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Sample records for floor augmentation surgery

  1. Maxillary Sinus Floor Augmentation

    Starch-Jensen, Thomas; Jensen, Janek Dalsgaard

    2017-01-01

    , radiological and histomorphometric outcome as well as complications are presented after maxillary sinus floor augmentation applying the lateral window technique with a graft material, maxillary sinus membrane elevation without a graft material and osteotome-mediated sinus floor elevation with or without...

  2. Augmented reality in surgery.

    Shuhaiber, Jeffrey H

    2004-02-01

    To evaluate the history and current knowledge of computer-augmented reality in the field of surgery and its potential goals in education, surgeon training, and patient treatment. National Library of Medicine's database and additional library searches. Only articles suited to surgical sciences with a well-defined aim of study, methodology, and precise description of outcome were included. Augmented reality is an effective tool in executing surgical procedures requiring low-performance surgical dexterity; it remains a science determined mainly by stereotactic registration and ergonomics. Strong evidence was found that it is an effective teaching tool for training residents. Weaker evidence was found to suggest a significant influence on surgical outcome, both morbidity and mortality. No evidence of cost-effectiveness was found. Augmented reality is a new approach in executing detailed surgical operations. Although its application is in a preliminary stage, further research is needed to evaluate its long-term clinical impact on patients, surgeons, and hospital administrators. Its widespread use and the universal transfer of such technology remains limited until there is a better understanding of registration and ergonomics.

  3. [Perioperative nursing of internal sinus floor elevation surgery with piezosurgery].

    He, Jing; Lei, Yiling; Wang, Liqiong

    2013-12-01

    This study aims to summarize the nursing experience in the internal sinus floor elevation surgery with piezosurgery. The medical records of 48 patients who underwent sinus floor elevation surgery with piezosurgery in the Department of Implantation, West China Hospital of Stomatology, Sichuan University, were reviewed. The preoperative, intraoperative, and postoperative nursing methods were summarized. All 48 patients underwent smooth surgeries and did not encounter complications. Careful preoperative preparation, careful and meticulous intraoperative nursing cooperation, and provision of sufficient health education after surgery to the patients are the key factors that ensure the success of internal sinus floor elevation surgery with piezosurgery.

  4. [Functional aspects of pelvic floor surgery].

    Wagenlehner, F M E; Gunnemann, A; Liedl, B; Weidner, W

    2009-11-01

    Pelvic floor dysfunctions are frequently seen in females. The human pelvic floor is a complex structure and heavily stressed throughout female life. Recent findings in the functional anatomy of the pelvic floor have led to a much better understand-ing, on the basis of which enormous improvements in the therapeutic options have arisen. The pelvic floor activity is regulated by three main muscular forces that are responsible for vaginal tension and suspension of the pelvic floor -organs, bladder and rectum. For different reasons laxity in the vagina or its supporting ligaments as a result of altered connective tissue can distort this functional anatomy. A variety of symptoms can derive from these pelvic floor dysfunctions, such as urinary urge and stress incontinence, abnormal bladder emptying, faecal incontinence, obstructive bowel disease syndrome and pelvic pain. Pelvic floor reconstruction is nowadays driven by the concept that in the case of pelvic floor symptoms restoration of the anatomy will translate into restoration of the physiology and ultimately improve the patients' symptoms. The exact surgical reconstruction of the anatomy is there-fore almost exclusively focused on the restoration of the lax pelvic floor ligaments. An exact identification of the anatomic lesions preoperatively is eminently necessary, to allow for an exact anatomic reconstruction with respect to the muscular forces of the pelvic floor. Georg Thieme Verlag Stuttgart * New York.

  5. Augmented reality-assisted skull base surgery.

    Cabrilo, I; Sarrafzadeh, A; Bijlenga, P; Landis, B N; Schaller, K

    2014-12-01

    Neuronavigation is widely considered as a valuable tool during skull base surgery. Advances in neuronavigation technology, with the integration of augmented reality, present advantages over traditional point-based neuronavigation. However, this development has not yet made its way into routine surgical practice, possibly due to a lack of acquaintance with these systems. In this report, we illustrate the usefulness and easy application of augmented reality-based neuronavigation through a case example of a patient with a clivus chordoma. We also demonstrate how augmented reality can help throughout all phases of a skull base procedure, from the verification of neuronavigation accuracy to intraoperative image-guidance. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  6. Is Bariatric Surgery a Prophylaxis for Pelvic Floor Disorders?

    Pomian, Andrzej; Majkusiak, Wojciech; Lisik, Wojciech; Tomasik, Paweł; Horosz, Edyta; Zwierzchowska, Aneta; Kociszewski, Jacek; Barcz, Ewa

    2018-06-01

    Obesity is one of the well-documented risk factors of pelvic floor disorders (PFDs). The PFDs include urinary and fecal incontinence (UI, FI) and pelvic organ prolapse (POP). Surgery-induced weight loss improves different kinds of incontinence as well as POP symptoms. However, there is a lack of evidence how bariatric surgery influences pelvic floor anatomy and function in women without previous PFDs and whether it may be concerned as PFD prophylaxis tool. The present analysis is a prospective, non-randomized case-control study from January 2014 to September 2017. Participants underwent pelvic floor ultrasound examination with bladder neck position estimation at rest, during levator ani tension, and at Valsalva maneuver before surgery and 12-18 months after. Pelvic organ prolapse quantification (POPQ) > 2 stage and PFD complaints were the exclusion criteria. Fifty-nine patients underwent bariatric surgery (57 sleeve gastrectomy and 2 gastric bypass). Mean BMI decreased from 43.8 ± 5.9 to 29 ± 4.6 kg/m 2 after surgery (p betterment of bladder neck position at rest, tension, and Valsalva maneuver in women without PFDs. We postulate that bariatric surgery may be a tool for PFD prevention. It does not improve levator ani function and does not limit bladder neck mobility, which implicates that it has no influence on preexisting pelvic dysfunction.

  7. Stereoscopic augmented reality for laparoscopic surgery.

    Kang, Xin; Azizian, Mahdi; Wilson, Emmanuel; Wu, Kyle; Martin, Aaron D; Kane, Timothy D; Peters, Craig A; Cleary, Kevin; Shekhar, Raj

    2014-07-01

    Conventional laparoscopes provide a flat representation of the three-dimensional (3D) operating field and are incapable of visualizing internal structures located beneath visible organ surfaces. Computed tomography (CT) and magnetic resonance (MR) images are difficult to fuse in real time with laparoscopic views due to the deformable nature of soft-tissue organs. Utilizing emerging camera technology, we have developed a real-time stereoscopic augmented-reality (AR) system for laparoscopic surgery by merging live laparoscopic ultrasound (LUS) with stereoscopic video. The system creates two new visual cues: (1) perception of true depth with improved understanding of 3D spatial relationships among anatomical structures, and (2) visualization of critical internal structures along with a more comprehensive visualization of the operating field. The stereoscopic AR system has been designed for near-term clinical translation with seamless integration into the existing surgical workflow. It is composed of a stereoscopic vision system, a LUS system, and an optical tracker. Specialized software processes streams of imaging data from the tracked devices and registers those in real time. The resulting two ultrasound-augmented video streams (one for the left and one for the right eye) give a live stereoscopic AR view of the operating field. The team conducted a series of stereoscopic AR interrogations of the liver, gallbladder, biliary tree, and kidneys in two swine. The preclinical studies demonstrated the feasibility of the stereoscopic AR system during in vivo procedures. Major internal structures could be easily identified. The system exhibited unobservable latency with acceptable image-to-video registration accuracy. We presented the first in vivo use of a complete system with stereoscopic AR visualization capability. This new capability introduces new visual cues and enhances visualization of the surgical anatomy. The system shows promise to improve the precision and

  8. β-TCP/HA with or without enamel matrix proteins for maxillary sinus floor augmentation

    Nery, James Carlos; Pereira, Luís Antônio Violin Dias; Guimarães, George Furtado

    2017-01-01

    BACKGROUND: It is still unclear whether enamel matrix proteins (EMD) as adjunct to bone grafting enhance bone healing. This study compared histomorphometrically maxillary sinus floor augmentation (MSFA) with β-TCP/HA in combination with or without EMD in humans. METHODS: In ten systemically healthy...

  9. Maxillary Sinus Floor Augmentation With Synthetic Bone Substitutes Compared With Other Grafting Materials

    Starch-Jensen, Thomas; Mordenfeld, Arne; Becktor, Jonas Peter

    2018-01-01

    OBJECTIVE: To test the hypotheses of no differences in implant treatment outcome after maxillary sinus floor augmentation (MSFA) with synthetic bone substitutes (SBS) compared with other grafting materials applying the lateral window technique. MATERIALS AND METHODS: A MEDLINE/PubMed, Embase and ...

  10. Effects of maxillary sinus floor elevation surgery on maxillary sinus physiology

    Timmenga, NM; Raghoebar, GM; Liem, RSB; van Weissenbruch, R; Manson, WL; Vissink, A

    In a prospective study, the effects of elevation surgery of the maxillary sinus floor on maxillary sinus physiology were assessed. Seventeen consecutive patients without preoperative anamnestic, clinical and radiological signs of maxillary sinusitis underwent sinus floor elevation surgery with iliac

  11. Recent Development of Augmented Reality in Surgery: A Review

    Vávra, P.; Zonča, P.; Ihnát, P.; El-Gendi, A.

    2017-01-01

    Introduction The development augmented reality devices allow physicians to incorporate data visualization into diagnostic and treatment procedures to improve work efficiency, safety, and cost and to enhance surgical training. However, the awareness of possibilities of augmented reality is generally low. This review evaluates whether augmented reality can presently improve the results of surgical procedures. Methods We performed a review of available literature dating from 2010 to November 2016 by searching PubMed and Scopus using the terms “augmented reality” and “surgery.” Results. The initial search yielded 808 studies. After removing duplicates and including only journal articles, a total of 417 studies were identified. By reading of abstracts, 91 relevant studies were chosen to be included. 11 references were gathered by cross-referencing. A total of 102 studies were included in this review. Conclusions The present literature suggest an increasing interest of surgeons regarding employing augmented reality into surgery leading to improved safety and efficacy of surgical procedures. Many studies showed that the performance of newly devised augmented reality systems is comparable to traditional techniques. However, several problems need to be addressed before augmented reality is implemented into the routine practice. PMID:29065604

  12. Recent Development of Augmented Reality in Surgery: A Review

    P. Vávra

    2017-01-01

    Full Text Available Introduction. The development augmented reality devices allow physicians to incorporate data visualization into diagnostic and treatment procedures to improve work efficiency, safety, and cost and to enhance surgical training. However, the awareness of possibilities of augmented reality is generally low. This review evaluates whether augmented reality can presently improve the results of surgical procedures. Methods. We performed a review of available literature dating from 2010 to November 2016 by searching PubMed and Scopus using the terms “augmented reality” and “surgery.” Results. The initial search yielded 808 studies. After removing duplicates and including only journal articles, a total of 417 studies were identified. By reading of abstracts, 91 relevant studies were chosen to be included. 11 references were gathered by cross-referencing. A total of 102 studies were included in this review. Conclusions. The present literature suggest an increasing interest of surgeons regarding employing augmented reality into surgery leading to improved safety and efficacy of surgical procedures. Many studies showed that the performance of newly devised augmented reality systems is comparable to traditional techniques. However, several problems need to be addressed before augmented reality is implemented into the routine practice.

  13. Maxillary sinus floor elevation surgery - A clinical, radiographic and endoscopic evaluation

    Timmenga, NM; Raghoebar, GM; van Weissenbruch, R; Vissink, A

    Although augmentation of the maxillary sinus floor with autogenous bone grafts has become a well established preimplantology procedure, its effect on the function of the maxillary sinus has not been the subject of prospective human studies. In this prospective study the effects of sinus floor

  14. [Sinus floor elevation and augmentation. Evidence-based analysis of prognosis and risk factors].

    Strietzel, F P

    2004-03-01

    It was the aim of this investigation to analyze evidence of prognosis, predictors, and risk factors concerning sinus floor elevation and augmentation (SFEA). A MEDLINE search was performed to analyze the literature published between 1990 and 2002, limited to keywords ("sinus floor elevation and dental implants", "complications", "success"), study type (randomized as well as clinical prospective studies, retrospective studies, reviews), and language (German or English). Of 229 publications identified, 72 met the inclusion criteria (22 prospective and 47 retrospective studies, 3 reviews). Considering the augmentation material [autogenous bone (AB), bone substitution materials (BSM), and combinations of AB and BSM], the frequency of implant loss was not significantly different (AB 8%, BSM 9%, AB + BSM 5%, p>0.09) after an observation period of 2-4 years. The average duration of the healing period was 6 months (AB) and 8 months (BSM) with simultaneous SFEA and implantation and 6-7 months (AB and BSM) for the staged approach after an average healing period of 6 months for the augmentation materials. Frequency of implant loss was not different between simultaneous and staged approaches (7-8%). Postoperative sinusitis occurred in 3-8% of the cases. Smoking, positive sinusitis history, obstructive pathoses of the nose and ostium, allergic rhino-pathoses, use of short implants (bruxism, and uncontrolled early loading of implants were identified as predictors for complications. Presupposing proper consideration of indications, SFEA should be considered as an evidence-based and clinically established method for implant prosthetic rehabilitation of the atrophic posterior maxilla with an overall cumulative survival rate of 90% within an average observation period of 4 years.

  15. Surgeons' performance determining the amount of graft material for sinus floor augmentation using tomography

    Cruz, Adriana Dibo; Peixoto, Guilherme Alvares; Aguiar, Marcelo Freitas; Camargo, Gabriela Alessandra Cruz Galhardo; Homs, Nicolas, E-mail: adrianadibo@gmail.com [Universidade Federal Fluminense (UFF), Nova Friburgo, RJ, (Brazil)

    2017-05-15

    This study aimed to assess the performance of surgeons in determining the amount of graft material required for maxillary sinus floor augmentation in a preoperative analysis using cone-beam computed tomography images. A convenience sample of 10 retrospective CBCT exams (i-CAT®) was selected. Scans of the posterior maxilla area with an absence of at least one tooth and residual alveolar bone with an up to 5 mm height were used. Templates (n=20) contained images of representative cross-sections in multiplanar view. Ten expert surgeons voluntarily participated as appraisers of the templates for grafting surgical planning of a 10 mm long implant. Appraisers could choose a better amount of graft material using scores: 0) when considered grafting unnecessary, 1) for 0.25 g in graft material, 2) for 0.50 g, 3) for 1.00 g and 4) for 1.50 g or more. Reliability of the response pattern was analyzed using Cronbach's α. Wilcoxon and Mann-Whitney tests were performed to compare scores. Regression analysis was performed to evaluate whether the volume of sinuses (mm{sup 3}) influenced the choose of scores. In the reliability analysis, all values were low and the score distribution was independent of the volume of the maxillary sinuses (p>0.05), which did not influence choosing the amount of graft material. Surgeons were unreliable to determine the best amount of graft material for the maxillary sinus floor augmentation using only CBCT images. Surgeons require auxiliary diagnostic tools to measure the volume associated to CBCT exams in order to perform better. (author)

  16. Surgeons' performance determining the amount of graft material for sinus floor augmentation using tomography

    Cruz, Adriana Dibo; Peixoto, Guilherme Alvares; Aguiar, Marcelo Freitas; Camargo, Gabriela Alessandra Cruz Galhardo; Homs, Nicolas

    2017-01-01

    This study aimed to assess the performance of surgeons in determining the amount of graft material required for maxillary sinus floor augmentation in a preoperative analysis using cone-beam computed tomography images. A convenience sample of 10 retrospective CBCT exams (i-CAT®) was selected. Scans of the posterior maxilla area with an absence of at least one tooth and residual alveolar bone with an up to 5 mm height were used. Templates (n=20) contained images of representative cross-sections in multiplanar view. Ten expert surgeons voluntarily participated as appraisers of the templates for grafting surgical planning of a 10 mm long implant. Appraisers could choose a better amount of graft material using scores: 0) when considered grafting unnecessary, 1) for 0.25 g in graft material, 2) for 0.50 g, 3) for 1.00 g and 4) for 1.50 g or more. Reliability of the response pattern was analyzed using Cronbach's α. Wilcoxon and Mann-Whitney tests were performed to compare scores. Regression analysis was performed to evaluate whether the volume of sinuses (mm"3) influenced the choose of scores. In the reliability analysis, all values were low and the score distribution was independent of the volume of the maxillary sinuses (p>0.05), which did not influence choosing the amount of graft material. Surgeons were unreliable to determine the best amount of graft material for the maxillary sinus floor augmentation using only CBCT images. Surgeons require auxiliary diagnostic tools to measure the volume associated to CBCT exams in order to perform better. (author)

  17. Sinus Floor Elevation and Augmentation Using Synthetic Nanocrystalline and Nanoporous Hydroxyapatite Bone Substitute Materials: Preliminary Histologic Results.

    Belouka, Sofia-Maria; Strietzel, Frank Peter

    To compare the tissue composition of augmented sites after using two different synthetic bone substitute materials, nanocrystalline and nanoporous hydroxyapatite (HA), for sinus floor elevation and augmentation. Forty-four patients received 88 titanium screw implants (Camlog Promote plus) of 4.3-mm diameter and 11- or 13-mm length, placed simultaneously during sinus floor elevation and augmentation. Nanocrystalline (Ostim) or nanoporous (NanoBone) HA were used exclusively. Bone substitute materials and implant lengths were allocated by randomization. Bone biopsy specimens were obtained from the former area of the lateral access window at implant exposure during healing abutment placement after 6 months. Biopsy specimens were prepared and examined histologically and histomorphometrically. All implants were osseointegrated at the time of exposure. Clinically and histologically, no signs of inflammation in the augmented sites were present. The histomorphometric analysis of 44 biopsy specimens revealed 31.8% ± 11.6% newly formed bone for sites augmented with nanocrystalline HA and 34.6% ± 9.2% for nanoporous HA (P = .467). The proportion of remaining bone substitute material was 28.4% ± 18.6% and 30% ± 13%, respectively (P = .453). The proportion of soft tissue within the biopsy specimens was 39.9% ± 11.1% and 35.4% ± 6.8%, respectively (P = .064). No significant differences were found between the area fractions of bone, bone substitute material, and soft tissue concerning the bone substitute material utilized. Within the present study, both synthetic bone substitute materials, nanocrystalline and nanoporous HA, were found to support bone formation in sinus floor elevation and augmentation procedures by osteoconductivity. They were not completely resorbed after 6 months. The amounts of newly formed bone, soft tissue, and bone substitute material remnants were found to be similar, indicating that both materials are likewise suitable for sinus floor elevation and

  18. Nasal Floor Augmentation for the Reconstruction of the Atrophic Maxilla: A Case Series

    El-Ghareeb, Moustafa; Pi-Anfruns, Joan; Khosousi, Mohammed; Aghaloo, Tara; Moy, Peter

    2012-01-01

    Purpose The severely atrophic edentulous maxilla imposes a challenge for dental implant rehabilitation. Nasal floor augmentation (NFA) is a method of augmenting bone height in the anterior maxilla. Autogenous bone has been commonly used as a graft material. Because of variations in results and lack of insufficient studies reporting the use of bone substitutes to graft the nasal floor, this study aims to evaluate the survival and success of dental implants placed in nasally grafted maxillae with osteoconductive bone substitutes. Materials and Methods Six patients with completely edentulous maxillae and inadequate height in the anterior to support implants underwent NFA. The nasal floor was exposed through an intraoral approach and grafted with osteoconductive bone graft substitutes. Twenty-four dental implants were placed, restored with a bar-retained implant-supported overdenture after a traditional healing period, and followed up after prosthetic loading. Patient satisfaction was evaluated with a questionnaire, and responses were expressed on a visual analog scale from 1 to 10. Bone levels were quantified radiographically based on a score ranging from 1 to 3, where 3 represented the highest bone support. Implants were evaluated for thread exposure and soft tissue health and were considered successful if the following criteria were met: absence of mobility; lack of symptoms; bone score of 3; and healthy peri-implant soft tissue without thread exposure. Results The age of patients ranged from 48 to 84 years, with a mean of 71.2 years. Three patients underwent NFA and simultaneous implant placement, whereas the other 3 had a mean healing period of 6.5 months before implant placement. Post-loading follow-up ranged from 4 to 29 months, with a mean of 14.2 months. The implant survival rate was 100%, with no complications. Ninety-three percent of the responses to the treatment satisfaction questionnaire had a score of 7 or greater. Bone scores ranged from 2 to 3, with 87

  19. Augmented reality assisted surgery: a urologic training tool.

    Dickey, Ryan M; Srikishen, Neel; Lipshultz, Larry I; Spiess, Philippe E; Carrion, Rafael E; Hakky, Tariq S

    2016-01-01

    Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  20. Augmented reality assisted surgery: a urologic training tool

    Dickey, Ryan M; Srikishen, Neel; Lipshultz, Larry I; Spiess, Philippe E; Carrion, Rafael E; Hakky, Tariq S

    2016-01-01

    Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training. PMID:26620455

  1. Augmented reality assisted surgery: a urologic training tool

    Ryan M Dickey

    2016-01-01

    Full Text Available Augmented reality is widely used in aeronautics and is a developing concept within surgery. In this pilot study, we developed an application for use on Google Glass ® optical head-mounted display to train urology residents in how to place an inflatable penile prosthesis. We use the phrase Augmented Reality Assisted Surgery to describe this novel application of augmented reality in the setting of surgery. The application demonstrates the steps of the surgical procedure of inflatable penile prosthesis placement. It also contains software that allows for detection of interest points using a camera feed from the optical head-mounted display to enable faculty to interact with residents during placement of the penile prosthesis. Urology trainees and faculty who volunteered to take part in the study were given time to experience the technology in the operative or perioperative setting and asked to complete a feedback survey. From 30 total participants using a 10-point scale, educational usefulness was rated 8.6, ease of navigation was rated 7.6, likelihood to use was rated 7.4, and distraction in operating room was rated 4.9. When stratified between trainees and faculty, trainees found the technology more educationally useful, and less distracting. Overall, 81% of the participants want this technology in their residency program, and 93% see this technology in the operating room in the future. Further development of this technology is warranted before full release, and further studies are necessary to better characterize the effectiveness of Augmented Reality Assisted Surgery in urologic surgical training.

  2. Virtual Reality and Augmented Reality in Plastic Surgery: A Review.

    Kim, Youngjun; Kim, Hannah; Kim, Yong Oock

    2017-05-01

    Recently, virtual reality (VR) and augmented reality (AR) have received increasing attention, with the development of VR/AR devices such as head-mounted displays, haptic devices, and AR glasses. Medicine is considered to be one of the most effective applications of VR/AR. In this article, we describe a systematic literature review conducted to investigate the state-of-the-art VR/AR technology relevant to plastic surgery. The 35 studies that were ultimately selected were categorized into 3 representative topics: VR/AR-based preoperative planning, navigation, and training. In addition, future trends of VR/AR technology associated with plastic surgery and related fields are discussed.

  3. Superficial thrombophlebitis (Mondor′s Disease after breast augmentation surgery

    Viana Giovanni Andre

    2008-01-01

    Full Text Available Although the aetiology of Mondor′s disease remains unclear, the most commonly cited cause is trauma of some sort. Although surgical trauma has frequently been quoted, reports that specifically implicate aesthetic breast surgery are unusual in the literature. In this article, the authors report a case of superficial thrombophlebitis of the anterolateral chest wall secondary to breast augmentation surgery in a woman, five months after the procedure. The authors performed an analysis of the disease′s main etiologic components and preponderant clinical aspects, and determined all appropriate therapeutic measures.

  4. Outcomes of rotator cuff augmentation surgery with autologous fascia lata.

    Rosales-Varo, A P; García-Espona, M A; Roda-Murillo, O

    To evaluate whether augmentation grafts using autologous fascia lata improve functional results for rotator cuff repairs and reduce the retear rate compared to those without augmentation. This is a prospective evaluation comprising 20 patients with a complete symptomatic rotator cuff tear. The operations were carried out from a superior approach performing a total cuff repair, for 10 patients we used a suture augmented with an autologous graft taken from their own fascia lata while unaugmented sutures were used for the other 10 patients. The follow-up period lasted for one year post-intervention. We measured variables for tear type, functionality and pain, both baseline and at 6 and 12-month follow ups. We evaluated retear incidence in each group as well as each group's pain and functionality response. The improved pain levels in the non-graft group evolved gradually over time. Conversely, in the group with the augmentation grafts, average Constant-Murley shoulder outcome scores at six months were already above 10 and were maintained at 12 months. One retear occurred in the graft group and 2 in the group without grafts, thus presenting no significant differences. There were no significant changes in pain and function values at the one year follow up in either group. Our preliminary results regarding rotator cuff augmentation surgery with autologous fascia lata showed a significant improvement in pain levels after 6 months compared to the patients with no augmentation, who required 12 months to reach the same values. After a year of follow up, there were no differences between the mean Constant and pain scores in either intervention group The number of retears in the non-graft group was greater than that in the group with grafts although the difference was not significant. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Preliminary development of augmented reality systems for spinal surgery

    Nguyen, Nhu Q.; Ramjist, Joel M.; Jivraj, Jamil; Jakubovic, Raphael; Deorajh, Ryan; Yang, Victor X. D.

    2017-02-01

    Surgical navigation has been more actively deployed in open spinal surgeries due to the need for improved precision during procedures. This is increasingly difficult in minimally invasive surgeries due to the lack of visual cues caused by smaller exposure sites, and increases a surgeon's dependence on their knowledge of anatomical landmarks as well as the CT or MRI images. The use of augmented reality (AR) systems and registration technologies in spinal surgeries could allow for improvements to techniques by overlaying a 3D reconstruction of patient anatomy in the surgeon's field of view, creating a mixed reality visualization. The AR system will be capable of projecting the 3D reconstruction onto a field and preliminary object tracking on a phantom. Dimensional accuracy of the mixed media will also be quantified to account for distortions in tracking.

  6. Virtual Reality and Augmented Reality in Plastic Surgery: A Review

    Youngjun Kim

    2017-05-01

    Full Text Available Recently, virtual reality (VR and augmented reality (AR have received increasing attention, with the development of VR/AR devices such as head-mounted displays, haptic devices, and AR glasses. Medicine is considered to be one of the most effective applications of VR/AR. In this article, we describe a systematic literature review conducted to investigate the state-of-the-art VR/AR technology relevant to plastic surgery. The 35 studies that were ultimately selected were categorized into 3 representative topics: VR/AR-based preoperative planning, navigation, and training. In addition, future trends of VR/AR technology associated with plastic surgery and related fields are discussed.

  7. Biological augmentation and tissue engineering approaches in meniscus surgery.

    Moran, Cathal J; Busilacchi, Alberto; Lee, Cassandra A; Athanasiou, Kyriacos A; Verdonk, Peter C

    2015-05-01

    The purpose of this review was to evaluate the role of biological augmentation and tissue engineering strategies in meniscus surgery. Although clinical (human), preclinical (animal), and in vitro tissue engineering studies are included here, we have placed additional focus on addressing preclinical and clinical studies reported during the 5-year period used in this review in a systematic fashion while also providing a summary review of some important in vitro tissue engineering findings in the field over the past decade. A search was performed on PubMed for original works published from 2009 to March 31, 2014 using the term "meniscus" with all the following terms: "scaffolds," "constructs," "cells," "growth factors," "implant," "tissue engineering," and "regenerative medicine." Inclusion criteria were the following: English-language articles and original clinical, preclinical (in vivo), and in vitro studies of tissue engineering and regenerative medicine application in knee meniscus lesions published from 2009 to March 31, 2014. Three clinical studies and 18 preclinical studies were identified along with 68 tissue engineering in vitro studies. These reports show the increasing promise of biological augmentation and tissue engineering strategies in meniscus surgery. The role of stem cell and growth factor therapy appears to be particularly useful. A review of in vitro tissue engineering studies found a large number of scaffold types to be of promise for meniscus replacement. Limitations include a relatively low number of clinical or preclinical in vivo studies, in addition to the fact there is as yet no report in the literature of a tissue-engineered meniscus construct used clinically. Neither does the literature provide clarity on the optimal meniscus scaffold type or biological augmentation with which meniscus repair or replacement would be best addressed in the future. There is increasing focus on the role of mechanobiology and biomechanical and

  8. Highly porous hydroxyapatite with and without local harvested bone in sinus floor augmentation: a histometric study in pigs.

    Möller, Björn; Acil, Yahya; Birkenfeld, Falk; Behrens, Eleonore; Terheyden, Hendrik; Wiltfang, Jörg

    2014-07-01

    Sinus floor augmentation with autologous bone is an accepted treatment option in dental implantology. In this study, an entirely synthetic, nano-structured, hydroxyapatite-based bone substitute material (SBSM, NanoBone(®); Artoss, Rostock, Germany) was supplemented with a mixture of locally harvested bone to enhance osteogenesis. Bilateral sinus augmentation procedures were performed in eight domestic pigs using the lateral window technique. On the right side (control), 2.6 ml of SBSM was used, and on the left side (test), 2.6 ml of SBSM with additional 15% (390 μl) autologous bone was used. At the time of augmentation, a titanium implant (ITI(®)) was inserted from a laterocaudal direction. After 3 months, the sites of augmentation were removed and examined in non-decalcified sections by microradiography and fluorescence microscopy of sequentially labelled specimens and histometry. On both sides, a significant amount of newly formed bone was observed. However, a statistically significant difference in the bone-implant contact was observed in the control group (median, 28.9%) compared with the test side with the additional autologous bone (median, 40.6%) (P = 0.01). Different bone density was achieved from the coronal to apical surfaces (medians, 54.6%, 9.6%, and 27.5%) compared with the test side (medians, 55.2%, 40.6%, and 44.2%). The median of augmentation height was 8.6 mm on the control side and 11.5 mm on the test side (P = 0.01). Bone apposition was observed in both groups after 15 days. The SBSM shows acceptable results in sinus floor augmentation. The additional use of locally harvested autologous bone enhances bone density and osseointegration of the implants. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  9. Laparoscopic removal of mesh used in pelvic floor surgery.

    Khong, Su-Yen; Lam, Alan

    2009-01-01

    Various meshes are being used widely in clinical practice for pelvic reconstructive surgery despite the lack of evidence of their long-term safety and efficacy. Management of complications such as mesh erosion and dyspareunia can be challenging. Most mesh-related complications can probably be managed successfully via the transvaginal route; however, this may be impossible if surgical access is poor. This case report demonstrates the successful laparoscopic removal of mesh after several failed attempts via the vaginal route.

  10. EFFECTS OF AUGMENTED REALITY PRESENTATIONS ON CONSUMER'S VISUAL PERCEPTION OF FLOOR PLANS

    Lutheran, April L

    2012-01-01

    Home architects and designers use many types of presentation drawings to convey design ideas. Augmented reality is a relatively new technology that can be used to aid in design and marketing for residential builders. An augmented reality presentation provides a more complete idea of a design than other presentations such as 3D model renderings and hand drawn artist sketches. While designers are accustomed to visualizing 2D plans, this task is difficult for home buyers. This difficulty has bee...

  11. Recombinant human bone morphogenetic protein 2 outcomes for maxillary sinus floor augmentation: a systematic review and meta-analysis.

    Lin, Guo-Hao; Lim, Glendale; Chan, Hsun-Liang; Giannobile, William V; Wang, Hom-Lay

    2016-11-01

    To study the effect of the recombinant human bone morphogenetic protein 2 (rhBMP-2) on sinus volumetric and histometric changes after sinus floor augmentation compared to a conventional approach of non-biologic bone grafting materials. An electronic search of 4 databases (January 1990-February 2015), including PubMed/MEDLINE, EMBASE, Web of Science and Cochrane Central, and a hand search of peer-reviewed journals for relevant articles were performed. Human clinical trials with data on comparison of sinus volumetric and/or histometric outcomes with and without the use of rhBMP-2 in sinus grafting procedures, with ≥10 augmentation sites in each study group, and with a follow-up period of at least 6 months, were included. Random-effects meta-analyses were performed to analyze weighted mean difference (WMD) and confidence interval (CI) for the recorded variables according to PRISMA guidelines. Six randomized controlled trials (RCTs) were included. The results of the meta-analyses showed that the WMD of vertical bone height gain was -0.14 mm (95% CI = -1.91 to 1.62 mm, P = 0.87), the WMD of bone density was -142.42 mg/cm 3 (95% CI = -310.62-25.78 mg/cm 3 , P = 0.10), the WMD of the percentage of vital bone was -4.59% (95% CI = -11.73-2.56%, P = 0.21), and the WMD of the percentage of residual bone grafting materials was -9.90% (95% CI = -26.38-6.58%, P = 0.21). The comparison of implant survival rate presented an overall risk ratio of 1.00 (95% CI = 0.94-1.07). The two approaches (conventional bone grafting compared to BMPs) demonstrated comparable effectiveness for both clinical and histomorphometric measures. This systematic review revealed that the use of rhBMP-2 in maxillary sinus floor augmentation achieved similar clinical and histometric outcomes when compared to conventional sinus grafting procedures after a healing period of 6-9 months. However, previous studies showed the morbidity and other patient-reported outcomes were improved in

  12. Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women

    Herderschee, Roselien; Hay-Smith, E. Jean C.; Herbison, G. Peter; Roovers, Jan Paul; Heineman, Maas Jan

    2011-01-01

    Pelvic floor muscle training (PFMT) is an effective treatment for stress urinary incontinence in women. Whilst most of the PFMT trials have been done in women with stress urinary incontinence, there is also some trial evidence that PFMT is effective for urgency urinary incontinence and mixed urinary

  13. Pelvic floor physical therapy: impact on quality of life 6 months after vaginal reconstructive surgery.

    Pauls, Rachel N; Crisp, Catrina C; Novicki, Kathleen; Fellner, Angela N; Kleeman, Steven D

    2014-01-01

    Pelvic floor physical therapy (PFPT) is often used as a treatment of pelvic floor disorders and may improve function after pelvic reconstructive surgery. However, the long-term impact of this modality is not understood. This randomized controlled trial compared PFPT to the standard care in women undergoing vaginal reconstruction. The intervention group received PFPT biweekly until 12 weeks postoperatively, in conjunction with a physician assessment. Control subjects underwent a physician assessment alone at all postoperative intervals. The final follow-up was at 24 weeks. Physical examinations (pelvic organ prolapse quantification assessment), intravaginal electromyography, voiding diaries, and validated questionnaires were completed by all subjects. The primary outcome was change in the World Health Organization Quality of Life-BREF. Forty-nine women completed the study, 24 in the PFPT group and 25 in the control group. Although electromyography measures showed better muscular function in PFPT subjects after 12 weeks, at 6 months after surgery, this was no longer noted. However, quality of life parameters improved for the entire sample at 24 weeks, with no difference between groups. Positive change from 12 to 24 weeks was also documented in scores on the Pelvic Floor Distress Inventory-20 (P = 0.04) and Pelvic Floor Impact Questionnaire-7 (P = 0.018), corresponding with continued improvement in bladder symptoms. Finally, Prolapse and Incontinence Sexual Questionnaire-12 and Female Sexual Function Index scores improved between 12 and 24 weeks, suggesting better sexual function overall with time elapsed from surgery. Quality of life improves in all subjects after vaginal reconstructive surgery, with ongoing benefit between 3 and 6 months. Nevertheless, standardized PFPT was not associated with differences at 24 weeks in this cohort of women.

  14. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft in animals

    Jensen, T; Schou, S; Stavropoulos, Andreas

    2012-01-01

    The objective of the present systematic review was to test the hypothesis of no differences between the use of Bio-Oss or Bio-Oss mixed with autogenous bone as graft for maxillary sinus floor augmentation (MSFA) applying the lateral window technique, as evaluated in animals. A MEDLINE (Pub...... of the graft improved significantly with increased proportion of Bio-Oss. Bone regeneration, bone-to-implant contact (BIC), biomechanical implant test values, and biodegradation of Bio-Oss after MSFA with Bio-Oss or Bio-Oss mixed with autogenous bone have never been compared within the same study in animals....... Thus, the hypothesis of no differences between the use of Bio-Oss and Bio-Oss mixed with autogenous bone as graft for MSFA could neither be confirmed nor rejected based on existing animal studies....

  15. Allograft for maxillary sinus floor augmentation: a retrospective study of 90 cases.

    Guerrero, Jaime S; Al-Jandan, Badr A

    2012-04-01

    The aim of this study is to demonstrate the clinical applicability and efficacy of an allograft for maxillary sinus augmentations in patients requiring placement of dental implants. Sixty consecutive patients underwent a total of 90 sinus augmentations. Twenty-nine were women and 31 men, with a mean age of 54 years. Twenty-six patients received a bilateral procedure and 34 unilateral. All cases were treated with the lateral wall technique. Allograft consisted of demineralized freeze-dried blocks in 6 cases, particulate in 82 cases, and a combination of both in 2 cases. In 30 patients, it was combined with platelet-rich plasma. A total of 84 implants were inserted. Bone samples of grafted areas were obtained in two patients for histological examination. Seventy-three implants were clinically successful at the reentry time. Eleven implants in seven patients were removed between 15 days and 6 months after their placement. Seven of these implants were replaced and received prostheses as well, for an overall postloading success rate of 95.2%. Follow-up for all patients after final restoration was between 12 and 96 months. Specimen's histological evaluation revealed bone formation and evidence of inflammatory infiltrate. Based on the findings of this study, it can be suggested that the use of the demineralized freeze-dried bone allograft from the Banco de Huesos y Tejidos Fundación Cosme y Damian for sinus augmentation is effective and constitutes a feasible therapeutic alternative for implant placement.

  16. Augmented reality in the surgery of cerebral arteriovenous malformations: technique assessment and considerations.

    Cabrilo, Ivan; Bijlenga, Philippe; Schaller, Karl

    2014-09-01

    Augmented reality technology has been used for intraoperative image guidance through the overlay of virtual images, from preoperative imaging studies, onto the real-world surgical field. Although setups based on augmented reality have been used for various neurosurgical pathologies, very few cases have been reported for the surgery of arteriovenous malformations (AVM). We present our experience with AVM surgery using a system designed for image injection of virtual images into the operating microscope's eyepiece, and discuss why augmented reality may be less appealing in this form of surgery. N = 5 patients underwent AVM resection assisted by augmented reality. Virtual three-dimensional models of patients' heads, skulls, AVM nidi, and feeder and drainage vessels were selectively segmented and injected into the microscope's eyepiece for intraoperative image guidance, and their usefulness was assessed in each case. Although the setup helped in performing tailored craniotomies, in guiding dissection and in localizing drainage veins, it did not provide the surgeon with useful information concerning feeder arteries, due to the complexity of AVM angioarchitecture. The difficulty in intraoperatively conveying useful information on feeder vessels may make augmented reality a less engaging tool in this form of surgery, and might explain its underrepresentation in the literature. Integrating an AVM's hemodynamic characteristics into the augmented rendering could make it more suited to AVM surgery.

  17. Update on laparoscopic, robotic, and minimally invasive vaginal surgery for pelvic floor repair.

    Ross, J W; Preston, M R

    2009-06-01

    Advanced laparoscopic surgery marked the beginning of minimally invasive pelvic surgery. This technique lead to the development of laparoscopic hysterectomy, colposuspension, paravaginal repair, uterosacral suspension, and sacrocolpopexy without an abdominal incision. With laparoscopy there is a significant decrease in postoperative pain, shorter length of hospital stay, and a faster return to normal activities. These advantages made laparoscopy very appealing to patients. Advanced laparoscopy requires a special set of surgical skills and in the early phase of development training was not readily available. Advanced laparoscopy was developed by practicing physicians, instead of coming down through the more usual academic channels. The need for special training did hinder widespread acceptance. Nonetheless by physician to physician training and society training courses it has continued to grow and now has been incorporated in most medical school curriculums. In the last few years there has been new interest in laparoscopy because of the development of robotic assistance. The 3D vision and 720 degree articulating arms with robotics have made suture intensive procedures much easier. Laparosco-pic robotic-assisted sacrocolpopexy is in the reach of most surgeons. This field is so new that there is very little data to evaluate at this time. There are short comings with laparoscopy and even with robotic-assisted procedures it is not the cure all for pelvic floor surgery. Laparoscopic procedures are long and many patients requiring pelvic floor surgery have medical conditions preventing long anesthesia. Minimally invasive vaginal surgery has developed from the concept of tissue replacement by synthetic mesh. Initially sheets of synthetic mesh were tailored by physicians to repair the anterior and posterior vaginal compartment. The use of mesh by general surgeons for hernia repair has served as a model for urogynecology. There have been rapid improvements in biomaterials

  18. Reimplantation of cultivated human bone cells from the posterior maxilla for sinus floor augmentation. Histological results from a randomized controlled clinical trial

    Hermund, N.U.; Stavropoulos, Andreas; Donatsky, O

    2012-01-01

    OBJECTIVES: The aim of the present randomized clinical study was to evaluate histologically whether the addition of cultivated, autogenous bone cells to a composite graft of deproteinized bovine bone mineral (DBBM) and autogenous bone (AB) for sinus floor augmentation (SFA) enhance bone formation...... bone cells, which were cultivated from a bone biopsy harvested earlier from the tuberosity area. Four months after SFA, two cylindrical biopsies were taken from the augmented sinuses concomitantly with the implant site preparation by means of a trephine bur. An additional biopsy was taken from...... the tuberosity area. Bone density at the augmented sinus and the tuberosity area and the height of augmentation were estimated on non-decalcified histological sections prepared from the biopsies. A relative bone density index (RBD) was also calculated by dividing bone density at the augmented sinus with bone...

  19. Real-Time Augmented Reality for Robotic-Assisted Surgery

    Jørgensen, Martin Kibsgaard; Kraus, Martin

    2015-01-01

    Training in robotic-assisted minimally invasive surgery is crucial, but the training with actual surgery robots is relatively expensive. Therefore, improving the efficiency of this training is of great interest in robotic surgical education. One of the current limitations of this training is the ......-dimensional computer graphics in real time. Our system makes it possible to easily deploy new user interfaces for robotic-assisted surgery training. The system has been positively evaluated by two experienced instructors in robot-assisted surgery....... is the limited visual communication between the instructor and the trainee. As the trainee's view is limited to that of the surgery robot's camera, even a simple task such as pointing is difficult. We present a compact system to overlay the video streams of the da Vinci surgery systems with interactive three...

  20. Three-Dimensional Finite Element Analysis of Maxillary Sinus Floor Augmentation with Optimal Positioning of a Bone Graft Block

    Peter Schuller-Götzburg

    2018-01-01

    Full Text Available Purpose: the aim of the computational 3D-finite element study is to evaluate the influence of an augmented sinus lift with additional inserted bone grafting. The bone graft block stabilizes the implant in conjunction with conventional bone augmentation. Two finite element models were applied: the real geometry based bone models and the simplified geometry models. The bone graft block was placed in three different positions. The implants were loaded first with an axial force and then with forces simulating laterotrusion and protrusion. This study examines whether the calculated stress behavior is symmetrical for both models. Having established a symmetry between the primary axis, the laterotrusion and protrusion behavior reduces calculation efforts, by simplifying the model. Material and Methods: a simplified U-shaped 3D finite element model of the molar region of the upper jaw and a more complex anatomical model of the left maxilla with less cortical bone were created. The bone graft block was placed in the maxillary sinus. Then the von Mises stress distribution was calculated and analyzed at three block positions: at contact with the sinus floor, in the middle of the implant helix and in the upper third of the implant. The two finite element models were then compared to simplify the modelling. Results: the position of the bone graft block significantly influences the magnitude of stress distribution. A bone graft block positioned in the upper third or middle of the implant reduces the quantity of stress compared to the reference model without a bone graft block. The low bone graft block position is clearly associated with lower stress distribution in compact bone. We registered no significant differences in stress in compact bone with regard to laterotrusion or protrusion. Conclusions: maximum values of von Mises stresses in compact bone can be reduced significantly by using a bone graft block. The reduction of stress is nearly the same for

  1. Feasibility and safety of augmented reality-assisted urological surgery using smartglass.

    Borgmann, H; Rodríguez Socarrás, M; Salem, J; Tsaur, I; Gomez Rivas, J; Barret, E; Tortolero, L

    2017-06-01

    To assess the feasibility, safety and usefulness of augmented reality-assisted urological surgery using smartglass (SG). Seven urological surgeons (3 board urologists and 4 urology residents) performed augmented reality-assisted urological surgery using SG for 10 different types of operations and a total of 31 urological operations. Feasibility was assessed using technical metadata (number of photographs taken/number of videos recorded/video time recorded) and structured interviews with the urologists on their use of SG. Safety was evaluated by recording complications and grading according to the Clavien-Dindo classification. Usefulness of SG for urological surgery was queried in structured interviews and in a survey. The implementation of SG use during urological surgery was feasible with no intrinsic (technical defect) or extrinsic (inability to control the SG function) obstacles being observed. SG use was safe as no grade 3-5 complications occurred for the series of 31 urological surgeries of different complexities. Technical applications of SG included taking photographs/recording videos for teaching and documentation, hands-free teleconsultation, reviewing patients' medical records and images and searching the internet for health information. Overall usefulness of SG for urological surgery was rated as very high by 43 % and high by 29 % of surgeons. Augmented reality-assisted urological surgery using SG is both feasible and safe and also provides several useful functions for urological surgeons. Further developments and investigations are required in the near future to harvest the great potential of this exciting technology for urological surgery.

  2. Augmented reality-assisted bypass surgery: embracing minimal invasiveness.

    Cabrilo, Ivan; Schaller, Karl; Bijlenga, Philippe

    2015-04-01

    The overlay of virtual images on the surgical field, defined as augmented reality, has been used for image guidance during various neurosurgical procedures. Although this technology could conceivably address certain inherent problems of extracranial-to-intracranial bypass procedures, this potential has not been explored to date. We evaluate the usefulness of an augmented reality-based setup, which could help in harvesting donor vessels through their precise localization in real-time, in performing tailored craniotomies, and in identifying preoperatively selected recipient vessels for the purpose of anastomosis. Our method was applied to 3 patients with Moya-Moya disease who underwent superficial temporal artery-to-middle cerebral artery anastomoses and 1 patient who underwent an occipital artery-to-posteroinferior cerebellar artery bypass because of a dissecting aneurysm of the vertebral artery. Patients' heads, skulls, and extracranial and intracranial vessels were segmented preoperatively from 3-dimensional image data sets (3-dimensional digital subtraction angiography, angio-magnetic resonance imaging, angio-computed tomography), and injected intraoperatively into the operating microscope's eyepiece for image guidance. In each case, the described setup helped in precisely localizing donor and recipient vessels and in tailoring craniotomies to the injected images. The presented system based on augmented reality can optimize the workflow of extracranial-to-intracranial bypass procedures by providing essential anatomical information, entirely integrated to the surgical field, and help to perform minimally invasive procedures. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. A novel augmented reality system for displaying inferior alveolar nerve bundles in maxillofacial surgery.

    Zhu, Ming; Liu, Fei; Chai, Gang; Pan, Jun J; Jiang, Taoran; Lin, Li; Xin, Yu; Zhang, Yan; Li, Qingfeng

    2017-02-15

    Augmented reality systems can combine virtual images with a real environment to ensure accurate surgery with lower risk. This study aimed to develop a novel registration and tracking technique to establish a navigation system based on augmented reality for maxillofacial surgery. Specifically, a virtual image is reconstructed from CT data using 3D software. The real environment is tracked by the augmented reality (AR) software. The novel registration strategy that we created uses an occlusal splint compounded with a fiducial marker (OSM) to establish a relationship between the virtual image and the real object. After the fiducial marker is recognized, the virtual image is superimposed onto the real environment, forming the "integrated image" on semi-transparent glass. Via the registration process, the integral image, which combines the virtual image with the real scene, is successfully presented on the semi-transparent helmet. The position error of this navigation system is 0.96 ± 0.51 mm. This augmented reality system was applied in the clinic and good surgical outcomes were obtained. The augmented reality system that we established for maxillofacial surgery has the advantages of easy manipulation and high accuracy, which can improve surgical outcomes. Thus, this system exhibits significant potential in clinical applications.

  4. Multiparametric MR imaging of the breast after augmentation and oncoplastic surgery

    Ivanov, V.; Kirova, G.

    2015-01-01

    Full text: Evaluation of breast lesions in patients after augmentation and oncoplastic surgery are difficult and uncertain with ultrasound and mammography. These two methods give us information of the lesions nature, but this information has low specificity. Morphologic MRI sequences enable to an exact assessment the nature of the lesions high sensitivity, but with low specificity. To enhance security in the evaluation of the lesions new series as DCE MRI, DWI and MRI proton spectroscopy have to be added. Teaching points: to learn how and when to use multiparametric MRI for evaluation of breast lesion after augmentation and oncoplastic surgery; to present the multiparametric MRI protocol for evaluation of malignant breast lesion after augmentation and oncoplastic surgery; to discuss the main signs differentiating benign from malignant breast lesions based on the features on multiparametric MR Inconclusive data from mammography, ultrasound and standard morphological MR series (T1,T2, FAT SAT) in the estimation of changes after augmentation and oncoplastic surgery require the use of multiparametric MRI analysis as a supplementary method for increasing sensitivity and specificity of breast MRI

  5. Histomorphometric and immunohistochemical analysis of human maxillary sinus-floor augmentation using porous β-tricalcium phosphate for dental implant treatment.

    Miyamoto, Shinji; Shinmyouzu, Kouhei; Miyamoto, Ikuya; Takeshita, Kenji; Terada, Toshihisa; Takahashi, Tetsu

    2013-08-01

    This study utilized the constitution and expression of Runx2/Cbfa1 to conduct 6-month-post-operation histomorphometrical and histochemical analysis of osteocalcin in bone regeneration following sinus-floor augmentation procedures using β-tricalcium phosphate (β-TCP) and autogenous cortical bone. Thirteen sinuses of nine patients were treated with sinus-floor augmentation using 50% β-TCP and 50% autogenous cancellous bone harvested from the ramus of the mandible. Biopsies of augmented sinuses were taken at 6 months for histomorphometric and immunohistochemical measurements. Runx2/Cbfa1- and osteocalcin-positive cells were found around TCP particles and on the bone surface. Approximately 60% of cells found around TCP particles stained positive for Runx2/Cbfa1. Fewer cells stained positive for osteocalcin. These positive cells decreased apically with increasing vertical distance from the maxillary bone surface. Histomorphometric analysis showed that the augmented site close to residual bone and periosteum contained approximately 42% bony tissue and 42% soft connective tissue, and the remaining 16% consisted of TCP particles. On the other hand, the augmented bone far from residual bone and periosteum contained 35% bony tissue and 50% soft connective tissue. Our data suggest that TCP particles attract osteoprogenitor cells that migrate into the interconnecting micropores of the bone-substitute material by 6 months. The augmented site close to residual bone contained a higher proportion of bony tissue and a lower proportion of soft connective tissue than did the augmented site far from residual bone. © 2012 John Wiley & Sons A/S.

  6. Maxillary sinus floor augmentation using a nano-crystalline hydroxyapatite silica gel: case series and 3-month preliminary histological results.

    Canullo, Luigi; Dellavia, Claudia; Heinemann, Friedhelm

    2012-03-20

    The aim of this case series is to histologically examine a new hydroxyapatite in sinus lift procedure after 3 months. Ten 2-stage sinus lifts were performed in 10 healthy patients having initial bone height of 1-2mm and bone width of 5mm, asking for a fixed implant-supported rehabilitation. After graft material augmentation, a rough-surfaced mini-implant was inserted to maintain stability of the sinus widow. A bioptical core containing a mini-implant was retrieved 3 months after maxillary sinus augmentation with NanoBone(®) and processed for undecalcified histology. From the histomorphometric analysis, NanoBone(®) residuals accounted for the 38.26% ± 8.07% of the bioptical volume, marrow spaces for the 29.23% ± 5.18% and bone for the 32.51% ± 4.96% (new bone: 20.64% ± 2.96%, native bone: 11.87% ± 3.27%). Well-mineralized regenerated bone with lamellar parallel-fibred structure and Haversian systems surrounded the residual NanoBone(®) particles. The measured bone-to-implant contact amounted to 26.02% ± 5.46%. No connective tissue was observed at the implant boundary surface. In conclusion, the tested material showed good histological outcomes also 3 months after surgery. In such critical conditions, the use of a rough-surfaced mini-implant showed BIC values supposed to be effective also in case of functional loading. Although longer follow-up and a wider patient size are needed, these preliminary results encourage further research on this biomaterial for implant load also under early stage and critical conditions. Copyright © 2011 Elsevier GmbH. All rights reserved.

  7. Augmented reality in neurovascular surgery: feasibility and first uses in the operating room.

    Kersten-Oertel, Marta; Gerard, Ian; Drouin, Simon; Mok, Kelvin; Sirhan, Denis; Sinclair, David S; Collins, D Louis

    2015-11-01

    The aim of this report is to present a prototype augmented reality (AR) intra-operative brain imaging system. We present our experience of using this new neuronavigation system in neurovascular surgery and discuss the feasibility of this technology for aneurysms, arteriovenous malformations (AVMs), and arteriovenous fistulae (AVFs). We developed an augmented reality system that uses an external camera to capture the live view of the patient on the operating room table and to merge this view with pre-operative volume-rendered vessels. We have extensively tested the system in the laboratory and have used the system in four surgical cases: one aneurysm, two AVMs and one AVF case. The developed AR neuronavigation system allows for precise patient-to-image registration and calibration of the camera, resulting in a well-aligned augmented reality view. Initial results suggest that augmented reality is useful for tailoring craniotomies, localizing vessels of interest, and planning resection corridors. Augmented reality is a promising technology for neurovascular surgery. However, for more complex anomalies such as AVMs and AVFs, better visualization techniques that allow one to distinguish between arteries and veins and determine the absolute depth of a vessel of interest are needed.

  8. Experimental Evaluation of the Effectiveness of Demineralized Bone Matrix and Collagenated Heterologous Bone Grafts Used Alone or in Combination with Platelet-Rich Fibrin on Bone Healing in Sinus Floor Augmentation.

    Peker, Elif; Karaca, Inci Rana; Yildirim, Benay

    2016-01-01

    The aim of this study was an experimental evaluation of the effectiveness of demineralized bone matrix (DBM) and collagenated heterologous bone graft (CHBG) used alone or in combination with platelet-rich fibrin on bone healing in sinus floor augmentation procedures. In this study, 36 New Zealand rabbits were used. The bilateral sinus elevation was performed, and 72 defects were obtained. The rabbit maxillary sinuses were divided into four groups according to the augmentation biomaterials obtained: demineralized bone matrix (Grafton DBM Putty, Osteotech; DBM group), DBM combined with platelet-rich fibrin (PRF; DBM + PRF group), collagenated heterologous bone graft (CHBG; Apatos Mix, OsteoBiol, Tecnoss; CHBG group), CHBG combined with PRF (CHBG + PRF group). All groups were sacrificed at 2, 4, and 8 weeks after surgery for histologic, histomorphometric, and immunohistochemical analyses. The inflammatory reaction was moderate to intense at the second week in all groups and declined from 2 to 8 weeks. New bone formation was started at the second week and increased from 2 to 8 weeks in all groups. There was no significant difference in bone formation between the experimental groups that used PRF mixed graft material and control groups that used only graft material. The percentage of new bone formation showed a significant difference in DBM groups and DBM + PRF groups compared with other groups. There were osteoclasts around all the bone graft materials used, but the percentage of residual graft particles was significantly higher in CHBG groups and CHBG + PRF groups at the eighth week. There is no beneficial effect of the application of PRF in combination with demineralized bone matrix or collagenated heterologous bone graft on bone formation in sinus floor augmentation. The results of this study showed that both collagenated heterologous bone graft and demineralized bone matrix have osteoconductive properties, but demineralized bone matrix showed more bone formation

  9. Design and Validation of an Augmented Reality System for Laparoscopic Surgery in a Real Environment

    López-Mir, F.; Naranjo, V.; Fuertes, J. J.; Alcañiz, M.; Bueno, J.; Pareja, E.

    2013-01-01

    Purpose. This work presents the protocol carried out in the development and validation of an augmented reality system which was installed in an operating theatre to help surgeons with trocar placement during laparoscopic surgery. The purpose of this validation is to demonstrate the improvements that this system can provide to the field of medicine, particularly surgery. Method. Two experiments that were noninvasive for both the patient and the surgeon were designed. In one of these experiments the augmented reality system was used, the other one was the control experiment, and the system was not used. The type of operation selected for all cases was a cholecystectomy due to the low degree of complexity and complications before, during, and after the surgery. The technique used in the placement of trocars was the French technique, but the results can be extrapolated to any other technique and operation. Results and Conclusion. Four clinicians and ninety-six measurements obtained of twenty-four patients (randomly assigned in each experiment) were involved in these experiments. The final results show an improvement in accuracy and variability of 33% and 63%, respectively, in comparison to traditional methods, demonstrating that the use of an augmented reality system offers advantages for trocar placement in laparoscopic surgery. PMID:24236293

  10. Design and Validation of an Augmented Reality System for Laparoscopic Surgery in a Real Environment

    F. López-Mir

    2013-01-01

    Full Text Available Purpose. This work presents the protocol carried out in the development and validation of an augmented reality system which was installed in an operating theatre to help surgeons with trocar placement during laparoscopic surgery. The purpose of this validation is to demonstrate the improvements that this system can provide to the field of medicine, particularly surgery. Method. Two experiments that were noninvasive for both the patient and the surgeon were designed. In one of these experiments the augmented reality system was used, the other one was the control experiment, and the system was not used. The type of operation selected for all cases was a cholecystectomy due to the low degree of complexity and complications before, during, and after the surgery. The technique used in the placement of trocars was the French technique, but the results can be extrapolated to any other technique and operation. Results and Conclusion. Four clinicians and ninety-six measurements obtained of twenty-four patients (randomly assigned in each experiment were involved in these experiments. The final results show an improvement in accuracy and variability of 33% and 63%, respectively, in comparison to traditional methods, demonstrating that the use of an augmented reality system offers advantages for trocar placement in laparoscopic surgery.

