.M. Albertos

    2006-01-01

    La osteogénesis mediante distracción aplicada a la reconstrucción del proceso alveolar es una técnica sobradamente contrastada en la literatura, al igual que la utilización del transporte óseo en la reconstrucción de defectos segmentarios mandibulares. Presentamos en este artículo un caso de reconstrucción de un defecto segmentario del maxilar superior mediante transporte de proceso alveolar y su posterior rehabilitación protésica implantosoportada. Mostramos tanto la técnica quirúrgica como ...

  18. Bone Tumor

    Science.gov (United States)

    ... the knee in either the femur (thigh) or tibia (shinbone). Other common locations include the hip and ... bone that is weakened by a tumor to fracture, or break. This may be severely painful. Occasionally, ...

  19. 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 ...

  20. Breast Reconstruction and Prosthesis

    Science.gov (United States)

    ... have breast reconstruction If you choose to have reconstructive surgery, follow these steps: STEP 1 — Ask your doctor to refer you to a plastic surgeon who is an expert in breast reconstruction. ...

  1. Sodium-dependent phosphate transporters in osteoclast differentiation and function

    OpenAIRE

    Giuseppe Albano; Matthias Moor; Silvia Dolder; Mark Siegrist; Wagner, Carsten A.; Jürg Biber; Nati Hernando; Willy Hofstetter; Olivier Bonny; Fuster, Daniel G

    2015-01-01

    Osteoclasts are multinucleated bone degrading cells. Phosphate is an important constituent of mineralized bone and released in significant quantities during bone resorption. Molecular contributors to phosphate transport during the resorptive activity of osteoclasts have been controversially discussed. This study aimed at deciphering the role of sodium-dependent phosphate transporters during osteoclast differentiation and bone resorption. Our studies reveal RANKL-induced differential expressio...

  2. A composite demineralized bone matrix--self assembling peptide scaffold for enhancing cell and growth factor activity in bone marrow.

    Science.gov (United States)

    Hou, Tianyong; Li, Zhiqiang; Luo, Fei; Xie, Zhao; Wu, Xuehui; Xing, Junchao; Dong, Shiwu; Xu, Jianzhong

    2014-07-01

    The need for suitable bone grafts is high; however, there are limitations to all current graft sources, such as limited availability, the invasive harvest procedure, insufficient osteoinductive properties, poor biocompatibility, ethical problems, and degradation properties. The lack of osteoinductive properties is a common problem. As an allogenic bone graft, demineralized bone matrix (DBM) can overcome issues such as limited sources and comorbidities caused by invasive harvest; however, DBM is not sufficiently osteoinductive. Bone marrow has been known to magnify osteoinductive components for bone reconstruction because it contains osteogenic cells and factors. Mesenchymal stem cells (MSCs) derived from bone marrow are the gold standard for cell seeding in tissue-engineered biomaterials for bone repair, and these cells have demonstrated beneficial effects. However, the associated high cost and the complicated procedures limit the use of tissue-engineered bone constructs. To easily enrich more osteogenic cells and factors to DBM by selective cell retention technology, DBM is modified by a nanoscale self-assembling peptide (SAP) to form a composite DBM/SAP scaffold. By decreasing the pore size and increasing the charge interaction, DBM/SAP scaffolds possess a much higher enriching yield for osteogenic cells and factors compared with DBM alone scaffolds. At the same time, SAP can build a cellular microenvironment for cell adhesion, proliferation, and differentiation that promotes bone reconstruction. As a result, a suitable bone graft fabricated by DBM/SAP scaffolds and bone marrow represents a new strategy and product for bone transplantation in the clinic. PMID:24755526

  3. The influence of sterilization on the osteoinductive properties of bone in rat bone marrow cell culture

    International Nuclear Information System (INIS)

    Bone allografting is useful in the reconstruction of defects or supplementation of bone required during the treatment of bone tumors or comminuted fractures. Gamma-irradiation or heat-treatment at 60degC for 10 h or 80degC for 10 min are recognized procedures for the sterilization of bone before grafting. We investigated the ability of sterilized bone to induce proliferation in rat bone marrow cell cultures, and to induce alkaline phosphatase (ALP) activity in the cells. Addition of irradiated bone resulted in increased numbers of bone marrow cells and ALP activity in such cultures. However, larger doses of radiation to the bones suppressed this cell proliferation-inducing activity, whereas induction of ALP activity was not depressed by higher radiation doses. When the inducing activity was compared after the various sterilization processes, processed bones increased the cell number in culture by 45 percent and 35 percent compared with controls on days 7 and 14, respectively, despite sterilization. ALP activity was also increased by the processed bones (37 percent and 9 percent compared with controls on days 7 and 14, respectively), and this was again independent of the sterilization method employed. These results indicate that osteoinductive activity is retained after sterilization by either of the common methods employed. (author)

  4. 后交叉韧带重建中股骨侧"锐角效应"的相关研究及骨道技术的评价%Correlative study of femur "acute angle" in reconstruction of posterior cruciate ligament with hamstring tendons and evaluation of bone tunnel technique

    Institute of Scientific and Technical Information of China (English)

    闫昌葆; 陈百成; 赵宝辉; 孙然; 刘虎; 李嘉

    2009-01-01

    [Objective]To explore the "acute angle" of femur,and evaluate the bone tunnel technique in posterior cruciate ligament reconstruction. [Method] Using the porcine flexor digilorum tendon as graft, the author reconstructed posterior cruciate ligament. The bone tunnel was established wilh the angle of 80°,90°and 100°comparison the tunnel and intercondylar fossa of femur side wall,and press sensitive film was set between the edge of tunnel and graft. The pressure between was used to represent abrasion. The bigger the pressure was, the larger the abrasion was. The difference of pressure between bone tunnel technique group and the control group was compared. [ResultJThe pressure of angle 100°was lowest(3. 55 ±0. 21 MPa). And the pressure of burnishing group(3.29 ±0.19 MPa)was lower than that of the control group(3.55 ±0.21 MPa). [Conclusion]The bone tunnel technique can reduce the femoral; "acute angle" of femur in posterior cruciate ligament reconstruction.%[目的]探讨后交叉韧带重建中股骨侧的"锐角效应"以及对骨道技术进行评价.[方法]应用猪的屈趾肌腱作为移植物重建后交叉韧带,分别建立与股骨髁间窝侧壁呈80°、90°、100°夹角的骨道,以及对骨道边缘进行打磨处理.在骨道边缘与移植物之间放置压敏片计算得压强值来表示磨损作用的大小,压强值越大表示磨损作用越大.通过比较应用骨道技术重建PCL组与对照组的压强值来说明这种减小"锐角效应"的方法是否可行.[结果]应用骨道技术重建后交叉韧带各组中移植物与股骨髁间窝侧壁夹角为100°时压强最小[(3.55±0.21)MPa],并且对骨道边缘进行打磨后压强值[(3.29±0.19)MPa]明显低于对照组[(3.55±0.21)MPa].[结论]应用骨道技术可以有效减小后交叉韧带重建中股骨侧的"锐角效应".

  5. Cemented total hip arthroplasty with impacted morcellized bone-grafts to restore acetabular bone defects in congenital hip dysplasia.

    NARCIS (Netherlands)

    Bolder, S.B.T.; Melenhorst, J.; Gardeniers, J.W.M.; Slooff, T.J.J.H.; Veth, R.P.H.; Schreurs, B.W.

    2001-01-01

    We evaluated the results of 27 acetabular reconstructions in 21 patients with secondary osteoarthritis resulting from congenital dysplasia of the hip in which the acetabular bone defects were restored with impacted morcellized bone-grafts in combination with a cemented cup. At an average follow-up o

  6. Multiple Looping Technique for Tibial Fixation in Posterior Cruciate Ligament Reconstruction of the Knee

    OpenAIRE

    Noh, Jung Ho; Yoon, Kyoung Ho; Song, Sang Jun; Roh, Young Hak; Lee, Jae Woo

    2015-01-01

    The outcomes of posterior cruciate ligament reconstruction may be negatively affected by insufficient tibial tunnel fixation due to relatively lower bone density of the proximal tibia. We introduce a new technique of tibial fixation for posterior cruciate ligament reconstruction using free tendon Achilles allograft that is less affected by the bone density of the tibial metaphysis.

  7. Bone densitometer

    International Nuclear Information System (INIS)

    In an x-ray bone densitometer, special calibration techniques are employed to accommodate variations. In one aspect, a bone-like calibration material is interposed and the system determines the calibration data from rays passing only through flesh. In another aspect, a rotating device carries the calibration material through the beam. The specific densitometer shown uses an x-ray tube operated at two different voltages to generate a pencil beam, the energy levels of the x-ray photons being a function of the voltage applied. An integrating detector is timed to integrate the detected signal of the patient-attenuated beam over each pulse, the signals are converted to digital values and a digital computer converts the set of values produced by the raster scan into a representation of the bone density of the patient. Multiple reference detectors with differing absorbers are used by the system to continuously correct for variation in voltage and current of the x-ray tube. Calibration is accomplished by the digital computer on the basis of passing the pencil beam through known bone-representing substance as the densitometer scans portions of the patient having bone and adjacent portions having only flesh. A set of detected signals affected by the calibration substance in regions having only flesh is compared by the computer with a set of detected signals unaffected by the calibration material

  8. Reconstruction of middle ear malformations

    Directory of Open Access Journals (Sweden)

    Schwager, Konrad

    2007-01-01

    Full Text Available Malformations of the middle ear are classified as minor and major malformations. Minor malformations appear with regular external auditory canal, tympanic membrane and aerated middle ear space. The conducting hearing loss is due to fixation or interruption of the ossicular chain. The treatment is surgical, following the rules of ossiculoplasty and stapes surgery. In major malformations (congenital aural atresia there is no external auditory canal and a deformed or missing pinna. The mastoid and the middle ear space may be underdevelopped, the ossicular chain is dysplastic. Surgical therapy is possible in patients with good aeration of the temporal bone, existing windows, a near normal positioned facial nerve and a mobile ossicular chain. Plastic and reconstructive surgery of the pinna should proceed the reconstruction of the external auditory canal and middle ear. In cases of good prognosis unilateral aural atresia can be approached already in childhood. In patients with high risk of surgical failure, bone anchored hearing aids are the treatment of choice. Recent reports of implantable hearing devices may be discussed as an alternative treatment for selected patients.

  9. Bone lesion biopsy

    Science.gov (United States)

    Bone biopsy; Biopsy - bone ... needle is gently pushed and twisted into the bone. Once the sample is obtained, the needle is ... sample is sent to a lab for examination. Bone biopsy may also be done under general anesthesia ...

  10. 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 ...

  11. 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. ...

  12. 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 ...

  13. 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 ...

  14. 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 ...

  15. Effect of changing the position of the transported bone on early vascularization after distraction osteoporosis%牵张成骨后移动骨段移位对早期血管生成的影响

    Institute of Scientific and Technical Information of China (English)

    孙明; 律娜; 张令达; 黄代营; 陈松龄

    2011-01-01

    To assess the effects of 1 -step changing the buccal position of the transported bone after distraction on early vascularization. Methods Total of 8 adult mongrel dogs were procured. The bilaterally mandible premolar canine were extracted. After 1 month, the complete osteotomy was performed and the devices were placed. The gradual distraction was started after 1 week latency at the rate of 1 mm once a day, total 6 mm height was achieved. 1 -step changing the buccal position of the transported bone was performed in the day after the vertical distraction period in one side of the animals, and the other side as the controlled side. All animals were killed after a 7-day consolidation period. The vascular system was stained post mortem carbon ink perfusion to assess possible damages, and analyzed the ratio of vascular squre in computer. Results All animals tolerated the procedures well. After vertical distraction, the tested side could be moved 3 mm in buccal direction. Vascular damage was not detected, and there was no statistical difference in the ratio of vascular squre with analysis the histological section in computer. Conclusion In some extent, 1 -step changing the buccal position of the transported bone after distraction can mold the regenerate bone to correct the axial displacement, without endangering early vascularization.%目的 研究牙槽骨垂直牵张成骨后移动骨段一步颊向移位较大距离对早期血管生成的影响.方法 杂种犬8只,拔除双侧下颌前磨牙1个月后,骨切开放置牵张器,间歇7 d后以1 mm/d速度牵张,垂直牵张高度为6 mm.垂直牵张完成后,每只犬的随机一侧作为实验侧,于牵张结束后第2天一步将移动骨段颊向移位3 mm,另一侧作为对照侧不改变移动骨段的颊向位置.完成垂直牵张后7 d处死动物并行墨汁灌注,图像分析血管面积比率.结果 实验动物均能顺利完成实验,实验侧移动骨段在垂直牵张后可较容易颊向移位3 mm,实

  16. Regulation of ATP-binding cassette transporters and cholesterol efflux by glucose in primary human monocytes and murine bone marrow-derived macrophages

    Science.gov (United States)

    Individuals with type 2 diabetes mellitus are at increased risk of developing atherosclerosis. This may be partially attributable to suppression of macrophage ATP-binding cassette (ABC) transporter mediated cholesterol efflux by sustained elevated blood glucose concentrations. Two models were used...

  17. Custom facial reconstruction for osteosarcoma of the jaw.

    Science.gov (United States)

    Lazarides, Alexander; Erdmann, Detlev; Powers, David; Eward, William

    2014-11-01

    Osteosarcoma accounts for most primary bone cancers in children and young adults. High-grade lesions are typically managed with a combination of chemotherapy and wide-margin surgical excision. Although this malignancy typically affects the metaphyseal region of long bones, it also can be seen in the axial skeleton. Of axial locations, tumors in the head and neck can be particularly troubling to treat. Segmental bone loss after resection of malignant mandibular tumors continues to present important challenges to the reconstructive surgeon. Recent advancements in 3-dimensional modeling have facilitated custom templates for patient-specific reconstructions. This report describes the case of a young woman with osteosarcoma of the mandible undergoing customized template composite facial reconstruction using a vascularized osteoseptocutaneous fibula flap. PMID:25438280

  18. 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 of...... aged bones....

  19. Improved dopamine transporter binding activity after bone marrow mesenchymal stem cell transplantation in a rat model of Parkinson's disease: small animal positron emission tomography study with F-18 FP-CIT

    International Nuclear Information System (INIS)

    We evaluated the effects of bone marrow-derived mesenchymal stem cells (BMSCs) in a model of Parkinson's disease (PD) using serial F-18 fluoropropylcarbomethoxyiodophenylnortropane (FP-CIT) PET. Hemiparkinsonian rats were treated with intravenously injected BMSCs, and animals without stem cell therapy were used as the controls. Serial FP-CIT PET was performed after therapy. The ratio of FP-CIT uptake in the lesion side to uptake in the normal side was measured. The changes in FP-CIT uptake were also analyzed using SPM. Behavioural and histological changes were observed using the rotational test and tyrosine hydroxylase (TH)-reactive cells. FP-CIT uptake ratio was significantly different in the BMSCs treated group (n = 28) at each time point. In contrast, there was no difference in the ratio in control rats (n = 25) at any time point. SPM analysis also revealed that dopamine transporter binding activity was enhanced in the right basal ganglia area in only the BMSC therapy group. In addition, rats that received BMSC therapy also exhibited significantly improved rotational behaviour and preservation of TH-positive neurons compared to controls. The therapeutic effect of intravenously injected BMSCs in a rat model of PD was confirmed by dopamine transporter PET imaging, rotational functional studies, and histopathological evaluation. (orig.)

  20. Improved dopamine transporter binding activity after bone marrow mesenchymal stem cell transplantation in a rat model of Parkinson's disease: small animal positron emission tomography study with F-18 FP-CIT

    Energy Technology Data Exchange (ETDEWEB)

    Park, Bok-Nam; Lee, Kwanjae; An, Young-Sil [School of Medicine, Ajou University, Department of Nuclear Medicine and Molecular Imaging, Woncheon-dong, Yeongtong-gu, Gyeonggi-do, Suwon (Korea, Republic of); Kim, Jang-Hee; Park, So Hyun [Ajou University School of Medicine, Department of Pathology, Suwon (Korea, Republic of)

    2015-05-01

    We evaluated the effects of bone marrow-derived mesenchymal stem cells (BMSCs) in a model of Parkinson's disease (PD) using serial F-18 fluoropropylcarbomethoxyiodophenylnortropane (FP-CIT) PET. Hemiparkinsonian rats were treated with intravenously injected BMSCs, and animals without stem cell therapy were used as the controls. Serial FP-CIT PET was performed after therapy. The ratio of FP-CIT uptake in the lesion side to uptake in the normal side was measured. The changes in FP-CIT uptake were also analyzed using SPM. Behavioural and histological changes were observed using the rotational test and tyrosine hydroxylase (TH)-reactive cells. FP-CIT uptake ratio was significantly different in the BMSCs treated group (n = 28) at each time point. In contrast, there was no difference in the ratio in control rats (n = 25) at any time point. SPM analysis also revealed that dopamine transporter binding activity was enhanced in the right basal ganglia area in only the BMSC therapy group. In addition, rats that received BMSC therapy also exhibited significantly improved rotational behaviour and preservation of TH-positive neurons compared to controls. The therapeutic effect of intravenously injected BMSCs in a rat model of PD was confirmed by dopamine transporter PET imaging, rotational functional studies, and histopathological evaluation. (orig.)

