Sample records for real surgical instruments

  1. Real-time localization of articulated surgical instruments in retinal microsurgery.

    Rieke, Nicola; Tan, David Joseph; Amat di San Filippo, Chiara; Tombari, Federico; Alsheakhali, Mohamed; Belagiannis, Vasileios; Eslami, Abouzar; Navab, Nassir


    Real-time visual tracking of a surgical instrument holds great potential for improving the outcome of retinal microsurgery by enabling new possibilities for computer-aided techniques such as augmented reality and automatic assessment of instrument manipulation. Due to high magnification and illumination variations, retinal microsurgery images usually entail a high level of noise and appearance changes. As a result, real-time tracking of the surgical instrument remains challenging in in-vivo sequences. To overcome these problems, we present a method that builds on random forests and addresses the task by modelling the instrument as an articulated object. A multi-template tracker reduces the region of interest to a rectangular area around the instrument tip by relating the movement of the instrument to the induced changes on the image intensities. Within this bounding box, a gradient-based pose estimation infers the location of the instrument parts from image features. In this way, the algorithm does not only provide the location of instrument, but also the positions of the tool tips in real-time. Various experiments on a novel dataset comprising 18 in-vivo retinal microsurgery sequences demonstrate the robustness and generalizability of our method. The comparison on two publicly available datasets indicates that the algorithm can outperform current state-of-the art. Copyright © 2016. Published by Elsevier B.V.

  2. Passive markers for tracking surgical instruments in real-time 3-D ultrasound imaging.

    Stoll, Jeffrey; Ren, Hongliang; Dupont, Pierre E


    A family of passive echogenic markers is presented by which the position and orientation of a surgical instrument can be determined in a 3-D ultrasound volume, using simple image processing. Markers are attached near the distal end of the instrument so that they appear in the ultrasound volume along with the instrument tip. They are detected and measured within the ultrasound image, thus requiring no external tracking device. This approach facilitates imaging instruments and tissue simultaneously in ultrasound-guided interventions. Marker-based estimates of instrument pose can be used in augmented reality displays or for image-based servoing. Design principles for marker shapes are presented that ensure imaging system and measurement uniqueness constraints are met. An error analysis is included that can be used to guide marker design and which also establishes a lower bound on measurement uncertainty. Finally, examples of marker measurement and tracking algorithms are presented along with experimental validation of the concepts.

  3. Manual of Surgical Instruments

    Olga Lidia Sánchez Sarría


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

  4. Intraoperative optical coherence tomography using an optimized reflective optical relay, real-time heads-up display, and semitransparent surgical instrumentation

    Tao, Yuankai K.; El-Haddad, Mohamed T.; Srivastava, Sunil K.; Feiler, Daniel; Noonan, Amanda I.; Rollins, Andrew M.; Ehlers, Justis P.


    Ophthalmic surgical maneuvers are currently limited by the ability of surgeons to visualize and manipulate semitransparent tissue layers as thin as tens of microns. We describe several iterative advances in iOCT technology, including a novel iOCT system, real-time heads-up display (HUD) feedback, visualization of intraoperative maneuvers, and OCT-compatible surgical instrumentation. Simulated surgical maneuvers were performed on freshly enucleated porcine eyes. Subretinal space cannulation with injection was performed and imaged using spatial compounding. The optical properties of semitransparent materials were quantified to identify OCT-compatible substrates, and surgical instrument prototypes were machined, including corneal, surgical picks, and retinal forceps.

  5. Endotoxins in surgical instruments of hip arthroplasty

    Vania Regina Goveia


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

  6. Dermatologic Surgical Instruments: A History and Review.

    Gandhi, Sumul A; Kampp, Jeremy T


    Dermatologic surgery requires precision and accuracy given the delicate nature of procedures performed. The use of the most appropriate instrument for each action helps optimize both functionality and cosmetic outcome. To review the history of surgical instruments used in dermatology, with a focus on mechanism and evolution to the instruments that are used in current practice. A comprehensive literature search was conducted via textbook and journal research for historic references while review of current references was conducted online using multiple search engines and PubMed. There are a number of articles that review instruments in dermatology, but this article adds a unique perspective in classifying their evolution, while also presenting them as levers that serve to increase human dexterity during the course of surgery. Surgical instruments allow fine manipulation of tissue, which in turn produces optimal outcomes. Surgical tools have been around since the dawn of man, and their evolution parallels the extent to which human civilization has specialized over time. This article describes the evolution of instruments from the general surgical armamentaria to the specialized tools that are used today.

  7. 21 CFR 888.4540 - Orthopedic manual surgical instrument.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Orthopedic manual surgical instrument. 888.4540... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.4540 Orthopedic manual surgical instrument. (a) Identification. An orthopedic manual surgical instrument is a nonpowered hand-held...

  8. 21 CFR 886.4350 - Manual ophthalmic surgical instrument.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual ophthalmic surgical instrument. 886.4350... (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4350 Manual ophthalmic surgical instrument. (a) Identification. A manual ophthalmic surgical instrument is a nonpowered, handheld...



    Objective. To observe the clinical outcomes of using a new instrumentation SOCON system in the treatment of degenerative spondylolisthesis.Methods. Retrospective clinical and roentgenograph review of 21 patients who suffered from degenerative spondylolisthesis with spinal stenosis treated by decompression, posterolateral intertransverse arthrodesis, and with transpedicle instrumentation of SOCON system.Results. Nineteen of 21 patients were completely recovery from their preoperative symptoms, 17 of 18 cases with grade one slippage reduced to normal spine alignment, 2 cases of grade two slippage fully reduced, and one case of grade two spondylolisthesis got 70% reduction. Post- operative satisfactory rate was 90.5%. Pain relief was 90.5%. Neither infection nor neurologic complication occurred in this series.Conclusion. Our short time follow-up and limited cases showed satisfactory preliminary result of surgical treatment of spondylolisthesis with SOCON instrumentation.

  10. Electrical Bioimpedance-Controlled Surgical Instrumentation.

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


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


    金今; 沈建雄; 邱贵兴; 赵宏; 翁习生; 王以朋


    Objective. To observe the clinical outcomes of using a new imtnunentafion SOCON system in the treatment of degenerative spondylolisthesis. Methods. Retrospective clinical and roentgenograph review of 21 patients who suffered from degenerative spondylolisthesis with spinal stenosis treated by decompression, posterolateral intertransverse arthrodesis, and with transpedicle instrumentation of SOCON system. Results. Nineteen of 21 patients were completely recovery from their preoperative symptoms, 17 of 18 cases with grade one slippage reduced to normal spine alignment, 2 cases of grade two slippage fully reduced, and one case of grade two spondylolisthesis got 70% reduction. Post-operative satisfactory rate was 90.5%. Pain relief was 90.5%.Neither infection nor neurologic complication occurred in this series. Conclusion. Our short time follow-up and limited cases showed satisfactory preliminary result of surgical treatment of spondylolisthesis with SOCON instrumentation.

  12. Endotoxins in surgical instruments of hip arthroplasty.

    Goveia, Vania Regina; Mendoza, Isabel Yovana Quispe; Guimarães, Gilberto Lima; Ercole, Flavia Falci; Couto, Bráulio Roberto Gonçalves Marinho; Leite, Edna Marilea Meireles; Stoianoff, Maria Aparecida Resende; Ferreira, José Antonio Guimarães


    To investigate endotoxins in sterilized surgical instruments used in hip arthroplasties. A descriptive exploratory study conducted in a public teaching hospital. Six types of surgical instruments were selected, namely: acetabulum rasp, femoral rasp, femoral head remover, chisel box, flexible bone reamer and femoral head test. The selection was based on the analysis of the difficulty in removing bone and blood residues during cleaning. The sample was made up of 60 surgical instruments, which were tested for endotoxins in three different stages. The EndosafeTM Gel-Clot LAL (Limulus Amebocyte Lysate method) was used. There was consistent gel formation with positive analysis in eight instruments, corresponding to 13.3%, being four femoral rasps and four bone reamers. Endotoxins in quantity ≥0.125 UE/mL were detected in 13.3% of the instruments tested. Investigar endotoxinas em instrumentais cirúrgicos esterilizados empregados em artroplastias do quadril. Estudo exploratório, descritivo, desenvolvido em um hospital público de ensino. Foram selecionados seis tipos de instrumentais, a saber: raspa acetabular, raspa femural, saca-cabeça de fêmur, formão box, fresa de fêmur e cabeça de prova de fêmur. A seleção foi feita a partir da análise da dificuldade para a remoção de resíduos de sangue e osso durante a limpeza. A amostra foi constituída por 60 instrumentais cirúrgicos, que foram testados para endotoxinas em três momentos distintos. Foi utilizado o método de gel-clot pelo Limulus Amebócito Lisado (LAL) Endosafe(tm). Houve formação de gel consistente com análise positiva em oito instrumentais, o que corresponde a 13,3%, sendo quatro raspas de fêmur e quatro fresas de fêmur. Foram detectadas endotoxinas em quantidade ≥0,125 UE/mL em 13,3% dos instrumentais testados.

  13. Bacterial migration through punctured surgical gloves under real surgical conditions

    Heidecke Claus-Dieter


    Full Text Available Abstract Background The aim of this study was to confirm recent results from a previous study focussing on the development of a method to measure the bacterial translocation through puncture holes in surgical gloves under real surgical conditions. Methods An established method was applied to detect bacterial migration from the operating site through the punctured glove. Biogel™ double-gloving surgical gloves were used during visceral surgeries over a 6-month period. A modified Gaschen-bag method was used to retrieve organisms from the inner glove, and thus-obtained bacteria were compared with micro-organisms detected by an intra-operative swab. Results In 20 consecutive procedures, 194 gloves (98 outer gloves, 96 inner gloves were examined. The rate of micro-perforations of the outer surgical glove was 10% with a median wearing time of 100 minutes (range: 20-175 minutes. Perforations occurred in 81% on the non-dominant hand, with the index finger most frequently (25% punctured. In six cases, bacterial migration could be demonstrated microbiologically. In 5% (5/98 of outer gloves and in 1% (1/96 of the inner gloves, bacterial migration through micro-perforations was observed. For gloves with detected micro-perforations (n = 10 outer layers, the calculated migration was 50% (n = 5. The minimum wearing time was 62 minutes, with a calculated median wearing time of 71 minutes. Conclusions This study confirms previous results that bacterial migration through unnoticed micro-perforations in surgical gloves does occur under real practical surgical conditions. Undetected perforation of surgical gloves occurs frequently. Bacterial migration from the patient through micro-perforations on the hand of surgeons was confirmed, limiting the protective barrier function of gloves if worn over longer periods.

  14. Surgical instrument similarity metrics and tray analysis for multi-sensor instrument identification

    Glaser, Bernhard; Schellenberg, Tobias; Franke, Stefan; Dänzer, Stefan; Neumuth, Thomas


    A robust identification of the instrument currently used by the surgeon is crucial for the automatic modeling and analysis of surgical procedures. Various approaches for intra-operative surgical instrument identification have been presented, mostly based on radio-frequency identification (RFID) or endoscopic video analysis. A novel approach is to identify the instruments on the instrument table of the scrub nurse with a combination of video and weight information. In a previous article, we successfully followed this approach and applied it to multiple instances of an ear, nose and throat (ENT) procedure and the surgical tray used therein. In this article, we present a metric for the suitability of the instruments of a surgical tray for identification by video and weight analysis and apply it to twelve trays of four different surgical domains (abdominal surgery, neurosurgery, orthopedics and urology). The used trays were digitized at the central sterile services department of the hospital. The results illustrate that surgical trays differ in their suitability for the approach. In general, additional weight information can significantly contribute to the successful identification of surgical instruments. Additionally, for ten different surgical instruments, ten exemplars of each instrument were tested for their weight differences. The samples indicate high weight variability in instruments with identical brand and model number. The results present a new metric for approaches aiming towards intra-operative surgical instrument detection and imply consequences for algorithms exploiting video and weight information for identification purposes.

  15. Paul of Aegina's surgical instruments: a complete surgical instrumentarium in the seventh century AD.

    Papadakis, Marios; de Bree, Eelco; Trompoukis, Constantinos; Manios, Andreas


    Although current progress in surgical instruments is oriented towards stapler devices, minimally invasive instrumentation and advanced cautery tools, it definitely seems intriguing to determine what instruments were used in antiquity and to appraise their use. Most adequate information can be retrieved from manuscripts of early medical authors, of whom Paul of Aegina (AD 625-690), also being a most important surgeon, is the most recent. The aim of this study is to present surgical instruments used in his practice. Surgical instruments mentioned in the original Greek text of his monumental work named Epitome of Medicine were sought using computer software. Further, similar research was performed on other significant manuscripts of earlier Greek medical writers to determine whether some of the instruments were exclusively mentioned by Paul of Aegina. In total, 121 different surgical instruments were identified and described in detail in the Epitome of Medicine. Thirty-three instruments (27%) were exclusively reported by Paul of Aegina. In antiquity a large number of surgical instruments were already being used. Paul of Aegina described in detail a large variety of fine, as well as a substantial number of, original surgical instruments, which he himself used in a wide spectrum of surgical operations. © 2015 Royal Australasian College of Surgeons.

  16. ToolNet: Holistically-Nested Real-Time Segmentation of Robotic Surgical Tools

    Garcia-Peraza-Herrera, Luis C.; Li, Wenqi; Fidon, Lucas; Gruijthuijsen, Caspar; Devreker, Alain; Attilakos, George; Deprest, Jan; Poorten, Emmanuel Vander; Stoyanov, Danail; Vercauteren, Tom; Ourselin, Sebastien


    Real-time tool segmentation from endoscopic videos is an essential part of many computer-assisted robotic surgical systems and of critical importance in robotic surgical data science. We propose two novel deep learning architectures for automatic segmentation of non-rigid surgical instruments. Both methods take advantage of automated deep-learning-based multi-scale feature extraction while trying to maintain an accurate segmentation quality at all resolutions. The two proposed methods encode ...

  17. Toward fluorescence detection of protein residues on surgical instruments

    Richardson, Patricia R.; Jones, Anita C.; Baxter, Robert L.; Baxter, Helen C.; Whittaker, A. Gavin; Campbell, Gaynor A.


    Prion proteins are the infectious agents that cause Creutzfeldt-Jakob Disease (CJD) in humans. These proteins are particularly resistant to normal sterilization procedures, and the theoretical risk of prion transmission via surgical instruments is of current public and professional concern. We are currently investigating fluorescence methods for the detection of proteins on surfaces, with a view to developing an optical-fiber-based system for routine, online monitoring of residual protein contamination on surgical instruments, in hospital sterilization departments. This paper presents preliminary results on the detection of femtomole amounts of fluorescently labelled protein on surgical steel and discusses some of the problems involved in the detection of fluorescence from metal samples.

  18. Sensorization of a surgical robotic instrument for force sensing

    Shahzada, Kaspar S.; Yurkewich, Aaron; Xu, Ran; Patel, Rajni V.


    This paper presents the development and application of an approach for sensorizing a surgical robotic instrument for two degree-of-freedom (DOF) lateral force sensing. The sensorized instrument is compatible with the da Vinci® Surgical System and can be used for skills assessment and force control in specific surgical tasks. The sensing technology utilizes a novel layout of four fiber Bragg grating (FBG) sensors attached to the shaft of a da Vinci® surgical instrument. The two cross-section layout is insensitive to error caused by combined force and torque loads, and the orientation of the sensors minimizes the condition number of the instrument's compliance matrix. To evaluate the instrument's sensing capabilities, its performance was tested using a commercially available force-torque sensor, and showed a resolution of 0.05N at 1 kHz sampling rate. The performance of the sensorized instrument was evaluated by performing three surgical tasks on phantom tissue using the da Vinci® system with the da Vinci Research Kit (dVRK): tissue palpation, knot tightening during suturing and Hem-O-Lok® tightening during knotless suturing. The tasks were designed to demonstrate the robustness of the sensorized force measurement approach. The paper reports the results of further evaluation by a group of expert and novice surgeons performing the three tasks mentioned above.

  19. 3D Printed Surgical Instruments: The Design and Fabrication Process.