  11. Measuring the Latency of an Augmented Reality System for Robot-Assisted Minimally Invasive Surgery

    Jørgensen, Martin Kibsgaard; Kraus, Martin

    2017-01-01

    Minimal latency is important for augmented reality systems and teleoperation interfaces as even small increases in latency can affect user performance. Previously, we have developed an augmented reality system that can overlay stereoscopic video streams with computer graphics in order to improve....... The latency of the da Vinci S surgical system was on average 62 ms. None of the components of our overlay system (separately or combined) significantly affected the latency. However, the latency of the assistant's monitor increased by 14 ms. Passing the video streams through CPU or GPU memory increased...... visual communication in training for robot-assisted minimally invasive surgery with da Vinci surgical systems. To make sure that our augmented reality system provides the best possible user experience, we investigated the video latency of the da Vinci surgical system and how the components of our system...

  12. Dynamic evaluation of pelvic floor reconstructive surgery using radiopaque meshes and three-dimensional helical CT

    Paulo Palma

    2010-04-01

    Full Text Available PURPOSE: This prospective study was performed to achieve visualization of the reestablishment of anatomy after reconstructive surgery in the different pelvic compartments with non-absorbable radiopaque meshes, providing valuable anatomic information for surgeons implanting meshes. MATERIALS AND METHODS: A total of 30 female patients with stress urinary incontinence (SUI, anterior and posterior vaginal wall prolapse, or both underwent surgical repair using radiopaque meshes after written informed consent. Patients with SUI underwent five different surgeries. Patients with anterior vaginal prolapse underwent a procedure using a combined pre-pubic and transobturator mesh, and those with posterior vaginal prolapse underwent posterior slingplasty. Three-dimensional reconstruction using helical CT was performed four weeks postoperatively. RESULTS: In all cases, the mesh was clearly visualized. Transobturator slings were shown at the midurethra, and the anchoring tails perforated the obturator foramen at the safety region. Mini-slings were in the proper place, and computed angiography revealed that the anchoring system was away from the obturator vessels. In patients undergoing procedure for anterior vaginal prolapse, both pre-pubic armpit and obturator slings were clearly seen and the mesh was in the proper position, supporting the bladder base and occluding the distal part of the urogenital hiatus. Transcoccygeal sacropexy revealed indirectly a well-supported "neo rectovaginal fascia" and the anchoring tails at the level of ischial spines. CONCLUSION: Three-dimensional helical tomography images of the female pelvis using radiopaque meshes have a potential role in improving our understanding of pelvic floor reconstructive surgeries. These radiopaque meshes might be the basis of a new investigative methodology.

  13. Sellar Floor Reconstruction with the Medpor Implant Versus Autologous Bone After Transnasal Transsphenoidal Surgery: Outcome in 200 Consecutive Patients.

    Liebelt, Brandon D; Huang, Meng; Baskin, David S

    2015-08-01

    The Medpor porous polyethylene implant provides benefits to perform sellar floor reconstruction when indicated. This material has been used for cranioplasty and reconstruction of skull base defects and facial fractures. We present the most extensive use of this implant for sellar floor reconstruction and document the safety and benefits provided by this unique implant. The medical charts for 200 consecutive patients undergoing endonasal transsphenoidal surgery from April 2008 through December 2011 were reviewed. Material used for sellar floor reconstruction, pathologic diagnosis, immediate inpatient complications, and long-term complications were documented and analyzed. Outpatient follow-up was documented for a minimum of 1-year duration, extending in some patients up to 5 years. Of the 200 consecutive patients, 136 received sellar floor cranioplasty using the Medpor implant. Postoperative complications included 6 complaints of sinus irritation or drainage, 1 postoperative cerebrospinal fluid leak requiring operative re-exploration, 1 event of tension pneumocephalus requiring operative decompression, 1 case of aseptic meningitis, 1 subdural hematoma, and 1 case of epistaxis. The incidence of these complications did not differ from the autologous nasal bone group in a statistically significant manner. Sellar floor reconstruction remains an important part of transsphenoidal surgery to prevent postoperative complications. Various autologous and synthetic options are available to reconstruct the sellar floor, and the Medpor implant is a safe and effective option. The complication rate after surgery is equivalent to or less frequent than other methods of reconstruction and the implant is readily incorporated into host tissue after implantation, minimizing infectious risk. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. A study of an assisting robot for mandible plastic surgery based on augmented reality.

    Shi, Yunyong; Lin, Li; Zhou, Chaozheng; Zhu, Ming; Xie, Le; Chai, Gang

    2017-02-01

    Mandible plastic surgery plays an important role in conventional plastic surgery. However, its success depends on the experience of the surgeons. In order to improve the effectiveness of the surgery and release the burden of surgeons, a mandible plastic surgery assisting robot, based on an augmented reality technique, was developed. Augmented reality assists surgeons to realize positioning. Fuzzy control theory was used for the control of the motor. During the process of bone drilling, both the drill bit position and the force were measured by a force sensor which was used to estimate the position of the drilling procedure. An animal experiment was performed to verify the effectiveness of the robotic system. The position error was 1.07 ± 0.27 mm and the angle error was 5.59 ± 3.15°. The results show that the system provides a sufficient accuracy with which a precise drilling procedure can be performed. In addition, under the supervision's feedback of the sensor, an adequate safety level can be achieved for the robotic system. The system realizes accurate positioning and automatic drilling to solve the problems encountered in the drilling procedure, providing a method for future plastic surgery.

  15. What is going on in augmented reality simulation in laparoscopic surgery?

    Botden, Sanne M B I; Jakimowicz, Jack J

    2009-08-01

    To prevent unnecessary errors and adverse results of laparoscopic surgery, proper training is of paramount importance. A safe way to train surgeons for laparoscopic skills is simulation. For this purpose traditional box trainers are often used, however they lack objective assessment of performance. Virtual reality laparoscopic simulators assess performance, but lack realistic haptic feedback. Augmented reality (AR) combines a virtual reality (VR) setting with real physical materials, instruments, and feedback. This article presents the current developments in augmented reality laparoscopic simulation. Pubmed searches were performed to identify articles regarding surgical simulation and augmented reality. Identified companies manufacturing an AR laparoscopic simulator received the same questionnaire referring to the features of the simulator. Seven simulators that fitted the definition of augmented reality were identified during the literature search. Five of the approached manufacturers returned a completed questionnaire, of which one simulator appeared to be VR and was therefore not applicable for this review. Several augmented reality simulators have been developed over the past few years and they are improving rapidly. We recommend the development of AR laparoscopic simulators for component tasks of procedural training. AR simulators should be implemented in current laparoscopic training curricula, in particular for laparoscopic suturing training.

  16. Reconstruction of the sellar floor using a silicone plate in transsphenoidal surgery and its postoperative appearance on magnetic resonance images

    Kabuto, Masanori; Kubota, Toshihiko; Kobayashi, Hidenori; Sato, Kazufumi; Ishii, Hisao; Nakagawa, Takao; Arai, Ryowa; Kitai, Ryuhei; Tuchida, Akira

    1993-01-01

    The reconstruction of the sellar floor using a silicone plate in transsphenoidal surgery and its postoperative appearance on magnetic resonance (MR) images are described. Thirty-eight patients with pituitary adenoma and four with Rathke's cleft cyst underwent this operation and postoperative MR imaging over a 4-year period. A fitting silicone plate for closing of the sellar floor window could be easily made from a large silicone block at the operation. The postoperative position of the silicone plate could be clearly detected by MR imaging as a very low intensity plate on both T1- and T2-weighted sagittal images. (author)

  17. A Novel Augmented Reality Navigation System for Endoscopic Sinus and Skull Base Surgery: A Feasibility Study.

    Liang Li

    Full Text Available To verify the reliability and clinical feasibility of a self-developed navigation system based on an augmented reality technique for endoscopic sinus and skull base surgery.In this study we performed a head phantom and cadaver experiment to determine the display effect and accuracy of our navigational system. We compared cadaver head-based simulated operations, the target registration error, operation time, and National Aeronautics and Space Administration Task Load Index scores of our navigation system to conventional navigation systems.The navigation system developed in this study has a novel display mode capable of fusing endoscopic images to three-dimensional (3-D virtual images. In the cadaver head experiment, the target registration error was 1.28 ± 0.45 mm, which met the accepted standards of a navigation system used for nasal endoscopic surgery. Compared with conventional navigation systems, the new system was more effective in terms of operation time and the mental workload of surgeons, which is especially important for less experienced surgeons.The self-developed augmented reality navigation system for endoscopic sinus and skull base surgery appears to have advantages that outweigh those of conventional navigation systems. We conclude that this navigational system will provide rhinologists with more intuitive and more detailed imaging information, thus reducing the judgment time and mental workload of surgeons when performing complex sinus and skull base surgeries. Ultimately, this new navigational system has potential to increase the quality of surgeries. In addition, the augmented reality navigational system could be of interest to junior doctors being trained in endoscopic techniques because it could speed up their learning. However, it should be noted that the navigation system serves as an adjunct to a surgeon's skills and knowledge, not as a substitute.

  18. A Novel Augmented Reality Navigation System for Endoscopic Sinus and Skull Base Surgery: A Feasibility Study

    Li, Liang; Yang, Jian; Chu, Yakui; Wu, Wenbo; Xue, Jin; Liang, Ping; Chen, Lei

    2016-01-01

    Objective To verify the reliability and clinical feasibility of a self-developed navigation system based on an augmented reality technique for endoscopic sinus and skull base surgery. Materials and Methods In this study we performed a head phantom and cadaver experiment to determine the display effect and accuracy of our navigational system. We compared cadaver head-based simulated operations, the target registration error, operation time, and National Aeronautics and Space Administration Task Load Index scores of our navigation system to conventional navigation systems. Results The navigation system developed in this study has a novel display mode capable of fusing endoscopic images to three-dimensional (3-D) virtual images. In the cadaver head experiment, the target registration error was 1.28 ± 0.45 mm, which met the accepted standards of a navigation system used for nasal endoscopic surgery. Compared with conventional navigation systems, the new system was more effective in terms of operation time and the mental workload of surgeons, which is especially important for less experienced surgeons. Conclusion The self-developed augmented reality navigation system for endoscopic sinus and skull base surgery appears to have advantages that outweigh those of conventional navigation systems. We conclude that this navigational system will provide rhinologists with more intuitive and more detailed imaging information, thus reducing the judgment time and mental workload of surgeons when performing complex sinus and skull base surgeries. Ultimately, this new navigational system has potential to increase the quality of surgeries. In addition, the augmented reality navigational system could be of interest to junior doctors being trained in endoscopic techniques because it could speed up their learning. However, it should be noted that the navigation system serves as an adjunct to a surgeon’s skills and knowledge, not as a substitute. PMID:26757365

  19. Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft: a systematic review

    Jensen, Thomas; Schou, Søren; Stavropoulos, Andreas

    2012-01-01

    Aims: The objective of the present systematic review was to test the hypothesis of no differences in the implant treatment outcome when Bio-Oss or Bio-Oss mixed with autogenous bone is used as graft for the maxillary sinus floor augmentation (MSFA) applying the lateral window technique. Material...... and methods: A MEDLINE (PubMed) search in combination with a hand search of relevant journals was conducted by including human studies published in English from January 1, 1990 to June 1, 2010. The search provided 879 titles and 35 studies fulfilled the inclusion criteria. Considerable variation...... in the included studies prevented meta-analysis from being performed and no long-term study comparing MSFA with the two treatment modalities was identified. Also, the survival of suprastructures after the two augmentation procedures was not compared within the same study. Results: The 1-year implant survival...

  20. Deformable three-dimensional model architecture for interactive augmented reality in minimally invasive surgery.

    Vemuri, Anant S; Wu, Jungle Chi-Hsiang; Liu, Kai-Che; Wu, Hurng-Sheng

    2012-12-01

    Surgical procedures have undergone considerable advancement during the last few decades. More recently, the availability of some imaging methods intraoperatively has added a new dimension to minimally invasive techniques. Augmented reality in surgery has been a topic of intense interest and research. Augmented reality involves usage of computer vision algorithms on video from endoscopic cameras or cameras mounted in the operating room to provide the surgeon additional information that he or she otherwise would have to recognize intuitively. One of the techniques combines a virtual preoperative model of the patient with the endoscope camera using natural or artificial landmarks to provide an augmented reality view in the operating room. The authors' approach is to provide this with the least number of changes to the operating room. Software architecture is presented to provide interactive adjustment in the registration of a three-dimensional (3D) model and endoscope video. Augmented reality including adrenalectomy, ureteropelvic junction obstruction, and retrocaval ureter and pancreas was used to perform 12 surgeries. The general feedback from the surgeons has been very positive not only in terms of deciding the positions for inserting points but also in knowing the least change in anatomy. The approach involves providing a deformable 3D model architecture and its application to the operating room. A 3D model with a deformable structure is needed to show the shape change of soft tissue during the surgery. The software architecture to provide interactive adjustment in registration of the 3D model and endoscope video with adjustability of every 3D model is presented.

  1. Imaging Evaluation of the Location and Fenestration of Sellar Floor during Endonasal Transsphenoidal Surgery in Patients with Pituitary Adenomas.

    Wang, Shousen; Qin, Yong; Xiao, Deyong; Wu, Zhifeng; Wei, Liangfeng

    2018-05-03

    To evaluate the clinical value of three-dimensional (3D) CT reconstruction of the sphenoidal sinus separation in localizing sellar floor during endonasal transsphenoidal surgery, and determine the size and location of sellar floor fenestration. After exclusion,51 patients were eligible for study inclusion. A pre-operative CT scan of the paranasal sinus and CT scan and MRI of the pituitary gland were obtained. Sphenoidal sinus separation was reconstructed using Mimics 15.0 software and the quantity, shape, and orientation were observed and compared with intra-operative data, the purpose of which was to guide the localization of sellar floor. Anatomic variation of the sphenoidal sinus and adjacent structures, tumor and sella turcica morphology, minimal distance between the cavernous segment of the internal carotid artery(CSICA) bilaterally, and the shortest distance from the midline were measured. Based upon the shape of the sphenoidal sinus separation, sellar floor was accurately localized in all cases. Intra-operative sphenoidal sinus separation was consistent with pre-operative 3D CT reconstruction images. The sellar floor was extremely small in two patients, and insufficient fenestration of the sellar floor negatively affected tumor resection. Pre-operative 3D CT reconstruction is helpful for accurate and rapid localization of the saddle floor. The anatomic variation of sphenoidal sinus and adjacent structures, the characteristics of tumor and Sella, the minimum distance between bilateral CSICA and the shortest distance from the midline are helpful for the establishment of individualized Sellar bottom fenestration. Copyright © 2018. Published by Elsevier Inc.

  2. Augmented and virtual reality in surgery-the digital surgical environment: applications, limitations and legal pitfalls.

    Khor, Wee Sim; Baker, Benjamin; Amin, Kavit; Chan, Adrian; Patel, Ketan; Wong, Jason

    2016-12-01

    The continuing enhancement of the surgical environment in the digital age has led to a number of innovations being highlighted as potential disruptive technologies in the surgical workplace. Augmented reality (AR) and virtual reality (VR) are rapidly becoming increasingly available, accessible and importantly affordable, hence their application into healthcare to enhance the medical use of data is certain. Whether it relates to anatomy, intraoperative surgery, or post-operative rehabilitation, applications are already being investigated for their role in the surgeons armamentarium. Here we provide an introduction to the technology and the potential areas of development in the surgical arena.

  3. Measuring the Latency of an Augmented Reality System for Robot-Assisted Minimally Invasive Surgery

    Jørgensen, Martin Kibsgaard; Kraus, Martin

    2017-01-01

    visual communication in training for robot-assisted minimally invasive surgery with da Vinci surgical systems. To make sure that our augmented reality system provides the best possible user experience, we investigated the video latency of the da Vinci surgical system and how the components of our system...... affect the overall latency. To measure the photon-to-photon latency, we used a microcontroller to determine the time between the activation of a lightemitting diode in front of the endoscopic camera and the corresponding increase in intensity of the surgeon's display as measured by a phototransistor...

  4. Method, apparatus, and system for utilizing augmented reality to improve surgery

    Cali, Corrado

    2016-10-13

    A method, apparatus, and computer readable medium are provided for utilizing augmented reality visualization to assist surgery. An example method includes generating a three dimensional reconstruction of an image stack representing a target area of a patient, and superimposing, by a head-mounted display, a projection of the three dimensional reconstruction onto a field of view of a user. The method further includes maintaining alignment between the projection and the user\\'s actual view of the target area using a plurality of fiducial markers associated with the target area. In some embodiments, the method further includes scanning the target area to generate the image stack.

  5. Piezosurgery in Bone Augmentation Procedures Previous to Dental Implant Surgery: A Review of the Literature

    Magrin, Gabriel Leonardo; Sigua-Rodriguez, Eder Alberto; Goulart, Douglas Rangel; Asprino, Luciana

    2015-01-01

    The piezosurgery has been used with increasing frequency and applicability by health professionals, especially those who deal with dental implants. The concept of piezoelectricity has emerged in the nineteenth century, but it was applied in oral surgery from 1988 by Tomaso Vercellotti. It consists of an ultrasonic device able to cut mineralized bone tissue, without injuring the adjacent soft tissue. It also has several advantages when compared to conventional techniques with drills and saws, such as the production of a precise, clean and low bleed bone cut that shows positive biological results. In dental implants surgery, it has been used for maxillary sinus lifting, removal of bone blocks, distraction osteogenesis, lateralization of the inferior alveolar nerve, split crest of alveolar ridge and even for dental implants placement. The purpose of this paper is to discuss the use of piezosurgery in bone augmentation procedures used previously to dental implants placement. PMID:26966469

  6. In vivo estimation of target registration errors during augmented reality laparoscopic surgery.

    Thompson, Stephen; Schneider, Crispin; Bosi, Michele; Gurusamy, Kurinchi; Ourselin, Sébastien; Davidson, Brian; Hawkes, David; Clarkson, Matthew J

    2018-06-01

    Successful use of augmented reality for laparoscopic surgery requires that the surgeon has a thorough understanding of the likely accuracy of any overlay. Whilst the accuracy of such systems can be estimated in the laboratory, it is difficult to extend such methods to the in vivo clinical setting. Herein we describe a novel method that enables the surgeon to estimate in vivo errors during use. We show that the method enables quantitative evaluation of in vivo data gathered with the SmartLiver image guidance system. The SmartLiver system utilises an intuitive display to enable the surgeon to compare the positions of landmarks visible in both a projected model and in the live video stream. From this the surgeon can estimate the system accuracy when using the system to locate subsurface targets not visible in the live video. Visible landmarks may be either point or line features. We test the validity of the algorithm using an anatomically representative liver phantom, applying simulated perturbations to achieve clinically realistic overlay errors. We then apply the algorithm to in vivo data. The phantom results show that using projected errors of surface features provides a reliable predictor of subsurface target registration error for a representative human liver shape. Applying the algorithm to in vivo data gathered with the SmartLiver image-guided surgery system shows that the system is capable of accuracies around 12 mm; however, achieving this reliably remains a significant challenge. We present an in vivo quantitative evaluation of the SmartLiver image-guided surgery system, together with a validation of the evaluation algorithm. This is the first quantitative in vivo analysis of an augmented reality system for laparoscopic surgery.

  7. Landmark-based augmented reality system for paranasal and transnasal endoscopic surgeries.

    Thoranaghatte, Ramesh; Garcia, Jaime; Caversaccio, Marco; Widmer, Daniel; Gonzalez Ballester, Miguel A; Nolte, Lutz-P; Zheng, Guoyan

    2009-12-01

    In this paper we present a landmark-based augmented reality (AR) endoscope system for endoscopic paranasal and transnasal surgeries along with fast and automatic calibration and registration procedures for the endoscope. Preoperatively the surgeon selects natural landmarks or can define new landmarks in CT volume. These landmarks are overlaid, after proper registration of preoperative CT to the patient, on the endoscopic video stream. The specified name of the landmark, along with selected colour and its distance from the endoscope tip, is also augmented. The endoscope optics are calibrated and registered by fast and automatic methods. Accuracy of the system is evaluated in a metallic grid and cadaver set-up. Root mean square (RMS) error of the system is 0.8 mm in a controlled laboratory set-up (metallic grid) and was 2.25 mm during cadaver studies. A novel landmark-based AR endoscope system is implemented and its accuracy is evaluated. Augmented landmarks will help the surgeon to orientate and navigate the surgical field. Studies prove the capability of the system for the proposed application. Further clinical studies are planned in near future. Copyright (c) 2009 John Wiley & Sons, Ltd.

  8. Augmented reality as an aid in maxillofacial surgery: validation of a wearable system allowing maxillary repositioning.

    Badiali, Giovanni; Ferrari, Vincenzo; Cutolo, Fabrizio; Freschi, Cinzia; Caramella, Davide; Bianchi, Alberto; Marchetti, Claudio

    2014-12-01

    We present a newly designed, localiser-free, head-mounted system featuring augmented reality as an aid to maxillofacial bone surgery, and assess the potential utility of the device by conducting a feasibility study and validation. Our head-mounted wearable system facilitating augmented surgery was developed as a stand-alone, video-based, see-through device in which the visual features were adapted to facilitate maxillofacial bone surgery. We implement a strategy designed to present augmented reality information to the operating surgeon. LeFort1 osteotomy was chosen as the test procedure. The system is designed to exhibit virtual planning overlaying the details of a real patient. We implemented a method allowing performance of waferless, augmented-reality assisted bone repositioning. In vitro testing was conducted on a physical replica of a human skull, and the augmented reality system was used to perform LeFort1 maxillary repositioning. Surgical accuracy was measured with the aid of an optical navigation system that recorded the coordinates of three reference points (located in anterior, posterior right, and posterior left positions) on the repositioned maxilla. The outcomes were compared with those expected to be achievable in a three-dimensional environment. Data were derived using three levels of surgical planning, of increasing complexity, and for nine different operators with varying levels of surgical skill. The mean error was 1.70 ± 0.51 mm. The axial errors were 0.89 ± 0.54 mm on the sagittal axis, 0.60 ± 0.20 mm on the frontal axis, and 1.06 ± 0.40 mm on the craniocaudal axis. The simplest plan was associated with a slightly lower mean error (1.58 ± 0.37 mm) compared with the more complex plans (medium: 1.82 ± 0.71 mm; difficult: 1.70 ± 0.45 mm). The mean error for the anterior reference point was lower (1.33 ± 0.58 mm) than those for both the posterior right (1.72 ± 0.24 mm) and posterior left points (2.05 ± 0.47 mm). No significant difference

  9. Augmentation Phalloplasty Patient Selection and Satisfaction Inventory: a novel questionnaire to evaluate patients considered for augmentation phalloplasty surgery because of penile dysmorphophobia.

    Spyropoulos, Evangelos; Galanakis, Ioannis; Dellis, Athanasios

    2007-08-01

    To introduce a novel questionnaire by which we attempted to identify the most suitable candidates for augmentation phalloplasty surgery for penile dysmorphophobia and to objectively estimate the outcome. A total of 45 physically normal young adult men who presented with complaints of a "small penis" and were seeking surgical correction were included in the study. In addition to the ordinary evaluation, all completed the questionnaire devised by our department, the Augmentation Phalloplasty Patient Selection and Satisfaction Inventory (APPSSI). The APPSSI aims to quantitatively assess the severity of the condition and the degree of the patient's willingness to undergo penile augmentation and to numerically measure the postoperative result. The APPSSI consists of four questions, with each having five possible answers (scale 0 to 4). Questions 1 through 3 were asked preoperatively (suitability assessment) and questions 1, 2, and 4 postoperatively (outcome evaluation). The eligibility threshold for surgery was a preoperative score of 6 or less. The preoperative scores ranged from 0 (surgery justified) to 12 (surgery not justified), and the postoperative scores ranged from 0 (disappointed) to 12 (excited). The Student t test was used for statistical analysis, and P enlargement (n = 4), or celioplasty-penile lengthening (n = 2). Postoperatively, the score increased by 4.36 (mean 7.54, P <0.001), and the condition improved by 25% to 50% in 11 patients, 66.6% in 1, and remained unchanged (0%) in 1 patient. The APPSSI questionnaire properly identified patients who significantly benefited from augmentation phalloplasty. Nevertheless, because of the small sample size and nonrandomized study, the questionnaire's validation requires a larger number of patients tested in a randomized manner by more researchers to become a valuable clinical instrument and patient eligibility criterion for this type of surgery.

  10. Real-time geometry-aware augmented reality in minimally invasive surgery.

    Chen, Long; Tang, Wen; John, Nigel W

    2017-10-01

    The potential of augmented reality (AR) technology to assist minimally invasive surgery (MIS) lies in its computational performance and accuracy in dealing with challenging MIS scenes. Even with the latest hardware and software technologies, achieving both real-time and accurate augmented information overlay in MIS is still a formidable task. In this Letter, the authors present a novel real-time AR framework for MIS that achieves interactive geometric aware AR in endoscopic surgery with stereo views. The authors' framework tracks the movement of the endoscopic camera and simultaneously reconstructs a dense geometric mesh of the MIS scene. The movement of the camera is predicted by minimising the re-projection error to achieve a fast tracking performance, while the three-dimensional mesh is incrementally built by a dense zero mean normalised cross-correlation stereo-matching method to improve the accuracy of the surface reconstruction. The proposed system does not require any prior template or pre-operative scan and can infer the geometric information intra-operatively in real time. With the geometric information available, the proposed AR framework is able to interactively add annotations, localisation of tumours and vessels, and measurement labelling with greater precision and accuracy compared with the state-of-the-art approaches.

  11. Saksenaea erythrospora infection after medical tourism for esthetic breast augmentation surgery.

    Rodríguez, José Y; Rodríguez, Gerson J; Morales-López, Soraya E; Cantillo, Carlos E; Le Pape, Patrice; Álvarez-Moreno, Carlos A

    2016-08-01

    Mucormycosis caused by Saksenaea erythrospora is rarely reported in humans. Three previous cases have been reported in the literature, two associated with trauma (a sailing accident in Argentina and a combat trauma in Iraq) and one as a cause of invasive rhinosinusitis (India), all in immunocompetent patients . The first case of mucormycosis following esthetic surgery, associated with medical tourism, is reported herein. A case study of an S. erythrospora infection in an immunocompetent woman after the completion of esthetic surgery (dermolipectomy and breast augmentation) is reported. The infection presented as a rapidly progressive necrotizing infection of the skin and soft tissue, which required a bilateral mastectomy and extensive surgical debridement associated with prolonged antifungal therapy. The organism was identified phenotypically and confirmed biologically after rDNA amplification and sequencing. Two months later, the patient remains hospitalized awaiting the start of reconstructive surgeries. The present case is, to the best of the authors' knowledge, the first report from Colombia. Mucormycosis should be considered in the differential diagnosis of necrotizing infections of the skin and soft tissue that evolve rapidly after cosmetic surgery performed in tropical or subtropical countries. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. General or Spinal Anaesthetic for Vaginal Surgery in Pelvic Floor Disorders (GOSSIP): a feasibility randomised controlled trial.

    Purwar, B; Ismail, K M; Turner, N; Farrell, A; Verzune, M; Annappa, M; Smith, I; El-Gizawy, Zeiad; Cooper, J C

    2015-08-01

    Spinal anaesthesia (SA) and general anaesthesia (GA) are widely used techniques for vaginal surgery for pelvic floor disorders with inconclusive evidence of the superiority of either. We conducted a randomised controlled trial (RCT) to assess the feasibility of a full scale RCT aiming to examine the effect of anaesthetic mode for vaginal surgery on operative, patient reported and length of hospital stay (LOHS) outcomes. Patients undergoing vaginal surgery, recruited through a urogynaecology service in a University teaching hospital, were randomised to receive either GA or SA. Patients were followed up for 12 weeks postoperatively. Pain was measured on a visual analogue scale; nausea was assessed with a four-point verbal rating scale. Patient's subjective perception of treatment outcome, quality of life (QoL) and functional outcomes were assessed using the International Consultation on Incontinence Modular Questionnaire (ICIQ) on vaginal symptoms and the SF-36 questionnaire. Sixty women were randomised, 29 to GA and 31 to SA. The groups were similar in terms of age and type of vaginal surgery performed. No statistically significant differences were noted between the groups with regard to pain, nausea, quality of life (QoL), functional outcomes as well as length of stay in the postoperative recovery room, use of analgesia postoperatively and LOHS. This study has demonstrated that a full RCT is feasible and should focus on the length of hospital stay in a subgroup of patients undergoing vaginal surgery where SA may help to facilitate enhanced recovery or day surgery.

  13. Ethics, economics and the regulation and adoption of new medical devices: case studies in pelvic floor surgery

    Ross Sue

    2010-08-01

    Full Text Available Abstract Background Concern has been growing in the academic literature and popular media about the licensing, introduction and adoption of surgical devices before full effectiveness and safety evidence is available to inform clinical practice. Our research will seek empirical survey evidence about the roles, responsibilities, and information and policy needs of the key stakeholders in the introduction into clinical practice of new surgical devices for pelvic floor surgery, in terms of the underlying ethical principals involved in the economic decision-making process, using the example of pelvic floor procedures. Methods/Design Our study involves three linked case studies using, as examples, selected pelvic floor surgery devices representing Health Canada device safety risk classes: low, medium and high risk. Data collection will focus on stakeholder roles and responsibilities, information and policy needs, and perceptions of those of other key stakeholders, in seeking and using evidence about new surgical devices when licensing and adopting them into practice. For each class of device, interviews will be used to seek the opinions of stakeholders. The following stakeholders and ethical and economic principles provide the theoretical framework for the study: Stakeholders - federal regulatory body, device manufacturers, clinicians, patients, health care institutions, provincial health departments, and professional societies. Clinical settings in two centres (in different provinces will be included. Ethics - beneficence, non-maleficence, autonomy, justice. Economics - scarcity of resources, choices, opportunity costs. For each class of device, responses will be analysed to compare and contrast between stakeholders. Applied ethics and economic theory, analysis and critical interpretation will be used to further illuminate the case study material. Discussion The significance of our research in this new area of ethics will lie in providing

  14. Ethics, economics and the regulation and adoption of new medical devices: case studies in pelvic floor surgery

    2010-01-01

    Background Concern has been growing in the academic literature and popular media about the licensing, introduction and adoption of surgical devices before full effectiveness and safety evidence is available to inform clinical practice. Our research will seek empirical survey evidence about the roles, responsibilities, and information and policy needs of the key stakeholders in the introduction into clinical practice of new surgical devices for pelvic floor surgery, in terms of the underlying ethical principals involved in the economic decision-making process, using the example of pelvic floor procedures. Methods/Design Our study involves three linked case studies using, as examples, selected pelvic floor surgery devices representing Health Canada device safety risk classes: low, medium and high risk. Data collection will focus on stakeholder roles and responsibilities, information and policy needs, and perceptions of those of other key stakeholders, in seeking and using evidence about new surgical devices when licensing and adopting them into practice. For each class of device, interviews will be used to seek the opinions of stakeholders. The following stakeholders and ethical and economic principles provide the theoretical framework for the study: Stakeholders - federal regulatory body, device manufacturers, clinicians, patients, health care institutions, provincial health departments, and professional societies. Clinical settings in two centres (in different provinces) will be included. Ethics - beneficence, non-maleficence, autonomy, justice. Economics - scarcity of resources, choices, opportunity costs. For each class of device, responses will be analysed to compare and contrast between stakeholders. Applied ethics and economic theory, analysis and critical interpretation will be used to further illuminate the case study material. Discussion The significance of our research in this new area of ethics will lie in providing recommendations for regulatory bodies

  15. Augmented environments for the targeting of hepatic lesions during image-guided robotic liver surgery.

    Buchs, Nicolas C; Volonte, Francesco; Pugin, François; Toso, Christian; Fusaglia, Matteo; Gavaghan, Kate; Majno, Pietro E; Peterhans, Matthias; Weber, Stefan; Morel, Philippe

    2013-10-01

    Stereotactic navigation technology can enhance guidance during surgery and enable the precise reproduction of planned surgical strategies. Currently, specific systems (such as the CAS-One system) are available for instrument guidance in open liver surgery. This study aims to evaluate the implementation of such a system for the targeting of hepatic tumors during robotic liver surgery. Optical tracking references were attached to one of the robotic instruments and to the robotic endoscopic camera. After instrument and video calibration and patient-to-image registration, a virtual model of the tracked instrument and the available three-dimensional images of the liver were displayed directly within the robotic console, superimposed onto the endoscopic video image. An additional superimposed targeting viewer allowed for the visualization of the target tumor, relative to the tip of the instrument, for an assessment of the distance between the tumor and the tool for the realization of safe resection margins. Two cirrhotic patients underwent robotic navigated atypical hepatic resections for hepatocellular carcinoma. The augmented endoscopic view allowed for the definition of an accurate resection margin around the tumor. The overlay of reconstructed three-dimensional models was also used during parenchymal transection for the identification of vascular and biliary structures. Operative times were 240 min in the first case and 300 min in the second. There were no intraoperative complications. The da Vinci Surgical System provided an excellent platform for image-guided liver surgery with a stable optic and instrumentation. Robotic image guidance might improve the surgeon's orientation during the operation and increase accuracy in tumor resection. Further developments of this technological combination are needed to deal with organ deformation during surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Psychosocial characteristics and motivational factors in woman seeking cosmetic breast augmentation surgery

    Nikolić Jelena

    2013-01-01

    Full Text Available Background/Aim. There are various opinions regarding the factors motivating women to undergo breast augmentation. The aim of this study was to estimate motivation for augmentation mammaplasty (AM, self-esteem and body image perception in breast augmentation patients. Methods. This prospective study involved AM patients operated in the Clinical Center of Vojvodina during a 3-year period. A total of 45 patients responded to our package of questionnaires designed to assess motivation for surgery, self-esteem level and body image perception. Those patients were compared to the control group of women who did not want to change their breast size, and who were similar in their age, social status and education level. Our package of questionnaires included a general questionnaire, Photographic Figure Rating Scale (PFRS and Rosenberg’s Self-Esteem Scale. Results. Differences in marital status, educational level, habitation and employment status were statistically insignificant, but there was a significantly lower body mass index (BMI in the operated women. Considering motives for surgery, a few factors were distinguished: desire to feel more feminine (82.2%, confident (75.5% and attractive (73.3%, to feel less shy with men (64.4%, to improve their sex life (46.5%, teasing history (42.2% and easier to find a partner (11.1% and job (2.2%. Both groups demonstrated a high self-esteem level, but in the AM group results were lower than in the control group. The mean current self-rating by the PFRS in the group AM was lower than in the control group (4.28 ± 1.3 vs 5.12 ± 1.23, respectively and this coincided with lower BMI in the AM group. The women in the AM group had chosen significantly smaller body size as maximally attractive, and had chosen a narrower attractive body size range than the women in the control group. Conclusion. Preoperative evaluation of patients’ motives for surgery can help surgeons to exclude woman with unrealistic expectations and

  17. Psychosocial characteristics and motivational factors in woman seeking cosmetic breast augmentation surgery.

    Nikolić, Jelena; Janjić, Zlata; Marinković, Marija; Petrović, Jelica; Bozić, Teodora

    2013-10-01

    There are various opinions regarding the factors motivating women to undergo breast augmentation. The aim of this study was to estimate motivation for augmentation mammaplasty (AM), self-esteem and body image perception in breast augmentation patients. This prospective study involved AM patients operated in the Clinical Center of Vojvodina during a 3-year period. A total of 45 patients responded to our package of questionnaires designed to assess motivation for surgery, self-esteem level and body image perception. Those patients were compared to the control group of women who did not want to change their breast size, and who were similar in their age, social status and education level. Our package of questionnaires included a general questionnaire, Photographic Figure Rating Scale (PFRS) and Rosenberg's Self-Esteem Scale. Differences in marital status, educational level, habitation and employment status were statistically insignificant, but there was a significantly lower body mass index (BMI) in the operated women. Considering motives for surgery, a few factors were distinguished: desire to feel more feminine (82.2%), confident (75.5%) and attractive (73.3%), to feel less shy with men (64.4%), to improve their sex life (46.5%), teasing history (42.2%) and easier to find a partner (11.1%) and job (2.2%). Both groups demonstrated a high self-esteem level, but in the the AM group results were lower than in the control group. The mean current self-rating by the PFRS in the group AM was lower than in the control group (4.28 +/- 1.3 vs 5.12 +/- 1.23, respectively) and this coincided with lower BMI in the AM group. The women in the AM group had chosen significantly smaller body size as maximally attractive, and had chosen a narrower attractive body size range than the women in the control group. CONCLUSION. Preoperative evaluation of patients' motives for surgery can help surgeons to exclude woman with unrealistic expectations and different psychological problems.

  18. An augmented reality platform for planning of minimally invasive cardiac surgeries

    Chen, Elvis C. S.; Sarkar, Kripasindhu; Baxter, John S. H.; Moore, John; Wedlake, Chris; Peters, Terry M.

    2012-02-01

    One of the fundamental components in all Image Guided Surgery (IGS) applications is a method for presenting information to the surgeon in a simple, effective manner. This paper describes the first steps in our new Augmented Reality (AR) information delivery program. The system makes use of new "off the shelf" AR glasses that are both light-weight and unobtrusive, with adequate resolution for many IGS applications. Our first application is perioperative planning of minimally invasive robot-assisted cardiac surgery. In this procedure, a combination of tracking technologies and intraoperative ultrasound is used to map the migration of cardiac targets prior to selection of port locations for trocars that enter the chest. The AR glasses will then be used to present this heart migration data to the surgeon, overlaid onto the patients chest. The current paper describes the calibration process for the AR glasses, their integration into our IGS framework for minimally invasive robotic cardiac surgery, and preliminary validation of the system. Validation results indicate a mean 3D triangulation error of 2.9 +/- 3.3mm, 2D projection error of 2.1 +/- 2.1 pixels, and Normalized Stereo Calibration Error of 3.3.

  19. Intra-operative ultrasound-based augmented reality guidance for laparoscopic surgery.

    Singla, Rohit; Edgcumbe, Philip; Pratt, Philip; Nguan, Christopher; Rohling, Robert

    2017-10-01

    In laparoscopic surgery, the surgeon must operate with a limited field of view and reduced depth perception. This makes spatial understanding of critical structures difficult, such as an endophytic tumour in a partial nephrectomy. Such tumours yield a high complication rate of 47%, and excising them increases the risk of cutting into the kidney's collecting system. To overcome these challenges, an augmented reality guidance system is proposed. Using intra-operative ultrasound, a single navigation aid, and surgical instrument tracking, four augmentations of guidance information are provided during tumour excision. Qualitative and quantitative system benefits are measured in simulated robot-assisted partial nephrectomies. Robot-to-camera calibration achieved a total registration error of 1.0 ± 0.4 mm while the total system error is 2.5 ± 0.5 mm. The system significantly reduced healthy tissue excised from an average (±standard deviation) of 30.6 ± 5.5 to 17.5 ± 2.4 cm 3 ( p < 0.05) and reduced the depth from the tumor underside to cut from an average (±standard deviation) of 10.2 ± 4.1 to 3.3 ± 2.3 mm ( p < 0.05). Further evaluation is required in vivo, but the system has promising potential to reduce the amount of healthy parenchymal tissue excised.

  20. Floor Effect of PROMIS Depression CAT Associated With Hasty Completion in Orthopaedic Surgery Patients.

    Guattery, Jason M; Dardas, Agnes Z; Kelly, Michael; Chamberlain, Aaron; McAndrew, Christopher; Calfee, Ryan P

    2018-04-01

    The Patient Reported Outcomes Measurement Information System (PROMIS) was developed to provide valid, reliable, and standardized measures to gather patient-reported outcomes for many health domains, including depression, independent of patient condition. Most studies confirming the performance of these measures were conducted with a consented, volunteer study population for testing. Using a study population that has undergone the process of informed consent may be differentiated from the validation group because they are educated specifically as to the purpose of the questions and they will not have answers recorded in their permanent health record. (1) When given as part of routine practice to an orthopaedic population, do PROMIS Physical Function and Depression item banks produce score distributions different than those produced by the populations used to calibrate and validate the item banks? (2) Does the presence of a nonnormal distribution in the PROMIS Depression scores in a clinical population reflect a deliberately hasty answering of questions by patients? (3) Are patients who are reporting minimal depressive symptoms by scoring the minimum score on the PROMIS Depression Computer Adaptive Testing (CAT) distinct from other patients according to demographic data or their scores on other PROMIS assessments? Univariate descriptive statistics and graphic histograms were used to describe the frequency distribution of scores for the Physical Function and Depression item banks for all orthopaedic patients 18 years or older who had an outpatient visit between June 2015 and December 2016. The study population was then broken into two groups based on whether they indicated a lack of depressive symptoms and scored the minimum score (34.2) on the Depression CAT assessment (Floor Group) or not (Standard Group). The distribution of Physical Function CAT scores was compared between the two groups. Finally, a time-per-question value was calculated for both the Physical

  1. A novel dental implant guided surgery based on integration of surgical template and augmented reality.

    Lin, Yen-Kun; Yau, Hong-Tzong; Wang, I-Chung; Zheng, Cheng; Chung, Kwok-Hung

    2015-06-01

    Stereoscopic visualization concept combined with head-mounted displays may increase the accuracy of computer-aided implant surgery. The aim of this study was to develop an augmented reality-based dental implant placement system and evaluate the accuracy of the virtually planned versus the actual prepared implant site created in vitro. Four fully edentulous mandibular and four partially edentulous maxillary duplicated casts were used. Six implants were planned in the mandibular and four in the maxillary casts. A total of 40 osteotomy sites were prepared in the casts using stereolithographic template integrated with augmented reality-based surgical simulation. During the surgery, the dentist could be guided accurately through a head-mounted display by superimposing the virtual auxiliary line and the drill stop. The deviation between planned and prepared positions of the implants was measured via postoperative computer tomography generated scan images. Mean and standard deviation of the discrepancy between planned and prepared sites at the entry point, apex, angle, depth, and lateral locations were 0.50 ± 0.33 mm, 0.96 ± 0.36 mm, 2.70 ± 1.55°, 0.33 ± 0.27 mm, and 0.86 ± 0.34 mm, respectively, for the fully edentulous mandible, and 0.46 ± 0.20 mm, 1.23 ± 0.42 mm, 3.33 ± 1.42°, 0.48 ± 0.37 mm, and 1.1 ± 0.39 mm, respectively, for the partially edentulous maxilla. There was a statistically significant difference in the apical deviation between maxilla and mandible in this surgical simulation (p augmented reality technology. © 2013 Wiley Periodicals, Inc.

  2. Computer-assisted surgery: virtual- and augmented-reality displays for navigation during urological interventions.

    van Oosterom, Matthias N; van der Poel, Henk G; Navab, Nassir; van de Velde, Cornelis J H; van Leeuwen, Fijs W B

    2018-03-01

    To provide an overview of the developments made for virtual- and augmented-reality navigation procedures in urological interventions/surgery. Navigation efforts have demonstrated potential in the field of urology by supporting guidance for various disorders. The navigation approaches differ between the individual indications, but seem interchangeable to a certain extent. An increasing number of pre- and intra-operative imaging modalities has been used to create detailed surgical roadmaps, namely: (cone-beam) computed tomography, MRI, ultrasound, and single-photon emission computed tomography. Registration of these surgical roadmaps with the real-life surgical view has occurred in different forms (e.g. electromagnetic, mechanical, vision, or near-infrared optical-based), whereby the combination of approaches was suggested to provide superior outcome. Soft-tissue deformations demand the use of confirmatory interventional (imaging) modalities. This has resulted in the introduction of new intraoperative modalities such as drop-in US, transurethral US, (drop-in) gamma probes and fluorescence cameras. These noninvasive modalities provide an alternative to invasive technologies that expose the patients to X-ray doses. Whereas some reports have indicated navigation setups provide equal or better results than conventional approaches, most trials have been performed in relatively small patient groups and clear follow-up data are missing. The reported computer-assisted surgery research concepts provide a glimpse in to the future application of navigation technologies in the field of urology.

  3. Follow the light: projector-based augmented reality intracorporeal system for laparoscopic surgery.

    Edgcumbe, Philip; Singla, Rohit; Pratt, Philip; Schneider, Caitlin; Nguan, Christopher; Rohling, Robert

    2018-04-01

    A projector-based augmented reality intracorporeal system (PARIS) is presented that includes a miniature tracked projector, tracked marker, and laparoscopic ultrasound (LUS) transducer. PARIS was developed to improve the efficacy and safety of laparoscopic partial nephrectomy (LPN). In particular, it has been demonstrated to effectively assist in the identification of tumor boundaries during surgery and to improve the surgeon's understanding of the underlying anatomy. PARIS achieves this by displaying the orthographic projection of the cancerous tumor on the kidney's surface. The performance of PARIS was evaluated in a user study with two surgeons who performed 32 simulated robot-assisted partial nephrectomies. They performed 16 simulated partial nephrectomies with PARIS for guidance and 16 simulated partial nephrectomies with only an LUS transducer for guidance. With PARIS, there was a significant reduction [30% ([Formula: see text])] in the amount of healthy tissue excised and a trend toward a more accurate dissection around the tumor and more negative margins. The combined point tracking and reprojection root-mean-square error of PARIS was 0.8 mm. PARIS' proven ability to improve key metrics of LPN surgery and qualitative feedback from surgeons about PARIS supports the hypothesis that it is an effective surgical navigation tool.

  4. A virtual reality endoscopic simulator augments general surgery resident cancer education as measured by performance improvement.

    White, Ian; Buchberg, Brian; Tsikitis, V Liana; Herzig, Daniel O; Vetto, John T; Lu, Kim C

    2014-06-01

    Colorectal cancer is the second most common cause of death in the USA. The need for screening colonoscopies, and thus adequately trained endoscopists, particularly in rural areas, is on the rise. Recent increases in required endoscopic cases for surgical resident graduation by the Surgery Residency Review Committee (RRC) further emphasize the need for more effective endoscopic training during residency to determine if a virtual reality colonoscopy simulator enhances surgical resident endoscopic education by detecting improvement in colonoscopy skills before and after 6 weeks of formal clinical endoscopic training. We conducted a retrospective review of prospectively collected surgery resident data on an endoscopy simulator. Residents performed four different clinical scenarios on the endoscopic simulator before and after a 6-week endoscopic training course. Data were collected over a 5-year period from 94 different residents performing a total of 795 colonoscopic simulation scenarios. Main outcome measures included time to cecal intubation, "red out" time, and severity of simulated patient discomfort (mild, moderate, severe, extreme) during colonoscopy scenarios. Average time to intubation of the cecum was 6.8 min for those residents who had not undergone endoscopic training versus 4.4 min for those who had undergone endoscopic training (p Virtual reality endoscopic simulation is an effective tool for both augmenting surgical resident endoscopy cancer education and measuring improvement in resident performance after formal clinical endoscopic training.

  5. RECONSTRUCTIVE PLASTIC SURGERIES IN PATIENTS WITH MALIGNANCIES OF TONGUE AND FLOOR OF THE MOUTH. TYPES OF PLASTICS

    Z. A. Radjabova

    2015-01-01

    Full Text Available Issues of tissue defects replacement after radical surgery for tumors of the head and neck do not lose their relevance. The article presents the results of plastics and replacement of the perforating combined defects of the floor of the mouth, portion of the upper and lower lips, the angle of the mouth, cheeks, neck lateral parts with simultaneous reduction of the configuration and function of the operated organs. Depending on the depth and nature of the existing tissue defect various methods of plastics were applied using arterialized flaps on the vascular pedicle in a free and non-free version. Satisfactory cosmetic and functional results were achieved in patients allowing to improve life quality and to adapt socially.

  6. Augmented reality system for oral surgery using 3D auto stereoscopic visualization.

    Tran, Huy Hoang; Suenaga, Hideyuki; Kuwana, Kenta; Masamune, Ken; Dohi, Takeyoshi; Nakajima, Susumu; Liao, Hongen

    2011-01-01

    We present an augmented reality system for oral and maxillofacial surgery in this paper. Instead of being displayed on a separated screen, three-dimensional (3D) virtual presentations of osseous structures and soft tissues are projected onto the patient's body, providing surgeons with exact knowledge of depth information of high risk tissues inside the bone. We employ a 3D integral imaging technique which produce motion parallax in both horizontal and vertical direction over a wide viewing area in this study. In addition, surgeons are able to check the progress of the operation in real-time through an intuitive 3D based interface which is content-rich, hardware accelerated. These features prevent surgeons from penetrating into high risk areas and thus help improve the quality of the operation. Operational tasks such as hole drilling, screw fixation were performed using our system and showed an overall positional error of less than 1 mm. Feasibility of our system was also verified with a human volunteer experiment.

  7. MEDIASSIST: medical assistance for intraoperative skill transfer in minimally invasive surgery using augmented reality

    Sudra, Gunther; Speidel, Stefanie; Fritz, Dominik; Müller-Stich, Beat Peter; Gutt, Carsten; Dillmann, Rüdiger

    2007-03-01

    Minimally invasive surgery is a highly complex medical discipline with various risks for surgeon and patient, but has also numerous advantages on patient-side. The surgeon has to adapt special operation-techniques and deal with difficulties like the complex hand-eye coordination, limited field of view and restricted mobility. To alleviate with these new problems, we propose to support the surgeon's spatial cognition by using augmented reality (AR) techniques to directly visualize virtual objects in the surgical site. In order to generate an intelligent support, it is necessary to have an intraoperative assistance system that recognizes the surgical skills during the intervention and provides context-aware assistance surgeon using AR techniques. With MEDIASSIST we bundle our research activities in the field of intraoperative intelligent support and visualization. Our experimental setup consists of a stereo endoscope, an optical tracking system and a head-mounted-display for 3D visualization. The framework will be used as platform for the development and evaluation of our research in the field of skill recognition and context-aware assistance generation. This includes methods for surgical skill analysis, skill classification, context interpretation as well as assistive visualization and interaction techniques. In this paper we present the objectives of MEDIASSIST and first results in the fields of skill analysis, visualization and multi-modal interaction. In detail we present a markerless instrument tracking for surgical skill analysis as well as visualization techniques and recognition of interaction gestures in an AR environment.

  8. Maxillary sinus floor elevation surgery with BioOss (R) mixed with a bone marrow concentrate or autogenous bone : test of principle on implant survival and clinical performance

    Rickert, D.; Vissink, A.; Slot, Jan; Sauerbier, S.; Meijer, H. J. A.; Raghoebar, G. M.

    The purpose of this study was to assess implant survival and 1-year clinical performance of implants placed in the posterior maxilla that had been subjected to maxillary sinus floor elevation surgery with bovine bone mineral (BioOss (R)) mixed with autogenous bone marrow concentrate or autogenous

  9. Modified Augmented Renal Clearance Score Predicts Rapid Piperacillin and Tazobactam Clearance in Critically Ill Surgery and Trauma Patients

    2014-04-24

    collision; VAP , ventilator-associated pneumonia. TABLE 2. PK Parameter Estimates for Free Piperacillin and Tazobactam in Patients Stratified by ARC Score...SOFA score are typically generated during routine care of the most severely ill patients . Positive screening test results (high ARC scores) can be...Modified Augmented Renal Clearance score predicts rapid piperacillin and tazobactam clearance in critically ill surgery and trauma patients Kevin S

  10. A new technique for augmentation phalloplasty: albugineal surgery with bilateral saphenous grafts--three years of experience.

    Austoni, E; Guarneri, A; Cazzaniga, A

    2002-09-01

    Penile augmentation surgery is a highly controversial issue due to the low level of standardisation of surgical techniques. The aim of the study is to illustrate a new technique to solve the problem of enlarging the penis by means of additive surgery on the albuginea of the corpora cavernosa, guaranteeing a real increase in size of the erect penis. Between 1995 and 1997, 39 patients who requested an increase in the diameter of their penises underwent augmentation phalloplasty with bilateral saphena grafts. The patients considered eligible for surgery were patients with either hypoplasia of the penis or functional penile dysmorphophobia. All the patients included in our study presented normal erection at screening. The average penis diameter in a flaccid state and during erection was found to be 2.1cm (1.6-2.7 cm) and 2.9 cm (2.2-3.7 cm), respectively. Before surgery the patients were informed of the experimental nature of the surgical procedure. The increase in volume of the corpora cavernosa was achieved by applying saphena grafts to longitudinal openings made bilaterally in the albuginea along the whole length of the penis. No major complications and specifically no losses of sensitivity of the penis or erection deficiencies occurred during the post-operative follow-up period. All the patients resumed their sexual activity in 4 months. A measurement of the penile dimensions was carried out 9 months after surgery. No clinical meaningful increases in the diameter of the flaccid penis were documented. The average penis diameter during erection was found to be 4.2 cm (3.4-4.9) with post-surgery increases in diameter varying from 1.1 to 2.1cm (penlargement phalloplasty technique with albuginea surgery suggested by the authors definitely is indicated for increasing the volume of the corpora cavernosa during erection. Albuginea surgery with saphena grafts has been found to be free from aesthetic and functional complications with excellent patient satisfaction.

  11. Utilizing image guided surgery for user interaction in medical augmented reality

    Fischer, Jan; Bartz, Dirk

    2005-01-01

    The graphical overlay of additional medical information over the patient during a surgical procedure has long been considered one of the most promising applications of augmented reality. While many experimental systems for augmented reality in medicine have reached an advanced state and can deliver high-quality augmented video streams, they usually depend heavily on specialized dedicated hardware. Such dedicated system components, which originally have been designed for engineering applicatio...

  12. Influence of Healing Period Upon Bone Turn Over on Maxillary Sinus Floor Augmentation Grafted Solely with Deproteinized Bovine Bone Mineral: A Prospective Human Histological and Clinical Trial.

    Wang, Feng; Zhou, Wenjie; Monje, Alberto; Huang, Wei; Wang, Yueping; Wu, Yiqun

    2017-04-01

    To investigate the influence of maturation timing upon histological, histomorphometric and clinical outcomes when deproteinized bovine bone mineral (DBBM) was used as a sole biomaterial for staged maxillary sinus floor augmentation (MSFA). Patients with a posterior edentulous maxillary situation and a vertical bone height ≤ 4 mm were included in this study. A staged MSFA was carried out. After MSFA with DBBM as a sole grafting material, biopsy cores were harvested with simultaneous implant placement followed by a healing period of 5, 8, and 11 months, respectively. Micro-CT, histologic and histomorphometric analyses were performed. Forty-one patients were enrolled and 38 bone core biopsies were harvested. Significantly greater BV/TV was observed between 5- and 8-month healing from micro-CT analysis. Histomorphometric analyses showed the ratio of mineralized newly formed bone increased slightly from 5 to 11 months; however, no statistically significant difference was reached (p = .409). Residual bone substitute decreased from 37.3 ± 5.04% to 20.6 ± 7.45%, achieving a statistical significant difference from of 5 up to 11 months (p < .01). Moreover, no implant failure, biological or technical complication occurred after 12-month follow-up of functional loading. DBBM utilized as sole grafting material in staged MSFA demonstrated to be clinically effective regardless of the healing period. Histomorphometrical and micro-CT assessments revealed that at later stages of healing (8 and 11 months) there is a higher proportion of newly-bone formation compared to earlier stages (5 months). Moreover, the longer the maturation period, the substantially lesser remaining biomaterial could be expected. Even though, these facts did not seem to negatively impact on the implant prognosis 1-year after loading. © 2016 Wiley Periodicals, Inc.

  13. Cadaveric feasibility study of da Vinci Si-assisted cochlear implant with augmented visual navigation for otologic surgery.

    Liu, Wen P; Azizian, Mahdi; Sorger, Jonathan; Taylor, Russell H; Reilly, Brian K; Cleary, Kevin; Preciado, Diego

    2014-03-01

    To our knowledge, this is the first reported cadaveric feasibility study of a master-slave-assisted cochlear implant procedure in the otolaryngology-head and neck surgery field using the da Vinci Si system (da Vinci Surgical System; Intuitive Surgical, Inc). We describe the surgical workflow adaptations using a minimally invasive system and image guidance integrating intraoperative cone beam computed tomography through augmented reality. To test the feasibility of da Vinci Si-assisted cochlear implant surgery with augmented reality, with visualization of critical structures and facilitation with precise cochleostomy for electrode insertion. Cadaveric case study of bilateral cochlear implant approaches conducted at Intuitive Surgical Inc, Sunnyvale, California. Bilateral cadaveric mastoidectomies, posterior tympanostomies, and cochleostomies were performed using the da Vinci Si system on a single adult human donor cadaveric specimen. Radiographic confirmation of successful cochleostomies, placement of a phantom cochlear implant wire, and visual confirmation of critical anatomic structures (facial nerve, cochlea, and round window) in augmented stereoendoscopy. With a surgical mean time of 160 minutes per side, complete bilateral cochlear implant procedures were successfully performed with no violation of critical structures, notably the facial nerve, chorda tympani, sigmoid sinus, dura, or ossicles. Augmented reality image overlay of the facial nerve, round window position, and basal turn of the cochlea was precise. Postoperative cone beam computed tomography scans confirmed successful placement of the phantom implant electrode array into the basal turn of the cochlea. To our knowledge, this is the first study in the otolaryngology-head and neck surgery literature examining the use of master-slave-assisted cochleostomy with augmented reality for cochlear implants using the da Vinci Si system. The described system for cochleostomy has the potential to improve the

  14. Mesh complications in female pelvic floor reconstructive surgery and their management: A systematic review

    Hemendra N Shah

    2012-01-01

    , its magnitude, severity and potential recurrence of pelvic floor defect.