  1. 骨骼重建与自体脂肪移植在面部整形中的应用%Bone reconstruction with autologous fat transplantation in facial plasty

    Institute of Scientific and Technical Information of China (English)

    聂云飞; 李小林; 巫国辉

    2012-01-01

    BACKGROUND: The use of autologous fat transplantation, liposuction, fillers, Botox, lasers and radiofrequency has become absolutely necessary prelude or accompaniment in facial plasty. OBJECTIVE: To retrospectively analyze effect of face lift and fat injection on facial rejuvenation. METHODS: Articles addressing face anatomy, ageing and facial fat transplantation, excluding repetitive studies, were identified by searching PubMed (1893-01 to 2011-12) using the keywords of "bone, facial, autologous fat transplantation, facial plastic, superficial musculoaponeuroticsystem (SMAS)". Finally, 47 articles were summarized. RESULTS AND CONCLUSION: Pigment patch, wrinkle and ptosis are the main features in facial ageing. The mandibular angle is blunt with aging. Bone resorption mainly exist in the orbital rim, piriform aperture, alveolar bone maxilla notch, chin projection and mandibular angle. SMAS do not change obviously. Fat injection is the direct method for facial volume. Totally 1 936 results of facial profiles moulding show that face lift and fat injection get satisfactory outcome for the elderly with facial emaciation, and patients with hemifacial atrophy can almost have normal facial profile. Facial fat injection cannot only recover face plump and ascend profile curve, but also improve facial skin texture and tinct.%背景:面部整形中自体脂肪注射、脂肪抽吸、填充剂、肉毒素、激光和射频等技术的应用成了不可或缺的前奏或伴奏.目的:回顾性总结分析面部提升术和脂肪注射技术在面部年轻化中的作用.方法:以英文检索词"bone,facial,autologous fat transplantation,facial plastic,superfical musculoaponeuroticsystem(SMAS)"为主,由第一作者重点检索1893-01/2011-12 PubMed数据有关面部解剖与老化及面部脂肪移植技术相关的文献,排除重复性研究.保留47篇文献进行归纳总结.结果与结论:面部老龄化主要存在3个表现:色斑、皱纹、松垂.随着

  2. Como mensurar o alargamento dos túneis ósseos na cirurgia de reconstrução do ligamento cruzado anterior? descrição de uma técnica How can bone tunnel enlargement in anterior cruciate ligament reconstruction surgery be measured? description of a technique

    Directory of Open Access Journals (Sweden)

    Adriano Barros de Aguiar Leonardi

    2011-01-01

    Full Text Available OBJETIVO: Constatar a presença do alargamento do túnel ósseo tibial após a cirurgia de reconstrução do ligamento cruzado anterior usando enxerto quádruplo de tendões flexores e propor uma nova técnica para sua mensuração. MÉTODOS: O estudo durou seis meses, com 25 pacientes de idades variando entre 18 e 43 anos. A avaliação baseou-se em radiografias realizadas no pós-operatório imediato, terceiro e sexto meses de evolução das operações de reconstrução dos ligamentos cruzados anteriores reconstruídos com os enxertos do tendão do músculo semitendíneo e do músculo grácil, fixados no fêmur com parafuso transverso metálico e, na tíbia, com parafuso de interferência. As radiografias foram avaliadas pelo valor relativo entre o diâmetro do túnel e do osso, ambos 2cm abaixo do côndilo tibial medial. RESULTADOS: Aumento significativo dos diâmetros dos túneis, de 20,56% para radiografias na incidência anteroposterior e de 26,48% na incidência de perfil. O alargamento esteve presente em 48% das radiografias AP e perfil, porém esteve presente nas duas incidências em apenas 16% dos casos. CONCLUSÕES: O alargamento dos túneis ósseos é um fenômeno presente nos primeiros meses após a cirurgia de reconstrução do ligamento cruzado anterior. A técnica de mensuração proposta neste estudo é suficiente para sua detecção.OBJECTIVE: To assess the presence of tibial bone tunnel enlargement after surgery to reconstruct the anterior cruciate ligament using quadruple flexor tendon grafts, and to propose a new technique for its measurement. METHODS: The study involved 25 patients aged 18-43 years over a six-month period. The assessment was based on radiographs taken immediately postoperatively and in the third and sixth months of evolution after operations to reconstruct the anterior cruciate ligament using grafts from the tendons of the semitendinosus and gracilis muscles, fixed in the femur with a transverse metal

  3. Mandibular reconstruction with composite microvascular tissue transfer

    International Nuclear Information System (INIS)

    Microvascular free tissue transfer has provided a variety of methods of restoring vascularized bone and soft tissue to difficult defects created by tumor resection and trauma. Over 7 years, 26 patients have undergone 28 free flaps for mandibular reconstruction, 15 for primary squamous cell carcinoma of the floor of the mouth or tongue, 7 for recurrent tumor, and 6 for other reasons [lymphangioma (1), infection (1), gunshot wound (1), and osteoradionecrosis (3)]. Primary reconstruction was performed in 19 cases and secondary in 9. All repairs were composite flaps including 12 scapula, 5 radial forearm, 3 fibula, 2 serratus, and 6 deep circumflex iliac artery. Mandibular defects included the symphysis alone (7), symphysis and body (5), symphysis-body-ramus condyle (2), body or ramus (13), and bilateral body (1). Fourteen patients had received prior radiotherapy to adjuvant or curative doses. Eight received postoperative radiotherapy. All patients had initially successful vascularized reconstruction by clinical examination (28) and positive radionuclide scan (22 of 22). Bony stability was achieved in 25 of 26 patients and oral continence in 24 of 26. One complete flap loss occurred at 14 days. Complications of some degree developed in 22 patients including partial skin necrosis (3), orocutaneous fistula (3), plate exposure (1), donor site infection (3), fracture of reconstruction (1), and fracture of the radius (1). Microvascular transfer of bone and soft tissue allows a reliable reconstruction--despite previous radiotherapy, infection, foreign body, or surgery--in almost every situation in which mandible and soft tissue are absent. Bony union, a healed wound, and reasonable function and appearance are likely despite early fistula, skin loss, or metal plate or bone exposure

  4. Cranial reconstruction with prefabricated 3D implant after a gunshot injury: A case report

    Directory of Open Access Journals (Sweden)

    Malivuković Ana

    2016-01-01

    Full Text Available Introduction. Complex defects of skull bones with different etiology, still present the challenge in reconstructive surgery. The goldstandard for cranioplasty is the autologous calvarial bone graft removed during surgery which cannot be always applied, especially in gunshot wounds for sometimes complete bone destruction. Autologous reconstruction with split calvarial, rib bones or iliac bone graft is also possible. Materials routinely used for reconstructions like titanium mesh, polymethyl metacrylate (PMMA, and other have numerous disadvantages and limitations. Case report. We presented a patient with gunshot injury to the head with residual large bone defect in the frontal region, with involvement of the skull base, and open frontal sinus. After conservative treatment, six months after the injury, reconstruction of the residual bone defect was performed. The chosen material was computerdesigned PEEK-OPTIMA® implant, manufactured on the basis of MSCT scan. This material has not been used in this region so far. The postoperative and follow-up period of the next 12 months passed without surgical complications, neurological deficit, with satisfactory functional and aesthetic results. Conclusion. Implanted bone replacement was designed and manufactured precisely according to the skull defect, and we found it suitable for the treatment of complex defects of the cranium. Early results are in favor of this cranioplasty method over standardized materials. Therefore, this material is expected to become a method of choice for reconstructive surgery of bony defects of the face and skull especially in complex cases.

  5. Novel technique for ulnar collateral ligament reconstruction of the elbow.

    Science.gov (United States)

    Acevedo, Daniel C; Lee, Brian; Mirzayan, Raffy

    2012-11-01

    Ulnar collateral ligament (UCL) reconstruction of the elbow has been shown to restore function in overhead athletes with valgus instability. Since the initial description of using bone tunnels for reconstruction, many modifications to the surgical technique have been introduced, including the modified Jobe technique, the docking technique, fixation with interference screws, and button fixation. The authors introduce a technique that uses a button on each of the humeral and ulnar sides for fixation. This method allows proper tensioning of the graft and provides immediate secure fixation that relies on metal implants as opposed to sutures over bone bridges alone. PMID:23127439

  6. Patella fracture following anterior cruciate ligament reconstruction: A case report

    OpenAIRE

    Milankov Miroslav; Kecojević Vaso; Ninković Srđan; Gajdobranski Đorđe R.

    2003-01-01

    Introduction The most frequent procedure in treatment of acute or chronic anterior cruciate ligament (ACL) rupture is the so called bone-tendon-bone reconstruction. A transverse dislocated patella fracture is a rare complication of this procedure with an incidence of 0.23%-2.3%. In a five year period, (1998-2002), 407 arthroscopic reconstructions of the anterior cruciate ligaments were done at our Clinic, and there was only one case of patella fracture. Case report An 18-year-old female patie...

  7. Three-dimensional Microarchitecture of Adolescent Cancellous Bone

    DEFF Research Database (Denmark)

    Ding, Ming; Hvid, I; Overgaard, Søren

    regarding three-dimensional (3-D) microarchitecture of normal adolescent cancellous bone. The objective of this study was to investigate 3-D microarchitecture of normal adolescent cancellous bone, and compared them with adult cancellous bone, thus seeking more insight into the subchondral bone adaptations...... during development and growth. We hypothesized that adolescent cancellous bone differed significantly from adult cancellous bone in their microarchitecture and mechanical properties. METHODS: Twenty-three human proximal tibiae were harvested and divided into 3 groups according to their ages: adolescence...... Orthopaedics & Traumatology and Institute of Forensic Medicine, Odense and Aarhus University Hospitals, Denmark. RESULTS: Three-dimensional reconstructions of cancellous bone from micro-CT imaging are shown in Figure 1. Our data showed that trabecular separation was significantly greater in the adolescence...

  8. Effect of Polycaprolactone Scaffold Permeability on Bone Regeneration In Vivo

    OpenAIRE

    Mitsak, Anna G.; Kemppainen, Jessica M.; Harris, Matthew T.; Hollister, Scott J

    2011-01-01

    Successful bone tissue engineering depends on the scaffold's ability to allow nutrient diffusion to and waste removal from the regeneration site, as well as provide an appropriate mechanical environment. Since bone is highly vascularized, scaffolds that provide greater mass transport may support increased bone regeneration. Permeability encompasses the salient features of three-dimensional porous scaffold architecture effects on scaffold mass transport. We hypothesized that higher permeabilit...

  9. Analysis of the of bones through 3D computerized tomography

    International Nuclear Information System (INIS)

    This work shows the analysis of the internal structure of the bones samples through 3D micro tomography technique (3D-μTC). The comprehension of the bone structure is particularly important when related to osteoporosis diagnosis because this implies in a deterioration of the trabecular bone architecture, which increases the fragility and the possibility to have bone fractures. Two bone samples (human calcaneous and Wistar rat femur) were used, and the method was a radiographic system in real time with an X Ray microfocus tube. The quantifications parameters are based on stereological principles and they are five: a bone volume fraction, trabecular number, the ratio between surface and bone volume, the trabecular thickness and the trabecular separation. The quantifications were done with a program developed especially for this purpose in Nuclear Instrumentation Laboratory - COPPE/UFRJ. This program uses as input the 3D reconstructions images and generates a table with the quantifications. The results of the human calcaneous quantifications are presented in tables 1 and 2, and the 3D reconstructions are illustrated in Figure 5. The Figure 6 illustrate the 2D reconstructed image and the Figure 7 the 3D visualization respectively of the Wistar femur sample. The obtained results show that the 3D-μTC is a powerful technique that can be used to analyze bone microstructures. (author)

  10. Esthetic Craniofacial Bony and Skull Base Reconstruction Using Flap Wrapping Technique.

    Science.gov (United States)

    Yano, Tomoyuki; Suesada, Nobuko; Usami, Satoshi

    2016-07-01

    For a safe and esthetic skull base reconstruction combined with repair of craniofacial bone defects, the authors introduce the flap wrapping technique in this study. This technique consists of skull base reconstruction using the vastus lateralis muscle of an anterolateral thigh (ALT) free flap, and structural craniofacial bony reconstruction using an autologous calvarial bone graft. The key to this technique is that all of the grafted autologous bone is wrapped with the vascularized fascia of the ALT free flap to protect the grafted bone from infection and exposure. Two anterior skull base tumors combined with craniofacial bony defects were included in this study. The subjects were a man and a woman, aged 18 and 64. Both patients had preoperative proton beam therapy. First, the skull base defect was filled with vastus lateralis muscle, and then structural reconstruction was performed with an autologous bone graft and a fabricated inner layer of calvarial bone, and then the grafted bone was completely wrapped in the vascularized fascia of the ALT free flap. By applying this technique, there was no intracranial infection or grafted bone exposure in these 2 patients postoperatively, even though both patients had preoperative proton beam therapy. Additionally, the vascularized fascia wrapped bone graft could provide a natural contour and prevent collapse of the craniofacial region, and this gives patients a better facial appearance even though they have had skull base surgery. PMID:27300454

  11. Low-intensity pulsed ultrasound therapy: a potential strategy to stimulate tendon-bone junction healing*

    OpenAIRE

    Ying, Zhi-Min; Lin, Tiao; Yan, Shi-Gui

    2012-01-01

    Incorporation of a tendon graft within the bone tunnel represents a challenging clinical problem. Successful anterior cruciate ligament (ACL) reconstruction requires solid healing of the tendon graft in the bone tunnel. Enhancement of graft healing to bone is important to facilitate early aggressive rehabilitation and a rapid return to pre-injury activity levels. No convenient, effective or inexpensive procedures exist to enhance tendon-bone (T-B) healing after surgery. Low-intensity pulsed u...

  12. “Subcritical” Glenoid Bone Loss Increases Redislocation Rates in Primary Arthroscopic Bankart Repair

    OpenAIRE

    Shaha, James S.; Cook, Jay B.; Song, Daniel J.; Rowles, Douglas J.; Bottoni, Craig R.; Shaha, Steven H.; Tokish, John M.

    2014-01-01

    Objectives: While bone loss is increasingly recognized as a risk factor for failure after arthroscopic stabilization, the precise definition of critical bone loss has not been defined. Additionally, there is no clarity on the amount of bone loss routinely present in patients presenting for primary arthroscopic stabilization of anterior glenohumeral instability. The purpose of this study is to report on the average bone loss measured in primary isolated Bankart reconstructions of the shoulder ...

  13. Predictable dental rehabilitation in maxillomandibular reconstruction with free flaps. The role of implant guided surgery

    Science.gov (United States)

    Cebrian-Carretero, José L.; Sobrino, José A.; Yu, Tomás; Burgueño-García, Miguel

    2014-01-01

    The reconstruction of maxillomandibular defects secondary to oral cancer surgery, represent a great challenge for Maxillofacial surgeons. During the last decades the reconstructive surgery has experimented a big advance due to the development of the microsurgical techniques. At present, we are able to reconstruct complex defects using free flaps that provide both soft and bone tissue. Fibula, iliac crest and scapula free flaps have been the three classic options for the maxillomandibular reconstruction owing to the amount of bone that this flaps provide, allowing the posterior dental rehabilitation with implants. Today, our objective it is not only the aesthetic reconstruction, but also the functional reconstruction of the patients enhancing their life quality. Guided implant surgery in free flap reconstructed patients has become an essential tool, helping to define the exact position of the dental implant in the flap. In this way it is possible to look for the areas with better bone conditions, avoiding the osteosynthesis material used to fixate the flap with the native bone and deciding the best biomechanical option, in terms of number and situation of the implants, for the future dental prostheses. In summary, using the guided implant surgery, it is possible to design an exact and predictable dental implant rehabilitation in patients with oral cancer who are reconstructed with free microvascular flap, resulting in an optimal aesthetic and functional result. Key words:Oral cancer, mandibulectomy, maxillectomy, microvascular reconstruction, fibula flap, dental implant, guided surgery. PMID:25129241

  14. Hanford Environmental Dose Reconstruction Project

    International Nuclear Information System (INIS)

    The objective of the Hanford Environmental Dose Reconstruction (HEDR) Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The TSP consists of experts in environmental pathways, epidemiology, surface-water transport, ground-water transport, statistics, demography, agriculture, meteorology, nuclear engineering, radiation dosimetry, and cultural anthropology. Included are appointed technical members representing the states of Oregon, Washington, and Idaho, a representative of Native American tribes, and an individual representing the public. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed from release to impact on humans (dose estimates): Source terms, environmental transport, environmental monitoring data, demography, food consumption, and agriculture, and environmental pathways and dose estimates. Progress is discussed

  15. Breast Reconstruction After Mastectomy

    Science.gov (United States)

    ... reconstruction with or without radiotherapy. Current Opinion in Obstetrics and Gynecology 2011;23(1):44–50. [PubMed Abstract] Barry M, Kell MR. Radiotherapy and breast reconstruction: a meta-analysis. Breast ...

  16. Tibial Tunnel Cyst Formation after Anterior Cruciate Ligament Reconstruction Using a Non-Bioabsorbable Interference Screw.

    Science.gov (United States)

    Joshi, Yogesh V; Bhaskar, Deepu; Phaltankar, Padmanabh M; Charalambous, Charalambos P

    2015-12-01

    Tibial cyst formation following the use of bioabsorbable interference screws in anterior cruciate ligament (ACL) reconstruction is well-described; however, cyst formation after the use of metallic interference screws is not well-documented. We describe a case of osteolytic lesion of the proximal tibia presenting to us 20 years after ACL reconstruction using an autologous bone-tendon-bone graft. The original graft fixation technique was interference fixation with a metal screw in the tibial and femoral tunnels. A two-stage revision reconstruction of the ACL was undertaken with curettage and bone grafting of the tibial lesion in the first stage and reconstruction using a four-strand hamstring tendon in the second stage. The patient recovered satisfactorily with complete healing of the cyst and returned to pre-injury level of activities. We have reviewed case reports and case series that describe the aetiology of intra-osseous cyst formation following ACL reconstruction. PMID:26673117

  17. Review of methods used in the reconstruction and rehabilitation of the maxillofacial region.

    LENUS (Irish Health Repository)

    O'Fearraigh, Pádraig

    2010-04-23

    Maxillofacial and dental defects often have detrimental effects on patient health and appearance. A holistic approach of restoring lost dentition along with bone and soft tissue is now the standard treatment of these defects. Recent improvements in reconstructive techniques, especially osseointegration, microvascular free tissue transfer, and improvements in bone engineering, have yielded excellent functional and aesthetic outcomes. This article reviews the literature on these modern reconstructive and rehabilitation techniques.

  18. The science of reading bones

    International Nuclear Information System (INIS)

    Stable isotope ratio measurements (of carbon, nitrogen and oxygen) are used to reconstruct ancient diets and plant environments. The characteristic isotope ratios of C3 and C4 plants are passed along the food chain to animals and humans. Fractionations take place during the formation of different tissues. The end result is that a carbon isotope reading on a sample of bone, flesh or hair provides a measure of the plant mixture at the base of the food web of the animal or human in question

  19. Surfaces, Digitisations and Reconstructions

    DEFF Research Database (Denmark)

    Christensen, Sabrina Tang

    2015-01-01

    We present a new digital reconstruction of r-regular sets in three-dimensional Euclidean space. We introduce a vector field and analyse the relation between the topologies of the boundaries of the r-regular set and its reconstruction. This reconstruction can be carried out faster than prior model...

  20. 骨移植重建肩关节后脱位合并肱骨头前内侧骨缺损的临床疗效分析%The clinical outcome of anatomical reconstruction with bone graft for humeral head impression fractures after posterior shoulder dislocation

    Institute of Scientific and Technical Information of China (English)

    徐德兴; 陈昌礼; 陈硕

    2012-01-01

    目的 自体或异体骨移植方法解剖重建肩关节后脱位伴有前内侧骨缺损,恢复肱骨头关节面形态,为肩关节后脱位的诊治提供一种有效、可靠方法.方法 6例患者纳入本次研究,患者平均年龄46.3(35~65)岁,所有患者肩关节后脱位伴有25%~45%肱骨头关节面前内侧骨缺损,2例患者伴有小结节撕脱性骨折,1例患者小结节联合外科颈骨折.6例患者中5例发生肩关节脱位延迟诊断,延迟诊断时间平均71.2(36~105)d.所有患者均采用自体或异体骨移植来解剖修复肱骨头前内侧骨缺损,恢复肱骨头关节面形态.结果 所有患者术后随访16.8(6~30)个月,优秀5例,良好1例,Constant评分平均为84.8(76~90)分,随访时无复发性肩关节脱位、移植骨塌陷以及肩关节不稳表现.结论 采用自体/异体骨移植、重建肱骨头形态是一种有效、可靠方法,能够恢复良好肩关节功能及稳定性.%There had an anatomical reconstruction with bone autograft/allograft for humeral head impression fractures after posterior shoulder dislocation . It provide a valid and good method for the diagnosis and treatment of posterior shoulder dislocation. Methods Six patients with an average age of 46. 3years (35 ~ 65 ) at time of surgery were included. All patients had a 25% ~45% anteromedial humeral head articular surface defect associated with five missed locked posterior shoulder dislocation. Two patients had an less tuberosity fracture,one patient had an additional less tuberosity and surgical neck fracture . For five patients the time span between the injury and the diagnosis is 71. 2 days,ranged between 36 and 105 days, all patients used an anatomical repair with bone autograft/allograft for humeral head impression fractures after posterior shoulder dislocation. Results At a mean time follow-up of 16. S months (6 to 30) , the result was found to be excellent for five patients and good for one patient with a mean

  1. Reconstruction of midfacial defects after surgical resection of malignancies.

    Science.gov (United States)

    Wells, M D; Luce, E A

    1995-01-01

    Midfacial and orbital defects after ablative oncologic surgery are difficult problems for the reconstructive surgeon. Our goal is to address the devastating functional and aesthetic consequences of these extirpations and to improve the quality of life for this unfortunate group of patients. Partial maxillectomy defects are best treated by skin grafting the residual cavity and reconstructing the maxillary defect by prosthetic means. Local tissues can be used when the defects are small and the bone loss is not extensive. For massive midfacial defects with insufficient bony support for prosthetic reconstruction, osseocutaneous free flaps have proved useful to restore contour and the necessary structural support. PMID:7743712

  2. Genome-scale reconstruction of the Saccharomyces cerevisiae metabolic network

    DEFF Research Database (Denmark)

    Förster, Jochen; Famili, I.; Fu, P.; Palsson, B.O.; Nielsen, Jens

    2003-01-01

    The metabolic network in the yeast Saccharomyces cerevisiae was reconstructed using currently available genomic, biochemical, and physiological information. The metabolic reactions were compartmentalized between the cytosol and the mitochondria, and transport steps between the compartments and the...... containing 1175 metabolic reactions and 584 metabolites. The number of gene functions included in the reconstructed network corresponds to similar to16% of all characterized ORFs in S. cerevisiae. Using the reconstructed network, the metabolic capabilities of S. cerevisiae were calculated and compared with...