    George, Mitchell; Aroom, Kevin R; Hawes, Harvey G; Gill, Brijesh S; Love, Joseph


    3D printing is an additive manufacturing process allowing the creation of solid objects directly from a digital file. We believe recent advances in additive manufacturing may be applicable to surgical instrument design. This study investigates the feasibility, design and fabrication process of usable 3D printed surgical instruments. The computer-aided design package SolidWorks (Dassault Systemes SolidWorks Corp., Waltham MA) was used to design a surgical set including hemostats, needle driver, scalpel handle, retractors and forceps. These designs were then printed on a selective laser sintering (SLS) Sinterstation HiQ (3D Systems, Rock Hill SC) using DuraForm EX plastic. The final printed products were evaluated by practicing general surgeons for ergonomic functionality and performance, this included simulated surgery and inguinal hernia repairs on human cadavers. Improvements were identified and addressed by adjusting design and build metrics. Repeated manufacturing processes and redesigns led to the creation of multiple functional and fully reproducible surgical sets utilizing the user feedback of surgeons. Iterative cycles including design, production and testing took an average of 3 days. Each surgical set was built using the SLS Sinterstation HiQ with an average build time of 6 h per set. Functional 3D printed surgical instruments are feasible. Advantages compared to traditional manufacturing methods include no increase in cost for increased complexity, accelerated design to production times and surgeon specific modifications.

  20. Femoral Test Bed for Impedance Controlled Surgical Instrumentation

    Christian Brendle


    Full Text Available The risk for patients during the standard procedure of revision of cemented artificial hip joints is unsatisfactorily highdue to its high level of invasiveness and limited access to the operative field. To reduce this risk we are developing anImpedance Controlled Surgical Instrumentation (ICOS system, which aims to establish real-time control during a BoneCement (BC milling process. For this, the relationship between the thickness of the BC and its frequency-dependentelectrical impedance is used to estimate the residual BC thickness. The aim is to avoid unintended cutting of boneby detecting the passage of the BC/bone boundary layer by the milling head. In a second step, an estimation of theresidual BC thickness will be used to improve process control. As a first step towards demonstrating the feasibility ofour approach, presented here are experimental studies to characterize the BC permittivity and to describe the process indetail. The results show that the permittivity properties of BC are dominated by its polymethyl methacrylate (PMMAfraction. Thus, PMMA can be used as a substitute for future experiments. Furthermore, a Femoral Test Bed (FTB wasdesigned. Using this setup we show it is feasible to accurately distinguish between slightly different thicknesses of BC.

  1. Design of teleoperated surgical instruments for minimally invasive surgery

    Madhani, Akhil Jiten


    Minimally invasive surgery (MIS) is performed today using hand held instruments passed through small incisions into the body. The internal surgical site and instruments are viewed remotely on a monitor using images obtained with an endoscopic camera. It is well recognized that the marked therapeutic benefits of MIS must be weighed against the increased technical difficulty for the surgeon and the ensuing risk of surgical errors. Here I describe the design, construction, and operation of teleoperated surgical instruments that solve several key problems in current minimally invasive surgical practice. These improvements are primarily achieved through (1) an increase in dexterity and degrees of freedom, (2) force feedback to allow surgeons to feel instrument-tissue interactions, and (3) the elimination of geometrical discrepancies between actual and observed tool motions. I present the design of two teleoperator slave manipulators for minimally invasive surgery, the seven- degree-of-freedom Silver Falcon and the eight-degree-of- freedom Black Falcon. Both systems were tested using an existing PHANToM TM haptic interface which was modified for use as a master manipulator. Position based bilateral force-reflecting teleoperation was implemented using sound cable design principles, without force sensors. Through the design of system dynamics that accommodate a macro-micro control scheme, a substantial reduction was achieved in slave endpoint inertia and friction reflected to the user. The Black Falcon was successfully used to drive surgical sutures along arbitrarily oriented paths, a task which is rarely feasible using today's instruments. This test demonstrates successful kinematic design and range of motion, although the quality of force reflection was not sufficient to be helpful when suturing soft tissue. Force reflection was found to be more useful during rigid contact tasks where force information is not already available to the operator via visual cues. (Copies

  2. 3D printing surgical instruments: Are we there yet?

    Rankin, Timothy M.; Giovinco, Nicholas A.; Cucher, Daniel J.; Watts, George; Hurwitz, Bonnie; Armstrong, David G.


    Background The applications for rapid prototyping have expanded dramatically over the last 20 years. In recent years, additive manufacturing has been intensely investigated for surgical implants, tissue scaffolds, and organs. There is, however, scant literature to date that has investigated the viability of 3D printing of surgical instruments. Materials and Methods Using a fused deposition manufacturing (FDM) printer, an army/ navy surgical retractor was replicated from polylactic acid (PLA) filament. The retractor was sterilized using standard FDA approved glutaraldehyde protocols, tested for bacteria by PCR, and stressed until fracture in order to determine if the printed instrument could tolerate force beyond the demands of an operating room. Results Printing required roughly 90 minutes. The instrument tolerated 13.6 kg of tangential force before failure, both before and after exposure to the sterilant. Freshly extruded PLA from the printer was sterile and produced no PCR product. Each instrument weighed 16g and required only $0.46 of PLA. Conclusions Our estimates place the cost per unit of a 3D printed retractor to be roughly 1/10th the cost of a stainless steel instrument. The PLA Army/ Navy is strong enough for the demands of the operating room. Freshly extruded PLA in a clean environment, such as an OR, would produce a sterile, ready to use instrument. Due to the unprecedented accessibility of 3D printing technology world wide, and the cost efficiency of these instruments, there are far reaching implications for surgery in some underserved and less developed parts of the world. PMID:24721602

  3. 21 CFR 878.4800 - Manual surgical instrument for general use.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual surgical instrument for general use. 878... SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4800 Manual surgical instrument for general use. (a) Identification. A manual surgical instrument for general use is...

  4. Instrumentation development for real time brainwave monitoring.

    Anderson, Lawrence Frederick; Clough, Benjamin W.


    The human brain functions through a chemically-induced biological process which operates in a manner similar to electrical systems. The signal resulting from this biochemical process can actually be monitored and read using tools and having patterns similar to those found in electrical and electronics engineering. The primary signature of this electrical activity is the ''brain wave'', which looks remarkably similar to the output of many electrical systems. Likewise, the device currently used in medical arenas to read brain electrical activity is the electroencephalogram (EEG) which is synonymous with a multi-channel oscilloscope reading. Brain wave readings and recordings for medical purposes are traditionally taken in clinical settings such as hospitals, laboratories or diagnostic clinics. The signal is captured via externally applied scalp electrodes using semi-viscous gel to reduce impedance. The signal will be in the 10 to 100 microvolt range. In other instances, where surgeons are attempting to isolate particular types of minute brain signals, the electrodes may actually be temporarily implanted in the brain during a preliminary procedure. The current configurations of equipment required for EEGs involve large recording instruments, many electrodes, wires, and large amounts of hard disk space devoted to storing large files of brain wave data which are then eventually analyzed for patterns of concern. Advances in sensors, signal processing, data storage and microelectronics over the last decade would seem to have paved the way for the realization of devices capable of ''real time'' external monitoring, and possible assessment, of brain activity. A myriad of applications for such a capability are likewise presenting themselves, including the ability to assess brain functioning, level of functioning and malfunctioning. Our plan is to develop the sensors, signal processing, and portable instrumentation package which could

  5. From flint to stainless steel: observations on surgical instrument composition.

    Kirkup, J.


    Man's failure to extract deeply embedded thorns and arrowheads, with bare hands and teeth, stimulated 'instrument substitutes' mimicking these appendages. Evidence from primitive communities suggest animal, plant and mineral items were employed, both before and after metal became the standard material of today's armamentarium. Changing surgical instrument composition has mirrored concurrent technology and manufacturing methods both of which are reviewed. Particular significance is accorded flint, bronze, crucible steel, thermal sterilisation, nickel-plate, stainless steel and disposable plastics. The paper is based on an exhibition From Flint to Stainless Steel on display at the College. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 PMID:8215156

  6. Left-handed surgical instruments - a guide for cardiac surgeons.

    Burdett, Clare; Theakston, Maureen; Dunning, Joel; Goodwin, Andrew; Kendall, Simon William Henry


    For ease of use and to aid precision, left-handed instruments are invaluable to the left-handed surgeon. Although they exist, they are not available in many surgical centres. As a result, most operating theatre staff (including many left-handers) have little knowledge of their value or even application. With specific reference to cardiac surgery, this article addresses the ways in which they differ, why they are needed and what is required - with tips on use.

  7. [Development of an automatic ultrasonic cleaning machine for surgical instruments].

    Geng, Shu-qing; He, Wei; Tao, Ren-hai; Ma, Bao-Qiu; Lu, Hai-long; Li, Li-hua; Feng, Hui-zhi; Zheng, Jin-zhi


    The automatic cleaning machine we have developed, adopts a SCM system in automatic cleaning. The machine has five functions: ultrasonic cleaning, cold or hot water spraying, drying and greasing. The clinical applications show that the machine with a good effectiveness is suitable for the cleaning of many surgical instruments. It also raises working efficiency, cuts down on the cost of repair and maintenance and reduces the injury and infection to nurses caused by manual cleaning, satisfying the needs of clinical applications.

  8. Ergonomic T-Handle for Minimally Invasive Surgical Instruments.

    Parekh, J; Shepherd, Det; Hukins, Dwl; Maffulli, N


    A T-handle has been designed to be used for minimally invasive implantation of a dynamic hip screw to repair fractures of the proximal femur. It is capable of being used in two actions: (i) push and hold (while using an angle guide) and (ii) application of torque when using the insertion wrench and lag screw tap. The T-handle can be held in a power or precision grip. It is suitable for either single (sterilised by γ-irradiation) or multiple (sterilised by autoclaving) use. The principles developed here are applicable to handles for a wide range of surgical instruments.

  9. Integrated high pressure microhydraulic actuation and control for surgical instruments.

    Moers, A J M; De Volder, M F L; Reynaerts, D


    To reduce the surgical trauma to the patient, minimally invasive surgery is gaining considerable importance since the eighties. More recently, robot assisted minimally invasive surgery was introduced to enhance the surgeon's performance in these procedures. This resulted in an intensive research on the design, fabrication and control of surgical robots over the last decades. A new development in the field of surgical tool manipulators is presented in this article: a flexible manipulator with distributed degrees of freedom powered by microhydraulic actuators. The tool consists of successive flexible segments, each with two bending degrees of freedom. To actuate these compliant segments, dedicated fluidic actuators are incorporated, together with compact hydraulic valves which control the actuator motion. Especially the development of microvalves for this application was challenging, and are the main focus of this paper. The valves distribute the hydraulic power from one common high pressure supply to a series of artificial muscle actuators. Tests show that the angular stroke of the each segment of this medical instrument is 90°.

  10. 21 CFR 876.4730 - Manual gastroenterology-urology surgical instrument and accessories.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual gastroenterology-urology surgical... Devices § 876.4730 Manual gastroenterology-urology surgical instrument and accessories. (a) Identification. A manual gastroenterology-urology surgical instrument and accessories is a device designed to...

  11. Fast, real-time, DFT instrument based on VMEbus

    Snell, Jay

    An emerging class of VMEbus-based test and measurement instruments is benchmarked by a recently introduced digital spectrum analyzer. The instrument performs real-time spectrum analysis in the DC-to-10 MHz range at 5000 spectrums per second. Its architecture is based on the VMEbus and is partly adapted for high-speed pipeline processing. The keyboard and color graphic displays suit basic spectrum analysis, as well as advanced analysis of amplitude vs. both frequency and time. The instrument provides a DSP (digital signal processing) programming environment when an RS232 terminal is attached. With addition of an RF spectrum analyzer, downconverter, and software, real-time analysis is extended to 21 GHz and beyond. Postprocessable spectral output makes the instrument suitable for use in a larger signal analysis or test system. This digital spectrum analyzer, which has 17 boards on the bus, is representative of an emerging class of filled-enclosure instruments.

  12. Development of Real-Time Coal Monitoring Instrument

    Rajan Gurjar, Ph.D.


    Relying on coal for energy requires optimizing the extraction of heat content from various blends of coal fuel and reducing harmful constituents and byproducts. Having a real-time measurement instrument provides relevant information about toxic constituents released in the atmosphere from burning coal and optimizes the performance of a power plant. A few commercial instruments exist and have been in operation for more than a decade. However, most of these instruments are based on radioactive sources and are bulky, expensive and time-consuming. The proposed instrument is based on the Laser Induced Breakdown Spectroscopy (LIBS). The advantage of LIBS is that it is a standoff instrument, does not require sample preparation and provides precise information about sample constituents.

  13. 21 CFR 874.4420 - Ear, nose, and throat manual surgical instrument.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ear, nose, and throat manual surgical instrument. 874.4420 Section 874.4420 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN..., and throat manual surgical instrument. (a) Identification. An ear, nose, and throat manual...

  14. Instrumentation of the da Vinci Robotic Surgical System

    Hansen, Karl Damkjær; Jensen, Simon; Sloth, Christoffer


    This paper details the AAU surgical robot, its hardware and software setup. The aim of the paper is to explain how a surgical robot has been rebuild as an open source platform for research in surgical robotics. As a result, the robot has full actuation and sensing capabilities at high sampling ra....... We aim at exploiting the developed surgical robot for research in semi-autonomous control, and safety mechanisms in the context of robotic surgery.......This paper details the AAU surgical robot, its hardware and software setup. The aim of the paper is to explain how a surgical robot has been rebuild as an open source platform for research in surgical robotics. As a result, the robot has full actuation and sensing capabilities at high sampling rate...

  15. Instrumentation of the da Vinci Robotic Surgical System

    Hansen, Karl Damkjær; Jensen, Simon; Sloth, Christoffer


    This paper details the AAU surgical robot, its hardware and software setup. The aim of the paper is to explain how a surgical robot has been rebuild as an open source platform for research in surgical robotics. As a result, the robot has full actuation and sensing capabilities at high sampling ra....... We aim at exploiting the developed surgical robot for research in semi-autonomous control, and safety mechanisms in the context of robotic surgery.......This paper details the AAU surgical robot, its hardware and software setup. The aim of the paper is to explain how a surgical robot has been rebuild as an open source platform for research in surgical robotics. As a result, the robot has full actuation and sensing capabilities at high sampling rate...

  16. Real-time automatic registration in optical surgical navigation

    Lin, Qinyong; Yang, Rongqian; Cai, Ken; Si, Xuan; Chen, Xiuwen; Wu, Xiaoming


    An image-guided surgical navigation system requires the improvement of the patient-to-image registration time to enhance the convenience of the registration procedure. A critical step in achieving this aim is performing a fully automatic patient-to-image registration. This study reports on a design of custom fiducial markers and the performance of a real-time automatic patient-to-image registration method using these markers on the basis of an optical tracking system for rigid anatomy. The custom fiducial markers are designed to be automatically localized in both patient and image spaces. An automatic localization method is performed by registering a point cloud sampled from the three dimensional (3D) pedestal model surface of a fiducial marker to each pedestal of fiducial markers searched in image space. A head phantom is constructed to estimate the performance of the real-time automatic registration method under four fiducial configurations. The head phantom experimental results demonstrate that the real-time automatic registration method is more convenient, rapid, and accurate than the manual method. The time required for each registration is approximately 0.1 s. The automatic localization method precisely localizes the fiducial markers in image space. The averaged target registration error for the four configurations is approximately 0.7 mm. The automatic registration performance is independent of the positions relative to the tracking system and the movement of the patient during the operation.

  17. Research on seamless development of surgical instruments based on biological mechanisms using CAD and 3D printer.

    Yamamoto, Ikuo; Ota, Ren; Zhu, Rui; Lawn, Murray; Ishimatsu, Takakazu; Nagayasu, Takeshi; Yamasaki, Naoya; Takagi, Katsunori; Koji, Takehiko


    In the area of manufacturing surgical instruments, the ability to rapidly design, prototype and test surgical instruments is critical. This paper provides a simple case study of the rapid development of two bio-mechanism based surgical instruments which are ergonomic, aesthetic and were successfully designed, prototyped and conceptually tested in a very short period of time.