  15. Mesh complications in female pelvic floor reconstructive surgery and their management: A systematic review

    Shah, Hemendra N.; Badlani, Gopal H.

    2012-01-01

    , severity and potential recurrence of pelvic floor defect. PMID:22919127

  16. Towards cybernetic surgery: robotic and augmented reality-assisted liver segmentectomy.

    Pessaux, Patrick; Diana, Michele; Soler, Luc; Piardi, Tullio; Mutter, Didier; Marescaux, Jacques

    2015-04-01

    Augmented reality (AR) in surgery consists in the fusion of synthetic computer-generated images (3D virtual model) obtained from medical imaging preoperative workup and real-time patient images in order to visualize unapparent anatomical details. The 3D model could be used for a preoperative planning of the procedure. The potential of AR navigation as a tool to improve safety of the surgical dissection is outlined for robotic hepatectomy. Three patients underwent a fully robotic and AR-assisted hepatic segmentectomy. The 3D virtual anatomical model was obtained using a thoracoabdominal CT scan with a customary software (VR-RENDER®, IRCAD). The model was then processed using a VR-RENDER® plug-in application, the Virtual Surgical Planning (VSP®, IRCAD), to delineate surgical resection planes including the elective ligature of vascular structures. Deformations associated with pneumoperitoneum were also simulated. The virtual model was superimposed to the operative field. A computer scientist manually registered virtual and real images using a video mixer (MX 70; Panasonic, Secaucus, NJ) in real time. Two totally robotic AR segmentectomy V and one segmentectomy VI were performed. AR allowed for the precise and safe recognition of all major vascular structures during the procedure. Total time required to obtain AR was 8 min (range 6-10 min). Each registration (alignment of the vascular anatomy) required a few seconds. Hepatic pedicle clamping was never performed. At the end of the procedure, the remnant liver was correctly vascularized. Resection margins were negative in all cases. The postoperative period was uneventful without perioperative transfusion. AR is a valuable navigation tool which may enhance the ability to achieve safe surgical resection during robotic hepatectomy.

  17. Subconjunctival bevacizumab to augment trabeculectomy with mitomycin C in the management of failed glaucoma surgery

    Saeed AM

    2014-09-01

    Full Text Available Ahmed M Saeed, Tarek Tawfeek AboulNasrOphthalmology Department, Benha University, Egypt Purpose: To provide a feasible solution to the problem of failed glaucoma surgery. The aim was to evaluate the efficacy and safety of the additional effects of a combined surgical approach. This approach augments the application of trabeculectomy with mitomycin C (MMC by adding subconjunctival bevacizumab injection. The results were compared with those of trabeculectomy with only adjunctive MMC. Methods: A randomized controlled prospective clinical trial included 28 eyes diagnosed with failed scarred bleb of a previous trabeculectomy. The eyes were divided into two equal groups: combined group A, “trabeculectomy with adjunctive MMC and subconjunctival bevacizumab,” and control group B, “trabeculectomy with adjunctive MMC only.” The main outcome results included the cumulative probability of surgical success, intraocular pressure (IOP values, and number of IOP-lowering medications needed to achieve the target IOP.Results: Group A achieved a cumulative probability of complete success of 0.769 and of qualified success of 0.231 at the end of the 24 month study period; group B achieved cumulative probabilities of 0.538 and 0.308, respectively. Group A achieved a lower mean IOP value than group B, with fewer antiglaucoma drugs at all postoperative visits, but this lower value did not reach a statistically significant level (P>0.05. There was no statistically significant difference between both groups regarding best corrected visual acuity, visual field parameters, operative and/or postoperative complications, and additional interventions. No significant adverse effects were caused by this combined approach.Conclusion: Bevacizumab was not found to add much to the favorable long-term outcome of conventional trabeculectomy with MMC as a solution to the problem of scarred failed bleb. Keywords: glaucoma, bevacizumab, mitomycin C, failed trabeculectomy

  18. Breast Augmentation

    1974-04-13

    Apr 13, 1974 ... Complications encountered after breast augmentation are dealt with in .... in Phisohex or other suitable preparation for a few days before surgery ... In all cases, the prosthesis causes a fibrous tissue capsule to form around it.

  19. Augmentation surgery on the cartilaginous portion of the vocal fold in a patient with cricoarytenoid joint ankylosis.

    Fukahori, Mioko; Chitose, Shun-Ichi; Sato, Kiminori; Kamimura, Hiroyuki; Sato, Kiminobu; On, Ririko; Umeno, Hirohito

    2018-01-04

    Surgical management of cricoarytenoid joint (CAJ) ankylosis is challenging and has the risk of worsening voice quality. In the present case, augmentation surgery was performed on the cartilaginous portion of the vocal fold in a patient with CAJ ankylosis. A 24-year-old man sustained blunt trauma to the anterior neck three years prior to developing severe breathiness. Posterior glottal insufficiency resulting from lateral fixation of the right vocal fold was observed during phonation under laryngoscopy. In addition, electromyography and CT scan revealed severe ankylosis of the right CAJ. Type I thyroplasty performed on the right vocal fold did not improve postoperative vocal function. Therefore, augmentation surgery on the cartilaginous portion of the right vocal fold was performed via endolaryngeal microsurgery under general anesthesia with jet ventilation. A piece of temporalis fascia was autotransplanted into the submucosal space created at the posterior cartilaginous portion of the right vocal fold. This resulted in the narrowing of the posterior glottal gap during phonation, leading to improvement in hoarseness. Microsurgical management with autologous fascia augmentation of the cartilaginous portion of the vocal fold can be effective in patients with lateral vocal fold fixation due to CAJ ankylosis. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. A clinical pilot study of a modular video-CT augmentation system for image-guided skull base surgery

    Liu, Wen P.; Mirota, Daniel J.; Uneri, Ali; Otake, Yoshito; Hager, Gregory; Reh, Douglas D.; Ishii, Masaru; Gallia, Gary L.; Siewerdsen, Jeffrey H.

    2012-02-01

    Augmentation of endoscopic video with preoperative or intraoperative image data [e.g., planning data and/or anatomical segmentations defined in computed tomography (CT) and magnetic resonance (MR)], can improve navigation, spatial orientation, confidence, and tissue resection in skull base surgery, especially with respect to critical neurovascular structures that may be difficult to visualize in the video scene. This paper presents the engineering and evaluation of a video augmentation system for endoscopic skull base surgery translated to use in a clinical study. Extension of previous research yielded a practical system with a modular design that can be applied to other endoscopic surgeries, including orthopedic, abdominal, and thoracic procedures. A clinical pilot study is underway to assess feasibility and benefit to surgical performance by overlaying CT or MR planning data in realtime, high-definition endoscopic video. Preoperative planning included segmentation of the carotid arteries, optic nerves, and surgical target volume (e.g., tumor). An automated camera calibration process was developed that demonstrates mean re-projection accuracy (0.7+/-0.3) pixels and mean target registration error of (2.3+/-1.5) mm. An IRB-approved clinical study involving fifteen patients undergoing skull base tumor surgery is underway in which each surgery includes the experimental video-CT system deployed in parallel to the standard-of-care (unaugmented) video display. Questionnaires distributed to one neurosurgeon and two otolaryngologists are used to assess primary outcome measures regarding the benefit to surgical confidence in localizing critical structures and targets by means of video overlay during surgical approach, resection, and reconstruction.

  1. Floor interaction

    Petersen, Marianne Graves; Krogh, Peter; Ludvigsen, Martin

    2005-01-01

    Within architecture, there is a long tradition of careful design of floors. The design has been concerned with both decorating floors and designing floors to carry information. Ubiquitous computing technology offers new opportunities for designing interactive floors. This paper presents three...... different interactive floor concepts. Through an urban perspective it draws upon the experiences of floors in architecture, and provides a set of design issues for designing interactive floors....

  2. Augmented reality technology for preoperative planning and intraoperative navigation during hepatobiliary surgery: A review of current methods.

    Tang, Rui; Ma, Long-Fei; Rong, Zhi-Xia; Li, Mo-Dan; Zeng, Jian-Ping; Wang, Xue-Dong; Liao, Hong-En; Dong, Jia-Hong

    2018-04-01

    Augmented reality (AR) technology is used to reconstruct three-dimensional (3D) images of hepatic and biliary structures from computed tomography and magnetic resonance imaging data, and to superimpose the virtual images onto a view of the surgical field. In liver surgery, these superimposed virtual images help the surgeon to visualize intrahepatic structures and therefore, to operate precisely and to improve clinical outcomes. The keywords "augmented reality", "liver", "laparoscopic" and "hepatectomy" were used for searching publications in the PubMed database. The primary source of literatures was from peer-reviewed journals up to December 2016. Additional articles were identified by manual search of references found in the key articles. In general, AR technology mainly includes 3D reconstruction, display, registration as well as tracking techniques and has recently been adopted gradually for liver surgeries including laparoscopy and laparotomy with video-based AR assisted laparoscopic resection as the main technical application. By applying AR technology, blood vessels and tumor structures in the liver can be displayed during surgery, which permits precise navigation during complex surgical procedures. Liver transformation and registration errors during surgery were the main factors that limit the application of AR technology. With recent advances, AR technologies have the potential to improve hepatobiliary surgical procedures. However, additional clinical studies will be required to evaluate AR as a tool for reducing postoperative morbidity and mortality and for the improvement of long-term clinical outcomes. Future research is needed in the fusion of multiple imaging modalities, improving biomechanical liver modeling, and enhancing image data processing and tracking technologies to increase the accuracy of current AR methods. Copyright © 2018 First Affiliated Hospital, Zhejiang University School of Medicine in China. Published by Elsevier B.V. All rights

  3. Effect of a Particulate and a Putty-Like Tricalcium Phosphate-Based Bone-grafting Material on Bone Formation, Volume Stability and Osteogenic Marker Expression after Bilateral Sinus Floor Augmentation in Humans

    Christine Knabe

    2017-07-01

    Full Text Available This study examines the effect of a hyaluronic acid (HyAc containing tricalcium phosphate putty scaffold material (TCP-P and of a particulate tricalcium phosphate (TCP-G graft on bone formation, volume stability and osteogenic marker expression in biopsies sampled 6 months after bilateral sinus floor augmentation (SFA in 7 patients applying a split-mouth design. 10% autogenous bone chips were added to the grafting material during surgery. The grain size of the TCP granules was 700 to 1400 µm for TCP-G and 125 to 250 µm and 500 to 700 µm (ratio 1:1 for TCP-P. Biopsies were processed for immunohistochemical analysis of resin-embedded sections. Sections were stained for collagen type I (Col I, alkaline phosphatase (ALP, osteocalcin (OC and bone sialoprotein (BSP. Furthermore, the bone area and biomaterial area fraction were determined histomorphometrically. Cone-beam CT data recorded after SFA and 6 months later were used for calculating the graft volume at these two time points. TCP-P displayed more advantageous surgical handling properties and a significantly greater bone area fraction and smaller biomaterial area fraction. This was accompanied by significantly greater expression of Col I and BSP and in osteoblasts and osteoid and a less pronounced reduction in grafting volume with TCP-P. SFA using both types of materials resulted in formation of sufficient bone volume for facilitating stable dental implant placement with all dental implants having been in function without any complications for 6 years. Since TCP-P displayed superior surgical handling properties and greater bone formation than TCP-G, without the HyAc hydrogel matrix having any adverse effect on bone formation or graft volume stability, TCP-P can be regarded as excellent grafting material for SFA in a clinical setting. The greater bone formation observed with TCP-P may be related to the difference in grain size of the TCP granules and/or the addition of the HyAc.

  4. Comparison between conventional and piezoelectric surgical tools for maxillary sinus floor elevation : a randomized controlled clinical trial

    Rickert, Daniela; Vissink, Arjan; Huddleston Slater, James; Meijer, Henny J. A.; Raghoebar, Gerry M.

    Aim: The aim of this study was to assess the performance of conventional rotative instruments and a piezoelectric device for maxillary sinus floor elevation surgery, and to assess whether application of a resorbable membrane reduces resorption of an augmented site in a randomized clinical trial.

  5. Pico Lantern: Surface reconstruction and augmented reality in laparoscopic surgery using a pick-up laser projector.

    Edgcumbe, Philip; Pratt, Philip; Yang, Guang-Zhong; Nguan, Christopher; Rohling, Robert

    2015-10-01

    The Pico Lantern is a miniature projector developed for structured light surface reconstruction, augmented reality and guidance in laparoscopic surgery. During surgery it will be dropped into the patient and picked up by a laparoscopic tool. While inside the patient it projects a known coded pattern and images onto the surface of the tissue. The Pico Lantern is visually tracked in the laparoscope's field of view for the purpose of stereo triangulation between it and the laparoscope. In this paper, the first application is surface reconstruction. Using a stereo laparoscope and an untracked Pico Lantern, the absolute error for surface reconstruction for a plane, cylinder and ex vivo kidney, is 2.0 mm, 3.0 mm and 5.6 mm, respectively. Using a mono laparoscope and a tracked Pico Lantern for the same plane, cylinder and kidney the absolute error is 1.4 mm, 1.5 mm and 1.5 mm, respectively. These results confirm the benefit of the wider baseline produced by tracking the Pico Lantern. Virtual viewpoint images are generated from the kidney surface data and an in vivo proof-of-concept porcine trial is reported. Surface reconstruction of the neck of a volunteer shows that the pulsatile motion of the tissue overlying a major blood vessel can be detected and displayed in vivo. Future work will integrate the Pico Lantern into standard and robot-assisted laparoscopic surgery. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women: shortened version of a Cochrane systematic review

    Herderschee, Roselien; Hay-Smith, E. C. Jean; Herbison, G. Peter; Roovers, Jan Paul; Heineman, Maas Jan

    2013-01-01

    Feedback and biofeedback (BF) are common adjuncts to pelvic floor muscle training (PFMT) for women with stress, urgency, and mixed urinary incontinence (UI). An up to date systematic review of adjunctive feedback or BF was needed to guide practice and further research. To determine whether feedback

  7. A novel rotational matrix and translation vector algorithm: geometric accuracy for augmented reality in oral and maxillofacial surgeries.

    Murugesan, Yahini Prabha; Alsadoon, Abeer; Manoranjan, Paul; Prasad, P W C

    2018-06-01

    Augmented reality-based surgeries have not been successfully implemented in oral and maxillofacial areas due to limitations in geometric accuracy and image registration. This paper aims to improve the accuracy and depth perception of the augmented video. The proposed system consists of a rotational matrix and translation vector algorithm to reduce the geometric error and improve the depth perception by including 2 stereo cameras and a translucent mirror in the operating room. The results on the mandible/maxilla area show that the new algorithm improves the video accuracy by 0.30-0.40 mm (in terms of overlay error) and the processing rate to 10-13 frames/s compared to 7-10 frames/s in existing systems. The depth perception increased by 90-100 mm. The proposed system concentrates on reducing the geometric error. Thus, this study provides an acceptable range of accuracy with a shorter operating time, which provides surgeons with a smooth surgical flow. Copyright © 2018 John Wiley & Sons, Ltd.

  8. Autoimmune Syndrome Induced by Adjuvants (ASIA after Silicone Breast Augmentation Surgery

    Daniel Nunes e Silva, MD

    2017-09-01

    Full Text Available Summary:. Generally, the main complications of silicone implantation are local symptoms. However, some patients develop late-onset systemic symptoms often associated with a rare form of hyperactive immune response, as part of a syndrome known as autoimmune syndrome induced by adjuvants (ASIA. Reported cases of ASIA have shown resolution with explantation, but not with immunomodulatory therapy. In this report, we described a case of a previously healthy 23-year-old woman, who has undergone silicone breast implant augmentation, for aesthetic reasons, and developed localized cutaneous impairment 3 years postsurgery. She received a diagnosis of ASIA with a new presentation: Lupus-like manifestation through localized cutaneous impairment. This patient’s symptoms were managed without the need for surgical intervention, which has not been previously reported, because the patient did not want an explantation for aesthetic reasons. The patient was started on hydroxychloroquine, 400 mg per day, and remains asymptomatic after 2 years of treatment. The exact predisposition to ASIA is still unknown. Without implant explantation and with immunomodulatory treatment, this patient’s condition substantially improved. Based on our current understanding of this disease, it might not be prudent to indicate breast augmentation with silicone implants in patients with documented autoimmune reaction to an adjuvant, an established autoimmune condition, or genetic predisposition. However, if a patient does develop silicone-induced ASIA, explantation is no longer the only successfully reported option, as these symptoms can be managed with immune suppression.

  9. On-the-fly augmented reality for orthopedic surgery using a multimodal fiducial.

    Andress, Sebastian; Johnson, Alex; Unberath, Mathias; Winkler, Alexander Felix; Yu, Kevin; Fotouhi, Javad; Weidert, Simon; Osgood, Greg; Navab, Nassir

    2018-04-01

    Fluoroscopic x-ray guidance is a cornerstone for percutaneous orthopedic surgical procedures. However, two-dimensional (2-D) observations of the three-dimensional (3-D) anatomy suffer from the effects of projective simplification. Consequently, many x-ray images from various orientations need to be acquired for the surgeon to accurately assess the spatial relations between the patient's anatomy and the surgical tools. We present an on-the-fly surgical support system that provides guidance using augmented reality and can be used in quasiunprepared operating rooms. The proposed system builds upon a multimodality marker and simultaneous localization and mapping technique to cocalibrate an optical see-through head mounted display to a C-arm fluoroscopy system. Then, annotations on the 2-D x-ray images can be rendered as virtual objects in 3-D providing surgical guidance. We quantitatively evaluate the components of the proposed system and, finally, design a feasibility study on a semianthropomorphic phantom. The accuracy of our system was comparable to the traditional image-guided technique while substantially reducing the number of acquired x-ray images as well as procedure time. Our promising results encourage further research on the interaction between virtual and real objects that we believe will directly benefit the proposed method. Further, we would like to explore the capabilities of our on-the-fly augmented reality support system in a larger study directed toward common orthopedic interventions.

  10. Breast augmentation and reconstructive surgery: MR imaging of implant rupture and malignancy

    Herborn, Christoph U. [Institute of Diagnostic Radiology, University Hospital, Zuerich (Switzerland); Department of Diagnostic and Interventional Radiology, University Hospital Essen, Hufelandstrasse 55, 45128 Essen (Germany); Marincek, Borut; Erfmann, Daniel; Kubik-Huch, Rahel A. [Institute of Diagnostic Radiology, University Hospital, Zuerich (Switzerland); Meuli-Simmen, Claudia; Wedler, Volker [Department of Surgery, Clinic for Reconstructive Surgery, University Hospital, Zurich (Switzerland); Bode-Lesniewska, Beate [Department of Pathology, University Hospital, Zurich (Switzerland)

    2002-09-01

    The purpose of this study was to assess the diagnostic accuracy of MRI in detecting prosthesis integrity and malignancy after breast augmentation and reconstruction. Forty-one implants in 25 patients were analyzed by MRI before surgical removal. Imaging results were compared with ex vivo findings. Magnetic resonance imaging of the breast was performed on a 1.5-T system using a dedicated surface breast coil. Axial and sagittal T2-weighted fast spin-echo as well as dynamic contrast-enhanced T1-weighted gradient-recalled-echo sequences were acquired. The linguine sign indicating collapse of the silicone shell or siliconomas indicating free silicone proved implant rupture, whereas early focal contrast enhancement of a lesion was suspicious for malignancy. The sensitivity for detection of implant rupture was 86.7% with a specificity of 88.5%. The positive and negative predictive values were 81.3 and 92.0%, respectively. The linguine sign as a predictor of intracapsular implant rupture had a sensitivity of 80% with a specificity of 96.2%. Magnetic resonance imaging revealed two lesions with suspicious contrast enhancement (one carcinoma, one extra-abdominal fibromatosis). Magnetic resonance imaging is a reliable and reproducible technique for diagnosing both implant rupture and malignant lesions in women after breast augmentation and reconstruction. (orig.)

  11. Breast augmentation and reconstructive surgery: MR imaging of implant rupture and malignancy

    Herborn, Christoph U.; Marincek, Borut; Erfmann, Daniel; Kubik-Huch, Rahel A.; Meuli-Simmen, Claudia; Wedler, Volker; Bode-Lesniewska, Beate

    2002-01-01

    The purpose of this study was to assess the diagnostic accuracy of MRI in detecting prosthesis integrity and malignancy after breast augmentation and reconstruction. Forty-one implants in 25 patients were analyzed by MRI before surgical removal. Imaging results were compared with ex vivo findings. Magnetic resonance imaging of the breast was performed on a 1.5-T system using a dedicated surface breast coil. Axial and sagittal T2-weighted fast spin-echo as well as dynamic contrast-enhanced T1-weighted gradient-recalled-echo sequences were acquired. The linguine sign indicating collapse of the silicone shell or siliconomas indicating free silicone proved implant rupture, whereas early focal contrast enhancement of a lesion was suspicious for malignancy. The sensitivity for detection of implant rupture was 86.7% with a specificity of 88.5%. The positive and negative predictive values were 81.3 and 92.0%, respectively. The linguine sign as a predictor of intracapsular implant rupture had a sensitivity of 80% with a specificity of 96.2%. Magnetic resonance imaging revealed two lesions with suspicious contrast enhancement (one carcinoma, one extra-abdominal fibromatosis). Magnetic resonance imaging is a reliable and reproducible technique for diagnosing both implant rupture and malignant lesions in women after breast augmentation and reconstruction. (orig.)

  12. Breast augmentation and reconstructive surgery: MR imaging of implant rupture and malignancy.

    Herborn, Christoph U; Marincek, Borut; Erfmann, Daniel; Meuli-Simmen, Claudia; Wedler, Volker; Bode-Lesniewska, Beate; Kubik-Huch, Rahel A

    2002-09-01

    The purpose of this study was to assess the diagnostic accuracy of MRI in detecting prosthesis integrity and malignancy after breast augmentation and reconstruction. Forty-one implants in 25 patients were analyzed by MRI before surgical removal. Imaging results were compared with ex vivo findings. Magnetic resonance imaging of the breast was performed on a 1.5-T system using a dedicated surface breast coil. Axial and sagittal T2-weighted fast spin-echo as well as dynamic contrast-enhanced T1-weighted gradient-recalled-echo sequences were acquired. The linguine sign indicating collapse of the silicone shell or siliconomas indicating free silicone proved implant rupture, whereas early focal contrast enhancement of a lesion was suspicious for malignancy. The sensitivity for detection of implant rupture was 86.7% with a specificity of 88.5%. The positive and negative predictive values were 81.3 and 92.0%, respectively. The linguine sign as a predictor of intracapsular implant rupture had a sensitivity of 80% with a specificity of 96.2%. Magnetic resonance imaging revealed two lesions with suspicious contrast enhancement (one carcinoma, one extra-abdominal fibromatosis). Magnetic resonance imaging is a reliable and reproducible technique for diagnosing both implant rupture and malignant lesions in women after breast augmentation and reconstruction.

  13. Genetically modified vaccines augment the efficacy of cancer surgery and chemotherapy

    Bubeník, Jan

    2009-01-01

    Roč. 55, č. 6 (2009), s. 199-200 ISSN 0015-5500 Institutional research plan: CEZ:AV0Z50520514 Keywords : genetically modified vaccines * cancer surgery and chemotherapy Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 0.924, year: 2009

  14. Augmented reality fluoroscopy simulation of the guide-wire insertion in DHS surgery: A proof of concept study.

    van Duren, B H; Sugand, K; Wescott, R; Carrington, R; Hart, A

    2018-05-01

    Hip fractures contribute to a significant clinical burden globally with over 1.6 million cases per annum and up to 30% mortality rate within the first year. Insertion of a dynamic hip screw (DHS) is a frequently performed procedure to treat extracapsular neck of femur fractures. Poorly performed DHS fixation of extracapsular neck of femur fractures can result in poor mobilisation, chronic pain, and increased cut-out rate requiring revision surgery. A realistic, affordable, and portable fluoroscopic simulation system can improve performance metrics in trainees, including the tip-apex distance (the only clinically validated outcome), and improve outcomes. We developed a digital fluoroscopic imaging simulator using orthogonal cameras to track coloured markers attached to the guide-wire which created a virtual overlay on fluoroscopic images of the hip. To test the accuracy with which the augmented reality system could track a guide-wire, a standard workshop femur was used to calibrate the system with a positional marker fixed to indicate the apex; this allowed for comparison between guide-wire tip-apex distance (TAD) calculated by the system to be compared to that physically measured. Tests were undertaken to determine: (1) how well the apex could be targeted; (2) the accuracy of the calculated TAD. (3) The number of iterations through the algorithm giving the optimal accuracy-time relationship. The calculated TAD was found to have an average root mean square error of 4.2 mm. The accuracy of the algorithm was shown to increase with the number of iterations up to 20 beyond which the error asymptotically converged to an error of 2 mm. This work demonstrates a novel augmented reality simulation of guide-wire insertion in DHS surgery. To our knowledge this has not been previously achieved. In contrast to virtual reality, augmented reality is able to simulate fluoroscopy while allowing the trainee to interact with real instrumentation and performing the procedure on

  15. Predictive value of ridge dimensions on autologous bone graft resorption in staged maxillary sinus augmentation surgery using Cone-Beam CT.

    Klijn, R.J.; Beucken, J.J.J.P van den; Bronkhorst, E.M.; Berge, S.J.; Meijer, G.J.; Jansen, J.B.M.J.

    2012-01-01

    INTRODUCTION: No studies are available that provide predictive parameters regarding the expected amount of resorption after maxillary sinus augmentation surgery using autologous bone grafts. Therefore, the aim of this study was to determine parameters influencing the outcome of the bone graft

  16. Cotard's Syndrome after breast surgery successfully treated with aripiprazole augmentation of escitalopram: a case report.

    De Berardis, Domenico; Brucchi, Maurizio; Serroni, Nicola; Rapini, Gabriella; Campanella, Daniela; Vellante, Federica; Valchera, Alessandro; Fornaro, Michele; Iasevoli, Felice; Mazza, Monica; Lucidi, Giuliana; Martinotti, Giovanni; di Giannantonio, Massimo

    2015-01-01

    In 1880 the French neurologist Jules Cotard described a condition characterized by delusion of negation (nihilistic delusion) in a melancholia context. Recently, there has been a resurgence of interest in Cotard's syndrome (CS), but the nosographical figure of CS remains unclear. It isn't determined if it pertains to the delusional themes area or if it is related to the sense of immanent ruin in some depressive episodes. For these reasons CS has recently been supposed to be an intermediate form. Furthermore, since even less is known about secondary CS in subjects who had never suffered of psychiatric disorders, in the present case we report the development of a secondary CS in a female patient who underwent a lumpectomy for the removal of a benign fibroadenoma. The patient responded well to aripiprazole augmentation of escitalopram and totally remitted.

  17. Stereoscopic Augmented Reality System for Supervised Training on Minimal Invasive Surgery Robots

    Matu, Florin-Octavian; Thøgersen, Mikkel; Galsgaard, Bo

    2014-01-01

    the need for efficient training. When training with the robot, the communication between the trainer and the trainee is limited, since the trainee often cannot see the trainer. To overcome this issue, this paper proposes an Augmented Reality (AR) system where the trainer is controlling two virtual robotic...... arms. These arms are virtually superimposed on the video feed to the trainee, and can therefore be used to demonstrate and perform various tasks for the trainee. Furthermore, the trainer is presented with a 3D image through a stereoscopic display. Because of the added depth perception, this enables...... the procedure, and thereby enhances the training experience. The virtual overlay was also found to work as a good and illustrative approach for enhanced communication. However, the delay of the prototype made it difficult to use for actual training....

  18. Augmented real-time navigation with critical structure proximity alerts for endoscopic skull base surgery.

    Dixon, Benjamin J; Daly, Michael J; Chan, Harley; Vescan, Allan; Witterick, Ian J; Irish, Jonathan C

    2014-04-01

    Image-guided surgery (IGS) systems are frequently utilized during cranial base surgery to aid in orientation and facilitate targeted surgery. We wished to assess the performance of our recently developed localized intraoperative virtual endoscopy (LIVE)-IGS prototype in a preclinical setting prior to deployment in the operating room. This system combines real-time ablative instrument tracking, critical structure proximity alerts, three-dimensional virtual endoscopic views, and intraoperative cone-beam computed tomographic image updates. Randomized-controlled trial plus qualitative analysis. Skull base procedures were performed on 14 cadaver specimens by seven fellowship-trained skull base surgeons. Each subject performed two endoscopic transclival approaches; one with LIVE-IGS and one using a conventional IGS system in random order. National Aeronautics and Space Administration Task Load Index (NASA-TLX) scores were documented for each dissection, and a semistructured interview was recorded for qualitative assessment. The NASA-TLX scores for mental demand, effort, and frustration were significantly reduced with the LIVE-IGS system in comparison to conventional navigation (P < .05). The system interface was judged to be intuitive and most useful when there was a combination of high spatial demand, reduced or absent surface landmarks, and proximity to critical structures. The development of auditory icons for proximity alerts during the trial better informed the surgeon while limiting distraction. The LIVE-IGS system provided accurate, intuitive, and dynamic feedback to the operating surgeon. Further refinements to proximity alerts and visualization settings will enhance orientation while limiting distraction. The system is currently being deployed in a prospective clinical trial in skull base surgery. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  19. Pico Lantern: a pick-up projector for augmented reality in laparoscopic surgery.

    Edgcumbe, Philip; Pratt, Philip; Yang, Guang-Zhong; Nguan, Chris; Rohling, Rob

    2014-01-01

    The Pico Lantern is proposed as a new tool for guidance in laparoscopic surgery. Its miniaturized design allows it to be picked up by a laparoscopic tool during surgery and tracked directly by the endoscope. By using laser projection, different patterns and annotations can be projected onto the tissue surface. The first explored application is surface reconstruction. The absolute error for surface reconstruction using stereo endoscopy and untracked Pico Lantern for a plane, cylinder and ex vivo kidney is 2.0 mm, 3.0 mm and 5.6 mm respectively. The absolute error using a mono endoscope and a tracked Pico Lantern for the same plane, cylinder and kidney is 0.8mm, 0.3mm and 1.5mm respectively. The results show the benefit of the wider baseline produced by tracking the Pico Lantern. Pulsatile motion of a human carotid artery is also detected in vivo. Future work will be done on the integration into standard and robot-assisted laparoscopic surgery.

  20. Modifications to a 3D-printed temporal bone model for augmented stapes fixation surgery teaching.

    Nguyen, Yann; Mamelle, Elisabeth; De Seta, Daniele; Sterkers, Olivier; Bernardeschi, Daniele; Torres, Renato

    2017-07-01

    Functional outcomes and complications in otosclerosis surgery are governed by the surgeon's experience. Thus, teaching the procedure to residents to guide them through the learning process as quickly as possible is challenging. Artificial 3D-printed temporal bones are replacing cadaver specimens in many institutions to learn mastoidectomy, but these are not suitable for middle ear surgery training. The goal of this work was to adapt such an artificial temporal bone to aid the teaching of otosclerosis surgery and to evaluate this tool. We have modified a commercially available 3D-printed temporal bone by replacing the incus and stapes of the model with in-house 3D-printed ossicles. The incus could be attached to a 6-axis force sensor. The stapes footplate was fenestrated and attached to a 1-axis force sensor. Six junior surgeons (residents) and seven senior surgeons (fellows or consultants) were enrolled to perform piston prosthesis placement and crimping as performed during otosclerosis surgery. The time required to perform the tasks and the forces applied to the incus and stapes were collected and analyzed. No statistically significant differences were observed between the junior and senior groups for time taken to perform the tasks and the forces applied to the incus during crimping and placement of the prosthesis. However, significantly lower forces were applied to the stapes by the senior surgeons in comparison with the junior surgeons during prosthesis placement (junior vs senior group, 328 ± 202.9 vs 80 ± 99.6 mN, p = 0.008) and during prosthesis crimping (junior vs senior group, 565 ± 233 vs 66 ± 48.6 mN, p = 0.02). We have described a new teaching tool for otosclerosis surgery based on the modification of a 3D-printed temporal bone to implement force sensors on the incus and stapes. This tool could be used as a training tool to help the residents to self-evaluate their progress with recording of objective measurements.

  1. The GOSTT concept and hybrid mixed/virtual/augmented reality environment radioguided surgery

    Valdés Olmos, R. A.; Van Leeuwen, F. W. B.; Vidal-Sicart, S.; Giammarile, F.; Zaknun, J. J.; Mariani, G.

    2014-01-01

    The popularity gained by the sentinel lymph node (SLN) procedure in the last two decades did increase the interest of the surgical disciplines for other applications of radioguided surgery. An example is the gamma-probe guided localization of occult or difficult to locate neoplastic lesions. Such guidance can be achieved by intralesional delivery (ultrasound, stereotaxis or CT) of a radiolabelled agent that remains accumulated at the site of the injection. Another possibility rested on the use of systemic administration of a tumour-seeking radiopharmaceutical with favourable tumour accumulation and retention. On the other hand, new intraoperative imaging devices for radioguided surgery in complex anatomical areas became available. All this a few years ago led to the delineation of the concept Guided intraOperative Scintigraphic Tumour Targeting (GOSTT) to include the whole spectrum of basic and advanced nuclear medicine procedures required for providing a roadmap that would optimise surgery. The introduction of allied signatures using, e.g. hybrid tracers for simultaneous detection of the radioactive and fluorescent signals did amply the GOSTT concept. It was now possible to combine perioperative nuclear medicine imaging with the superior resolution of additional optical guidance in the operating room. This hybrid approach is currently in progress and probably will become an important model to follow in the coming years. A cornerstone in the GOSTT concept is constituted by diagnostic imaging technologies like SPECT/CT. SPECT/CT was introduced halfway the past decade and was immediately incorporated into the SLN procedure. Important reasons attributing to the success of SPECT/CT were its combination with lymphoscintigraphy, and the ability to display SLNs in an anatomical environment. This latter aspect has significantly been improved in the new generation of SPECT/CT cameras and provides the base for the novel mixed reality protocols of image-guided surgery. In

  2. The GOSTT concept and hybrid mixed/virtual/augmented reality environment radioguided surgery.

    Valdés Olmos, R A; Vidal-Sicart, S; Giammarile, F; Zaknun, J J; Van Leeuwen, F W; Mariani, G

    2014-06-01

    The popularity gained by the sentinel lymph node (SLN) procedure in the last two decades did increase the interest of the surgical disciplines for other applications of radioguided surgery. An example is the gamma-probe guided localization of occult or difficult to locate neoplastic lesions. Such guidance can be achieved by intralesional delivery (ultrasound, stereotaxis or CT) of a radiolabelled agent that remains accumulated at the site of the injection. Another possibility rested on the use of systemic administration of a tumour-seeking radiopharmaceutical with favourable tumour accumulation and retention. On the other hand, new intraoperative imaging devices for radioguided surgery in complex anatomical areas became available. All this a few years ago led to the delineation of the concept Guided intraOperative Scintigraphic Tumour Targeting (GOSTT) to include the whole spectrum of basic and advanced nuclear medicine procedures required for providing a roadmap that would optimise surgery. The introduction of allied signatures using, e.g. hybrid tracers for simultaneous detection of the radioactive and fluorescent signals did amply the GOSTT concept. It was now possible to combine perioperative nuclear medicine imaging with the superior resolution of additional optical guidance in the operating room. This hybrid approach is currently in progress and probably will become an important model to follow in the coming years. A cornerstone in the GOSTT concept is constituted by diagnostic imaging technologies like SPECT/CT. SPECT/CT was introduced halfway the past decade and was immediately incorporated into the SLN procedure. Important reasons attributing to the success of SPECT/CT were its combination with lymphoscintigraphy, and the ability to display SLNs in an anatomical environment. This latter aspect has significantly been improved in the new generation of SPECT/CT cameras and provides the base for the novel mixed reality protocols of image-guided surgery. In

  3. SLAM-based dense surface reconstruction in monocular Minimally Invasive Surgery and its application to Augmented Reality.

    Chen, Long; Tang, Wen; John, Nigel W; Wan, Tao Ruan; Zhang, Jian Jun

    2018-05-01

    While Minimally Invasive Surgery (MIS) offers considerable benefits to patients, it also imposes big challenges on a surgeon's performance due to well-known issues and restrictions associated with the field of view (FOV), hand-eye misalignment and disorientation, as well as the lack of stereoscopic depth perception in monocular endoscopy. Augmented Reality (AR) technology can help to overcome these limitations by augmenting the real scene with annotations, labels, tumour measurements or even a 3D reconstruction of anatomy structures at the target surgical locations. However, previous research attempts of using AR technology in monocular MIS surgical scenes have been mainly focused on the information overlay without addressing correct spatial calibrations, which could lead to incorrect localization of annotations and labels, and inaccurate depth cues and tumour measurements. In this paper, we present a novel intra-operative dense surface reconstruction framework that is capable of providing geometry information from only monocular MIS videos for geometry-aware AR applications such as site measurements and depth cues. We address a number of compelling issues in augmenting a scene for a monocular MIS environment, such as drifting and inaccurate planar mapping. A state-of-the-art Simultaneous Localization And Mapping (SLAM) algorithm used in robotics has been extended to deal with monocular MIS surgical scenes for reliable endoscopic camera tracking and salient point mapping. A robust global 3D surface reconstruction framework has been developed for building a dense surface using only unorganized sparse point clouds extracted from the SLAM. The 3D surface reconstruction framework employs the Moving Least Squares (MLS) smoothing algorithm and the Poisson surface reconstruction framework for real time processing of the point clouds data set. Finally, the 3D geometric information of the surgical scene allows better understanding and accurate placement AR augmentations

  4. Titanium Granules for Augmentation of the Maxillary Sinus

    Lyngstadaas, Ståle Petter; Verket, Anders; Pinholt, Else Marie

    2015-01-01

    BACKGROUND: Biomaterials are commonly used to augment the maxillary sinus floor prior to or in conjunction with dental implant installation. Recently, porous titanium granules (PTGs) have been used in oral implant surgery to stabilize implants and function as an osteoconductive matrix. PURPOSE...... in the study. RESULTS: One immobile implant was removed. The mean marginal bone loss was 0.5 mm and 0.8 mm, on the mesial and distal side, respectively. Histologically, all biopsies demonstrated bone ingrowth. CONCLUSIONS: The results suggest that PTG can be safely and effectively used as augmentation material...

  5. Sinus Augmentation by Platelet-Rich Fibrin Alone: A Report of Two Cases with Histological Examinations

    Naofumi Aoki

    2016-01-01

    Full Text Available In sinus floor augmentation of an atrophic posterior maxilla, platelet-rich fibrin (PRF has been used as a graft material. We herein report two cases with histological evaluations of PRF after the surgery. The first case was a 28-year-old female with an atrophic right posterior maxilla who was treated with sinus floor augmentation and simultaneous implant placement using PRF as the sole graft material in our hospital. Twenty-four months after surgery, the implant was unfortunately removed because of occlusal overloading by parafunctional habits. During implant replacement, a tissue sample was obtained from the site of augmentation with PRF and was evaluated histologically. The second case was a 58-year-old man with severe alveolar atrophy of the right maxilla who underwent lateral sinus augmentation using only PRF in a two-stage procedure in our hospital. Samples were obtained at the second-stage surgery and histological examinations were performed. As a result, new bone formation was confirmed histologically in both cases. Our findings show that the use of PRF as a graft material during sinus floor augmentation induces natural bone regeneration.

  6. Impact of Virtual and Augmented Reality Based on Intraoperative Magnetic Resonance Imaging and Functional Neuronavigation in Glioma Surgery Involving Eloquent Areas.

    Sun, Guo-Chen; Wang, Fei; Chen, Xiao-Lei; Yu, Xin-Guang; Ma, Xiao-Dong; Zhou, Ding-Biao; Zhu, Ru-Yuan; Xu, Bai-Nan

    2016-12-01

    The utility of virtual and augmented reality based on functional neuronavigation and intraoperative magnetic resonance imaging (MRI) for glioma surgery has not been previously investigated. The study population consisted of 79 glioma patients and 55 control subjects. Preoperatively, the lesion and related eloquent structures were visualized by diffusion tensor tractography and blood oxygen level-dependent functional MRI. Intraoperatively, microscope-based functional neuronavigation was used to integrate the reconstructed eloquent structure and the real head and brain, which enabled safe resection of the lesion. Intraoperative MRI was used to verify brain shift during the surgical process and provided quality control during surgery. The control group underwent surgery guided by anatomic neuronavigation. Virtual and augmented reality protocols based on functional neuronavigation and intraoperative MRI provided useful information for performing tailored and optimized surgery. Complete resection was achieved in 55 of 79 (69.6%) glioma patients and 20 of 55 (36.4%) control subjects, with average resection rates of 95.2% ± 8.5% and 84.9% ± 15.7%, respectively. Both the complete resection rate and average extent of resection differed significantly between the 2 groups (P virtual and augmented reality based on functional neuronavigation and intraoperative MRI can facilitate resection of gliomas involving eloquent areas. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Presence of fusion in albinism after strabismus surgery augmented with botulinum toxin (type a) injection.

    Tavakolizadeh, Sepideh; Farahi, Azadeh

    2013-08-01

    It is commonly accepted that albino patients with strabismus rarely achieve binocularity and depth perception after strabismus surgery. The presence of retino-geniculo-cortical misrouting, a hallmark of the visual system in albinism, does not necessarily cause total loss of binocular vision, however, not even in albino patients with strabismus. Recently some degrees of stereopsis were reported in albinism patients with minimal clinical nystagmus, if any, in the absence of strabismus. It is possible that patients with albinism and strabismus have binocular visual potential which appears after strabismus correction and provides appropriate postoperative alignment in the long term. Here we present two cases of clinically diagnosed oculocutaneous albinism, an 18-year-old girl and a 16-year-old boy, both with exotropia ≥40 prism diopter, who gained acceptable alignment and fusion after surgical correction of their strabismus as demonstrated on Bagolini testing. In cases of albinism accompanied by visual pathway abnormalities and strabismus, binocular visual potential is not impossible, and some levels can be expected. Thus, these patients, like other cases of strabismus, may benefit from treatment of strabismus at an earlier age to achieve appropriate alignment, cosmetic satisfaction, and a possibly increased chance of fusion.

  8. A 3-year clinical and radiographic study of implants placed simultaneously with maxillary sinus floor augmentations using a new nanocrystalline hydroxyapatite.

    Heinemann, F; Mundt, T; Biffar, R; Gedrange, T; Goetz, W

    2009-12-01

    The aims of this case series was to evaluate the success rate of implants and their restorations, the sinus bone graft resorption, and the marginal bone loss around the implants when nanocristalline HA embedded in a silica matrix was exclusively used as grafting material. In 13 partially edentulous patients of a private practice having missing teeth in the posterior maxilla and a subantral bone height between 3 and 7 mm, 19 sinus augmentations (100% Nanobone, Artoss, Rostock, Germany) by the lateral lift technique were performed. The implants (Tiolox/Tiologic Implants, Dentaurum, Ispringen, Germany) were simultaneously placed. After 6 to 9 months 37 implants were restored with fixed dental prostheses. The clinical evaluation included peri-implant parameters, periotest measurements and the restorations. The radiographic bone heights over time were estimated with linear mixed models. The implant success rate was 100% after three years. The periotest values (between -7 and -6) after implant abutment connection indicated a solid osseointegration. The mean rates of the marginal bone loss over the first year were higher (mesial: -0.55, distal: -0.51 mm) than the annual rates thereafter (mesial: -0.09 mm, distal: -0.08 mm). The mean rates of changes in the total bone height were neglectable (<0.2 mm) and not significant. The prosthodontic and esthetic evaluation revealed a successful outcome. Within the limits of this clinical report it may be concluded that maxillary sinus augmentation using 100% nanocristalline HA embedded in a silica matrix to support implants is a reliable procedure.

  9. Enabling or Cultivating? The Role of Prostate Cancer Patients' Received Partner Support and Self-Efficacy in the Maintenance of Pelvic Floor Exercise Following Tumor Surgery.

    Hohl, Diana Hilda; Knoll, Nina; Wiedemann, Amelie; Keller, Jan; Scholz, Urte; Schrader, Mark; Burkert, Silke

    2016-04-01

    To manage incontinence following tumor surgery, prostate cancer patients are advised to perform pelvic floor exercise (PFE). Patients' self-efficacy and support from partners were shown to facilitate PFE. Whereas support may enhance self-efficacy (enabling function), self-efficacy may also cultivate support (cultivation function). Cross-lagged inter-relationships among self-efficacy, support, and PFE were investigated. Post-surgery patient-reported received support, self-efficacy, PFE, and partner-reported provided support were assessed from 175 couples at four times. Autoregressive models tested interrelations among variables, using either patients' or partners' reports of support. Models using patients' data revealed positive associations between self-efficacy and changes in received support, which predicted increased PFE. Using partners' accounts of support provided, these associations were partially cross-validated. Furthermore, partner-provided support was related with increases in patients' self-efficacy. Patients' self-efficacy may cultivate partners' support provision for patients' PFE, whereas evidence of an enabling function of support as a predictor of self-efficacy was inconsistent.

  10. A CT-ultrasound-coregistered augmented reality enhanced image-guided surgery system and its preliminary study on brain-shift estimation

    Huang, C H; Hsieh, C H; Lee, J D; Huang, W C; Lee, S T; Wu, C T; Sun, Y N; Wu, Y T

    2012-01-01

    With the combined view on the physical space and the medical imaging data, augmented reality (AR) visualization can provide perceptive advantages during image-guided surgery (IGS). However, the imaging data are usually captured before surgery and might be different from the up-to-date one due to natural shift of soft tissues. This study presents an AR-enhanced IGS system which is capable to correct the movement of soft tissues from the pre-operative CT images by using intra-operative ultrasound images. First, with reconstructing 2-D free-hand ultrasound images to 3-D volume data, the system applies a Mutual-Information based registration algorithm to estimate the deformation between pre-operative and intra-operative ultrasound images. The estimated deformation transform describes the movement of soft tissues and is then applied to the pre-operative CT images which provide high-resolution anatomical information. As a result, the system thus displays the fusion of the corrected CT images or the real-time 2-D ultrasound images with the patient in the physical space through a head mounted display device, providing an immersive augmented-reality environment. For the performance validation of the proposed system, a brain phantom was utilized to simulate brain-shift scenario. Experimental results reveal that when the shift of an artificial tumor is from 5mm ∼ 12mm, the correction rates can be improved from 32% ∼ 45% to 87% ∼ 95% by using the proposed system.

  11. Relationship between the Pelvic Organ Prolapse Quantification system (POP-Q), the Pelvic Floor Impact Questionnaire (PFIQ-7), and the Pelvic Floor Distress Inventory (PFDI-20) before and after anterior vaginal wall prolapse surgery

    Rudnicki, Martin

    2015-01-01

    between the change in point Ba and scores following surgery. Statistical analyses used McNemar's and Wilcoxon signed-rank tests, Spearman's rank-order correlation, and multiple linear regression. RESULTS: Surgery significantly improved POP-Q, PFIQ-7, and PFDI-20 scores, including subscales. We observed...

  12. Floors: Selection and Maintenance.

    Berkeley, Bernard

    Flooring for institutional, commercial, and industrial use is described with regard to its selection, care, and maintenance. The following flooring and subflooring material categories are discussed--(1) resilient floor coverings, (2) carpeting, (3) masonry floors, (4) wood floors, and (5) "formed-in-place floors". The properties, problems,…

  13. Characteristics of women with cosmetic breast augmentation surgery compared with breast reduction surgery patients and women in the general population of Sweden

    Fryzek, JP; Weiderpass, E; Signorello, LB; Hakelius, L; Lipworth, L; Blot, WJ; McLaughlin, JK; Nyren, O

    2000-01-01

    To determine whether women with cosmetic breast implants have distinct demographic, lifestyle, and reproductive characteristics that put them at increased risk for subsequent morbidity, the authors compared 1,369 such women to 2,211 women who had undergone breast reduction surgery, and to a random

  14. Laparoscopic Pelvic Floor Repair Using Polypropylene Mesh

    Shih-Shien Weng

    2008-09-01

    Conclusion: Laparoscopic pelvic floor repair using a single piece of polypropylene mesh combined with uterosacral ligament suspension appears to be a feasible procedure for the treatment of advanced vaginal vault prolapse and enterocele. Fewer mesh erosions and postoperative pain syndromes were seen in patients who had no previous pelvic floor reconstructive surgery.

  15. Augmented reality in dentistry: a current perspective.

    Kwon, Ho-Beom; Park, Young-Seok; Han, Jung-Suk

    2018-02-21

    Augmentation reality technology offers virtual information in addition to that of the real environment and thus opens new possibilities in various fields. The medical applications of augmentation reality are generally concentrated on surgery types, including neurosurgery, laparoscopic surgery and plastic surgery. Augmentation reality technology is also widely used in medical education and training. In dentistry, oral and maxillofacial surgery is the primary area of use, where dental implant placement and orthognathic surgery are the most frequent applications. Recent technological advancements are enabling new applications of restorative dentistry, orthodontics and endodontics. This review briefly summarizes the history, definitions, features, and components of augmented reality technology and discusses its applications and future perspectives in dentistry.

  16. Local complications after cosmetic breast augmentation: results from the Danish Registry for Plastic Surgery of the breast

    Hvilsom, Gitte B; Hölmich, Lisbet R; Henriksen, Trine F

    2009-01-01

    to 30 days, 0 to 3 years, and 0 to 5 years) after primary implantation. Outcomes of primary interest were capsular contracture, asymmetry/displacement of the implant, hematoma, and infection. RESULTS: During the entire follow-up period (mean, 3.8 years; range, 0.1 to 8.7 years), 16.7 percent...... of the women were registered with an adverse event and 4.8 percent of the women were registered with a surgery-requiring complication. The most common adverse events within 30 days were hematoma (1.1 percent) and infections (1.2 percent), whereas the most common adverse events within 5 years were change...

  17. Physical Therapy Intervention to Augment Outcomes Of Lymph Node Transfer Surgery for a Breast Cancer Survivor with Secondary Upper Extremity Lymphedema: A Case Report.

    McKey, Katelyn P; Alappattu, Meryl J

    Lymphedema is an incurable complication of breast cancer treatment that affects roughly 20 percent of women. It is often managed via complete decongestive therapy, which includes manual lymph drainage, therapeutic compression, skin care, and exercise. Lymph node transfer is a new and expensive surgical intervention that uses one's own lymph nodes and implants them in the affected upper extremity. Previous research has investigated augmenting lymph node transfer surgery with complete decongestive therapy, but there is a lack of evidence regarding the success of focusing lymph drainage against the normal pressure gradient toward a surgical flap located on the wrist. The patient's main motivation for the surgical intervention was to alleviate her daily burden of complete decongestive therapy. The purpose of this case report was to compare the methods and results of pre-surgical complete decongestive physical therapy to a post-operation modified approach that directed lymph fluid away from the major lymphatic ducts and instead toward a surgical flap on the wrist of a patient with lymphedema. A 65-year-old female presented with secondary upper extremity lymphedema following breast cancer treatment. Her circumferential measurements and L-Dex score corroborated this diagnosis, and she had functional deficits in upper extremity range of motion. She was seen for 10 visits of traditional complete decongestive therapy prior to her lymph node transfer surgery and 24 treatments of modified complete decongestive therapy over the course of six months following surgery. At six months, the patient had minor improvements in the Functional Assessment of Chronic Illness Therapy-Fatigue, Disabilities of the Arm, Shoulder and Hand questionnaire, range of motion, and upper extremity strength. However, her circumferential measurements and L-Dex scores showed a meaningful increase in limb girth. The patient's smallest upper extremity volumes were documented before the operation after two

  18. Augmented postcard

    Bernik , Aleš

    2012-01-01

    The aim of this thesis is the examination of augmented reality technology, which allows us mixing real and virtual elements. Augmented reality is a relatively new technology which is becoming more widespread, thanks to a fairly reasonable price of smart phones. Here we presents the types of augmented reality, the necessary technology and their advantages and disadvantages, its current use in applications, and software for building augmented reality applications. The thesis is mainly focuse...

  19. Augmented reality in neurosurgery.

    Tagaytayan, Raniel; Kelemen, Arpad; Sik-Lanyi, Cecilia

    2018-04-01

    Neurosurgery is a medical specialty that relies heavily on imaging. The use of computed tomography and magnetic resonance images during preoperative planning and intraoperative surgical navigation is vital to the success of the surgery and positive patient outcome. Augmented reality application in neurosurgery has the potential to revolutionize and change the way neurosurgeons plan and perform surgical procedures in the future. Augmented reality technology is currently commercially available for neurosurgery for simulation and training. However, the use of augmented reality in the clinical setting is still in its infancy. Researchers are now testing augmented reality system prototypes to determine and address the barriers and limitations of the technology before it can be widely accepted and used in the clinical setting.

  20. [Augmented reality for image guided therapy (ARIGT) of kidney tumor during nephron sparing surgery (NSS): animal model and clinical approach].

    Drewniak, Tomasz; Rzepecki, Maciej; Juszczak, Kajetan; Kwiatek, Wojciech; Bielecki, Jakub; Zieliński, Krzysztof; Ruta, Andrzej; Czekierda, Łukasz; Moczulskis, Zbigniew

    2011-01-01

    The main problem in nephron sparing surgery (NSS) is to preserve renal tumors oncological purity during the removal of the tumor with a margin of macroscopically unchanged kidney tissue while keeping the largest possible amount of normal parenchyma of the operated kidney. The development of imaging techniques, in particular IGT (Image Guided Therapy) allows precise imaging of the surgical field and, therefore, is essential in improving the effectiveness of NSS (increase of nephron sparing with the optimal radicality). The aim of this study was to develop a method of the three-dimensional (3D) imaging of the kidney tumor and its lodge in the operated kidney using 3D laser scanner during NSS procedure. Additionally, the animal model of visualization was developed. The porcine kidney model was used to test the set built up with HD cameras and linear laser scanner connected to a laptop with graphic software (David Laser Scanner, Germany) showing the surface of the kidney and the lodge after removal the chunk of renal parenchyma. Additionally, the visualization and reconstruction was performed on animal porcine model. Moreover, 5 patients (3 women, 2 men) aged from 37 to 68 years (mean 56), diagnosed with kidney tumors in CT scans with a diameter of 3.7-6.9 cm (mean 4.9) were operated in our Department this year, scanning the surface during the treatment with the kidney tumor and kidney tumor after it is removed with a margin of renal tissue. In one case, the lodge of removed tumor was scanned. Dimensions in 3D reconstruction images of laser scans in the study of animal model and the images obtained intraoperatively were compared with the dimensions evaluated during preoperative CT scans, intraoperative measurements. Three-dimensional imaging laser scanner operating field loge resected tumor and the tumor on the kidney of animal models and during NSS treatments for patients with kidney tumors is possible in real time with an accuracy of -2 mm do +9 mm (+/- 3 mm). The

  1. AUGMENTED REALITY

    Skov, Kirsten; Bahn, Anne Louise

    2017-01-01

    Projektets grundlæggende idé er udvikling af visuel, æstetisk læring med Augmented Reality, hvor intentionen er at bidrage med konkrete undersøgelser og udforskning af begrebet Augmented Reality – herunder koblingen mellem det analoge og digitale i forhold til læring, multimodalitet og it...

  2. SUSTAINABLE TRAILER FLOORING

    John Lu; Marc Chorney; Lowell Peterson

    2009-01-01

    Different trailer flooring materials, including wood-based, aluminum, steel, and synthetic plastic floors, were evaluated in accordance with their durability and sustainability to our natural environment. Wood-based trailer flooring is an eco-friendly product. It is the most sustainable trailer flooring material compared with fossil fuel-intensive steel, aluminum, and plastics. It is renewable and recyclable. Oak, hard maple, and apitong are strong and durable hardwood species that are curren...

  3. Decontamination of floor surfaces

    Smirous, F.

    1983-01-01

    Requirements are presented put on the surfaces of floors of radiochemical workplaces. The mechanism is described of retaining the contaminant in the surface of the flooring, ways of reducing the hazards of floor surface contamination, decontamination techniques and used decontamination agents. (J.P.)

  4. Chin augmentation

    ... or bigger compared to the nose. The best candidates for chin augmentation are people with weak or ... www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. ...

  5. SUSTAINABLE TRAILER FLOORING

    John Lu

    2009-05-01

    Full Text Available Different trailer flooring materials, including wood-based, aluminum, steel, and synthetic plastic floors, were evaluated in accordance with their durability and sustainability to our natural environment. Wood-based trailer flooring is an eco-friendly product. It is the most sustainable trailer flooring material compared with fossil fuel-intensive steel, aluminum, and plastics. It is renewable and recyclable. Oak, hard maple, and apitong are strong and durable hardwood species that are currently extensively used for trailer flooring. For manufacture, wood-based flooring is higher in energy efficiency and lower in carbon emission than steel, aluminum and plastics. Moreover, wood per se is a natural product that sequesters carbon. Accordingly, using more wood-based trailer flooring is effective to reduce global warming.