  3. Cisplatin inhibits bone healing during distraction osteogenesis.

    Science.gov (United States)

    Stine, Kimo C; Wahl, Elizabeth C; Liu, Lichu; Skinner, Robert A; Vanderschilden, Jacquelyn; Bunn, Robert C; Montgomery, Corey O; Suva, Larry J; Aronson, James; Becton, David L; Nicholas, Richard W; Swearingen, Christopher J; Lumpkin, Charles K

    2014-03-01

    Osteosarcoma (OS) is the most common malignant bone tumor affecting children and adolescents. Many patients are treated with a combination of chemotherapy, resection, and limb salvage protocols. Surgical reconstructions after tumor resection include structural allografts, non-cemented endoprostheses, and distraction osteogenesis (DO), which require direct bone formation. Although cisplatin (CDP) is extensively used for OS chemotherapy, the effects on bone regeneration are not well studied. The effects of CDP on direct bone formation in DO were compared using two dosing regimens and both C57BL/6 (B6) and tumor necrosis factor receptor 1 knockout (TNFR1KO) mice, as CDP toxicity is associated with elevated TNF levels. Detailed evaluation of the five-dose CDP regimen (2 mg/kg/day), demonstrated significant decreases in new bone formation in the DO gaps of CDP treated versus vehicle treated mice (p CDP regimen were observed in TNFR1KO mice. The two-dose regimen significantly inhibited new bone formation in B6 mice. These results demonstrate that CDP has profound short term negative effects on the process of bone repair in DO. These data provide the mechanistic basis for modeling peri-operative chemotherapy doses and schedules and may provide new opportunities to identify molecules that spare normal cells from the inhibitory effects of CDP. PMID:24259375

  4. 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 ...

  5. 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 ...

  6. Bone mineralization pathways during the rapid growth of embryonic chicken long bones.

    Science.gov (United States)

    Kerschnitzki, Michael; Akiva, Anat; Ben Shoham, Adi; Asscher, Yotam; Wagermaier, Wolfgang; Fratzl, Peter; Addadi, Lia; Weiner, Steve

    2016-07-01

    The uptake and transport of ions from the environment to the site of bone formation is only partially understood and, for the most part, based on disparate observations in different animals. Here we study different aspects of the biomineralization pathways in one system, the rapidly forming long bones of the chicken embryo. We mainly used cryo-fixation and cryo-electron imaging to preserve the often unstable mineral phases in the tissues. We show the presence of surprisingly large amounts of mineral particles located inside membrane-delineated vesicles in the bone forming tissue between the blood vessels and the forming bone surface. Some of these particles are also located inside mitochondrial networks. The surfaces of the forming bones in the extracellular space contain abundant aggregates of amorphous calcium phosphate particles, but these are not enveloped by vesicle membranes. In the bone resorbing region, osteoclasts also contain many particles in both mitochondrial networks and within vesicles. Some of these particles are present also between cells. These observations, together with the previously reported observation that CaP mineral particles inside membranes are present in blood vessels, leads us to the conclusion that important components of the bone mineralization pathways in rapidly forming chicken bone are dense phase mineral particles bound within membranes. It remains to be determined whether these mineral particles are transported to the site of bone formation in the solid state, fluid state or dissolve and re-precipitate. PMID:27108185

  7. 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...

  8. Reconstruction of large traumatic segmental defects of the femur using segmental allograft with vascularized fibula inlay.

    Science.gov (United States)

    Ridha, Hyder; Bernard, Jason; Gateley, David; Vesely, Martin J

    2011-07-01

    Segmental defects of the distal femur following trauma pose a reconstructive challenge. A stable reconstruction capable of withstanding high forces while allowing early mobility is paramount. The Capanna technique of reconstruction combining allograft with vascularized bone graft provides such a construct and has been described for oncological resection. We describe a modified Capanna technique, the "inlay" construct. Three reconstructions were performed for distal femoral segmental loss following trauma. One patient had bilateral reconstructions. Bone defects measuring 11, 9, and 8 cm were reconstructed using a large segmental allograft and free fibular flap inlay assembly. Both patients made uneventful recoveries and achieved full weight-bearing without walking aids 6 months postreconstruction. Range of movement of each knee joint achieved at least 90 degrees of active flexion. We have shown that large segmental traumatic defects of the femur can be successfully reconstructed using segmental allograft with vascularized fibula inlay. This reconstruction provides early mechanical stability, protecting the fibula from fracturing and allowing axial loading of healing bone. The inlay assembly allows a large area of bony contact between allograft and vascularized bone, optimizing bony healing. It is a good alternative to other established techniques of managing significant segmental defects of the distal femur. PMID:21717390

  9. Hanford Environmental Dose Reconstruction Project

    International Nuclear Information System (INIS)

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that populations could have received from nuclear operations at Hanford since 1944. The project is being managed and conducted by the Pacific Northwest Laboratory (PNL) under the direction of an independent Technical Steering Panel (TSP). The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from released to impact on humans (dose estimates): source terms; environmental transport; environmental monitoring data; demographics, agriculture, food habits; and, environmental pathways and dose estimates

  10. Hanford Environmental Dose Reconstruction Project

    International Nuclear Information System (INIS)

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is being managed and conducted by the Battelle Pacific Northwest Laboratories under contract with the Centers for Disease Control. The independent Technical Steering Panel (TSP) provides technical direction. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): source terms; environmental transport; environmental monitoring data; demography, food consumption, and agriculture; environmental pathways and dose estimates

  11. Predictors of bone loss in revision total knee arthroplasty.

    Science.gov (United States)

    Bloomfield, Michael R; Klika, Alison K; Lee, Ho H; Joyce, David M; Mehta, Priyesh; Barsoum, Wael K

    2010-03-01

    Revision total knee arthroplasty (RTKA) requires preoperative planning to enable the reconstruction of bony deficiencies. The objective of this project was to identify predictors of bone loss management at RTKA based on the preoperative failure mode and patient demographics known preoperatively. We retrospectively reviewed 245 consecutive RTKA procedures in which the same revision knee system was utilized. Patient demographic and treatment data were recorded, and locations of bone loss were identified based on the reconstructive management. We identified significant predictors for use of femoral augments at all four positions. Several predictors significantly predisposed to use of a thick (>19 mm) polyethylene; however, no predictors of tibial augments were significant. Although the reconstruction of bone loss is primarily based on the intraoperative assessment, these findings may provide additional information to help the surgeon prepare for difficult revision procedures. PMID:20812582

  12. A RARE CASE PRESENTATION OF SIMPLE BONE CYST IN CLAVICLE

    Directory of Open Access Journals (Sweden)

    Vittal

    2015-05-01

    Full Text Available Simple bone cyst represent approximately 3% of all primary bone tumors sampled for biopsy and nearly always occur during the first two decades of life. They are common in metaphyseal region of long bones. Clavicle is rare s ite for this lesion and not many have been reported in literature. We report a case of Histopathologically confirmed Simple bone cyst in a 65 yr s old manual laborer who presented with pain and swelling of long duration. The occurrence of this lesion at unu sual age and at unusual location carries a lot of diagnostic dilemma and various differentials like ABC , Eosinophilic granuloma , and enchondroma were considered only to confirm simple bone cyst on HPE . The symptoms were relieved after resection of lesion. Clavicle was reconstructed with tricortical iliac crest bone graft. At 18th month follow up the patient had no recurrences and had a good functional outcome .

  13. Quantification of osteolytic bone lesions in a preclinical rat trial

    Science.gov (United States)

    Fränzle, Andrea; Bretschi, Maren; Bäuerle, Tobias; Giske, Kristina; Hillengass, Jens; Bendl, Rolf

    2013-10-01

    In breast cancer, most of the patients who died, have developed bone metastasis as disease progression. Bone metastases in case of breast cancer are mainly bone destructive (osteolytic). To understand pathogenesis and to analyse response to different treatments, animal models, in our case rats, are examined. For assessment of treatment response to bone remodelling therapies exact segmentations of osteolytic lesions are needed. Manual segmentations are not only time-consuming but lack in reproducibility. Computerized segmentation tools are essential. In this paper we present an approach for the computerized quantification of osteolytic lesion volumes using a comparison to a healthy reference model. The presented qualitative and quantitative evaluation of the reconstructed bone volumes show, that the automatically segmented lesion volumes complete missing bone in a reasonable way.

  14. Bone strength: more than just bone density.

    Science.gov (United States)

    Ott, Susan M

    2016-01-01

    The following bone density measurements have limited utility in determining bone strength because they do not include bone quality: microarchitecture, mineralization, ability to repair damage, collagen structure, crystal size, or marrow composition. Patients with kidney disease have poor bone quality. Newman et al. now describe beneficial effects with raloxifene in an animal model of progressive kidney disease. These biomechanical measurements will be important in the development of medications to decrease fractures in patients. PMID:26759040

  15. [Regulation of bone homeostasis by glucose].

    Science.gov (United States)

    Fukasawa, Kazuya; Hinoi, Eiichi

    2016-08-01

    Synthesis of type Ⅰ collagen, a major component of the bone matrix, precedes the expression of Runt-related transcription factor 2(Runx2), a master regulator in osteoblast differentiation. Thus, a direct link between osteoblast differentiation and bone formation is seemingly absent, and how these are maintained in a coordinated matter remains unclear. It was recently demonstrated that osteoblasts depend on glucose, which glucose transporter type 1(GLUT1)takes up as an energy source, and it was found that glucose uptake promotes osteoblast differentiation and bone formation via AMP-activated protein kinase. It was also shown that Runx2 upregulates GLUT1 expression, and this Runx2-GLUT1 feedforward regulation integrates and coordinates osteoblast differentiation and bone formation throughout life. These previous findings revealed that the energy metabolism balance in osteoblasts integrates the differentiation and function of osteoblasts, and re-emphasized the importance of crosstalk between bone and sugar metabolism. PMID:27461500

  16. Bone development

    DEFF Research Database (Denmark)

    Tatara, M.R.; Tygesen, Malin Plumhoff; Sawa-Wojtanowicz, B.;

    2007-01-01

    The objective of this study was to determine the long-term effect of alpha-ketoglutarate (AKG) administration during early neonatal life on skeletal development and function, with emphasis on bone exposed to regular stress and used to serve for systemic changes monitoring, the rib. Shropshire ram...... at 146 days of life and five left and right ribs (fourth to eighth) were removed for analysis. The influence of AKG on skeletal system development was evaluated in relation to both geometrical and mechanical properties, as well as quantitative computed tomography (QCT). No significant differences between...... has a long-term effect on skeletal development when given early in neonatal life, and that changes in rib properties serve to improve chest mechanics and functioning in young animals. Moreover, neonatal administration of AKG may be considered as an effective factor enhancing proper development...

  17. Exercise, lifestyle, and your bones

    Science.gov (United States)

    Osteoporosis - exercise; Low bone density - exercise ... Osteoporosis is a disease that causes bones to become brittle and more likely to fracture (break). With osteoporosis, the bones lose density. Bone density is the amount of bone ...

  18. Bioengineered periosteal progenitor cell sheets to enhance tendon-bone healing in a bone tunnel

    Directory of Open Access Journals (Sweden)

    Chih-Hsiang Chang

    2012-12-01

    Full Text Available Background: Tendon-bone tunnel healing is crucial for long term success in anterior cruciate liga­ment (ACL reconstruction. The periosteum contains osteochondral progenitor cells that can differenti­ate into osteoblasts and chondroblasts during tendon-bone healing. We developed a scaf­fold-free method using polymerized fibrin-coated dishes to make functional periosteal progenitor cell (PPC sheets. Bioengineered PPC sheets for enhancing tendon-bone healing were evaluated in an extra-articular bone tunnel model in rabbit. Methods: PPC derived from rabbit tibia periosteum, cultivated on polymerized fi­brin-coated dishes and harvested as PPC sheet. A confocal microscopy assay was used to evaluate the morphology of PPC sheets. PPC sheets as a periosteum to wrap around hamstring tendon grafts were pulled into a 3-mm diameter bone tunnel of tibia, and compared with a tendon graft without PPC sheets treatment. Rabbits were sacrificed at 4 and 8 weeks postoperatively for biochemical as­say and histological assay to demonstrate the enhancement of PPC sheets in tendon-bone healing. Results: PPC spread deposit on fibrin on the dish surface with continuous monolayer PPC was ob­served. Histological staining revealed that PPC sheets enhance collagen and glycosaminoglycans deposi­tion with fibrocartilage formation in the tendon-bone junction at 4 weeks. Collagen fiber with fibrocartilage formation at tendon-bone junction was also found at 8 weeks. Matured fibrocartilage and dense collagen fiber were formed at the tendon-bone interface at 8 weeks by Masson trichrome and Safranin-O staining Conclusions: Periosteal progenitor cell monolayer maintains the differentiated capacity and osteochon­dral potential in order to promote fibrocartilage formation in tendon-bone junction. Bioengi­neered PPC sheets can offer a new feasible therapeutic strategy of a novel approach to en­hance tendon-bone junction healing.

  19. Cosmic Tidal Reconstruction

    CERN Document Server

    Zhu, Hong-Ming; Yu, Yu; Er, Xinzhong; Chen, Xuelei

    2015-01-01

    The gravitational coupling of a long wavelength tidal field with small scale density fluctuations leads to anisotropic distortions of the locally measured small scale matter correlation function. Since the local correlation function is statistically isotropic in the absence of such tidal interactions, the tidal distortions can be used to reconstruct the long wavelength tidal field and large scale density field in analogy with the cosmic microwave background lensing reconstruction. In this paper we present in detail a formalism for the cosmic tidal reconstruction and test the reconstruction in numerical simulations. We find that the density field on large scales can be reconstructed with good accuracy and the cross correlation coefficient between the reconstructed density field and the original density field is greater than 0.9 on large scales ($k\\lesssim0.1h/\\mathrm{Mpc}$). This is useful in the 21cm intensity mapping survey, where the long wavelength radial modes are lost due to foreground subtraction proces...

  20. Epiphyseal preservation and reconstruction with inactivated bone in distal femur for metaphyseal osteosarcoma in children%保留骨骺灭活再植术治疗儿童股骨远端骨肉瘤及术后肢体功能恢复特征

    Institute of Scientific and Technical Information of China (English)

    于秀淳; 刘晓平; 周银; 付志厚; 宋若先; 孙海宁; 徐明

    2007-01-01

    和肢体长度的保持.%BACKGROUND: Limb salvage operations with preservation of the epiphysis (LSPPE) had been used clinically in order to overcome discrepancy of affected limb and poorer limb function, but more post-operation complications existed, including infection, grafting bone resorption, fracture and internal fixation cinch.OBJECTIVE: To study the clinical related matters of inactivated bone replantation with preservation of the epiphysis in children limb salvage with osteosarcoma.DESIGN: Clinical observation regularly.SETTING: General Hospital of Jinan Military Area Command of Chinese PLA.MATERIALS: Eleven patients corresponded selected standard and accepted treatment from January 1999 to January distal metastasis was found with lung X-ray check and CT scanning, the patient would be excluded this study. There were 5 males, 6 females, and the mean age of (8±2) years old (4-11 years). The disease history was 1-6 months.FO) were adopted. After 2 weeks of chemotherapy, the operations of inactivated bone replantation with preservation of the epiphysis were performed. The operation was performed under epidural or general anesthesia. The patient lied on operating table. The knee anteriomedialis incision was adopted. Firstly, femur periosteum was opened beyond proximal end 2-3 cm from tumor, subperiosteum stripping was done to the proximal femur, descend femur with wire saw, separated and disconnected aboral periosteum, blunt dissecting femur aboral blood vessel and nerves to the popliteal fossa,deligating blood vessel around the tumor. Attachment of gastroenemius was cut off. Epiphyseal plate was identified carefully. According to pre-operation MR, the distal femur descend level was determined and the femur was descend with electro-saw. It was determined with cytology that no tumor cell existed in descend level, and reconstruction of bone de-fect with inactivated tumor-bone shell with 95% alcohol and bone cement containing ADR (20 g bone cement: 10 mg ADR), the diaphysis was fixed by intramedullary

  1. 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.

  2. [Secondary reconstruction, after maxillectomy, using an osteocutaneous flap from the fibula. Report of a case].

    Science.gov (United States)

    Ferrari, S; Raffaini, M; Caradonna, L; Sesenna, E

    1997-10-01

    Surgical functional reconstruction after partial maxillectomy with fibula free flap. A bilateral upper alveolar bone, gingival and palatal defect after tumor resection, has various problems originating from reconstruction with prosthesis or temporalis muscle flap. We report a secondary reconstructive procedure using the fibula osteocutaneous free flap. The combined bone segments created the upper alveolar arch, and the skin paddle closed the palatal defect. This procedure restored the patient to masticatory function of the upper jaw, intelligible speech and natural facial appearance. As a result quality of life of patient was extremely improved. PMID:9432561

  3. Regenerate augmentation with bone marrow concentrate after traumatic bone loss

    Directory of Open Access Journals (Sweden)

    Jan Gessmann

    2012-03-01

    Full Text Available Distraction osteogenesis after post-traumatic segmental bone loss of the tibia is a complex and time-consuming procedure that is often complicated due to prolonged consolidation or complete insufficiency of the regenerate. The aim of this feasibility study was to investigate the potential of bone marrow aspiration concentrate (BMAC for percutaneous regenerate augmentation to accelerate bony consolidation of the regenerate. Eight patients (age 22-64 with an average posttraumatic bone defect of 82.4 mm and concomitant risk factors (nicotine abuse, soft-tissue defects, obesity and/or circulatory disorders were treated with a modified Ilizarov external frame using an intramedullary cable transportation system. At the end of the distraction phase, each patient was treated with a percutaneously injection of autologous BMAC into the centre of the regenerate. The concentration factor was analysed using flow cytometry. The mean follow up after frame removal was 10 (4-15 months. With a mean healing index (HI of 36.9 d/cm, bony consolidation of the regenerate was achieved in all eight cases. The mean concentration factor of the bone marrow aspirate was 4.6 (SD 1.23. No further operations concerning the regenerate were needed and no adverse effects were observed with the BMAC procedure. This procedure can be used for augmentation of the regenerate in cases of segmental bone transport. Further studies with a larger number of patients and control groups are needed to evaluate a possible higher success rate and accelerating effects on regenerate healing.

  4. Re-construction

    OpenAIRE

    Bernadette Marie Devilat

    2013-01-01

    Re-construct: to build again. The necessary reconstruction process after an earthquake can be seen as an opportunity to improve previous conditions. All damaged buildings undergo a renovation process in which every piece is carefully returned to its original place. The photograph shows roof reconstruction work in San Pedro de Alcántara, a heritage area in the central valley of Chile, which was particularly affected by the 2010 earthquake. 