  18. Medical Devices; General and Plastic Surgery Devices; Classification of the Magnetic Surgical Instrument System. Final order.


    The Food and Drug Administration (FDA) is classifying the Magnetic Surgical Instrument System into class II (special controls). The special controls that will apply to the device are identified in this order and will be part of the codified language for the magnetic surgical instrument system's classification. The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.

  19. Effect of Intraperitoneal Radiotelemetry Instrumentation on Voluntary Wheel Running and Surgical Recovery in Mice


    small transmitter group; model G2 Emitter, Mini Mitter, Bend, OR). Surgical preparation con- sisted of shaving the abdominal fur and scrubbing the...Sl , No 5 September 2012 Pages 600-608 Effect of Intraperitoneal Radiotelemetry Instrumentation on Voluntary Wheel Running and Surgical Recovery...of the diaphragm, large intestine, and duodenum. These results demonstrate that the large transmitter delayed surgical recovery, disrupted normal

  20. A cyber-physical management system for delivering and monitoring surgical instruments in the OR.

    Li, Yu-Ting; Jacob, Mithun; Akingba, George; Wachs, Juan P


    The standard practice in the operating room (OR) is having a surgical technician deliver surgical instruments to the surgeon quickly and inexpensively, as required. This human "in the loop" system may result in mistakes (eg, missing information, ambiguity of instructions, and delays). Errors can be reduced or eliminated by integrating information technology (IT) and cybernetics into the OR. Gesture and voice automatic acquisition, processing, and interpretation allow interaction with these new systems without disturbing the normal flow of surgery. This article describes the development of a cyber-physical management system (CPS), including a robotic scrub nurse, to support surgeons by passing surgical instruments during surgery as required and recording counts of surgical instruments into a personal health record (PHR). The robot used responds to hand signals and voice messages detected through sophisticated computer vision and data mining techniques. The CPS was tested during a mock surgery in the OR. The in situ experiment showed that the robot recognized hand gestures reliably (with an accuracy of 97%), it can retrieve instruments as close as 25 mm, and the total delivery time was less than 3 s on average. This online health tool allows the exchange of clinical and surgical information to electronic medical record-based and PHR-based applications among different hospitals, regardless of the style viewer. The CPS has the potential to be adopted in the OR to handle surgical instruments and track them in a safe and accurate manner, releasing the human scrub tech from these tasks.

  1. Identification of surgical instruments using UHF-RFID technology

    Bourouah Mohamed


    Full Text Available The paper presents research, development and advantage of Radio Frequency IDentification (RFID technology based system for medical instrument management and safe usage. The system is developed for two scenarios. In the first scenario, a Ultra High Frequency (UHF is used and the UHF–interrogator system with UHF-antennas is constructed to work as conveyor-belt and instruments are placed between two antennas. Second scenario, suitable for the operating rooms, includes four antennas, placed under the table with instruments, system’s phase shifter, inserted between the antenna and reader in order to reduce the effect of dead spots, caused by the electromagnetic reflections. High reliable identification rate is achieved by synchronizing phase shifters with particular interrogator. The system is software calibrated and can be re-calibrated at run-time to achieve high efficiency of power transmission to the antenna and in order to enable the receiver to decode the tag signals. With currently on the market available RFID tags and previously mentioned technology approaches, detection rate of 87.5% can be achieved.

  2. Use of Synthetic Single-Stranded Oligonucleotides as Artificial Test Soiling for Validation of Surgical Instrument Cleaning Processes

    Nadja Wilhelm


    Full Text Available Surgical instruments are often strongly contaminated with patients’ blood and tissues, possibly containing pathogens. The reuse of contaminated instruments without adequate cleaning and sterilization can cause postoperative inflammation and the transmission of infectious diseases from one patient to another. Thus, based on the stringent sterility requirements, the development of highly efficient, validated cleaning processes is necessary. Here, we use for the first time synthetic single-stranded DNA (ssDNA_ODN, which does not appear in nature, as a test soiling to evaluate the cleaning efficiency of routine washing processes. Stainless steel test objects were coated with a certain amount of ssDNA_ODN. After cleaning, the amount of residual ssDNA_ODN on the test objects was determined using quantitative real-time PCR. The established method is highly specific and sensitive, with a detection limit of 20 fg, and enables the determination of the cleaning efficiency of medical cleaning processes under different conditions to obtain optimal settings for the effective cleaning and sterilization of instruments. The use of this highly sensitive method for the validation of cleaning processes can prevent, to a significant extent, the insufficient cleaning of surgical instruments and thus the transmission of pathogens to patients.

  3. Real time optical Biopsy: Time-resolved Fluorescence Spectroscopy instrumentation and validation

    Kittle, David S.; Vasefi, Fartash; Patil, Chirag G.; Mamelak, Adam; Black, Keith L.; Butte, Pramod V.


    The Time-resolved fluorescence spectroscopy (TR-FS) has the potential to differentiate tumor and normal tissue in real time during surgical excision. In this manuscript, we describe the design of a novel TR-FS device, along with preliminary data on detection accuracy for fluorophores in a mixture. The instrument is capable of near real-time fluorescence lifetime acquisition in multiple spectral bands and analysis. It is also able to recover fluorescence lifetime with sub-20ps accuracy as validated with individual organic fluorescence dyes and dye mixtures yielding lifetime values for standard fluorescence dyes that closely match with published data. We also show that TR-FS is able to quantify the relative concentration of fluorescence dyes in a mixture by the unmixing of lifetime decays. We show that the TR-FS prototype is able to identify in near-real time the concentrations of dyes in a complex mixture based on previously trained data. As a result, we demonstrate that in complex mixtures of fluorophores, the relative concentration information is encoded in the fluorescence lifetime across multiple spectral bands. We show for the first time the temporal and spectral measurements of a mixture of fluorochromes and the ability to differentiate relative concentrations of each fluorochrome mixture in real time.

  4. Automatic localization of the da Vinci surgical instrument tips in 3-D transrectal ultrasound.

    Mohareri, Omid; Ramezani, Mahdi; Adebar, Troy K; Abolmaesumi, Purang; Salcudean, Septimiu E


    Robot-assisted laparoscopic radical prostatectomy (RALRP) using the da Vinci surgical system is the current state-of-the-art treatment option for clinically confined prostate cancer. Given the limited field of view of the surgical site in RALRP, several groups have proposed the integration of transrectal ultrasound (TRUS) imaging in the surgical workflow to assist with accurate resection of the prostate and the sparing of the neurovascular bundles (NVBs). We previously introduced a robotic TRUS manipulator and a method for automatically tracking da Vinci surgical instruments with the TRUS imaging plane, in order to facilitate the integration of intraoperative TRUS in RALRP. Rapid and automatic registration of the kinematic frames of the da Vinci surgical system and the robotic TRUS probe manipulator is a critical component of the instrument tracking system. In this paper, we propose a fully automatic registration technique based on automatic 3-D TRUS localization of robot instrument tips pressed against the air-tissue boundary anterior to the prostate. The detection approach uses a multiscale filtering technique to identify and localize surgical instrument tips in the TRUS volume, and could also be used to detect other surface fiducials in 3-D ultrasound. Experiments have been performed using a tissue phantom and two ex vivo tissue samples to show the feasibility of the proposed methods. Also, an initial in vivo evaluation of the system has been carried out on a live anaesthetized dog with a da Vinci Si surgical system and a target registration error (defined as the root mean square distance of corresponding points after registration) of 2.68 mm has been achieved. Results show this method's accuracy and consistency for automatic registration of TRUS images to the da Vinci surgical system.

  5. Radius surgical system and conventional laparoscopic instruments in abdominal surgery: application, learning curve and ergonomy.

    Di Lorenzo, N; Camperchioli, I; Gaspari, A L


    We illustrate our experience with a new class of instruments, the mechanical manipulators (MM), whose main features are an improved mobility, and ergonomy and a modular structure. A specific MM, the Radius Surgical System (RADIUS), has been used both for educational purposes as well as in clinical studies, demonstrating that it can represent an efficient tool to support surgeons performing surgical complex procedures, with a short learning curve for the postural attitude.

  6. 3D tracking of surgical instruments using a single camera for laparoscopic surgery simulation.

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


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

  7. Efficacy of a washer-disinfector in eliminating healthcare-associated pathogens from surgical instruments.

    Rutala, William A; Gergen, Maria F; Weber, David J


    This study was designed to test the efficacy of a washer-disinfector in eliminating selected healthcare-associated pathogens from surgical instruments. Our results showed that a washer-disinfector was extremely effective in eliminating microorganisms (>7-log(10) reduction), including vegetative and spore-forming bacteria, from experimentally contaminated instruments. The washer-disinfector remained effective in eliminating microorganisms in the absence of enzymatic cleaners and detergents.

  8. Surgical instrument biocontaminant fluorescence detection in ambient lighting conditions for hospital reprocessing and sterilization department (Conference Presentation)

    Baribeau, François; Bubel, Annie; Dumont, Guillaume; Vachon, Carl; Lépine, André; Rochefort, Stéphane; Massicotte, Martin; Buteau-Vaillancourt, Louis; Gallant, Pascal; Mermut, Ozzy


    Hospitals currently rely on simple human visual inspection for assessing cleanliness of surgical instruments. Studies showed that surgical site infections are in part attributed to inadequate cleaning of medical devices. Standards groups recognize the need to objectively quantify the amount of residues on surgical instruments and establish guidelines. We developed a portable technology for the detection of contaminants on surgical instruments through fluorescence following cleaning. Weak fluorescence signals are usually detected in the obscurity only with the lighting of the excitation source. The key element of this system is that it works in ambient lighting conditions, a requirement to not disturb the normal workflow of hospital reprocessing facilities. A biocompatible fluorescent dye is added to the detergent and labels the proteins of organic residues. It is resistant to the harsh environment in a washer-disinfector. Two inspection devices have been developed with a 488nm laser as the excitation source: a handheld scanner and a tabletop station using spectral-domain and time-domain ambient light cancellation schemes. The systems are eye safe and equipped with image processing and interfacing software to provide visual or audible warnings to the operator based on a set of adjustable signal thresholds. Micron-scale residues are detected by the system which can also evaluate soil size and mass. Unlike swabbing, it can inspect whole tools in real-time. The technology has been validated in an independent hospital decontamination research laboratory. It also has potential applications in the forensics, agro-food, and space fields. Technical aspects and results will be presented and discussed.

  9. Multisensor Instrument for Real-Time Biological Monitoring

    Zhang, Sean (Zhanxiang); Xu, Guoda; Qiu, Wei; Lin, Freddie


    The figure schematically depicts an instrumentation system, called a fiber optic-based integration system (FOBIS), that is undergoing development to enable real-time monitoring of fluid cell cultures, bioprocess flows, and the like. The FOBIS design combines a micro flow cytometer (MFC), a microphotometer (MP), and a fluorescence-spectrum- or binding-force-measuring micro-sensor (MS) in a single instrument that is capable of measuring multiple biological parameters simultaneously or sequentially. The fiber-optic-based integration system is so named because the MFC, the MP, and the MS are integrated into a single optical system that is coupled to light sources and photometric equipment via optical fibers. The optical coupling components also include a wavelength-division multiplexer and diffractive optical elements. The FOBIS includes a laserdiode- and fiber-optic-based optical trapping subsystem (optical tweezers ) with microphotometric and micro-sensing capabilities for noninvasive confinement and optical measurement of relevant parameters of a single cell or other particle. Some of the measurement techniques implemented together by the FOBIS have long been used separately to obtain basic understanding of the optical properties of individual cells and other organisms, the optical properties of populations of organisms, and the interrelationships among these properties, physiology of the organisms, and physical processes that govern the media that surround the organisms. For example, flow cytometry yields information on numerical concentrations, cross-sectional areas, and types of cells or other particles. Micro-sensing can be used to measure pH and concentrations of oxygen, carbon dioxide, glucose, metabolites, calcium, and antigens in a cell-culture fluid, thereby providing feedback that can be helpful in improving control over a bioprocess. Microphotometry (including measurements of scattering and fluorescence) can yield further information about optically

  10. Endoscopic vision-based tracking of multiple surgical instruments during robot-assisted surgery.

    Ryu, Jiwon; Choi, Jaesoon; Kim, Hee Chan


    Robot-assisted minimally invasive surgery is effective for operations in limited space. Enhancing safety based on automatic tracking of surgical instrument position to prevent inadvertent harmful events such as tissue perforation or instrument collisions could be a meaningful augmentation to current robotic surgical systems. A vision-based instrument tracking scheme as a core algorithm to implement such functions was developed in this study. An automatic tracking scheme is proposed as a chain of computer vision techniques, including classification of metallic properties using k-means clustering and instrument movement tracking using similarity measures, Euclidean distance calculations, and a Kalman filter algorithm. The implemented system showed satisfactory performance in tests using actual robot-assisted surgery videos. Trajectory comparisons of automatically detected data and ground truth data obtained by manually locating the center of mass of each instrument were used to quantitatively validate the system. Instruments and collisions could be well tracked through the proposed methods. The developed collision warning system could provide valuable information to clinicians for safer procedures.

  11. Development and Validation of a Near-Infrared Optical System for Tracking Surgical Instruments.

    Lin, Qinyong; Cai, Ken; Yang, Rongqian; Chen, Huazhou; Wang, Zhigang; Zhou, Jing


    Surgical navigation systems can help doctors maximize the accuracy of surgeries, minimize operation durations, avoid mistakes, and improve the survival chances of patients. The tracking of device is an important component in surgical navigation systems. However, commercial surgical tracking devices are expensive, thus hindering the development of surgical navigation systems, particularly in developing countries. Therefore, an accurate and low-cost near-infrared optical tracking system is presented in this study for the real-time tracking of surgical tools and for measuring and displaying the positions of these tools relative to lesions and other targets inside a patient's body. A relative algorithm for the registration of surgical tools is also proposed in this paper to yield easy, safe, and precise tracking. Experiments are conducted to test the performance of the system. Results show that the mean square errors of the distances between the light-emitting points on the surgical tools are less than 0.3 mm, with the mean square error of distance between the tip and light-emitting points is less than 0.025 mm and that between two adjacent corner points is 0.2714 mm.

  12. 3D printing of surgical instruments for long-duration space missions.

    Wong, Julielynn Y; Pfahnl, Andreas C


    The first off-Earth fused deposition modeling (FDM) 3D printer will explore thermoplastic manufacturing capabilities in microgravity. This study evaluated the feasibility of FDM 3D printing 10 acrylonitrile butadiene styrene (ABS) thermoplastic surgical instruments on Earth. Three-point bending tests compared stiffness and yield strength between FDM 3D printed and conventionally manufactured ABS thermoplastic. To evaluate the relative speed of using four printed instruments compared to conventional instruments, 13 surgeons completed simulated prepping, draping, incising, and suturing tasks. Each surgeon ranked the performance of six printed instruments using a 5-point Likert scale. At a thickness of 5.75 mm or more, the FDM printing process had a less than 10% detrimental effect on the tested yield strength and stiffness of horizontally printed ABS thermoplastic relative to conventional ABS thermoplastic. Significant weakness was observed when a bending load was applied transversely to a 3D printed layer. All timed tasks were successfully performed using a printed sponge stick, towel clamp, scalpel handle, and toothed forceps. There was no substantial difference in time to completion of simulated surgical tasks with control vs. 3D printed instruments. Of the surgeons, 100%, 92%, 85%, 77%, 77%, and 69% agreed that the printed smooth and tissue forceps, curved and straight hemostats, tissue and right angle clamps, respectively, would perform adequately. It is feasible to 3D print ABS thermoplastic surgical instruments on Earth. Loadbearing structures were designed to be thicker, when possible. Printing orientations were selected so that the printing layering direction of critical structures would not be transverse to bending loads.