  6. Augmented reality

    Patrik Pucer

    2011-08-01

    Full Text Available Today we can obtain in a simple and rapid way most of the information that we need. Devices, such as personal computers and mobile phones, enable access to information in different formats (written, pictorial, audio or video whenever and wherever. Daily we use and encounter information that can be seen as virtual objects or objects that are part of the virtual world of computers. Everyone, at least once, wanted to bring these virtual objects from the virtual world of computers into real environments and thus mix virtual and real worlds. In such a mixed reality, real and virtual objects coexist in the same environment. The reality, where users watch and use the real environment upgraded with virtual objects is called augmented reality. In this article we describe the main properties of augmented reality. In addition to the basic properties that define a reality as augmented reality, we present the various building elements (possible hardware and software that provide an insight into such a reality and practical applications of augmented reality. The applications are divided into three groups depending on the information and functions that augmented reality offers, such as help, guide and simulator.

  7. Production of ascorbic acid releasing biomaterials for pelvic floor repair.

    Mangır, Naşide; Bullock, Anthony J; Roman, Sabiniano; Osman, Nadir; Chapple, Christopher; MacNeil, Sheila

    2016-01-01

    An underlying abnormality in collagen turnover is implied in the occurrence of complications and recurrences after mesh augmented pelvic floor repair surgeries. Ascorbic acid is a potent stimulant of collagen synthesis. The aim of this study is to produce ascorbic acid releasing poly-lactic acid (PLA) scaffolds and evaluate them for their effects on extracellular matrix production and the strength of the materials. Scaffolds which contained either l-ascorbic acid (AA) and Ascorbate-2-Phosphate (A2P) were produced with emulsion electrospinning. The release of both drugs was measured by UV spectrophotometry. Human dermal fibroblasts were seeded on scaffolds and cultured for 2weeks. Cell attachment, viability and total collagen production were evaluated as well as mechanical properties. No significant differences were observed between AA, A2P, Vehicle and PLA scaffolds in terms of fibre diameter and pore size. The encapsulation efficiency and successful release of both AA and A2P were demonstrated. Both AA and A2P containing scaffolds were significantly more hydrophilic and stronger in both dry and wet states compared to PLA scaffolds. Fibroblasts produced more collagen on scaffolds containing either AA or A2P compared to cells grown on control scaffolds. This study is the first to directly compare the two ascorbic acid derivatives in a tissue engineered scaffold and shows that both AA and A2P releasing electrospun PLA scaffolds increased collagen production of fibroblasts to similar extents but AA scaffolds seemed to be more hydrophilic and stronger compared to A2P scaffolds. Mesh augmented surgical repair of the pelvic floor currently relies on non-degradable materials which results in severe complications in some patients. There is an unmet and urgent need for better pelvic floor repair materials. Our current understanding suggests that the ideal material should be able to better integrate into sites of implantation both biologically and mechanically. The impact of

  8. Fixation of Light Weight Polypropylene Mesh with n-Butyl-2-cyanocrylate in Pelvic Floor Surgery: Experimental Design Approach in Sheep for Effectiveness Evaluation

    Sandra Barbosa

    2015-01-01

    Full Text Available Objective. The aim of this study was to find a proper experimental design and to evaluate n-butyl-2-cyanoacrylate (Histoacryl as a fixation method for a light-weight and large pore PP mesh (Synthetic PP Mesh-1 using the sheep as an animal model. Methods. Posterior vaginal implantation by means of episiotomy was used to implant 8 ewes which were evaluated macroscopically and histologically at 3 months (n=4 and 6 months (n=4 post-surgery. In previous pilot studies anterior vaginal implantation was evaluated, as well as different synthetic mesh materials, sizes and fixation methods (n=1 to 3 during three weeks. In all cases a clinical evaluation of the animal was performed. Results. A reduction in the mesh size (Synthetic PP Mesh-1 together with precise application of the surgical glue Histoacryl to fix the mesh yielded significantly better histocompatibility results (P<0.01 compared to larger size or other fixation methods. Conclusion. The combination of Synthetic PP Mesh-1 with Histoacryl offered a high degree of graft integration without vaginal ulceration and a minimal foreign body reaction, being the sheep a proper animal model to test these types of medical devices.

  9. Supporting shop floor intelligence

    Carstensen, Peter; Schmidt, Kjeld; Wiil, Uffe Kock

    1999-01-01

    Many manufacturing enterprises are now trying to introduce various forms of flexible work organizations on the shop floor. However, existing computer-based production planning and control systems pose severe obstacles for autonomous working groups and other kinds of shop floor control to become r......-to-day production planning by supporting intelligent and responsible workers in their situated coordination activities on the shop floor....

  10. Augmented Reality

    Kjærgaard, Hanne Wacher; Kjeldsen, Lars Peter Bech; Rahn, Annette

    2015-01-01

    This chapter describes the use of iPad-facilitated application of augmented reality in the teaching of highly complex anatomical and physiological subjects in the training of nurses at undergraduate level. The general aim of the project is to investigate the potentials of this application in terms...... of making the complex content and context of these subjects more approachable to the students through the visualization made possible through the use of this technology. A case study is described in this chapter. Issues and factors required for the sustainable use of the mobile-facilitated application...... of augmented reality are discussed....

  11. Short-term complications associated with the use of transvaginal mesh in pelvic floor reconstructive surgery: Results from a multi-institutional prospectively maintained dataset.

    Caveney, Maxx; Haddad, Devin; Matthews, Catherine; Badlani, Gopal; Mirzazadeh, Majid

    2017-11-01

    Vaginal reconstructive surgery can be performed with or without mesh. We sought to determine comparative rates of perioperative complications of native tissue versus vaginal mesh repairs for pelvic organ prolapse. Using the National Surgical Quality Improvement Program (NSQIP) database, we concatenated surgical data from vaginal procedures for prolapse repair, including anterior and posterior colporrhaphy, paravaginal defect repair, enterocele repair, and vaginal colpopexy using Current Procedural Terminology (CPT) coding. We stratified this data by the modifier associated with mesh usage at the time of the procedure. We then compared 30-day perioperative outcomes, postoperative complications (bleeding, infection, etc), and readmission rates between women with and without mesh-based repairs. We identified 10 657 vaginal reconstructive procedures without mesh and 959 mesh-based repairs from 2009 through 2013. Patients undergoing mesh repair were more likely to experience at least one complication than native tissue repair (9.28% vs 6.15%, P mesh group (11.37% vs 9.39%, P = 0.03). Procedures with mesh had a higher rate of perioperative bleeding requiring transfusion than native tissue repair (2.3% vs 0.49%, P surgical site infection (SSI) (0.52% vs 0.17%, P = 0.02). There were no significant differences in rates of readmission, superficial, or deep SSIs, pneumonia, urinary tract infection, sepsis, or renal failure. The use of vaginal mesh for pelvic organ prolapse repair appears to result in a higher rate of perioperative complications than native tissue repair. Patients undergoing these procedures should be counselled preoperatively concerning these risks. © 2017 Wiley Periodicals, Inc.

  12. Introductory guide to floors and flooring

    Billingham, PA

    1977-01-01

    Full Text Available not make use of the warming and cooling effects of direct contact with the ground. Indeed the precautions that are necessary to protect such floors against damp and decay may actually reduce the comfort levels within a house. This is because there is a... with resultant discomfort and extra heating costs. Today, in South Africa, most modern homesareof singlestorey con- struction with aconcrete floor slab in direct contact with theground which once again makes its full contribution to the comfort and structural...

  13. Augmented Reality

    Nielsen, Birgitte Lund; Brandt, Harald; Radmer, Ole

    2017-01-01

    Artiklen præsenterer resultater fra pilotafprøvning i 7.-klasses fysik/kemi og biologi af to Augmented Reality (AR)-apps til naturfagsundervisning. Muligheder og udfordringer ved lærerens stilladsering af elevernes undersøgende samtale og modelleringskompetence er undersøgt med interview...

  14. Floors: Care and Maintenance.

    Post Office Dept., Washington, DC.

    Guidelines, methods and policies regarding the care and maintenance of post office building floors are overviewed in this handbook. Procedures outlined are concerned with maintaining a required level of appearance without wasting manpower. Flooring types and characteristics and the particular cleaning requirements of each type are given along with…

  15. School Flooring Factors

    McGrath, John

    2012-01-01

    With all of the hype that green building is receiving throughout the school facility-management industry, it's easy to overlook some elements that may not be right in front of a building manager's nose. It is helpful to examine the role floor covering plays in a green building project. Flooring is one of the most significant and important systems…

  16. Solving decontaminable flooring problems

    Anon.

    1989-01-01

    Pennsylvania Power and Light wanted to cover deteriorating concrete in unit 2 of its Susquehanna BWR with a smooth, durable, decontaminable coating. Traditionally, floors in the plant had been coated with epoxy paint, but many of these floors suffered delamination, and failed in three to five years. Painting with epoxy would also interrupt operations for as much as three days while the floor dried, yet critical instruments in some areas had to be monitored at least once per shift. In addition, conventional floor surface preparation produced dust and vibration around sensitive equipment. The solution was a dustless scabbling system for surface preparation, followed by the installation of a high-strength acrylic industrial floor known as Silakal. The work was carried out by Pentek. Silikal bonds to the underlying concrete, so that delamination of the floor will not occur even under severe traffic conditions. Another advantage of this type of flooring is that it cures in one hour, so floor resurfacing has only minimal impact on plant operations. (author)

  17. Floor heating systems

    Radtke, U

    1984-02-01

    The question of whether PPC- and VPE-floor heating pipes can endure damage when incompletely imbedded in the floor finish is investigated in an experimental setup. An expansion of the pipe, caused by a temperature increase from 20/sup 0/C to 50/sup 0/C was measured and considered too small to deduce the degree of danger from the damage.

  18. Mersiline mesh in premaxillary augmentation.

    Foda, Hossam M T

    2005-01-01

    Premaxillary retrusion may distort the aesthetic appearance of the columella, lip, and nasal tip. This defect is characteristically seen in, but not limited to, patients with cleft lip nasal deformity. This study investigated 60 patients presenting with premaxillary deficiencies in which Mersiline mesh was used to augment the premaxilla. All the cases had surgery using the external rhinoplasty technique. Two methods of augmentation with Mersiline mesh were used: the Mersiline roll technique, for the cases with central symmetric deficiencies, and the Mersiline packing technique, for the cases with asymmetric deficiencies. Premaxillary augmentation with Mersiline mesh proved to be simple technically, easy to perform, and not associated with any complications. Periodic follow-up evaluation for a mean period of 32 months (range, 12-98 months) showed that an adequate degree of premaxillary augmentation was maintained with no clinically detectable resorption of the mesh implant.

  19. Perceived floor slipperiness and floor roughness in a gait experiment.

    Yu, Ruifeng; Li, Kai Way

    2015-01-01

    Slips and falls contribute to occupational injuries and fatalities globally. Both floor slipperiness and floor roughness affect the occurrence of slipping and falling. Investigations on fall-related phenomena are important for the safety and health of workers. The purposes of this study were to: compare the perceived floor slipperiness before and after walking on the floor; compare the perceived floor slipperiness with and without shoes for males and females; discuss the perceived floor roughness based on barefoot walking; and establish regression models to describe the relationship between perceived floor slipperiness and actual friction of the floors. Male and female subjects walked on 3 m walkways with or without shoes. The perceived floor slipperiness ratings both before and after their walk were collected. The perceived floor slipperiness both before and after walking were significantly affected by both floor and surface conditions. Gender, floor, surface, and footwear conditions were all significant factors affecting the adjustment of perceived floor slipperiness. The subjects made more adjustment on perceived floor slipperiness rating when they had shoes on than when they were barefooted. Regression models were established to describe the relationship between perceived floor slipperiness and floor coefficient of friction. These models may be used to estimate perceived floor slipperiness, or in reverse, the coefficient of friction of the floor, so as to prevent slipping and falling in workplaces.

  20. Augmented reality

    Jecha, Jakub

    2011-01-01

    This thesis is focused on a technology called Augmented reality, especially on its use in marketing. The main objective of the thesis is to define why this technology is a suitable tool for marketing and to assess its use in real conditions. This is achieved by defining specific devices and use cases of this technology in practice, whereas evaluation of its use in real enviroment is based on statistics. The contribution of the thesis is objective evaluation of this technology and provision of...

  1. Mandibular angle augmentation with the use of distraction and homologous lyophilized cartilage in a case of morphing to Michael Jackson surgery.

    Mommaerts, M Y; Abeloos, J S; Gropp, H

    2001-08-01

    Correction of an ill-defined mandibular angle is not an easy task, whether it is requested by the "congenital, orthognathic or cosmetic" patient. Deliberate over-correction has not been reported to our knowledge. This article presents a combination of distraction osteogenesis and lyophilized cartilage used to three-dimensionally over-augment the mandibular angle of a long-face prognathic patient who had the wish to be morphed to Michael Jackson or at least as far as current technique and his endogenic features allowed.

  2. Radiant Floor Cooling Systems

    Olesen, Bjarne W.

    2008-01-01

    In many countries, hydronic radiant floor systems are widely used for heating all types of buildings such as residential, churches, gymnasiums, hospitals, hangars, storage buildings, industrial buildings, and smaller offices. However, few systems are used for cooling.This article describes a floor...... cooling system that includes such considerations as thermal comfort of the occupants, which design parameters will influence the cooling capacity and how the system should be controlled. Examples of applications are presented....

  3. Mobile Collaborative Augmented Reality: The Augmented Stroll

    Renevier , Philippe; Nigay , Laurence

    2001-01-01

    International audience; The paper focuses on Augmented Reality systems in which interaction with the real world is augmented by the computer, the task being performed in the real world. We first define what mobile AR systems, collaborative AR systems and finally mobile and collaborative AR systems are. We then present the augmented stroll and its software design as one example of a mobile and collaborative AR system. The augmented stroll is applied to Archaeology in the MAGIC (Mobile Augmente...

  4. A cone-beam computed tomography triple scan procedure to obtain a three-dimensional augmented virtual skull model appropriate for orthognathic surgery planning.

    Swennen, G.R.J.; Mollemans, W.; Clercq, C. De; Abeloos, J.V.S.; Lamoral, P.; Lippens, F.R.C.; Neyt, N.; Casselman, J.W.; Schutyser, F.A.C.

    2009-01-01

    The aim of this study was to present a new approach to acquire a three-dimensional virtual skull model appropriate for orthognathic surgery planning without the use of plaster dental models and without deformation of the facial soft-tissue mask. A "triple" cone-beam computed tomography (CBCT) scan

  5. Relleno de cavidades óseas en cirugía maxilofacial con materiales autólogos Bone cavity augmentation in maxillofacial surgery using autologous material

    P. Infante-Cossío

    2007-02-01

    Full Text Available Aunque se han descrito numerosos materiales para rellenar una cavidad ósea, el mejor material sigue siendo el hueso autólogo corticoesponjoso o particulado, que puede formar hueso nuevo por mecanismos de osteogénesis, osteinducción y osteoconducción. El cirujano oral y maxilofacial debe conocer las propiedades biológicas y las características fundamentales de los materiales autólogos, las diferentes técnicas de obtención y sus aplicaciones clínicas. Como zonas donantes se emplean preferentemente las intraorales, el filtro de hueso y los raspadores para pequeños defectos, y el hueso ilíaco, tibia o calota cuando se requiere más cantidad. No existen estudios concluyentes respecto a la asociación de injertos óseos con membranas. La combinación de injertos autólogos con otros materiales de relleno, ha desembocado en múltiples estudios, sin que se puedan establecer conclusiones definitivas por el momento. El hueso autólogo es de elección para el relleno de cavidades óseas, ya que es útil para dar solución a variadas situaciones clínicas de forma simple, rápida y segura.Although a large number of materials have been described for augmenting bone cavities, the best material is still autologous cortical-cancellous bone or bone chip, which can form new bone through osteogenesis, osteoinduction and osteoconduct ion mechanisms. The oral and maxillofacial surgeon needs to be familiar with the biological properties and the fundamental characteristics of autologous material, the different techniques for obtaining it and its clinical application. Donor sites should preferably be intraoral. Bone filters and scrapers should be used for small defects, and the iliac, tibial or calvaria bones [should be used] when more quantity is required. There are no conclusive studies with regard to combining bone grafts with membranes. The combination of autologous grafts with other augmentation material has led to multiple studies, although

  6. Polygons on Crater Floor

    2003-01-01

    MGS MOC Release No. MOC2-357, 11 May 2003This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) picture shows a pattern of polygons on the floor of a northern plains impact crater. These landforms are common on crater floors at high latitudes on Mars. Similar polygons occur in the arctic and antarctic regions of Earth, where they indicate the presence and freeze-thaw cycling of ground ice. Whether the polygons on Mars also indicate water ice in the ground is uncertain. The image is located in a crater at 64.8oN, 292.7oW. Sunlight illuminates the scene from the lower left.

  7. ARLearn: augmented reality meets augmented virtuality

    Ternier, Stefaan; Klemke, Roland; Kalz, Marco; Van Ulzen, Patricia; Specht, Marcus

    2012-01-01

    Ternier, S., Klemke, R., Kalz, M., Van Ulzen, P., & Specht, M. (2012). ARLearn: augmented reality meets augmented virtuality [Special issue]. Journal of Universal Computer Science - Technology for learning across physical and virtual spaces, 18(15), 2143-2164.

  8. Augmented reality navigation in open surgery for hilar cholangiocarcinoma resection with hemihepatectomy using video-based in situ three-dimensional anatomical modeling: A case report.

    Tang, Rui; Ma, Longfei; Xiang, Canhong; Wang, Xuedong; Li, Ang; Liao, Hongen; Dong, Jiahong

    2017-09-01

    Patients who undergo hilar cholangiocarcinoma (HCAC) resection with concomitant hepatectomy have a high risk of postoperative morbidity and mortality due to surgical trauma to the hepatic and biliary vasculature. A 58-year-old Chinese man with yellowing skin and sclera, abdominal distension, pruritus, and anorexia for approximately 3 weeks. Magnetic resonance cholangiopancreatography and enhanced computed tomography (CT) scanning revealed a mass over the biliary tree at the porta hepatis, which diagnosed to be s a hilar cholangiocarcinoma. Three-dimensional (3D) images of the patient's hepatic and biliary structures were reconstructed preoperatively from CT data, and the 3D images were used for preoperative planning and augmented reality (AR)-assisted intraoperative navigation during open HCAC resection with hemihepatectomy. A 3D-printed model of the patient's biliary structures was also used intraoperatively as a visual reference. No serious postoperative complications occurred, and the patient was tumor-free at the 9-month follow-up examination based on CT results. AR-assisted preoperative planning and intraoperative navigation might be beneficial in other patients with HCAC patients to reduce postoperative complications and ensure disease-free survival. In our postoperative analysis, we also found that, when the3D images were superimposed 3D-printed model using a see-through integral video graphy display device, our senses of depth perception and motion parallax were improved, compared with that which we had experienced intraoperatively using the videobased AR display system.

  9. Pelvic floor muscle function in women with pelvic floor dysfunction

    Tibaek, Sigrid; Dehlendorff, Christian

    2014-01-01

    The objectives of this study were to investigate the level of pelvic floor muscle (PFM) function in women with pelvic floor dysfunction (PFD) referred by gynaecologists and urologists for in-hospital pelvic floor muscle training (PFMT), and to identity associated factors for a low level of PFM...

  10. Chronic pelvic floor dysfunction.

    Hartmann, Dee; Sarton, Julie

    2014-10-01

    The successful treatment of women with vestibulodynia and its associated chronic pelvic floor dysfunctions requires interventions that address a broad field of possible pain contributors. Pelvic floor muscle hypertonicity was implicated in the mid-1990s as a trigger of major chronic vulvar pain. Painful bladder syndrome, irritable bowel syndrome, fibromyalgia, and temporomandibular jaw disorder are known common comorbidities that can cause a host of associated muscular, visceral, bony, and fascial dysfunctions. It appears that normalizing all of those disorders plays a pivotal role in reducing complaints of chronic vulvar pain and sexual dysfunction. Though the studies have yet to prove a specific protocol, physical therapists trained in pelvic dysfunction are reporting success with restoring tissue normalcy and reducing vulvar and sexual pain. A review of pelvic anatomy and common findings are presented along with suggested physical therapy management. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Modular Flooring System

    Thate, Robert

    2012-01-01

    The modular flooring system (MFS) was developed to provide a portable, modular, durable carpeting solution for NASA fs Robotics Alliance Project fs (RAP) outreach efforts. It was also designed to improve and replace a modular flooring system that was too heavy for safe use and transportation. The MFS was developed for use as the flooring for various robotics competitions that RAP utilizes to meet its mission goals. One of these competitions, the FIRST Robotics Competition (FRC), currently uses two massive rolls of broadloom carpet for the foundation of the arena in which the robots are contained during the competition. The area of the arena is approximately 30 by 72 ft (approximately 9 by 22 m). This carpet is very cumbersome and requires large-capacity vehicles, and handling equipment and personnel to transport and deploy. The broadloom carpet sustains severe abuse from the robots during a regular three-day competition, and as a result, the carpet is not used again for competition. Similarly, broadloom carpets used for trade shows at convention centers around the world are typically discarded after only one use. This innovation provides a green solution to this wasteful practice. Each of the flooring modules in the previous system weighed 44 lb (.20 kg). The improvements in the overall design of the system reduce the weight of each module by approximately 22 lb (.10 kg) (50 %), and utilize an improved "module-to-module" connection method that is superior to the previous system. The MFS comprises 4-by-4-ft (.1.2-by- 1.2-m) carpet module assemblies that utilize commercially available carpet tiles that are bonded to a lightweight substrate. The substrate surface opposite from the carpeted surface has a module-to-module connecting interface that allows for the modules to be connected, one to the other, as the modules are constructed. This connection is hidden underneath the modules, creating a smooth, co-planar flooring surface. The modules are stacked and strapped

  12. Frames of Reference in Mobile Augmented Reality Displays

    Mou, Weimin; Biocca, Frank; Owen, Charles B.; Tang, Arthur; Xiao, Fan; Lim, Lynette

    2004-01-01

    In 3 experiments, the authors investigated spatial updating in augmented reality environments. Participants learned locations of virtual objects on the physical floor. They were turned to appropriate facing directions while blindfolded before making pointing judgments (e.g., "Imagine you are facing X. Point to Y"). Experiments manipulated the…

  13. The influence of body mass index and gender on the impact attenuation properties of flooring systems.

    Bhan, Shivam; Levine, Iris; Laing, Andrew C

    2013-12-01

    The biomechanical effectiveness of safety floors has never been assessed during sideways falls with human volunteers. Furthermore, the influence of body mass index (BMI) and gender on the protective capacity of safety floors is unknown. The purpose of this study was to test whether safety floors provide greater impact attenuation compared with traditional flooring, and whether BMI and gender modify their impact attenuation properties. Thirty participants (7 men and 7 women of low BMI; 7 men and 9 women of high BMI) underwent lateral pelvis release trials on 2 common floors and 4 safety floors. As a group, the safety floors reduced peak force (by up to 11.7%), and increased the time to peak force (by up to 25.5%) compared with a traditional institutional grade floor. Force attenuation was significantly higher for the low BMI group, and for males. Force attenuation was greatest for the low BMI males, averaging 26.5% (SD = 3.0) across the safety floors. These findings demonstrate an overall protective effect of safety floors during lateral falls on the pelvis, but also suggest augmented benefits for frail older adults (often with low body mass) who are at an increased risk of hip fracture.

  14. An approach to constipation associated with pelvic floor dysfunction ...

    A small group of patients, refractory to medical therapy should be considered for surgery. Should test results show pelvic floor dysfunction, then behavioural modifications such as biofeedback is successful in up to 76% of patients. An algorithmic approach to treatment is associated with an excellent long term outcome.

  15. Reconstruction of Orbital Floor With Auricular Concha.

    Seven, Ergin; Tellioglu, Ali Teoman; Inozu, Emre; Ozakpinar, Hulda Rifat; Horoz, Ugur; Eryilmaz, Avni Tolga; Karamursel, Sebat

    2017-10-01

    Orbital floor fractures of varying sizes commonly occur after orbital injuries and remain a serious challenge. Serious complications of such fractures include enopthalmos, restriction of extraocular movement, and diplopia. There is a dearth of literature that can be applied widely, easily, and successfully in all such situations, and therefore there is no consensus on the treatment protocol of this pathology yet. Autogenous grafts and alloplastic and allogenic materials with a wide variety of advantages and disadvantages have been discussed. The value of preoperative and postoperative ophthalmological examination should be standard of care in all orbital fracture patients. An ideal reconstructed orbital floor fracture should accelerate the restoration of orbital function with acceptable cosmetic results. Management parameters of orbital fractures such as timing of surgery, incision type, and implant materials, though widely discussed, remain controversial. In this study, 55 patients with orbital floor fractures surgically reconstructed with conchal cartilage grafts between 2008 and 2014 were retrospectively evaluated. Complications and long-time follow-up visit results have been reported with clinical and radiographic findings. The aim of this study was to present the authors' clinical experiences of reconstruction of blow-out fractures with auricular conchal graft and to evaluate the other materials available for use.

  16. Sea floor magnetic observatory

    Korepanov, V.; Prystai, A.; Vallianatos, F.; Makris, J.

    2003-04-01

    The electromagnetic precursors of seismic hazards are widely accepted as strong evidence of the approaching earthquake or volcano eruption. The monitoring of these precursors are of main interest in densely populated areas, what creates serious problems to extract them at the strong industrial noise background. An interesting possibility to improve signal-to-noise ratio gives the installation of the observation points in the shelf zones near the possible earthquake places, what is fairly possible in most seismically active areas in Europe, e. g. in Greece and Italy. The serious restriction for this is the cost of the underwater instrumentation. To realize such experiments it requires the unification of efforts of several countries (e. g., GEOSTAR) or of the funds of some great companies (e. g., SIO magnetotelluric instrument). The progress in electronic components development as well as the appearance of inexpensive watertight glass spheres made it possible to decrease drastically the price of recently developed sea floor magnetic stations. The autonomous vector magnetometer LEMI-301 for sea bed application is described in the report. It is produced on the base of three-component flux-gate sensor. Non-magnetic housing and minimal magnetism of electronic components enable the instrument to be implemented as a monoblock construction where the electronic unit is placed close to the sensor. Automatic circuit provides convenient compensation of the initial field offset and readings of full value (6 digits) of the measured field. Timing by internal clock provides high accuracy synchronization of data. The internal flash memory assures long-term autonomous data storage. The system also has two-axes tilt measurement system. The methodological questions of magnetometer operation at sea bed were studied in order to avoid two types of errors appearing at such experimental cases. First is sea waving influence and second one magnetometer orientation at its random positioning on

  17. A prospective, randomized pilot study on the safety and efficacy of recombinant human growth and differentiation factor-5 coated onto β-tricalcium phosphate for sinus lift augmentation.

    Koch, Felix P; Becker, Jürgen; Terheyden, Hendrik; Capsius, Björn; Wagner, Wilfried

    2010-11-01

    The aim of this prospective, randomized clinical trial was to investigate the potential of recombinant human growth and differentiation factor-5 (rhGDF-5) coated onto β-tricalcium phosphate (β-TCP) (rhGDF-5/β-TCP) to support bone formation after sinus lift augmentation. In total, 31 patients participated in this multicenter clinical trial. They required a two-stage unilateral maxillary sinus floor augmentation (residual bone height augmentation with rhGDF-5/β-TCP and a 3-month healing period, (b) augmentation with rhGDF-5/β-TCP and a 4-month healing period and (c) medical device β-TCP mixed with autologous bone and a 4-month healing period. The primary study objective was the area of newly formed bone within the augmented area as assessed by histomorphometric evaluation of trephine bur biopsies. The osseous regeneration was similar in each treatment group; the amount of newly formed bone ranged between 28% (± 15.5%) and 31.8% (± 17.9%). Detailed analysis of histological data will be published elsewhere. As secondary efficacy variables, the augmentation height at the surgery site was measured by radiography. The largest augmentation was radiologically achieved in the rhGDF-5/β-TCP - 3-month and the rhGDF-5/β-TCP - 4-month treatment groups. As safety parameters, adverse events were recorded and anti-drug antibody levels were evaluated. Most of the adverse events were judged as unrelated to the study medication. Four out of 47 (8.5%) implants failed in patients treated with rhGDF-5/β-TCP, a result that is in agreement with the general implant failure rate of 5-15%. Transiently very low amounts of anti-rhGDF-5 antibodies were detected in some patients who received rhGDF-5, which was not related to the bone formation outcome. rhGDF-5/β-TCP was found to be effective and safe as the control treatment with autologous bone mixed β-TCP in sinus floor augmentation. Thus, further investigation regarding efficacy and safety will be carried out in larger patient

  18. Floor heating maximizes residents` comfort

    Tirkkanen, P.; Wikstroem, T.

    1996-11-01

    Storing heat in floors by using economical night-time electricity does not increase the specific consumption of heating. According to studies done by IVO, the optimum housing comfort is achieved if the room is heated mainly by means of floor heating that is evened out by window or ceiling heating, or by a combination of all three forms of heating. (orig.)

  19. Evaluation of the treatment modalities for neurosensory disturbances of the inferior alveolar nerve following retromolar bone harvesting for bone augmentation.

    Nogami, Shinnosuke; Yamauchi, Kensuke; Shiiba, Shunji; Kataoka, Yoshihiro; Hirayama, Bunichi; Takahashi, Tetsu

    2015-03-01

    The purpose of this study was to evaluate the treatment modalities for neurosensory disturbances (NSDs) of the inferior alveolar nerve occurring after retromolar bone harvesting for bone augmentation procedures before implant placement. One hundred four patients, of which 49 and 55 exhibited vertical or horizontal alveolar ridge defects in the mandible and maxilla, respectively, were enrolled. Nineteen patients underwent block bone grafting, 38 underwent guided bone generation or autogenous bone grafting combined with titanium mesh reconstruction, and 47 underwent sinus floor augmentation. Using a visual analog scale, we examined subjective symptoms and discomfort related to sensory alteration within the area of the NSDs in these patients. NSDs were clinically investigated using a two-point discrimination test with blunt-tipped calipers. In addition, neurometry was used for evaluation of trigeminal nerve injury. We tested three treatment modalities for NSDs: follow-up observation (no treatment), medication, and stellate ganglion block (SGB). A week after surgery, 26 patients (25.0%) experienced NSDs. Five patients received no treatment, 10 patients received medication, and 11 patients received SGB. Three months after surgery, patients in the medication and SGB group achieved complete recovery. Current perception threshold values recovered to near-baseline values at 3 months: recovery was much earlier in this group than in the other two groups. SGB can accelerate recovery from NSDs. Our results justify SGB as a reasonable treatment modality for NSDs occurring after the harvesting of retromolar bone grafts. Wiley Periodicals, Inc.

  20. Crustal Ages of the Ocean Floor - Poster

    National Oceanic and Atmospheric Administration, Department of Commerce — The Crustal Ages of the Ocean Floor Poster was created at NGDC using the Crustal Ages of the Ocean Floor database draped digitally over a relief of the ocean floor...

  1. Secondary Breast Augmentation.

    Brown, Mitchell H; Somogyi, Ron B; Aggarwal, Shagun

    2016-07-01

    After studying this article, the participant should be able to: 1. Assess common clinical problems in the secondary breast augmentation patient. 2. Describe a treatment plan to correct the most common complications of breast augmentation. 3. Provide surgical and nonsurgical options for managing complications of breast augmentation. 4. Decrease the incidence of future complications through accurate assessment, preoperative planning, and precise surgical technique. Breast augmentation has been increasing steadily in popularity over the past three decades. Many of these patients present with secondary problems or complications following their primary breast augmentation. Two of the most common complications are capsular contracture and implant malposition. Familiarity and comfort with the assessment and management of these complications is necessary for all plastic surgeons. An up-to-date understanding of current devices and techniques may decrease the need to manage future complications from the current cohort of breast augmentation patients.

  2. Mobile Augmented Reality Applications

    Prochazka, David; Stencl, Michael; Popelka, Ondrej; Stastny, Jiri

    2011-01-01

    Augmented reality have undergone considerable improvement in past years. Many special techniques and hardware devices were developed, but the crucial breakthrough came with the spread of intelligent mobile phones. This enabled mass spread of augmented reality applications. However mobile devices have limited hardware capabilities, which narrows down the methods usable for scene analysis. In this article we propose an augmented reality application which is using cloud computing to enable using...

  3. Flooring choices for newborn ICUs.

    White, R D

    2007-12-01

    Floors are a major element of newborn intensive care unit (NICU) construction. They provide visual cues, sound control, and with certain materials, some degree of physical comfort for workers. Flooring materials may entail a significant cost for installation and upkeep and can have substantial ecological impact, both in the choice of the flooring itself, as well as the substances used to clean it. In this article the important aspects to consider for each factor are explored and recommendations are offered for appropriate choices in various NICU areas.

  4. Floor cooler for floor trough of a nuclear reactor

    Friedrich, H.J.

    1985-01-01

    Cooling pipes are situated below the floor trough of a BWR, which are connected to the annular distribution or collection pipes. The distribution and collection pipes are connected by parallel hairpin pipes with involute shape to the centre of the floor trough. These hairpin pipes are situated in a lower plane than the annular distribution pipe to the centre and in a higher plane from the centre to the outer annular collector pipe. (orig./HP) [de

  5. Pelvic floor physical therapy in urogynecologic disorders.

    Kotarinos, Rhonda K

    2003-08-01

    Physical therapists are uniquely qualified to treat pelvic floor dysfunction with conservative management techniques. Techniques associated with incontinence and support functions of the pelvic floor include bladder training and pelvic floor rehabilitation: pelvic floor exercises, biofeedback therapy, and pelvic floor electrical stimulation. Pain associated with mechanical pelvic floor dysfunction can be treated by physical therapists utilizing various manual techniques and modalities. Research documents that conservative management is effective in treating many conditions associated with pelvic floor dysfunction. Research should be conducted to determine if addressing diastasis recti and contracture of the pelvic floor musculature should be a component of the standard physical therapy protocol.

  6. Surgical intervention and capsular contracture after breast augmentation

    Henriksen, Trine F; Fryzek, Jon P; Hölmich, Lisbet R

    2005-01-01

    Epidemiologic data on local complications after breast augmentation are scarce. In particular, few prospectively collected data are available on modern breast implants on this issue. Using data from the Danish Registry for Plastic Surgery of the Breast, the authors examined determinants of surgery...... characteristics....

  7. Touch Is Everywhere: Floor Surfaces as Ambient Haptic Interfaces.

    Visell, Y; Law, A; Cooperstock, J R

    2009-01-01

    Floor surfaces are notable for the diverse roles that they play in our negotiation of everyday environments. Haptic communication via floor surfaces could enhance or enable many computer-supported activities that involve movement on foot. In this paper, we discuss potential applications of such interfaces in everyday environments and present a haptically augmented floor component through which several interaction methods are being evaluated. We describe two approaches to the design of structured vibrotactile signals for this device. The first is centered on a musical phrase metaphor, as employed in prior work on tactile display. The second is based upon the synthesis of rhythmic patterns of virtual physical impact transients. We report on an experiment in which participants were able to identify communication units that were constructed from these signals and displayed via a floor interface at well above chance levels. The results support the feasibility of tactile information display via such interfaces and provide further indications as to how to effectively design vibrotactile signals for them.

  8. Price floors for emissions trading

    Wood, Peter John; Jotzo, Frank

    2011-01-01

    Price floors in greenhouse gas emissions trading schemes can guarantee minimum abatement efforts if prices are lower than expected, and they can help manage cost uncertainty, possibly as complements to price ceilings. Provisions for price floors are found in several recent legislative proposals for emissions trading. Implementation however has potential pitfalls. Possible mechanisms are government commitments to buy back permits, a reserve price at auction, or an extra fee or tax on acquittal of emissions permits. Our analysis of these alternatives shows that the fee approach has budgetary advantages and is more compatible with international permit trading than the alternatives. It can also be used to implement more general hybrid approaches to emissions pricing. - Research highlights: → Price floors for emissions trading schemes guarantee a minimum carbon price. → Price floors mean that emissions can be less than specified by the ETS cap. → We examine how price floors can relate to different policy objectives. → We compare different mechanisms for implementing a price floor. → We find that a mechanism where there is an extra tax or fee has advantages.

  9. Confronting an Augmented Reality

    Munnerley, Danny; Bacon, Matt; Wilson, Anna; Steele, James; Hedberg, John; Fitzgerald, Robert

    2012-01-01

    How can educators make use of augmented reality technologies and practices to enhance learning and why would we want to embrace such technologies anyway? How can an augmented reality help a learner confront, interpret and ultimately comprehend reality itself ? In this article, we seek to initiate a discussion that focuses on these questions, and…

  10. Augmented Reality on Android

    Chunghan Li; Chang-Shyh Peng; Daisy F. Sang

    2013-01-01

    Augmented Reality is an application which combines a live view of real-world environment and computer-generated images. This paper studies and demonstrates an efficient Augmented Reality development in the mobile Android environment with the native Java language and Android SDK. Major components include Barcode Reader, File Loader, Marker Detector, Transform Matrix Generator, and a cloud database.

  11. The influence of various risk factors on the strength of pelvic floor muscle in women

    Parezanović-Ilić Katarina

    2017-01-01

    Full Text Available Background/Aim. Damage of any element of pelvic floor leads to its functional damages, reflected in the occurrence of urinary incontinence, prolapse of pelvic organs, fecal incontinence and sexual dysfunction. Basic aim of our paper was to investigate the influence of various risk factors on pelvic floor muscle strength in women. Methods. The study included 90 female patients and examined how age, job, body weight and height, number of deliveries, sports activities, incontinence occurrence, previous prolapse-caused gynecological surgeries, other gynecological surgeries and other conservatively treated gynecological diseases influence the value of pelvic floor muscle strength. Pelvic floor muscle strength was measured using vaginal dynamometer. Results. Univariate regression analysis showed that parameters such as age, demanding job, body height, number of deliveries, sports activities, prolapse-caused gynecological surgeries, other gynecological surgeries and other gynecological diseases were in positive correlation with the values of pelvic floor muscle strength. In multivariate regression model, incontinence and gynecological operation of prolapse were singled out as independent risk factors. Conclusion. If risk factors that cause damage to pelvic floor muscle are known, it is possible to prevent the damages and improve the quality of women's life.

  12. Functional anatomy of pelvic floor

    Salvatore Rocca Rossetti

    2016-03-01

    Full Text Available Generally, descriptions of the pelvic floor are discordant, since its complex structures and the complexity of pathological disorders of such structures; commonly the descriptions are sectorial, concerning muscles, fascial developments, ligaments and so on. On the contrary to understand completely nature and function of the pelvic floor it is necessary to study it in the most unitary view and in the most global aspect, considering embriology, philogenesy, anthropologic development and its multiple activities others than urological, gynaecological and intestinal ones. Recent acquirements succeeded in clarifying many aspects of pelvic floor activity, whose musculature has been investigated through electromyography, sonography, magnetic resonance, histology, histochemistry, molecular research. Utilizing recent research concerning not only urinary and gynecologic aspects but also those regarding statics and dynamics of pelvis and its floor, it is now possible to study this important body part as a unit; that means to consider it in the whole body economy to which maintaining upright position, walking and behavior or physical conduct do not share less than urinary, genital, and intestinal functions. It is today possible to consider the pelvic floor as a musclefascial unit with synergic and antagonistic activity of muscular bundles, among them more or less interlaced, with multiple functions and not only the function of pelvic cup closure.

  13. Physical activity and the pelvic floor.

    Nygaard, Ingrid E; Shaw, Janet M

    2016-02-01

    Pelvic floor disorders are common, with 1 in 4 US women reporting moderate to severe symptoms of urinary incontinence, pelvic organ prolapse, or fecal incontinence. Given the high societal burden of these disorders, identifying potentially modifiable risk factors is crucial. Physical activity is one such potentially modifiable risk factor; the large number of girls and women participating in sport and strenuous training regimens increases the need to understand associated risks and benefits of these exposures. The aim of this review was to summarize studies reporting the association between physical activity and pelvic floor disorders. Most studies are cross-sectional and most include small numbers of participants. The primary findings of this review include that urinary incontinence during exercise is common and is more prevalent in women during high-impact sports. Mild to moderate physical activity, such as brisk walking, decreases both the odds of having and the risk of developing urinary incontinence. In older women, mild to moderate activity also decreases the odds of having fecal incontinence; however, young women participating in high-intensity activity are more likely to report anal incontinence than less active women. Scant data suggest that in middle-aged women, lifetime physical activity increases the odds of stress urinary incontinence slightly and does not increase the odds of pelvic organ prolapse. Women undergoing surgery for pelvic organ prolapse are more likely to report a history of heavy work than controls; however, women recruited from the community with pelvic organ prolapse on examination report similar lifetime levels of strenuous activity as women without this examination finding. Data are insufficient to determine whether strenuous activity while young predisposes to pelvic floor disorders later in life. The existing literature suggests that most physical activity does not harm the pelvic floor and does provide numerous health benefits for

  14. Autologous Fat Injection for Augmented Mammoplasty

    Yoon, Eul Sik; Seo, Bo Kyoung; Yi, Ann; Cho, Kyu Ran

    2008-01-01

    Autologous fat injection is one of the methods utilized for augmented mammoplasty methods. In this surgical procedure, the fat for transfer is obtained from the donor site of the patient's own body by liposuction and the fat is then injected into the breast. We report here cases of three patients who underwent autologous fat injection. Two of the patients had palpable masses that were present after surgery. The serial imaging findings and surgical method of autologous fat transfer are demonstrated

  15. Augmented reality: a review.

    Berryman, Donna R

    2012-01-01

    Augmented reality is a technology that overlays digital information on objects or places in the real world for the purpose of enhancing the user experience. It is not virtual reality, that is, the technology that creates a totally digital or computer created environment. Augmented reality, with its ability to combine reality and digital information, is being studied and implemented in medicine, marketing, museums, fashion, and numerous other areas. This article presents an overview of augmented reality, discussing what it is, how it works, its current implementations, and its potential impact on libraries.

  16. Robotics in General Surgery

    Wall, James; Chandra, Venita; Krummel, Thomas

    2008-01-01

    In summary, robotics has made a significant contribution to General Surgery in the past 20 years. In its infancy, surgical robotics has seen a shift from early systems that assisted the surgeon to current teleoperator systems that can enhance surgical skills. Telepresence and augmented reality surgery are being realized, while research and development into miniaturization and automation is rapidly moving forward. The future of surgical robotics is bright. Researchers are working to address th...

  17. Augmented Reality, Phase I

    National Aeronautics and Space Administration — Augmented Reality systems come with many benefits derived by co-locating information with a user's environment through the use of one or more output modalities such...

  18. Chin augmentation - slideshow

    ... page: //medlineplus.gov/ency/presentations/100009.htm Chin augmentation - series—Normal anatomy To use the sharing features ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  19. Augmenting Clozapine With Sertindole

    Nielsen, Jimmi; Emborg, Charlotte; Gydesen, Susanne

    2012-01-01

    Clozapine augmentation with antipsychotic drugs is widely used despite sparse evidence supporting this strategy. Sertindole is a nonsedating atypical antipsychotic drug with low affinity for cholinergic receptors, which makes it potentially suitable for augmentation of clozapine. The study design...... glucose, lipids, and electrocardiogram. Clozapine augmentation with sertindole was not superior to placebo regarding total score or subscale score of the Positive and Negative Syndrome Scale, Clinical Global Impression, World Health Organization Quality of Life Brief, or Drug Attitude Inventory....... No increased adverse effects compared with placebo were found. Four patients randomized to sertindole experienced a significant worsening of psychosis, and 2 of them required psychiatric admission. Metabolic parameters were unchanged during the study, but augmentation of clozapine with sertindole...

  20. Breast augmentation - slideshow

    ... page: //medlineplus.gov/ency/presentations/100205.htm Breast augmentation - series—Normal anatomy To use the sharing features ... Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated: ...

  1. Exploration Augmentation Module Project

    National Aeronautics and Space Administration — The Exploration Augmentation Module (EAM) project goal is to design and deliver a flight module that is to be deployed to Earth-Lunar Distant Retrograde Orbit (DRO)....

  2. Marketing and Augmented Reality

    Zelený, Martin

    2010-01-01

    The main goal of this diploma thesis is to identify the usage of augmented reality in contemporary marketing practice and the expectations of marketers for the future use. This will be achieved by conducting a quantitative and qualitative research among existing creative and advertising companies. Secondary goal is introducing the concept of augmented reality from the theoretical point of view and also description of potential utilization based on known examples. The tools for the practical p...

  3. INFORMATION VIA AUGMENTED

    Tetteh, Sampson

    2015-01-01

    The vast majority of mobile technology today has developed over the past dec-ades. The thirst for information and communication has brought about high data transfer speed on modern mobile handset devices. This makes it possible for Augmented Reality to be used on mobile phones. Vaasa University of Applied Science, Technobothnia science resource center and Lumivaara Museum saw the importance of information and decided to embark on a pilot project where Augmented Reality will not be only us...

  4. Physical, Complementary, and Alternative Medicine in the Treatment of Pelvic Floor Disorders.

    Arnouk, Alex; De, Elise; Rehfuss, Alexandra; Cappadocia, Carin; Dickson, Samantha; Lian, Fei

    2017-06-01

    The purpose of the study was to catalog the most recent available literature regarding the use of conservative measures in treatment of pelvic floor disorders. Pelvic floor disorders encompass abnormalities of urination, defecation, sexual function, pelvic organ prolapse, and chronic pain, and can have significant quality of life implications for patients. Current guidelines recommend behavioral modifications and conservative treatments as first-line therapy for pelvic floor disorders. We have reviewed the literature for articles published on physical, complementary, and alternative treatments for pelvic floor disorders over the past 5 years. Review of pelvic floor muscle physiotherapy (PFMT) and biofeedback (BF) shows a benefit for patients suffering from bladder dysfunction (incontinence, overactive bladder), bowel dysfunction (constipation, fecal incontinence), pelvic organ prolapse, and sexual dysfunction (pelvic pain). Combination of PFMT and BF has shown improved results compared to PFMT alone, and some studies find that electrical stimulation can augment the benefit of BF and PFMT. Additionally, acupuncture and cognitive behavioral therapy has shown to be an effective treatment for pelvic floor disorders, particularly with respect to pelvic pain. This update highlights beneficial conservative treatments available for pelvic floor dysfunction, and supplements the current literature on treatment options for patients suffering from these disorders.

  5. Confronting an augmented reality

    John Hedberg

    2012-08-01

    Full Text Available How can educators make use of augmented reality technologies and practices to enhance learning and why would we want to embrace such technologies anyway? How can an augmented reality help a learner confront, interpret and ultimately comprehend reality itself? In this article, we seek to initiate a discussion that focuses on these questions, and suggest that they be used as drivers for research into effective educational applications of augmented reality. We discuss how multi-modal, sensorial augmentation of reality links to existing theories of education and learning, focusing on ideas of cognitive dissonance and the confrontation of new realities implied by exposure to new and varied perspectives. We also discuss connections with broader debates brought on by the social and cultural changes wrought by the increased digitalisation of our lives, especially the concept of the extended mind. Rather than offer a prescription for augmentation, our intention is to throw open debate and to provoke deep thinking about what interacting with and creating an augmented reality might mean for both teacher and learner.

  6. Augmented reality in intraventricular neuroendoscopy.

    Finger, T; Schaumann, A; Schulz, M; Thomale, Ulrich-W

    2017-06-01

    fenestration. Augmented reality-navigated neuroendoscopy is accurate and feasible to use in clinical application. By integrating relevant planning information directly into the endoscope's field of view, safety and efficacy for intraventricular neuroendoscopic surgery may be improved.

  7. Augmented reality (AR and virtual reality (VR applied in dentistry

    Ta-Ko Huang

    2018-04-01

    Full Text Available The OSCE is a reliable evaluation method to estimate the preclinical examination of dental students. The most ideal assessment for OSCE is used the augmented reality simulator to evaluate. This literature review investigated a recently developed in virtual reality (VR and augmented reality (AR starting of the dental history to the progress of the dental skill. As result of the lacking of technology, it needs to depend on other device increasing the success rate and decreasing the risk of the surgery. The development of tracking unit changed the surgical and educational way. Clinical surgery is based on mature education. VR and AR simultaneously affected the skill of the training lesson and navigation system. Widely, the VR and AR not only applied in the dental training lesson and surgery, but also improved all field in our life. Keywords: OSCE, Dental simulator, Augmented reality, Virtual reality, Dentistry

  8. The Integral Theory System Questionnaire: an anatomically directed questionnaire to determine pelvic floor dysfunctions in women.

    Wagenlehner, Florian Martin Erich; Fröhlich, Oliver; Bschleipfer, Thomas; Weidner, Wolfgang; Perletti, Gianpaolo

    2014-06-01

    Anatomical damage to pelvic floor structures may cause multiple symptoms. The Integral Theory System Questionnaire (ITSQ) is a holistic questionnaire that uses symptoms to help locate damage in specific connective tissue structures as a guide to reconstructive surgery. It is based on the integral theory, which states that pelvic floor symptoms and prolapse are both caused by lax suspensory ligaments. The aim of the present study was to psychometrically validate the ITSQ. Established psychometric properties including validity, reliability, and responsiveness were considered for evaluation. Criterion validity was assessed in a cohort of 110 women with pelvic floor dysfunctions by analyzing the correlation of questionnaire responses with objective clinical data. Test-retest was performed with questionnaires from 47 patients. Cronbach's alpha and "split-half" reliability coefficients were calculated for inner consistency analysis. Psychometric properties of ITSQ were comparable to the ones of previously validated Pelvic Floor Questionnaires. Face validity and content validity were approved by an expert group of the International Collaboration of Pelvic Floor surgeons. Convergent validity assessed using Bayesian method was at least as accurate as the expert assessment of anatomical defects. Objective data measurement in patients demonstrated significant correlations with ITSQ domains fulfilling criterion validity. Internal consistency values ranked from 0.85 to 0.89 in different scenarios. The ITSQ proofed accurate and is able to serve as a holistic Pelvic Floor Questionnaire directing symptoms to site-specific pelvic floor reconstructive surgery.

  9. Ploughing the deep sea floor.

    Puig, Pere; Canals, Miquel; Company, Joan B; Martín, Jacobo; Amblas, David; Lastras, Galderic; Palanques, Albert

    2012-09-13

    Bottom trawling is a non-selective commercial fishing technique whereby heavy nets and gear are pulled along the sea floor. The direct impact of this technique on fish populations and benthic communities has received much attention, but trawling can also modify the physical properties of seafloor sediments, water–sediment chemical exchanges and sediment fluxes. Most of the studies addressing the physical disturbances of trawl gear on the seabed have been undertaken in coastal and shelf environments, however, where the capacity of trawling to modify the seafloor morphology coexists with high-energy natural processes driving sediment erosion, transport and deposition. Here we show that on upper continental slopes, the reworking of the deep sea floor by trawling gradually modifies the shape of the submarine landscape over large spatial scales. We found that trawling-induced sediment displacement and removal from fishing grounds causes the morphology of the deep sea floor to become smoother over time, reducing its original complexity as shown by high-resolution seafloor relief maps. Our results suggest that in recent decades, following the industrialization of fishing fleets, bottom trawling has become an important driver of deep seascape evolution. Given the global dimension of this type of fishery, we anticipate that the morphology of the upper continental slope in many parts of the world’s oceans could be altered by intensive bottom trawling, producing comparable effects on the deep sea floor to those generated by agricultural ploughing on land.

  10. Flooring for Schools: Unsightly Walkways

    Baxter, Mark

    2011-01-01

    Many mattress manufacturers recommend that consumers rotate their mattresses at least twice a year to help prevent soft spots from developing and increase the product's life span. It's unfortunate that the same kind of treatment can't be applied to flooring for schools, such as carpeting, especially in hallways. Being able to flip or turn a carpet…

  11. Container floor at high temperatures

    Reutler, H.; Klapperich, H.J.; Mueller-Frank, U.

    1978-01-01

    The invention describes a floor for container which is stressed at high, changing temperatures and is intended for use in gas-cooled nuclear reactors. Due to the downward cooling gas flow in these types of reactor, the reactor floor is subjected to considerable dimensional changes during switching on and off. In the heating stage, the whole graphite structure of the reactor core and floor expands. In order to avoid arising constraining forces, sufficiently large expansion spaces must be allowed for furthermore restoring forces must be present to close the gaps again in the cooling phase. These restoring forces must be permanently present to prevent loosening of the core cuits amongst one another and thus uncontrollable relative movement. Spring elements are not suitable due to fast fatigue as a result of high temperatures and radiation exposure. It is suggested to have the floor elements supported on rollers whose rolling planes are downwards inclined to a fixed point for support. The construction is described in detail by means of drawings. (GL) [de

  12. Timber floors strengthened with concrete

    Blass, H.J.; Linden, M.L.R. van der; Schlager, M.

    1998-01-01

    Timber-concrete composite (tcc) beams may be used for the renovation of old timber floors. Although these systems are not new (Pokulka, 1997) and form a simple and practical solution, they are not widely adopted. One of the reasons for this is the Jack of uniform design rules. In this research

  13. Augmented marked graphs

    Cheung, King Sing

    2014-01-01

    Petri nets are a formal and theoretically rich model for the modelling and analysis of systems. A subclass of Petri nets, augmented marked graphs possess a structure that is especially desirable for the modelling and analysis of systems with concurrent processes and shared resources.This monograph consists of three parts: Part I provides the conceptual background for readers who have no prior knowledge on Petri nets; Part II elaborates the theory of augmented marked graphs; finally, Part III discusses the application to system integration. The book is suitable as a first self-contained volume

  14. Augmented reality som wearable

    Buhl, Mie; Rahn, Annette

    2015-01-01

    Artiklen omhandler design og implementering af Augmented Reality (AR) i form af en wearable i sygeplejerskeuddannelsens anatomiundervisning, mere specifikt undervisning i lungeanatomi og respiration, med fokus på potentialer for visuel læring. Projektet undersøger, hvordan en udviklet AR-applikat......Artiklen omhandler design og implementering af Augmented Reality (AR) i form af en wearable i sygeplejerskeuddannelsens anatomiundervisning, mere specifikt undervisning i lungeanatomi og respiration, med fokus på potentialer for visuel læring. Projektet undersøger, hvordan en udviklet AR...

  15. Prototyping Augmented Reality

    Mullen, Tony

    2011-01-01

    Learn to create augmented reality apps using Processing open-source programming language Augmented reality (AR) is used all over, and you may not even realize it. Smartphones overlay data onto live camera views to show homes for sale, restaurants, or historical sites. American football broadcasts use AR to show the invisible first-down line on the field to TV viewers. Nike and Budweiser, among others, have used AR in ads. Now, you can learn to create AR prototypes using 3D data, Processing open-source programming language, and other languages. This unique book is an easy-to-follow guide on how

  16. Dynamic magnetic resonance imaging for assessment of minimally invasive pelvic floor reconstruction with polypropylene implant

    Siegmann, Katja C.; Reisenauer, Christl; Speck, Sina; Barth, Sonja; Kraemer, Bernhard; Claussen, Claus D.

    2011-01-01

    Introduction: The purpose of the study was to assess the usefulness of dynamic MRI in patients with pelvic organ prolapse after pelvic floor repair with polypropylene mesh. Materials and methods: Fifteen consecutive patients (mean age 66.5 years) who were scheduled for either anterior (n = 9) or posterior (n = 6) pelvic floor repair were prospectively evaluated by clinical assessment and dynamic MRI 1 day before and 3 months after surgery. MRI diagnoses and MRI measurements of relevant anatomical points at rest and on straining were analysed before and after surgery. Results: At follow-up assessment 93.3% of all patients were clinically cured. Dynamic MRI showed newly developed (n = 6) or increased (n = 6) pelvic organ prolapse in 80% (n = 12) of all patients 3 months after pelvic floor repair. Most of them (n = 11; 91.7%) affected the untreated pelvic floor compartment. On straining anatomical points of reference in the anterior pelvic floor compartment were significantly (p < 0.05) elevated after anterior repair and rectal bulging was significantly (p = 0.036) reduced after posterior pelvic floor repair. Conclusions: In this study dynamic MRI could verify the effective support of anterior and posterior pelvic floor structures by anterior and posterior polypropylene implant respectively. But dynamic MRI demonstrates if one compartment of the pelvic floor is repaired another compartment frequently (73.3%) develops dysfunction. These results did not correspond to clinical symptoms on short-term follow-up (3 months). Studies with long-term follow-up are necessary to prove if dynamic MRI can reliably identify clinically significant pelvic organ prolapse after pelvic floor repair before the onset of symptoms.

  17. Towards Pervasive Augmented Reality: Context-Awareness in Augmented Reality.

    Grubert, Jens; Langlotz, Tobias; Zollmann, Stefanie; Regenbrecht, Holger

    2017-06-01

    Augmented Reality is a technique that enables users to interact with their physical environment through the overlay of digital information. While being researched for decades, more recently, Augmented Reality moved out of the research labs and into the field. While most of the applications are used sporadically and for one particular task only, current and future scenarios will provide a continuous and multi-purpose user experience. Therefore, in this paper, we present the concept of Pervasive Augmented Reality, aiming to provide such an experience by sensing the user's current context and adapting the AR system based on the changing requirements and constraints. We present a taxonomy for Pervasive Augmented Reality and context-aware Augmented Reality, which classifies context sources and context targets relevant for implementing such a context-aware, continuous Augmented Reality experience. We further summarize existing approaches that contribute towards Pervasive Augmented Reality. Based our taxonomy and survey, we identify challenges for future research directions in Pervasive Augmented Reality.