  5. Reconstruction of personalized three-dimensional entity model of hip bone based on reverse engineering and rapid prototyping technology%基于逆向工程和快速成型技术的髋骨三维实体模型个性化重建

    Institute of Scientific and Technical Information of China (English)

    唐通鸣; 邓佳文; 张政; 黄明宇; 倪红军

    2015-01-01

    BACKGROUND:Hip’s anatomy structure is complex, and the traditional two-dimensional imaging, such as X-ray film or CT scan, is susceptible to image overlap and other soft tissue. As a result, there are some limitations in the diagnosis of hip disease. The digital model is built based on reverse engineering and rapid prototyping. It is comprehensive, intuitive and accurate of the stereo configuration of the hip and the spatial relations of other parts’ anatomical structures. This study has a broad application prospect. OBJECTIVE:To reconstruct the personalized three-dimensional entity model of the hip bone with computer aided technology. METHODS: The human hips were scanned with a portable three-dimensional laser scanner, and then the point cloud data of the hips were gotten. The point cloud was processed and the three-dimensional model reconstruction was carried out by using the engineering software Geomagic and the computer aided software CimatronE. Three-dimensional print of hip was completed and the model was gotten, which was consistent with the geometry of hip bone, through the rapid prototyping machine. RESULTS AND CONCLUSION:A model with good geometric similarity and biomechanical characteristics was built by digital modeling method based on reverse engineering and rapid prototyping. This way of digital modeling provided the basis for digital manufacturing of artificial hip, virtual assembly, stress analysis and surgical simulation.%背景:髋骨解剖结构复杂,传统的X射线片及CT扫描等二维影像检查易受到影像重叠、软组织等的干扰,在髋骨的诊断中具有一定的局限性。通过基于逆向工程技术的数字化建模能全面、直观、精确地显示髋骨立体形态和各部位解剖结构的空间关系,在骨骼研究中有着广阔的应用前景。目的:利用计算机辅助技术重建个性化的髋骨三维实体模型。方法:使用手持式三维激光扫描仪对人体髋骨表面进行扫

  6. GMP-level adipose stem cells combined with computer-aided manufacturing to reconstruct mandibular ameloblastoma resection defects: Experience with three cases

    OpenAIRE

    Wolff, Jan; Sándor, George K.; Miettinen, Aimo; Tuovinen, Veikko J.; Mannerström, Bettina; Patrikoski, Mimmi; Miettinen, Susanna

    2013-01-01

    Background: The current management of large mandibular resection defects involves harvesting of autogenous bone grafts and repeated bending of generic reconstruction plates. However, the major disadvantage of harvesting large autogenous bone grafts is donor site morbidity and the major drawback of repeated reconstruction plate bending is plate fracture and difficulty in reproducing complex facial contours. The aim of this study was to describe reconstruction of three mandibular ameloblastoma ...

  7. Resection followed by vascularized bone autograft in patients with possible recurrence of malignant bone tumors after conservative treatment

    International Nuclear Information System (INIS)

    In conservative treatment of malignant bone tumors, assessment of the local condition is difficult. The radiological changes seen in the irradiated tumor and the frequent occurrence of pathological fractures at this site may give rise to the fear that the tumor has relapsed. Resection of the whole of the involved bone is the best way to assure adequate local control but the extent of the bone defect and the bad local conditions secondary to irradiation make reconstruction hazardous. In two patients (one with Ewing's sarcoma of the femur and one with osteogenic sarcoma of the humerus) the authors used a free, vascularized fibular graft for the reconstruction having obtained consolidation of the limb after resection of the irradiated tumor, with preservation of its function. The encouraging results obtained have suggested a conservative attitude as primary treatment of specific malignant bone tumors

  8. Flexor pulley reconstruction.

    Science.gov (United States)

    Dy, Christopher J; Daluiski, Aaron

    2013-05-01

    Flexor pulley reconstruction is a challenging surgery. Injuries often occur after traumatic lacerations or forceful extension applied to an acutely flexed finger. Surgical treatment is reserved for patients with multiple closed pulley ruptures, persistent pain, or dysfunction after attempted nonoperative management of a single pulley rupture, or during concurrent or staged flexor tendon repair or reconstruction. If the pulley cannot be repaired primarily, pulley reconstruction can be performed using graft woven into remnant pulley rim or looping graft around the phalanx. Regardless of the reconstructive technique, the surgeon should emulate the length, tension, and glide of the native pulley. PMID:23660059

  9. Visualisation of three-dimensional microcracks in compact bone.

    OpenAIRE

    O'Brien, Fergal J.; Taylor, David; Dickson, G R R; Lee, T Clive

    2000-01-01

    Microdamage in bone contributes to the loss of bone quality in osteoporosis and is thought to play a major role in both fragility and stress fractures (Schaffler et al. 1995). In this study, in vivo microcracks in human ribs were bulk-stained in basic fuchsin and viewed in longitudinal section and in 3 dimensions using 2 different computer-based methods of reconstruction: (1) serial sectioning of methylmethacrylate embedded sections using a sledge macrotome and identification of microcracks u...

  10. 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

  11. Bone Adaptation and Regeneration - New Developments

    Science.gov (United States)

    Klein-Nulend, Jenneke; Bacabac, Rommel Gaud

    Bone is a dynamic tissue that is constantly renewed and adapts to its local loading environment. Mechanical loading results in adaptive changes in bone size and shape that strengthen bone structure. The mechanisms for adaptation involve a multistep process called mechanotransduction, which is the ability of resident bone cells to perceive and translate mechanical energy into a cascade of structural and biochemical changes within the cells. The transduction of a mechanical signal to a biochemical response involves pathways within the cell membrane and cytoskeleton of the osteocytes, the professional mechansensor cells of bone. During the last decade the role of mechanosensitive osteocytes in bone metabolism and turnover, and the lacuno-canalicular porosity as the structure that mediates mechanosensing, is likely to reveal a new paradigm for understanding the bone formation response to mechanical loading, and the bone resorption response to disuse. Strain-derived fluid flow of interstitial fluid through the lacuno-canalicular porosity seems to mechanically activate the osteocytes, as well as ensures transport of cell signaling molecules, nutrients and waste products. Cell-cell signaling from the osteocyte sensor cells to the effector cells (osteoblasts or osteoclasts), and the effector cell response - either bone formation or resorption, allow an explanation of local bone gain and loss as well as remodeling in response to fatigue damage as processes supervised by mechanosensitive osteocytes. The osteogenic activity of cultured bone cells has been quantitatively correlated with varying stress stimulations highlighting the importance of the rate of loading. Theoretically a possible mechanism for the stress response by osteocytes is due to strain amplification at the pericellular matrix. Single cell studies on molecular responses of osteocytes provide insight on local architectural alignment in bone during remodeling. Alignment seems to occur as a result of the

  12. 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

  13. Bone Marrow Diseases

    Science.gov (United States)

    Bone marrow is the spongy tissue inside some of your bones, such as your hip and thigh bones. It contains stem cells. The stem cells can ... the platelets that help with blood clotting. With bone marrow disease, there are problems with the stem ...

  14. 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 ...

  15. Bone grafts in dentistry

    OpenAIRE

    Prasanna Kumar; Belliappa Vinitha; Ghousia Fathima

    2013-01-01

    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.

  16. 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.

  17. Failure load of patellar tendon grafts at the femoral side: 10- versus 20-mm-bone blocks.

    Science.gov (United States)

    Meuffels, Duncan E; Niggebrugge, Marnix J N; Verhaar, Jan A N

    2009-02-01

    The aim of the study was to investigate whether use of short bone blocks is safe in anterior cruciate ligament (ACL) reconstruction. Our hypothesis was that the smaller 10-mm-length bone blocks will fail at lower loads than 20-mm-bone blocks. Ten paired human cadaver knees were randomly assigned to the 10- or 20-mm group (group 1 and 2) and underwent bone-patellar tendon-bone femoral fixation with interference screw. Tensile tests were performed using a tensile testing machine (Instron). Stiffness, failure load and failure mode were recorded. Median stiffness was 72 N/mm (16-103) for 10-mm-bone blocks and 91 N/mm (40-130) for 20-mm-bone blocks. Median failure loads were 402 N (87-546) for 10-mm-long bone block and 456 N (163-636) for 20-mm-bone blocks. There was no statistically significant difference between groups (P = 0.35). All bone-patellar tendon-bone grafts were pulled out of the femoral tunnel with interference screw, due to slippage. We concluded that a 10-mm-long bone block was not significantly weaker than a 20-mm-long bone block. Failure loads of a 10-mm-bone block exceeded loading values at passive and active extension of the knee under normal conditions. Ten millimetre bone blocks offered sufficient fixation strength in ACL reconstruction. PMID:18839146

  18. Osteoradionecrosis of the temporal bone

    International Nuclear Information System (INIS)

    We report a case of temporal bone necrosis that emerged after radiotherapy for epipharyngeal carcinoma performed 13 years ago. The patient was a 51-year-old male. His major complaint was left facial swelling. The patient underwent chemotherapy and radiotherapy (Co 60, 6120 rad), as the treatment of that period, for epipharyngeal carcinoma from September 30, 1986 to January 31, 1987. He also underwent lobectomy of the left temporal lobe in brain surgery for left temporal lobe necrosis in August, 1989. After that operation, we saw constriction in his left external acoustic meatus and continued the follow-up. On October 22, 1999 he felt a left facial swelling. We found skin defects and ulcer formation in the front part of his left ear. Although we administered an antiseptic and antibiotic to the diseased area, his condition did not improve. He was hospitalized for the purpose of undergoing medical treatment on January 6, 2000. We found extensive skin necrosis and defects in his left auricular area. The corrupted temporal bone reached the zygomatic, the bone department external acoustic meatus and the mastoid process was exposing. We performed debridement of the diseased area on January 19, 2000. On February 23, we performed reconstruction by left trapezius muscle flap after debridement once again. One year after the operation, the flap was completely incorporated. (author)

  19. Reconstruction of maxillectomy defects using deep circumflex iliac artery-based composite free flap.

    Science.gov (United States)

    Baliarsing, Amresh S; Kumar, Vinay V; Malik, Neelima A; B, Dilip Kumar

    2010-03-01

    Reconstruction of maxillectomy defects is a challenging endeavor, and various methods have been described to rehabilitate these defects, out of which composite free tissue transfer has an established role in reconstruction of the maxillary defects. The deep circumflex iliac artery (DCIA) flap has distinct advantages regarding the volume and length of the bone in reconstruction. The contour of the iliac bone is similar to the maxilla and provides good esthetic result. Good volume of bone allows placement of osseointegrated implant for dental rehabilitation. We present 8 cases of maxilla reconstruction using DCIA flap (3 osteocutaneous and 5 osseous flaps) for benign and malignant pathologies of the maxilla. DCIA flap is difficult to harvest, has variable anatomy, and needs meticulous planning for optimum result. PMID:20219591

  20. 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

  1. Clinical evaluation of bone- patellar tendon- bone grafts for anterior cruciate ligament injury

    International Nuclear Information System (INIS)

    One thousand and thirty-eight cases of Anterior Cruciate Ligament (ACL) rupture were treated between January 2002 and November 2010. Eight hundred sixty-six cases (83.9%) were observed for at least six months. All cases were reconstructed with a bone to tendon to bone (BTB) graft from the patella. Much effort was made to return the patient to a competitive sports activity level within one year. The age at suffering from the initial injury ranged from 9 to 74 years old with a mean of 24.7 years old. There were 493 female (50.7%) and 427 male (49.3%) cases. The injured side was right in 408 cases and left in 458 cases. The mean postoperative observation period was 449.2 days. The number of patients who felt 80% or more certain that they could return to competitive sports activities was 538 (61.9%). From the MRI findings, continuity of the reconstructed graft was observed in 793 cases (98.5%). Arthroscopy after reconstruction was performed in 775 cases (89.5%). The reconstructed ACL was observed to be covered with an adequate synovium in 629 cases (81.2%). The medial meniscus and lateral meniscus showed no changes in 657 cases (84.8%) and 666 cases (85.9%) respectively. Reconstructions performed less than two weeks after injury showed no significant differences in terms of Range Of Motion (ROM), arthroscopic findings, or the number of patients who could return to competitive sports activities. Statistically significantly more patients who underwent their reconstruction at an age over forty experienced a loss motion of five degree in extension or ten degree in flexion and resumed a lower level of sports activities. Patients who underwent the reconstruction could return to exercises for muscle strengthening and ROMs within 2 weeks. Patients over forty years old who underwent their reconstruction could prevent their menisci from fraying, tearing, or undergoing osteoarthritic changes. (author)

  2. Characterization and simulation of fate and transport of selected volatile organic compounds in the vicinities of the Hadnot Point Industrial Area and landfill: Chapter A Supplement 6 in Analyses and historical reconstruction of groundwater flow, contaminant fate and transport, and distribution of drinking water within the service areas of the Hadnot Point and Holcomb Boulevard Water Treatment Plants and vicinities, U.S. Marine Corps Base Camp Lejeune, North Carolina

    Science.gov (United States)

    Jones, L. Elliott; Suárez-Soto, René J.; Anderson, Barbara A.; Maslia, Morris L.

    2013-01-01

    This supplement of Chapter A (Supplement 6) describes the reconstruction (i.e. simulation) of historical concentrations of tetrachloroethylene (PCE), trichloroethylene (TCE), and benzene3 in production wells supplying water to the Hadnot Base (USMCB) Camp Lejeune, North Carolina (Figure S6.1). A fate and transport model (i.e., MT3DMS [Zheng and Wang 1999]) was used to simulate contaminant migration from source locations through the groundwater system and to estimate mean contaminant concentrations in water withdrawn from water-supply wells in the vicinity of the Hadnot Point Industrial Area (HPIA) and the Hadnot Point landfill (HPLF) area.4 The reconstructed contaminant concentrations were subsequently input into a flow-weighted, materials mass balance (mixing) model (Masters 1998) to estimate monthly mean concentrations of the contaminant in finished water 5 at the HPWTP (Maslia et al. 2013). The calibrated fate and transport models described herein were based on and used groundwater velocities derived from groundwater-flow models that are described in Suárez-Soto et al. (2013). Information data pertinent to historical operations of water-supply wells are described in Sautner et al. (2013) and Telci et al. (2013).

  3. Anorexia nervosa and bone.

    Science.gov (United States)

    Misra, Madhusmita; Klibanski, Anne

    2014-06-01

    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 additional concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, and hormonal alterations secondary to nutritional factors contribute to impaired bone metabolism in AN. The best strategy to improve bone density is to regain weight and menstrual function. Oral estrogen-progesterone combinations are not effective in increasing bone density in adults or adolescents with AN, and transdermal testosterone replacement is not effective in increasing bone density in adult women with AN. However, physiological estrogen replacement as transdermal estradiol with cyclic progesterone does increase bone accrual rates in adolescents with AN to approximate that in normal-weight controls, leading to a maintenance of bone density Z-scores. A recent study has shown that risedronate increases bone density at the spine and hip in adult women with AN. However, bisphosphonates should be used with great caution in women of reproductive age, given their long half-life and potential for teratogenicity, and should be considered only in patients with low bone density and clinically significant fractures when non-pharmacological therapies for weight gain are ineffective. Further studies are necessary to determine the best therapeutic strategies for low bone density in AN. PMID:24898127

  4. Anorexia Nervosa and Bone

    Science.gov (United States)

    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 contribute to impaired bone metabolism in AN. The best strategy to improve bone density is to regain weight and menstrual function. Oral estrogen-progesterone combinations are not effective in increasing bone density in adults or adolescents with AN, and transdermal testosterone replacement is not effective in increasing bone density in adult women with AN. However, physiologic estrogen replacement as transdermal estradiol with cyclic progesterone does increase bone accrual rates in adolescents with AN to approximate that in normal-weight controls, leading to a maintenance of bone density Z-scores. A recent study has shown that risedronate increases bone density at the spine and hip in adult women with AN. However, bisphosphonates should be used with great caution in women of reproductive age given their long half-life and potential for teratogenicity, and should be considered only in patients with low bone density and clinically significant fractures when non-pharmacological therapies for weight gain are ineffective. Further studies are necessary to determine the best therapeutic strategies for low bone density in AN. PMID:24898127

  5. Image Reconstruction. Chapter 13

    International Nuclear Information System (INIS)

    This chapter discusses how 2‑D or 3‑D images of tracer distribution can be reconstructed from a series of so-called projection images acquired with a gamma camera or a positron emission tomography (PET) system [13.1]. This is often called an ‘inverse problem’. The reconstruction is the inverse of the acquisition. The reconstruction is called an inverse problem because making software to compute the true tracer distribution from the acquired data turns out to be more difficult than the ‘forward’ direction, i.e. making software to simulate the acquisition. There are basically two approaches to image reconstruction: analytical reconstruction and iterative reconstruction. The analytical approach is based on mathematical inversion, yielding efficient, non-iterative reconstruction algorithms. In the iterative approach, the reconstruction problem is reduced to computing a finite number of image values from a finite number of measurements. That simplification enables the use of iterative instead of mathematical inversion. Iterative inversion tends to require more computer power, but it can cope with more complex (and hopefully more accurate) models of the acquisition process

  6. Bitzer's Model Reconstructed.

    Science.gov (United States)

    Lybarger, Scott; Smith, Craig R.

    1996-01-01

    Reconstructs Lloyd Bitzer's situational model to serve as a guide for the generation of multiperspectival critical assessments of rhetorical discourse. Uses two of President Bush's speeches on the drug crisis to illustrate how the reconstructed model can account for such modern problems as multiple audiences, perceptions, and exigencies. (PA)

  7. [The progress in application of parathyroid hormone in craniomaxillofacial bone regeneration study].

    Science.gov (United States)

    Chen, X Y; Tang, Z L

    2016-06-01

    Parathyroid hormone(PTH)is synthesized and secreted by chief cell of Gley's glands which possesses dual functions of catabolism and anabolism. It regulates the proliferation and differentiation of multiple cell lines including osteoblast, osteoclast and skeletal lining cells. Furthermore, PTH activates various signaling pathways which control calcium, phosphorous' metabolism and bone conversion, accelerating the bone regeneration and reconstruction. However, the study of PTH in craniomaxillofacial bone regeneration is relatively less and whether the role of parathyroid glands and the mechanism of ossification are consistent with the long bone or not needs further investigation. This review focuses on the progress of PTH in craniomaxillofacial bone regeneration in recent years. PMID:27256534

  8. Human stem cells for craniomaxillofacial reconstruction.

    Science.gov (United States)

    Jalali, Morteza; Kirkpatrick, William Niall Alexander; Cameron, Malcolm Gregor; Pauklin, Siim; Vallier, Ludovic

    2014-07-01

    Human stem cell research represents an exceptional opportunity for regenerative medicine and the surgical reconstruction of the craniomaxillofacial complex. The correct architecture and function of the vastly diverse tissues of this important anatomical region are critical for life supportive processes, the delivery of senses, social interaction, and aesthetics. Craniomaxillofacial tissue loss is commonly associated with inflammatory responses of the surrounding tissue, significant scarring, disfigurement, and psychological sequelae as an inevitable consequence. The in vitro production of fully functional cells for skin, muscle, cartilage, bone, and neurovascular tissue formation from human stem cells, may one day provide novel materials for the reconstructive surgeon operating on patients with both hard and soft tissue deficit due to cancer, congenital disease, or trauma. However, the clinical translation of human stem cell technology, including the application of human pluripotent stem cells (hPSCs) in novel regenerative therapies, faces several hurdles that must be solved to permit safe and effective use in patients. The basic biology of hPSCs remains to be fully elucidated and concerns of tumorigenicity need to be addressed, prior to the development of cell transplantation treatments. Furthermore, functional comparison of in vitro generated tissue to their in vivo counterparts will be necessary for confirmation of maturity and suitability for application in reconstructive surgery. Here, we provide an overview of human stem cells in disease modeling, drug screening, and therapeutics, while also discussing the application of regenerative medicine for craniomaxillofacial tissue deficit and surgical reconstruction. PMID:24564584

  9. The CMS Reconstruction Software

    Science.gov (United States)

    Lange, David J.; CMS Collaboration

    2011-12-01

    We report on the status and plans for the event reconstruction software of the CMS experiment. The CMS reconstruction algorithms are the basis for a wide range of data analysis approaches currently under study by the CMS collaboration using the first high-energy run of the LHC. These algorithms have been primarily developed and validated using simulated data samples, and are now being commissioned with LHC proton-proton collision data samples. The CMS reconstruction is now operated routinely on all events triggered by the CMS detector, both in a close to real-time prompt reconstruction processing and in frequent passes over the full recorded CMS data set. We discuss the overall software design, development cycle, computational requirements and performance, recent operational performance, and planned improvements of the CMS reconstruction software.