    D. Busonero


    Full Text Available L o s o b j e t i v o s d e l a m i s i ́ o n e s p a c i a l d e m i c r o a r c o s e g u n d o d e p e n d e n d e l a s l i m i t a c i o n e s d e d e s e m p e ̃ n o a s o c i a d a s a l a c o n fi g u r a c i ́ o n i n s t r u m e n t a l s e l e c c i o n a d a y a l a s c o n d i c i o n e s d e o b s e r v a c i ́ o n . E n p a r t i c u l a r , l a v a r i a c i ́ o n d e la respuesta instrumental sobre el campo, con respecto a la longitud de onda y el tiempo, son potencialmente cr ́ıticos. Discutimos el impacto sobre la calidad de los datos y c ́omo los datos cient ́ıficos pueden ser utilizados para rastrear directamente y en tiempo real la respuesta astrom ́etrica instrumental de Gaia. Esta es una de las filosof ́ıas que impulsan el Modelo de Instrumento Astrom ́etrico (AIM, por sus siglas en ingl ́es. Mostramos l o s r e s u l t a d o s d e l a s c a m p a ̃ n a s d e p r u e b a l l e v a d a s a c a b o e n 2 0 1 3 .

  14. On using an array of fiber bragg grating sensors for closed-loop control of flexible minimally invasive surgical instruments

    Roesthuis, Roy; Janssen, Sander; Misra, Sarthak


    Flexible minimally invasive surgical instruments can be used to target difficult-to-reach locations within the human body. Accurately steering these instruments requires information about the three-dimensional shape of the instrument. In the current study, we use an array of Fiber Bragg Grating

  15. Emerging technology in surgical education: combining real-time augmented reality and wearable computing devices.

    Ponce, Brent A; Menendez, Mariano E; Oladeji, Lasun O; Fryberger, Charles T; Dantuluri, Phani K


    The authors describe the first surgical case adopting the combination of real-time augmented reality and wearable computing devices such as Google Glass (Google Inc, Mountain View, California). A 66-year-old man presented to their institution for a total shoulder replacement after 5 years of progressive right shoulder pain and decreased range of motion. Throughout the surgical procedure, Google Glass was integrated with the Virtual Interactive Presence and Augmented Reality system (University of Alabama at Birmingham, Birmingham, Alabama), enabling the local surgeon to interact with the remote surgeon within the local surgical field. Surgery was well tolerated by the patient and early surgical results were encouraging, with an improvement of shoulder pain and greater range of motion. The combination of real-time augmented reality and wearable computing devices such as Google Glass holds much promise in the field of surgery.

  16. Real time analysis of brain tissue by direct combination of ultrasonic surgical aspiration and sonic spray mass spectrometry.

    Schäfer, Karl-Christian; Balog, Júlia; Szaniszló, Tamás; Szalay, Dániel; Mezey, Géza; Dénes, Júlia; Bognár, László; Oertel, Matthias; Takáts, Zoltán


    Direct combination of cavitron ultrasonic surgical aspirator (CUSA) and sonic spray ionization mass spectrometry is presented. A commercially available ultrasonic surgical device was coupled to a Venturi easy ambient sonic-spray ionization (V-EASI) source by directly introducing liquified tissue debris into the Venturi air jet pump. The Venturi air jet pump was found to efficiently nebulize the suspended tissue material for gas phase ion production. The ionization mechanism involving solely pneumatic spraying was associated with that of sonic spray ionization. Positive and negative ionization spectra were obtained from brain and liver samples reflecting the primary application areas of the surgical device. Mass spectra were found to feature predominantly complex lipid-type constituents of tissues in both ion polarity modes. Multiply charged peptide anions were also detected. The influence of instrumental settings was characterized in detail. Venturi pump geometry and flow parameters were found to be critically important in ionization efficiency. Standard solutions of phospholipids and peptides were analyzed in order to test the dynamic range, sensitivity, and suppression effects. The spectra of the intact tissue specimens were found to be highly specific to the histological tissue type. The principal component analysis (PCA) and linear discriminant analysis (LDA) based data analysis method was developed for real-time tissue identification in a surgical environment. The method has been successfully tested on post-mortem and ex vivo human samples including astrocytomas, meningeomas, metastatic brain tumors, and healthy brain tissue.

  17. An integrated approach to endoscopic instrument tracking for augmented reality applications in surgical simulation training.

    Loukas, Constantinos; Lahanas, Vasileios; Georgiou, Evangelos


    Despite the popular use of virtual and physical reality simulators in laparoscopic training, the educational potential of augmented reality (AR) has not received much attention. A major challenge is the robust tracking and three-dimensional (3D) pose estimation of the endoscopic instrument, which are essential for achieving interaction with the virtual world and for realistic rendering when the virtual scene is occluded by the instrument. In this paper we propose a method that addresses these issues, based solely on visual information obtained from the endoscopic camera. Two different tracking algorithms are combined for estimating the 3D pose of the surgical instrument with respect to the camera. The first tracker creates an adaptive model of a colour strip attached to the distal part of the tool (close to the tip). The second algorithm tracks the endoscopic shaft, using a combined Hough-Kalman approach. The 3D pose is estimated with perspective geometry, using appropriate measurements extracted by the two trackers. The method has been validated on several complex image sequences for its tracking efficiency, pose estimation accuracy and applicability in AR-based training. Using a standard endoscopic camera, the absolute average error of the tip position was 2.5 mm for working distances commonly found in laparoscopic training. The average error of the instrument's angle with respect to the camera plane was approximately 2°. The results are also supplemented by video segments of laparoscopic training tasks performed in a physical and an AR environment. The experiments yielded promising results regarding the potential of applying AR technologies for laparoscopic skills training, based on a computer vision framework. The issue of occlusion handling was adequately addressed. The estimated trajectory of the instruments may also be used for surgical gesture interpretation and assessment. Copyright © 2013 John Wiley & Sons, Ltd.

  18. Quality of life after surgical decompression of lumbar spinal stenosis with and without instrumentation.

    Grivas, Theodoros B; Vasiliadis, Elias; Papadakis, Stamatios A; Mouzakis, Vasilios; Segos, Dimitrios


    The aim is to evaluate the influence on quality of life of surgical decompression with and without instrumentation in lumbar spinal stenosis. Twenty three patients, (16 women, 7 men) with a mean age of 62,8 years old (range 44-80) who underwent a surgical decompression for lumbar spinal stenosis filled the SF-36 questionnaire pre- and postoperatively, during the follow up period which was at a mean value of 42 months (range 6 to 50 months). Spinal stenosis was degenerative in 18 patients and as a consequence of spondylolisthisis in 5. In 15 patients decompression and fusion using instrumentation (group I) was performed and in 8 patients only decompression was performed (group II). Statistical analysis was carried out using the Wilcoxon Signed Rank Test. In group I, the domains that evidenced statistical significant improvement were bodily pain (p<0,041), general health (p<0,042), vitality (p<0,042), social functioning (p<0,043), and mental health (p<0,042). Not any specific domain in group II showed a statistical significant improvement postoperatively. Comparing the two groups overall SF-36 score, a statistical significant improvement was noted for group I (p<0,001) and for group II (p<0,017). The statistical significance of improvement was stronger in patients of group I than group II. Surgical decompression for lumbar spinal stenosis reduces pain and restores significantly physical and mental health. Decompression and instrumentation presents superior results in patients' quality of life when compared to patients that single decompression was performed.

  19. 21 CFR 878.4810 - Laser surgical instrument for use in general and plastic surgery and in dermatology.


    ... plastic surgery and in dermatology. 878.4810 Section 878.4810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4810 Laser surgical instrument for use in general and plastic surgery and...

  20. Surgeons and their tools: a history of surgical instruments and their innovators. Part V: pass me the hemostat/clamp.

    El-Sedfy, Abraham; Chamberlain, Ronald S


    This is the last of five manuscripts reviewing the historical origins of some of the more commonly used surgical instruments and takes "time out" to remind current surgeons about the surgical pioneers on whose shoulders they now stand and whose inventions they now use.

  1. Surgeons and their tools: a history of surgical instruments and their innovators. Part IV: pass me the forceps.

    El-Sedfy, Abraham; Chamberlain, Ronald S


    This is the fourth of five manuscripts reviewing the historical origins of some of the more commonly used surgical instruments and takes "time out" to remind current surgeons about the surgical pioneers on whose shoulders they now stand and whose inventions they now use.

  2. Freeman's transorbital lobotomy as an anomaly: A material culture examination of surgical instruments and operative spaces.

    Collins, Brianne M; Stam, Henderikus J


    In 1946, Walter Freeman introduced the transorbital ice pick lobotomy. Touted as a procedure that could be learned and subsequently performed by psychiatrists outside of the operating room, the technique was quickly criticized by neurosurgeons. In this article, we take a material culture approach to consider 2 grounds upon which neurosurgeons based their objections-surgical instruments and operative spaces. On both counts, Freeman was in contravention of established normative neurosurgical practices and, ultimately, his technique was exposed as an anomaly by neurosurgeons. Despite its rejection, the transorbital lobotomy became entrenched in contemporary memory and remains the emblematic procedure of the psychosurgery era. (c) 2015 APA, all rights reserved).

  3. Stimulated penetrating keratoplasty using real-time virtual intraoperative surgical optical coherence tomography

    Lee, Changho; Kim, Kyungun; Han, Seunghoon; Kim, Sehui; Lee, Jun Hoon; Kim, Hong kyun; Kim, Chulhong; Jung, Woonggyu; Kim, Jeehyun


    Abstract. An intraoperative surgical microscope is an essential tool in a neuro- or ophthalmological surgical environment. Yet, it has an inherent limitation to classify subsurface information because it only provides the surface images. To compensate for and assist in this problem, combining the surgical microscope with optical coherence tomography (OCT) has been adapted. We developed a real-time virtual intraoperative surgical OCT (VISOCT) system by adapting a spectral-domain OCT scanner with a commercial surgical microscope. Thanks to our custom-made beam splitting and image display subsystems, the OCT images and microscopic images are simultaneously visualized through an ocular lens or the eyepiece of the microscope. This improvement helps surgeons to focus on the operation without distraction to view OCT images on another separate display. Moreover, displaying the OCT live images on the eyepiece helps surgeon’s depth perception during the surgeries. Finally, we successfully processed stimulated penetrating keratoplasty in live rabbits. We believe that these technical achievements are crucial to enhance the usability of the VISOCT system in a real surgical operating condition. PMID:24604471

  4. Highly sensitive rapid fluorescence detection of protein residues on surgical instruments

    Kovalev, Valeri I [School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS (United Kingdom); Bartona, James S [School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS (United Kingdom); Richardson, Patricia R [School of Chemistry, University of Edinburgh, Edinburgh, EH9 3JJ (United Kingdom); Jones, Anita C [School of Chemistry, University of Edinburgh, Edinburgh, EH9 3JJ (United Kingdom)


    There is a risk of contamination of surgical instruments by infectious protein residues, in particular, prions which are the agents for Creutzfeldt-Jakob Disease in humans. They are exceptionally resistant to conventional sterilization, therefore it is important to detect their presence as contaminants so that alternative cleaning procedures can be applied. We describe the development of an optimized detection system for fluorescently labelled protein, suitable for in-hospital use. We show that under optimum conditions the technique can detect {approx}10 attomole/cm{sup 2} with a scan speed of {approx}3-10 cm{sup 2}/s of the test instrument's surface. A theoretical analysis and experimental measurements will be discussed.

  5. A shape memory alloy-actuated surgical instrument with compact volume.

    Shi, Zhen Yun; Liu, Da; Wang, Tian Miao


    Surgical robotic systems have been proven to be accurate and dexterous during minimally invasive surgery (MIS). However, single incision laparoscopic surgery (SILS) requires more compact robotic arms with sufficient dexterity and output. A shape memory alloy (SMA)-actuated instrument was adopted to assist operations. The instrument fixed at the slave site had three degrees of freedom (DOFs) and was driven by SMA wires, pitch, yaw, and grip, with an 8 mm diameter; a passive hydraulic support mechanism was placed in vitro. In vitro, the maximum force, velocity and accuracy were proven to be sufficient for medical application. In an animal study, the system was inserted into the abdomen; three more generic constraints were tested: medical gesture, safety, and implementation. The robot was feasible and safe for multi-angle monitoring, grasping, and holding an organ. The SMA-actuated system was accurate and dexterous with minimal system volume. Copyright © 2013 John Wiley & Sons, Ltd.

  6. Minimally invasive cardiac surgery in the adult: surgical instruments, equipment, and techniques.

    Kitamura, M; Uwabe, K; Hirota, J; Kawai, A; Endo, M; Koyanagi, H


    To clarify the special instruments and equipment used for minimally invasive cardiac surgery (MICS), we examined the initial experiences with MICS operations with ministernotomy or minithoracotomy at our institution. Fifty adult patients with congenital, valvular, and/or ischemic heart diseases underwent MICS operations, and all surgical procedures were completed without conversion to full sternotomy. The length of the skin incision was about 10 cm or less in all patients. Postoperative recovery was favorable, and the majority of the patients were discharged from the hospital around the end of the second postoperative week. In this series of patients, an oscillating bone saw, lifting type retractor, 2 blade spreader, cannula with a balloon, and right-angled aortic clamp among other items, were very useful for successfully performing various operations with MICS approaches and techniques. The associated results suggest that MICS with ministernotomy or minithoracotomy was feasible using special instruments and equipment and could be encouraged for adult patients with various cardiovascular diseases.

  7. Real time noninvasive assessment of external trunk geometry during surgical correction of adolescent idiopathic scoliosis

    Mac-Thiong Jean-Marc


    Full Text Available Abstract Background The correction of trunk deformity is crucial in scoliosis surgery, especially for the patient's self-image. However, direct visualization of external scoliotic trunk deformity during surgical correction is difficult due to the covering draping sheets. Methods An optoelectronic camera system with 10 passive markers is used to track the trunk geometry of 5 scoliotic patients during corrective surgery. The position of 10 anatomical landmarks and 5 trunk indices computed from the position of the passive markers are compared during and after instrumentation of the spine. Results Internal validation of the accuracy of tracking was evaluated at 0.41 +/- 0.05 mm RMS. Intra operative tracking during surgical maneuvers shows improvement of the shoulder balance during and after correction of the spine. Improvement of the overall patient balance is observed. At last, a minor increase of the spinal length can be noticed. Conclusion Tracking of the external geometry of the trunk during surgical correction is useful to monitor changes occurring under the sterile draping sheets. Moreover, this technique can used be used to reach the optimal configuration on the operating frame before proceeding to surgery. The current tracking technique was able to detect significant changes in trunk geometry caused by posterior instrumentation of the spine despite significant correction of the spinal curvature. It could therefore become relevant for computer-assisted guidance of surgical maneuvers when performing posterior instrumentation of the scoliotic spine, provide important insights during positioning of patients.

  8. Surgical risks and perioperative complications of instrumented lumbar surgery in patients with liver cirrhosis

    Tung-Yi Lin


    Full Text Available Background: Patients with liver cirrhosis have high surgical risks due to malnutrition, impaired immunity, coagulopathy, and encephalopathy. However, there is no information in English literature about the results of liver cirrhotic patients who underwent instrumented lumbar surgery. The purpose of this study is to report the perioperative complications, clinical outcomes and determine the surgical risk factors in cirrhotic patients. Methods: We retrospectively reviewed 29 patients with liver cirrhosis who underwent instrumented lumbar surgery between 1997 and 2009. The hepatic functional reserves of the patients were recorded according to the Child-Turcotte-Pugh scoring system. Besides, fourteen other variables and perioperative complications were also collected. To determine the risks, we divided the patients into two groups according to whether or not perioperative complications developed. Results: Of the 29 patients, 22 (76% belonged to Child class A and 7 (24% belonged to Child class B. Twelve patients developed one or more complications. Patients with Child class B carried a significantly higher incidence of complications than those with Child class A (p = 0.011. In the Child class A group, patients with 6 points had a significantly higher incidence of complications than those with 5 points (p = 0.025. A low level of albumin was significantly associated with higher risk, and a similar trend was also noted for the presence of ascites although statistical difference was not reached. Conclusion: The study concludes that patients with liver cirrhosis who have undergone instrumented lumbar surgery carry a high risk of developing perioperative complications, especially in those with a Child-Turcotte-Pugh score of 6 or more.