  18. Linear Alkylbenzenesulfonates in indoor Floor Dust

    Madsen, Jørgen Øgaard; Wolkoff, Peder; Madsen, Jørgen Øgaard

    1999-01-01

    The amount of Linear Alkylbenzenesulfonates (LAS) in the particle fraction of floor dust sampled from 7 selected public buildings varied between 34 and 1500 microgram per gram dust, while the contents of the fibre fractions generally were higher with up to 3500 microgram LAS/g dust. The use...... of a cleaning agent with LAS resulted in an increase of the amount of LAS in the floor dust after floor wash relative to just before floor wash. However, the most important source of LAS in the indoor floor dust appears to be residues of detergent in clothing. Thus, a newly washed shirt contained 2960 microgram...

  19. Augmented Reality og kulturarv

    Nielsen, Mikkel Kirkedahl Lysholm

    2013-01-01

    Museerne står overfor at skulle omfavne den digitale kultur i håndteringen af den store mængde viden, institutionerne repræsenterer. Augmented Reality-systemer forbinder ved hjælp af moderne teknologi det virtuelle med det virkelige, og kan derfor synes som en oplagt anvendelsesmulighed i...

  20. Augmented Reality i naturfagsundervisningen

    Radmer, Ole; Surland, Mogens; Nielsen, Birgitte Lund

    Augmented Reality (AR) giver ny mulighed for, at elever kan lave undersøgelser i naturfag med enkel teknologi, hvor animationer og simulationer kobles med det virkelige fænomen. I workshoppen kan I afprøve AR eksempler, udviklet i et internationalt EU projekt. Der vil være noget, der direkte kan...

  1. Collaboration in Augmented Reality

    Lukosch, S.; Billinghurst, M.; Alem, L.; Kiyokawa, K.

    2015-01-01

    Augmented Reality (AR) is a technology that allows users to view and interact in real time with virtual images seamlessly superimposed over the real world. AR systems can be used to create unique collaborative experiences. For example, co-located users can see shared 3D virtual objects that they

  2. Capillary Refill using Augmented Reality

    Clausen, Christoffer

    2017-01-01

    Master's thesis in Computer science The opportunities within augmented reality is growing. Augmented reality is a combination of the real and the virtual world in real time, and large companies like Microsoft and Google is now investing heavily in the technology. This thesis presents a solution for simulating a medical test called capillary refill, by using augmented reality. The simulation is performed with an augmented reality headset called HoloLens. The HoloLens will recognise a mark...

  3. AR DOC: Augmented reality documentaries

    Vistisen, Peter

    2014-01-01

    Augmented Reality Documentaries (AR DOC) er et ’lille’ Shareplay projekt (ansøgte midler augmented reality cross media løsninger, til at skabe engagerende publikumsformidling...... indenfor oplevelsesindustrien. Projektet har genereret ny viden omkring, hvordan fysisk og digital formidling kan understøttes via Augmented Reality som formidlingsformat....

  4. Long-term psychological sequelae of augmentation mammoplasty ...

    A request for elective surgery for augmentation mammoplasty (AM) is often associated with underlying psychopathology and high expectations of a positive psychological outcome. This study was designed to ascertain the long-term psychological sequelae of AM in a group of patients who were reassessed 3 years or more ...

  5. Virtual, augmented reality and serious games for healthcare

    Jain, Lakhmi; Anderson, Paul

    2014-01-01

    There is a tremendous interest among researchers for the development of virtual, augmented reality and games technologies due to their widespread applications in medicine and healthcare. To date the major applications of these technologies include medical simulation, telemedicine, medical and healthcare training, pain control, visualisation aid for surgery, rehabilitation in cases such as stroke, phobia, and trauma therapies. Many recent studies have identified the benefits of using Virtual Reality, Augmented Reality, or serious games in a variety of medical applications.   This research volume on Virtual, Augmented Reality and Serious Games for Healthcare 1 offers an insightful introduction to the theories, development and applications of virtual, augmented reality and digital games technologies in medical and clinical settings and healthcare in general. It is divided into six sections: section one presents a selection of applications in medical education and healthcare management; Section two relates to th...

  6. Morphology and morphometry of the human sublingual glands in mouth floor enlargements of edentulous patients

    Josiane Costa Rodrigues de SA

    2013-12-01

    Full Text Available Asymptomatic mouth floor enlargements may be observed in edentulous patients. These masses, which protrude from the mouth floor, may complicate the fitting of dentures and require surgery. Whether this "entity" may be considered an anatomical variation of the mouth floor or represent specific alterations in the sublingual gland is not known. Objective: The aim of this work is to investigate the morphological and morphometric aspects of the sublingual glands of edentulous patients with mouth floor enlargements and compare the glands of these patients with the sublingual glands of human cadavers. Material and Methods: Microscopic evaluation was performed on human sublingual glands from edentulous patients with mouth floor enlargements (n=20 and edentulous cadavers (n=20. The patients and cadavers were of similar ages. The data were compared using Mann-Whitney U, Fisher's exact and Student's t tests (p0.05. Only the variables "autolysis" and "congested blood vessels" presented statistical difference between groups (p=0.014; p=0.043. The morphometric study revealed that the volume densities of acini, ducts, stroma and adipose tissue were similar between the groups (p>0.05. CONCLUSION: The microscopic characteristics of the sublingual glands in mouth floor enlargements in edentulous patients correspond to characteristics associated with the normal aging process. The glands are not pathological and represent an age-related alteration that occurs with or without the presence of the mouth floor enlargements.

  7. Normative Data for Interpreting the BREAST-Q: Augmentation

    Mundy, Lily R.; Homa, Karen; Klassen, Anne F.; Pusic, Andrea L.; Kerrigan, Carolyn L.

    2016-01-01

    Background The BREAST-Q is a rigorously developed, well-validated, patient-reported outcome (PRO) instrument with a module designed for evaluating breast augmentation outcomes. However, there are no published normative BREAST-Q scores, limiting interpretation. Methods Normative data were generated for the BREAST-Q Augmentation Module via the Army of Women (AOW), an online community of women (with and without breast cancer) engaged in breast-cancer related research. Members were recruited via email, with women 18 years or older without a history of breast cancer or breast surgery invited to participate. Descriptive statistics and a linear multivariate regression were performed. A separate analysis compared normative scores to findings from previously published BREAST-Q augmentation studies. Results The preoperative BREAST-Q Augmentation Module was completed by 1,211 women. Mean age was 54 ±24 years, mean body mass index (BMI) was 27 ±6, and 39% (n=467) had a bra cup size ≥D. Mean scores were Satisfaction with Breasts (54 ±19), Psychosocial Well-being (66 ±20), Sexual Well-being (49 ±20), and Physical Well-being (86 ±15). Women with a BMI of 30 or greater and bra cup size D or greater had lower scores. In comparison to AOW scores, published BREAST-Q augmentation scores were lower before and higher after surgery for all scales except Physical Well-being. Conclusions The AOW normative data represent breast-related satisfaction and well-being in woman not actively seeking breast augmentation. This data may be used as normative comparison values for those seeking and undergoing surgery as we did, demonstrating the value of breast augmentation in this patient population. PMID:28350657

  8. Transaxillary Endoscopic Breast Augmentation

    Hyung-Bo Sim

    2014-09-01

    Full Text Available The axillary technique is the most popular approach to breast augmentation among Korean women. Transaxillary breast augmentation is now conducted with sharp electrocautery dissection under direct endoscopic vision throughout the entire process. The aims of this method are clear: both a bloodless pocket and a sharp non-traumatic dissection. Round textured or anatomical cohesive gel implants have been used to make predictable well-defined inframammary creases because textured surface implants demonstrated a better stability attributable to tissue adherence compared with smooth surface implants. The axillary endoscopic technique has greatly evolved, and now the surgical results are comparable to those with the inframammary approach. The author feels that this technique is an excellent choice for young patients with an indistinct or absent inframammary fold, who do not want a scar in the aesthetic unit of their chest.

  9. Augmented reality services

    Tomáš Koubek

    2013-01-01

    Full Text Available We assume that one of the key reasons is in the difference between a standalone application and a web service. Both architectures have some advantages and disadvantages. The Standalone application (e.g. Nokia/OVI Maps provides the required functionality. From the user point of view, main asset of this “offline” approach is network connectivity independence. However, this kind of applications must be upgraded manually. Moreover, it is hard to get any data about the application usage because it requires additional actions from the user – data are usually acquired through conventional ways, such as email or web forms.The online service such as Google Maps (including its mobile application can offer the same functionality as the offline application. Nevertheless, a permanent connection to provider servers is necessary. This can be taken as a drawback. On the other hand, usage data collection is easier and can be done without the user intervention. The data collection provides a valuable analysis basis of the user habits and needs. This analysis is necessary for design of a complex “user” based solutions such as Google Now.Augmented reality applications are usually based on the first mentioned approach. In this article, we describe our model of augmented reality as a service and compare its features with standalone solutions. Further, other important key aspects for large emergence of augmented reality services in a mainstream market are discussed.

  10. Mode of delivery and Pelvic floor disorder

    Noor, R.; Neelam, H.; Bashir, M.S.

    2017-01-01

    Objective: To compare pelvic floor dysfunction in non pregnant women who had delivered vaginally versus those with cesarean delivery. Methodology: The prevalence of pelvic floor disorders among non pregnant women was assesses by using a standardized tool pelvic floor distress inventory short form (PFDI-20). Data was collected from Jinnah Hospital Lahore, Pakistan. Results: Total numbers of participants were 278. 47.12% subjects had moderate, 36.69% miner and 16.19% had severe pelvic floor dysfunction. The symptoms of pelvic organ prolapse were more prevalent (mean value is 59.1876) than Urinary Distress (mean value is 40.5426), while the Colorectal-Anal Distress (mean value is 35.9150) were least prevalent. Conclusion: Pelvic floor disorders are very common among females and are strongly associated with mode of delivery. Although spontaneous vaginal birth was extensively associated with pelvic floor disorders the instrumental delivery affects most. (author)

  11. Magnetic resonance imaging of pelvic floor dysfunction.

    Lalwani, Neeraj; Moshiri, Mariam; Lee, Jean H; Bhargava, Puneet; Dighe, Manjiri K

    2013-11-01

    Pelvic floor dysfunction is largely a complex problem of multiparous and postmenopausal women and is associated with pelvic floor or organ descent. Physical examination can underestimate the extent of the dysfunction and misdiagnose the disorders. Functional magnetic resonance (MR) imaging is emerging as a promising tool to evaluate the dynamics of the pelvic floor and use for surgical triage and operative planning. This article reviews the anatomy and pathology of pelvic floor dysfunction, typical imaging findings, and the current role of functional MR imaging. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Pelvic floor disorders in gynecological malignancies. An overlooked problem?

    Oana M. Bodean

    2018-04-01

    Full Text Available Cervical, endometrial, ovarian, vulvar, and vaginal cancers affect women of a broad age spectrum. Many of these women are still sexually active when their cancer is diagnosed. Treatment options for gynecological malignancies, such as gynecological surgery, radiation, and chemotherapy, are proven risk factors for pelvic floor dysfunction. The prevalence of urinary incontinence, fecal incontinence, and sexual dysfunction before cancer treatment is still unclear. Hypotheses have been raised in the literature that these manifestations could represent early symptoms of pelvic cancers, but most remain overlooked even in cancer surviving patients. The primary focus of therapy is always cancer eradication, but as oncological and surgical treatment options become more successful, the number of cancer survivors increases. The quality of life of patients with gynecological cancers often remains an underrated subject. Pelvic floor disorders are not consistently reported by patients and are frequently overlooked by many clinicians. In this brief review we discuss the importance of pelvic floor dysfunction in patients with gynecological malignant tumors.

  13. Image-guided surgery.

    Wagner, A; Ploder, O; Enislidis, G; Truppe, M; Ewers, R

    1996-04-01

    Interventional video tomography (IVT), a new imaging modality, achieves virtual visualization of anatomic structures in three dimensions for intraoperative stereotactic navigation. Partial immersion into a virtual data space, which is orthotopically coregistered to the surgical field, enhances, by means of a see-through head-mounted display (HMD), the surgeon's visual perception and technique by providing visual access to nonvisual data of anatomy, physiology, and function. The presented cases document the potential of augmented reality environments in maxillofacial surgery.

  14. Augmented reality (AR) and virtual reality (VR) applied in dentistry.

    Huang, Ta-Ko; Yang, Chi-Hsun; Hsieh, Yu-Hsin; Wang, Jen-Chyan; Hung, Chun-Cheng

    2018-04-01

    The OSCE is a reliable evaluation method to estimate the preclinical examination of dental students. The most ideal assessment for OSCE is used the augmented reality simulator to evaluate. This literature review investigated a recently developed in virtual reality (VR) and augmented reality (AR) starting of the dental history to the progress of the dental skill. As result of the lacking of technology, it needs to depend on other device increasing the success rate and decreasing the risk of the surgery. The development of tracking unit changed the surgical and educational way. Clinical surgery is based on mature education. VR and AR simultaneously affected the skill of the training lesson and navigation system. Widely, the VR and AR not only applied in the dental training lesson and surgery, but also improved all field in our life. Copyright © 2018. Published by Elsevier Taiwan.

  15. Soft tissue augmentation 2006: filler fantasy.

    Klein, Arnold William

    2006-01-01

    As an increasing number of patients seek esthetic improvement through minimally invasive procedures, interest in soft tissue augmentation and filling agents is at an all-time high. One reason for this interest is the availability of botulinum toxin type A, which works superbly in the upper face. The rejuvenation of the upper face has created much interest in injectable filling agents and implant techniques that work equally well in the restoration of the lower face. One of the central tenets of soft tissue augmentation is the concept of the three-dimensional face. The youthful face has a soft, full appearance, as opposed to the flat, pulled, two-dimensional look often achieved by more traditional surgical approaches. Injectable filling agents can augment and even at times, replace pulling. Additionally, with the lip as the focal center of the lower face, subtle lip enhancement is here to stay, and is in fact, the number one indication for injectable fillers. Moreover, minimally invasive soft tissue augmentation offers cosmetic enhancement without the cost and recovery time associated with more invasive procedures. As more and more physicians take interest in minimally invasive surgery, courses in cosmetic surgery techniques are becoming increasingly popular at the medical meetings of many specialties. Today, physicians have a much larger armamentarium of techniques and materials with which to improve facial contours, ameliorate wrinkles, and provide esthetic rejuvenation to the face. For a substance or device to be amenable for soft tissue augmentation in the medical community, it must meet certain criteria. It must have both a high "use" potential, producing cosmetically pleasing results with a minimum undesirable reactions, and have a low abuse potential in that widespread or incorrect or indiscriminate use would not result in significant morbidity. It must be nonteratogenic, noncarcinogenic, and nonmigratory. In addition, the agent must provide predictable

  16. Branding on the Shop Floor

    Szilvia Gyimóthy

    2010-09-01

    Full Text Available Service branding is a particular form of emotional management, where employees are regarded as adaptable media, who can be trained to convey corporate values while interacting with customers. This paper examines the identity work of butchers during the brand revitalisation campaign of Kvickly, a Danish supermarket chain. During the implementation of the “Best Butcher in Town”-project, Kvickly’s shop floor becomes an engineered servicescape where the norms of good salesmanship must be performed. By documenting the disloyal behaviour of butchers, we demonstrate that the affective commitment towards corporate brand values is closely related with self-enactment opportunities of occupational communities. Total service-orientation threatens butchers’ perception of autonomy and may therefore result in the emergence of resistant sub-cultures.

  17. The clinical value of membranes in bone augmentation procedures in oral implantology: 
A systematic review of randomised controlled trials

    Jonker, Brend P.; Roeloffs, Maarten W. K.; Wolvius, Eppo B.; Pijpe, Justin

    2016-01-01

    To determine the clinical value of membranes in bone augmentation procedures such as ridge augmentation with simultaneous (one-stage) and delayed (two-stage) implant placement, sinus augmentation surgery, ridge preservation and immediate implant placement. In April 2016, Embase, Medline (Ovid-SP),

  18. 9 CFR 91.26 - Concrete flooring.

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Concrete flooring. 91.26 Section 91.26... LIVESTOCK FOR EXPORTATION Inspection of Vessels and Accommodations § 91.26 Concrete flooring. (a) Pens aboard an ocean vessel shall have a 3 inch concrete pavement, proportioned and mixed to give 2000 psi...

  19. Comfort analysis of lightweight floor system

    Zegers, S.F.A.J.G.; Herwijnen, van F.; Randall, B.

    2007-01-01

    During the past 60 years, floor systems used in housing and office-buildings in the Netherlands were mostly made of concrete or other similar materials, These floor systems, which can be characterized as heavy, normally posed little problems concerning vibrations. In recent years, in light of

  20. Physical distribution of oak strip flooring 1969

    William C. Miller; William C. Miller

    1971-01-01

    As an aid to the marketing of oak strip flooring, a study was made of the distribution process for this product, from manufacture to consumer-where the flooring came from, where it went, how much was shipped, and who handled it.

  1. Biomechanics of the pelvic floor musculature

    Janda, S.

    2006-01-01

    The present thesis was motivated by two main goals. The first research goal of the thesis was to understand the complex biomechanical behaviour of the pelvic floor muscles. The second goal was to study the mechanism of the pelvic organ prolapse (genital prolapse). The pelvic floor in humans is a

  2. AMI: Augmented Michelson Interferometer

    Furió, David; Hachet, Martin; Guillet, Jean-Paul; Bousquet, Bruno; Fleck, Stéphanie; Reuter, Patrick; Canioni, Lionel

    2015-10-01

    Experiments in optics are essential for learning and understanding physical phenomena. The problem with these experiments is that they are generally time consuming for both their construction and their maintenance, potentially dangerous through the use of laser sources, and often expensive due to high technology optical components. We propose to simulate such experiments by way of hybrid systems that exploit both spatial augmented reality and tangible interaction. In particular, we focus on one of the most popular optical experiments: the Michelson interferometer. In our approach, we target a highly interactive system where students are able to interact in real time with the Augmented Michelson Interferometer (AMI) to observe, test hypotheses and then to enhance their comprehension. Compared to a fully digital simulation, we are investigating an approach that benefits from both physical and virtual elements, and where the students experiment by manipulating 3D-printed physical replicas of optical components (e.g. lenses and mirrors). Our objective is twofold. First, we want to ensure that the students will learn with our simulator the same concepts and skills that they learn with traditional methods. Second, we hypothesis that such a system opens new opportunities to teach optics in a way that was not possible before, by manipulating concepts beyond the limits of observable physical phenomena. To reach this goal, we have built a complementary team composed of experts in the field of optics, human-computer interaction, computer graphics, sensors and actuators, and education science.

  3. Augmented Reality for Science Education

    Brandt, Harald; Nielsen, Birgitte Lund; Georgsen, Marianne

    Augmented reality (AR) holds great promise as a learning tool. So far, however, most research has looked at the technology itself – and AR has been used primarily for commercial purposes. As a learning tool, AR supports an inquiry-based approach to science education with a high level of student...... involvement. The AR-sci-project (Augmented Reality for SCIence education) addresses the issue of applying augmented reality in developing innovative science education and enhancing the quality of science teaching and learning....

  4. Building with electromagnetic shield structure for individual floors

    Takahashi, T; Nakamura, M; Yabana, Y; Ishikawa, T; Nagata, K

    1991-09-10

    This invention relates to a building having a floor-by-floor electromagnetic shield structure well-suited for application to an information network system in which an electromagnetically shielded space is divided by individual floors and electric waves are utilized within the building on a floor-by-floor basis. (author). 8 figs.

  5. Building with electromagnetic shield structure for individual floors

    Takahashi, T.; Nakamura, M.; Yabana, Y.; Ishikawa, T.; Nagata, K.

    1991-01-01

    This invention relates to a building having a floor-by-floor electromagnetic shield structure well-suited for application to an information network system in which an electromagnetically shielded space is divided by individual floors and electric waves are utilized within the building on a floor-by-floor basis. (author). 8 figs

  6. Soft tissue augmentation - Use of hyaluronic acid as dermal filler

    Vedamurthy Maya

    2004-11-01

    Full Text Available Soft tissue augmentation has revolutionized the treatment of the aging face. It is a technique in which a substance is injected under the skin. The concept of utilizing materials for soft tissue augmentation actually began around 1950 with the use of fluid silicone. Today we have a large armamentarium of implant materials to delay the tell tale signs of aging. Filling has replaced conventional surgery in facial rejuvenation. In this article, the emphasis will be on hyaluronic acid as this substance is easily available in India and ranks among the most widely used dermal fillers.

  7. Soft tissue augmentation - Use of hyaluronic acid as dermal filler

    Vedamurthy Maya

    2004-01-01

    Full Text Available Soft tissue augmentation has revolutionized the treatment of the aging face. It is a technique in which a substance is injected under the skin. The concept of utilizing materials for soft tissue augmentation actually began around 1950 with the use of fluid silicone. Today we have a large armamentarium of implant materials to delay the tell tale signs of aging. Filling has replaced conventional surgery in facial rejuvenation. In this article, the emphasis will be on hyaluronic acid as this substance is easily available in India and ranks among the most widely used dermal fillers.

  8. Imaging pelvic floor disorders. 2. rev. ed.

    Stoker, Jaap; Taylor, Stuart A.; DeLancey, John O.L.

    2008-01-01

    This volume builds on the success of the first edition of imaging pelvic floor disorders and is aimed at those practitioners with an interest in the imaging, diagnosis and treatment of pelvic floor dysfunction. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving field. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor. State of the art imaging techniques and their application in pelvic floor dysfunction are then discussed in detail. Additions since the first edition include consideration of the effect of aging and new chapters on perineal ultrasound, functional MRI and MRI of the levator muscles. The closing sections of the book describe the modern clinical management of pelvic floor dysfunction, including prolapse, urinary and faecal incontinence and constipation, with specific emphasis on the integration of diagnostic and treatment algorithms. (orig.)

  9. Imaging pelvic floor disorders. 2. rev. ed.

    Stoker, Jaap [Amsterdam Univ. (Netherlands). Dept. of Radiology; Taylor, Stuart A. [University College Hospital, London (United Kingdom). Dept. of Specialist X-Ray; DeLancey, John O.L. (eds.) [Michigan Univ., Ann Arbor, MI (United States). L4000 Women' s Hospital

    2008-07-01

    This volume builds on the success of the first edition of imaging pelvic floor disorders and is aimed at those practitioners with an interest in the imaging, diagnosis and treatment of pelvic floor dysfunction. Concise textual information from acknowledged experts is complemented by high-quality diagrams and images to provide a thorough update of this rapidly evolving field. Introductory chapters fully elucidate the anatomical basis underlying disorders of the pelvic floor. State of the art imaging techniques and their application in pelvic floor dysfunction are then discussed in detail. Additions since the first edition include consideration of the effect of aging and new chapters on perineal ultrasound, functional MRI and MRI of the levator muscles. The closing sections of the book describe the modern clinical management of pelvic floor dysfunction, including prolapse, urinary and faecal incontinence and constipation, with specific emphasis on the integration of diagnostic and treatment algorithms. (orig.)

  10. Crime Scenes as Augmented Reality

    Sandvik, Kjetil

    2010-01-01

    Using the concept of augmented reality, this article will investigate how places in various ways have become augmented by means of different mediatization strategies. Augmentation of reality implies an enhancement of the places' emotional character: a certain mood, atmosphere or narrative surplus......, physical damage: they are all readable and interpretable signs. As augmented reality the crime scene carries a narrative which at first is hidden and must be revealed. Due to the process of investigation and the detective's ability to reason and deduce, the crime scene as place is reconstructed as virtual...

  11. A hemangioma on the floor of the mouth presenting as a ranula.

    Skoulakis, Charalampos E; Khaldi, Lubna; Serletis, Demetre; Semertzidis, Themistoklis

    2008-11-01

    A painless, bluish, submucosal swelling on one side of the floor of the mouth usually indicates the presence of a ranula. Rarely, such a swelling may be caused by an inflammatory disease process in a salivary gland, a neoplasm in the sublingual salivary gland, a lymphatic nodular swelling, or embryologic cysts. We report a patient with swelling in the floor of her mouth that was clinically diagnosed as a ranula. Suspicion arose during surgery that it was a vascular tumor and, on histologic testing, the swelling was confirmed to be a hemangioma. To our knowledge, this is the first report in the literature of a hemangioma presenting as a ranula.

  12. NASA Communications Augmentation network

    Omidyar, Guy C.; Butler, Thomas E.; Laios, Straton C.

    1990-01-01

    The NASA Communications (Nascom) Division of the Mission Operations and Data Systems Directorate (MO&DSD) is to undertake a major initiative to develop the Nascom Augmentation (NAUG) network to achieve its long-range service objectives for operational data transport to support the Space Station Freedom Program, the Earth Observing System (EOS), and other projects. The NAUG is the Nascom ground communications network being developed to accommodate the operational traffic of the mid-1990s and beyond. The NAUG network development will be based on the Open Systems Interconnection Reference Model (OSI-RM). This paper describes the NAUG network architecture, subsystems, topology, and services; addresses issues of internetworking the Nascom network with other elements of the Space Station Information System (SSIS); discusses the operations environment. This paper also notes the areas of related research and presents the current conception of how the network will provide broadband services in 1998.

  13. Augmented fish health monitoring

    Michak, P.; Rogers, R.; Amos, K.

    1991-05-01

    The Bonneville Power Administration (BPA) initiated the Augmented Fish Health Monitoring project in 1986. This project was a five year interagency project involving fish rearing agencies in the Columbia Basin. Historically, all agencies involved with fish health in the Columbia Basin were conducting various levels of fish health monitoring, pathogen screening and collection. The goals of this project were; to identify, develop and implement a standardized level of fish health methodologies, develop a common data collection and reporting format in the area of artificial production, evaluate and monitor water quality, improve communications between agencies and provide annual evaluation of fish health information for production of healthier smolts. This completion report will contain a project evaluation, review of the goals of the project, evaluation of the specific fish health analyses, an overview of highlights of the project and concluding remarks. 8 refs., 1 fig., 4 tabs

  14. Augmented Virtual Reality Laboratory

    Tully-Hanson, Benjamin

    2015-01-01

    Real time motion tracking hardware has for the most part been cost prohibitive for research to regularly take place until recently. With the release of the Microsoft Kinect in November 2010, researchers now have access to a device that for a few hundred dollars is capable of providing redgreenblue (RGB), depth, and skeleton data. It is also capable of tracking multiple people in real time. For its original intended purposes, i.e. gaming, being used with the Xbox 360 and eventually Xbox One, it performs quite well. However, researchers soon found that although the sensor is versatile, it has limitations in real world applications. I was brought aboard this summer by William Little in the Augmented Virtual Reality (AVR) Lab at Kennedy Space Center to find solutions to these limitations.

  15. Augmented reality system

    Lin, Chien-Liang; Su, Yu-Zheng; Hung, Min-Wei; Huang, Kuo-Cheng

    2010-08-01

    In recent years, Augmented Reality (AR)[1][2][3] is very popular in universities and research organizations. The AR technology has been widely used in Virtual Reality (VR) fields, such as sophisticated weapons, flight vehicle development, data model visualization, virtual training, entertainment and arts. AR has characteristics to enhance the display output as a real environment with specific user interactive functions or specific object recognitions. It can be use in medical treatment, anatomy training, precision instrument casting, warplane guidance, engineering and distance robot control. AR has a lot of vantages than VR. This system developed combines sensors, software and imaging algorithms to make users feel real, actual and existing. Imaging algorithms include gray level method, image binarization method, and white balance method in order to make accurate image recognition and overcome the effects of light.

  16. Maxillary sinus augmentation

    A B Tarun Kumar

    2015-01-01

    Full Text Available Placing dental implants in the maxillary posterior region can be both challenging and un-nerving for a regular implant dentist who is not well versed with advanced surgical procedures. It is vital for a general dentist to understand the fundamentals of bone grafting the maxillary sinus if he/she is really committed to providing the best health care for their patients. The dental practice is seeing an increasing group of patients who are living longer, and this group of older baby boomers often has an edentulous posterior maxilla either unilateral or bilateral. When edentulous, the posterior maxilla more likely has diminished bone height, which does not allow for the placement of dental implants without creating additional bone. Through grafting the maxillary sinus, bone of ideal quality can be created (allowing for placement of dental implants, which offer many advantages over other tooth replacement modalities. The sinus graft offers the dental patient a predictable procedure of regenerating lost osseous structure in the posterior maxilla. This offers the patient many advantages for long-term success. If dentists understand these concepts, they can better educate their patients and guide them to have the procedure performed. This article outlines bone grafting of the maxillary sinus for the purpose of placing dental implants. This review will help the readers to understand the intricacies of sinus augmentation. They can relate their patient's condition with the available literature and chalk out the best treatment plan for the patient, especially by using indirect sinus augmentation procedures which are less invasive and highly successful if done using prescribed technique.

  17. Patellar Tendon Repair Augmentation With a Knotless Suture Anchor Internal Brace: A Biomechanical Cadaveric Study.

    Rothfeld, Alex; Pawlak, Amanda; Liebler, Stephenie A H; Morris, Michael; Paci, James M

    2018-04-01

    Patellar tendon repair with braided polyethylene suture alone is subject to knot slippage and failure. Several techniques to augment the primary repair have been described. Purpose/Hypothesis: The purpose was to evaluate a novel patellar tendon repair technique augmented with a knotless suture anchor internal brace with suture tape (SAIB). The hypothesis was that this technique would be biomechanically superior to a nonaugmented repair and equivalent to a standard augmentation with an 18-gauge steel wire. Controlled laboratory study. Midsubstance patellar tendon tears were created in 32 human cadaveric knees. Two comparison groups were created. Group 1 compared #2 supersuture repair without augmentation to #2 supersuture repair with SAIB augmentation. Group 2 compared #2 supersuture repair with an 18-gauge stainless steel cerclage wire augmentation to #2 supersuture repair with SAIB augmentation. The specimens were potted and biomechanically loaded on a materials testing machine. Yield load, maximum load, mode of failure, plastic displacement, elastic displacement, and total displacement were calculated for each sample. Standard statistical analysis was performed. There was a statistically significant increase in the mean ± SD yield load and maximum load in the SAIB augmentation group compared with supersuture alone (mean yield load: 646 ± 202 N vs 229 ± 60 N; mean maximum load: 868 ± 162 N vs 365 ± 54 N; P augmented repairs (mean yield load: 495 ± 213 N vs 566 ± 172 N; P = .476; mean maximum load: 737 ± 210 N vs 697 ± 130 N; P = .721). Patellar tendon repair augmented with SAIB is biomechanically superior to repair without augmentation and is equivalent to repair with augmentation with an 18-gauge stainless steel cerclage wire. This novel patellar tendon repair augmentation is equivalent to standard 18-gauge wire augmentation at time zero. It does not require a second surgery for removal, and it is biomechanically superior to primary repair alone.

  18. Simulations of floor cooling system capacity

    Odyjas, Andrzej; Górka, Andrzej

    2013-01-01

    Floor cooling system capacity depends on its physical and operative parameters. Using numerical simulations, it appears that cooling capacity of the system largely depends on the type of cooling loads occurring in the room. In the case of convective cooling loads capacity of the system is small. However, when radiation flux falls directly on the floor the system significantly increases productivity. The article describes the results of numerical simulations which allow to determine system capacity in steady thermal conditions, depending on the type of physical parameters of the system and the type of cooling load occurring in the room. Moreover, the paper sets out the limits of system capacity while maintaining a minimum temperature of the floor surface equal to 20 °C. The results are helpful for designing system capacity in different type of cooling loads and show maximum system capacity in acceptable thermal comfort condition. -- Highlights: ► We have developed numerical model for simulation of floor cooling system. ► We have described floor system capacity depending on its physical parameters. ► We have described floor system capacity depending on type of cooling loads. ► The most important in the obtained cooling capacities is the type of cooling loads. ► The paper sets out the possible maximum cooling floor system capacity

  19. Pelvic floor and sexual male dysfunction

    Antonella Pischedda

    2013-04-01

    Full Text Available The pelvic floor is a complex multifunctional structure that corresponds to the genito- urinary-anal area and consists of muscle and connective tissue. It supports the urinary, fecal, sexual and reproductive functions and pelvic statics. The symptoms caused by pelvic floor dysfunction often affect the quality of life of those who are afflicted, worsening significantly more aspects of daily life. In fact, in addition to providing support to the pelvic organs, the deep floor muscles support urinary continence and intestinal emptying whereas the superficial floor muscles are involved in the mechanism of erection and ejaculation. So, conditions of muscle hypotonia or hypertonicity may affect the efficiency of the pelvic floor, altering both the functionality of the deep and superficial floor muscles. In this evolution of knowledge it is possible imagine how the rehabilitation techniques of pelvic floor muscles, if altered and able to support a voiding or evacuative or sexual dysfunction, may have a role in improving the health and the quality of life.

  20. Advanced Intellect-Augmentation Techniques.

    Engelbart, D. C.

    This progress report covers a two-year project which is part of a program that is exploring the value of computer aids in augmenting human intellectual capability. The background and nature of the program, its resources, and the activities it has undertaken are outlined. User experience in applying augmentation tools and techniques to various…

  1. Augmented Reality Comes to Physics

    Buesing, Mark; Cook, Michael

    2013-01-01

    Augmented reality (AR) is a technology used on computing devices where processor-generated graphics are rendered over real objects to enhance the sensory experience in real time. In other words, what you are really seeing is augmented by the computer. Many AR games already exist for systems such as Kinect and Nintendo 3DS and mobile apps, such as…

  2. Augmented reality som wearable technology

    Rahn, Annette

    “How Augmented reality can facilitate learning in visualizing human anatomy “ At this station I demonstrate how Augmented reality can be used to visualize the human lungs in situ and as a wearable technology which establish connection between body, image and technology in education. I will show...

  3. Nonsurgical Medical Penile Girth Augmentation: Experience-Based Recommendations.

    Oates, Jayson; Sharp, Gemma

    2017-10-01

    Penile augmentation is increasingly sought by men who are dissatisfied with the size and/or appearance of their penis. However, augmentation procedures are still considered to be highly controversial with no standardized recommendations reported in the medical literature and limited outcome data. Nevertheless, these procedures continue to be performed in increasing numbers in private settings. Therefore, there is a need for safe, effective, and minimally invasive procedures to be developed, evaluated, and reported in the research literature. In this article, we focus particularly on girth enhancement procedures rather than lengthening procedures as penile girth appears to be particularly important for sexual satisfaction. We discuss the advantages and disadvantages of the common techniques to date, with a focus on the minimally invasive injectable girth augmentation techniques. Based on considerable operative experience, we offer our own suggestions for patient screening, technique selection, and perioperative care. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  4. Robotic aortic surgery.

    Duran, Cassidy; Kashef, Elika; El-Sayed, Hosam F; Bismuth, Jean

    2011-01-01

    Surgical robotics was first utilized to facilitate neurosurgical biopsies in 1985, and it has since found application in orthopedics, urology, gynecology, and cardiothoracic, general, and vascular surgery. Surgical assistance systems provide intelligent, versatile tools that augment the physician's ability to treat patients by eliminating hand tremor and enabling dexterous operation inside the patient's body. Surgical robotics systems have enabled surgeons to treat otherwise untreatable conditions while also reducing morbidity and error rates, shortening operative times, reducing radiation exposure, and improving overall workflow. These capabilities have begun to be realized in two important realms of aortic vascular surgery, namely, flexible robotics for exclusion of complex aortic aneurysms using branched endografts, and robot-assisted laparoscopic aortic surgery for occlusive and aneurysmal disease.

  5. Magnetohydrodynamic Augmented Propulsion Experiment

    Litchford, Ron J.; Cole, John; Lineberry, John; Chapman, Jim; Schmidt, Harold; Cook, Stephen (Technical Monitor)

    2002-01-01

    A fundamental obstacle to routine space access is the specific energy limitations associated with chemical fuels. In the case of vertical take-off, the high thrust needed for vertical liftoff and acceleration to orbit translates into power levels in the 10 GW range. Furthermore, useful payload mass fractions are possible only if the exhaust particle energy (i.e., exhaust velocity) is much greater than that available with traditional chemical propulsion. The electronic binding energy released by the best chemical reactions (e.g., LOX/LH2 for example, is less than 2 eV per product molecule (approx. 1.8 eV per H2O molecule), which translates into particle velocities less than 5 km/s. Useful payload fractions, however, will require exhaust velocities exceeding 15 km/s (i.e., particle energies greater than 20 eV). As an added challenge, the envisioned hypothetical RLV (reusable launch vehicle) should accomplish these amazing performance feats while providing relatively low acceleration levels to orbit (2-3g maximum). From such fundamental considerations, it is painfully obvious that planned and current RLV solutions based on chemical fuels alone represent only a temporary solution and can only result in minor gains, at best. What is truly needed is a revolutionary approach that will dramatically reduce the amount of fuel and size of the launch vehicle. This implies the need for new compact high-power energy sources as well as advanced accelerator technologies for increasing engine exhaust velocity. Electromagnetic acceleration techniques are of immense interest since they can be used to circumvent the thermal limits associated with conventional propulsion systems. This paper describes the Magnetohydrodynamic Augmented Propulsion Experiment (MAPX) being undertaken at NASA Marshall Space Flight Center (MSFC). In this experiment, a 1-MW arc heater is being used as a feeder for a 1-MW magnetohydrodynamic (MHD) accelerator. The purpose of the experiment is to demonstrate

  6. Disorders of the pelvic floor and anal sphincters; a gastroenterologist’s perspective

    Eamonn M.M. Quigley, MD FRCP FACP FACG FRCPI

    2013-03-01

    Full Text Available The integration and coordination of the musculature of the pelvic floor and the anal sphincters is critical to two important physiological functions: defecation and continence. Consequently, disorders affecting the pelvic floor muscles, the anal sphincters, their innervation or their precise coordination will, depending on their nature, result either in obstructed defecation or fecal incontinence. Both of these disorders are much more common in females and the latter, in particular, is linked with parity. While the symptomatology, presentation and optimal mode of investigation of fecal incontinence are well standardized, considerable debate and controversy continues to surround the contributions of pelvic floor and anal sphincter dysfunction to chronic constipation and the optimal clinical approach to their investigation remains to be defined. In appropriately chosen cases surgical intervention may provide the best outcome for sufferers from incontinence; biofeedback approaches may be of value in both incontinence and obstructed defecation and surgery has little role to play in the latter.

  7. Magnetic Resonance Imaging (MRI): Dynamic Pelvic Floor

    ... to a CD or uploaded to a digital cloud server. Dynamic pelvic floor MRI provides detailed pictures ... with you. top of page What are the benefits vs. risks? Benefits MRI is a noninvasive imaging ...

  8. Pelvic floor electrophysiology patterns associated with faecal ...

    Hussein Al-Moghazy Sultan

    2012-12-28

    Dec 28, 2012 ... pelvic floor electrophysiological abnormalities associated with. FI were illustrated in ... detection of a localized anal sphincter defect clinically and ..... Woods R, Voyvodic F, Schloithe A, Sage M, Wattchow D. Anal sphincter ...

  9. Decontamination of polyvinylchloride- and rubber type flooring

    Kunze, S.

    1975-01-01

    These types, fabricated by mixing of the basic components, showed no relation between content of fillers and decontamination results. Decontamination results are partly poorer, if the flooring contains a high concentration of the filler, especially if the latter consists mainly of hydrophilic materials. The coloring of the floorings seems to have no influence on the decontamination but floorings with clearly separated patterns can not be recommended for nuclear facilities. Fabricated by chemical reactions between polymeres, vulcanization materials and fillers, the decontamination results depend definitely from the proper choice of the filler. Flooring types, containing lampblack, graphite, kaoline, barium sulfate and titanium oxide are easy to decontamine. Again, increasing contents of hydrophilic filler cause a fall off in the decontamination results. (orig.) [de

  10. Review of soft tissue augmentation in the face

    James Newman

    2009-08-01

    Full Text Available James NewmanFacial Plastic Surgery, Stanford University Medical Center, Palo Alto, CAFacial Plastic Surgery, Stanford University Medical Center, Palo Alto, CA, USAAbstract: A primary pillar of facial rejuvenation is the replacement of soft tissue atrophy via a variety of augmentation techniques. The techniques can be classified into three categories, skeletal onlay grafts, subcutaneous volumizers, and dermal fillers. While onlay grafts and subcutaneous volumizers have the most persistent results, the emergence of improved dermal fillers in the past 5 years has become increasingly popular. An accurate diagnosis of the level(s of soft tissue atrophy in the face needs to be made prior to selection of the category or combination of techniques. In the younger patient, the selection of a dermal filler or combination of fillers can be adequate for treatment. A comparison of the composition and characteristics of the available dermal fillers are discussed in detail to assist the clinician in understanding the actual mechanism of soft tissue augmentation. In the more advanced aging face, a combination of the three categories may be necessary to produce optimal results. Just as dermal fillers have become more differentiated to increase their longevity, the non-injectible long-lasting implants are becoming more developed to mimic accurate viscoelastic properties of the facial soft tissues. All three classes of augmentation techniques can provide patients with very satisfactory results as part of overall facial rejuvenation.Keywords: soft tissue, dermal fillers, facial implants, facial augmentation

  11. Graft shrinkage and survival rate of implants after sinus floor elevation using a nanocrystalline hydroxyapatite embedded in silica gel matrix: a 1-year prospective study.

    El Hage, Marc; Abi Najm, Semaan; Bischof, Mvark; Nedir, Rabah; Carrel, Jean-Pierre; Bernard, Jean-Pierre

    2012-06-01

    The aims of this study were (1) to evaluate the vertical shrinkage percentage of nanocrystalline hydroxyapatite embedded in silica gel used for maxillary sinus floor elevation (SFE) and (2) to determine the survival rate of the implants 1 year after placement in the healed grafted sinuses. Eleven maxillary sinuses were augmented in eight patients with NanoBone. After a healing period averaging 14.42 months, 19 implants were placed and followed up with clinical and radiographic evaluation. Panoramic radiographs were taken immediately after SFE and at 12 months after grafting. Measurements of changes in height were made by a computerized measuring technique using an image editing software. The mean graft height shrinkage percentage at 12 months after surgery was 8.84% (±5.32). One implant was lost before loading. All the 18 remaining osseointegrated implants received the prosthetic rehabilitation and were controlled after 3 months of functional loading. The implant survival rate at the 1-year interval was 94.74%. A 100% NanoBone alloplastic graft used in lateral SFE procedures presented limited height shrinkage. Implants placed in these grafted sinuses showed survival rates similar to those found in published data. These results should be interpreted cautiously considering the study's reduced sample size.

  12. Anonymous electronic trading versus floor trading

    Franke, Günter; Hess, Dieter

    1995-01-01

    This paper compares the attractiveness of floor trading and anonymous electronic trading systems. It is argued that in times of low information intensity the insight into the order book of the electronic trading system provides more valuable information than floor trading, but in times of high information intensity the reverse is true. Thus, the electronic system's market share in trading activity should decline in times of high information intensity. This hypothesis is tested by data on BUND...

  13. Ligament augmentation for prevention of proximal junctional kyphosis and proximal junctional failure in adult spinal deformity.

    Safaee, Michael M; Deviren, Vedat; Dalle Ore, Cecilia; Scheer, Justin K; Lau, Darryl; Osorio, Joseph A; Nicholls, Fred; Ames, Christopher P

    2018-05-01

    OBJECTIVE Proximal junctional kyphosis (PJK) is a well-recognized, yet incompletely defined, complication of adult spinal deformity surgery. There is no standardized definition for PJK, but most studies describe PJK as an increase in the proximal junctional angle (PJA) of greater than 10°-20°. Ligament augmentation is a novel strategy for PJK reduction that provides strength to the upper instrumented vertebra (UIV) and adjacent segments while also reducing junctional stress at those levels. METHODS In this study, ligament augmentation was used in a consecutive series of adult spinal deformity patients at a single institution. Patient demographics, including age; sex; indication for surgery; revision surgery; surgical approach; and use of 3-column osteotomies, vertebroplasty, or hook fixation at the UIV, were collected. The PJA was measured preoperatively and at last follow-up using 36-inch radiographs. Data on change in PJA and need for revision surgery were collected. Univariate and multivariate analyses were performed to identify factors associated with change in PJA and proximal junctional failure (PJF), defined as PJK requiring surgical correction. RESULTS A total of 200 consecutive patients were included: 100 patients before implementation of ligament augmentation and 100 patients after implementation of this technique. The mean age of the ligament augmentation cohort was 66 years, and 67% of patients were women. Over half of these cases (51%) were revision surgeries, with 38% involving a combined anterior or lateral and posterior approach. The mean change in PJA was 6° in the ligament augmentation group compared with 14° in the control group (p historical cohort, ligament augmentation is associated with a significant decrease in PJK and PJF. These data support the implementation of ligament augmentation in surgery for adult spinal deformity, particularly in patients with a high risk of developing PJK and PJF.

  14. Innovations in robotic surgery.

    Gettman, Matthew; Rivera, Marcelino

    2016-05-01

    Developments in robotic surgery have continued to advance care throughout the field of urology. The purpose of this review is to evaluate innovations in robotic surgery over the past 18 months. The release of the da Vinci Xi system heralded an improvement on the Si system with improved docking, the ability to further manipulate robotic arms without clashing, and an autofocus universal endoscope. Robotic simulation continues to evolve with improvements in simulation training design to include augmented reality in robotic surgical education. Robotic-assisted laparoendoscopic single-site surgery continues to evolve with improvements on technique that allow for tackling previously complex pathologic surgical anatomy including urologic oncology and reconstruction. Last, innovations of new surgical platforms with robotic systems to improve surgeon ergonomics and efficiency in ureteral and renal surgery are being applied in the clinical setting. Urologic surgery continues to be at the forefront of the revolution of robotic surgery with advancements in not only existing technology but also creation of entirely novel surgical systems.

  15. Phenobarbital Augments Hypothermic Neuroprotection

    Barks, John D.; Liu, Yi-Qing; Shangguan, Yu; Silverstein, Faye S.

    2010-01-01

    Seizures are associated with adverse outcome in infants with hypoxic-ischemic encephalopathy. We hypothesized that early administration of the anticonvulsant phenobarbital after cerebral hypoxia-ischemia could enhance the neuroprotective efficacy of delayed-onset hypothermia. We tested this hypothesis in a neonatal rodent model. Seven-day-old rats (n=104) underwent right carotid ligation, followed by 90 min 8%O2 exposure; 15 min later, they received injections of phenobarbital (40 mg/kg) or saline. One or 3h later, all were treated with hypothermia (30°C, 3h). Function and neuropathology were evaluated after 7 days (“early outcomes”) or 1 month (“late outcomes”). Early outcome assessment demonstrated better sensorimotor performance and less cortical damage in phenobarbital-treated groups; there were no differences between groups in which the hypothermia delay was shortened from 3h to 1h. Late outcome assessment confirmed sustained benefits of phenobarbital+hypothermia treatment; sensorimotor performance was better (persistent attenuation of contralateral forepaw placing deficits and absence of contralateral forepaw neglect); neuropathology scores were lower (medians, phenobarbital 2, saline 8.5, pphenobarbital may augment the neuroprotective efficacy of therapeutic hypothermia. PMID:20098339

  16. Understanding augmented reality concepts and applications

    Craig, Alan B

    2013-01-01

    Augmented reality is not a technology. Augmented reality is a medium. Likewise, a book on augmented reality that only addresses the technology that is required to support the medium of augmented reality falls far short of providing the background that is needed to produce, or critically consume augmented reality applications. One reads a book. One watches a movie. One experiences augmented reality. Understanding Augmented Reality addresses the elements that are required to create compelling augmented reality experiences. The technology that supports

  17. CT after transsphenoidal surgery

    Tazawa, Satoru

    1991-01-01

    Two hundred and ten CT studies of 95 patients after transsphenoidal surgery were reviewed. Spheno-ethmoid opacificaiton, intrasellar hematoma and gas bubbles were noted within 2 weeks after surgery. Bone defect of the sellar floor and bone stent were seen on coronal scans in most cases. The packing material frequently disappeared on follow-up studies. Hormonal assessment of the functioning tumor, according to which the effect of treatment was evaluated, was correlated with CT findings. Because differentiation between postoperative changes and residual mass was difficult, there was no definite CT criteria to indicate residual functioning tumor except upward convexity of the diaphragma sellae on CT more than 3 months after surgery. Initial follow up CT study is recommended to be performed at about 3 months after surgery, at which time the immediate postoperative inflammatory changes have been disappeared. The incidence of recurrence was 3/47 (6%), which was shown on follow-up CT from 4 to 10 years after surgery. Therefore, subsequent CT study should be done in every year or two, taking the clinical symptoms and hormonal data into consideration. (author)

  18. CT after transsphenoidal surgery

    Tazawa, Satoru [Tohoku Univ., Sendai (Japan). School of Medicine

    1991-03-01

    Two hundred and ten CT studies of 95 patients after transsphenoidal surgery were reviewed. Spheno-ethmoid opacificaiton, intrasellar hematoma and gas bubbles were noted within 2 weeks after surgery. Bone defect of the sellar floor and bone stent were seen on coronal scans in most cases. The packing material frequently disappeared on follow-up studies. Hormonal assessment of the functioning tumor, according to which the effect of treatment was evaluated, was correlated with CT findings. Because differentiation between postoperative changes and residual mass was difficult, there was no definite CT criteria to indicate residual functioning tumor except upward convexity of the diaphragma sellae on CT more than 3 months after surgery. Initial follow up CT study is recommended to be performed at about 3 months after surgery, at which time the immediate postoperative inflammatory changes have been disappeared. The incidence of recurrence was 3/47 (6%), which was shown on follow-up CT from 4 to 10 years after surgery. Therefore, subsequent CT study should be done in every year or two, taking the clinical symptoms and hormonal data into consideration. (author).

  19. When the tendon autograft is dropped accidently on the floor: A study about bacterial contamination and antiseptic efficacy.

    Barbier, O; Danis, J; Versier, G; Ollat, D

    2015-10-01

    Inadvertent contamination of the autograft can occur during anterior cruciate ligament (ACL) reconstruction if the autograft is dropped on the floor during surgery. A study was undertaken to determine the incidence of contamination when a graft is dropped on the operating room floor and the efficacy of antimicrobial solutions to decontaminate it. Samples from 25 patients undergoing ACL reconstruction with a hamstring tendon were sectioned and dropped onto the floor. Cultures were taken after immersion in antiseptic solutions (a chlorhexidine gluconate solution (group 1), a povidone-iodine solution (group 2), and a sodium hypochlorite solution (group 3)). A fourth piece (group 0) was cultured without being exposed to any solution. Cultures of a floor swab were taken at the same time. The floor swab cultures were positive in 96% of cases. The rate of contamination was 40% in group 0, 8% in group 1, 4% in group 2, and 16% in group 3. There was a significant difference between groups 1 and 2 and group 0 (p<0.05) but not between groups 3 and 0. Immersing a graft dropped on the floor during surgery in a chlorhexidine gluconate solution or povidone-iodine solution significantly reduces contamination of the graft. Soaking of the hamstring autograft in one of these solutions is recommended in the case of inadvertent contamination. Laboratory investigation (level 2). Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Experimental simulation of the water cooling of corium spread over the floor of a BWR containment

    Morage, F.; Lahey, R.T. Jr.; Podowski, M.Z. [Rensselaer Polytechnic Institute, Troy, NY (United States)

    1995-09-01

    This paper is concerned with an experimental investigation of the cooling effect of water collected on the surface of corium released onto the floor of a BWR drywell. In the present experiments, the actual reactor materials were replaced by simulant materials. Specifically, the results are shown for Freon-11 film boiling over liquid Wood`s metal spread above a solid porous surface through which argon gas was injected. An analysis of the obtained experimental data revealed that the actual film boiling heat transfer between a molten pool of corium and the water above the pool should be more efficient than predicted by using standard correlations for boiling over solid surfaces. This effect will be further augmented by the gas released due to the ablation of concrete floor beneath the corium and percolating towards its upper surface and into through the water layer above.

  1. Augmented Mirror: Interactive Augmented Reality System Based on Kinect

    Vera , Lucía; Gimeno , Jesús; Coma , Inmaculada; Fernández , Marcos

    2011-01-01

    Part 1: Long and Short Papers; International audience; In this paper we present a virtual character controlled by an actor in real time, who talks with an audience through an augmented mirror. The application, which integrates video images, the avatar and other virtual objects within an Augmented Reality system, has been implemented using a mixture of technologies: two kinect systems for motion capture, depth map and real images, a gyroscope to detect head movements, and control algorithms to...

  2. Labia Majora Augmentation: A Systematic Review of the Literature.

    Jabbour, Samer; Kechichian, Elio; Hersant, Barbara; Levan, Philippe; El Hachem, Lena; Noel, Warren; Nasr, Marwan

    2017-10-16

    Currently, there is no standardized approach for labia majora augmentation and controversies still exist regarding this subject. This systematic review aimed to assess the evidence in the literature regarding labia majora augmentation. On November 20, 2016, we conducted an online search of published articles in the Medline, Embase, and Cochrane databases. All articles describing labia majora augmentation were included in this review. Nine studies were selected for inclusion in the systematic review. Only 2 studies were prospective trials. The most commonly used technique was fat grafting with a total of 4 articles and 183 patients. The mean total injected fat volume ranged from 18 mL to 120 mL per session. Two articles described hyaluronic acid injection techniques. The total injected volume of hyaluronic acid ranged from 2 to 6 mL per session. Three articles used surgical techniques for labia majora augmentation. All included articles did not report any major or life-threatening complications. All techniques demonstrated high satisfaction rates. Labia majora augmentation appears to be a safe, efficient technique with a high satisfaction rate and no reported major complications. However, further randomized controlled trials are warranted. 4. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

  3. [Display technologies for augmented reality in medical applications].

    Eck, Ulrich; Winkler, Alexander

    2018-04-01

    One of the main challenges for modern surgery is the effective use of the many available imaging modalities and diagnostic methods. Augmented reality systems can be used in the future to blend patient and planning information into the view of surgeons, which can improve the efficiency and safety of interventions. In this article we present five visualization methods to integrate augmented reality displays into medical procedures and the advantages and disadvantages are explained. Based on an extensive literature review the various existing approaches for integration of augmented reality displays into medical procedures are divided into five categories and the most important research results for each approach are presented. A large number of mixed and augmented reality solutions for medical interventions have been developed as research prototypes; however, only very few systems have been tested on patients. In order to integrate mixed and augmented reality displays into medical practice, highly specialized solutions need to be developed. Such systems must comply with the requirements with respect to accuracy, fidelity, ergonomics and seamless integration into the surgical workflow.

  4. Augmented reality for the surgeon: Systematic review.

    Yoon, Jang W; Chen, Robert E; Kim, Esther J; Akinduro, Oluwaseun O; Kerezoudis, Panagiotis; Han, Phillip K; Si, Phong; Freeman, William D; Diaz, Roberto J; Komotar, Ricardo J; Pirris, Stephen M; Brown, Benjamin L; Bydon, Mohamad; Wang, Michael Y; Wharen, Robert E; Quinones-Hinojosa, Alfredo

    2018-04-30

    Since the introduction of wearable head-up displays, there has been much interest in the surgical community adapting this technology into routine surgical practice. We used the keywords augmented reality OR wearable device OR head-up display AND surgery using PubMed, EBSCO, IEEE and SCOPUS databases. After exclusions, 74 published articles that evaluated the utility of wearable head-up displays in surgical settings were included in our review. Across all studies, the most common use of head-up displays was in cases of live streaming from surgical microscopes, navigation, monitoring of vital signs, and display of preoperative images. The most commonly used head-up display was Google Glass. Head-up displays enhanced surgeons' operating experience; common disadvantages include limited battery life, display size and discomfort. Due to ergonomic issues with dual-screen devices, augmented reality devices with the capacity to overlay images onto the surgical field will be key features of next-generation surgical head-up displays. Copyright © 2018 John Wiley & Sons, Ltd.

  5. Effect of Reduced Stiffness Dance Flooring on Lower Extremity Joint Angular Trajectories During a Ballet Jump.

    Hackney, James; Brummel, Sara; Newman, Mary; Scott, Shannon; Reinagel, Matthew; Smith, Jennifer

    2015-09-01

    We carried out a study to investigate how low stiffness flooring may help prevent overuse injuries of the lower extremity in dancers. It was hypothesized that performing a ballet jump (sauté) on a reduced stiffness dance floor would decrease maximum joint flexion angles and negative angular velocities at the hips, knees, or ankles compared to performing the same jump on a harder floor. The participants were 15 young adult female dancers (age range 18 to 28, mean = 20.89 ± 2.93 years) with at least 5 years of continuous ballet experience and without history of serious lower body injury, surgery, or recent pain. They performed sautés on a (low stiffness) Harlequin ® WoodSpring Floor and on a vinyl-covered hardwood on concrete floor. Maximum joint flexion angles and negative velocities at bilateral hips, knees, and ankles were measured with the "Ariel Performance Analysis System" (APAS). Paired one-tailed t-tests yielded significant decreases in maximum knee angle (average decrease = 3.4° ± 4.2°, p = 0.026) and angular negative velocity of the ankles (average decrease = 18.7°/sec ± 27.9°/sec, p = 0.009) with low stiffness flooring. If the knee angle is less acute, then the length of the external knee flexion moment arm will also be shorter and result in a smaller external knee flexion moment, given an equal landing force. Also, high velocities of eccentric muscle contraction, which are necessary to control negative angular velocity of the ankle joint, are associated with higher risk of musculotendinous injury. Hence, our findings indicate that reduced floor stiffness may indeed help decrease the likelihood of lower extremity injuries.