  10. BMP2 genetically engineered MSCs and EPCs promote vascularized bone regeneration in rat critical-sized calvarial bone defects.

    Directory of Open Access Journals (Sweden)

    Xiaoning He

    Full Text Available Current clinical therapies for critical-sized bone defects (CSBDs remain far from ideal. Previous studies have demonstrated that engineering bone tissue using mesenchymal stem cells (MSCs is feasible. However, this approach is not effective for CSBDs due to inadequate vascularization. In our previous study, we have developed an injectable and porous nano calcium sulfate/alginate (nCS/A scaffold and demonstrated that nCS/A composition is biocompatible and has proper biodegradability for bone regeneration. Here, we hypothesized that the combination of an injectable and porous nCS/A with bone morphogenetic protein 2 (BMP2 gene-modified MSCs and endothelial progenitor cells (EPCs could significantly enhance vascularized bone regeneration. Our results demonstrated that delivery of MSCs and EPCs with the injectable nCS/A scaffold did not affect cell viability. Moreover, co-culture of BMP2 gene-modified MSCs and EPCs dramatically increased osteoblast differentiation of MSCs and endothelial differentiation of EPCs in vitro. We further tested the multifunctional bone reconstruction system consisting of an injectable and porous nCS/A scaffold (mimicking the nano-calcium matrix of bone and BMP2 genetically-engineered MSCs and EPCs in a rat critical-sized (8 mm caviarial bone defect model. Our in vivo results showed that, compared to the groups of nCS/A, nCS/A+MSCs, nCS/A+MSCs+EPCs and nCS/A+BMP2 gene-modified MSCs, the combination of BMP2 gene -modified MSCs and EPCs in nCS/A dramatically increased the new bone and vascular formation. These results demonstrated that EPCs increase new vascular growth, and that BMP2 gene modification for MSCs and EPCs dramatically promotes bone regeneration. This system could ultimately enable clinicians to better reconstruct the craniofacial bone and avoid donor site morbidity for CSBDs.

  11. BMP2 Genetically Engineered MSCs and EPCs Promote Vascularized Bone Regeneration in Rat Critical-Sized Calvarial Bone Defects

    Science.gov (United States)

    He, Xiaoning; Dziak, Rosemary; Yuan, Xue; Mao, Keya; Genco, Robert; Swihart, Mark; Sarkar, Debanjan; Li, Chunyi; Wang, Changdong; Lu, Li; Andreadis, Stelios; Yang, Shuying

    2013-01-01

    Current clinical therapies for critical-sized bone defects (CSBDs) remain far from ideal. Previous studies have demonstrated that engineering bone tissue using mesenchymal stem cells (MSCs) is feasible. However, this approach is not effective for CSBDs due to inadequate vascularization. In our previous study, we have developed an injectable and porous nano calcium sulfate/alginate (nCS/A) scaffold and demonstrated that nCS/A composition is biocompatible and has proper biodegradability for bone regeneration. Here, we hypothesized that the combination of an injectable and porous nCS/A with bone morphogenetic protein 2 (BMP2) gene-modified MSCs and endothelial progenitor cells (EPCs) could significantly enhance vascularized bone regeneration. Our results demonstrated that delivery of MSCs and EPCs with the injectable nCS/A scaffold did not affect cell viability. Moreover, co-culture of BMP2 gene-modified MSCs and EPCs dramatically increased osteoblast differentiation of MSCs and endothelial differentiation of EPCs in vitro. We further tested the multifunctional bone reconstruction system consisting of an injectable and porous nCS/A scaffold (mimicking the nano-calcium matrix of bone) and BMP2 genetically-engineered MSCs and EPCs in a rat critical-sized (8 mm) caviarial bone defect model. Our in vivo results showed that, compared to the groups of nCS/A, nCS/A+MSCs, nCS/A+MSCs+EPCs and nCS/A+BMP2 gene-modified MSCs, the combination of BMP2 gene -modified MSCs and EPCs in nCS/A dramatically increased the new bone and vascular formation. These results demonstrated that EPCs increase new vascular growth, and that BMP2 gene modification for MSCs and EPCs dramatically promotes bone regeneration. This system could ultimately enable clinicians to better reconstruct the craniofacial bone and avoid donor site morbidity for CSBDs. PMID:23565253

  12. Radiographic evaluation of new orthopedic surgical techniques for cruciate and medial collateral ligament knee reconstruction

    International Nuclear Information System (INIS)

    The normal postoperative radiographic appearance of ligamentous knee reconstructions, postoperative complications, and potential pitfalls are presented. Anterior cruciate ligament repair with bone-patella tendon-bone grafts is evaluated in terms of hardware position, location of the drill holes, and change in position, fracture, or healing of the bone graft itself. Posterior cruciate ligament injuries may be repaired similarly with a bone-patella tendon-bone graft or may involve entirely soft-tissue reconstruction, in which case they are evaluated by location of the drill holes and hardware position. Medial collateral ligament repairs are evaluated entirely by hardware position, based on an anatomic understanding of the normal origin and insertion of the ligament

  13. Relation between in vitro and in vivo osteogenic potential of cultured human bone marrow stromal cells

    NARCIS (Netherlands)

    Mendes, SC; Tibbe, JM; Veenhof, M; Both, S; Oner, FC; van Blitterswijk, CA; de Bruijn, Joost D.

    2004-01-01

    The use of cell therapies in bone reconstruction has been the subject of extensive research. It is known that human bone marrow stromal cell (HBMSC) cultures contain a population of progenitor cells capable of differentiation towards the osteogenic lineage. In the present study, the correlation betw

  14. Secondary bone grafting for alveolar cleft in children with cleft lip or cleft lip and palate

    NARCIS (Netherlands)

    J. Guo; C. Li; Q. Zhang; G. Wu; S.A. Deacon; J. Chen; H. Hu; S. Zou; Q. Ye

    2011-01-01

    BACKGROUND: Secondary alveolar bone grafting has been widely used to reconstruct alveolar cleft. However, there is still some controversy. OBJECTIVES: To compare the effectiveness and safety of different secondary bone grafting methods. SEARCH STRATEGY: The final electronic and handsearches were car

  15. [Microdestruction of the bone].

    Science.gov (United States)

    Iankovskiĭ, V É

    2014-01-01

    The objective of the present study was the detection of microcracks in the compact bone tissue surrounding the fracture and in deformed bone undergoing subcritical loading. The portions of deformed bone tissue and terminal fragments of broken bones were obtained in the form of blocks longitudinally sawcut from the regions of primary and secondary bone rupture. A total of 300 such blocks were available for the examination. All portions of the deformed bone tissue and terminal fragments of broken bones showed up microcracks commensurate with the bone structures. They were actually hardened traces of deformation that preceded the fracture and reflected the volume of the destroyed bone tissue; moreover, in certain cases they allowed to identify the kind of the object that exerted the external action (either a blow or slow bending). PMID:25269164

  16. Is alveolar cleft reconstruction still controversial? (Review of literature

    Directory of Open Access Journals (Sweden)

    Sameh A. Seifeldin

    2016-01-01

    Full Text Available Cleft lip and palate (CL/P is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral and complete or incomplete. Alveolar cleft reconstruction remains controversial with regard to timing, graft materials, surgical techniques, and methods of evaluation. Many studies have been conducted addressing these points to develop an acceptable universal protocol for managing CL/P. The primary goal of alveolar cleft reconstruction in CL/P patients is to provide a bony bridge at the cleft site that allows maxillary arch continuity, oronasal fistula repair, eruption of the permanent dentition into the newly formed bone, enhances nasal symmetry through providing alar base support, orthodontic movement and placement of osseointegrated implants when indicated. Other goals include improving speech, improvement of periodontal conditions, establishing better oral hygiene, and limiting growth disturbances. In order to rehabilitate oral function in CL/P patients alveolar bone grafting is necessary. Secondary bone grafting is the most widely accepted method for treating alveolar clefts. Autogenous bone graft is the primary source for reconstructing alveolar cleft defects and is currently the preferred grafting material.

  17. A New Bone Substitute in the Definitive Management of Furcation Involvement A Case Report

    OpenAIRE

    Develioglu, H; Altintepe, SS

    2014-01-01

    Bone xenografts are used for reconstructive surgery in medicine and dentistry. The grafts are osteoconductive, serving as a matrix in bone regeneration. Furcation involvements are one of the most challenging clinical problems in periodontics. Unilab Surgibone is a bone xenograft and has been investigated in many clinical and experimental studies. In this case report, a 50-year old male patient was diagnosed with a class III furcation problem in his upper right first molar. The tooth was surgi...

  18. Revision Anterior Cruciate Ligament Reconstruction in Military Personnel.

    Science.gov (United States)

    Balazs, George C; Grimm, Patrick D; Donohue, Michael A; Keblish, David J; Rue, John-Paul

    2016-08-01

    This study aims to report the clinical and functional outcomes of revision anterior cruciate ligament (ACL) reconstruction in a young, active duty military population. Patients undergoing revision ACL reconstruction were enrolled in an institutional clinical database and followed prospectively. The primary outcomes were patients' scores on a timed run, as compared with recorded scores before reinjury. Secondary outcomes included scores on the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC), the International Knee Documentation Committee subjective (IKDC subjective), the Short Form - 36 health survey (SF-36) version 2, the Single Assessment Numeric Evaluation (SANE), and the Tegner activity scale. A total of 13 patients were identified who met the inclusion criteria and had complete follow-up. The mean age at revision ACL reconstruction was 20.5 years (range, 19-22 years), and mean follow-up was 40.2 months (range, 13-66 months). All patients underwent a single stage revision ACL reconstruction with ipsilateral bone-patellar tendon-bone autograft, ipsilateral hamstring autograft, or bone-tendon-bone allograft. Mean physical readiness test (PRT) score at final follow-up was not statistically different than documented preinjury PRT score (77.9 vs. 85.5, p > 0.05), nor was the mean run time (7:12 vs. 6:43/mile, p > 0.05). Significant improvements exceeding published minimal clinically important differences were seen in SANE score, SF-36 physical component summary score, KOOS sports and recreation, KOOS quality of life, WOMAC pain score, and WOMAC function score. Patients undergoing revision ACL reconstruction at our facility show good recovery of baseline physical performance as measured by the semiannual PRT and timed run test, and significant improvements in patient-reported outcome scores. Level of Evidence Level IV, case series. PMID:26524090

  19. Treatment of severe bone deficiency in acetabular revision surgery using a reinforcement device and bone grafting

    Institute of Scientific and Technical Information of China (English)

    ZHAI Ji-liang; LIN Jin; JIN Jin; QIAN Wen-wei; WENG Xi-sheng

    2011-01-01

    Background Severe acetabular bone deficiency is a major challenge in acetabular revision surgery. Most cases require reconstruction of the acetabulum with bone grafting and a reinforcement device. The purpose of this study was to evaluate the results of this procedure for severe acetabular bone deficiency in acetabular revision surgery.Methods This study involved 12 patients (2 males and 10 females) with severe acetabular bone defects who underwent implantation of a reinforcement device (ring or cage) and bone grafting between February 2003 and October 2008. Using the Paprosky classification, 2 cases were Paprosky ⅡC, 6 were ⅢA, and 4 were ⅢB. The mean age at the time of surgery was 63.0 years (range, 46-78 years). During revision surgery, a reinforcement ring was implanted in 6patients, and a cage in 6 patients. The clinical and radiographic results were evaluated retrospectively. The mean duration of follow-up was 37 months (range, 9-71 months).Results The average Harris Hip Score improved from 35.2 preoperatively to 82.9 at the time of the final follow-up visit.The results were excellent in 8 hips (66.7%), good in 2 (16.7%), and fair in 2 (16.7%). Osteolysis was found in 1 case, but did not worsen. Three patients had yellow wound effusion, with healing after administration of dressing changes,debridement, and antibiotics. Dislocation occurred in a 62-year-old woman. Closed reduction was performed, and dislocation did not recur. There was no evidence of intraoperative acetabular fracture, nerve injury, ectopic ossification,aseptic loosening, or infection.Conclusion Reconstruction with a reinforcement device and bone grafting is an effective approach to the treatment of acetabular bone deficiency in acetabular revision surgery, given proper indications and technique.

  20. Delayed breast implant reconstruction

    DEFF Research Database (Denmark)

    Hvilsom, Gitte B.; Hölmich, Lisbet R.; Steding-Jessen, Marianne;

    2011-01-01

    -stage procedures. From the Danish Registry for Plastic Surgery of the Breast, which has prospectively registered data for women undergoing breast implantations since 1999, we identified 559 women without a history of radiation therapy undergoing 592 delayed breast reconstructions following breast cancer during the......Studies of complications following reconstructive surgery with implants among women with breast cancer are needed. As the, to our knowledge, first prospective long-term study we evaluated the occurrence of complications following delayed breast reconstruction separately for one- and two...

  1. Classification of temporal bone pneumatization based on sigmoid sinus using computed tomography

    International Nuclear Information System (INIS)

    Aim: To analyse several reference structures using axial computed tomography (CT) imaging of the temporal bone, which may reflect pneumatization of the entire temporal bone by statistical correlation to the actual volume of the temporal bone measured using three-dimensional reconstruction. Materials and methods: One hundred and sixteen temporal bones were studied, comprising 48 with normal findings and 68 sides showing chronic otitis media or temporal bone fracture. After measuring the volume of temporal bone air cells by the volume rendering technique using three-dimensional reconstruction images, classification of temporal bone pneumatization was performed using various reference structures on axial images to determine whether significant differences in the volume of temporal bone air cells could be found between the groups. Results: When the sigmoid sinus at the level of the malleoincudal complex was used in the classification, there were statistically significant differences between the groups that correlated with the entire volume of the temporal bone. Grouping based on the labyrinth and the ascending carotid artery showed insignificant differences in volume. Furthermore, there was no significant correlation between the cross-sectional area of the antrum and the entire volume of the temporal bone. Conclusion: The degree of pneumatization of temporal bone can be estimated easily by the evaluation of the air cells around the sigmoid sinus on axial CT images

  2. Craniofacial reconstruction - series (image)

    Science.gov (United States)

    ... syndrome) injuries to the head, face, or jaws (maxillofacial) tumors deformities caused by treatments of tumors ... the new bone positions in place. If the surgery is expected to cause significant swelling of the ...

  3. Giant cells tumor of radius distal end and bone reconstruction

    International Nuclear Information System (INIS)

    This is the case of a black women aged 40 presenting with a tumor of distal end of right radium with histological diagnosis of low-grade malignancy giant cells tumor and proposal of limb amputation. A conservative surgery was performed with a two-steps total exeresis of lesion sparing the oncologic margin. A fibular free-graft was used and wrist arthrodesis and internal fixation of graft using AO system. There was a good graft consolidation and an active incorporation of patient to social activities. The diagnosis, treatment, follow-up, rehabilitation and case prognosis are exposed

  4. PROXIMAL RADIUS RECONSTRUCTION BY METATARSAL OSTEOCHONDRAL AUTO GRAFT

    Directory of Open Access Journals (Sweden)

    Kammar

    2015-04-01

    Full Text Available 17 Year Old student, Pavan presents with swelling since 8 months. Swelling was diffuse over forearm. Tenderness was present. No local rise of temperature. Range of m ovement at elbow was restricted and painful terminally. No distal neurovascular deficits. X - ray reveale d it to be an a neurysmal bone cyst of proximal right radius. FNAC showed Aneurysmal bone cyst for which curettage and bone grafting was done. Post 6 months tumour recurred with a swelling around upper third of right fo rearm. FNAC and J - needle biopsy showed it to be a neurysmal bone cyst. MRI showed ABC of proximal radius without soft tissue involvement. Excision of proximal third of radius with reconstruction by 3 rd metatarsal and augmented with fib ular graft and stabili zed with dynamic c ompression plate and screws . Tumour specimen was sent for h istopathology a t 2 weeks p ost operatively patient had good range of movements. At present patient has full range of flexion , extension , supination & pronation . He is able to carry out his ADL. In the literature proximal radius reconstruction has been tried in traumatic communited radial head fractures. Here it done for r ecurrent benign tumour like aneurysmal bone cyst, as the base of 3rd metatarsal anatomically coincides with radial head and hence a better radio - capital articulation

  5. 3D CT Imaging Method for Measuring Temporal Bone Aeration

    International Nuclear Information System (INIS)

    Objective: 3D volume reconstruction of CT images can be used to measure temporal bene aeration. This study evaluates the technique with respect to reproducibility and acquisition parameters. Material and methods: Helical CT images acquired from patients with radiographically normal temporal bones using standard clinical protocols were retrospectively analyzed. 3D image reconstruction was performed to measure the volume of air within the temporal bone. The appropriate threshold values for air were determined from reconstruction of a phantom with a known air volume imaged using the same clinical protocols. The appropriate air threshold values were applied to the clinical material. Results: Air volume was measured according to an acquisition algorithm. The average volume in the temporal bone CT group was 5.56 ml, compared to 5.19 ml in the head CT group (p = 0.59). The correlation coefficient between examiners was > 0.92. There was a wide range of aeration volumes among individual ears (0.76-18.84 ml); however, paired temporal bones differed by an average of just 1.11 ml. Conclusions: The method of volume measurement from 3D reconstruction reported here is widely available, easy to perform and produces consistent results among examiners. Application of the technique to archival CT data is possible using corrections for air segmentation thresholds according to acquisition parameters

  6. Application of DSA three-dimensional reconstruction in percutaneous vertebroplasty of upper

    International Nuclear Information System (INIS)

    Objective: To evaluate the application value of DSA three-dimensional reconstruction in percutaneous vertebroplasty (PVP). Methods: There were 32 patients with 48 upper thoracic vertebrae (T1-T6). Of which, 10 were compression fracture of vertabral body, 21 were metastatic tumors, 1 was myeloma. Three-dimensional rotary acquisition and three-dimensional reconstruction were carried out before operation, in the course of inserting the needles and after injecting the bone cement. Before the operation, the shape of pedicle and centrum and integrity of bone cortex were observed. During the operation, the direction and location of the needles were all observed. While the distribution of the bone cement in vertebral bodies and leakage of bone cement were observed after the operation. Results: By three-dimensional reconstruction after the operation, leakage of bone cement was found in 8 thoracic vertebrae, 5 of which were leaked into paravertebral space and intervertebral disc, 3 of which were leaked into the spinal canal. There were no severe complications in all patients. Conclusion: Three-dimensional reconstruction of vertebral bodies is a practical way to prevent leakage of bone cement during percutaneous vertebroplasty (PVP) of upper thoracic vertebra. (authors)

  7. 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. ...

  8. Bone marrow (stem cell) donation

    Science.gov (United States)

    ... lymphoma , and myeloma can be treated with a bone marrow transplant . This is now often called a stem cell ... are two types of bone marrow donation: Autologous bone marrow transplant is when people donate their own bone marrow. " ...