  9. Real-time stereo generation for surgical vision during minimal invasive robotic surgery

    Laddi, Amit; Bhardwaj, Vijay; Mahapatra, Prasant; Pankaj, Dinesh; Kumar, Amod


    This paper proposes a framework for 3D surgical vision for minimal invasive robotic surgery. It presents an approach for generating the three dimensional view of the in-vivo live surgical procedures from two images captured by very small sized, full resolution camera sensor rig. A pre-processing scheme is employed to enhance the image quality and equalizing the color profile of two images. Polarized Projection using interlacing two images give a smooth and strain free three dimensional view. The algorithm runs in real time with good speed at full HD resolution.

  10. Surgical Outcome of Reduction and Instrumented Fusion in Lumbar Degenerative Spondylolisthesis

    Farzad Omidi-Kashani


    Full Text Available Background: Lumbar degenerative spondylolisthesis (LDS is a degenerative slippage of the lumbar vertebrae. We aimed to evaluate the surgical outcome of degenerative spondylolisthesis with neural decompression, pedicular screw fixation, reduction, and posterolateral fusion. Methods: This before-after study was carried out on 45 patients (37 female and 8 male with LDS operated from August 2008 to January 2011. The patients’ pain and disability were assessed by visual analogue scale (VAS and Oswestry disability index (ODI questionnaire. In surgery, we applied distraction force to facilitate slip reduction. All the intra- and postoperative complications were recorded. The paired t-test and Pearson correlation coefficient were used for statistical analysis. Results: The mean age of patients and mean follow-up period were 58.3±3.5 years and 31.2±4.8 months, respectively. The mean slip correction rate was 52.2% with a mean correction loss of 4.8%. Preoperative VAS and ODI improved from 8.8 and 71.6 to postoperative 2.1 and 28.7, respectively. Clinical improvement was more prominent in more reduced patients, but Pearson coefficient could not find a significant correlation. Conclusion: Although spinal decompression with fusion and posterior instrumentation in surgical treatment of the patients with LDS result in satisfactory outcome, vertebral reduction cannot significantly enhance the clinical improvement.

  11. Using FPGAs to Implement DSP Algorithms in Real Time for Gamma Spectroscopy Instruments

    Bushart, B.


    Today's DSPs are capable of handling audio processing or even real time video processing; however, when the sample rate is equal to or exceeds the DSP instruction clock rate it becomes impossible to perform real time signal processing. The Savannah River Technology Center has developed a nearly all-digital radiation instrument that incorporates a single integer processor, as well as an FPGA.

  12. Real-time 3D visual tracking of laparoscopic instruments for robotized endoscope holder.

    Zhao, Zijian


    Robotized endoscope holder in laparoscopic surgeries allows surgeons to control the endoscope without the assistants' intervention. In this paper, a new method is proposed for the automatic 3D-tracking of laparoscopic instruments in real-time to provide more convenient interactions between surgeons and the robotized endoscope holder. The method is based on the 3D position measurements of the insertion points of the instruments and the strip markers, combined with the depth estimation of the instruments. The results of our experiments show that our method is fast and robust in the simulated laparoscopic surgeries.

  13. Non-surgical instrumentation associated with povidone-iodine in the treatment of interproximal furcation involvements

    Érica del Peloso Ribeiro


    Full Text Available OBJECTIVE: The aim of this controlled clinical trial was to evaluate the effect of topically applied povidone-iodine (PVP-I used as an adjunct to non-surgical treatment of interproximal class II furcation involvements. MATERIAL AND METHODS: Thirty-two patients presenting at least one interproximal class II furcation involvement that bled on probing with probing pocket depth (PPD >5 mm were recruited. Patients were randomly chosen to receive either subgingival instrumentation with an ultrasonic device using PVP-I (10% as the cooling liquid (test group or identical treatment using distilled water as the cooling liquid (control group. The following clinical outcomes were evaluated: visible plaque index, bleeding on probing (BOP, position of the gingival margin, relative attachment level (RAL, PPD and relative horizontal attachment level (RHAL. BAPNA (N-benzoyl-L-arginine-p-nitroanilide testing was used to analyze trypsin-like activity in dental biofilm. All parameters were evaluated at baseline and 1, 3 and 6 months after non-surgical subgingival instrumentation. RESULTS: Six months after treatment, both groups had similar means of PPD reduction, RAL and RHAL gain (p>0.05. These variables were, respectively, 2.20±1.10 mm, 1.27±1.02 mm and 1.33±0.85 mm in the control group and 2.67±1.21 mm, 1.50±1.09 mm and 1.56±0.93 mm in the test group. No difference was observed between groups at none of the posttreatment periods, regarding the number of sites showing clinical attachment gain >2 mm. However, at 6 months posttreatment, the test group presented fewer sites with PPD >5 mm than the control group. Also at 6 months the test group had lower BAPNA values than control group. CONCLUSION: The use of PVP-I as an adjunct in the non-surgical treatment of interproximal class II furcation involvements provided limited additional clinical benefits.

  14. Sterile and economic instrumentation in laparoscopic surgery. Experiences with 6,000 surgical laparoscopies, 1990-1996.

    Fengler, T W; Pahlke, H; Kraas, E


    Because so many common surgical problems can now be addressed by the laparoscopic approach, the issue of sterile processing has to be reconsidered. Selected laparoscopic instrumentation was analyzed regarding wear and tear and decontamination after sterile processing following 6,000 surgical laparoscopies carried out between 1990 and 1996 at the Academic Hospital Moabit, Berlin. Fewer than 7.9 (parts of) instruments failed per 100 laparoscopies. Most of the repairs involved scissors. The main problems were blunting, burnt or disconnected electromechanical components, defective insulation, and damaged or lost parts of dismantable instruments. Residues of human blood proteins were detected on a few instruments. The effect of intraluminal rinsing was documented by measuring the iron content (as an indicator for blood contamination). A comparison of costs showed that it was >10 times cheaper to use instrumentation with reusable components. The sterile processing of economic reusable instrumentation for laparoscopies needs staff well trained in sterile supply. Instrument design should allow easy dismantling and rinsing of internal parts. Insulating compounds present a problem for decontamination. Disinfection with aldehydes before cleaning the lumina of instruments must be avoided because protein coagulation will occur. A tube-in-tube concept for tubular instruments offering compatibility should be favored.

  15. A novel set of surgical instruments facilitate the procedure of laparoscopic pyeloplasty

    CHEN Wen-zheng; GUO Fei; LI Yun; Riccardo Autorino; LI Jin-yi; WANG Hui-qing; Fatih Altunrende; SUN Ying-hao


    Background Open pyeloplasty has been historically described as the gold standard for the surgical treatment of ureteropelvic junction obstruction (UPJO),even if new techniques have recently gained a prominent role in this field.Laparoscopic pyeloplasty (LP) is not widely prevelant because of the technically challenging nature and it represents the gold standard for UPJO only in expert hands.To overcome some difficulties and technical challenges encountered during pure laparoscopic pyeloplasty,we designed a set of new instruments and assessed them using porcine model.Methods According to the ideas from the surgeons,our medical engineer designed three new instruments,including the right angle laparoscopy scissors,the petal-shape ureter dilator and the guide tube.Four experienced laparoscopic experts were involved in a no survival porcine study to assess the help of these new instruments.Four experiments were conducted on live pigs that weighed 22 to 25 kg at the same time.After general anesthesia was administered,transperitoneal ureteroureterostomy was performed using standard laparoscopic instruments,including placing the double J stent anterograde.Then,the opposite lateral was done by the same surgeon plus these new devices for side-by-side comparative analysis.All experts were interviewed to assess these new instruments by the questionnaire based on the visual analog scale (VAS) from 1 (none) to 10 (very much).Results The procedures were all technically successful.The right angle laparoscopy scissors and the guide tube were accepted by all participants and the Help Score were 6.75 and 4.25 respectively,at the same time the New Difficulty Score 1.25 and 1.75.However,the petal-shape ureter dilator got 1.5 Help Score and 6.5 New Difficulty Score.These surgeons made a negative comment and one of surgeons recommended the stone basket was more suitable.Conclusion The right angle laparoscopy scissors and the guide tube may be helpful to minimize some difficulties in pure

  16. Protein Analysis Using Real-Time PCR Instrumentation: Incorporation in an Integrated, Inquiry-Based Project

    Southard, Jonathan N.


    Instrumentation for real-time PCR is used primarily for amplification and quantitation of nucleic acids. The capability to measure fluorescence while controlling temperature in multiple samples can also be applied to the analysis of proteins. Conformational stability and changes in stability due to ligand binding are easily assessed. Protein…

  17. Protein Analysis Using Real-Time PCR Instrumentation: Incorporation in an Integrated, Inquiry-Based Project

    Southard, Jonathan N.


    Instrumentation for real-time PCR is used primarily for amplification and quantitation of nucleic acids. The capability to measure fluorescence while controlling temperature in multiple samples can also be applied to the analysis of proteins. Conformational stability and changes in stability due to ligand binding are easily assessed. Protein…

  18. Instrument for Real-Time Digital Nucleic Acid Amplification on Custom Microfluidic Devices.

    Selck, David A; Ismagilov, Rustem F


    Nucleic acid amplification tests that are coupled with a digital readout enable the absolute quantification of single molecules, even at ultralow concentrations. Digital methods are robust, versatile and compatible with many amplification chemistries including isothermal amplification, making them particularly invaluable to assays that require sensitive detection, such as the quantification of viral load in occult infections or detection of sparse amounts of DNA from forensic samples. A number of microfluidic platforms are being developed for carrying out digital amplification. However, the mechanistic investigation and optimization of digital assays has been limited by the lack of real-time kinetic information about which factors affect the digital efficiency and analytical sensitivity of a reaction. Commercially available instruments that are capable of tracking digital reactions in real-time are restricted to only a small number of device types and sample-preparation strategies. Thus, most researchers who wish to develop, study, or optimize digital assays rely on the rate of the amplification reaction when performed in a bulk experiment, which is now recognized as an unreliable predictor of digital efficiency. To expand our ability to study how digital reactions proceed in real-time and enable us to optimize both the digital efficiency and analytical sensitivity of digital assays, we built a custom large-format digital real-time amplification instrument that can accommodate a wide variety of devices, amplification chemistries and sample-handling conditions. Herein, we validate this instrument, we provide detailed schematics that will enable others to build their own custom instruments, and we include a complete custom software suite to collect and analyze the data retrieved from the instrument. We believe assay optimizations enabled by this instrument will improve the current limits of nucleic acid detection and quantification, improving our fundamental

  19. Real-time segmentation and recognition of surgical tasks in cataract surgery videos.

    Quellec, Gwénolé; Lamard, Mathieu; Cochener, Béatrice; Cazuguel, Guy


    In ophthalmology, it is now common practice to record every surgical procedure and to archive the resulting videos for documentation purposes. In this paper, we present a solution to automatically segment and categorize surgical tasks in real-time during the surgery, using the video recording. The goal would be to communicate information to the surgeon in due time, such as recommendations to the less experienced surgeons. The proposed solution relies on the content-based video retrieval paradigm: it reuses previously archived videos to automatically analyze the current surgery, by analogy reasoning. Each video is segmented, in real-time, into an alternating sequence of idle phases, during which no clinically-relevant motions are visible, and action phases. As soon as an idle phase is detected, the previous action phase is categorized and the next action phase is predicted. A conditional random field is used for categorization and prediction. The proposed system was applied to the automatic segmentation and categorization of cataract surgery tasks. A dataset of 186 surgeries, performed by ten different surgeons, was manually annotated: ten possibly overlapping surgical tasks were delimited in each surgery. Using the content of action phases and the duration of idle phases as sources of evidence, an average recognition performance of Az = 0.832 ± 0.070 was achieved.

  20. Elimination of transmissible spongiform encephalopathy infectivity and decontamination of surgical instruments by using radio-frequency gas-plasma treatment.

    Baxter, H C; Campbell, G A; Whittaker, A G; Jones, A C; Aitken, A; Simpson, A H; Casey, M; Bountiff, L; Gibbard, L; Baxter, R L


    It has now been established that transmissible spongiform encephalopathy (TSE) infectivity, which is highly resistant to conventional methods of deactivation, can be transmitted iatrogenically by contaminated stainless steel. It is important that new methods are evaluated for effective removal of protein residues from surgical instruments. Here, radio-frequency (RF) gas-plasma treatment was investigated as a method of removing both the protein debris and TSE infectivity. Stainless-steel spheres contaminated with the 263K strain of scrapie and a variety of used surgical instruments, which had been cleaned by a hospital sterile-services department, were examined both before and after treatment by RF gas plasma, using scanning electron microscopy and energy-dispersive X-ray spectroscopic analysis. Transmission of scrapie from the contaminated spheres was examined in hamsters by the peripheral route of infection. RF gas-plasma treatment effectively removed residual organic residues on reprocessed surgical instruments and gross contamination both from orthopaedic blades and from the experimentally contaminated spheres. In vivo testing showed that RF gas-plasma treatment of scrapie-infected spheres eliminated transmission of infectivity. The infectivity of the TSE agent adsorbed on metal spheres could be removed effectively by gas-plasma cleaning with argon/oxygen mixtures. This treatment can effectively remove 'stubborn' residual contamination on surgical instruments.

  1. Contributors to Surgical In-patient Satisfaction—Development and Reliability of a Targeted Instrument

    CSK Cheung


    Conclusions: The initial version of HK2Happ was reliable in assessing surgical patient satisfaction. The measure is now undergoing validity testing across different surgical patient populations for generalisation and generation of a short form of discriminant items.

  2. Real-time Graphics Processing Unit Based Fourier Domain Optical Coherence Tomography and Surgical Applications

    Zhang, Kang


    In this dissertation, real-time Fourier domain optical coherence tomography (FD-OCT) capable of multi-dimensional micrometer-resolution imaging targeted specifically for microsurgical intervention applications was developed and studied. As a part of this work several ultra-high speed real-time FD-OCT imaging and sensing systems were proposed and developed. A real-time 4D (3D+time) OCT system platform using the graphics processing unit (GPU) to accelerate OCT signal processing, the imaging reconstruction, visualization, and volume rendering was developed. Several GPU based algorithms such as non-uniform fast Fourier transform (NUFFT), numerical dispersion compensation, and multi-GPU implementation were developed to improve the impulse response, SNR roll-off and stability of the system. Full-range complex-conjugate-free FD-OCT was also implemented on the GPU architecture to achieve doubled image range and improved SNR. These technologies overcome the imaging reconstruction and visualization bottlenecks widely exist in current ultra-high speed FD-OCT systems and open the way to interventional OCT imaging for applications in guided microsurgery. A hand-held common-path optical coherence tomography (CP-OCT) distance-sensor based microsurgical tool was developed and validated. Through real-time signal processing, edge detection and feed-back control, the tool was shown to be capable of track target surface and compensate motion. The micro-incision test using a phantom was performed using a CP-OCT-sensor integrated hand-held tool, which showed an incision error less than +/-5 microns, comparing to >100 microns error by free-hand incision. The CP-OCT distance sensor has also been utilized to enhance the accuracy and safety of optical nerve stimulation. Finally, several experiments were conducted to validate the system for surgical applications. One of them involved 4D OCT guided micro-manipulation using a phantom. Multiple volume renderings of one 3D data set were

  3. Developing a hybrid wind instrument: using a loudspeaker to couple a theoretical exciter to a real resonator

    Buys, K.; D. Sharp; Laney, R.


    A hybrid wind instrument generates self-sustained sounds via a real-time interaction between a computed physical model of an exciter (such as human lips interacting with a mouthpiece) and a real acoustic resonator. Successful implementation of a hybrid wind instrument will not only open up new musical possibilities but will also provide a valuable research tool. However, attempts to produce a hybrid instrument have so far fallen short, in terms of both the accuracy and the variation in the so...

  4. Kinect based real-time position calibration for nasal endoscopic surgical navigation system

    Fan, Jingfan; Yang, Jian; Chu, Yakui; Ma, Shaodong; Wang, Yongtian


    Unanticipated, reactive motion of the patient during skull based tumor resective surgery is the source of the consequence that the nasal endoscopic tracking system is compelled to be recalibrated. To accommodate the calibration process with patient's movement, this paper developed a Kinect based Real-time positional calibration method for nasal endoscopic surgical navigation system. In this method, a Kinect scanner was employed as the acquisition part of the point cloud volumetric reconstruction of the patient's head during surgery. Then, a convex hull based registration algorithm aligned the real-time image of the patient head with a model built upon the CT scans performed in the preoperative preparation to dynamically calibrate the tracking system if a movement was detected. Experimental results confirmed the robustness of the proposed method, presenting a total tracking error within 1 mm under the circumstance of relatively violent motions. These results point out the tracking accuracy can be retained stably and the potential to expedite the calibration of the tracking system against strong interfering conditions, demonstrating high suitability for a wide range of surgical applications.