  6. Orbital floor reconstruction using a tensor fascia lata sling after total maxillectomy.

    Jung, Bok Ki; Yun, In Sik; Lee, Won Jai; Lew, Dae Hyun; Choi, Eun Chang; Lee, Dong Won

    2016-05-01

    Reconstruction after total maxillectomy with extensive orbital floor defects poses a significant challenge for the reconstruction. The aim of this study is to present the outcomes of orbital floor reconstruction using tensor fascia lata slings after total maxillectomy and to compare these results to orbital floor reconstruction using alloplastic implants. This was a retrospective analysis of 19 consecutive patients who underwent tumor resection with orbital floor removal for malignancies. Reconstructions were performed using either tensor fascia lata slings (Group A) or alloplastic implants (Group B). The early and late postoperative outcomes such as wound infection, plate exposure, ectropion, diplopia, and enophthalmos, were analyzed and compared between the two groups. Patients in group A had significantly less wound complication than in group B (p < 0.05). In group A, there were no early or late wound complications after the operation. However, in group B, five patients had infection, the plate was exposed in eight of fourteen patients, and three patients had enophthalmos. Eight patients in group B underwent reoperation to correct their complications. Reconstruction of the orbital floor with a tensor fascia lata sling offers reliable support to the globe and prevents the ophthalmic complications associated with loss of orbital support. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  7. Polypropylene Darning: A New Alternative for Reconstruction of Orbital Floor after Total Maxillectomy.

    Sharma, Prashant

    2015-06-01

    Removal of orbital floor is an integral part of total (radical) maxillectomy (type IIIa), which if not managed properly, may lead to some eye related distressing complications like diplopia, eyelid malposition, epiphora, dacryocystitis, enopthalmos and ectoprion. Among all, diplopia is the most distressing complication which hampers daily activity. Various options for orbital floor reconstruction are available like titanium sheet, polypropylene mesh, non-vascularized or vascularized bone graft, pedicled flaps, micro-vascular free flaps, prosthesis placement, and split skin graft followed by obturator placement. Till date no-body has tried stabilization of eye ball by 'darning' the orbital floor using non-absorbable suture. 'Polypropylene suture darning' is an easy to learn, novel method with equally good results. Five patients with potentially resectable tumors underwent total maxillectomy. I used polypropylene 3-0 round body suture and 'darning' was done at orbital floor, incorporating periosteum (if remaining) and peri-orbital fat into the sutures. Muscle flaps were done to provide bulk and palatal reconstruction. Assessment of patients was done post-operatively at day-5 i.e., before discharge and at 1 month after surgery, and also in further follow up visits. The results were very good in terms of clear vision & eye movements (directly related to 'darning'), and the aesthetic look of patients and bilateral symmetry were satisfactory (not related to darning). Darning of orbital floor by polypropylene after total maxillectomy is an easy to learn and cost-effective method of reconstruction with good results.

  8. 75 FR 66126 - Multilayered Wood Flooring From China

    2010-10-27

    ...)] Multilayered Wood Flooring From China AGENCY: United States International Trade Commission. ACTION: Institution... flooring, provided for in subheadings 4409.10, 4409.29, 4412.31, 4412.32, 4412.39, 4412.94, 4412.99, 4418... multilayered wood flooring. The following companies are members of the CAHP: Anderson Hardwood Floors, LLC...

  9. 75 FR 79019 - Multilayered Wood Flooring From China

    2010-12-17

    ...)] Multilayered Wood Flooring From China Determinations On the basis of the record \\1\\ developed in the subject... imports from China of multilayered wood flooring, provided for in subheadings 4409.10, 4409.29, 4412.31... multilayered wood flooring. The following companies are members of the CAHP: Anderson Hardwood Floors, LLC...

  10. 76 FR 76435 - Multilayered Wood Flooring From China

    2011-12-07

    ...)] Multilayered Wood Flooring From China Determinations On the basis of the record \\1\\ developed in the subject... multilayered wood flooring, provided for in subheadings 4409.10, 4409.29, 4412.31, 4412.32, 4412.39, 4412.94... flooring. The following companies are members of the CAHP: Anderson Hardwood Floors, LLC, Fountain Inn, SC...

  11. Investigation of floor Nusselt number in floor heating system for insulated ceiling conditions

    Karadag, Refet; Teke, Ismail

    2007-01-01

    In this study, in a floor heated room, natural convection heat transfer over the floor is analysed numerically for different thermal conditions. An equation relevant to Nusselt number over the floor has been obtained by using the numerical data. Different equations are given in the literature. They consider the effect of floor Rayleigh number while neglecting the effect of wall and ceiling thermal conditions. Numerical data obtained in this study show that the Nusselt number over the floor depends on not only the floor Rayleigh number but also the wall Rayleigh number (for insulated ceiling conditions). The equations given in the literature are different from each other due to their not considering the effect of wall and ceiling Rayleigh numbers. This difference between the equations may be eliminated by obtaining an equation containing the effect of floor, wall and ceiling Rayleigh numbers. In this new approach, an equation relevant to the floor Nusselt number that depends on the floor and wall Rayleigh numbers has been obtained in the floor heating system for insulated ceiling conditions. The equation obtained in this study has been compared with the equations given in the literature. It has been seen that the equation obtained in this study matches the numerical values under more extensive thermal conditions than the equations given in the literature. The maximum deviation for the equations given in the literature is 35%, but in the current study, the maximum deviation has been found to be 10%. As a result, it is more convenient to use the equation found in the new approach as a function of Rayleigh number over the floor and wall for insulated ceiling conditions

  12. Effect of pelvic floor rehabilitation technique in preventing the postpartum pelvic floor dysfunction

    Shi-Qiong Li

    2017-04-01

    Full Text Available Objective: To explore the effect of pelvic floor rehabilitation technique in preventing the postpartum pelvic floor dysfunction and on the sexual life quality. Methods: A total of 286 puerpera with pelvic floor dysfunction who were admitted in our hospital from May, 2014 to May, 2015 42 d after delivery were included in the study, and randomized into the treatment group and the control group with 143 cases in each group. After guidance, the puerpera in the control group were given pelvic floor muscle training by themselves at home. On this basis, the puerpera in the treatment group were treated by the pelvic floor rehabilitation apparatus. The puerpera in the two groups were treated for 4 weeks. The pelvic floor function before treatment, 6 months and 1 year after delivery was detected. The color Doppler ultrasound apparatus was used to detect BSD, PUVA, UVJ-M, and BND 3 months after delivery. Results: BND, PUVA-R, PUVA-S, and UVJ-M 3 months after delivery in the treatment groups were significantly lower than those in the control group, while BSD-S was significantly higher than that in the control group. The improvement of type I and II muscle fiber fatigue (%, POP-Q degree, AP indication point (cm, and vaginal dynamic pressure (cmH2O was significantly superior to that in the control group. The comparison of pelvic floor muscle strength classification before treatment between the two groups was not statistically significant. After treatment, the pelvic floor muscle in the two groups was significantly strengthened, and the proportion of V grade patients was significantly increased when compared with before treatment. Conclusions: The postpartum early pelvic floor rehabilitation technique can effectively enhance the pelvic floor function, and prevent the postpartum pelvic floor dysfunction, with an accurate efficacy; therefore, it deserves to be widely recommended in the clinic.

  13. Treating Pelvic Floor Disorders of Defecation: Management or Cure?

    Rao, Satish S.C.; Go, Jorge T.

    2013-01-01

    Pelvic floor disorders that affect defecation consist of structural disorders such as rectocele and functional disorders such as dyssynergic defecation. Evaluation includes a good history and physical examination, a careful digital rectal exam, as well as physiological tests such as anorectal manometry, colonic transit study and balloon expulsion test. Defecography and dynamic magnetic resonance imaging may facilitate detection of structural defects. Their management consists of education and counseling regarding bowel function, diet, laxatives and behavioral therapies. Recently, several randomized clinical trials have shown that biofeedback therapy is effective in dyssynergic defecation. Dyssynergia may also co-exist in structural disorders such as solitary rectal ulcer syndrome or rectocele. Hence, before proceeding with surgery, neuromuscular training or biofeedback should be considered. Several surgical approaches including stapled transanal rectal resection (STARR) have been advocated, but there is lack of well controlled randomized studies and their efficacy is unproven. PMID:19615303

  14. The Augmented REality Sandtable (ARES)

    2015-10-01

    Introduction The US Army Research Laboratory (ARL) Human Sciences Campaign calls out the topic of Virtual /Mixed and Augmented Reality as one of the...type of virtual environment. In virtual reality (VR), the totality of the environment is computer generated. In AR, the real world is augmented by...tangible user interfaces; and the effectiveness of virtual sand tables and similar systems. A market survey was also done to discover the state of

  15. Turbinate surgery

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - turbinate surgery ... There are several types of turbinate surgery: Turbinectomy: All or ... This can be done in several different ways, but sometimes a ...

  16. Bariatric Surgery

    ... often. Each type of surgery has advantages and disadvantages. Bariatric Surgery Benefits Bariatric surgery can improve many ... Grants & Grant History Research Resources Research at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information Diabetes Digestive ...

  17. Lung surgery

    ... are thoracotomy and video-assisted thoracoscopic surgery (VATS). Robotic surgery may also be used. Lung surgery using ... Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

  18. Plastic Surgery

    ... Staying Safe Videos for Educators Search English Español Plastic Surgery KidsHealth / For Teens / Plastic Surgery What's in ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word " ...

  19. 17 CFR 3.11 - Registration of floor brokers and floor traders.

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Registration of floor brokers and floor traders. 3.11 Section 3.11 Commodity and Securities Exchanges COMMODITY FUTURES TRADING... a contract market or registered as a derivatives transaction execution facility by the Commission...

  20. Flooring-systems and their interaction with usage of the floor

    Pedersen, Lars; Frier, Christian; Andersen, Lars Vabbersgaard

    2017-01-01

    Some flooring-system designs might be sensitive to their vibrational performance, as there might be the risk that serviceability-limit-state problems may be encountered. For evaluating the vibrational performance of the flooring-system at the design stage, decisions need to be made by the enginee...

  1. No bulging of floor heating pipes to be expected in case of incomplete floor plastering

    Radtke, U

    1983-02-01

    According to advertising slogans floor heating pipes are said to be damaged prematurely by bulges if they are not completely surrounded by flooring plaster. The author has thoroughly dealt with this problem and made the respective measurements. He found out that there are so few bulges occurring that they cannot lead to damages.

  2. Glazed Tiles as Floor Finish in Nigeria

    Toyin Emmanuel AKINDE

    2013-09-01

    Full Text Available Tile is no doubt rich in antiquity; its primordial  show, came as mosaic with primary prospect in sacred floor finish before its oblivion, courtesy of, later consciousness towards wall finish in banquets, kitchens, toilets, restaurants and even bars. Today, its renaissance as floor finish is apparent in private and public architectural structures with prevalence in residential, recreational, commercial, governmental and other spaces. In Nigeria, the use of glazed tiles as floor finish became apparent, supposedly in mid-twentieth century; and has since, witnessed ever increasing demands from all sundry; a development that is nascent and has necessitated its mass  production locally with pockets of firms in the country. The latter however, is a resultant response to taste cum glazed tiles affordability, whose divergent sophistication in design, colour, size and shape is believed preferred to terrazzo, carpet and floor flex tile. Accessible as glazed tile and production is, in recent times; its dearth of a holistic literature in Nigeria is obvious. In the light of the latter, this paper examine glazed tiles as floor finish in Nigeria, its advent, usage, production, challenge, benefit and prospect with the hope of opening further frontier in discipline specifics.

  3. Global floor planning approach for VLSI design

    LaPotin, D.P.

    1986-01-01

    Within a hierarchical design environment, initial decisions regarding the partitioning and choice of module attributes greatly impact the quality of the resulting IC in terms of area and electrical performance. This dissertation presents a global floor-planning approach which allows designers to quickly explore layout issues during the initial stages of the IC design process. In contrast to previous efforts, which address the floor-planning problem from a strict module placement point of view, this approach considers floor-planning from an area planning point of view. The approach is based upon a combined min-cut and slicing paradigm, which ensures routability. To provide flexibility, modules may be specified as having a number of possible dimensions and orientations, and I/O pads as well as layout constraints are considered. A slicing-tree representation is employed, upon which a sequence of traversal operations are applied in order to obtain an area efficient layout. An in-place partitioning technique, which provides an improvement over previous min-cut and slicing-based efforts, is discussed. Global routing and module I/O pin assignment are provided for floor-plan evaluation purposes. A computer program, called Mason, has been developed which efficiently implements the approach and provides an interactive environment for designers to perform floor-planning. Performance of this program is illustrated via several industrial examples

  4. WOODEN FLOORING – BETWEEN PRESENT AND FUTURE

    Ivan CISMARU

    2015-06-01

    Full Text Available The paper aims at presenting a systematization of the wood floors, both in terms of the areas of application, and in terms of the fastening solutions and structures in constructions. In this respect, an extensive bibliographic research was achieved, on the researchers’ preoccupations. Starting from the current situation and forecasting the future, from the point of view of the chances held by wooden flooring, in competition with other types of materials, we dare say the wooden flooring or the wood in combination with other materials are not likely to be eliminated from the “civil-engineering market”. The wood floors are likely to develop as an application, especially in the area of the “special floors”, specific to the indoor sports or social halls; and even for some industrial sectors, with strict operating conditions (elasticity, thermal insulation, soundproofing that cannot be provided by other types of materials or structures. Starting from this last observation, the paper also aims at submitting current opinions with respect to this type of floors, both in the light of the current databases and in the light of the future researches, to this end

  5. Surgery versus physiotherapy for stress urinary incontinence

    Labrie, J.; Berghmans, B.L.; Fischer, K.; Milani, A.L.; Wijk, I. van; Smalbraak, D.J.; Vollebregt, A.; Schellart, R.P.; Graziosi, G.C.; Ploeg, J.M. van der; Brouns, J.F.; Tiersma, E.S.; Groenendijk, A.G.; Scholten, P.; Mol, B.W.; Blokhuis, E.E.; Adriaanse, A.H.; Schram, A.; Roovers, J.P.; Lagro-Janssen, A.L.M.; Vaart, C.H. van der

    2013-01-01

    BACKGROUND: Physiotherapy involving pelvic-floor muscle training is advocated as first-line treatment for stress urinary incontinence; midurethral-sling surgery is generally recommended when physiotherapy is unsuccessful. Data are lacking from randomized trials comparing these two options as initial

  6. Surgery versus Physiotherapy for Stress Urinary Incontinence

    Labrie, Julien; Berghmans, Bary L. C. M.; Fischer, Kathelijn; Milani, Alfredo L.; van der Wijk, Ileana; Smalbraak, Dina J. C.; Vollebregt, Astrid; Schellart, Rene P.; Graziosi, Giuseppe C. M.; van der Ploeg, J. Marinus; Brouns, Joseph F. G. M.; Tiersma, E. Stella M.; Groenendijk, Annette G.; Scholten, Piet; Mol, Ben Willem; Blokhuis, Elisabeth E.; Adriaanse, Albert H.; Schram, Aaltje; Roovers, Jan-Paul W. R.; Lagro-Janssen, Antoine L. M.; van der Vaart, Carl H.

    2013-01-01

    BackgroundPhysiotherapy involving pelvic-floor muscle training is advocated as first-line treatment for stress urinary incontinence; midurethral-sling surgery is generally recommended when physiotherapy is unsuccessful. Data are lacking from randomized trials comparing these two options as initial

  7. Effects of Floor Covering Resistance of a Radiant Floor on System Energy and Exergy Performances

    Kazanci, Ongun Berk; Shukuya, Masanori; Olesen, Bjarne W.

    2016-01-01

    Floor covering resistance (material and thickness) can be influenced by subjective choices (architectural design, interior design, texture, etc.) with significant effects on the performance of a radiant heating and cooling system. To study the effects of floor covering resistance on system...... performance, a water-based radiant floor heating and cooling system (dry, wooden construction) was considered to be coupled to an air-to-water heat pump, and the effects of varying floor covering resistances (0.05 m2K/W, 0.09 m2K/W and 0.15 m2K/W) on system performance were analyzed in terms of energy...... and exergy. In order to achieve the same heating and cooling outputs, higher average water temperatures are required in the heating mode (and lower temperatures in the cooling mode) with increasing floor covering resistance. These temperature requirements decrease the heat pump’s performance (lower...

  8. A prospective randomized controlled trial of the two-window technique without membrane versus the solo-window technique with membrane over the osteotomy window for maxillary sinus augmentation.

    Yu, Huajie; He, Danqing; Qiu, Lixin

    2017-12-01

    Maturation of the grafted volume after lateral sinus elevation is crucial for the long-term survival of dental implants. To compare endo-sinus histomorphometric bone formation between the solo- and two-window maxillary sinus augmentation techniques with or without membrane coverage for the rehabilitation of multiple missing posterior teeth. Patients with severely atrophic posterior maxillae were randomized to receive lateral sinus floor elevation via the solo-window technique with membrane coverage (Control Group) or the two-window technique without coverage (Test Group). Six months after surgery, bone core specimens harvested from the lateral aspect were histomorphometrically analyzed. Ten patients in each group underwent 21 maxillary sinus augmentations. Histomorphometric analysis revealed mean newly formed bone values of 26.08 ± 16.23% and 27.14 ± 18.11%, mean connective tissue values of 59.34 ± 12.42% and 50.03 ± 17.13%, and mean residual graft material values of 14.6 ± 14.56% and 22.78 ± 10.83% in the Test and Control Groups, respectively, with no significant differences. The two-window technique obtained comparative maturation of the grafted volume even without membrane coverage, and is a viable alternative for the rehabilitation of severely atrophic posterior maxillae with multiple missing posterior teeth. © 2017 Wiley Periodicals, Inc.

  9. Virtual reality: new method of teaching anorectal and pelvic floor anatomy.

    Dobson, Howard D; Pearl, Russell K; Orsay, Charles P; Rasmussen, Mary; Evenhouse, Ray; Ai, Zhuming; Blew, Gregory; Dech, Fred; Edison, Marcia I; Silverstein, Jonathan C; Abcarian, Herand

    2003-03-01

    A clear understanding of the intricate spatial relationships among the structures of the pelvic floor, rectum, and anal canal is essential for the treatment of numerous pathologic conditions. Virtual-reality technology allows improved visualization of three-dimensional structures over conventional media because it supports stereoscopic-vision, viewer-centered perspective, large angles of view, and interactivity. We describe a novel virtual reality-based model designed to teach anorectal and pelvic floor anatomy, pathology, and surgery. A static physical model depicting the pelvic floor and anorectum was created and digitized at 1-mm intervals in a CT scanner. Multiple software programs were used along with endoscopic images to generate a realistic interactive computer model, which was designed to be viewed on a networked, interactive, virtual-reality display (CAVE or ImmersaDesk). A standard examination of ten basic anorectal and pelvic floor anatomy questions was administered to third-year (n = 6) and fourth-year (n = 7) surgical residents. A workshop using the Virtual Pelvic Floor Model was then given, and the standard examination was readministered so that it was possible to evaluate the effectiveness of the Digital Pelvic Floor Model as an educational instrument. Training on the Virtual Pelvic Floor Model produced substantial improvements in the overall average test scores for the two groups, with an overall increase of 41 percent (P = 0.001) and 21 percent (P = 0.0007) for third-year and fourth-year residents, respectively. Resident evaluations after the workshop also confirmed the effectiveness of understanding pelvic anatomy using the Virtual Pelvic Floor Model. This model provides an innovative interactive educational framework that allows educators to overcome some of the barriers to teaching surgical and endoscopic principles based on understanding highly complex three-dimensional anatomy. Using this collaborative, shared virtual-reality environment

  10. Dermoid cyst in the mouth floor

    Portelles Masso, Ayelen Maria; Torres Inniguez, Ailin Tamara.

    2010-01-01

    The Dermoid cyst account for the 0.01 % of all cysts of buccal cavity. Its more frequent location is in the mouth floor. This is the case of a female patient aged 19 who approximately 7 years noted an increase of volume under tongue growing gradually and noting outside face and the discomfort at to speak and to chew. Complementary studies were conducted and under general anesthesia a surgical exeresis was carried out by intrabuccal approach achieving excellent esthetic and functional results. Histopathologic diagnosis matched with a dermoid cyst of mouth floor. Patient has not lesion recurrence after three years after operation. We conclude that the Dermoid cyst of mouth floor appear as benign tumor of middle line. The intrabuccal exeresis demonstrates esthetic and functional benefits. (author)

  11. Imaging of the posterior pelvic floor

    Stoker, Jaap; Bartram, Clive I.; Halligan, Steve

    2002-01-01

    Disorders of the posterior pelvic floor are relatively common. The role of imaging in this field is increasing, especially in constipation, prolapse and anal incontinence, and currently imaging is an integral part of the investigation of these pelvic floor disorders. Evacuation proctography provides both structural and functional information for rectal voiding and prolapse. Dynamic MRI may be a valuable alternative as the pelvic floor muscles are visualised, and it is currently under evaluation. Endoluminal imaging is important in the management of anal incontinence. Both endosonography and endoanal MRI can be used for detection of anal sphincter defects. Endoanal MRI has the advantage of simultaneously evaluating external sphincter atrophy, which is an important predictive factor for the outcome of sphincter repair. Many aspects of constipation and prolapse remain incompletely understood and treatment is partly empirical; however, imaging has a central role in management to place patients into treatment-defined groups. (orig.)

  12. Development of rationalized system treating floor drain

    Nakamura, Yasuyuki; Serizawa, Kenichi; Komatsu, Akihiro; Shimizu, Takayuki

    1998-01-01

    Radioactive liquid wastes generated at BWR plants are collected and treated as required. These days, however, generation of floor drain has deceased and HFF (Hollow Fiber Filter) has experienced a wide applicability to several kinds of liquid wastes. We should consider that the floor drain can be mixed and diluted with equipment drain and be purified by HFF. That enables some of the sumps and long priming pipes to be combined. From this point of view, we have developed a highly rationalized waste liquid system. We have evaluated the applicability of this system after an investigation into the generation and properties of floor drain and equipment drain at the latest BWR'S and an on-site test at a typical BWR. (author)

  13. Imaging of the posterior pelvic floor

    Stoker, Jaap [Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands); Bartram, Clive I.; Halligan, Steve [Intestinal Imaging Centre, St. Mark' s Hospital, London (United Kingdom)

    2002-04-01

    Disorders of the posterior pelvic floor are relatively common. The role of imaging in this field is increasing, especially in constipation, prolapse and anal incontinence, and currently imaging is an integral part of the investigation of these pelvic floor disorders. Evacuation proctography provides both structural and functional information for rectal voiding and prolapse. Dynamic MRI may be a valuable alternative as the pelvic floor muscles are visualised, and it is currently under evaluation. Endoluminal imaging is important in the management of anal incontinence. Both endosonography and endoanal MRI can be used for detection of anal sphincter defects. Endoanal MRI has the advantage of simultaneously evaluating external sphincter atrophy, which is an important predictive factor for the outcome of sphincter repair. Many aspects of constipation and prolapse remain incompletely understood and treatment is partly empirical; however, imaging has a central role in management to place patients into treatment-defined groups. (orig.)

  14. Bayesian Alternation During Tactile Augmentation

    Caspar Mathias Goeke

    2016-10-01

    Full Text Available A large number of studies suggest that the integration of multisensory signals by humans is well described by Bayesian principles. However, there are very few reports about cue combination between a native and an augmented sense. In particular, we asked the question whether adult participants are able to integrate an augmented sensory cue with existing native sensory information. Hence for the purpose of this study we build a tactile augmentation device. Consequently, we compared different hypotheses of how untrained adult participants combine information from a native and an augmented sense. In a two-interval forced choice (2 IFC task, while subjects were blindfolded and seated on a rotating platform, our sensory augmentation device translated information on whole body yaw rotation to tactile stimulation. Three conditions were realized: tactile stimulation only (augmented condition, rotation only (native condition, and both augmented and native information (bimodal condition. Participants had to choose one out of two consecutive rotations with higher angular rotation. For the analysis, we fitted the participants’ responses with a probit model and calculated the just notable difference (JND. Then we compared several models for predicting bimodal from unimodal responses. An objective Bayesian alternation model yielded a better prediction (χred2 = 1.67 than the Bayesian integration model (χred2= 4.34. Slightly higher accuracy showed a non-Bayesian winner takes all model (χred2= 1.64, which either used only native or only augmented values per subject for prediction. However the performance of the Bayesian alternation model could be substantially improved (χred2= 1.09 utilizing subjective weights obtained by a questionnaire. As a result, the subjective Bayesian alternation model predicted bimodal performance most accurately among all tested models. These results suggest that information from augmented and existing sensory modalities in

  15. Modal analysis for floors in lightweight buildings

    Sjökvist, Lars-Göran; Brunskog, Jonas

    2007-01-01

    of acoustical prediction methods for those houses. The calculation standard EN 12354 is under evaluation since it cannot include most of the wooden houses that are built. It is important during such a work to have a great understanding of the acoustical behaviour for the wooden houses. The floors in lightweight...... constructions usually consist of plates that are stiffened by beams and by the dividing walls. In this study the wave equation for a plate is expanded by Fourier series and an analytical solution in terms of the eigenmodes of the entire system is presented. The studied system consists of one lightweigt floor...

  16. Coatings and floor covers for nuclear applications

    Kunze, S.

    1998-01-01

    To prevent damage to, or even the destruction of, components of very sensitive electrical equipment in rooms in which unsealed radioactive emitters are handled, floors must be antistatic and capable of being decontaminated. Conductive additives to the cover compounds achieve the desired leakage resistance of 5.10 4 to 10 6 Ω. Investigations have shown the decontamination capability of all floor covers and coatings to be excellent in most cases, and good in a few cases. Except for one coating, the coatings examined after radiation exposure also meet the requirements applying to nuclear installations. (orig.) [de

  17. Augmented reality for breast imaging.

    Rancati, Alberto; Angrigiani, Claudio; Nava, Maurizio B; Catanuto, Giuseppe; Rocco, Nicola; Ventrice, Fernando; Dorr, Julio

    2018-02-21

    Augmented reality (AR) enables the superimposition of virtual reality reconstructions onto clinical images of a real patient, in real time. This allows visualization of internal structures through overlying tissues, thereby providing a virtual transparency vision of surgical anatomy. AR has been applied to neurosurgery, which utilizes a relatively fixed space, frames, and bony references; the application of AR facilitates the relationship between virtual and real data. Augmented Breast imaging (ABI) is described. Breast MRI studies for breast implant patients with seroma were performed using a Siemens 3T system with a body coil and a four-channel bilateral phased-array breast coil as the transmitter and receiver, respectively. The contrast agent used was (CA) gadolinium (Gd) injection (0.1 mmol/kg at 2 ml/s) by a programmable power injector. Dicom formated images data from 10 MRI cases of breast implant seroma and 10 MRI cases with T1-2 N0 M0 breast cancer, were imported and transformed into Augmented reality images. Augmented breast imaging (ABI) demonstrated stereoscopic depth perception, focal point convergence, 3D cursor use, and joystick fly-through. Augmented breast imaging (ABI) to the breast can improve clinical outcomes, giving an enhanced view of the structures to work on. It should be further studied to determine its utility in clinical practice.

  18. Advances in bone augmentation to enable dental implant placement: Consensus Report of the Sixth European Workshop on Periodontology.

    Tonetti, Maurizio S; Hämmerle, Christoph H F

    2008-09-01

    Bone augmentation procedures to enable dental implant placement are frequently performed in practice. In this session the European Workshop on Periodontology discussed the evidence in support of the procedures and examined both adverse events and implant performance in the augmented bone. While the available evidence improved both in quantity and quality since previous workshops the conclusions that could be drawn were limited by elements of design and/or reporting that are amenable to improvement. With regards to lateral bone augmentation, a sizable body of evidence supports its use to enable dental implant placement. The group recognized the potential for vertical ridge augmentation procedures to allow implant placement in clinical practice but questioned the applicability of these data to a wider array of operators and clinical settings. With regards to sinus floor augmentation, perforation of the sinus membrane, graft infection and graft loss resulting in inability of implant placement were the major reported adverse events. In cases with dental implants placed in pristine sites. The consensus emphasized the research need to answer questions on: (i) long-term performance of dental implants placed in augmented bone; (ii) the clinical performance of dental implants placed in augmented or pristine sites; and (iii) the clinical benefits of bone augmentation with respect to alternative treatments.

  19. Some Passive Damping Sources on Flooring Systems besides the TMD

    Pedersen, Lars

    2010-01-01

    Impulsive loads and walking loads can generate problematic structural vibrations in flooring-systems. Measures that may be taken to mitigate the problem would often be to consider the implementation of a tuned mass damper or even more advanced vibration control technologies; this in order to add...... damping to the structure. Basically also passive humans on a floor act as a damping source, but it also turns out from doing system identification tests with a floor strip that a quite simple set-up installed on the floor (cheap and readily at hand) might do a good job in terms of reducing vertical floor...... vibrations for some floors. The paper describes the tests with the floor strip, and the results, in terms of dynamic floor behaviour, are compared with what would be expected had the floor instead been equipped with a tuned mass damper....

  20. Pelvic floor muscle training for female urinary incontinence: Does it work?

    Singh, Nilanjana; Rashid, Mumtaz; Bayliss, Lorna; Graham, Penny

    2016-06-01

    Supervised pelvic floor muscle training in patients of stress and mixed urinary incontinence has been recommended. Our aim was to assess the utilisation and effectiveness of our supervised pelvic floor muscle training service and assess the impact of incontinence scores before physiotherapy on the subsequent results of physiotherapy. All 271 patients referred to physiotherapy for symptoms of incontinence filled out the International Consultation on Incontinence Modular Questionnaire-Female Lower Urinary Tract Symptoms before starting treatment. Depending on pelvic floor muscle assessment, plans for exercises and follow up were made. If the strength of pelvic floor muscles was poor, electrical stimulation was offered. If awareness of the pelvic floor muscle contraction was poor, bio feedback was offered. Group sessions and vaginal cones were also used. Depending on the response to the treatment; patients were either discharged, referred to Urogynaecology clinic or continued physiotherapy. All patients who were discharged or referred for surgery were given a post treatment questionnaire to fill out. 79 (56 %) of 132 women with stress, 49 (51 %) of 98 with mixed and 27 (66 %) of 41 with urge incontinence reported successful control of symptoms (overall success 54 %). However, 65 % of women with incontinence scores of 0-5 before physiotherapy, 64 % with 6-10, 42 % with 11-15 and mere 28 % with 16-20 achieved success with physiotherapy. 27 (10 %) were lost to follow up. 1 in 2 women referred to physiotherapy for incontinence, achieved successful control of symptoms without the need for invasive investigations or surgery. However, poor incontinence scores before the start of physiotherapy is a poor prognostic indicator for success. 90 % women utilised the service.

  1. Augmented Reality Tower Technology Assessment

    Reisman, Ronald J.; Brown, David M.

    2009-01-01

    Augmented Reality technology may help improve Air Traffic Control Tower efficiency and safety during low-visibility conditions. This paper presents the assessments of five off-duty controllers who shadow-controlled' with an augmented reality prototype in their own facility. Initial studies indicated unanimous agreement that this technology is potentially beneficial, though the prototype used in the study was not adequate for operational use. Some controllers agreed that augmented reality technology improved situational awareness, had potential to benefit clearance, control, and coordination tasks and duties and could be very useful for acquiring aircraft and weather information, particularly aircraft location, heading, and identification. The strongest objections to the prototype used in this study were directed at aircraft registration errors, unacceptable optical transparency, insufficient display performance in sunlight, inadequate representation of the static environment and insufficient symbology.

  2. Therapeutic options for lip augmentation.

    Segall, Lorne; Ellis, David A F

    2007-11-01

    Aesthetic ideals vary with emerging fashion trends and within different cultures. However, over the past few decades, fuller lips have been considered a desirable trait. Many younger patients are presenting for lip augmentation to achieve the sought-after look commonly seen in many fashion magazines. In addition, as individuals age, they lose lip volume, with a thinning of the red lip, some effacement of the vermillion border, and elongation and flattening of the white portion of the lip. Rejuvenation of the lips plays a key role in restoring a more youthful appearance. As a result, lip augmentation appeals to a wide spectrum of patients who present with various different aesthetic goals and expectations. Numerous therapeutic options exist for aesthetic lip augmentation, ranging from temporary and permanent injectable fillers to implants and other surgical techniques.

  3. AUGMENTATION-RELATED BRAIN PLASTICITY

    Giovanni eDi Pino

    2014-06-01

    Full Text Available Today, the anthropomorphism of the tools and the development of neural interfaces require reconsidering the concept of human-tools interaction in the framework of human augmentation. This review analyzes the plastic process that the brain undergoes when it comes into contact with augmenting artificial sensors and effectors and, on the other hand, the changes that the use of external augmenting devices produces in the brain.Hitherto, few studies investigated the neural correlates of augmentation, but clues on it can be borrowed from logically-related paradigms: sensorimotor training, cognitive enhancement, cross-modal plasticity, sensorimotor functional substitution, use and embodiment of tools.Augmentation modifies function and structure of a number of areas, i.e. primary sensory cortices shape their receptive fields to become sensitive to novel inputs. Motor areas adapt the neuroprosthesis representation firing-rate to refine kinematics. As for normal motor outputs, the learning process recruits motor and premotor cortices and the acquisition of proficiency decreases attentional recruitment, focuses the activity on sensorimotor areas and increases the basal ganglia drive on the cortex. Augmentation deeply relies on the frontoparietal network. In particular, premotor cortex is involved in learning the control of an external effector and owns the tool motor representation, while the intraparietal sulcus extracts its visual features. In these areas, multisensory integration neurons enlarge their receptive fields to embody supernumerary limbs. For operating an anthropomorphic neuroprosthesis, the mirror system is required to understand the meaning of the action, the cerebellum for the formation of its internal model and the insula for its interoception. In conclusion, anthropomorphic sensorized devices can provide the critical sensory afferences to evolve the exploitation of tools through their embodiment, reshaping the body representation and the

  4. Superconducting augmented rail gun (SARG)

    Homan, C.G.; Cummings, C.E.; Fowler, C.M.

    1986-01-01

    Superconducting augmentation consists of a superconducting coil operating in the persistent mode closely coupled magnetically with a normally conducting rail gun. A theoretical investigation of the effect of this system on a rail gun has shown that two benefits occur. Projectile velocities and launch efficiencies increase significantly depending on the magnetic coupling between the rail and augmentation circuits. Previous work evaluated an idealized system by neglecting energy dissipation effects. In this paper, the authors extend the analysis to include the neglected terms and show improved actual launch efficiencies for the SARG configuration. In this paper, the authors discuss details of projectile design in depth and present preliminary results of rail gun performance

  5. Fire resistance of slim floor beams

    Fellinger, J.H.H.; Twilt, L.

    1996-01-01

    Slim floor beams support decks on a wide plate welded on the lower flange of an 1- shaped beam. The air gap between the plate and the lower flange increases the fire resistance of the beam. A Finite Element Method (FEM) model, validated with three fire tests, is used to set up simple calculation

  6. Seeing Results in Flooring for Schools

    Simmons, Brian

    2011-01-01

    Operations staffs at education facilities of all sizes are tasked with selecting a hard floor cleaning program that is cost-effective, efficient and highly productive. With an increased focus on the sustainability of an environment, facility managers also must select a program that meets sustainability goals while maintaining a healthful, safe…

  7. Maple Flooring - How Architects View it

    Gary R. Lindell

    1971-01-01

    In a study of architects'' opinions of maple flooring versus vinyl asbestos tile for school gymnasuims, resiliency and durability were found to be important factors favoring maple whereas vinyl asbestos tile was felt to be less costly and more dimesionally stable.

  8. Architectural Considerations for Holonic Shop Floor Control

    Langer, Gilad; Bilberg, Arne

    1997-01-01

    of the HMS concept, followed by an investigation regard-ing the development of shop floor control architectures. This will include a summary of the ongoing research on HMS, and current results regarding the development of a holonic SFC architecture in a cellular manufacturing perspective. The paper...

  9. Biomimetic matrices for pelvic floor repair

    Vashaghian, M.

    2017-01-01

    Pelvic organ prolapsed (POP) is a dysfunctional disease in female pelvic floor that affects a lot of women worldwide, and reduces their quality of life. Currently, trans-vaginal knitted polypropylene meshes are used as secondary treatment, for anatomical correction of the dysfunctional tissues.

  10. Piezoelectric energy harvester under parquet floor

    Bischur, E.; Schwesinger, N.

    2011-03-01

    The design, fabrication and testing of piezoelectric energy harvesting modules for floors is described. These modules are used beneath a parquet floor to harvest the energy of people walking over it. The harvesting modules consist of monoaxial stretched PVDF-foils. Multilayer modules are built up as roller-type capacitors. The fabrication process of the harvesting modules is simple and very suitable for mass production. Due to the use of organic polymers, the modules are characterized by a great flexibility and the possibility to create them in almost any geometrical size. The energy yield was determined depending on the dynamic loading force, the thickness of piezoelectric active material, the size of the piezoelectric modules, their alignment in the walking direction and their position on the floor. An increase of the energy yield at higher loading forces and higher thicknesses of the modules was observed. It was possible to generate up to 2.1mWs of electric energy with dynamic loads of 70kg using a specific module design. Furthermore a test floor was assembled to determine the influence of the size, alignment and position of the modules on the energy yield.

  11. Timber-concrete composite floor systems

    Linden, M.L.R. van der; Blass, H.J.

    1996-01-01

    Timber-concrete composite (tcc) beams may be used for the renovation of old timber floors. Although these systems are a simple and practical solution, they are not widely adopted. One of the reasons for this is the lack of uniform design mies. In this research programme shear tests on four different

  12. Corrective Jaw Surgery

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  13. Pelvic floor dyssynergia: efficacy of biofeedback training.

    Gadel Hak, Nabil; El-Hemaly, Mohamed; Hamdy, Emad; El-Raouf, Ahmed Abd; Atef, Ehab; Salah, Tarek; El-Hanafy, Ehab; Sultan, Ahmad; Haleem, Magdy; Hamed, Hala

    2011-03-01

    Paradoxical contraction of the pelvic floor during attempts to defaecate is described as pelvic floor dyssynergia (anismus). It is a behavioural disorder (no associated morphological or neurological abnormalities); consequently, biofeedback training has been recommended as a behavioural therapy for such a disorder. The aim of the present study was to evaluate long-term satisfaction of patients diagnosed with pelvic floor dyssynergia after biofeedback. Sixty patients (35 females and 25 males) with a mean age of 30±12years and a 4year duration of constipation were included. Forty-five patients had normal colonic transit and 15 patients had slow colonic transit. History, physical examination and barium enema were done to exclude constipation secondary to organic causes. Colonic and pelvic floor functions (colon-transit time, anorectal manometry, EMG and defaecography) were performed before and after biofeedback treatments. Patients were treated on a weekly basis with an average of (6±2) sessions. At the end of sessions, 55 out of 60 patients (91.6%) reported a subjectively overall improvement. Symptoms of dyschezia were reported less frequently after biofeedback. Age and gender were not predictive factors of outcome. No symptoms at initial assessment were predictive for patient's satisfaction but the only factor of predictive value was the diagnosis of anismus and the motivated patient who wanted to continue the sessions. Biofeedback remains a morbidity free, low-cost and effective outpatient therapy for well-motivated patients complaining of functional constipation and diagnosed as pelvic floor dyssynergia. Copyright © 2011 Arab Journal of Gastroenterology. Published by Elsevier Ltd. All rights reserved.

  14. Functional imaging of the pelvic floor

    Lienemann, Andreas E-mail: andreaslienemann@web.de; Fischer, Tanja

    2003-08-01

    Introduction/Objective: Pelvic floor dysfunction and associated pelvic organ prolapse represent a major problem in our present-day society, mostly afflicting parous women. Magnetic resonance imaging (MRI) is assuming an increasingly important role in the more accurate delineation of the extent of the problem. This article briefly reviews one of the main radiological methods for the dynamic evaluation of the pelvic floor: functional cine MRI. Methods and Material: Out of the literature the smallest common denominator for functional cine MRI can be defined as follows: high field system; patient either in supine or sitting position; fast gradient echo sequence; midsagittal slice orientation; either a stack of slices or repeated measurements at the same slice position with the patient at rest or straining; image analysis using the pubococcygeal reference line. Results: All except two publications stress the usefulness of functional cine MRI in the evaluation of patients with organ descent and prolapse. This well accepted method allows for the visualization of all relevant structures in the anterior, middle and posterior compartment. It is especially useful in the detection of enteroceles, and provides a reliable postoperative follow-up tool. Isolated urinary or stool incontinence are not an indication for functional cine MRI, as is the case in patients with equivocal clinical findings. To date it does not allow for real 3D imaging of the pelvic floor or sufficient determination of fascial defects. Discussion: Functional cine MRI of the pelvic floor is a promising new imaging method for the detection of organ descent and prolapse in patients with equivocal clinical findings. The combination of function and morphology allows for an innovative view of the pelvic floor, and thus adds to our understanding of the various interactions of the structures.

  15. A comparative study on thermal efficiency between the present floor and a ceramic floor

    Kim, Y.M.; Kim, K.S. [Korea Institute of Science and Technology, Seoul (Korea, Republic of); Choi, B.S. [Kyung Hee University, Yongin (Korea, Republic of); Ko, J.S.; Park, S.K. [Bomwoo and Co. LTD., Kwangju (Korea, Republic of)

    1999-04-01

    A ceramic floor with improved thermal conductivity and efficiency has been developed in this study. The new ceramic floor minimizes the shrinkage rate to below 0.07% and shows almost no cleavage. There is no need to repair the ceramic floor because its bottom surface is flat. It especially shows an excellent performance in the test of a compressive strength (300 kg/cm{sup 2} based on 28 days), a flexural strength (64 kg/cm{sup 2} based on 28 days), and a convenient pressing. It is lighter than the present floor and it is expected to be applicable for a self-leveling ceramic motar in the residences and apartments. It shows an excellent character in the thermal conductivity and other physical properties compare to the present cement mortar. 5 refs., 3 figs., 2 tabs.

  16. Attendance at Prescribed Pelvic Floor Physical Therapy in a Diverse, Urban Urogynecology Population.

    Shannon, Megan Brady; Genereux, Madeleine; Brincat, Cynthia; Adams, William; Brubaker, Linda; Mueller, E R; Fitzgerald, Colleen M

    2017-11-11

    Pelvic floor physical therapy (PFPT) is a common and effective treatment for several pelvic floor disorders, but there is limited knowledge about adherence to the therapy or what factors influence attendance. To determine rates of PFPT attendance (initiation and completion) as well as correlates of PFPT attendance. Retrospective cohort analysis. Urban outpatient clinics at a tertiary medical center treating women with pelvic floor disorders. Patients prescribed PFPT during the time period January 1, 2014, through January 1, 2015. Number of PFPT visits recommended and attended; diagnoses associated with PFPT referral. Two-thirds of participants (66%; 118/180) initiated PFPT but less than one-third (29%; 52/180) completed the full treatment course. On univariate analysis, age, body mass index, diagnosis requiring PFPT treatment, marital or employment status, insurance type, number of comorbidities, incontinence status on examination, and stage of prolapse did not differ between PFPT initiators and noninitiators. Those who self-identified as Hispanic were less likely to initiate PFPT when compared with non-Hispanic patients, although this only trended toward significance (odds ratio 0.40, 95% confidence interval 0.14-1.09; exact P = .078). Two thirds (66%) of patients initiated PFPT but less than one third (29%) completed the treatment course. There appears to be an opportunity to augment PFPT attendance, as well as explore racial disparities in attendance. To be determined. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  17. Effects of vaginal prolapse surgery and ageing on vaginal vascularization

    Weber, M.A.

    2016-01-01

    Ageing affects pelvic floor anatomy and function, resulting in several disorders like pelvic organ prolapse (POP), lower urinary tract symptoms and vaginal atrophy (VA). In this thesis we searched for methods to link the function of pelvic organs to physiological changes. The effects of POP and vaginal prolapse surgery on vaginal vascularization and the influence of ageing and topical oestrogens on pelvic floor disorders were examined. The lack of knowledge regarding the effects of ageing on ...

  18. Computer Augmented Learning; A Survey.

    Kindred, J.

    The report contains a description and summary of computer augmented learning devices and systems. The devices are of two general types programed instruction systems based on the teaching machines pioneered by Pressey and developed by Skinner, and the so-called "docile" systems that permit greater user-direction with the computer under student…

  19. Aplikasi Web Augmented Reality Villa

    Gede Yudha Prema Pangestu

    2017-07-01

    Full Text Available Bali is one of the highly developed tourist destination in Indonesia. The arrival of tourists having holiday in Bali led to increase residential needs with complete amenities. The occupancy rate of hotel and villa in Bali is increase significantlly during the long vacation. The emergence of new villa and hotel occupancy raises the level of competition in business, so it needs a correct use good marketing communication strategy in marketing the product in order to attract the attention of consumers. Web Application Augmented Reality Villa can help visualize the residential villa in three-dimensional shapes that look more attractive and practical. The use of brochures as written information and the application of augmented reality technology on the Web Application Augmented Reality Villa aims to develop an application that can provide information about the villa to visitors. Web Application uses Augmented Reality Villa designed by FlarToolkit library. Based on the test results show the application can display 3-dimensional objects by scanning marker villa in a brochure which already contain marker.

  20. Data Augmentation for Plant Classification

    Pawara, Pornntiwa; Okafor, Emmanuel; Schomaker, Lambertus; Wiering, Marco

    2017-01-01

    Data augmentation plays a crucial role in increasing the number of training images, which often aids to improve classification performances of deep learning techniques for computer vision problems. In this paper, we employ the deep learning framework and determine the effects of several

  1. The effect of patient age on bone formation using a fully synthetic nanocrystalline bone augmentation material in maxillary sinus grafting.

    Wolf, Michael; Wurm, Alexander; Heinemann, Friedhelm; Gerber, Thomas; Reichert, Christoph; Jäger, Andreas; Götz, Werner

    2014-01-01

    Maxillary sinus floor augmentation is a treatment that has been proposed for patients in whom the alveolar bone height is insufficient. This procedure is commonly used in patients aged 40 to 70 years and older. However, little information exists whether the factor of age might influence the outcome of augmentation procedures. The aim of this study was to investigate whether the patient's age has an effect on bone formation and incorporation in maxillary sinus floor augmentation procedures. A fully synthetic nanocrystalline bone augmentation material (NanoBone, Artoss) was used for sinus floor augmentation in patients with a subantral vertical bone height of at least 3 mm and maximum of 7 mm. After 7 months healing time, biopsy specimens were taken and were divided into two groups according to the patient's age. Exclusion criteria were poor general health (eg, severe renal/and or liver disease), history of a radiotherapy in the head region, chemotherapy at the time of surgical procedure, noncompensated diabetes mellitus, symptoms of a maxillary sinus disease, active periodontal or systemic diseases, smoking, and poor oral hygiene. Histologic analyses with hematoxylin-eosin stain were performed. Multinucleated osteoclast-like cells were identified by histochemical staining (tartrate-resistant acid phosphatase [TRAP]). Quantitative and age-dependent assessment of bone formation, residual bone grafting material, and soft tissue formation following sinus augmentation was performed using histomorphometric analysis and the Bonferroni adjustment of the Student t test. Twenty biopsy specimens from 17 patients were taken and divided into two groups according to age (group 1: 41 to 52 years; group 2: 66 to 71 years) containing 10 specimens each, which were analyzed in triplicate resulting in a total of 30 specimens per group. A regeneration process with varying amounts of newly formed bone surrounded by marrow-like tissue was present in all augmented regions. No signs of

  2. Development of floor smear sampler (floor radioactive contamination measuring instrument) for nuclear facilities

    Miyagawa, Minoru; Ito, Haruo; Nozawa, Katsuro; Shinohara, Yotaro; Hashimoto, Hiroshi.

    1980-01-01

    The control of the floor contamination with radioactive substances in nuclear facilities is strictly carried out by smear method, in which the contaminants on floor surfaces are wiped off with filter papers or cloths, and the contamination density on the floor surfaces is measured through their intensity of radioactivity. This wiping work is laborious since it is carried out in leaning-over posture when many samples must be taken in wide floor area. Therefore, to achieve labor saving in this work, an automatic sampler was developed. In the floor smear sampler developed, samples are taken on long band type wiping cloths only by handle operation, and the sample numbers are printed. When many samples are taken in wide floor area, this is especially effective, and the labor saving by 1/3 to 1/2 can be achieved. At present, this sampler is put in practical use in Hamaoka Nuclear Power Station. At the time of trial manufacture, the method of wiping, the mechanisms of wiping, cloth feeding and running, the contact pressure and the number of times of wiping affecting wiping efficiency and the required torque of a motor were examined. The developed sampler is that of constant contact pressure, vibration wiping type, and the rate of sampling is 10 sec per one sample. 100 samples can be taken on one roll of wiping cloth. The results of performance test are reported. (Kako, I.)

  3. Formaldehyde and TVOC emission behavior of laminate flooring by structure of laminate flooring and heating condition.

    An, Jae-Yoon; Kim, Sumin; Kim, Hyun-Joong

    2011-03-15

    Formaldehyde was measured with a desiccator, a 20 L chamber and the FLEC method. The formaldehyde emission rate from laminate was the highest at 32 °C using the desiccator, which then decreased with time. The formaldehyde emission using the 20 L small chamber and FLEC showed a similar tendency. There was a strong correlation between the formaldehyde and total volatile organic compounds (TVOCs) with both types of floorings using the two different methods. The formaldehyde emission rate and TVOC results were higher when tested using the FLEC method than with the 20 L small chamber method. The emission rate was affected by the joint edge length in laminate flooring. Toluene, ethylbenzene and xylene were the main VOCs emitted from laminate flooring, and there were more unidentified VOCs emitted than identified VOCs. The samples heated with a floor heating system emitted more formaldehyde than those heated using an air circulation system due to the temperature difference between the bottom panel and flooring. The TVOC emission level of the samples was higher when an air circulation system was used than when a floor heating system was used due to the high ventilation rate. Copyright © 2010 Elsevier B.V. All rights reserved.

  4. A novel & affordable interactive floor for educational applications

    Boisen, Ulrik; Hansen, Anders Juul; Knudsen, Lars

    2011-01-01

    This article examines two research areas: How interactive floors can be used beneficially in an educational context, and how an interactive floor can be created which is mobile and relatively inexpensive....

  5. Portable flooring protects finished surfaces, is easily moved

    Carmody, R. J.

    1964-01-01

    To protect curved, finished surface and provide support for workmen, portable flooring has been made from rigid plastic foam blocks, faced with aluminum strips. Held together by nylon webbing, the flooring can be rolled up for easy carrying.

  6. Assessment of pelvic floor dysfunctions using dynamic magnetic resonance imaging

    Hoda Salah Darwish

    2014-03-01

    Conclusion: Dynamic MRI is an ideal, non invasive technique which does not require patient preparation for evaluation of pelvic floor. It acts as one stop shop for diagnosing single or multiple pelvic compartment involvement in patients with pelvic floor dysfunction.

  7. Factors influencing long-term adherence to pelvic floor exercises in women with urinary incontinence.

    Venegas, Mónica; Carrasco, Bernardita; Casas-Cordero, Romina

    2018-03-01

    To ensure the effectiveness of Physical Therapy for urinary incontinence (UI), it is crucial that patients adhere to treatment in both the long and the short term. Treatment adherence may prevent symptom progression and the need for surgery, which is associated with higher costs and potential complications. Adherence is defined as carrying out a recommended behavioral modification or change. The World Health Organization (WHO) has established that adherence is a multifactorial phenomenon determined by the interaction of five dimensions, which include diverse factors that affect long-term adherence on many levels. To identify the factors that influence long-term adherence to pelvic floor exercises in women with UI. Observational, descriptive, cross-sectional study. The sample was recruited from the "Centro Integral de Reeducación de Piso Pélvico" (CIREP), and included 61 women treated for UI at the center in 2014 and 2015. Participants completed a self-administered, 28-item questionnaire developed for this study based on the WHO five dimensions. Data analysis was performed using STATA 13.0 software. Having performed pelvic floor home exercises after discharge from Physical Therapy was significantly associated with self-rated treatment adherence (P pelvic floor exercise program (P pelvic floor exercises in women with UI; forgetting to do the exercises and boredom with the exercises were the factors most strongly related to low treatment adherence, while motivation and commitment were associated with high adherence in this population. © 2017 Wiley Periodicals, Inc.

  8. Mapping of multi-floor buildings: A barometric approach

    Özkil, Ali Gürcan; Fan, Zhun; Xiao, Jizhong

    2011-01-01

    This paper presents a new method for mapping multi5floor buildings. The method combines laser range sensor for metric mapping and barometric pressure sensor for detecting floor transitions and map segmentation. We exploit the fact that the barometric pressure is a function of the elevation......, and it varies between different floors. The method is tested with a real robot in a typical indoor environment, and the results show that physically consistent multi5floor representations are achievable....

  9. Knowledge of the pelvic floor in nulliparous women

    Neels, Hedwig; Wyndaele, Jean-Jacques; Tjalma, Wiebren A. A.; De Wachter, Stefan; Wyndaele, Michel; Vermandel, Alexandra

    2016-01-01

    [Purpose] Proper pelvic floor function is important to avoid serious dysfunctions including incontinence, prolapse, and sexual problems. The current study evaluated the knowledge of young nulliparous women about their pelvic floor and identified what additional information they wanted. [Subjects and Methods] In this cross-sectional survey, a validated, 36 item questionnaire was distributed to 212 nulliparous women. The questionnaire addressed demography, pelvic floor muscles, pelvic floor dys...

  10. Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

    Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

    2012-01-01

    Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and ...

  11. Robotic-assisted transoral removal of a bilateral floor of mouth ranulas

    Stromeyer Frederick W

    2011-07-01

    Full Text Available Abstract Objective To describe the management of bilateral oral ranulas with the use of the da Vinci Si Surgical System and discuss advantages and disadvantages over traditional transoral resection. Study Design Case Report and Review of Literature. Results A 47 year old woman presented to our service with an obvious right floor of mouth swelling. Clinical evaluation and computerized tomography scan confirmed a large floor of mouth ranula on the right and an incidental asymptomatic early ranula of the left sublingual gland. After obtaining an informed consent, the patient underwent a right transoral robotic-assisted transoral excision of the ranula and sublingual gland with identification and dissection of the submandibular duct and lingual nerve. The patient had an excellent outcome with no evidence of lingual nerve paresis and a return to oral intake on the first postoperative day. Subsequently, the patient underwent an elective transoral robotic-assisted excision of the incidental ranula on the left sublingual gland. Conclusion We describe the first robotic-assisted excision of bilateral oral ranulas in current literature. The use of the da Vinci system provides excellent visualization, magnification, and dexterity for transoral surgical management of ranulas with preservation of the lingual nerve and Wharton's duct with good functional outcomes. However, the use of the robotic system for anterior floor of mouth surgery in terms of improved surgical outcomes as compared to traditional transoral surgery, long-term recurrence rates, and cost effectiveness needs further validation.

  12. Augmented reality and its practical application

    ZÍTKOVÁ, Helena

    2011-01-01

    This thesis combines topic of augmented reality with tourism. For analyzing the state of the use of augmented reality was composed case studies. It was created product, which is called Guide to mobile phone.

  13. Robotic surgery

    ... with this type of surgery give it some advantages over standard endoscopic techniques. The surgeon can make ... Elsevier Saunders; 2015:chap 87. Muller CL, Fried GM. Emerging technology in surgery: Informatics, electronics, robotics. In: ...

  14. Nose Surgery

    ... Patient Health Home Copyright © 2018 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2018. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  15. After Surgery

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  16. Floor Vibrations - as Induced and Reduced by Humans

    Pedersen, Lars

    . As for dynamic loads focus is placed on heel impact excitation and actions of jumping people causing floor vibrations. As for interaction between stationary humans and the vibrating floor focus is on modelling humans as oscillating spring-mass-damper systems attached to the floor rather than as simple added mass...

  17. An architecture for agile shop floor control systems

    Langer, Gilad; Alting, Leo

    2000-01-01

    as shop floor control. This paper presents the Holonic Multi-cell Control System (HoMuCS) architecture that allows for design and development of holonic shop floor control systems. The HoMuCS is a shop floor control system which is sometimes referred to as a manufacturing execution system...

  18. 78 FR 30329 - Multilayered Wood Flooring from China

    2013-05-22

    ...)] Multilayered Wood Flooring from China AGENCY: United States International Trade Commission. ACTION: Notice of...-1179 (Final) concerning multilayered wood flooring (``MLWF'') from China. For further information... reconsider ``its decision not to investigate domestic producers of hardwood plywood used for flooring'' 2. to...