  9. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available SURGICAL VENTRICULAR RECONSTRUCTION MONTEFIORE-EINSTEIN HEART CENTER NEW YORK CITY, NEW YORK February 13, 2008 00:00:09 NARRATOR: Welcome to the Montefiore-Einstein Heart Center in ...

  10. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available SURGICAL VENTRICULAR RECONSTRUCTION MONTEFIORE-EINSTEIN HEART CENTER NEW YORK CITY, NEW YORK February 13, 2008 00:00:09 NARRATOR: Welcome to the Montefiore-Einstein Heart Center in New York City. In ...

  11. Prairie Reconstruction Initiative

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of the Prairie Reconstruction Initiative Advisory Team (PRIAT) is to identify and take steps to resolve uncertainties in the process of prairie...

  12. Overview of Image Reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Marr, R. B.

    1980-04-01

    Image reconstruction (or computerized tomography, etc.) is any process whereby a function, f, on Rn is estimated from empirical data pertaining to its integrals, ∫f(x) dx, for some collection of hyperplanes of dimension k < n. The paper begins with background information on how image reconstruction problems have arisen in practice, and describes some of the application areas of past or current interest; these include radioastronomy, optics, radiology and nuclear medicine, electron microscopy, acoustical imaging, geophysical tomography, nondestructive testing, and NMR zeugmatography. Then the various reconstruction algorithms are discussed in five classes: summation, or simple back-projection; convolution, or filtered back-projection; Fourier and other functional transforms; orthogonal function series expansion; and iterative methods. Certain more technical mathematical aspects of image reconstruction are considered from the standpoint of uniqueness, consistency, and stability of solution. The paper concludes by presenting certain open problems. 73 references. (RWR)

  13. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available ... reconstruction. This study is going to be a land…landmark study. And in all likelihood will influence ... improve postoperatively. But, nevertheless, this is an acute change and may take some time for the myocardium ...

  14. Overview of image reconstruction

    International Nuclear Information System (INIS)

    Image reconstruction (or computerized tomography, etc.) is any process whereby a function, f, on R/sup n/ is estimated from empirical data pertaining to its integrals, ∫f(x) dx, for some collection of hyperplanes of dimension k < n. The paper begins with background information on how image reconstruction problems have arisen in practice, and describes some of the application areas of past or current interest; these include radioastronomy, optics, radiology and nuclear medicine, electron microscopy, acoustical imaging, geophysical tomography, nondestructive testing, and NMR zeugmatography. Then the various reconstruction algorithms are discussed in five classes: summation, or simple back-projection; convolution, or filtered back-projection; Fourier and other functional transforms; orthogonal function series expansion; and iterative methods. Certain more technical mathematical aspects of image reconstruction are considered from the standpoint of uniqueness, consistency, and stability of solution. The paper concludes by presenting certain open problems. 73 references

  15. Breast reconstruction - natural tissue

    Science.gov (United States)

    After a mastectomy , some women choose to have cosmetic surgery to remake their breast. This type of surgery ... Risks of anesthesia and surgery are: Reactions to medicines Breathing problems Bleeding, blood clots , or infection Risks of breast reconstruction with ...

  16. Permutationally invariant state reconstruction

    CERN Document Server

    Moroder, Tobias; Toth, Geza; Schwemmer, Christian; Niggebaum, Alexander; Gaile, Stefanie; Gühne, Otfried; Weinfurter, Harald

    2012-01-01

    Feasible tomography schemes for large particle numbers must possess, besides an appropriate data acquisition protocol, also an efficient way to reconstruct the density operator from the observed finite data set. Since state reconstruction typically requires the solution of a non-linear large-scale optimization problem, this is a major challenge in the design of scalable tomography schemes. Here we present an efficient state reconstruction scheme for permutationally invariant quantum state tomography. It works for all common state-of-the-art reconstruction principles, including, in particular, maximum likelihood and least squares methods, which are the preferred choices in today's experiments. This high efficiency is achieved by greatly reducing the dimensionality of the problem employing a particular representation of permutationally invariant states known from spin coupling combined with convex optimization, which has clear advantages regarding speed, control and accuracy in comparison to commonly employed n...

  17. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available ... a better procedure, the ventricular reconstruction or heart transplantation. This particular viewer actually saw our previous video on heart transplantation. And to answer that question, they are both ...

  18. On TPC cluster reconstruction

    CERN Document Server

    Dydak, F; Nefedov, Y; Wotschack, J; Zhemchugov, A

    2004-01-01

    For a bias-free momentum measurement of TPC tracks, the correct determination of cluster positions is mandatory. We argue in particular that (i) the reconstruction of the entire longitudinal signal shape in view of longitudinal diffusion, electronic pulse shaping, and track inclination is important both for the polar angle reconstruction and for optimum r phi resolution; and that (ii) self-crosstalk of pad signals calls for special measures for the reconstruction of the z coordinate. The problem of 'shadow clusters' is resolved. Algorithms are presented for accepting clusters as 'good' clusters, and for the reconstruction of the r phi and z cluster coordinates, including provisions for 'bad' pads and pads next to sector boundaries, respectively.

  19. Surgical Ventricular Reconstruction

    Medline Plus

    Full Text Available ... He has not been readmitted for any reasons related to heart failure. 00:41:57 ROBERT E. ... question, because it really deals with whether anything related to surgical ventricular reconstruction would add to the ...

  20. Bone Graft Alternatives

    Science.gov (United States)

    ... cadavers. The types of allograft bone used for spine surgery include fresh frozen and lyophilized (freeze dried). The ... the most common uses of bone grafts in spine surgery is during spinal fusion. The use of autogenous ...

  1. Bone Loss in IBD

    Science.gov (United States)

    ... DENSITY? Although bone seems as hard as a rock, it’s actually living tissue. Throughout your life, old ... available Bone Loss (.pdf) File: 290 KB 733 Third Avenue, Suite 510, New York, NY 10017 | 800- ...

  2. Bone mineral density test

    Science.gov (United States)

    ... Paula FJA, Black DM, Rosen CJ. Osteoporosis and bone biology.In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology . 13th ed. Philadelphia, ... Bone-density testing interval and transition to osteoporosis in ...

  3. Bone mineral density test

    Science.gov (United States)

    BMD test; Bone density test; Bone densitometry; DEXA scan; DXA; Dual-energy x-ray absorptiometry; p-DEXA; Osteoporosis-BMD ... need to undress. This scan is the best test to predict your risk of fractures. Peripheral DEXA ( ...

  4. Smoking and Bone Health

    Science.gov (United States)

    ... It has been called a childhood disease with old age consequences because building healthy bones in youth helps ... stronger. Weight-bearing exercise that forces you to work against gravity is the best exercise for bone. ...

  5. Chalet. Reconstruction from Memory

    OpenAIRE

    Gheysen, Eva

    2015-01-01

    In the research project several design tactics are developed in order to counteract the phenomenon of experiential erosion. This particular project explored one of the tactics: Reconstruction from Memory. When reconstructing space from memory, isolated spatial fragments from the past are reformed into a new, decontextualized construct that represents the most memorable experiences evoked by that space. These memories give insight in which architectural features strongly affect our experience ...

  6. Reconstructing baryon oscillations

    OpenAIRE

    Noh, Yookyung; White, Martin; Padmanabhan, Nikhil

    2009-01-01

    The baryon acoustic oscillation (BAO) method for constraining the expansion history is adversely affected by non-linear structure formation, which washes out the correlation function peak created at decoupling. To increase the constraining power of low z BAO experiments, it has been proposed that one use the observed distribution of galaxies to "reconstruct'' the acoustic peak. Recently Padmanabhan, White and Cohn provided an analytic formalism for understanding how reconstruction works withi...

  7. Materials used for reconstruction after orbital floor fracture.

    Science.gov (United States)

    Avashia, Yash J; Sastry, Ananth; Fan, Kenneth L; Mir, Haaris S; Thaller, Seth R

    2012-11-01

    Advances in biotechnology continue to introduce new materials for reconstruction of orbital floor fractures. Which material is best fit for orbital floor reconstruction has been a controversial topic. Individual surgeon preferences have been supported by inconsistent inconclusive data. The purpose of this study was to assess and analyze published evidence supporting various materials used for orbital floor reconstruction and to develop a decision-making algorithm for clinical application. A systematic literature review was performed from which 48 studies were selected after primary and secondary screening based on set inclusion and exclusion criteria. This cumulatively included 3475 separate orbital floor reconstructions. Results revealed risk and benefit profiles for all materials. Autologous calvarial bone grafts, porous polyethylene, and polydioxanone (PDS) were most widely used for orbital floor reconstruction. Increased infection rates were reported with polyglactin 910/PDS composites and silastic rubber. Ocular motility was reduced most with lyophilized dura and PDS. Preoperative and postoperative rates for diplopia and enophthalmos varied among the materials. In conclusion, our results revealed continued inadequate evidence to exclusively support the use of any one biomaterial/implant for orbital floor reconstruction. Results have served to create a decision-making algorithm for clinical application. Our authors propose certain parameters for future studies seeking to demonstrate a comparison between 2 or more materials for orbital floor reconstruction. PMID:23154365

  8. Monocortical Deep Circumflex Iliac Artery Flap in Jaw Reconstruction.

    Science.gov (United States)

    Moon, Seong-Yong

    2015-06-01

    Conventionally deep circumflex iliac artery (DCIA) flap had been harvested as bicortical form. However, several complications and adverse effects occurred such as abnormal hip contour, hernia, severe bleeding tendency, gait disturbance, and hypoesthesia. All the 9 patients required reconstruction of the jaw with microvascular free flaps after radical resection. Monocortical bone segment was harvested from the anterior iliac crest, and the amount of bone harvested was from 47 to 90 mm (mean, 63 ± 14.6). Monocortical deep circumflex iliac artery flap has sufficient advantages in donor-site morbidity, which is one of the factors to choose flap. PMID:26080179

  9. Bone regeneration in dentistry

    OpenAIRE

    Tonelli, Paolo; Duvina, Marco; Barbato, Luigi; Biondi, Eleonora; Nuti, Niccolò; Brancato, Leila; Rose, Giovanna Delle

    2011-01-01

    The edentulism of the jaws and the periodontal disease represent conditions that frequently leads to disruption of the alveolar bone. The loss of the tooth and of its bone of support lead to the creation of crestal defects or situation of maxillary atrophy. The restoration of a functional condition involves the use of endosseous implants who require adequate bone volume, to deal with the masticatory load. In such situations the bone need to be regenerated, taking advantage of the biological p...

  10. Eating disorders and bone.

    Science.gov (United States)

    Tomlinson, Dale; Morgan, Sarah L

    2013-01-01

    Low bone mineral density (BMD) is a frequent and often-overlooked consequence of eating disorders, in particular anorexia nervosa and eating disorders associated with the female athlete triad. The causes of low BMD are multifactorial and include low peak bone mass accrual, accelerated bone resorption, and changes in bone microarchitecture. Early diagnosis and interventions focused on nutritional rehabilitation and weight gain reduce the risk of further BMD deficits and fractures. PMID:24094471

  11. Bone densitometry and osteoporosis

    International Nuclear Information System (INIS)

    The purpose of this book is to provide a perspective on the current status of bone densitometry and its relevance to osteoporosis diagnosis and management. Therefore, this book will give the reader an introduction to the nature of osteoporosis, its pathophysiology and epidemiology, and the clinical consequences of performing bone densitometry. Aside from standard bone densitometry, newer technologies such as quantitative ultrasound techniques, magnetic resonance imaging and bone structure analysis are discussed in the context of diagnosing osteoporosis. (orig.)

  12. BONE MECHANOTRANSDUCTION: A REVIEW

    OpenAIRE

    Reis, Joana; Capela e Silva, Fernando; Queiroga, Cristina; Lucena, Sónia; Potes, José

    2011-01-01

    This review focus on the bone physiology and mechanotransduction elements and mechanisms. Bone biology and architecture is deeply related to the mechanical environment. Orthopaedic implants cause profound changes in the biomechanics and electrophysiology of the skeleton. In the context of biomedical engineering, a deep reflexion on bone physiology and electromechanics is needed. Strategic development of new biomaterials and devices that respect and promote continuity with bone str...

  13. Cosmic tidal reconstruction

    Science.gov (United States)

    Zhu, Hong-Ming; Pen, Ue-Li; Yu, Yu; Er, Xinzhong; Chen, Xuelei

    2016-05-01

    The gravitational coupling of a long-wavelength tidal field with small-scale density fluctuations leads to anisotropic distortions of the locally measured small-scale matter correlation function. Since the local correlation function is known to be statistically isotropic in the absence of such tidal interactions, the tidal distortions can be used to reconstruct the long-wavelength tidal field and large-scale density field in analogy with the cosmic microwave background lensing reconstruction. In this paper we present the theoretical framework of cosmic tidal reconstruction and test the reconstruction in numerical simulations. We find that the density field on large scales can be reconstructed with good accuracy and the cross-correlation coefficient between the reconstructed density field and the original density field is greater than 0.9 on large scales (k ≲0.1 h /Mpc ), with the filter scale ˜1.25 Mpc /h . This is useful in the 21 cm intensity mapping survey, where the long-wavelength radial modes are lost due to a foreground subtraction process.

  14. Permutationally invariant state reconstruction

    DEFF Research Database (Denmark)

    Moroder, Tobias; Hyllus, Philipp; Tóth, Géza;

    2012-01-01

    Feasible tomography schemes for large particle numbers must possess, besides an appropriate data acquisition protocol, an efficient way to reconstruct the density operator from the observed finite data set. Since state reconstruction typically requires the solution of a nonlinear large-scale opti......Feasible tomography schemes for large particle numbers must possess, besides an appropriate data acquisition protocol, an efficient way to reconstruct the density operator from the observed finite data set. Since state reconstruction typically requires the solution of a nonlinear large......-scale optimization problem, this is a major challenge in the design of scalable tomography schemes. Here we present an efficient state reconstruction scheme for permutationally invariant quantum state tomography. It works for all common state-of-the-art reconstruction principles, including, in particular, maximum...... likelihood and least squares methods, which are the preferred choices in today's experiments. This high efficiency is achieved by greatly reducing the dimensionality of the problem employing a particular representation of permutationally invariant states known from spin coupling combined with convex...

  15. MicroCT evaluation of bone mineral density loss in human bones

    International Nuclear Information System (INIS)

    Bone is a connective tissue largely composed of an organic protein, collagen and the inorganic mineral hydroxyapatite [Ca10(PO4)6OH2], which combine to provide a mechanical and supportive role in the body. Depending on the orientation of collagen fibers, two types of bone can be distinguished: trabecular and cortical bone. Degree of mineralization is considered an important feature of bone quality. Changes in the degree of mineralization is generally due to osteoporosis, but many recent studies have already shown that alterations in degree of mineralization can occur due to a large variety of factors. The transmission X-ray microtomography is one of the most popular methods, which provides the spatial distribution of the total absorption coefficient inside the sample. The aim of this study was to investigate the suitability of using microCT as a supplementary tool for the diagnosis of the health status of human bones. Eleven samples were constructed simulating the physiological range of bone mineral density (BMD) found in cortical human bone. The samples represent healthy mixtures of swine compact bone dried at room temperature, powdered and mixed with fat (0 - 100 % by mass). The samples were imaged by a microfocus tube (Fein-Focus) with focal size of about 60 μm (±5%), and a CCD camera (0.143 mm pixel size) coupled with an intensifier tube with fluoroscope screen at the Nuclear Instrumentation Laboratory (COPPE/UFRJ), Brazil. The images were reconstructed and treated with suitable software developed at the Nuclear Instrumentation Laboratory. The mineral content in cortical bone is defined by the volume of dry, fat-free bone per unit bulk volume of the bone. The volumes were calculated from the bone density using the relationship between volume and density. The densities of fat and bone were taken to be 0.95 g.cm-3 and 1.92 g.cm-3 respectively. The correlation of the measured absorption coefficient with the mineral content in the samples was then investigated

  16. 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

  17. Menopause and Bone Loss

    Science.gov (United States)

    Fact Sheet & Menopause Bone Loss How are bone loss and menopause related? Throughout life your body keeps a balance between the loss ... The sooner you take steps to prevent bone loss, the lower your risk of osteoporosis later in life. If you are skipping menstrual periods, have had ...

  18. What's a Funny Bone?

    Science.gov (United States)

    ... Help White House Lunch Recipes What's a Funny Bone? KidsHealth > For Kids > What's a Funny Bone? Print A A A Text Size Have you ... prickly kind of dull pain? That's your funny bone! It doesn't really hurt as much as ...

  19. Hanford Environmental Dose Reconstruction Project monthly report

    International Nuclear Information System (INIS)

    The objective of the Hanford Environmental Dose Reconstruction Project is to estimate the radiation doeses that individuals and populations could have received from nuclear operations at Hanford since 1944. The project is divided into the following technical tasks. These tasks correspond to the path radionuclides followed, from release to impact on humans (dose estimates): Source terms; environmental transport; environmental monitoring data; demographics, agriculture, food habits; environmental pathways and dose estimates

  20. Factors affecting isokinetic muscle strength before and after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Yüksel, Halil Yalçin; Erkan, Serkan; Uzun, Macit

    2011-06-01

    The purpose of this study was to evaluate the factors affecting muscle strength of ACL-deficient knees before and after ACL reconstruction. The study included 122 male patients who underwent primary ACL reconstruction with a bone-patellar tendon-bone autograft. Preoperative loss and change in muscle strength in both extensor and flexor muscle groups after ACL reconstruction were calculated separately at 60 degrees/sec and 180 degrees/sec angular velocities. We evaluated the effect of surgical delay on the preoperative deficit and on its change after surgery. Muscle strength change after ACL reconstruction was also evaluated in relation to patient compliance to treatment. The longer the delay of ACL reconstruction the more the muscle strength deficit of flexor and extensor muscles increased. In the ACL deficient knees with high strength deficit, improvement in muscle strength was higher after ACL reconstruction for both muscle groups. When delay of ACL reconstruction was short and the patient was compliant to treatment, flexor muscle strength recovery was early. Shortening the delay to reconstruction had a positive influence on muscle strength after ACL reconstruction when preoperative muscle strength deficit was high. PMID:21846002

  1. Modularity and robustness of bone networks.

    Science.gov (United States)

    Viana, Matheus Palhares; Tanck, Esther; Beletti, Marcelo Emílio; Costa, Luciano da Fontoura

    2009-03-01

    Cortical bones, essential for mechanical support and structure in many animals, involve a large number of canals organized in intricate fashion. By using state-of-the art image analysis and computer graphics, the 3D reconstruction of a whole bone (phalange) of a young chicken was obtained and represented in terms of a complex network where each canal was associated to an edge and every confluence of three or more canals yielded a respective node. The representation of the bone canal structure as a complex network has allowed several methods to be applied in order to characterize and analyze the canal system organization and the robustness. First, the distribution of the node degrees (i.e. the number of canals connected to each node) confirmed previous indications that bone canal networks follow a power law, and therefore present some highly connected nodes (hubs). The bone network was also found to be partitioned into communities or modules, i.e. groups of nodes which are more intensely connected to one another than with the rest of the network. We verified that each community exhibited distinct topological properties that are possibly linked with their specific function. In order to better understand the organization of the bone network, its resilience to two types of failures (random attack and cascaded failures) was also quantified comparatively to randomized and regular counterparts. The results indicate that the modular structure improves the robustness of the bone network when compared to a regular network with the same average degree and number of nodes. The effects of disease processes (e.g., osteoporosis) and mutations in genes (e.g., BMP4) that occur at the molecular level can now be investigated at the mesoscopic level by using network based approaches. PMID:19225616

  2. Chest wall resection and reconstruction using titanium micromesh covered with Marlex mesh for metastatic follicular thyroid carcinoma: a case report

    OpenAIRE

    Suganuma Nobuyasu; Wada Nobuyuki; Arai Hiromasa; Nakayama Hirotaka; Fujii Keita; Masudo Katsuhiko; Yukawa Norio; Rino Yasushi; Masuda Munetaka; Imada Toshio

    2009-01-01

    Abstract Introduction The distant metastases from differentiated thyroid carcinomas are often untreatable. In particular, bone metastasis is significantly related to poor prognosis since radioactive iodine therapy is generally less effective. Therefore, surgical resection is considered one of the treatments for patients with bone metastases. We report chest wall resection and reconstruction using titanium micromesh covered with polypropylene mesh (Marlex mesh) for metastatic rib bones as a re...