  5. Jules Horowitz Reactor Project- Fuel irradiation device, innovative instrumentation proposal for experimental phenomena real time measurement

    Gaillot, Stephane; Cheymol, Guy [CEA, Paris (France)


    The fuel irradiation devices used for the tests or rods allow reproducing at small scales the conditions of the studied nuclear reactors (as LWR type). During the irradiation phase, the tested fuel rod can be stressed due to thermal, mechanical, nuclear effects which can modify its geometry (dilatation, swelling effects). After the test, the return to normal conditions can have as consequence the disappearance of the phenomenon or give access to partial information (final deformation). Generally, to follow the phenomena related to the irradiation phase, the experimental rod contained in the test device is instrumented with thermocouples and LVDT. As complement of this instrumentation, new sensors using innovating technologies are studied (deformation sensor integrating optical fibres). Through the example of a fuel irradiation device foreseen for the JHR, this paper aims to describe the present development of an innovating instrumentation with the objective to measure, in real time and under flux, the fuel rod deformation phenomena during a ramp test.

  6. Is there a role for the use of aviation assessment instruments in surgical training preparation? A feasibility study.

    Stolk-Vos, Aline C; Heres, Marion H; Kesteloo, Jasper; Verburg, Dick; Hiddema, Frans; Lie, Desiree A; de Korne, Dirk F


    Selection for surgical residency programmes could potentially be improved through pretraining preparation, after assessment of surgical candidates' sensorimotor skills and personality traits. Existing aviation pilot selection instruments are available to test sensorimotor skills and personality traits. This study examined selected instruments to assess medical trainees' sensorimotor skills and personality traits. Aviation's validated computer-based Computerized Pilot Aptitude and Screening System (COMPASS) and Checklist Professional Profile (CPP) were applied to 166 final year medical students during a surgical clerkship between 2013 and 2015. All trainees completed COMPASS and CPP within the prescribed 2 hours. Compared with an age-matched and gender-matched cohort of 165 pilot candidates, medical trainees scored significantly higher on eye-hand coordination (peye-hand-foot coordination (pdominance (p<0.001), ambition (p<0.001) and resilience (p<0.001). Final year medical trainees from one medical school were able to complete aviation's sensorimotor skills and personality traits selection instruments within the set time frame. They scored differently from aviation trainees on selected skills and personality traits. The applicability and utility of aviation instruments to presurgical training preparation remains to be tested. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  7. Study of Individual Characteristic Abdominal Wall Thickness Based on Magnetic Anchored Surgical Instruments

    Ding-Hui Dong; Wen-Yan Liu; Hai-Bo Feng; Yi-Li Fu; Shi Huang; Jun-Xi Xiang; Yi Lyu


    Background:Magnetic anchored surgical instruments (MASI),relying on magnetic force,can break through the limitations of the single port approach in dexterity.Individual characteristic abdominal wall thickness (ICAWT) deeply influences magnetic force that determines the safety of MASI.The purpose of this study was to research the abdominal wall characteristics in MASI applied environment to find ICAWT,and then construct an artful method to predict ICAWT,resulting in better safety and feasibility for MASI.Methods:For MASI,ICAWT is referred to the thickness of thickest point in the applied environment.We determined ICAWT through finding the thickest point in computed tomography scans.We also investigated the traits of abdominal wall thickness to discover the factor that can be used to predict ICAWT.Results:Abdominal wall at C point in the middle third lumbar vertebra plane (L3) is the thickest during chosen points.Fat layer thickness plays a more important role in abdominal wall thickness than muscle layer thickness."BMI-ICAWT" curve was obtained based on abdominal wall thickness of C point in L3 plane,and the expression was as follow:f(x) =P1 × x2 + P2 x x + P3,where P1 =0.03916 (0.01776,0.06056),P2 =1.098 (0.03197,2.164),P3 =-18.52 (-31.64,-5.412),R-square:0.99.Conclusions:Abdominal wall thickness of C point at L3 could be regarded as ICAWT.BMI could be a reliable predictor of ICAWT.In the light of "BMI-ICAWT" curve,we may conveniently predict ICAWT by BMI,resulting a better safety and feasibility for MASI.

  8. Study of Individual Characteristic Abdominal Wall Thickness Based on Magnetic Anchored Surgical Instruments

    Ding-Hui Dong


    Full Text Available Background: Magnetic anchored surgical instruments (MASI, relying on magnetic force, can break through the limitations of the single port approach in dexterity. Individual characteristic abdominal wall thickness (ICAWT deeply influences magnetic force that determines the safety of MASI. The purpose of this study was to research the abdominal wall characteristics in MASI applied environment to find ICAWT, and then construct an artful method to predict ICAWT, resulting in better safety and feasibility for MASI. Methods: For MASI, ICAWT is referred to the thickness of thickest point in the applied environment. We determined ICAWT through finding the thickest point in computed tomography scans. We also investigated the traits of abdominal wall thickness to discover the factor that can be used to predict ICAWT. Results: Abdominal wall at C point in the middle third lumbar vertebra plane (L3 is the thickest during chosen points. Fat layer thickness plays a more important role in abdominal wall thickness than muscle layer thickness. "BMI-ICAWT" curve was obtained based on abdominal wall thickness of C point in L3 plane, and the expression was as follow: f(x = P1 × x 2 + P2 × x + P3, where P1 = 0.03916 (0.01776, 0.06056, P2 = 1.098 (0.03197, 2.164, P3 = −18.52 (−31.64, −5.412, R-square: 0.99. Conclusions: Abdominal wall thickness of C point at L3 could be regarded as ICAWT. BMI could be a reliable predictor of ICAWT. In the light of "BMI-ICAWT" curve, we may conveniently predict ICAWT by BMI, resulting a better safety and feasibility for MASI.


    M. V. Mikhailovsky


    Full Text Available Introduction. The analysis Results of surgical treatment of growing children with infantile and juvenile scoliosis (IS can the optimal method of treatment select. In young children with significant growth potential spinal fusion may not be the best option as it limits further longitudinal growth of the spine and may to the thoracic insufficiency syndrome result. To address this problem recently several techniques focused, their have advantages and drawbacks.Material and methods. Since 2008 year 127 patients (64 girls, 63 boys aged (4.5 ± 2.1 years were operated on. In group I 65 patients were operated on using VEPTR (Vertical Expandable Prosthetic Titanium Rib instrumentation, in group II 42 patients using various spinal instrumentation. 20 patients with congenital kyphosis were excluded. The average follow-up time was (5.6 ± 1.1 years.Results. In group I average value of the primary scoliotic curve before surgery was (74.7 ± 22.9, secondary curve (42.8 ± 16.0, thoracic kyphosis (46.3 ± 27.4, lumbar lordosis (54.6 ± 14. Average value of the primary scoliotic curve after surgery was reduced to (51 ± 20 (correction 31.7%, at followup to (56.5 ± 18.5, secondary curve (31.8 ± 12.8 (25.7%, at follow-up to (32.4 ± 18.4, thoracic kyphosis (36.8 ± 20.8 (20,5%, at follow-up to (41.8 ± 21.0, lumbar lordosis (45.4 ± 12.7 (16,9%, at follow-up to (48.2 ± 11.7 (p < 0.05. Space available for lung before surgery was (84.5 ± 8.7 %, after surgery was (94.8 ± 6.7%, at follow-up increased to (98.6 ± 5.4 % (p < 0.05. Complications included 11 implant dislocations and 1 infection. In group II average value of the primary scoliotic curve before surgery was (87.6 ± 6.6, secondary curve (47.8 ± 4.6, thoracic kyphosis (61.4 ± 10.4, lumbar lordosis (61.8 ± 4.9. Average value of the primary scoliotic curve after surgery was reduced to 50.6 ± 5.3 (correction 42.3%, at follow-up to (66.1 ± 6.3

  10. Peta-Flop Real Time Radio Astronomy Signal Processing Instrumentation and the CASPER Collaboration

    Werthimer, Dan


    I will briefly describe next generation radio telescopes, such as HERA and the Square Kilometer Array (SKA), which will require 1E15 to 1E17 operations per second of real time processing. I'll present some of the new architectures we've used to develop a variety of heterogeneous FPGA-GPU-CPU based signal processing systems for such telescopes, including spectrometers, correlators, and beam formers. I will also describe the CASPER collaboration, which has developed architectures, open source programming tools, libraries and reference designs that make it relatively easy to develop a variety of scalable, upgradeable, fault tolerant, low power, real time digital signal processing instrumentation. CASPER utilizes commercial 10Gbit and 40 Gbit ethernet switches to interconnect open source general purpose field programmable gate array (FPGA) boards with GPUs and software modules. CASPER collaborators at hundreds of universities, government labs and observatories have used these techniques to rapidly develop and deploy a variety of correlators, beamformers, spectrometers, pulsar/transient machines, and VLBI instrumentation. CASPER instrumentation is also utilized in physics, medicine, genomics and engineering. Open source source hardware, software, libraries, tools, tutorials, reference designs, information about workshops, and how to join the collaboration are available at

  11. A Novel Combination Point-of-View (POV) Action Camera Recording to Capture the Surgical Field and Instrument Ergonomics in Oculoplastic Surgery.

    Warrian, Kevin J; Ashenhurst, Michael; Gooi, Adrian; Gooi, Patrick


    To evaluate a novel combination head-mounted/chest-mounted point-of-view recording system for oculoplastic surgical procedures. The point-of-view head camera captures the surgical field, while the point-of-view chest camera captures a wide field of view to record instrument ergonomics. Various methods of recording were trialed. The head camera with a narrow field of view was better for recording fine details of the surgical field. The chest camera recording a wide field of view was optimal for recording hand positions. Stereoscopic recording of the instrument ergonomics was helpful in relaying the relative positions of the surgeon's hands and instruments. Point-of-view cameras are cost-effective means of recording oculoplastics procedures. The authors feel simultaneously recording the surgeon's ergonomics and the corresponding instrument movements within the surgical field, from the "surgeon's view", will augment surgical education.

  12. Virtual instrumentation and real-time executive dashboards. Solutions for health care systems.

    Rosow, Eric; Adam, Joseph; Coulombe, Kathleen; Race, Kathleen; Anderson, Rhonda


    Successful organizations have the ability to measure and act on key indicators and events in real time. By leveraging the power of virtual instrumentation and open architecture standards, multidimensional executive dashboards can empower health care organizations to make better and faster data-driven decisions. This article will highlight how user-defined virtual instruments and dashboards can connect to hospital information systems (e.g., admissions/discharge/transfer systems, patient monitoring networks) and use statistical process control to "visualize" information and make timely, data-driven decisions. The case studies described will illustrate enterprisewide solutions for: bed management and census control, operational management, data mining and business intelligence applications, and clinical applications (physiological data acquisition and wound measurement and analysis).

  13. A real time study of the human equilibrium using an instrumented insole with 3 pressure sensors.

    Abou Ghaida, Hussein; Mottet, Serge; Goujon, Jean-Marc


    The present work deals with the study of the human equilibrium using an ambulatory e-health system. One of the point on which we focus is the fall risk, when losing equilibrium control. A specific postural learning model is presented, and an ambulatory instrumented insole is developed using 3 pressures sensors per foot, in order to determine the real-time displacement and the velocity of the centre of pressure (CoP). The increase of these parameters signals a loss of physiological sensation, usually of vision or of the inner ear. The results are compared to those obtained from classical more complex systems.

  14. Real-time stratum-deciding using the drilling parameter instrument

    Teng, Z. [Shandong Bureau of Coal and Geology (China)


    The drilling parameter instrument described in this paper can gather large amounts of data of drilling speed, drilling pressure and rotation speed. With the data, apparent drilling indexes of all kinds of rocks can be calculated through regression analysis. The results of the calculations are displayed on the computer screen and the condition of the stratum can be evaluated real time as drilling is going on. Practical application of this method shows that it is feasible and efficient. 1 ref., 1 fig., 4 tabs.

  15. Portable Chemical Sterilizer for Microbial Decontamination of Surgical Instruments, Fruits and Vegetables, and Field Feeding Equipment

    Doona, C. J; Feeherry, F. E; Kustin, K; Curtin, M. A; Baer, D. G


    The Portable Chemical Sterilizer (PCS) is a revolutionary biomedical sterilization technology that provides the capability for portable, power-free, point-of-use sterilization to meet the Army's Far-Forward Surgical Teams (FSTs...

  16. Instrumentation


    Journal Scope:Instrumentation is a high quality open access peer reviewed research journal.Authors are solicited to contribute to these journals by submitting articles that illustrate most up-to-date research results,projects,surveying works and industrial experiences that describe significant advances in the instrumental science.The mission of the Instrumentation is

  17. Comparison by objective parameters in patients with chronic rhinosinusitis managed medically and surgically (with and without powered instruments)

    Behera, Samarendra; Patro, Sourabha K.; Gupta, Ashok K.


    Objective: To compare mucociliary clearance time and quality of life in patients who underwent sinus surgery using conventional and powered instruments, and in patients who were treated nonsurgically. Methods: A total of 151 patients with chronic rhinosinusitis were included. Fifty-four patients were treated conservatively, 48 patients were managed surgically by using conventional instruments and 49 patients were managed by using a microdebrider. Kupferberg nasal endoscopy grades, 20-item Sino-Nasal Outcome Test scores, Lund-Mackay scores, and mucociliary clearance time were analyzed. Results: On comparison among the groups, it was found that there was a significant difference between group A (nonsurgically treated) compared with group B (surgery by conventional means) or group C (surgery with microdebrider) in nasal endoscopic grades, Lund-Mackay scores, 20-item Sino-Nasal Outcome Test scores, and mucociliary clearance time. However, in comparison between groups B and C, there was no statistically significant difference. Conclusion: Mucociliary clearance time tended to recover after starting treatment for chronic rhinosinusitis both after conservative treatment and after surgical treatment. Surgery provided better improvement in different objective scores in chronic rhinosinusitis. There exists no statistical difference in parameters independent of the instrument used for surgery. PMID:28107141

  18. A Portable Array-Type Optical Fiber Sensing Instrument for Real-Time Gas Detection

    San-Shan Hung


    Full Text Available A novel optical fiber array-type of sensing instrument with temperature compensation for real-time detection was developed to measure oxygen, carbon dioxide, and ammonia simultaneously. The proposed instrument is multi-sensing array integrated with real-time measurement module for portable applications. The sensing optical fibers were etched and polished before coating to increase sensitivities. The ammonia and temperature sensors were each composed of a dye-coated single-mode fiber with constructing a fiber Bragg grating and a long-period filter grating for detecting light intensity. Both carbon dioxide and oxygen sensing structures use multimode fibers where 1-hydroxy-3,6,8-pyrene trisulfonic acid trisodium salt is coated for carbon dioxide sensing and Tris(2,2′-bipyridyl dichlororuthenium(II hexahydrate and Tris(bipyridineruthenium(II chloride are coated for oxygen sensing. Gas-induced fluorescent light intensity variation was applied to detect gas concentration. The portable gas sensing array was set up by integrating with photo-electronic measurement modules and a human-machine interface to detect gases in real time. The measured data have been processed using piecewise-linear method. The sensitivity of the oxygen sensor were 1.54%/V and 9.62%/V for concentrations less than 1.5% and for concentrations between 1.5% and 6%, respectively. The sensitivity of the carbon dioxide sensor were 8.33%/V and 9.62%/V for concentrations less than 2% and for concentrations between 2% and 5%, respectively. For the ammonia sensor, the sensitivity was 27.78%/V, while ammonia concentration was less than 2%.