  19. Special aspects of attic floor warming in historic buildings

    Murgul Vera

    2017-01-01

    Full Text Available This article containsreasoningof the heat transfer performance uniformity factor determination for attic floors of historic residential buildings while energy effective modifying buildings. The numeral value of this heat transfer performance uniformity factor for the wooden attic floor structure was founddurung investigation. It was estimated that there was no moisture condensation in the wooden attic floor structure.

  20. 75 FR 70061 - Dealer Floor Plan Pilot Program Meeting

    2010-11-16

    ... SMALL BUSINESS ADMINISTRATION Dealer Floor Plan Pilot Program Meeting AGENCY: U.S. Small Business... location, date, time, and agenda for a meeting regarding the Dealer Floor Plan Pilot Program established in the Small Business Jobs Act of 2010. The meeting will be open to the public. DATES: The Dealer Floor...

  1. Pelvic floor function during and after first pregnancy

    Brummen, H.J. van

    2006-01-01

    This study evaluated the effects the first pregnancy and childbirth on the pelvic floor. Pregnancy and vaginal delivery can negatively affect pelvic floor function. Micturition symptoms, defecation symptoms and sexual dysfunction are all signs of an impaired pelvic floor function. These symptoms are

  2. Augmented assessment as a means to augmented reality.

    Bergeron, Bryan

    2006-01-01

    Rigorous scientific assessment of educational technologies typically lags behind the availability of the technologies by years because of the lack of validated instruments and benchmarks. Even when the appropriate assessment instruments are available, they may not be applied because of time and monetary constraints. Work in augmented reality, instrumented mannequins, serious gaming, and similar promising educational technologies that haven't undergone timely, rigorous evaluation, highlights the need for assessment methodologies that address the limitations of traditional approaches. The most promising augmented assessment solutions incorporate elements of rapid prototyping used in the software industry, simulation-based assessment techniques modeled after methods used in bioinformatics, and object-oriented analysis methods borrowed from object oriented programming.

  3. Use of Augmented Reality in Education

    Jeřábek, Tomáš

    2014-01-01

    This thesis deals with phenomena of augmented reality in context of didactics. The thesis aims to define augmented reality in conceptual and content area and focuses on augmented reality in the structure of educational tools and identification of its functions and use from the didactical standpoint. The thesis characterizes augmented reality as a specific technological-perceptual concept and establishes a system of perceptual, technological and resulting aspects that reflect important paramet...

  4. Affordances in Mobile Augmented Reality Applications

    Gjøsæter, Tor

    2014-01-01

    This paper explores the affordances of augmented reality content in a mobile augmented reality application. A user study was conducted by performing a multi-camera video recording of seven think aloud sessions. The think aloud sessions consisted of individual users performing tasks, exploring and experiencing a mobile augmented reality (MAR) application we developed for the iOS platform named ARad. We discuss the instrumental affordances we observed when users interacted with augmented realit...

  5. New Augmented Reality Taxonomy: Technologies and Features of Augmented Environment.

    Hugues , Olivier; Fuchs , Philippe; Nannipieri , Olivier

    2011-01-01

    978-1-4614-0063-9; This article has a dual aim: firstly to define augmented reality (AR) en- vironments and secondly, based on our definition, a new taxonomy enabling these environments to be classified. After briefly reviewing existing classifica- tions, we define AR by its purpose, ie. to enable someone to create sensory- motor and cognitive activities in a new space combining the real environment and a virtual environment. Below we present our functional taxonomy of AR environments. We div...

  6. Thyroid Surgery

    ... Hypothyroidism in Children and Adolescents Pediatric Differentiated Thyroid Cancer Thyroid Nodules in Children and Adolescents Thyroid Surgery Resources Thyroid Surgery Brochure PDF Thyroid Surgery FAQs PDF En Español Cirugia De La Tiroides El folleto de Cirugia De La Tiroides Search Thyroid ...

  7. [Augmentation technique on the proximal humerus].

    Scola, A; Gebhard, F; Röderer, G

    2015-09-01

    The treatment of osteoporotic fractures is still a challenge. The advantages of augmentation with respect to primary in vitro stability and the clinical use for the proximal humerus are presented in this article. In this study six paired human humeri were randomized into an augmented and a non-augmented group. Osteosynthesis was performed with a PHILOS plate (Synthes®). In the augmented group the two screws finding purchase in the weakest cancellous bone were augmented. The specimens were tested in a 3-part fracture model in a varus bending test. The augmented PHILOS plates withstood significantly more load cycles until failure. The correlation to bone mineral density (BMD) showed that augmentation could partially compensate for low BMD. The augmentation of the screws in locked plating in a proximal humerus fracture model is effective in improving the primary stability in a cyclic varus bending test. The targeted augmentation of two particular screws in a region of low bone quality within the humeral head was almost as effective as four screws with twice the amount of bone cement. Screw augmentation combined with a knowledge of the local bone quality could be more effective in enhancing the primary stability of a proximal humerus locking plate because the effect of augmentation can be exploited more effectively limiting it to the degree required. The technique of augmentation is simple and can be applied in open and minimally invasive procedures. When the correct procedure is used, complications (cement leakage into the joint) can be avoided.

  8. Augmented Reality for Multi-disciplinary Collaboration

    Wang, Xiangyu; Rui,

    2010-01-01

    This chapter presents a framework for multi-disciplinary collaboration. Tangible Augmented Reality has been raised as one of suitable systems for design collaboration. Furthermore, it emphasizes the advantages of Tangible Augmented Reality to illustrate the needs for integrating the Tangible User Interfaces and Augmented Reality Systems.

  9. Development of remote operated floor contamination monitor

    Sreekumar, K.; Gangamohan, M.; Kannan, R.K.; Rajan, S.

    2005-01-01

    Contamination check of floors and walkways in and around Reactor building areas forms an integral part of Radiation Protection Program in Power Stations. Though random swipe check method is adopted for the detection of loose contamination, this method has the disadvantage of leaving the fixed contamination and hotspots undetected. Hence, scanning the area with a sensitive detector, held close to the surface provides positive means for the detection of contamination. Checking large areas and walkways by holding the detector close to the surface involves physical work. Also, areas which are unapproachable due to congestion of equipment, may go uncovered by contamination monitoring in order to eliminate the physical strain involved in such contamination monitoring and to cover unapproachable areas, a small size prototype device that can be operated remotely was fabricated. This device detects contamination instantaneously and accurately. This paper describes design and fabrication of the device used for floor contamination monitoring. (author)

  10. RFID Data Cleaning for Shop Floor Applications

    Ziekow, Holger; Ivantysynova, Lenka; Günter, Oliver

    In several case studies we found that shop-floor applications in manufacturing pose special challenges to cleaning RFID data. The underlying problem in many scenarios is the uncertainty about the exact location of observed RFID tags. Simple filter s provided in common middleware solutions do not cope well with these challenges. Therefore we have developed an approach based on maximum-likelihood estimation to infer a tag's location within the reader range. This enables improved RFID data cleaning in a number of application scenarios. We stress the benefits of our approach along exemplary application scenarios that we found in manufacturing. In simulations and experiments with real world data we show that our approach outperforms existing solutions. Our approach can extend RFID middleware or reader firmware, to improve the use of RFID in a range of shop-floor applications.

  11. Rectocele repair using biomaterial augmentation: current documentation and clinical experience.

    Altman, Daniel; Mellgren, Anders; Zetterström, Jan

    2005-11-01

    Although the etiology of rectocele remains debated, surgical innovations are currently promoted to improve anatomic outcome while avoiding dyspareunia and alleviating rectal emptying difficulties following rectocele surgery. Use of biomaterials in rectocele repair has become widespread in a short time, but the clinical documentation of their effectiveness and complications is limited. Medline and the Cochrane database were searched electronically from 1964 to May 2005 using the Pubmed and Ovid search engines. All English language publications including any of the search terms "rectocele," "implant," "mesh," "biomaterial," "prolapse," "synthetical," "pelvic floor," "biological," and "compatibility" were reviewed. This review outlines the basic principles for use of biomaterials in pelvic reconstructive surgery and provides a condensation of peer-reviewed articles describing clinical use of biomaterials in rectocele surgery. Historical and new concepts in rectocele surgery are discussed. Factors of importance for human in vivo biomaterial compatibility are presented together with current knowledge from clinical studies. Potential risks and problems associated with the use of biomaterials in rectocele and pelvic reconstructive surgery in general are described. Although use of biomaterials in rectocele and other pelvic organ prolapse surgery offers exciting possibilities, it raises treatment costs and may be associated with unknown and potentially severe complications at short and long term. Clinical benefits are currently unknown and need to be proven in clinical studies. Obstetricians & Gynecologists, Family Physicians After completion of this article, the reader should be able to explain that the objective of surgical treatment is to improve anatomic outcome and alleviate rectal emptying difficulties, describe the efficacy of biomaterials in rectocele repair, and summarize the potential risks and problems associated with use of biomaterials in rectocele and pelvic

  12. Use of dermal fat graft for augmentation of the labia majora.

    Salgado, Christopher J; Tang, Jennifer C; Desrosiers, Arthur E

    2012-02-01

    Dermal fat grafts have been utilized in plastic surgery for both reconstructive and aesthetic purposes of the face, breast, and body. There are multiple reports in the literature on the male phallus augmentation with the use of dermal fat grafts. Few reports describe female genitalia aesthetic surgery, in particular rejuvenation of the labia majora. In this report we describe an indication and use of autologous dermal fat graft for labia majora augmentation in a patient with loss of tone and volume in the labia majora. We found that this procedure is an option for labia majora augmentation and provides a stable result in volume-restoration. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Ocean floor mounting of wave energy converters

    Siegel, Stefan G

    2015-01-20

    A system for mounting a set of wave energy converters in the ocean includes a pole attached to a floor of an ocean and a slider mounted on the pole in a manner that permits the slider to move vertically along the pole and rotate about the pole. The wave energy converters can then be mounted on the slider to allow adjustment of the depth and orientation of the wave energy converters.

  14. Understanding gaming floor influences on player behaviour

    Griffiths, MD

    2009-01-01

    Efforts to entice and retain player activity within a casino gaming environment require bringing to bear a range of sensory and physical influences. The challenge is to accomplish the operators’ objectives while at the same time ensuring any potential negative effects on the player are minimised. How casinos keep this in balance is at the heart of how the gaming floor works, and assessing such matters is becoming a necessary part of social responsibility.

  15. A comparison of floor response spectra techniques

    Yan, M.J.; Galford, J.E.

    1983-01-01

    Floor response spectra (FRS) conventionally have been generated using a time-history method. Babcock and Wilcox has developed a new technique, the Fast Floor Response Spectra (FFRS) method, in which dynamic analyses are done entirely in the frequency domain. This paper compares the two techniques and demonstrates that the FFRS method complies with the 'equivalency' and 'conservatism' requirements of the US NRC's Standard Review Plan. The upper end of a once-through steam generator in the B and W 205 nuclear steam supply system (NSSS) was used to demonstrate that the FFRS method is equivalent to the time-history technique. The two techniques were compared with respect to frequency content and magnitude of response for a given point on the structure. First, the specified forcing function was described in terms of an acceleration time history and an acceleration spectra enveloping that time history. The time-history forcing function was then used in a direct transient analysis to determine the response at the specified point on the NSSS. The resultant response was subsequently converted to a floor response spectra for that point. To show that the FFRS method gave equivalent and conservative results, the FFRS technique was used to determine the modal response directly from the spectral description of the forcing function. The FFRS- and time-history-generated data agreed to within 13 (worst case on conservative side) of each other with the former cutting analytical costs by 99%. (orig./HP)

  16. Mechanical decontamination techniques for floor drain systems

    Palau, G.L.

    1987-01-01

    The unprecedented nature of cleanup activities at Three Mile Island Unit 2 (TMI-2) following the 1979 accident has necessitated the development of new techniques to deal with radiation and contamination in the plant. One of these problems was decontamination of floor drain systems, which had become highly contaminated with various forms of dirt and sludge containing high levels of fission products and fuel from the damaged reactor core. The bulk of this contamination is loosely adherent to the drain pipe walls; however, significant amounts of contamination have become incorporated into pipe wall oxide and corrosion layers and embedded in microscopic pits and fissures in the pipe wall material. The need to remove this contamination was recognized early in the TMI-2 cleanup effort. A program consisting of development and laboratory testing of floor drain decontamination techniques was undertaken early in the cleanup with support from the Electric Power Research Institute (EPRI). Based on this initial research, two techniques were judged to show promise for use at TMI-2: a rotating brush hone system and a high-pressure water mole nozzle system. Actual use of these devices to clean floor drains at TMI-2 has yielded mixed decontamination results. The decontamination effectiveness that has been obtained is highly dependent on the nature of the contamination in the drain pipe and the combination of decontamination techniques used

  17. Lead exposures from varnished floor refinishing.

    Schirmer, Joseph; Havlena, Jeff; Jacobs, David E; Dixon, Sherry; Ikens, Robert

    2012-01-01

    We evaluated the presence of lead in varnish and factors predicting lead exposure from floor refinishing and inexpensive dust suppression control methods. Lead in varnish, settled dust, and air were measured using XRF, laboratory analysis of scrape and wipe samples, and National Institute for Occupational Safety and Health (NIOSH) Method 7300, respectively, during refinishing (n = 35 homes). Data were analyzed using step-wise logistic regression. Compared with federal standards, no lead in varnish samples exceeded 1.0 mg/cm(2), but 52% exceeded 5000 ppm and 70% of settled dust samples after refinishing exceeded 40 μg/ft(2). Refinishing pre-1930 dwellings or stairs predicted high lead dust on floors. Laboratory analysis of lead in varnish was significantly correlated with airborne lead (r = 0.23, p = 0.014). Adding dust collection bags into drum sanders and HEPA vacuums to edgers and buffers reduced mean floor lead dust by 8293 μg Pb/ft(2) (pairborne lead exposures to less than 50 μg/m(3). Refinishing varnished surfaces in older housing produces high but controllable lead exposures.

  18. Public Interest in Breast Augmentation: Analysis and Implications of Google Trends Data.

    Wilson, Stelios C; Daar, David A; Sinno, Sammy; Levine, Steven M

    2018-06-01

    Breast augmentation is the most common aesthetic surgery performed in the United States (US) annually. Analysis of Google Trends (GT) data may give plastic surgeons useful information regarding worldwide, national, and regional interest for breast augmentation and other commonly performed aesthetic surgeries. Data were collected using GT for breast augmentation and associated search terms from January 2004 to May 2017. Case volume was obtained from the American Society of Plastic Surgeons (ASPS) annual reports for the calendar year 2005-2016. Trend analysis showed that total search term volume for breast augmentation and breast implants gradually decreased worldwide and in the US over the study period while the search term boob job slowly increased. Univariate linear regression demonstrated a statistically significant positive correlation between average annual Google search volume of "breast augmentation" and the annual volume of breast augmentations performed in the US according to ASPS data (R 2  = 0.44, p = 0.018). There was no significant correlation between national volume of breast augmentations performed and search volume using the terms "breast implants" or "boob job" over time (p = 0.84 and p = 0.07, respectively). In addition, there appears to be country specific variation in interest based on time of year and peaks in interest following specific policies. To our knowledge, this is the first and only analysis of GT data in the plastic surgery literature to date. To that end, this study highlights this large and potentially powerful data set for plastic surgeons both in the US and around the world. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  19. Giant cystadenoma of the floor of the mouth: A case report

    Castro, Victor Labres da Silva

    2013-01-01

    Full Text Available Introduction: Cystadenoma is an uncommon epithelial neoplasia that arises from the salivary glands. The malignancy can affect structures such as the larynx, nasopharynx, buccal mucosa, and palate. Objective: To describe a case of a giant cystadenoma of the floor of the mouth treated at a public hospital in midwestern Brazil. Case report: The patient was a 46-year-old woman with complaints of difficulties in articulating words and swallowing solid food and vocal fatigue. The progression of the disease since the initial consultation, the results of clinical examinations, and the outcome of surgery are described. Finals Comments: Cystadenoma must be considered in the differential diagnosis of cystic injuries in the floor of the mouth if the patient's symptoms are suggestive of this malignancy.

  20. To mesh or not to mesh: a review of pelvic organ reconstructive surgery

    Dällenbach P

    2015-04-01

    Full Text Available Patrick Dällenbach Department of Gynecology and Obstetrics, Division of Gynecology, Urogynecology Unit, Geneva University Hospitals, Geneva, Switzerland Abstract: Pelvic organ prolapse (POP is a major health issue with a lifetime risk of undergoing at least one surgical intervention estimated at close to 10%. In the 1990s, the risk of reoperation after primary standard vaginal procedure was estimated to be as high as 30% to 50%. In order to reduce the risk of relapse, gynecological surgeons started to use mesh implants in pelvic organ reconstructive surgery with the emergence of new complications. Recent studies have nevertheless shown that the risk of POP recurrence requiring reoperation is lower than previously estimated, being closer to 10% rather than 30%. The development of mesh surgery – actively promoted by the marketing industry – was tremendous during the past decade, and preceded any studies supporting its benefit for our patients. Randomized trials comparing the use of mesh to native tissue repair in POP surgery have now shown better anatomical but similar functional outcomes, and meshes are associated with more complications, in particular for transvaginal mesh implants. POP is not a life-threatening condition, but a functional problem that impairs quality of life for women. The old adage “primum non nocere” is particularly appropriate when dealing with this condition which requires no treatment when asymptomatic. It is currently admitted that a certain degree of POP is physiological with aging when situated above the landmark of the hymen. Treatment should be individualized and the use of mesh needs to be selective and appropriate. Mesh implants are probably an important tool in pelvic reconstructive surgery, but the ideal implant has yet to be found. The indications for its use still require caution and discernment. This review explores the reasons behind the introduction of mesh augmentation in POP surgery, and aims to

  1. Augmented reality building operations tool

    Brackney, Larry J.

    2014-09-09

    A method (700) for providing an augmented reality operations tool to a mobile client (642) positioned in a building (604). The method (700) includes, with a server (660), receiving (720) from the client (642) an augmented reality request for building system equipment (612) managed by an energy management system (EMS) (620). The method (700) includes transmitting (740) a data request for the equipment (612) to the EMS (620) and receiving (750) building management data (634) for the equipment (612). The method (700) includes generating (760) an overlay (656) with an object created based on the building management data (634), which may be sensor data, diagnostic procedures, or the like. The overlay (656) is configured for concurrent display on a display screen (652) of the client (642) with a real-time image of the building equipment (612). The method (700) includes transmitting (770) the overlay (656) to the client (642).

  2. Augmented Reality 2.0

    Schmalstieg, Dieter; Langlotz, Tobias; Billinghurst, Mark

    Augmented Reality (AR) was first demonstrated in the 1960s, but only recently have technologies emerged that can be used to easily deploy AR applications to many users. Camera-equipped cell phones with significant processing power and graphics abilities provide an inexpensive and versatile platform for AR applications, while the social networking technology of Web 2.0 provides a large-scale infrastructure for collaboratively producing and distributing geo-referenced AR content. This combination of widely used mobile hardware and Web 2.0 software allows the development of a new type of AR platform that can be used on a global scale. In this paper we describe the Augmented Reality 2.0 concept and present existing work on mobile AR and web technologies that could be used to create AR 2.0 applications.

  3. Augmented Reality in Science Education

    Nielsen, Birgitte Lund; Brandt, Harald; Swensen, Hakon

    Augmented reality (AR) holds great promise as a learning tool. However, most extant studies in this field have focused on the technology itself. The poster presents findings from the first stage of the AR-sci project addressing the issue of applying AR for educational purposes. Benefits and chall......Augmented reality (AR) holds great promise as a learning tool. However, most extant studies in this field have focused on the technology itself. The poster presents findings from the first stage of the AR-sci project addressing the issue of applying AR for educational purposes. Benefits...... and challenges related to AR enhancing student learning in science in lower secondary school were identified by expert science teachers, ICT designers and science education researchers from four countries in a Delphi survey. Findings were condensed in a framework to categorize educational AR designs....

  4. Reconstructive approach for patients with augmentation mammaplasty undergoing nipple-sparing mastectomy.

    Alperovich, Michael; Choi, Mihye; Frey, Jordan D; Karp, Nolan S

    2014-09-01

    Nipple-sparing mastectomy (NSM) is a recent advance in the therapeutic and prophylactic management of breast cancer; however, the procedure is associated with increased reconstructive complications. Data on NSM after previous breast augmentation are limited. The authors compared reconstructive complications after NSM between patients with previously augmented breasts and a larger cohort that had not undergone prior augmentation. An approach to NSM that involves 2-stage reconstruction in augmented patients is also described. Medical records of NSMs performed at New York University Langone Medical Center from 2006 to 2013 were reviewed. Data points evaluated included patient characteristics, comorbidities, breast implant plane, and reconstructive complications. Fisher's exact and t tests were used for the comparisons. During the study period, NSMs were performed in 17 augmented breasts at this institution. After NSM, 15 of these breasts underwent implant-based reconstruction and 2 breasts underwent microvascular free flaps. Reconstructive complications included 1 hematoma managed nonoperatively (5.9%) and 1 partial necrosis of the nipple-areola complex (NAC) (5.9%). Compared with the larger nonaugmented cohort (n=332), patients with previously augmented breasts had fewer complications, and there were no statistically significant differences in the rates of mastectomy flap necrosis, partial NAC necrosis, complete NAC necrosis, hematoma, capsular contracture, explantation, implant displacement, seroma, or breast cellulitis. The results indicate that NSM reconstruction is associated with minimal complications in patients with previous augmentation mammaplasty. 4. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.

  5. Study of peak broadening effect in floor time histories

    Soni, R.S.; Kushwaha, H.S.; Mahajan, S.C.; Kakodkar, A.

    1996-01-01

    Seismic design of secondary systems such components and piping is usually carried out by using the floor motions at their support points. These floor motions can be in the form of Floor Response Spectra (FRS) or the Floor Time Histories (FTH). In order to account for the various uncertainties in generating these floor motions, these motions should be peak broadened and smoothened as per the regulatory codes. Presented here in this paper is the methodology to account for such peak broadening effect in the FTH. Results of this study have been compared with the FRS approach and various important conclusions have been arrived at based on the study

  6. 40 CFR 427.70 - Applicability; description of the asbestos floor tile subcategory.

    2010-07-01

    ... asbestos floor tile subcategory. 427.70 Section 427.70 Protection of Environment ENVIRONMENTAL PROTECTION... Asbestos Floor Tile Subcategory § 427.70 Applicability; description of the asbestos floor tile subcategory... manufacture of asbestos floor tile. ...

  7. Media-Augmented Exercise Machines

    Krueger, T.

    2002-01-01

    Cardio-vascular exercise has been used to mitigate the muscle and cardiac atrophy associated with adaptation to micro-gravity environments. Several hours per day may be required. In confined spaces and long duration missions this kind of exercise is inevitably repetitive and rapidly becomes uninteresting. At the same time, there are pressures to accomplish as much as possible given the cost- per-hour for humans occupying orbiting or interplanetary. Media augmentation provides a the means to overlap activities in time by supplementing the exercise with social, recreational, training or collaborative activities and thereby reducing time pressures. In addition, the machine functions as an interface to a wide range of digital environments allowing for spatial variety in an otherwise confined environment. We hypothesize that the adoption of media augmented exercise machines will have a positive effect on psycho-social well-being on long duration missions. By organizing and supplementing exercise machines, data acquisition hardware, computers and displays into an interacting system this proposal increases functionality with limited additional mass. This paper reviews preliminary work on a project to augment exercise equipment in a manner that addresses these issues and at the same time opens possibilities for additional benefits. A testbed augmented exercise machine uses a specialty built cycle trainer as both input to a virtual environment and as an output device from it using spatialized sound, and visual displays, vibration transducers and variable resistance. The resulting interactivity increases a sense of engagement in the exercise, provides a rich experience of the digital environments. Activities in the virtual environment and accompanying physiological and psychological indicators may be correlated to track and evaluate the health of the crew.

  8. The 12-month effects of structured lifestyle advice and pelvic floor muscle training for pelvic organ prolapse

    Due, Ulla; Brostrøm, Søren; Lose, Gunnar

    2016-01-01

    INTRODUCTION: We evaluated the 12-month effects of adding pelvic floor muscle training to a lifestyle advice program in women with symptomatic pelvic organ prolapse stage II-III and the number of women who had sought further treatment. MATERIAL AND METHODS: This study was a 12-month follow up...... of a randomized controlled trial comparing a structured lifestyle advice program alone (lifestyle group) or in combination with pelvic floor muscle training (training and lifestyle group). Both programs consisted of six separate group sessions within 12 weeks. RESULTS: Data were available from 83 (76%) of the 109...... surgery. More severe anterior prolapse and more bladder symptoms at the 3-month follow up were significantly associated with having sought further treatment in both groups. CONCLUSIONS: At 12-month follow up, the effects of adding pelvic floor muscle training to a structured lifestyle advice program were...

  9. Tracking for Outdoor Mobile Augmented Reality: Further development of the Zion Augmented Reality Application

    Strand, Tor Egil Riegels

    2008-01-01

    This report deals with providing tracking to an outdoor mobile augmented reality system and the Zion Augmented Reality Application. ZionARA is meant to display a virtual recreation of a 13th century castle on the site it once stood through an augmented reality Head Mounted Display. Mobile outdoor augmented/mixed reality puts special demands on what kind of equipment is practical. After briefly evaluating the different existing tracking methods, a solution based on GPS and an augmented inertia...

  10. Aesthetic occiput augmentation using methylmethacrylate.

    Song, Yong Tai

    2015-01-01

    Cranioplasty for only aesthetic reasons has not been commonly performed to date. However, recently there has been a new focus by the public on a more aesthetically pleasing head shape with frequent patient requests for purely aesthetic contouring of the occiput, an important definer of cosmetic head shape. For example, in Asia, where the normal cranial shape is mesocephalic or brachycephalic and often with a planar occiput, requests for its aesthetic correction are increasingly common. Accordingly, the author developed a minimally invasive occiput augmentation using methylmethacrylate. In this study, the indications for aesthetic occiput contouring were planar occiput, left-right asymmetric occiput, and grooved occiput. Under local anesthesia, soft methylmethacrylate is subperiosteally inserted through a small incision (about 5-cm length), manually and precisely contoured in situ through the scalp to the desired occipital shape. All is performed as an outpatient procedure, and a quick recovery is the case. Between March 2007 and October 2013, 959 patients received such aesthetic occiput augmentation. The mean follow-up period was 49 months (range, 3-84 months). Nearly all patients were satisfied with the outcome, and complications were very rare. Only 5 patients (0.5%) needed additional corrective procedures. The author has concluded that aesthetic occiput augmentation using methylmethacrylate yields consistent, predictable, and satisfactory results. Additional long-term follow-up is required for a final conclusion, however.

  11. Facial sculpting and tissue augmentation.

    Carruthers, Jean D A; Carruthers, Alastair

    2005-11-01

    Until recently, deep facial sculpting was exclusively the domain of surgical interventions. Recent advances in the available array of dermal and subdermal fillers combined with an esthetic appreciation by both surgeons and nonsurgeons alike of the positive effect of filling the volume-depleted face have led to an expansion in the indications for the use of soft tissue augmenting agents. Subdermal support of the lateral two-thirds of the brow, the nasojugal fold, the malar and buccal fat pads, the lateral lip commissures, and the perioral region, including the pre-jowl sulcus, all restore youthful facial contour and harmony. An important advance in technique is the subdermal rather than the intradermal injection plane. "Instant" facial sculpting giving a brow-lift, cheek-lift, lip expansion, and perioral augmentation is possible using modern soft tissue augmenting agents. The softer, more relaxed appearance contrasts to the somewhat "pulled" appearance of subjects who have had surgical overcorrections. Treatments can be combined with botulinum toxin and other procedures if required. Newer advances in the use of fillers include the use of fillers injected in the subdermal plane for "lunchtime" facial sculpting. Using the modern esthetic filler compounds, which are biodegradable but longer lasting, subjects can have a "rehearsal" treatment or make it ongoing. Some individuals, such as those with human immunodeficiency virus (HIV)-related lipoatrophy or those who desire to obtain a longer-lasting effect, may elect to use a nonbiodegradable filling agent.

  12. The influence of flooring on environmental stressors: a study of three flooring materials in a hospital.

    Harris, Debra D

    2015-01-01

    Three flooring materials, terrazzo, rubber, and carpet tile, in patient unit corridors were compared for absorption of sound, comfort, light reflectance, employee perceptions and preferences, and patient satisfaction. Environmental stressors, such as noise and ergonomic factors, effect healthcare workers and patients, contributing to increased fatigue, anxiety and stress, decreased productivity, and patient safety and satisfaction. A longitudinal comparative cohort study comparing three types of flooring assessed sound levels, healthcare worker responses, and patient Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings over 42 weeks. A linear mixed model analysis was conducted to determine significant differences between the means for participant responses and objective sound meter data during all three phases of the study. A significant difference was found for sound levels between flooring type for equivalent continuous sound levels. Carpet tile performed better for sound attenuation by absorption, reducing sound levels 3.14 dBA. Preferences for flooring materials changed over the course of the study. The HCAHPS ratings aligned with the sound meter data showing that patients perceived the noise levels to be lower with carpet tiles, improving patient satisfaction ratings. Perceptions for healthcare staff and patients were aligned with the sound meter data. Carpet tile provides sound absorption that affects sound levels and influences occupant's perceptions of environmental factors that contribute to the quality of the indoor environment. Flooring that provides comfort underfoot, easy cleanability, and sound absorption influence healthcare worker job satisfaction and patient satisfaction with their patient experience. © The Author(s) 2015.

  13. What Is Low Profile Access Flooring and Why More Businesses Need It

    NetfloorUSA

    2017-01-01

    Low profile access flooring is being commonly used in a variety of businesses today. To understand why more businesses, need this type of flooring, it is essential that we take the time to first understand what is low profile flooring actually is. What Is Low Profile Access Flooring A low profile access floor is a floor that is designed to sit above the original concrete slab flooring installed in any home, business, or public building. The higher floor height creates a space between ...

  14. Investigation of Floor Surface Finishes for Optimal Slip Resistance Performance

    In-Ju Kim

    2018-03-01

    Full Text Available Background: Increasing the slip resistance of floor surfaces would be desirable, but there is a lack of evidence on whether traction properties are linearly correlated with the topographic features of the floor surfaces or what scales of surface roughness are required to effectively control the slipperiness of floors. Objective: This study expands on earlier findings on the effects of floor surface finishes against slip resistance performance and determines the operative ranges of floor surface roughness for optimal slip resistance controls under different risk levels of walking environments. Methods: Dynamic friction tests were conducted among three shoes and nine floor specimens under wet and oily environments and compared with a soapy environment. Results: The test results showed the significant effects of floor surface roughness on slip resistance performance against all the lubricated environments. Compared with the floor-type effect, the shoe-type effect on slip resistance performance was insignificant against the highly polluted environments. The study outcomes also indicated that the oily environment required rougher surface finishes than the wet and soapy ones in their lower boundary ranges of floor surface roughness. Conclusion: The results of this study with previous findings confirm that floor surface finishes require different levels of surface coarseness for different types of environmental conditions to effectively manage slippery walking environments. Collected data on operative ranges of floor surface roughness seem to be a valuable tool to develop practical design information and standards for floor surface finishes to efficiently prevent pedestrian fall incidents. Keywords: floor surface finishes, operational levels of floor surface roughness, slip resistance, wet, soapy and oily environments

  15. Robotic surgery in gynecology

    Jean eBouquet De Jolinière

    2016-05-01

    Full Text Available Abstract Minimally invasive surgery (MIS can be considered as the greatest surgical innovation over the past thirty years. It revolutionized surgical practice with well-proven advantages over traditional open surgery: reduced surgical trauma and incision-related complications, such as surgical-site infections, postoperative pain and hernia, reduced hospital stay, and improved cosmetic outcome. Nonetheless, proficiency in MIS can be technically challenging as conventional laparoscopy is associated with several limitations as the two-dimensional (2D monitor reduction in-depth perception, camera instability, limited range of motion and steep learning curves. The surgeon has a low force feedback which allows simple gestures, respect for tissues and more effective treatment of complications.Since 1980s several computer sciences and robotics projects have been set up to overcome the difficulties encountered with conventional laparoscopy, to augment the surgeon's skills, achieve accuracy and high precision during complex surgery and facilitate widespread of MIS. Surgical instruments are guided by haptic interfaces that replicate and filter hand movements. Robotically assisted technology offers advantages that include improved three- dimensional stereoscopic vision, wristed instruments that improve dexterity, and tremor canceling software that improves surgical precision.

  16. Image-guided robotic surgery.

    Marescaux, Jacques; Solerc, Luc

    2004-06-01

    Medical image processing leads to an improvement in patient care by guiding the surgical gesture. Three-dimensional models of patients that are generated from computed tomographic scans or magnetic resonance imaging allow improved surgical planning and surgical simulation that offers the opportunity for a surgeon to train the surgical gesture before performing it for real. These two preoperative steps can be used intra-operatively because of the development of augmented reality, which consists of superimposing the preoperative three-dimensional model of the patient onto the real intraoperative view. Augmented reality provides the surgeon with a view of the patient in transparency and can also guide the surgeon, thanks to the real-time tracking of surgical tools during the procedure. When adapted to robotic surgery, this tool tracking enables visual serving with the ability to automatically position and control surgical robotic arms in three dimensions. It is also now possible to filter physiologic movements such as breathing or the heart beat. In the future, by combining augmented reality and robotics, these image-guided robotic systems will enable automation of the surgical procedure, which will be the next revolution in surgery.

  17. Biomechanical paradigm and interpretation of female pelvic floor conditions before a treatment

    Lucente V

    2017-08-01

    Full Text Available Vincent Lucente,1 Heather van Raalte,2 Miles Murphy,1 Vladimir Egorov3 1The Institute for Female Pelvic Medicine and Reconstructive Surgery, Allentown, PA, USA; 2Princeton Urogynecology, Princeton, NJ, USA; 3Artann Laboratories, Trenton, NJ, USA Background: Further progress in restoring a woman’s health may be possible if a patient with a damaged pelvic floor could undergo medical imaging and biomechanical diagnostic tests. The results of such tests could contribute to the analysis of multiple treatment options and suggest the optimal one for that patient.Aim: To develop a new approach for the biomechanical characterization of vaginal conditions, muscles, and connective tissues in the female pelvic floor.Methods: Vaginal tactile imaging (VTI allows biomechanical assessment of the soft tissue along the entire length of the anterior, posterior, and lateral vaginal walls at rest, with manually applied deflection pressures and with muscle contraction, muscle relaxation, and Valsalva maneuver. VTI allows a large body of measurements to evaluate individual variations in tissue elasticity, support defects, as well as pelvic muscle function. Presuming that 1 the female pelvic floor organs are suspended by ligaments against which muscles contract to open or close the outlets and 2 damaged ligaments weaken the support and may reduce the force of muscle contraction, we made an attempt to characterize multiple pelvic floor structures from VTI data.Results: All of the 138 women enrolled in the study were successfully examined with the VTI. The study subjects have had normal pelvic support or pelvic organ prolapse (stages I–IV. The average age of this group of subjects was 60±15 years. We transposed a set of 31 VTI parameters into a quantitative characterization of pelvic muscles and ligamentous structures. Interpretation of the acquired VTI data for normal pelvic floor support and prolapse conditions is proposed based on biomechanical assessment of the

  18. Using virtual ridge augmentation and 3D printing to fabricate a titanium mesh positioning device: A novel technique letter.

    Al-Ardah, Aladdin; Alqahtani, Nasser; AlHelal, Abdulaziz; Goodacre, Brian; Swamidass, Rajesh; Garbacea, Antoanela; Lozada, Jaime

    2018-05-02

    This technique describes a novel approach for planning and augmenting a large bony defect using a titanium mesh (TiMe). A 3-dimensional (3D) surgical model was virtually created from a cone beam computed tomography (CBCT) and wax-pattern of the final prosthetic outcome. The required bone volume (horizontally and vertically) was digitally augmented and then 3D printed to create a bone model. The 3D model was then used to contour the TiMe in accordance with the digital augmentation. With the contoured / preformed TiMe on the 3D printed model a positioning jig was made to aid the placement of the TiMe as planned during surgery. Although this technique does not impact the final outcome of the augmentation procedure, it allows the clinician to virtually design the augmentation, preform and contour the TiMe, and create a positioning jig reducing surgical time and error.

  19. Visual error augmentation enhances learning in three dimensions.

    Sharp, Ian; Huang, Felix; Patton, James

    2011-09-02

    Because recent preliminary evidence points to the use of Error augmentation (EA) for motor learning enhancements, we visually enhanced deviations from a straight line path while subjects practiced a sensorimotor reversal task, similar to laparoscopic surgery. Our study asked 10 healthy subjects in two groups to perform targeted reaching in a simulated virtual reality environment, where the transformation of the hand position matrix was a complete reversal--rotated 180 degrees about an arbitrary axis (hence 2 of the 3 coordinates are reversed). Our data showed that after 500 practice trials, error-augmented-trained subjects reached the desired targets more quickly and with lower error (differences of 0.4 seconds and 0.5 cm Maximum Perpendicular Trajectory deviation) when compared to the control group. Furthermore, the manner in which subjects practiced was influenced by the error augmentation, resulting in more continuous motions for this group and smaller errors. Even with the extreme sensory discordance of a reversal, these data further support that distorted reality can promote more complete adaptation/learning when compared to regular training. Lastly, upon removing the flip all subjects quickly returned to baseline rapidly within 6 trials.

  20. Visual error augmentation enhances learning in three dimensions

    Huang Felix

    2011-09-01

    Full Text Available Abstract Because recent preliminary evidence points to the use of Error augmentation (EA for motor learning enhancements, we visually enhanced deviations from a straight line path while subjects practiced a sensorimotor reversal task, similar to laparoscopic surgery. Our study asked 10 healthy subjects in two groups to perform targeted reaching in a simulated virtual reality environment, where the transformation of the hand position matrix was a complete reversal--rotated 180 degrees about an arbitrary axis (hence 2 of the 3 coordinates are reversed. Our data showed that after 500 practice trials, error-augmented-trained subjects reached the desired targets more quickly and with lower error (differences of 0.4 seconds and 0.5 cm Maximum Perpendicular Trajectory deviation when compared to the control group. Furthermore, the manner in which subjects practiced was influenced by the error augmentation, resulting in more continuous motions for this group and smaller errors. Even with the extreme sensory discordance of a reversal, these data further support that distorted reality can promote more complete adaptation/learning when compared to regular training. Lastly, upon removing the flip all subjects quickly returned to baseline rapidly within 6 trials.

  1. Deflection of resilient materials for reduction of floor impact sound.

    Lee, Jung-Yoon; Kim, Jong-Mun

    2014-01-01

    Recently, many residents living in apartment buildings in Korea have been bothered by noise coming from the houses above. In order to reduce noise pollution, communities are increasingly imposing bylaws, including the limitation of floor impact sound, minimum thickness of floors, and floor soundproofing solutions. This research effort focused specifically on the deflection of resilient materials in the floor sound insulation systems of apartment houses. The experimental program involved conducting twenty-seven material tests and ten sound insulation floating concrete floor specimens. Two main parameters were considered in the experimental investigation: the seven types of resilient materials and the location of the loading point. The structural behavior of sound insulation floor floating was predicted using the Winkler method. The experimental and analytical results indicated that the cracking strength of the floating concrete floor significantly increased with increasing the tangent modulus of resilient material. The deflection of the floating concrete floor loaded at the side of the specimen was much greater than that of the floating concrete floor loaded at the center of the specimen. The Winkler model considering the effect of modulus of resilient materials was able to accurately predict the cracking strength of the floating concrete floor.

  2. Surgical reconstruction of pelvic floor descent: anatomic and functional aspects.

    Wagenlehner, F M E; Bschleipfer, T; Liedl, B; Gunnemann, A; Petros, P; Weidner, W

    2010-01-01

    The human pelvic floor is a complex structure and pelvic floor dysfunction is seen frequently in females. This review focuses on the surgical reconstruction of the pelvic floor employing recent findings on functional anatomy. A selective literature research was performed by the authors. Pelvic floor activity is regulated by 3 main muscular forces that are responsible for vaginal tension and suspension of the pelvic floor organs, bladder and rectum. A variety of symptoms can derive from pelvic floor dysfunctions, such as urinary urge and stress incontinence, abnormal bladder emptying, fecal incontinence, obstructive bowel disease syndrome and pelvic pain. These symptoms mainly derive, for different reasons, from laxity in the vagina or its supporting ligaments as a result of altered connective tissue. Pelvic floor reconstruction is nowadays driven by the concept that in case of pelvic floor symptoms, restoration of the anatomy will translate into restoration of the physiology and ultimately improve patients' symptoms. The surgical reconstruction of the anatomy is almost exclusively focused on the restoration of the lax pelvic floor ligaments. Exact preoperative identification of the anatomical lesions is necessary to allow for exact anatomical reconstruction with respect to the muscular forces of the pelvic floor. Copyright 2010 S. Karger AG, Basel.

  3. DESIGN OF SUBSOIL IMPROVEMENT BELOW HALL FLOORS

    Peter Turček

    2017-10-01

    Full Text Available The construction of an industrial park is now being prepared near the town of Nitra. The investor fixed very strict conditions for the bearing capacity and, above all, the settlement of halls and their floors. The geological conditions at the construction site are difficult: there are soft clay soils with high compressibility and low bearing capacity. A detailed analysis of soil improvement was made. Stone columns were prepared to be fitted into an approximately 5 m thick layer of soft clay. The paper shows the main steps used in the design of the stone columns.

  4. Osteolipoma of floor of the mouth.

    Raghunath, Vandana; Manjunatha, Bhari Sharanesha

    2015-06-25

    Lipomas are benign soft tissue tumours composed mainly of mature adipose tissue. Histological variants of lipomas have been named according to the type of tissue present and they include fibrolipoma, angiolipoma, osteolipoma, chondrolipoma and others. Osteolipoma, a classic lipoma with osseous metaplasia, is a very rare histological variant. Owing to the rarity of oral osteolipomas, we report an uncommon case of osteolipoma located on the floor of the mouth of a 20-year-old female patient and include a review of the literature. 2015 BMJ Publishing Group Ltd.

  5. Surgical treatment of the squamous cell carcinoma of tongue and floor of mouth: pos-operative radiotherapy effect

    Amar, Ali; Curioni, Otavio Alberto; Higuchi, Sergio T.; Rapoport, Abrao

    2003-01-01

    Assessment of the postoperative irradiation effectiveness for improvement local control of squamous cell carcinoma of tongue and floor of the mouth in stages III and IV. Study Design: clinical retrospective. Material and Method: a retrospective case-series of 72 patients with squamous cell carcinoma of tongue and floor of mouth who underwent surgery. The local control rate was assessed in front of stage, surgical margins and postoperative radiotherapy. Results: local recurrences were diagnosed in 28 (38%) patients. Only T stage and lymph node metastases were related to recurrences in the primary site. Control of disease in the primary site was achieved in 80% of pn patients and postoperative radiotherapy didn't show any effect in this group. Conclusion: advanced local disease without lymph node metastases can be treated with surgery only. (author)

  6. Webizing mobile augmented reality content

    Ahn, Sangchul; Ko, Heedong; Yoo, Byounghyun

    2014-01-01

    This paper presents a content structure for building mobile augmented reality (AR) applications in HTML5 to achieve a clean separation of the mobile AR content and the application logic for scaling as on the Web. We propose that the content structure contains the physical world as well as virtual assets for mobile AR applications as document object model (DOM) elements and that their behaviour and user interactions are controlled through DOM events by representing objects and places with a uniform resource identifier. Our content structure enables mobile AR applications to be seamlessly developed as normal HTML documents under the current Web eco-system.

  7. Controlling bistability by linear augmentation

    Sharma, Pooja Rani; Shrimali, Manish Dev; Prasad, Awadhesh; Feudel, Ulrike

    2013-01-01

    In many bistable oscillating systems only one of the attractors is desired to possessing certain system performance. We present a method to drive a bistable system to a desired target attractor by annihilating the other one. This shift from bistability to monostability is achieved by augmentation of the nonlinear oscillator with a linear control system. For a proper choice of the control function one of the attractors disappears at a critical coupling strength in an control-induced boundary crisis. This transition from bistability to monostability is demonstrated with two paradigmatic examples, the autonomous Chua oscillator and a neuronal system with a periodic input signal.

  8. Indeterminacy and labor augmenting externalities

    Poulsen, Odile; Goenka, Aditya

    2002-01-01

    In this two-sector discrete time model of endogenous economic growth intersectoral effects are assumed to be "labor augmenting" We derive necessary and sufficient conditions for local indeterminacy and multiplicity of the balanced growth path in terms of factor intensities in both sectors....... The balanced growth path is unique if the consumption good sector is more capital intensive. However, it can be indeterminate. When the investment good sector is more capital intensive a sufficient condition for indeterminacy is that there exists at least three balanced growth paths....

  9. "Non-filling" procedures for lip augmentation: a systematic review of contemporary techniques and their outcomes.

    Moragas, Joan San Miguel; Vercruysse, Herman Junior; Mommaerts, Maurice Y

    2014-09-01

    Ideal lip augmentation techniques have good longevity, low complication rates, and optimal functional and aesthetic results. No systematic review is currently available regarding the efficacy of lip augmentation techniques. This review will focus only on non-filling procedures for lip augmentation (NFPLAs). Current databases Elsevier Science Direct, PubMed, HighWire Press, Springer Standard Collection, SAGE, DOAJ, Sweetswise, Free E-Journals, Ovid Lippincott Williams & Wilkins, Willey Online Library Journals and Cochrane Plus were scrutinized and relevant article reference sections were studied for additional publications. The search heading sequence used was ("Lip" or "Mouth" or "Perioral" or "Nasolabial") and ("Augmentation" or "Enhancement" or "Surgery" or "Lift" or "V-Y" or "Corner"). Exclusion criteria applied to 6436 initial keyword-search retrievals yielded 12 articles. Eight more articles were retrieved from reference sections, for a total of 18 papers assessed. Only one article made a direct comparison of efficacy between two surgical techniques for lip augmentation, and none directly compared complications associated with different NFPLAs. Although this systematic review revealed a lack of quality data in comparing the efficacy and complications among different NFPLAs, it is important to review and pool the existing studies to better suggest proper treatment to patients. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  10. Percutaneous Vertebral Augmentation with Polyethylene Mesh and Allograft Bone for Traumatic Thoracolumbar Fractures

    C. Schulz

    2015-01-01

    Full Text Available Purpose. In cases of traumatic thoracolumbar fractures, percutaneous vertebral augmentation can be used in addition to posterior stabilisation. The use of an augmentation technique with a bone-filled polyethylene mesh as a stand-alone treatment for traumatic vertebral fractures has not yet been investigated. Methods. In this retrospective study, 17 patients with acute type A3.1 fractures of the thoracic or lumbar spine underwent stand-alone augmentation with mesh and allograft bone and were followed up for one year using pain scales and sagittal endplate angles. Results. From before surgery to 12 months after surgery, pain and physical function improved significantly, as indicated by an improvement in the median VAS score and in the median pain and work scale scores. From before to immediately after surgery, all patients showed a significant improvement in mean mono- and bisegmental kyphoses. During the one-year period, there was a significant loss of correction. Conclusions. Based on this data a stand-alone approach with vertebral augmentation with polyethylene mesh and allograft bone is not a suitable therapy option for incomplete burst fractures for a young patient collective.

  11. Corrective Jaw Surgery

    Full Text Available ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ...

  12. Effect of slatted and solid floors and permeability of floors in pig houses on environment, animal welfare and health and food safety: a review of literature

    Vermeij, I.; Enting, J.; Spoolder, H.A.M.

    2009-01-01

    An integrated approach can improve understanding of floor performance. Not only gap width or percentage of slatted floor is important, but a minimum percentage of permeability of the total floor area appears to be decisive

  13. Pelvic floor electrophysiology in spinal cord injury.

    Tankisi, H; Pugdahl, K; Rasmussen, M M; Clemmensen, D; Rawashdeh, Y F; Christensen, P; Krogh, K; Fuglsang-Frederiksen, A

    2016-05-01

    The study aimed to investigate sacral peripheral nerve function and continuity of pudendal nerve in patients with chronic spinal cord injury (SCI) using pelvic floor electrophysiological tests. Twelve patients with low cervical or thoracic SCI were prospectively included. Quantitative external anal sphincter (EAS) muscle electromyography (EMG), pudendal nerve terminal motor latency (PNTML) testing, bulbocavernosus reflex (BCR) testing and pudendal short-latency somatosensory-evoked potential (SEP) measurement were performed. In EAS muscle EMG, two patients had abnormal increased spontaneous activity and seven prolonged motor unit potential duration. PNTML was normal in 10 patients. BCR was present with normal latency in 11 patients and with prolonged latency in one. The second component of BCR could be recorded in four patients. SEPs showed absent cortical responses in 11 patients and normal latency in one. Pudendal nerve and sacral lower motor neuron involvement are significantly associated with chronic SCI, most prominently in EAS muscle EMG. The frequent finding of normal PNTML latencies supports earlier concerns on the utility of this test; however, BCR and pudendal SEPs may have clinical relevance. As intact peripheral nerves including pudendal nerve are essential for efficient supportive therapies, pelvic floor electrophysiological testing prior to these interventions is highly recommended. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  14. Flooring-systems and their interaction with furniture and humans

    Frier, Christian; Pedersen, Lars; Andersen, Lars Vabbersgaard

    2017-01-01

    Flooring-system designs may be sensitive in terms of their vibrational performance due the risk that serviceability-limit-state problems may be encountered. For evaluating the vibrational performance of a flooring system at the design stage, decisions must be made by the engineer in charge...... of computations. Passive humans and/or furniture are often present on a floor. Typically, these masses and their way of interacting with the floor mass are ignored in predictions of vibrational behaviour of the flooring system. Utilizing a shell finite-element model, the paper explores and quantifies how non......-structural mass can influence central parameters describing the dynamic behaviour of the flooring system with focus on elevated non-structural mass. © 2017 The Authors. Published by Elsevier Ltd....

  15. GENERAL SURGERY

    in the endoscopy room. GENERAL SURGERY. T du Toit, O C Buchel, S J A Smit. Department of Surgery, University of the Free State, Bloemfontein, ... The lack of video instrumentation in developing countries: Redundant fibre-optic instruments (the old. “eye scope”) are still being used. This instrument brings endoscopists ...

  16. GENERAL SURGERY

    mean time to first surgery post burn was 11.5 days with a median volume of 0.73 mls/kg/% ..... Mode. Mean (SD). Upper limit. 95% CI. Lower limit. 95% CI. Mode. Elective surgery .... evaluating single-unit red blood cell transfusions in reducing.

  17. Psychotherapy augmentation through preconscious priming

    Francois eBorgeat

    2013-03-01

    Full Text Available Objective: To test the hypothesis that repeated preconscious (masked priming of personalized positive cognitions could augment cognitive change and facilitate achievement of patients’ goals following a therapy.Methods: Twenty social phobic patients (13 women completed a 36 weeks study beginning by 12 weeks of group behavioural therapy. After the therapy, they received 6 weeks of preconscious priming and 6 weeks of a control procedure in a randomized cross-over design. The Priming condition involved listening twice daily with a passive attitude to a recording of individualized formulations of appropriate cognitions and attitudes masked by music. The Control condition involved listening to an indistinguishable recording where the formulations had been replaced by random numbers. Changes in social cognitions were measured by the Social Interaction Self Statements Test (SISST.Results: Patients improved following therapy. The Priming procedure was associated with increased positive cognitions and decreased negative cognitions on the SISST while the Control procedure was not. The Priming procedure induced more cognitive change when applied immediately after the group therapy. Conclusion: An effect of priming was observed on social phobia related cognitions in the expected direction. This self administered addition to a therapy could be seen as an augmentation strategy.

  18. Enhancing tourism with augmented and virtual reality

    Jenny, Sandra

    2017-01-01

    Augmented and virtual reality are on the advance. In the last twelve months, several interesting devices have entered the market. Since tourism is one of the fastest growing economic sectors in the world and has become one of the major players in international commerce, the aim of this thesis was to examine how tourism could be enhanced with augmented and virtual reality. The differences and functional principles of augmented and virtual reality were investigated, general uses were described ...

  19. Interactive Assembly Guide using Augmented Reality

    Andersen, Martin; Andersen, Rasmus Skovgaard; Larsen, Christian Lindequist

    2009-01-01

    This paper presents an Augmented Reality system for aiding a pump assembling process at Grundfos, one of the leading pump producers. Stable pose estimation of the pump is required in order to augment the graphics correctly. This is achieved by matching image edges with synthesized edges from CAD...... norm. A dynamic visualization of the augmented graphics provides the user with guidance. Usability tests show that the accuracy of the system is sufficient for assembling the pump....

  20. Augmented Reality Using JavaScript

    Hailemichael, Aida

    2013-01-01

    The project goal was to provide a mobile application, for a venue called Kulturhuset Karelia which is located in Tammisaari Finland. In this paper, the concept of Augmented Reality technology is briefly discussed along with the mobile application for the venue. The utilisation of JavaScript for creating Augmented reality content for mobile Augmented reality browser is also demonstrated. The application was created by using Architecht API which is Jacvascript library based on the Wikitude...

  1. Choosing surgery

    Thorstensson, Carina; Lohmander, L; Frobell, Richard

    2009-01-01

    -depth qualitative interviews were conducted with young (aged 18-35), physically active individuals with ACL rupture who were participating in a RCT comparing training and surgical reconstruction with training only. 22/34 were randomised to training only but crossed over to surgery. Of these, 11 were interviewed......ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in...... before surgery, and 11 were interviewed at least 6 months after surgery. To provide additional information, 12 patients were interviewed before randomisation. Interviews were audio-recorded, transcribed and analysed using the Framework approach. RESULTS: Strong preference for surgery was commonplace...

  2. Evolving practices in augmentation operative technique with Sientra HSC round implants.

    Calobrace, M Bradley; Kaufman, David L; Gordon, Ashley E; Reid, Dustin L

    2014-07-01

    As of 2012, breast augmentation surgery continues to be the most commonly performed aesthetic surgical procedure in the United States. Surgeons consider a multitude of factors when choosing the type and style of breast implant for a patient. With the continuous evolution of breast implant designs, there are a variety of breast implant options for plastic surgeons to choose from; however, round implants remain the implant of choice for breast augmentation. This article discusses preoperative planning, implant selection, surgical techniques, and postoperative management using Sientra's Silimed brand smooth and textured round implants.

  3. Augmenting Locomotion in an Anthropomorphic System

    Derek Wight

    2005-02-01

    Full Text Available A powered orthosis has applications ranging from assisting the elderly to augmenting astronauts. An assistive control scheme is developed that uses the force from a slave actuator to augment the force of a master actuator. This can be used to augment a closed-loop control scheme applied to the master actuator. Initially, actuator augmentation is explored both theoretically and experimentally using a simple mechanical system. The control scheme is then applied to a scale model of human lower limbs on a stationary bicycle to investigate the feasibility of a powered orthosis using pneumatic muscle actuators.

  4. [Cement augmentation on the spine : Biomechanical considerations].

    Kolb, J P; Weiser, L; Kueny, R A; Huber, G; Rueger, J M; Lehmann, W

    2015-09-01

    Vertebral compression fractures are the most common osteoporotic fractures. Since the introduction of vertebroplasty and screw augmentation, the management of osteoporotic fractures has changed significantly. The biomechanical characteristics of the risk of adjacent fractures and novel treatment modalities for osteoporotic vertebral fractures, including pure cement augmentation by vertebroplasty, and cement augmentation of screws for posterior instrumentation, are explored. Eighteen human osteoporotic lumbar spines (L1-5) adjacent to vertebral bodies after vertebroplasty were tested in a servo-hydraulic machine. As augmentation compounds we used standard cement and a modified low-strength cement. Different anchoring pedicle screws were tested with and without cement augmentation in another cohort of human specimens with a simple pull-out test and a fatigue test that better reflects physiological conditions. Cement augmentation in the osteoporotic spine leads to greater biomechanical stability. However, change in vertebral stiffness resulted in alterations with the risk of adjacent fractures. By using a less firm cement compound, the risk of adjacent fractures is significantly reduced. Both screw augmentation techniques resulted in a significant increase in the withdrawal force compared with the group without cement. Augmentation using perforated screws showed the highest stability in the fatigue test. The augmentation of cement leads to a significant change in the biomechanical properties. Differences in the stability of adjacent vertebral bodies increase the risk of adjacent fractures, which could be mitigated by a modified cement compound with reduced strength. Screws that were specifically designed for cement application displayed greatest stability in the fatigue test.

  5. INTEGRATIVE AUGMENTATION OF STANDARDIZED MANAGEMENT SYSTEMS

    Stanislav Karapetrovic

    2008-03-01

    Full Text Available The development, features and integrating abilities of different international standards related to management systems are discussed. A group of such standards that augment the performance of quality management systems in organizations is specifically focused on. The concept, characteristics and an illustrative example of one augmenting standard, namely ISO 10001, are addressed. Integration of standardized augmenting systems, both by themselves and within the overall management system, is examined. It is argued that, in research and practice alike, integrative augmentation represents the future of standardized quality and other management systems.