  3. Irradiated long bone transplants in limb saving surgeries for extremity bone cancers

    International Nuclear Information System (INIS)

    In the Philippines, the treatment of cancers of the limbs has always been by amputation. In recent decades, better understanding of these cancers and advances in the disciplines of cancer medicine have made the saving of these limbs almost routine in better developed countries. Surgeries entail two steps: (1) excision of the tumor and the bone from which the tumor arose, followed by (2) reconstruction of the defect resulting from the excision. Tumor implants, however, are not available locally, and are too costly for the average Filipino patient. Microvascular surgery is limited by the size of the defect it can bridge; and bone cement, not being biologic, can result in greater long term problems. Recently, the option of long bone transplants (aka large-segment allografts) to reconstruct these defects has become available locally. These bones are harvested from both cadaveric and live amputee donors after appropriate consent and medical work-up. After processing at the UP-PGH Tissue and Bone Bank, the bones are sterilized by irradiation at the PNRI(Philippine Nuclear Research Institute), and store in deep freezers until use. In the Philippines, limb saving surgery for bone cancers of the extremities using these large-segment alloografts was introduced in 1993 at the UP-PGH Musculoskeletal Tumor Unit. This paper will present the author's initial 3-year experience with 19 patients whose limbs were saved using bone transplantation. All surgeries were performed by the author and all patients have been personally followed up by the author (follow-up ranging from 6 months to 3-1/2 years). Cases will be presented to show the pre- and intraoperative processing of the irradiated bone; and the patients before and after the operations with emphasis on their improved quality of life and return to function. These results would seem to show that irradiated long bone transplants coupled with skills for limb saving surgery may make amputations a thing of the past for many of our

  4. Does collagen trigger the recruitment of osteoblasts into vacated bone resorption lacunae during bone remodeling?

    DEFF Research Database (Denmark)

    Abdelgawad, Mohamed Essameldin; Søe, Kent; Andersen, Thomas Levin;

    2014-01-01

    Osteoblast recruitment during bone remodeling is obligatory to re-construct the bone resorbed by the osteoclast. This recruitment is believed to be triggered by osteoclast products and is therefore likely to start early during the remodeling cycle. Several osteoclast products with osteoblast...... recruitment potential are already known. Here we draw the attention on the osteoblast recruitment potential of the collagen that is freshly demineralized by the osteoclast. Our evidence is based on observations on adult human cancellous bone, combined with in vitro assays. First, freshly eroded surfaces where...... osteoblasts have to be recruited show the presence of non-degraded demineralized collagen and close cell-collagen interactions, as revealed by electron microscopy, while surface-bound collagen strongly attracts osteoblast lineage cells in a transmembrane migration assay. Compared with other extracellular...

  5. The CMS Muon Reconstruction Software

    CERN Document Server

    Trocino, Daniele

    2009-01-01

    Muonic final states will provide clean signatures for many physics processes at the LHC. One of the main goals of the Compact Muon Solenoid (CMS) design is thus to ensure efficient and accurate identification and reconstruction of muons. A sophisticated muon system is used for muon identification and stand-alone reconstruction and the inner silicon tracker exploits the high magnetic field to ensure a very precise transverse momentum resolution. The global reconstruction algorithms combine muons reconstructed in the dedicated spectrometer with tracks reconstructed in the inner detector. The CMS reconstruction software is well suited for both offline reconstruction and online event selection (HLT) and its performance has been studied in detail using Monte Carlo simulations. The muon reconstruction has also been employed successfully to reconstruct cosmic muons traversing the CMS detector. The design of the CMS muon identification and reconstruction is presented, as well as its performance on simulated and cosmi...

  6. Enzymatic maceration of bone

    DEFF Research Database (Denmark)

    Uhre, Marie-Louise; Eriksen, Anne Marie; Simonsen, Kim Pilkjær;

    2015-01-01

    afterwards macerated by one of the two methods. DNA extraction was performed to see the effect of the macerations on DNA preservation. Furthermore, the bone pieces were examined in a stereomicroscope to assess for any bone damage. The results demonstrated that both methods removed all flesh/soft tissue from...... the bones. The DNA analysis showed that DNA was preserved on all the pieces of bones which were examined. Finally, the investigation suggests that enzyme maceration could be gentler on the bones, as the edges appeared less frayed. The enzyme maceration was also a quicker method; it took three hours...

  7. Tin in Human Bones

    OpenAIRE

    Jambor, Jaroslav; Smreka, Vâclav

    1993-01-01

    TIN IN HUMAN BONES. The tin content in the bones of 149 skeletons from the 1st - 5th centuries A.D., and of 11 individuals of the recent population was determined. The bone samples were carbonized and analyzed through emission spectroscopy with a.c. excitation. The tin content in bones of recent populations not exposed to extra tin supply is about one order of magnitude higher than is the case with the bones od some populations that lived at the beginning of our era. The distribut...

  8. Nipple-areola complex reconstruction

    OpenAIRE

    Nimboriboonporn, Anongporn; Chuthapisith, Suebwong

    2014-01-01

    Nipple areolar reconstruction (NAC) was introduced since 1940s and evolved as parallel with breast reconstruction since era of breast cancer treatment. It consists of nipple and areolar reconstruction. Ideal reconstruction of the NAC requires symmetry in position, size, shape, texture, and pigmentation and permanent projection. There are many innovative ways to create a nipple and each method has its unique characteristics that apply to certain breast types. NAC reconstruction techniques comp...

  9. Extensive tumor reconstruction with massive allograft

    International Nuclear Information System (INIS)

    Massive deep-frozen bone allografts were implanted in four patients after wide tumor resection. Two cases were solitary proximal femur metastases, secondary to Thyroid cancer and breast cancer respectively; while the other two cases were primary in nature i.e. Chondrosarcoma proximal humerus and Osteosarcoma proximal femur. All were treated with a cemented alloprosthesis except in the upper limb where shoulder fusion was performed. Augmentation of these techniques were done with a segment 1 free vascularised fibular composite graft to the proximal femur of breast secondaries and proximal humerus Chondrosarcoma. Coverage of the wound of the latter was also contributed by lattisimus dorsi flap. The present investigations demonstrated the massive bone allografts were intimately anchored by host bone and there had been no evidence of aseptic loosening at the graft-cement interface. This study showed that with good effective tumor control, reconstructive surgery with massive allografts represented a good alternative to prosthetic implants in tumors of the limbs. No infection was seen in all four cases

  10. Computer-Assisted Mandibular Reconstruction using a Patient-Specific Reconstruction Plate Fabricated with Computer-Aided Design and Manufacturing Techniques.

    Science.gov (United States)

    Wilde, Frank; Cornelius, Carl-Peter; Schramm, Alexander

    2014-06-01

    We investigated the workflow of computer-assisted mandibular reconstruction that was performed with a patient-specific mandibular reconstruction plate fabricated with computer-aided design and computer-aided manufacturing (CAD/CAM) techniques and a fibula flap. We assessed the feasibility of this technique from virtual planning to the completion of surgery. Computed tomography (CT) scans of a cadaveric skull and fibula were obtained for the virtual simulation of mandibular resection and reconstruction using ProPlan CMF software (Materialise(®)/DePuy Synthes(®)). The virtual model of the reconstructed mandible provided the basis for the computer-aided design of a patient-specific reconstruction plate that was milled from titanium using a five-axis milling machine and CAM techniques. CAD/CAM techniques were used for producing resection guides for mandibular resection and cutting guides for harvesting a fibula flap. Mandibular reconstruction was simulated in a cadaveric wet laboratory. No problems were encountered during the procedure. The plate was fixed accurately to the residual bone without difficulty. The fibula segments were attached to the plate rapidly and reliably. The fusion of preoperative and postoperative CT datasets demonstrated high reconstruction precision. Computer-assisted mandibular reconstruction with CAD/CAM-fabricated patient-specific reconstruction plates appears to be a promising approach for mandibular reconstruction. Clinical trials are required to determine whether these promising results can be translated into successful practice and what further developments are needed. PMID:25045420

  11. Kinetic Analysis of 18F-Fluoride PET Images of Breast Cancer Bone Metastases

    OpenAIRE

    Doot, Robert K; Muzi, Mark; Peterson, Lanell M.; Schubert, Erin K; Gralow, Julie R.; Specht, Jennifer M.; Mankoff, David A.

    2010-01-01

    The most common site of metastasis for breast cancer is bone. Quantitative 18F-fluoride PET can estimate the kinetics of fluoride incorporation into bone as a measure of fluoride transport, bone formation, and turnover. The purpose of this analysis was to evaluate the accuracy and precision of 18F-fluoride model parameter estimates for characterizing regional kinetics in metastases and normal bone in breast cancer patients.

  12. Thumb Reconstruction Using Foucher’s Flap

    Science.gov (United States)

    Kola, Nardi

    2016-01-01

    BACKGROUND: Extensive pulp defects of the thumb, with the exposure of tendon or bone, are challenging reconstructive problems. Surgical treatment includes the use of local, regional, and free flaps. AIM: This paper is focused in Foucher’s neuro vascular flap. First DMCA or Foucher’s pedicle flap is a successful thumb reconstruction method, especially in patients not disturbed by its cosmetic appearance. MATERIAL AND METHODS: The first dorsal metacarpal artery (FDMCA) arises from the radial artery in the first intermetacarpal space, just distal to the tendon of the extensor pollicis longus. Pulp area of the thumb is the area where Foucher’s flap is more utilizable. This technique has other applications such as first web reconstruction, thumb lengthening, and following resection of tumors on the dorsum of the hand. RESULTS: We have in study 7 cases with work related trauma in two years period of time, between 2012 and 2014. We had only one partial flap survival and all the other flaps survived entirely. We have also taken in consideration subjective satisfaction with a range score from 4 to 10, cold intolerance, flap area and donor site sensibility with a range score from low to medium to normal. CONCLUSION: Careful pedicle discovery, secured elevation, pedicle strangulation prevention are very important for flap survival.

  13. Bone stress injuries

    International Nuclear Information System (INIS)

    Bone stress injuries are due to cyclical overuse of the bone. They are relatively common in athletes and military recruits but also among otherwise healthy people who have recently started new or intensive physical activity. Diagnosis of bone stress injuries is based on the patient's history of increased physical activity and on imaging findings. The general symptom of a bone stress injury is stress-related pain. Bone stress injuries are difficult to diagnose based only on a clinical examination because the clinical symptoms may vary depending on the phase of the pathophysiological spectrum in the bone stress injury. Imaging studies are needed to ensure an early and exact diagnosis, because if the diagnosis is not delayed most bone stress injuries heal well without complications

  14. Patella fracture following anterior cruciate ligament reconstruction: A case report

    Directory of Open Access Journals (Sweden)

    Milankov Miroslav

    2003-01-01

    Full Text Available Introduction The most frequent procedure in treatment of acute or chronic anterior cruciate ligament (ACL rupture is the so called bone-tendon-bone reconstruction. A transverse dislocated patella fracture is a rare complication of this procedure with an incidence of 0.23%-2.3%. In a five year period, (1998-2002, 407 arthroscopic reconstructions of the anterior cruciate ligaments were done at our Clinic, and there was only one case of patella fracture. Case report An 18-year-old female patient, a handball player, suffered an acute rupture of anterior cruciate ligament of the left knee, so arthroscopic bone-tendon-bone reconstruction of the anterior cruciate ligament was performed. After adequate skin incision, a bone graft was taken from the patella and upper part of trapezoid tibia, which was 25 mm long, 10 mm wide and 5 mm thick, together with a part of patellar ligament. After the remains of the anterior cruciate ligament had been arthroscopically removed, tunnels were made in tibia and femur and a graft was inserted and fixed with two metal interference screws. Knee stability was tested, and drainage was put in the knee joint. The wound was closed by layers. The quadriceps exercises and passive knee movements started immediately. Full range of movements was accomplished six weeks later when the patient started to walk with full weight-bearing on her operated leg. Three weeks later, (nine weeks after the operation, the patient has accidentally lost her balance and fell. A transverse, dislocated fracture of the left patella was diagnosed and osteosynthesis of the fractured patella with two Kirschner wires and a metallic loop was performed. Postoperatively, full range of movement was allowed. Six months later, the patient felt no pain, there was no swelling, full range of knee movement was achieved, while the Lachman Test was identical in both knees and the pivot shift test was negative. Discussion Fracture of patella after ACL reconstruction is

  15. Alternative reconstruction after pancreaticoduodenectomy

    Directory of Open Access Journals (Sweden)

    Cooperman Avram M

    2008-01-01

    Full Text Available Abstract Background Pancreaticoduodenectomy is the procedure of choice for tumors of the head of the pancreas and periampulla. Despite advances in surgical technique and postoperative care, the procedure continues to carry a high morbidity rate. One of the most common morbidities is delayed gastric emptying with rates of 15%–40%. Following two prolonged cases of delayed gastric emptying, we altered our reconstruction to avoid this complication altogether. Subsequently, our patients underwent a classic pancreaticoduodenectomy with an undivided Roux-en-Y technique for reconstruction. Methods We reviewed the charts of our last 13 Whipple procedures evaluating them for complications, specifically delayed gastric emptying. We compared the outcomes of those patients to a control group of 15 patients who underwent the Whipple procedure with standard reconstruction. Results No instances of delayed gastric emptying occurred in patients who underwent an undivided Roux-en-Y technique for reconstruction. There was 1 wound infection (8%, 1 instance of pneumonia (8%, and 1 instance of bleeding from the gastrojejunal staple line (8%. There was no operative mortality. Conclusion Use of the undivided Roux-en-Y technique for reconstruction following the Whipple procedure may decrease the incidence of delayed gastric emptying. In addition, it has the added benefit of eliminating bile reflux gastritis. Future randomized control trials are recommended to further evaluate the efficacy of the procedure.

  16. Biomechanical Comparison Between Bashti Bone Plug Technique and Biodegradable Screw for Fixation of Grafts in Ligament surgery

    OpenAIRE

    Kaveh Bashti; Mohammad Naghi Tahmasebi; Hasan Kaseb; Farzam Farahmand; Mohammad Akbar; Amir Mobini

    2015-01-01

      Background: Ligament reconstruction is a common procedure in orthopedic surgery. Although several popular techniques are currently in use, new methods are proposed for secure fixation of the tendon graft into the bone tunnel. Purposes: We sought to introduce our new technique of Bashti bone plug for fixation of soft tissue graft in anterior cruciate ligament (ACL) reconstruction and to compare its biomechanical features with conventional absorbable interference screw technique in a bovine ...

  17. Chitosan Composites for Bone Tissue Engineering—An Overview

    Directory of Open Access Journals (Sweden)

    Jayachandran Venkatesan

    2010-08-01

    Full Text Available Bone contains considerable amounts of minerals and proteins. Hydroxyapatite [Ca10(PO46(OH2] is one of the most stable forms of calcium phosphate and it occurs in bones as major component (60 to 65%, along with other materials including collagen, chondroitin sulfate, keratin sulfate and lipids. In recent years, significant progress has been made in organ transplantation, surgical reconstruction and the use of artificial protheses to treat the loss or failure of an organ or bone tissue. Chitosan has played a major role in bone tissue engineering over the last two decades, being a natural polymer obtained from chitin, which forms a major component of crustacean exoskeleton. In recent years, considerable attention has been given to chitosan composite materials and their applications in the field of bone tissue engineering due to its minimal foreign body reactions, an intrinsic antibacterial nature, biocompatibility, biodegradability, and the ability to be molded into various geometries and forms such as porous structures, suitable for cell ingrowth and osteoconduction. The composite of chitosan including hydroxyapatite is very popular because of the biodegradability and biocompatibility in nature. Recently, grafted chitosan natural polymer with carbon nanotubes has been incorporated to increase the mechanical strength of these composites. Chitosan composites are thus emerging as potential materials for artificial bone and bone regeneration in tissue engineering. Herein, the preparation, mechanical properties, chemical interactions and in vitro activity of chitosan composites for bone tissue engineering will be discussed.

  18. 空心拉力螺钉加镍钛聚髌器置入内固定重建骨折髌骨的生物力学条件%Biomechanical requirement for the reconstruction of patellar fracture treated with cancellous bone screw and nickel-titanium-patellar concentrator internal fixation

    Institute of Scientific and Technical Information of China (English)

    高振巢; 刘德昌; 蔡国平

    2013-01-01

    BACKGROUND: There are various internal fixation methods for the clinical treatment of patel ar fractures, but each method has advantages and disadvantages, respectively. The selection of proper internal fixation method wil directly affect the healing time and recovery of knee joint function. OBJECTIVE: To investigate the biomechanical reconstruction effect on patel ar fracture treated with cancel ous bone screw and nickel-titanium-patel ar concentrator internal fixation. METHODS: A retrospective analysis was performed on 27 cases of acute patel ar fracture patients from January 2011 to January 2012 in the Department of Orthopedics, Jinshan Hospital, Fudan University, including 13 cases of transverse fracture, 11 cases of comminuted fracture and three cases of upper or lower pole fracture. Al the 27 patients received cancel ous bone screw and nickel-titanium-patel ar concentrator internal fixation without plaster external fixation, and then the quadriceps active contraction training was performed from the 2nd day after internal fixation, and bed knee flexion and extension exercises were performed at 1 week after internal fixation. The knee joint function was evaluated with Böstman score system. RESULTS AND CONCLUSION: Al the 27 patients were fol owed-up for 4-14 months. Incisions obtained stage Ⅰ healing, and there was no fracture fixation or shedding, wound infection, skin necrosis or other complications. The average healing time was 8.5 weeks without delayed healing. According to clinical grading scale of Böstman score system, the mean score was 27.9, included 27 cases of excel ent (81%), four cases of good (15%), one case of poor (4%), and the excel ent and good rate was 96%. The results suggest that cancel ous bone screw combined with nickel-titanium-patel ar concentrator internal fixation can maintain the advantages of traditional internal fixation method, and can avoid the disadvantages of the traditional internal fixation method.%  背景:目前

  19. Immediate function of temporomandibular joint after total resection and reconstruction

    OpenAIRE

    Richter, M.; Dulguerov, Pavel; Pittet Cuenod, Brigitte Maud; Becker, Minerva

    1997-01-01

    Two patients with recurrent parotid gland carcinoma required subtotal petrosectomy and infratemporal fossa type C approach. To achieve en bloc resection, the ascending mandibular ramus and the entire temporomandibular joint, including the adjacent temporal bone, were removed. An original technique for immediate reconstruction of the infratemporal region, including the glenoid fossa and the ramus of the mandible, is described. Rigid fixation, as well as good functional and aesthetic results, w...

  20. Current Role of Open Reconstruction of the Scapholunate Ligament

    OpenAIRE

    Luchetti, Riccardo; Atzei, Andrea; Cozzolino, Roberto; Fairplay, Tracy

    2013-01-01

    This paper is a review of the various surgical techniques used in repair or reconstruction of the scapholunate ligament according to the clinical stages and anatomic-pathologic findings. Arthroscopy permits a direct evaluation of the scapholunate injury and the status of the articular surfaces. Specific indications for each type of scapholunate ligament tear are proposed, from the different types of dorsal capsulodesis to bone–ligament–bone techniques and tenodesis procedures. The authors' pr...