  19. A Portable Array-Type Optical Fiber Sensing Instrument for Real-Time Gas Detection.

    Hung, San-Shan; Chang, Hsing-Cheng; Chang, I-Nan


    A novel optical fiber array-type of sensing instrument with temperature compensation for real-time detection was developed to measure oxygen, carbon dioxide, and ammonia simultaneously. The proposed instrument is multi-sensing array integrated with real-time measurement module for portable applications. The sensing optical fibers were etched and polished before coating to increase sensitivities. The ammonia and temperature sensors were each composed of a dye-coated single-mode fiber with constructing a fiber Bragg grating and a long-period filter grating for detecting light intensity. Both carbon dioxide and oxygen sensing structures use multimode fibers where 1-hydroxy-3,6,8-pyrene trisulfonic acid trisodium salt is coated for carbon dioxide sensing and Tris(2,2'-bipyridyl) dichlororuthenium(II) hexahydrate and Tris(bipyridine)ruthenium(II) chloride are coated for oxygen sensing. Gas-induced fluorescent light intensity variation was applied to detect gas concentration. The portable gas sensing array was set up by integrating with photo-electronic measurement modules and a human-machine interface to detect gases in real time. The measured data have been processed using piecewise-linear method. The sensitivity of the oxygen sensor were 1.54%/V and 9.62%/V for concentrations less than 1.5% and for concentrations between 1.5% and 6%, respectively. The sensitivity of the carbon dioxide sensor were 8.33%/V and 9.62%/V for concentrations less than 2% and for concentrations between 2% and 5%, respectively. For the ammonia sensor, the sensitivity was 27.78%/V, while ammonia concentration was less than 2%.

  20. Surgeons and their tools: a history of surgical instruments and their innovators--Part II: The surgeon's wand-evolution from knife to scalpel to electrocautery.

    El-Sedfy, Abraham; Chamberlain, Ronald S


    This is the second of five articles reviewing the historical origins of some of the more commonly used surgical instruments and takes "time out" to remind current surgeons about the surgical pioneers on whose shoulders they now stand and whose inventions they now use.

  1. Surgeons and their tools: a history of surgical instruments and their innovators. Part III: the medical student's best friend—retractors.

    El-Sedfy, Abraham; Chamberlain, Ronald S


    This is the third of five manuscripts reviewing the historical origins of some of the more commonly used surgical instruments and takes "time out" to remind current surgeons about the surgical pioneers on whose shoulders they now stand and whose inventions they now use.

  2. Surgeons and their tools: a history of surgical instruments and their innovators--part I: place the scissors on the Mayo stand.

    El-Sedfy, Abraham; Chamberlain, Ronald S


    This is the first of five articles reviewing the historical origins of some of the more commonly used surgical instruments and takes "time out" to remind current surgeons about the surgical pioneers on whose shoulders they now stand and whose inventions they now use.

  3. Instrumentation


    Journal Scope:Instrumentation is a high quality open access peer reviewed research journal.Authors are solicited to contribute to these journals by submitting articles that illustrate most up-to-date research results,projects,surveying works and industrial experiences that describe significant advances in the instrumental science.The mission of the Instrumentation is to provide a platform for the researchers,academicians,

  4. Shortened OR time and decreased patient risk through use of a modular surgical instrument with artificial intelligence.

    Miller, David J; Nelson, Carl A; Oleynikov, Dmitry


    With a limited number of access ports, minimally invasive surgery (MIS) often requires the complete removal of one tool and reinsertion of another. Modular or multifunctional tools can be used to avoid this step. In this study, soft computing techniques are used to optimally arrange a modular tool's functional tips, allowing surgeons to deliver treatment of improved quality in less time, decreasing overall cost. The investigators watched University Medical Center surgeons perform MIS procedures (e.g., cholecystectomy and Nissen fundoplication) and recorded the procedures to digital video. The video was then used to analyze the types of instruments used, the duration of each use, and the function of each instrument. These data were aggregated with fuzzy logic techniques using four membership functions to quantify the overall usefulness of each tool. This allowed subsequent optimization of the arrangement of functional tips within the modular tool to decrease overall time spent changing instruments during simulated surgical procedures based on the video recordings. Based on a prototype and a virtual model of a multifunction laparoscopic tool designed by the investigators that can interchange six different instrument tips through the tool's shaft, the range of tool change times is approximately 11-13 s. Using this figure, estimated time savings for the procedures analyzed ranged from 2.5 to over 32 min, and on average, total surgery time can be reduced by almost 17% by using the multifunction tool.

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

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


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

  6. Instrumentation

    Decreton, M


    SCK-CEN's research and development programme on instrumentation involves the assessment and the development of sensitive measurement systems used within a radiation environment. Particular emphasis is on the assessment of optical fibre components and their adaptability to radiation environments. The evaluation of ageing processes of instrumentation in fission plants, the development of specific data evaluation strategies to compensate for ageing induced degradation of sensors and cable performance form part of these activities. In 2000, particular emphasis was on in-core reactor instrumentation applied to fusion, accelerator driven and water-cooled fission reactors. This involved the development of high performance instrumentation for irradiation experiments in the BR2 reactor in support of new instrumentation needs for MYRRHA, and for diagnostic systems for the ITER reactor.

  7. Real-Time Virtual Instruments for Remote Sensor Monitoring Using Low Bandwidth Wireless Networks

    Biruk Gebre


    Full Text Available The development of a peer-to-peer virtual instrumentation system for remote acquisition, analysis and transmission of data on low bandwidth networks is described. The objective of this system is to collect high frequency/high bandwidth data from multiple sensors placed at remote locations and adaptively adjust the resolution of this data so that it can be transmitted on bandwidth limited networks to a central monitoring and command center. This is achieved by adaptively re-sampling (decimating the data from the sensors at the remote location before transmission. The decimation is adjusted to the available bandwidth of the communications network which is characterized in real-time. As a result, the system allows users at the remote command center to view high bandwidth data (at a lower resolution with user-aware and minimized latency. This technique is applied to an eight hydrophone data acquisition system that requires a 25.6 Mbps connection for the transmission of the full data set using a wireless connection with 1 – 3.5 Mbps variable bandwidth. This technique can be used for applications that require monitoring of high bandwidth data from remote sensors in research and education fields such as remote scientific instruments and visually driven control applications.

  8. Use of real-time kernels in process control: An application to beam instrumentation

    Brahy, D.; Momal, F.; Rabany, M.; Saban, R.; Thys, A. (European Organization for Nuclear Research, Geneva (Switzerland). LEP-BI/CS)


    Process-control system components have evolved from a state where they provided a simple digital and analog interface to the world, to very sophisticated dedicated computers offering a service. The software in these devices has followed the same evolution: on the one hand it has continued satisfying the real-time constraints dictated by process control, on the other hand it has coped with the complexity of the fully developed computer system which it has now become. The beam instrumentation of LEP consists of several types of instruments which are distributed over the whole perimeter of the collider and are interfaced to the control system using approximately 100 VME crates. Since most of the applications needed the same type of facilities, protection mechanisms and system services, it seemed justified to provide a common environment to all. The embedded applications environment is built around a commercially available operating-system kernel and provides services such as alarm management, communications, logbook, etc. The design goals and benefits of this approach and the description of this environment are discussed. (orig.).

  9. Real-Time Virtual Instruments for Remote Sensor Monitoring Using Low Bandwidth Wireless Networks

    Biruk Gebre


    Full Text Available The development of a peer-to-peer virtual instrumentation system for remote acquisition, analysis and transmission of data on low bandwidth networks is described. The objective of this system is to collect high frequency/high bandwidth data from multiple sensors placed at remote locations and adaptively adjust the resolution of this data so that it can be transmitted on bandwidth limited networks to a central monitoring and command center. This is achieved by adaptively re-sampling (decimating the data from the sensors at the remote location before transmission. The decimation is adjusted to the available bandwidth of the communications network which is characterized in real-time. As a result, the system allows users at the remote command center to view high bandwidth data (at a lower resolution with user-aware and minimized latency. This technique is applied to an eight hydrophone data acquisition system that requires a 25.6 Mbps connection for the transmission of the full data set using a wireless connection with 1 – 3.5 Mbps variable bandwidth. This technique can be used for applications that require monitoring of high bandwidth data from remote sensors in research and education fields such as remote scientific instruments and visually driven control applications.

  10. The impact of the use of different types of gloves and bare hands for preparation of clean surgical instruments 1

    Bruna, Camila Quartim de Moraes; de Souza, Rafael Queiroz; Massaia, Irineu Francisco Silva; Cruz, Áurea Silveira; Graziano, Kazuko Uchikawa


    ABSTRACT Objectives: to determine if there are differences on the safety of the preparation of clean surgical instruments using different types of gloves and bare hands and evaluate the microbiological load of these preparations without gloves. Method: laboratory procedure with a pragmatic approach, in which the samples were handled with different types of gloves and bare hands. In addition, cytotoxicity assays were carried out by means of the agar diffusion method. Further samples were subjected to microbiological analysis after being handled without gloves. Results: none of the samples showed cytotoxic effect. All microbiological cultures showed growth of microorganisms, but no microorganism has been recovered after autoclaving. Conclusion: there were no differences in the cytotoxic responses regarding the use of different types of gloves and bare hands in the handling of clean surgical instruments, which could entail iatrogenic risk. It is noteworthy that the use of gloves involves increase in the costs of process and waste generation, and the potential allergenic risk to latex. PMID:27737375

  11. Real-time monitoring for detection of retained surgical sponges and team motion in the surgical operation room using radio-frequency-identification (RFID) technology: a preclinical evaluation.

    Kranzfelder, Michael; Zywitza, Dorit; Jell, Thomas; Schneider, Armin; Gillen, Sonja; Friess, Helmut; Feussner, Hubertus


    Technical progress in the surgical operating room (OR) increases constantly, facilitating the development of intelligent OR systems functioning as "safety backup" in the background of surgery. Precondition is comprehensive data retrieval to identify imminent risky situations and inaugurate adequate security mechanisms. Radio-frequency-identification (RFID) technology may have the potential to meet these demands. We set up a pilot study investigating feasibility and appliance reliability of a stationary RFID system for real-time surgical sponge monitoring (passive tagged sponges, position monitoring: mayo-stand/abdominal situs/waste bucket) and OR team tracking (active transponders, position monitoring: right/left side of OR table). In vitro: 20/20 sponges (100%) were detected on the mayo-stand and within the OR-phantom, however, real-time detection accuracy declined to 7/20 (33%) when the tags were moved simultaneously. All retained sponges were detected correctly. In vivo (animal): 7-10/10 sterilized sponges (70%-100%) were detected correctly within the abdominal cavity. OR-team: detection accuracy within the OR (surveillance antenna) and on both sides of the OR table (sector antenna) was 100%. Mean detection time for position change (left to right side and contrariwise) was 30-60 s. No transponder failure was noted. This is the first combined RFID system that has been developed for stationary use in the surgical OR. Preclinical evaluation revealed a reliable sponge tracking and correct detection of retained textiles (passive RFID) but also demonstrated feasibility of comprehensive data acquisition of team motion (active RFID). However, detection accuracy needs to be further improved before implementation into the surgical OR. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. 28 CFR 552.13 - X-ray, major instrument, fluoroscope, or surgical intrusion.


    ... INSTITUTIONAL MANAGEMENT CUSTODY Searches of Housing Units, Inmates, and Inmate Work Areas § 552.13 X-ray, major... 28 Judicial Administration 2 2010-07-01 2010-07-01 false X-ray, major instrument, fluoroscope, or... reasons only, with the inmate's consent. (b) The institution physician may authorize use of an X-ray...

  13. Attaining high bending stiffness by full actuation in steerable minimally invasive surgical instruments.

    Jelínek, Filip; Gerboni, Giada; Henselmans, Paul W J; Pessers, Rob; Breedveld, Paul


    Steerable instruments are a promising trend in minimally invasive surgery (MIS), due to their manoeuvring capabilities enabling reaching over obstacles. Despite the great number of steerable joint designs, currently available steerable tips tend to be vulnerable to external loading, thus featuring low bending stiffness. This work aims to provide empirical evidence that the bending stiffness can be considerably increased by using fully actuated joint constructions, enabling left/right and up/down tip rotations with the minimum of two degrees of freedom (DOF), rather than conventional underactuated constructions enabling these rotations with more than two DOF. A steerable MIS instrument prototype with a fully actuated joint construction was compared to state-of-the-art underactuated steerable instruments in a number of tip deflection experiments. The tip deflections due to loading were measured by means of a universal testing machine in four bending scenarios: straight and bent over 20°, 40° and 60°. The experimental results support the claim that a fully actuated joint construction exhibits a significantly larger bending stiffness than an underactuated joint construction. Furthermore, it was shown that the underactuated instrument tips show a considerable difference between their neutral positions before and after loading, which could also be greatly minimised by full actuation.

  14. Instrumentation

    Decreton, M


    SCK-CEN's R and D programme on instrumentation involves the development of advanced instrumentation systems for nuclear applications as well as the assessment of the performance of these instruments in a radiation environment. Particular emphasis is on the use of optical fibres as umbilincal links of a remote handling unit for use during maintanance of a fusion reacor, studies on the radiation hardening of plasma diagnostic systems; investigations on new instrumentation for the future MYRRHA accelerator driven system; space applications related to radiation-hardened lenses; the development of new approaches for dose, temperature and strain measurements; the assessment of radiation-hardened sensors and motors for remote handling tasks and studies of dose measurement systems including the use of optical fibres. Progress and achievements in these areas for 2001 are described.

  15. Instrumentation

    Decreton, M


    SCK-CEN's research and development programme on instrumentation aims at evaluating the potentials of new instrumentation technologies under the severe constraints of a nuclear application. It focuses on the tolerance of sensors to high radiation doses, including optical fibre sensors, and on the related intelligent data processing needed to cope with the nuclear constraints. Main achievements in these domains in 1999 are summarised.

  16. Supportive periodontal therapy of furcation sites: non-surgical instrumentation with or without topical doxycycline.

    Dannewitz, Bettina; Lippert, Katherine; Lang, Niklaus P; Tonetti, Maurizio S; Eickholz, Peter


    Evaluation of the clinical effect of topical subgingival application of doxycycline gel adjunctively to scaling and root planing (SRP) at furcation sites during supportive periodontal therapy (SPT). In 39 SPT patients exhibiting at least four pockets > or m with bleeding on probing, SRP was rendered in all pockets > or m. Additionally, 14% doxycycline gel was applied subgingivally in 20 patients after random assignment (SRP&DOXY). Clinical parameters were assessed at baseline, 3, 6, and 12 months after therapy. Additional benefit of topical doxycycline was evaluated as a short-term (3 months) improvement of furcation involvement and influence on the frequency of re-instrumentation up to 12 months. A total of 323 furcation sites (class 0: 160; class I: 101; class II: 18; and class III: 44) were treated (SRP: 165, SRP&DOXY: 158). SRP&DOXY resulted in better improvement of furcation involvement than SRP alone 3 months after treatment (p=0.041). However, SRP&DOXY failed to show a significant difference between both groups in the number of re-instrumentations. Single subgingival application of doxycycline in addition to SRP had a short-term effect on furcation involvement. However, it failed to reduce the frequency of re-instrumentation up to 12 months at furcation sites.

  17. Standard management and maintenance of robot surgical instruments%机器人手术器械规范化管理及保养探讨

    银彩霞; 苑景; 赵悦; 董薪; 李丽霞; 孙建荷


    Objective To study how to prolong the working life of robot surgical instruments by strengthening their management and maintenance. Methods A series of regulations for the management and maintenance of robot surgical instruments were established. Results The working life of robot surgical instruments was prolonged and the satisfaction score of surgeons increased after implementation of the regulations for the management and maintenance of robot surgical instruments. Conclusion Effective management and maintenance of robot surgical instruments can prolong their working life, shorten the operation time, and improve the operation level.%目的 探讨达芬奇机器人手术器械日常使用管理及保养,延长器械使用寿命.方法 建立规范化机器人器械使用管理及保养条例.结果 器械使用寿命得以延长,医生满意度调查分数得到提高.结论 机器人设备、器械得到有效的管理和保养,延长了使用寿命,缩短了手术时间,提高了手术配合质量.