  6. Instrument Motion Metrics for Laparoscopic Skills Assessment in Virtual Reality and Augmented Reality.

    Fransson, Boel A; Chen, Chi-Ya; Noyes, Julie A; Ragle, Claude A

    2016-11-01

    To determine the construct and concurrent validity of instrument motion metrics for laparoscopic skills assessment in virtual reality and augmented reality simulators. Evaluation study. Veterinarian students (novice, n = 14) and veterinarians (experienced, n = 11) with no or variable laparoscopic experience. Participants' minimally invasive surgery (MIS) experience was determined by hospital records of MIS procedures performed in the Teaching Hospital. Basic laparoscopic skills were assessed by 5 tasks using a physical box trainer. Each participant completed 2 tasks for assessments in each type of simulator (virtual reality: bowel handling and cutting; augmented reality: object positioning and a pericardial window model). Motion metrics such as instrument path length, angle or drift, and economy of motion of each simulator were recorded. None of the motion metrics in a virtual reality simulator showed correlation with experience, or to the basic laparoscopic skills score. All metrics in augmented reality were significantly correlated with experience (time, instrument path, and economy of movement), except for the hand dominance metric. The basic laparoscopic skills score was correlated to all performance metrics in augmented reality. The augmented reality motion metrics differed between American College of Veterinary Surgeons diplomates and residents, whereas basic laparoscopic skills score and virtual reality metrics did not. Our results provide construct validity and concurrent validity for motion analysis metrics for an augmented reality system, whereas a virtual reality system was validated only for the time score. © Copyright 2016 by The American College of Veterinary Surgeons.

  7. Gait of dairy cows on floors with different slipperiness.

    Telezhenko, E; Magnusson, M; Bergsten, C

    2017-08-01

    This study assessed the slip resistance of different types of solid flooring in cattle housing using a range of technical tests and gait analysis. Dynamic and static coefficient of friction, skid resistance, and abrasiveness were tested on concrete flooring with a smooth finish, a grooved pattern, or a tamped pattern, acid-resistant mastic asphalt, soft rubber mats, and a worn slatted concrete floor. Coefficients of friction and skid resistance were tested under clean and slurry-soiled conditions. Linear kinematic variables were assessed in 40 cows with trackway measurements after the cows passed over the floors in a straight walk. All gait variables were assessed as deviations from those obtained on the slatted concrete floor, which was used as a baseline. The coefficient of friction tests divided the floors into 3 categories: concrete flooring, which had a low coefficient of friction (0.29-0.41); mastic asphalt flooring, which had medium values (0.38-0.45); and rubber mats, which had high values (0.49-0.57). The highest abrasion (g/10 m) was on the asphalt flooring (4.48), and the concrete flooring with a tamped pattern had significantly higher abrasiveness (2.77) than the other concrete floors (1.26-1.60). Lowest values on the skid-resistance tests (dry/wet) were for smooth concrete (79/35) and mastic asphalt (65/47), especially with a slurry layer on the surface. Gait analysis mainly differentiated floors with higher friction and abrasion by longer strides and better tracking. Step asymmetry was lower on floors with high skid-resistance values. The most secure cow gait, in almost every aspect, was observed on soft rubber mats. Relationships between gait variables and physical floor characteristics ranged from average to weak (partial correlations 0.54-0.16). Thus, none of the physical characteristics alone was informative enough to characterize slip resistance. With reference to gait analysis, the abrasiveness of the hard surfaces was more informative than the

  8. Obtaining and Estimating Low Noise Floors in Vibration Sensors

    Brincker, Rune; Larsen, Jesper Abildgaard

    2007-01-01

    For some applications like seismic applications and measuring ambient vibrations in structures, it is essential that the noise floors of the sensors and other system components are low and known to the user. Some of the most important noise sources are reviewed and it is discussed how the sensor...... can be designed in order to obtain a low noise floor. Techniques to estimate the noise floors for sensors are reviewed and are demonstrated on a commercial commonly used sensor for vibration testing. It is illustrated how the noise floor can be calculated using the coherence between simultaneous...

  9. Apparatus for treating the walls and floor of the pelvic cavity with radiation

    Clayton, R.S.

    1975-01-01

    An apparatus for reaing carcinoma of the walls and floor of the pelvic cavity is described. An elongated tube has an inner end adapted to be placed in the pelvic cavity and an outer end adapted to extend through to the outside of the body. Radioactive material is placed at the inner end. An inner balloon above the radioactive material is inflated to hold a body of liquid shielding material such as mercury. A lower balloon portion beneath the inner balloon spaces areas to be treated such as the walls and floor of the pelvic cavity from the radioactive material. An upper balloon portion above the inner balloon keeps the intestines out of the pelvic cavity and away from the radioactive material. The apparatus is inserted into the pelvic cavity through an abdominal incision. When treating a woman for carcinoma in the walls and floor of the pelvic cavity the tube is moved through the vaginal passage from the inside outwardly. When treating a woman with a closed vaginal passage, as may result from surgery, or when treating a man, such as for carcinoma of the bladder, the tube will pass out of the body through a lower abdominal incision. Following treatment, all balloons are deflated so that the apparatus can be withdrawn through the vaginal passage or the lower abdominal incision, as the case may be. (auth)

  10. Treatments for invasive carcinoma of the cervix: what are their impacts on the pelvic floor functions?

    Alessandra Ferreira de Noronha

    2013-01-01

    Full Text Available Aims: Describe the impact of surgery, radiotherapy and chemoradiation in the pelvic floor functions in cervical cancer patients. Materials and Methods: A prospective study with women submitted to radical hysterectomy (RH (n = 20, exclusive radiotherapy (RT (n = 20 or chemoradiation (CT/RT (n = 20 for invasive cervical cancer. Urinary, intestinal and sexual function, as well as vaginal length and pelvic floor muscle contraction were evaluated. Comparisons between groups were performed by Kruskal-Wallis and Chi-square tests (p < 0.05. Results: The groups were similar in stress urinary incontinence incidence (p = 0.56, urinary urgency (p = 0.44, urge incontinence (p = 0.54, nocturia (p = 0.53, incomplete bowel emptying (p = 0.76, bowel urgency (p = 0.12 and soilage (p = 0.43. The CT/RT group presented a higher urinary frequency (p < 0.001 and diarrhea (p = 0.025. Patients in the RH group were more sexually active (p = 0.01 and experienced less dyspareunia (p = 0.021. Vaginal length was shorter in RT group (5.5 ± 1.9cm and CT/RT(5.3 ± 1.5 cm than in the RH group (7.4 ± 1.1 cm (p < 0.001. Pelvic floor muscle contraction was similar (p = 0.302. Conclusions: RT and CT/RT treatment for cervical carcinoma are more associated to sexual and intestinal dysfunctions.

  11. Acoustics. Measurement of sound insulation in buildings and of building elements. Laboratory measurements of the reduction of transmitted impact noise by floor coverings on a heavyweight standard floor

    British Standards Institution. London

    1998-01-01

    Acoustics. Measurement of sound insulation in buildings and of building elements. Laboratory measurements of the reduction of transmitted impact noise by floor coverings on a heavyweight standard floor

  12. Jointly Optimize Data Augmentation and Network Training: Adversarial Data Augmentation in Human Pose Estimation

    Peng, Xi; Tang, Zhiqiang; Yang, Fei; Feris, Rogerio; Metaxas, Dimitris

    2018-01-01

    Random data augmentation is a critical technique to avoid overfitting in training deep neural network models. However, data augmentation and network training are usually treated as two isolated processes, limiting the effectiveness of network training. Why not jointly optimize the two? We propose adversarial data augmentation to address this limitation. The main idea is to design an augmentation network (generator) that competes against a target network (discriminator) by generating `hard' au...

  13. A histologic, histomorphometric, and radiographic comparison between two complexes of CenoBoen/CenoMembrane and Bio-Oss/Bio-Gide in lateral ridge augmentation: A clinical trial.

    Amoian, Babak; Moudi, Ehsan; Majidi, Maryam Seyed; Ali Tabatabaei, S M

    2016-09-01

    Several grafting materials have been used for alveolar ridge augmentation. The literature lacks researches to compare CenoBone to other grafting materials. The aim of this study was to compare CenoBone/CenoMembrane complex to Bio-Oss/Bio-Gide complex in lateral alveolar bone augmentation in terms of radiographic, histologic, and histomorphometric parameters. In this randomized controlled trial, ten patients who needed lateral ridge augmentation were selected and augmentations were done using either of CenoBone/CenoMembrane or Bio-Oss/Bio-Gide complexes. In the re-entry surgery in 6 months following augmentation, core biopsies were taken and clinical, radiographic, histologic, and histomorphometric evaluations were performed. No statistically significant difference was seen between groups except for the number of blood vessels and percentage of residual graft materials. CenoBone seems to present a comparable lateral ridge augmentation to Bio-Oss in.

  14. Development of floor design response spectra for seismic design of floor-supported equipment or components, Revision 1, February 1978

    Anon.

    1979-01-01

    This guide presents an acceptable method for developing two horizontal and one vertical floor design response spectra at various floor or other equipment-support locations from the time-history motions resulting from the dynamic analysis of the supporting structure. These floor design response spectra are used in the dynamic analysis of systems or equipment supported at various locations of the supporting structure. Consulation has been provided by the Advisory Committee on Reactor Safeguards

  15. Predicting who will undergo surgery after physiotherapy for female stress urinary incontinence

    Labrie, J.; Lagro-Janssen, A.; Fischer, K.; Berghmans, L.C.; Vaart, C.H. van der

    2015-01-01

    INTRODUCTION AND HYPOTHESIS: To predict who will undergo midurethral sling surgery (surgery) after initial pelvic floor muscle training (physiotherapy) for stress urinary incontinence in women. METHODS: This was a cohort study including women with moderate to severe stress incontinence who were

  16. Predicting who will undergo surgery after physiotherapy for female stress urinary incontinence

    Labrie, J.; Lagro-Janssen, A. L. M.; Fischer, K.; Berghmans, L. C. M.; van der Vaart, C. H.

    To predict who will undergo midurethral sling surgery (surgery) after initial pelvic floor muscle training (physiotherapy) for stress urinary incontinence in women. This was a cohort study including women with moderate to severe stress incontinence who were allocated to the physiotherapy arm from a

  17. Augmented reality in laparoscopic surgical oncology.

    Nicolau, Stéphane; Soler, Luc; Mutter, Didier; Marescaux, Jacques

    2011-09-01

    Minimally invasive surgery represents one of the main evolutions of surgical techniques aimed at providing a greater benefit to the patient. However, minimally invasive surgery increases the operative difficulty since the depth perception is usually dramatically reduced, the field of view is limited and the sense of touch is transmitted by an instrument. However, these drawbacks can currently be reduced by computer technology guiding the surgical gesture. Indeed, from a patient's medical image (US, CT or MRI), Augmented Reality (AR) can increase the surgeon's intra-operative vision by providing a virtual transparency of the patient. AR is based on two main processes: the 3D visualization of the anatomical or pathological structures appearing in the medical image, and the registration of this visualization on the real patient. 3D visualization can be performed directly from the medical image without the need for a pre-processing step thanks to volume rendering. But better results are obtained with surface rendering after organ and pathology delineations and 3D modelling. Registration can be performed interactively or automatically. Several interactive systems have been developed and applied to humans, demonstrating the benefit of AR in surgical oncology. It also shows the current limited interactivity due to soft organ movements and interaction between surgeon instruments and organs. If the current automatic AR systems show the feasibility of such system, it is still relying on specific and expensive equipment which is not available in clinical routine. Moreover, they are not robust enough due to the high complexity of developing a real-time registration taking organ deformation and human movement into account. However, the latest results of automatic AR systems are extremely encouraging and show that it will become a standard requirement for future computer-assisted surgical oncology. In this article, we will explain the concept of AR and its principles. Then, we

  18. Achilles Tendon Open Surgical Treatment With Platelet-Rich Fibrin Matrix Augmentation: Biomechanical Evaluation.

    Alviti, Federica; Gurzì, Michele; Santilli, Valter; Paoloni, Marco; Padua, Roberto; Bernetti, Andrea; Bernardi, Marco; Mangone, Massimiliano

    The relationship between surgical technique and ankle biomechanical properties after surgery for acute rupture of the Achilles tendon (ATR) has not yet been fully investigated. Platelet-rich fibrin (PRF) matrices seem to play a central role in the complex processes of tendon healing. Our aim was to analyze the biomechanical characteristics, stiffness, and mechanical work of the ankle during walking in patients who had undergone surgery after ATR with and without PRF augmentation. We performed a retrospective review of all consecutive patients who had been treated with surgical repair after ATR. Of the 20 male subjects enrolled, 9 (45%) had undergone conventional open repair of the Achilles tendon using the Krackow technique (no-PRF) and 11 (55%) had undergone surgery with PRF augmentation. An additional 8 healthy subjects were included as a control group. A gait analysis evaluation was performed at 6 months after surgery. The percentage of the stance time of the operated leg, double-support time of the healthy leg, and net work of the ankle during the gait cycle showed statistically significant differences between the no-PRF and the healthy group (p < .005). No differences were found between the PRF and healthy groups. Treatment with suture and PRF augmentation could result in significant functional improvements in term of efficiency of motion. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  19. The effect of sub-floor heating on house-dust-mite populations on floors and in furniture.

    de Boer, Rob

    2003-01-01

    It is well known that dehydrating conditions for house dust mites can be created by simply raising the temperature, causing loss of body water and eventually death. Thus, it can be expected that conditions for dust mites are less favourable on floors supplied with sub-floor heating. This was examined in a study of 16 houses with sub-floor heating and 21 without. The pattern of changes in air humidity and temperature on the floors was investigated and compared to known data of the tolerance of dust mites. Also the resident mite populations were compared. Floors with sub-floor heating had, on average, fewer mites, but the difference with unheated floors was small. It was remarkable that mite numbers were also lower in upholstered furniture. Another important observation was that some houses with sub-floor heating had high mite numbers, indicating that this type of heating is compatible with a thriving mite population. Temperature and humidity conditions of heated floors may allow mites not only to survive, but also to remain active in winter. A moderate increase in temperature, a moderate decrease in (absolute) air humidity, or a combination of both, will suffice to keep the humidity all winter below the Critical Equilibrium Humidity, the level of air humidity that is critical for mite growth and reproduction, hence for allergen production. However, it is argued that measures to suppress allergen production by house dust mites are likely to be far more effective if taken in summer rather than in winter.

  20. Toxic and fire hazard of flooring

    Illarionova L. V.

    2017-12-01

    Full Text Available polymer materials have become widespread in the modern construction industry due to their cheapness and variety. With regard to their popularity at the present time there can appear the issues of their toxic and fire danger. The work has studied the samples of two floor synthetic building materials. The results of the determination of the fire hazard indicators of materials (combustibility, flammability, smoke ratio showed their compliance with the current certificates. The authors have studied the properties of gaseous combustion products of samples by the method of thermal analysis and FTIR analysis. The results of chloride ions analysis according the formula of Maxwell-Mohr in thermolysis products indicate the toxicity of the materials studied.

  1. Robotic systems in spine surgery.

    Onen, Mehmet Resid; Naderi, Sait

    2014-01-01

    Surgical robotic systems have been available for almost twenty years. The first surgical robotic systems were designed as supportive systems for laparoscopic approaches in general surgery (the first procedure was a cholecystectomy in 1987). The da Vinci Robotic System is the most common system used for robotic surgery today. This system is widely used in urology, gynecology and other surgical disciplines, and recently there have been initial reports of its use in spine surgery, for transoral access and anterior approaches for lumbar inter-body fusion interventions. SpineAssist, which is widely used in spine surgery, and Renaissance Robotic Systems, which are considered the next generation of robotic systems, are now FDA approved. These robotic systems are designed for use as guidance systems in spine instrumentation, cement augmentations and biopsies. The aim is to increase surgical accuracy while reducing the intra-operative exposure to harmful radiation to the patient and operating team personnel during the intervention. We offer a review of the published literature related to the use of robotic systems in spine surgery and provide information on using robotic systems.

  2. Improving the cleaning procedure to make kitchen floors less slippery.

    Quirion, F; Poirier, P; Lehane, P

    2008-12-01

    This investigation shows that, in most cases, the floor cleaning procedure of typical restaurants could be improved, resulting in a better cleaning efficiency and a better floor friction. This simple approach could help reduce slips and falls in the workplace. Food safety officers visited ten European style restaurants in the London Borough of Bromley (UK) to identify their floor cleaning procedure in terms of the cleaning method, the concentration and type of floor cleaner and the temperature of the wash water. For all 10 restaurants visited, the cleaning method was damp mopping. Degreasers were used in three sites while neutral floor cleaners were used in seven sites. Typically, the degreasers were over diluted and the neutrals were overdosed. The wash water temperature ranged from 10 to 72 degrees C. The on-site cleaning procedures were repeated in the laboratory for the removal of olive oil from new and sealed quarry tiles, fouled and worn quarry tiles and new porcelain tiles. It is found that in 24 out of 30 cases, cleaning efficiency can be improved by simple changes in the floor cleaning procedure and that these changes result in a significant improvement of the floor friction. The nature of the improved floor cleaning procedure depends on the flooring type. New and properly sealed flooring tiles can be cleaned using damp mopping with a degreaser diluted as recommended by the manufacturer in warm or hot water (24 to 50 degrees C). But as the tiles become worn and fouled, a more aggressive floor cleaning is required such as two-step mopping with a degreaser diluted as recommended by the manufacturer in warm water (24 degrees C).

  3. LEARNING ANATOMY WITH AUGMENTED REALITY

    Nørgaard, Cita; Dyhrberg O'Neill, Lotte; Nielsen, Kurt Gammelgaard

    An Augmented Reality (AR) app for Hololens glasses was developed to help students learn the anatomy of the human body mediastinum. In this research project, we wanted to evaluate whether AR: strengthened the students’ self-efficacy and motivation, helped students to improve learning, and provided...... a questionnaire regarding their self-efficacy and motivation, presence in the virtual room, experiences with Hololens teaching, and how they used the quizzes. In addition, students answered a test with the same 20 questions used in the app and three additional transfer questions new to students. Finally, students......’ scores on the mediastinum questions in the exam 2 month later were collected to examine the long-term memory of content. Internal consistency was estimated for all measures. Correlations between measures were examined with a correlation matrix, and group differences were examined with one-way analysis...

  4. Augmented reality in laser laboratories

    Quercioli, Franco

    2018-05-01

    Laser safety glasses block visibility of the laser light. This is a big nuisance when a clear view of the beam path is required. A headset made up of a smartphone and a viewer can overcome this problem. The user looks at the image of the real world on the cellphone display, captured by its rear camera. An unimpeded and safe sight of the laser beam is then achieved. If the infrared blocking filter of the smartphone camera is removed, the spectral sensitivity of the CMOS image sensor extends in the near infrared region up to 1100 nm. This substantial improvement widens the usability of the device to many laser systems for industrial and medical applications, which are located in this spectral region. The paper describes this modification of a phone camera to extend its sensitivity beyond the visible and make a true augmented reality laser viewer.

  5. Augmented reality for improved safety

    Stefania Pandolfi

    2016-01-01

    Sometimes, CERN experts have to operate in low visibility conditions or in the presence of possible hazards. Minimising the duration of the operation and reducing the risk of errors is therefore crucial to ensuring the safety of personnel. The EDUSAFE project integrates different technologies to create a wearable personnel safety system based on augmented reality.    The EDUSAFE integrated safety system uses a camera mounted on the helmet to monitor the working area.  In its everyday operation of machines and facilities, CERN adopts a whole set of measures and safety equipment to ensure the safety of its personnel, including personal wearable safety devices and access control systems. However, sometimes, scheduled and emergency maintenance work needs to be done in zones with potential cryogenic hazards, in the presence of radioactive equipment or simply in demanding conditions where visibility is low and moving around is difficult. The EDUSAFE Marie Curie Innovative&...

  6. Augmented Reality and Mobile Art

    Gwilt, Ian

    The combined notions of augmented-reality (AR) and mobile art are based on the amalgamation of a number of enabling technologies including computer imaging, emergent display and tracking systems and the increased computing-power in hand-held devices such as Tablet PCs, smart phones, or personal digital assistants (PDAs) which have been utilized in the making of works of art. There is much published research on the technical aspects of AR and the ongoing work being undertaken in the development of faster more efficient AR systems [1] [2]. In this text I intend to concentrate on how AR and its associated typologies can be applied in the context of new media art practices, with particular reference to its application on hand-held or mobile devices.

  7. LOFT Augmented Operator Capability Program

    Hollenbeck, D.A.; Krantz, E.A.; Hunt, G.L.; Meyer, O.R.

    1980-01-01

    The outline of the LOFT Augmented Operator Capability Program is presented. This program utilizes the LOFT (Loss-of-Fluid Test) reactor facility which is located at the Idaho National Engineering Laboratory and the LOFT operational transient experiment series as a test bed for methods of enhancing the reactor operator's capability for safer operation. The design of an Operational Diagnotics and Display System is presented which was backfit to the existing data acquisition computers. Basic color-graphic displays of the process schematic and trend type are presented. In addition, displays were developed and are presented which represent safety state vector information. A task analysis method was applied to LOFT reactor operating procedures to test its usefulness in defining the operator's information needs and workload

  8. Sensory augmentation for the blind

    Silke Manuela Kärcher

    2012-03-01

    Full Text Available Enacted theories of consciousness conjecture that perception and cognition arise from an active experience of the regular relations that are tying together the sensory stimulation of different modalities and associated motor actions. Previous experiments investigated this concept by employing the technique of sensory substitution. Building on these studies, here we test a set of hypotheses derived from this framework and investigate the utility of sensory augmentation in handicapped people. We provide a late blind subject with a new set of sensorimotor laws: A vibro-tactile belt continually signals the direction of magnetic north. The subject completed a set of behavioral tests before and after an extended training period. The tests were complemented by questionnaires and interviews. This newly supplied information improved performance on different time scales. In a pointing task we demonstrate an instant improvement of performance based on the signal provided by the device. Furthermore, the signal was helpful in relevant daily tasks, often complicated for the blind, such as keeping a direction over longer distances or taking shortcuts in familiar environments. A homing task with an additional attentional load demonstrated a significant improvement after training. The subject found the directional information highly expedient for the adjustment of his inner maps of familiar environments and describes an increase in his feeling of security when exploring unfamiliar environments with the belt. The results give evidence for a firm integration of the newly supplied signals into the behavior of this late blind subject with better navigational performance and more courageous behavior in unfamiliar environments. Most importantly, the complementary information provided by the belt lead to a positive emotional impact with enhanced feeling of security. This experimental approach demonstrates the potential of sensory augmentation devices for the help of

  9. Impact of supervised physiotherapeutic pelvic floor exercises for treating female stress urinary incontinence

    Míriam Raquel Diniz Zanetti

    Full Text Available CONTEXT AND OBJECTIVE: Urinary incontinence is a public health problem that affects more than 200 million people worldwide. Stress incontinence is the most prevalent type. Pelvic floor muscle exercises have been used for treating it, although there is no consensus regarding their application. The aim of this study was to compare the results from treating female stress urinary incontinence with pelvic floor muscle exercises with or without physiotherapist supervision. DESIGN AND SETTING: This was a randomized, prospective, controlled trial in the Urogynecology and Vaginal Surgery Sector, Universidade Federal de São Paulo. METHODS: Forty-four women were randomized to be treated for stress urinary incontinence with pelvic floor exercises for three consecutive months, into two groups: one with and the other without physiotherapist supervision. They were evaluated before and after treatment using a quality-of-life questionnaire, pad test, micturition diary and subjective evaluation. Descriptive analysis was used to evaluate the population. The homogeneity of the two groups was evaluated using the Kruskal-Wallis and Chi-squared tests. The success of the two groups after treatment was evaluated using the Wilcoxon test. RESULTS: The supervised group showed statistically greater improvement in the pad test, micturition diary and quality of life than did the control group. In the subjective evaluation, only 23.8% of the control group patients were satised with their treatment. In the supervised group, 66.8% of patients did not want any other treatment. CONCLUSION: Supervised pelvic floor muscle exercises presented better results in objective and subjective evaluations than did unsupervised exercises.

  10. An Integrative Introduction to Human Augmentation Science

    Alicea, Bradly

    2018-01-01

    Human Augmentation (HA) spans several technical fields and methodological approaches, including Experimental Psychology, Human-Computer Interaction, Psychophysiology, and Artificial Intelligence. Augmentation involves various strategies for optimizing and controlling cognitive states, which requires an understanding of biological plasticity, dynamic cognitive processes, and models of adaptive systems. As an instructive lesson, we will explore a few HA-related concepts and outstanding issues. ...

  11. Augmented REality Sandtables (ARESs) Impact on Learning

    2016-07-01

    ARL-CR-0803 ● JULY 2016 US Army Research Laboratory Augmented REality Sandtable’s (ARES’s) Impact on Learning by Tarah N......The use of augmented reality (AR) to supplement training tools, specifically sand tables, can produce highly effective systems at relatively low

  12. Augmented Reality Interfaces for Additive Manufacturing

    Eiríksson, Eyþór Rúnar; Pedersen, David Bue; Frisvad, Jeppe Revall

    2017-01-01

    This paper explores potential use cases for using augmented reality (AR) as a tool to operate industrial machines. As a baseline we use an additive manufacturing system, more commonly known as a 3D printer. We implement novel augmented interfaces and controls using readily available open source...

  13. Enhancing Education through Mobile Augmented Reality

    Joan, D. R. Robert

    2015-01-01

    In this article, the author has discussed about the Mobile Augmented Reality and enhancing education through it. The aim of the present study was to give some general information about mobile augmented reality which helps to boost education. Purpose of the current study reveals the mobile networks which are used in the institution campus as well…

  14. Age grouping to optimize augmentation success.

    Gordon, Robert W

    2010-05-01

    This article has described the different age groups that present for noninvasive injectable lip and perioral augmentation, as well as the breakdown of 3 subgroups that present within the 4 general age groups. With the fundamental understanding of these presenting groups and subgroups, the practicing augmenter will be able to better treatment plan and educate the patient on realistic and optimal aesthetic outcomes.

  15. From Augmentation Media to Meme Media.

    Tanaka, Yuzuru

    Computers as meta media are now evolving from augmentation media vehicles to meme media vehicles. While an augmentation media system provides a seamlessly integrated environment of various tools and documents, meme media system provides further functions to edit and distribute tools and documents. Documents and tools on meme media can easily…

  16. Cataract Surgery

    ... Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology ... Are Cataracts? Pediatric Cataracts Cataract Diagnosis and Treatment Cataract Surgery IOL Implants: Lens Replacement After Cataracts ...

  17. Brain surgery

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  18. Foot Surgery

    ... coding trends along with compliance guidelines and practice marketing materials, APMA has you covered whether you are ... crutches after the surgery or in a cast. Fusions: Fusions are usually performed to treat arthritic or ...

  19. Hemorrhoid surgery

    ... this page: //medlineplus.gov/ency/article/002939.htm Hemorrhoid surgery To use the sharing features on this page, please enable JavaScript. Hemorrhoids are swollen veins around the anus. They may ...

  20. PLASTIC SURGERY

    Department of Plastic and Reconstructive Surgery Sefako Makgatho Health Science University, ... We report on a pilot study on the use of a circumareolar excision and the use of .... and 1 gynecomastia patient) requested reduction in NAC size.

  1. GENERAL SURGERY

    influence medical students in pursuing a career in surgery. ... training, females reported significantly higher levels of agreement that surgical training would be better overseas when ..... mentoring surgical research or educational lectures and.

  2. GENERAL SURGERY

    1 Department of Surgery, Nelson R Mandela School of Medicine, University of ... in 51 reports. Four reports were illegible; one was conducted by a junior consultant, two by a fourth year trainee specialist ... The study period was 12 months from.

  3. Sinus Surgery

    ... sinus computed tomography (CT) scan (without contrast), nasal physiology (rhinomanometry and nasal cytology), smell testing, and selected ... altered anatomical landmarks, or where a patient’s sinus anatomy is very unusual, making typical surgery difficult. Image ...

  4. Experiences of incontinence and pelvic floor muscle training after gynaecologic cancer treatment.

    Lindgren, Anna; Dunberger, G; Enblom, A

    2017-01-01

    The purpose of the present study is to describe how gynaecological cancer survivors (GCS) experience incontinence in relation to quality of life, their possibilities for physical activity and exercise and their perceptions and experiences of pelvic floor muscle training. This qualitative interview content analysis study included 13 women (48-82 age) with urinary (n = 10) or faecal (n = 3) incontinence after radiation therapy (n = 2), surgery (n = 5) and surgery and radiation therapy (n = 6) for gynaecological cancer, 0.5-21 years ago. Symptoms related to incontinence and restrictions in daily activities reduced physical quality of life. Emotions related to incontinence reduced psychological quality of life and social and existential quality of life, due to restrictions in activity and feelings of exclusion. Practical and mental strategies for maintaining quality of life were described, such as always bringing a change of clothes and accepting the situation. Possibilities for sexual and physical activity as well as exercise were also restricted by incontinence. The women had little or no experience of pelvic floor muscle training but have a positive attitude towards trying it. They also described a lack of information about the risk of incontinence. The women were willing to spend both money and time on an effective treatment for their incontinence. Nine out of 10 were willing to spend at least 7 h a week. GCS experienced that incontinence reduced quality of life and limited possibilities for sexual and physical activity as well as exercise. Coping strategies, both practical and emotional, facilitated living with incontinence. The women had a positive attitude towards pelvic floor muscle training. Lack of information had a negative impact on their way of dealing with the situation.

  5. The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery.

    MacLennan, A H; Taylor, A W; Wilson, D H; Wilson, D

    2000-12-01

    To define the prevalence of pelvic floor disorders in a non-institutionalised community and to determine the relationship to gender, age, parity and mode of delivery. A representative population survey using the 1998 South Australian Health Omnibus Survey. Random selection of 4400 households; 3010 interviews were conducted in the respondents' homes by trained female interviewers. This cross sectional survey included men and women aged 15-97 years. The prevalence of all types of self-reported urinary incontinence in men was 4.4% and in women was 35.3% (Pparity and age. The highest prevalence (51.9%) was reported in women aged 70-74 years. The prevalence of flatus and faecal incontinence was 6.8% and 2.3% in men and 10.9% and 3.5% in women, respectively. Pregnancy (> 20 weeks), regardless of the mode of delivery, greatly increased the prevalence of major pelvic floor dysfunction, defined as any type of incontinence, symptoms of prolapse or previous pelvic floor surgery. Multivariate logistic regression showed that, compared with nulliparity, pelvic floor dysfunction was significantly associated with caesarean section (OR 2.5, 95% CI 1.5-4.3), spontaneous vaginal delivery (OR 3.4, 95% CI 2.4-4.9) and at least one instrumental delivery (OR 4.3, 95% CI 2.8-6.6). The difference between caesarean and instrumental delivery was significant (Pparity and were reported in 19.9% of men and 30.2% of women. Pelvic floor disorders are very common and are strongly associated with female gender, ageing, pregnancy, parity and instrumental delivery. Caesarean delivery is not associated with a significant reduction in long term pelvic floor morbidity compared with spontaneous vaginal delivery.

  6. Biomimetic implants for pelvic floor repair

    Vashaghian, Mahshid; Zaat, Sebastianus A. J.; Smit, Theodoor H.; Roovers, Jan-Paul

    2017-01-01

    Polypropylene implants are used for the reconstructive surgery of urogynaecological disorders like pelvic organ prolapse, but severe complications associated with their use have been reported. There is evidence that surface properties and a difference in mechanical stiffness between the implant and

  7. Emergency surgery

    Stoneham, M; Murray, D; Foss, N

    2014-01-01

    National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

  8. Pelvic floor dysfunction, and effects of pregnancy and mode of delivery on pelvic floor

    Murat Bozkurt

    2014-12-01

    Full Text Available Pelvic floor dysfunction (PFD, although seems to be simple, is a complex process that develops secondary to multifactorial factors. The incidence of PFD is increasing with increasing life expectancy. PFD is a term that refers to a broad range of clinical scenarios, including lower urinary tract excretory and defecation disorders, such as urinary and anal incontinence, overactive bladder, and pelvic organ prolapse, as well as sexual disorders. It is a financial burden on the health care system and disrupts women's quality of life. Strategies applied to decrease PFD are focused on the course of pregnancy, mode and management of delivery, and pelvic exercise methods. Many studies in the literature define traumatic birth, usage of forceps, length of the second stage of delivery, and sphincter damage as modifiable risk factors for PFD. Maternal age, fetal position, and fetal head circumference are nonmodifiable risk factors. Although numerous studies show that vaginal delivery affects pelvic floor structures and their functions in a negative way, there is not enough scientific evidence to recommend elective cesarean delivery in order to prevent development of PFD. PFD is a heterogeneous pathological condition, and the effects of pregnancy, vaginal delivery, cesarean delivery, and possible risk factors of PFD may be different from each other. Observational studies have identified certain obstetrical exposures as risk factors for pelvic floor disorders. These factors often coexist; therefore, the isolated effects of these variables on the pelvic floor are difficult to study. The routine use of episiotomy for many years in order to prevent PFD is not recommended anymore; episiotomy should be used in selected cases, and the mediolateral procedures should be used if needed.

  9. Aspects of User Experience in Augmented Reality

    Madsen, Jacob Boesen

    in human factors related to Augmented Reality. This is investigated partly as how Augmented Reality applications are used in unsupervised settings, and partly in specific evaluations related to user performance in supervised settings. The thesis starts by introducing Augmented Reality to the reader......, followed by a presentation of the technical areas related to the field, and different human factor areas. As a contribution to the research area, this thesis presents five separate, but sequential, papers within the area of Augmented Reality.......In Augmented Reality applications, the real environment is annotated or enhanced with computer-generated graphics. This is a topic that has been researched in the recent decades, but for many people this is a brand new and never heard of topic. The main focus of this thesis is investigations...

  10. Novel Augmentation Strategies in Major Depression

    Martiny, Klaus

    2017-01-01

    Hypothesis The hypotheses of all the four included studies share the common idea that it is possible to augment the effect of antidepressant drug treatment by applying different interventions and with each intervention attain a clinically meaningful better effect compared to a control condition...... and randomised to augmentation with either active or placebo matching pindolol tablets. In the PEMF study patients were continued on ongoing medication and randomised to augmentation with active or inactive (sham) 30 minutes daily PEMF treatment on weekdays. In the Chronos study all patients were treated...... The results from the Pindolol study showed that pindolol did not augment the effect of venlafaxine for the whole sample. However, for those patients classified as slow metabolizers, based on their O-desmethylvenlafaxine/venlafaxine ratio (ODV/V), pindolol did augment the antidepressant effect. For patients...

  11. Performance of a self-augmented railgun

    Burton, R.L.; Witherspoon, F.D.; Goldstein, S.A.

    1991-01-01

    The accelerating force of a railgun 1/2L'I 2 a can be increased by augmenting the self-induced magnetic field created by the armature current. Augmentation fields can be produced by external current coils or, as is done here, by shorting the railgun muzzle, and using the gun rails as the augmentation coil. Experimental results are presented for a 3.6-m railgun operated in this self-augmented mode, and effective inductance gradients are achieved which are as much as 9.3 times that of the unaugmented gun. A circuit model is presented which explains features of the measured shunt current and voltage. It is concluded that self-augmentation is an effective way to reduce ohmic heating in the armature of a railgun

  12. 49 CFR 38.99 - Floors, steps and thresholds.

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Floors, steps and thresholds. 38.99 Section 38.99 Transportation Office of the Secretary of Transportation AMERICANS WITH DISABILITIES ACT (ADA) ACCESSIBILITY SPECIFICATIONS FOR TRANSPORTATION VEHICLES Commuter Rail Cars and Systems § 38.99 Floors, steps and thresholds...

  13. The architectural foundations for agent-based shop floor control

    Langer, Gilad; Bilberg, Arne

    1998-01-01

    simulation and cell controlenabling technologies. In order to continuethis research effortnew concepts and theories for shop floor control are investigated.This paper reviews the multi-agent concept aimed at investigatingits potential use in shop floor control systems. The paper willalso include a survey...

  14. Short communication: Flooring preferences of dairy cows at calving.

    Campler, M; Munksgaard, L; Jensen, M B; Weary, D M; von Keyserlingk, M A G

    2014-02-01

    The present study investigated the flooring preference during the 30 h before parturition in Holstein dairy cows housed individually in a maternity pen. Seventeen multiparous cows were moved, on average, 2 d before expected calving date into an individual maternity pen with 3 different flooring surfaces: 10 cm of sand, pebble-top rubber mats, or concrete flooring, each covered with 15 cm of straw. Calving location, lying time, and total time and number of lying bouts on each of the floor types were recorded during 2 periods: precalving (24 to 29 h before calving) and at calving (0 to 5h before calving). Ten cows calved on sand, 6 on concrete, and 1 on the rubber mat. Lying bouts increased during the hours closest to calving, regardless of flooring. The number of lying bouts did not differ between flooring types precalving but cows had more lying bouts on sand and concrete compared with rubber at calving. Cows spent more time lying down on sand and concrete compared with rubber precalving, but lying times did not differ between treatments at calving. Cows that calved on sand spent more time lying on sand at calving compared with the other 2 flooring types. Cows that calved on concrete did not show a flooring preference at calving. These results indicate that rubber mats are the least preferred by dairy cows in the maternity pens, even when covered with a deep layer of straw. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

  15. Rubber Flooring Impact on Production and Herdlife of Dairy Cows

    Use of rubber flooring in dairies has become popular because of perceived cow comfort. The overall objective of this longitudinal study was to evaluate production, reproduction, and retention of first and second lactations of cows assigned to either rubber (RUB) or concrete (CON) flooring at the fe...

  16. A Method of Assembling Wall or Floor Elements

    2002-01-01

    The invention relates to a method of constructing, at the site of use, a building wall (1) or a building floor (1) using a plurality of prefabricated concrete or lightweight concrete plate-shaped wall of floor elements (10), in particular cast elements, which have a front side and a rear side...

  17. 17 CFR 155.2 - Trading standards for floor brokers.

    2010-04-01

    ... 17 Commodity and Securities Exchanges 1 2010-04-01 2010-04-01 false Trading standards for floor brokers. 155.2 Section 155.2 Commodity and Securities Exchanges COMMODITY FUTURES TRADING COMMISSION TRADING STANDARDS § 155.2 Trading standards for floor brokers. Each contract market shall adopt and submit...

  18. Experimental Verification of an Instrument to Test Flooring Materials

    Philip, Rony; Löfgren, Hans, Dr

    2018-02-01

    The focus of this work is to validate the fluid model with different flooring materials and the measurements of an instrument to test flooring materials and its force attenuating capabilities using mathematical models to describe the signature and coefficients of the floor. The main contribution of the present work focus on the development of a mathematical fluid model for floors. The aim of the thesis was to analyze, compare different floor materials and to study the linear dynamics of falling impacts on floors. The impact of the hammer during a fall is captured by an accelerometer and response is collected using a picoscope. The collected data was analyzed using matlab least square method which is coded as per the fluid model. The finding from this thesis showed that the fluid model works with more elastic model but it doesn’t work for rigid materials like wood. The importance of parameters like velocity, mass, energy loss and other coefficients of floor which influences the model during the impact of falling on floors were identified and a standardized testing method was set.

  19. 76 FR 7098 - Dealer Floor Plan Pilot Program

    2011-02-09

    ... Plan Pilot Program AGENCY: U.S. Small Business Administration (SBA). ACTION: Program implementation with request for comments. SUMMARY: SBA is introducing a new Dealer Floor Plan Pilot Program to make... Plan Pilot Program was created in the Small Business Jobs Act of 2010. Under the new Dealer Floor Plan...

  20. Total Strain FE Model for Reinforced Concrete Floors on Piles

    Hofmeyer, H.; Bos, van den A.A.

    2008-01-01

    A finite element (FE) model using a total strain material model has been developed to predict the behavior of warehouse reinforced concrete floors on piles. The material model (not the FE model itself) was calibrated to material tests. The FE model for the floor structure was checked with full-scale

  1. 27 CFR 46.195 - Floor stocks requirements.

    2010-04-01

    ... Tubes Held for Sale on April 1, 2009 General § 46.195 Floor stocks requirements. (a) Take inventory. The dealer must establish the quantity of articles subject to the floor stocks tax held for sale on April 1, 2009. The dealer may take a physical inventory or may use a record (book) inventory, as specified in...

  2. Motor cortical representation of the pelvic floor muscles.

    Schrum, A; Wolff, S; van der Horst, C; Kuhtz-Buschbeck, J P

    2011-07-01

    Pelvic floor muscle training involves rhythmical voluntary contractions of the external urethral sphincter and ancillary pelvic floor muscles. The representation of these muscles in the motor cortex has not been located precisely and unambiguously. We used functional magnetic resonance imaging to determine brain activity during slow and fast pelvic floor contractions. Cerebral responses were recorded in 17 healthy male volunteers, 21 to 47 years old, with normal bladder control. Functional magnetic resonance imaging was performed during metronome paced slow (0.25 Hertz) and fast (0.7 Hertz) contractions of the pelvic floor that mimicked the interruption of voiding. To study the somatotopy of the cortical representations, flexion-extension movements of the right toes were performed as a control task. Functional magnetic resonance imaging during pelvic floor contractions detected activity of the supplementary motor area in the medial wall and of the midcingulate cortex, insula, posterior parietal cortex, putamen, thalamus, cerebellar vermis and upper ventral pons. There were no significant differences in activation between slow and fast contractions. Toe movements involved significantly stronger activity of the paracentral lobule (ie the medial primary motor cortex) than did the pelvic floor contractions. Otherwise the areas active during pelvic floor and leg muscle contractions overlapped considerably. The motor cortical representation of pelvic floor muscles is located mostly in the supplementary motor area. It extends further ventrally and anteriorly than the representation of distal leg muscles. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  3. Nondestructive structural evaluation of wood floor systems with a vibration technique.

    Xiping Wang; Robert J. Ross; Lawrence Andrew Soltis

    2002-01-01

    The objective of this study was to determine if transverse vibration methods could be used to effectively assess the structural integrity of wood floors as component systems. A total of 10 wood floor systems, including 3 laboratory-built floor sections and 7 in-place floors in historic buildings, were tested. A forced vibration method was applied to the floor systems...

  4. Recognition and Management of Nonrelaxing Pelvic Floor Dysfunction

    Faubion, Stephanie S.; Shuster, Lynne T.; Bharucha, Adil E.

    2012-01-01

    Nonrelaxing pelvic floor dysfunction is not widely recognized. Unlike in pelvic floor disorders caused by relaxed muscles (eg, pelvic organ prolapse or urinary incontinence, both of which often are identified readily), women affected by nonrelaxing pelvic floor dysfunction may present with a broad range of nonspecific symptoms. These may include pain and problems with defecation, urination, and sexual function, which require relaxation and coordination of pelvic floor muscles and urinary and anal sphincters. These symptoms may adversely affect quality of life. Focus on the global symptom complex, rather than the individual symptoms, may help the clinician identify the condition. The primary care provider is in a position to intervene early, efficiently, and effectively by (1) recognizing the range of symptoms that might suggest nonrelaxing pelvic floor dysfunction, (2) educating patients, (3) performing selective tests when needed to confirm the diagnosis, and (4) providing early referral for physical therapy. PMID:22305030

  5. Indoor radon seasonal variability at different floors of buildings

    De Francesco, S.; Tommasone, F. Pascale; Cuoco, E.; Tedesco, D.

    2010-01-01

    Indoor radon concentrations have been measured with the α track etch integrated method in public buildings in the town of Pietramelara, north-western Campania, Southern Italy. In particular, our measurements were part of an environmental monitoring program originally aimed at assessing the range of seasonal fluctuations in indoor radon concentrations, at various floors of the studied buildings. However, subsequent analysis of the data and its comparison with the meteorological data recorded in the same period has shown an unexpected pattern at the different floors. In this report we present data suggesting that, besides the well-known medium and longterm periodicity, there could also be a differentiation in major meteorological controlling factors at the different floors of the buildings, a fact that does not appear to have been reported previously. While the lower floors proved to be markedly affected by rainfall, for the upper floors, instead, a different behaviour has been detected, which could possibly be related to global solar radiation.

  6. Historical Cavern Floor Rise for All SPR Sites

    Moriarty, Dylan Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-09-01

    The Strategic Petroleum Reserve (SPR) contains the largest supply is the largest stockpile of government-owned emergency crude oil in the world. The oil is stored in multiple salt caverns spread over four sites in Louisiana and Texas. Cavern infrastructure near the bottom of the cavern can be damaged from vertical floor movement. This report presents a comprehensive history of floor movements in each cavern. Most of the cavern floor rise rates ranged from 0.5-3.5 ft/yr, however, there were several caverns with much higher rise rates. BH103, BM106, and BH105 had the three highest rise rates. Information from this report will be used to better predict future vertical floor movements and optimally place cavern infrastructure. The reasons for floor rise are not entirely understood and should be investigated.

  7. A Radiologic Study of the Relationship of the Maxillary Sinus Floor and Apex of the Maxillary Molar

    Yoon, Hae Rym; Park, Chang Seo

    1998-01-01

    In this study, radiographic evaluation was made using panoramic radiography and cross-sectional tomography of SCANORA in male and female adults in their 20 s on the relationship between the maxillary sinus floor and the apex of the maxillary molar, to test the accuracy and effectiveness of the cross-sectional tomography, and to use this information in the assessment of preop, and postop, root canal treatment, apical surgery, extraction and implantology. Forty-one adults with an average age of 24.4 years were studied panoramic radiography and cross-sectional tomography. In panoramic view and cross-sectional view, the position of the apices of maxillary molars were classified as separated, contacted, or protruded type; the general shape of the maxillary sinus floor was evaluated horizontally and vertically from cross-sectional tomography. The accuracy of each radiography was tested using maxilla from 5 fresh cadavers from the Anatomy Lab at Yonsei University Dental College, and panoramic view and cross-sectional tomography were taken in the same condition as with the patients. The results were as follows ; 1. Panoramic view and cross-sectional view were taken in the maxilla specimen, and the actual distance between the maxillary sinus floor and the tooth apices were measured in the specimen; the median values of the distance from the tooth apices to the maxillary sinus floor in the panoramic view, cross-sectional view and in the accrual maxilla specimen were 2.83 mm, 4.51 mm, and 4.15 mm, respectively. In the cross-sectional view, the measured distance was close to the actual distance but in the panoramic view, the measured distance was far from the actual distance. 2. When the results of the panoramic view and cross-sectional view were compared, 40.5% of the results agreed with each other in the two radiographic methods and buccal roots of the 2nd molar were the closest to the maxillary sinus floor in the cross-sectional tomography.3. In cross-sectional view, when

  8. Tennis elbow surgery

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is often an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

  9. Corrective Jaw Surgery

    Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

  10. Mohs micrographic surgery

    Skin cancer - Mohs surgery; Basal cell skin cancer - Mohs surgery; Squamous cell skin cancer - Mohs surgery ... Mohs surgery usually takes place in the doctor's office. The surgery is started early in the morning and is ...

  11. Results of cement augmentation and curettage in aneurysmal bone cyst of spine

    Saumyajit Basu

    2016-01-01

    Full Text Available Aneurysmal bone cyst (ABC is a vascular tumor of the spine. Management of spinal ABC still remains controversial because of its location, vascular nature and incidence of recurrence. In this manuscript, we hereby describe two cases of ABC spine treated by curettage, vertebral cement augmentation for control of bleeding and internal stabilization with two years followup. To the best of our knowledge, this is the first case report in the literature describing the role of cement augmentation in spinal ABC in controlling vascular bleeding in curettage of ABC of spine. Case 1: A 22 year old male patient presented with chronic back pain. On radiological investigation, there were multiple, osteolytic septite lesions at L3 vertebral body without neural compression or instability. Percutaneous transpedicular biopsy of L3 from involved pedicle was done. This was followed by cement augmentation through the uninvolved pedicle. Next, transpedicular complete curettage was done through involved pedicle. Case 2: A 15-year-old female presented with nonradiating back pain and progressive myelopathy. On radiological investigation, there was an osteolytic lesion at D9. At surgery, decompression, pedicle screw-rod fixation and posterolateral fusion from D7 to D11 was done. At D9 level, through normal pedicle cement augmentation was added to provide anterior column support and to control the expected bleeding following curettage. Transpedicular complete curettage was done through the involved pedicle with controlled bleeding at the surgical field. Cement augmentation was providing controlled bleeding at surgical field during curettage, internal stabilization and control of pain. On 2 years followup, pain was relieved and there was a stable spinal segment with well filled cement without any sign of recurrence in computed tomography scan. In selected cases of spinal ABC with single vertebral, single pedicle involvement; cement augmentation of vertebra through normal

  12. Do women with pelvic floor dysfunction referred by gynaecologists and urologists at hospitals complete a pelvic floor muscle training programme?

    Tibaek, Sigrid; Dehlendorff, Christian

    2013-01-01

    For decades women with pelvic floor dysfunction (PFD) have been referred to pelvic floor muscle training (PFMT), but there is only little information on whether the women complete the programmes and why. The objectives of this study were to investigate to which extent women completed a PFMT...

  13. Pelvic floor muscle training as a persistent nursing intervention: Effect on delivery outcome and pelvic floor myodynamia

    Xin Wang

    2014-03-01

    Conclusion: Persistent nursing intervention for pregnant/postpartum women helped to shorten the second stage of labour and contributed to the recovery of postpartum pelvic floor myodynamia. The influence of this intervention on the delivery mode, and rates of episiotomy and perineal laceration remains unknown. Medical staff should strengthen health education programmes that involve pelvic floor functional rehabilitation.

  14. Augmented reality-based navigation system for wrist arthroscopy: feasibility.

    Zemirline, Ahmed; Agnus, Vincent; Soler, Luc; Mathoulin, Christophe L; Obdeijn, Miryam; Liverneaux, Philippe A

    2013-11-01

    In video surgery, and more specifically in arthroscopy, one of the major problems is positioning the camera and instruments within the anatomic environment. The concept of computer-guided video surgery has already been used in ear, nose, and throat (ENT), gynecology, and even in hip arthroscopy. These systems, however, rely on optical or mechanical sensors, which turn out to be restricting and cumbersome. The aim of our study was to develop and evaluate the accuracy of a navigation system based on electromagnetic sensors in video surgery. We used an electromagnetic localization device (Aurora, Northern Digital Inc., Ontario, Canada) to track the movements in space of both the camera and the instruments. We have developed a dedicated application in the Python language, using the VTK library for the graphic display and the OpenCV library for camera calibration. A prototype has been designed and evaluated for wrist arthroscopy. It allows display of the theoretical position of instruments onto the arthroscopic view with useful accuracy. The augmented reality view represents valuable assistance when surgeons want to position the arthroscope or locate their instruments. It makes the maneuver more intuitive, increases comfort, saves time, and enhances concentration.

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

    Abd Rani Samsudin; Meor Zaidi Meor Kamal

    1999-01-01

    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

  16. [CSE vs. augmented epidural anesthesia for cesarean section. Spinal and epidural anesthesia with bupivacaine 0.5% "isobar" require augmentation].

    Halter, F; Niesel, H C; Gladrow, W; Kaiser, H

    1998-09-01

    Incomplete anaesthesia is a major clinical problem both in single spinal and in single epidural anaesthesia. The clinical efficacy of epidural anaesthesia with augmentation (aEA) and combined epidural and spinal anesthesia (CSE) for cesarean section was investigated in a prospective randomized study on 45 patients. Anaesthesia extending up to Th5 was aimed for. Depending on the patient's height, epidural anaesthesia was administered with a dose of 18-22 ml 0.5% bupivacaine and spinal anaesthesia with a dose of 11-15 mg 0.5% bupivacaine. Augmentation was carried out in all cases in epidural anaesthesia, initially with 7.5 ml 1% Lidocaine with epinephrine 1:400,000, raised by 1.5 ml per missing segment. The epidural reinjection in CSE was carried out as necessary with 9.5-15 ml 1% lidocaine with epinephrine, depending on the height and difference from the segment Th5. The extension of anaesthesia achieved in epidural anaesthesia after an initial dose of 101.8 mg bupivacaine and augmenting dose of 99 mg lidocaine reached the segment Th5. The primary spinal anaesthesia dose up to 15 mg corresponding to height led to a segmental extension to a maximum of Th3 under CSE. Augmentation was necessary in 13 patients; in 5 cases because of inadequate extent of anaesthesia and 8 cases because of pain resulting from premature reversion. The augmenting dose required was 13.9 ml. Readiness for operation was attained after 19.8 min (aEA) and after 10.5 min (CSE). No patient required analgesics before delivery. The additional analgesic requirement during operation was 63.6% (aEA) and 39.1% (CSE). Taking into account pain in the area of surgery, the requirement of analgesics was 50% (aEA) vs. 17.4% (CSE). Antiemetics were required in 18.2 (aEA) and in 65.2% (CSE). The systolic blood pressure fell by 17.7% (aEA) and in 30.3% (CSE). The minimum systolic pressure was observed after 13.4 min in aEA, and after 9.5 min in CSE. The APGAR score and the umbilical pH did not show any

  17. Augmentation with a reinforced acellular fascia lata strip graft limits cyclic gapping of supraspinatus repairs in a human cadaveric model.

    Milks, Ryan A; Kolmodin, Joel D; Ricchetti, Eric T; Iannotti, Joseph P; Derwin, Kathleen A

    2018-06-01

    A reinforced biologic strip graft was designed to mechanically augment the repair of rotator cuff tears that are fully reparable by arthroscopic techniques yet have a likelihood of failure. This study assessed the extent to which augmentation of human supraspinatus repairs with a reinforced fascia strip can reduce gap formation during in vitro cyclic loading. The supraspinatus tendon was sharply released from the proximal humerus and repaired back to its insertion with anchors in 9 matched pairs of human cadaveric shoulders. One repair from each pair was also augmented with a reinforced fascia strip. All repairs were subjected to cyclic mechanical loading of 5 to 180 N for 1000 cycles. All augmented and nonaugmented repair constructs completed 1000 cycles of loading. Augmentation with a reinforced fascia strip graft significantly decreased the amount of gap formation compared with nonaugmented repairs. The average gap formation of augmented repairs was 1.5 ± 0.7 mm after the first cycle vs. 3.0 ± 1.2 mm for nonaugmented repairs (P = .003) and 5.0 ± 1.5 mm after 1000 cycles of loading, which averaged 24% ± 21% less than the gap formation of nonaugmented repairs (7.0 ± 2.8 mm, P = .014). Cadaveric human supraspinatus repairs augmented with a reinforced fascia strip have significantly less initial stroke elongation and gap formation than repairs without augmentation. Augmentation limited gap formation to the greatest extent early in the testing protocol. Human studies are necessary to confirm the appropriate indications and effectiveness of augmentation scaffolds for rotator cuff repair healing in the clinical setting. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  18. New ways of visualization in laparoscopic surgery

    Bartłomiej Grobelski

    2010-09-01

    Full Text Available Scientific achievements enabled tremendous progress of surgical minimally invasive methods in the 20th century.Laparoscopy and endoscopy became everyday diagnostic and therapeutic tools of modern medicine. Despite itsirrefutable opportunities and advantages, classical minimally invasive surgery still has substantial limitations. Theseinclude: two-dimensional visualization without depth, a small field of view, and the necessity of precise hand-eyecoordination. That is why pressure is placed on manufacturers of endoscopic devices to surmount these technicalobstacles. To write this paper we searched databases for articles on new means of visualization in laparoscopicsurgery. We discuss augmented reality, three-dimensional vision and image-guided surgery.

  19. Invisible waves and hidden realms: augmented reality and experimental art

    Ruzanka, Silvia

    2012-03-01

    Augmented reality is way of both altering the visible and revealing the invisible. It offers new opportunities for artistic exploration through virtual interventions in real space. In this paper, the author describes the implementation of two art installations using different AR technologies, one using optical marker tracking on mobile devices and one integrating stereoscopic projections into the physical environment. The first artwork, De Ondas y Abejas (The Waves and the Bees), is based on the widely publicized (but unproven) hypothesis of a link between cellphone radiation and the phenomenon of bee colony collapse disorder. Using an Android tablet, viewers search out small fiducial markers in the shape of electromagnetic waves hidden throughout the gallery, which reveal swarms of bees scattered on the floor. The piece also creates a generative soundscape based on electromagnetic fields. The second artwork, Urban Fauna, is a series of animations in which features of the urban landscape become plants and animals. Surveillance cameras become flocks of birds while miniature cellphone towers, lampposts, and telephone poles grow like small seedlings in time-lapse animation. The animations are presented as small stereoscopic projections, integrated into the physical space of the gallery. These two pieces explore the relationship between nature and technology through the visualization of invisible forces and hidden alternate realities.

  20. Digital Augmented Reality Audio Headset

    Jussi Rämö

    2012-01-01

    Full Text Available Augmented reality audio (ARA combines virtual sound sources with the real sonic environment of the user. An ARA system can be realized with a headset containing binaural microphones. Ideally, the ARA headset should be acoustically transparent, that is, it should not cause audible modification to the surrounding sound. A practical implementation of an ARA mixer requires a low-latency headphone reproduction system with additional equalization to compensate for the attenuation and the modified ear canal resonances caused by the headphones. This paper proposes digital IIR filters to realize the required equalization and evaluates a real-time prototype ARA system. Measurements show that the throughput latency of the digital prototype ARA system can be less than 1.4 ms, which is sufficiently small in practice. When the direct and processed sounds are combined in the ear, a comb filtering effect is brought about and appears as notches in the frequency response. The comb filter effect in speech and music signals was studied in a listening test and it was found to be inaudible when the attenuation is 20 dB. Insert ARA headphones have a sufficient attenuation at frequencies above about 1 kHz. The proposed digital ARA system enables several immersive audio applications, such as a virtual audio tourist guide and audio teleconferencing.