  1. Processing of microCT implant-bone systems images using Fuzzy Mathematical Morphology

    Science.gov (United States)

    Bouchet, A.; Colabella, L.; Omar, S.; Ballarre, J.; Pastore, J.

    2016-04-01

    The relationship between a metallic implant and the existing bone in a surgical permanent prosthesis is of great importance since the fixation and osseointegration of the system leads to the failure or success of the surgery. Micro Computed Tomography is a technique that helps to visualize the structure of the bone. In this study, the microCT is used to analyze implant-bone systems images. However, one of the problems presented in the reconstruction of these images is the effect of the iron based implants, with a halo or fluorescence scattering distorting the micro CT image and leading to bad 3D reconstructions. In this work we introduce an automatic method for eliminate the effect of AISI 316L iron materials in the implant-bone system based on the application of Compensatory Fuzzy Mathematical Morphology for future investigate about the structural and mechanical properties of bone and cancellous materials.

  2. Breast Reconstruction with Microvascular

    Directory of Open Access Journals (Sweden)

    David W. Chang

    2012-01-01

    Full Text Available The free muscle-sparing transverse rectus abdominis myocutaneous (MS-TRAM and deepinferior epigastric perforator (DIEP flaps involve transferring skin and subcutaneous tissuefrom the lower abdominal area and have many features that make them well suited forbreast reconstruction. The robust blood supply of the free flap reduces the risk of fat necrosisand also enables aggressive shaping of the flap for breast reconstruction to optimize theaesthetic outcome. In addition, the free MS-TRAM flap and DIEP flap require minimal donorsitesacrifice in most cases. With proper patient selection and safe surgical technique, the freeMS-TRAM flap and DIEP flap can transfer the lower abdominal skin and subcutaneous tissueto provide an aesthetically pleasing breast reconstruction with minimal donor-site morbidity.

  3. Reconstructing random media

    International Nuclear Information System (INIS)

    We formulate a procedure to reconstruct the structure of general random heterogeneous media from limited morphological information by extending the methodology of Rintoul and Torquato [J. Colloid Interface Sci. 186, 467 (1997)] developed for dispersions. The procedure has the advantages that it is simple to implement and generally applicable to multidimensional, multiphase, and anisotropic structures. Furthermore, an extremely useful feature is that it can incorporate any type and number of correlation functions in order to provide as much morphological information as is necessary for accurate reconstruction. We consider a variety of one- and two-dimensional reconstructions, including periodic and random arrays of rods, various distribution of disks, Debye random media, and a Fontainebleau sandstone sample. We also use our algorithm to construct heterogeneous media from specified hypothetical correlation functions, including an exponentially damped, oscillating function as well as physically unrealizable ones. copyright 1998 The American Physical Society

  4. Reconstructed Jets at RHIC

    CERN Document Server

    Salur, Sevil

    2010-01-01

    To precisely measure jets over a large background such as pile up in high luminosity p+p collisions at LHC, a new generation of jet reconstruction algorithms is developed. These algorithms are also applicable to reconstruct jets in the heavy ion environment where large event multiplicities are produced. Energy loss in the medium created in heavy ion collisions are already observed indirectly via inclusive hadron distributions and di-hadron correlations. Jets can be used to study this energy loss in detail with reduced biases. We review the latest results on jet-medium interactions as seen in A+A collisions at RHIC, focusing on the recent progress on jet reconstruction in heavy ion collisions.

  5. Persistent wound drainage after tumor resection and endoprosthetic reconstruction of the proximal femur

    DEFF Research Database (Denmark)

    Hettwer, Werner H; Horstmann, Peter F; Grum-Schwensen, Tomas A;

    2014-01-01

    PURPOSE: To examine the prevalence of prolonged wound drainage (PWD) after tumor resection and endoprosthetic reconstruction of the hip. METHODS: Retrospective review of 86 consecutive patients with metastatic bone disease, malignant hematologic bone disease or bone sarcoma, treated with tumor...... (mean 8.7 days) and length of hospital stay (mean 10.2 days). Total femur replacement, bone sarcoma and additional pelvic reconstruction were identified as significant independent risk factors for an even longer duration of PWD. CONCLUSION: Compared to conventional hip arthroplasty, PWD appears to be...... significantly more prevalent in patients undergoing tumor arthroplasty procedures of the hip. Given the potentially increased risk for periprosthetic joint infection (PJI), increased awareness, identification and implementation of adequate strategies for prevention and treatment of this avoidable complication...

  6. Current and future options of regeneration methods and reconstructive surgery of the facial skeleton.

    Science.gov (United States)

    Götz, Carolin; Warnke, Patrick H; Kolk, Andreas

    2015-09-01

    Musculoskeletal defects attributable to trauma or infection or as a result of oncologic surgery present a common challenge in reconstructive maxillofacial surgery. The autologous vascularized bone graft still represents the gold standard for salvaging these situations. Preoperative virtual planning offers great potential and provides assistance in reconstructive surgery. Nevertheless, the applicability of autologous bone transfer might be limited within the medically compromised patient or because of the complexity of the defect and the required size of the graft to be harvested. The development of alternative methods are urgently needed in the field of regenerative medicine to enable the regeneration of the original tissue. Since the first demonstration of de novo bone formation by regenerative strategies and the application of bone growth factors some decades ago, further progress has been achieved by tissue engineering, gene transfer, and stem cell application concepts. This review summarizes recent approaches and current developments in regenerative medicine. PMID:26297391

  7. Possibilities of reconstruction and implant-prosthetic rehabilitation following mandible resection

    Directory of Open Access Journals (Sweden)

    Konstantinović Vitomir S.

    2013-01-01

    Full Text Available Introduction. Mandible reconstruction is still very challenging for surgeons. Mandible defects could be the consequence of ablative surgery for malignancies, huge jaw cysts, infection and trauma. Segmental resection of the mandible may compromise orofacial function and often lead to patients psychological disorders. Despite very frequent use of microvascular flaps, autogenous bone grafts are still very reliable technique for mandible reconstruction. Comprehensive therapy means not only mandible reconstruction, but prosthodontic rehabilitation supported by dental implants, which can significantly improve patients quality of life. The aim of this paper was to evaluate possible techniques of mandible reconstruction and to present a patient who had been submitted to mandible resection and reconstruction with autogenous iliac bone graft and prosthodontic rehabilitation with fixed denture anchoraged by disc-shaped implants in early loading protocol. Case report. Mandible reconstruction was performed simultaneously with resection. Autogenous iliac bone graft was taken, reshaped and placed in two parts, to the required optimal contour of the mandible. After graft consolidation, decision was made for prosthodontics rehabilitation with fixed dentures supported by implants. In addition to the standard preoperative procedures, planning was done based on a biomodel gained by rapid prototyping after CT scan. It offered a real 3D planning to obtain a proper shape, dimension and the position of implants. Conclusion. If bone dimensions of a reconstructed mandible are insufficient, like in the presented case, the use of basal osseointegrated implants may be a method of choice. Avoiding bone augmentation procedures, as well as early loading protocol for this type of implants, shorten the total rehabilitation time, which is very convenient for patients. Fixed denture supported by dental implants is the best solution for comprehensive rehabilitation after mandible

  8. The Design of Mechanically Compatible Fasteners for Human Mandible Reconstruction

    Science.gov (United States)

    Roberts, Jack C.; Ecker, John A.; Biermann, Paul J.

    1993-01-01

    Mechanically compatible fasteners for use with thin or weakened bone sections in the human mandible are being developed to help reduce large strain discontinuities across the bone/implant interface. Materials being considered for these fasteners are a polyetherertherketone (PEEK) resin with continuous quartz or carbon fiber for the screw. The screws were designed to have a shear strength equivalent to that of compact/trabecular bone and to be used with a conventional nut, nut plate, or an expandable shank/blind nut made of a ceramic filled polymer. Physical and finite element models of the mandible were developed in order to help select the best material fastener design. The models replicate the softer inner core of trabecular bone and the hard outer shell of compact bone. The inner core of the physical model consisted of an expanding foam and the hard outer shell consisted of ceramic particles in an epoxy matrix. This model has some of the cutting and drilling attributes of bone and may be appropriate as an educational tool for surgeons and medical students. The finite element model was exercised to establish boundary conditions consistent with the stress profiles associated with mandible bite forces and muscle loads. Work is continuing to compare stress/strain profiles of a reconstructed mandible with the results from the finite element model. When optimized, these design and fastening techniques may be applicable, not only to other skeletal structures, but to any composite structure.

  9. Histologic and histomorphometric evaluation of the effect of lactoferrin combined with anorganic bovine bone on healing of experimentally induced bony defects on rabbit calvaria

    OpenAIRE

    Mojgan Paknejad; Amir Reza Rokn; Ali Akbar Sabur Yaraghi; Flora Elhami; Mohammad Javad Kharazifard; Neda Moslemi

    2012-01-01

    Background: Recent studies have shown that lactoferrin promotes the proliferation and differentiation of osteoblasts and inhibits osteoclast-mediated bone resorption. Anorganic bovine bone (ABB) graft has been extensively used as an osteoconductive material in the bone reconstructive surgeries. The purpose of this study was to examine whether the combination of lactoferrin with Bio-Oss would improve ossification in experimentally induced bone defects in rabbit calvaria. Materials and Meth...

  10. Stature estimation from complete long bones in the Middle Pleistocene humans from the Sima de los Huesos, Sierra de Atapuerca (Spain)

    OpenAIRE

    Carretero, José Miguel; Rodríguez García, Laura; García González, Rebeca; Arsuaga, Juan Luis; Gómez Olivencia, Asier; Lorenzo Merino, Carlos; Bonmatí, Alejandro .; Gracia Téllez, Ana; Martínez Mendizábal, Ignacio; Quam, Rolf

    2012-01-01

    Systematic excavations at the site of the Sima de los Huesos (SH) in the Sierra de Atapuerca (Burgos, Spain) have allowed us to reconstruct 27 complete long bones of the human species Homo heidelbergensis. The SH sample is used here, together with a sample of 39 complete Homo neanderthalensis long bones and 17 complete early Homo sapiens (Skhul/Qafzeh) long bones, to compare the stature of these three different human species. Stature is estimated for each bone using race- and sex-...

  11. Vertex Reconstruction in CMS

    CERN Document Server

    Chabanat, E; D'Hondt, J; Vanlaer, P; Prokofiev, K; Speer, T; Frühwirth, R; Waltenberger, W

    2005-01-01

    Because of the high track multiplicity in the final states expected in proton collisions at the LHC experiments, novel vertex reconstruction algorithms are required. The vertex reconstruction problem can be decomposed into a pattern recognition problem ("vertex finding") and an estimation problem ("vertex fitting"). Starting from least-square methods, ways to render the classical algorithms more robust are discussed and the statistical properties of the novel methods are shown. A whole set of different approaches for the vertex finding problem is presented and compared in relevant physics channels.

  12. The evolving breast reconstruction

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Gunnarsson, Gudjon Leifur

    2014-01-01

    The aim of this editorial is to give an update on the use of the propeller thoracodorsal artery perforator flap (TAP/TDAP-flap) within the field of breast reconstruction. The TAP-flap can be dissected by a combined use of a monopolar cautery and a scalpel. Microsurgical instruments are generally...... not needed. The propeller TAP-flap can be designed in different ways, three of these have been published: (I) an oblique upwards design; (II) a horizontal design; (III) an oblique downward design. The latissimus dorsi-flap is a good and reliable option for breast reconstruction, but has been...

  13. Reconstruction of inflation models

    Energy Technology Data Exchange (ETDEWEB)

    Myrzakulov, Ratbay; Sebastiani, Lorenzo [Eurasian National University, Department of General and Theoretical Physics and Eurasian Center for Theoretical Physics, Astana (Kazakhstan); Zerbini, Sergio [Universita di Trento, Dipartimento di Fisica, Trento (Italy); TIFPA, Istituto Nazionale di Fisica Nucleare, Trento (Italy)

    2015-05-15

    In this paper, we reconstruct viable inflationary models by starting from spectral index and tensor-to-scalar ratio from Planck observations. We analyze three different kinds of models: scalar field theories, fluid cosmology, and f(R)-modified gravity. We recover the well-known R{sup 2} inflation in Jordan-frame and Einstein-frame representation, the massive scalar inflaton models and two models of inhomogeneous fluid. A model of R{sup 2} correction to Einstein's gravity plus a ''cosmological constant'' with an exact solution for early-time acceleration is reconstructed. (orig.)

  14. 1. Morphological Implication on Cellular Response to Mechanical Stress in Bone.

    Science.gov (United States)

    Amizuka, Norio

    2016-08-01

    In bone, there are 3 distinct cell types: an osteoblast, a bone forming cell; an osteocyte embedded in bone matrix as a consequence of being differentiated from an osteoblast; and an osteoclast, a multinucleated giant cell responsible for bone resorption. Bone is always remodeled by replacing old bone with new bone (bone remodeling), by which bone can maintain its stiffness and flexibility. However, in an osteoporotic state, the disrupted balance between bone resorption and formation results in not only markedly reduced bone mass, but also in disorganized geometry of trabecules, which can often give rise to a bone fracture. Osteocytes located in their lacunae insert their fine cytoplasmic processes into narrow passageways referred to as osteocytic canaliculi. Neighboring osteocytes connect to each other by means of a gap junction in their cytoplasmic processes. Therefore, osteocytes and their lacunae/canaliculi appear to form functional syncytium called osteocytic lacunar canalicular system (OLCS). The geometrical distribution of OLCS is poorly arranged in immature bone, while it appears well-arranged distribution in mature bone (cortical bone), in which molecular transports and sensing mechanical stress seems to be efficient, and therefore, may be able to respond to mechanical stress. In this seminar, I will introduce our recent findings on the morphology and function of OLCS which may respond to mechanical stress. PMID:27441762

  15. Bone marrow mesenchymal stem cell therapy in ischemic stroke: mechanisms of action and treatment optimization strategies

    Science.gov (United States)

    Li, Guihong; Yu, Fengbo; Lei, Ting; Gao, Haijun; Li, Peiwen; Sun, Yuxue; Huang, Haiyan; Mu, Qingchun

    2016-01-01

    Animal and clinical studies have confirmed the therapeutic effect of bone marrow mesenchymal stem cells on cerebral ischemia, but their mechanisms of action remain poorly understood. Here, we summarize the transplantation approaches, directional migration, differentiation, replacement, neural circuit reconstruction, angiogenesis, neurotrophic factor secretion, apoptosis, immunomodulation, multiple mechanisms of action, and optimization strategies for bone marrow mesenchymal stem cells in the treatment of ischemic stroke. We also explore the safety of bone marrow mesenchymal stem cell transplantation and conclude that bone marrow mesenchymal stem cell transplantation is an important direction for future treatment of cerebral ischemia. Determining the optimal timing and dose for the transplantation are important directions for future research.

  16. Total Lip Reconstruction with Tendinofasciocutaneous Radial Forearm Flap

    Directory of Open Access Journals (Sweden)

    Eldad Silberstein

    2014-01-01

    Full Text Available Introduction. Squamous cell carcinoma is a common tumour of lower lip. Small defects created by surgical resection may be readily reconstructed by linear closure or with local flaps. However, large tumours resection often results with microstomia and oral incompetence, drooling, and speech incomprehension. The goal of this study is to describe our experience with composite free radial forearm-palmaris longus tendon flap for total or near total lower lip reconstruction. Patients and Methods. This procedure was used in 5 patients with 80–100% lip defect resulting from Squamous cell carcinoma. Patients’ age ranged from 46 to 82 years. They are three male patients and two female. In 3 cases chin skin was reconstructed as well and in one case a 5 cm segment of mandible was reconstructed using radius bone. In one case where palmaris longus was missing hemi-flexor carpi radialis tendon was used instead. All patients tolerated the procedure well. Results. All flaps totally survived. No patient suffered from drooling. All patients regained normal diet and normal speech. Cosmetic result was fair to good in all patients accept one. Conclusion. We conclude that tendino-fasciocutaneous radial forearm flap for total lower lip reconstruction is safe. Functional and aesthetic result approaches reconstructive goals.

  17. Distraction osteogenesis of free flap reconstructed mandible following ameloblastoma resection for optimal functional rehabilitation.

    Science.gov (United States)

    Bousdras, V A; Kalavrezos, N

    2014-01-01

    This case highlights the use of a custom-made distractor (Synthes GmbH, Oberdorf, Switzerland), used to increase bone height prior to rehabilitation with implant placement, in a patient following excision of an ameloblastoma and reconstruction of her mandible with a fibular flap. A 27-year-old patient had her mandible reconstructed following wide resection of an ameloblastoma. Although a 2.0 LOCK reconstruction plate (Synthes GmbH, Oberdorf, Switzerland) was used for fixation of the fibular bone, the vertical deficiency between the reconstructed segment and the occlusal plane made oral rehabilitation impossible. To overcome this, the fibular bone segment was vertically distracted following a latency period of 4 days. Distractor was left in place for 20 weeks for bone consolidation. Following device removal implants were placed. The novelty of this approach included fixation of the lower arm of the distractor on the LOCK plate. The distractor was unidirectional with two arms of different length. The lower arm composed of a 2.0 mini-plate to fit exactly on the 2.0 LOCK plate whereas the upper arm used a standard 1.5 mini-plate. Advantages of this custom-made distractor included: (i) No need for removal of the reconstruction plate, (ii) no need for an extraoral surgical approach, and (iii) no need for additional drilling to fit the lower arm of the distractor. Technical details and limitations are presented. PMID:25593885

  18. Computed tomography to evaluate the association of fragmented heterolog cortical bone and methylmethacrylate to repare segmental bone defect produced in tibia of rabbits

    International Nuclear Information System (INIS)

    A 6mm segmental defect was performed on the metaphyseal region of the tibia of 12 rabbits and the autoclaved fragmented heterolog cortical bone conserved in glycerin (98%) and methylmethacrylate was used as a bone graft for the reconstruction. The graft was placed in the receptor bed and its integration was evaluated by computed tomography after 30, 60 and 90 days. There was gradual bone graft incorporation in the receptor bed during the time in 100% of the cases. Fragmented cortical bone heterograft and methylmethacrylate was biologically compatible and promotes bone defect reparation without signs of infection, migration and or rejection, featuring a new option of osseous substitute to fill in bone defects. (author)

  19. Minimally Invasive Reconstruction of the Medial Patellofemoral Ligament Using Quadriceps Tendon

    OpenAIRE

    Fink, Christian; Veselko, Matjaz; Herbort, Mirco; Hoser, Christian

    2014-01-01

    Reconstruction of the medial patellofemoral ligament (MPFL) for the treatment of patellar instability has received increased attention over the past few years. Most operative techniques use hamstring grafts fixed with bone tunnels and/or anchors on the patella. Despite good clinical results using these techniques, complications such as implant breakage, patellar fractures through bone tunnels, and loss of knee motion have occurred. We present a minimally invasive technique for MPFL reconstruc...

  20. Failure load of patellar tendon grafts at the femoral side: 10- versus 20-mm-bone blocks

    OpenAIRE

    Meuffels, Duncan; Niggebrugge, Marnix; Verhaar, Jan

    2009-01-01

    textabstractThe aim of the study was to investigate whether use of short bone blocks is safe in anterior cruciate ligament (ACL) reconstruction. Our hypothesis was that the smaller 10-mm-length bone blocks will fail at lower loads than 20-mm-bone blocks. Ten paired human cadaver knees were randomly assigned to the 10- or 20-mm group (group 1 and 2) and underwent bone-patellar tendon-bone femoral fixation with interference screw. Tensile tests were performed using a tensile testing machine (In...