  18. Evaluation of a tractor cab using real-time aerosol counting instrumentation.

    Hall, Ronald M; Heitbrink, William A; Reed, Laurence D


    concentration / inside concentration) was used to calculate how efficient the tractor cab was at removing aerosols. The John Deere cab was more than 99 percent efficient at removing aerosols larger than 3.0 microm in diameter and had protection factors greater than 260 for particles larger than 3.0 microm (indicated by the PDM results). The Nelson cab was more than 99 percent efficient at removing aerosols larger than 3.0 microm in diameter and had protection factors greater than 200 for particles larger than 3.0 microm (indicated by the PDM results). For aerosols smaller than 1.0 microm in diameter (indicated by a PortaCount Plus instrument), the John Deere cab provided a mean protection factor of 43 and the Nelson cab provided a mean protection factor of 16. The results from this study indicate that tractor cabs can be effective at removing different size aerosols depending on the seals and filters used with the enclosure. This study has also demonstrated the practical use of real-time aerosol counting instrumentation to evaluate the effectiveness of enclosures and to help identify leak sources. The method used in this study can be applied to various cabs used in different industries including agriculture, construction, and manufacturing.

  19. Toward real-time endoscopically-guided robotic navigation based on a 3D virtual surgical field model

    Gong, Yuanzheng; Hu, Danying; Hannaford, Blake; Seibel, Eric J.


    The challenge is to accurately guide the surgical tool within the three-dimensional (3D) surgical field for roboticallyassisted operations such as tumor margin removal from a debulked brain tumor cavity. The proposed technique is 3D image-guided surgical navigation based on matching intraoperative video frames to a 3D virtual model of the surgical field. A small laser-scanning endoscopic camera was attached to a mock minimally-invasive surgical tool that was manipulated toward a region of interest (residual tumor) within a phantom of a debulked brain tumor. Video frames from the endoscope provided features that were matched to the 3D virtual model, which were reconstructed earlier by raster scanning over the surgical field. Camera pose (position and orientation) is recovered by implementing a constrained bundle adjustment algorithm. Navigational error during the approach to fluorescence target (residual tumor) is determined by comparing the calculated camera pose to the measured camera pose using a micro-positioning stage. From these preliminary results, computation efficiency of the algorithm in MATLAB code is near real-time (2.5 sec for each estimation of pose), which can be improved by implementation in C++. Error analysis produced 3-mm distance error and 2.5 degree of orientation error on average. The sources of these errors come from 1) inaccuracy of the 3D virtual model, generated on a calibrated RAVEN robotic platform with stereo tracking; 2) inaccuracy of endoscope intrinsic parameters, such as focal length; and 3) any endoscopic image distortion from scanning irregularities. This work demonstrates feasibility of micro-camera 3D guidance of a robotic surgical tool.

  20. Instruments

    Buehrer, W. [Paul Scherrer Inst. (PSI), Villigen (Switzerland)


    The present paper mediates a basic knowledge of the most commonly used experimental techniques. We discuss the principles and concepts necessary to understand what one is doing if one performs an experiment on a certain instrument. (author) 29 figs., 1 tab., refs.

  1. Instrumentation


    Journal Scope:Instrumentation is a high quality open access peer reviewed research journal,Authors are solicited to contribute to these journals by submitting articles that illustrate most up-to-date research results,projects,surveying works and industrial

  2. A Rapid Evaluation of Activity in Lupus (LFA-REAL(™) ) Correlates with More Complex Disease Activity Instruments Whether Evaluated by Clinical Investigators or Real-World Clinicians.

    Askanase, Anca D; Nguyen, Samantha C; Costenbader, Karen; Lim, S Sam; Kamen, Diane; Aranow, Cynthia; Grossman, Jennifer; Kapoor, Teja M; Baker-Frost, DeAnna; Aberle, Teresa; Thanou-Stavraki, Aikaterini; Hanrahan, Leslie M; Kim, Mimi; Merrill, Joan T


    Lupus disease measures such as the SLE Disease Activity Index (SLEDAI) and the British Isles Lupus Assessment Group (BILAG) Index are challenging to interpret. The Lupus Foundation of America-Rapid Evaluation of Activity in Lupus (LFA-REAL) is intended to provide an efficient application of anchored visual analogue scores, each representing the individual severity of active symptoms, with the sum of individual scores deriving an overall disease activity assessment. To compare the performance of LFA-REAL to SLE disease activity assessments and compare scores between trained lupus clinical investigators and clinicians. Investigators scored the SLEDAI, BILAG, PGA, and LFA-REAL, while the clinicians scored the LFA-REAL. The level of agreement between physicians and instruments was determined. The study included 99 patients, 93% women, 31% Caucasian, 43.4 (±13.2) years old. At the first visit, the SLEDAI was 5.5 (±4.5), BILAG 6.7 (±7.8), and PGA 33.6 (±24.5). The investigator REAL was 46.2 (±42.9), and clinician REAL 56.1 (±53.6). At the second visit, the investigator REAL was 41.3 (±36.7), and clinician REAL 48.3 (±42.6). Total REAL scores correlated positively with PGA, SLEDAI, and BILAG (ρ 0.58-0.88, p 0.7 for musculoskeletal, mucocutaneous, and renal BILAG domains. The intra-class correlation coefficient between the REAL scores of investigators and clinicians was 0.79 for Visit1 (p < 0.001) and 0.86 for Visit2 (p < 0.001). The LFA-REAL provides a reliable surrogate for more complicated disease activity measures when used by lupus clinical investigators or clinicians. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  3. Human cadavers to evaluate prototypes of minimally invasive surgical instruments: A feasibility study.

    van den Haak, Lukas; Alleblas, Chantal; Rhemrev, Johann P; Scheltes, Jules; Nieboer, Bertho; Jansen, Frank Willem


    New technology should be extensively tested before it is tried on patients. Unfortunately representative models are lacking. In theory, fresh frozen human cadavers are excellent models. To identify strengths and weaknesses of fresh frozen human cadavers as research models for new technology prior to implementation in gynecological surgery. During pre-clinical validation studies regarding the MobiSep uterine manipulator, test procedures were performed on fresh frozen cadavers. Both the experimental setup as the performance of the prototype were assessed. Five tests including six human cadavers were performed. Major changes were made to the MobiSep prototype design. The cadavers of two tests closely resembled surgical experiences as found in live patients. The anatomy of 4 of the 6 cadavers was not fully representative due to atrophy of the internal genitalia caused by age and due to the presence of pathology such extensive tumorous tissue. The cadaver tests provided vital information regarding design and functionality, that failed to emerge during the in-vitro testing. However, experiments are subject to anatomical uncertainties or restrictions. Consequently, the suitability of a cadaver should be carefully assessed before it is used for testing new technology.

  4. Vertebral Osteomyelitis Caused by Mycobacterium abscessus Surgically Treated Using Antibacterial Iodine-Supported Instrumentation

    Satoshi Kato


    Full Text Available Mycobacterium abscessus infections rarely develop in healthy individuals, and mostly they occur in immunocompromised hosts. Vertebral osteomyelitis due to Mycobacterium abscessus is very rare and only three previous cases of spinal infection caused by Mycobacterium abscessus have been reported. Mycobacterium abscessus isolates are uniformly resistant to antituberculous agents and can display a virulent biofilm-forming phenotype. The patient was a 67-year-old woman with vertebral osteomyelitis of the L1-2. She was healthy without immune-suppressed condition, history of trauma, or intravenous drug use. The smear examination of the specimen harvested by CT-guided puncture of the paravertebral abscess revealed Mycobacterium abscessus. Her disease condition did not abate with conservative treatment using antimicrobial chemotherapy. Radical debridement of the vertebral osteomyelitis and anterior reconstruction from T12 to L2 using antibacterial iodine-supported instrumentation were performed. Chemotherapy using clarithromycin, amikacin, and imipenem was applied for 6 months after surgery as these antibiotics had been proven to be effective to Mycobacterium abscessus after surgery. Two years after surgery, the infected anterior site healed and bony fusion was successfully achieved without a recurrence of infection.

  5. Incidence and risk of delayed surgical site infection following instrumented lumbar spine fusion.

    Lewkonia, Peter; DiPaola, Christian; Street, John


    We reviewed a retrospective case series of patients with delayed infections after spinal fusion, and surveyed medical experts in Canada and the USA regarding their use of prophylactic antibiotics for patients undergoing invasive procedures following spine surgery. Infections after spinal fusion are a relatively common complication, which typically occur early in the postoperative period. Infections which occur more than 3months from the index procedure are rare and are often caused by atypical pathogens. The proportion of infections that required debridement and occurred 6 months after the index procedure was 4.3% (7/162). Over 85% of these infections were polymicrobial, with one third of those containing methicillin-resistant Staphylococcus aureus. The most common operative indications were either trauma or tumour, and most patients with a delayed infection had a distant chronic infection. The majority of spine experts do not routinely recommend prophylactic antibiotics for invasive procedures after spine fusion. In the multivariate analysis, experts were more likely to recommend antibiotics for patients undergoing a non-dental procedure, those who were diabetic, and those who were greater than 1year out from their procedure. In summary, the delayed presentation of infection after instrumented spinal fusion is a rare but serious complication. However, due to its infrequency, routine prophylaxis to prevent haematogenous seeding is likely unnecessary. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Ultra-high throughput real-time instruments for capturing fast signals and rare events

    Buckley, Brandon Walter

    Wide-band signals play important roles in the most exciting areas of science, engineering, and medicine. To keep up with the demands of exploding internet traffic, modern data centers and communication networks are employing increasingly faster data rates. Wide-band techniques such as pulsed radar jamming and spread spectrum frequency hopping are used on the battlefield to wrestle control of the electromagnetic spectrum. Neurons communicate with each other using transient action potentials that last for only milliseconds at a time. And in the search for rare cells, biologists flow large populations of cells single file down microfluidic channels, interrogating them one-by-one, tens of thousands of times per second. Studying and enabling such high-speed phenomena pose enormous technical challenges. For one, parasitic capacitance inherent in analog electrical components limits their response time. Additionally, converting these fast analog signals to the digital domain requires enormous sampling speeds, which can lead to significant jitter and distortion. State-of-the-art imaging technologies, essential for studying biological dynamics and cells in flow, are limited in speed and sensitivity by finite charge transfer and read rates, and by the small numbers of photo-electrons accumulated in short integration times. And finally, ultra-high throughput real-time digital processing is required at the backend to analyze the streaming data. In this thesis, I discuss my work in developing real-time instruments, employing ultrafast optical techniques, which overcome some of these obstacles. In particular, I use broadband dispersive optics to slow down fast signals to speeds accessible to high-bit depth digitizers and signal processors. I also apply telecommunication multiplexing techniques to boost the speeds of confocal fluorescence microscopy. The photonic time stretcher (TiSER) uses dispersive Fourier transformation to slow down analog signals before digitization and

  7. Integrative advances for OCT-guided ophthalmic surgery and intraoperative OCT: microscope integration, surgical instrumentation, and heads-up display surgeon feedback.

    Justis P Ehlers

    Full Text Available PURPOSE: To demonstrate key integrative advances in microscope-integrated intraoperative optical coherence tomography (iOCT technology that will facilitate adoption and utilization during ophthalmic surgery. METHODS: We developed a second-generation prototype microscope-integrated iOCT system that interfaces directly with a standard ophthalmic surgical microscope. Novel features for improved design and functionality included improved profile and ergonomics, as well as a tunable lens system for optimized image quality and heads-up display (HUD system for surgeon feedback. Novel material testing was performed for potential suitability for OCT-compatible instrumentation based on light scattering and transmission characteristics. Prototype surgical instruments were developed based on material testing and tested using the microscope-integrated iOCT system. Several surgical maneuvers were performed and imaged, and surgical motion visualization was evaluated with a unique scanning and image processing protocol. RESULTS: High-resolution images were successfully obtained with the microscope-integrated iOCT system with HUD feedback. Six semi-transparent materials were characterized to determine their attenuation coefficients and scatter density with an 830 nm OCT light source. Based on these optical properties, polycarbonate was selected as a material substrate for prototype instrument construction. A surgical pick, retinal forceps, and corneal needle were constructed with semi-transparent materials. Excellent visualization of both the underlying tissues and surgical instrument were achieved on OCT cross-section. Using model eyes, various surgical maneuvers were visualized, including membrane peeling, vessel manipulation, cannulation of the subretinal space, subretinal intraocular foreign body removal, and corneal penetration. CONCLUSIONS: Significant iterative improvements in integrative technology related to iOCT and ophthalmic surgery are demonstrated.

  8. The impact of the use of different types of gloves and bare hands for preparation of clean surgical instruments.

    Bruna, Camila Quartim de Moraes; Souza, Rafael Queiroz de; Massaia, Irineu Francisco Silva; Cruz, Áurea Silveira; Graziano, Kazuko Uchikawa


    to determine if there are differences on the safety of the preparation of clean surgical instruments using different types of gloves and bare hands and evaluate the microbiological load of these preparations without gloves. laboratory procedure with a pragmatic approach, in which the samples were handled with different types of gloves and bare hands. In addition, cytotoxicity assays were carried out by means of the agar diffusion method. Further samples were subjected to microbiological analysis after being handled without gloves. none of the samples showed cytotoxic effect. All microbiological cultures showed growth of microorganisms, but no microorganism has been recovered after autoclaving. there were no differences in the cytotoxic responses regarding the use of different types of gloves and bare hands in the handling of clean surgical instruments, which could entail iatrogenic risk. It is noteworthy that the use of gloves involves increase in the costs of process and waste generation, and the potential allergenic risk to latex. determinar se existe diferenças na segurança do preparo de instrumentais cirúrgicos relacionada ao uso de distintos tipos de luvas e das mãos nuas no preparo, e avaliar a carga microbiológica destes preparados sem luvas. experimento laboratorial com abordagem pragmática, onde amostras foram manipuladas com diferentes tipos de luvas e com as mãos nuas, elaborado teste de citotoxicidade por meio da difusão em ágar. Outras Amostras sofreram análise microbiológica após serem manipuladas sem luvas. nenhuma das amostras apresentou efeito citotóxico. Todas as culturas microbiológicas apresentaram crescimento de microrganismos, embora nenhum microrganismo tenha sido recuperado após a autoclavação. não houve diferenças nas respostas citotóxicas relacionadas ao uso de diferentes tipos de luvas e das mãos nuas na manipulação do instrumental cirúrgico limpo que sinalizasse risco de iatrogenia. Ressalta-se que o uso de luvas

  9. Analysis of risk factors for loss of lumbar lordosis in patients who had surgical treatment with segmental instrumentation for adolescent idiopathic scoliosis.

    Trobisch, Per D; Samdani, Amer F; Betz, Randal R; Bastrom, Tracey; Pahys, Joshua M; Cahill, Patrick J


    Iatrogenic flattening of lumbar lordosis in patients with adolescent idiopathic scoliosis (AIS) was a major downside of first generation instrumentation. Current instrumentation systems allow a three-dimensional scoliosis correction, but flattening of lumbar lordosis remains a significant problem which is associated with decreased health-related quality of life. This study sought to identify risk factors for loss of lumbar lordosis in patients who had surgical correction of AIS with the use of segmental instrumentation. Patients were included if they had surgical correction for AIS with segmental pedicle screw instrumentation Lenke type 1 or 2 and if they had a minimum follow-up of 24 months. Two groups were created, based on the average loss of lumbar lordosis. The two groups were then compared and multivariate analysis was performed to identify parameters that correlated to loss of lumbar lordosis. Four hundred and seventeen patients were analyzed for this study. The average loss of lumbar lordosis at 24 months follow-up was an increase of 10° lordosis for group 1 and a decrease of 15° for group 2. Risk factors for loss of lumbar lordosis included a high preoperative lumbar lordosis, surgical decrease of thoracic kyphosis, and the particular operating surgeon. The lowest instrumented vertebra or spinopelvic parameters were two of many parameters that did not seem to influence loss of lumbar lordosis. This study identified important risk factors for decrease of lumbar lordosis in patients who had surgical treatment for AIS with segmental pedicle screw instrumentation, including a high preoperative lumbar lordosis, surgical decrease of thoracic kyphosis, and factors attributable to a particular operating surgeon that were not quantified in this study.

  10. Evaluation of surgical strategy of conventional vs. percutaneous robot-assisted spinal trans-pedicular instrumentation in spondylodiscitis.

    Keric, Naureen; Eum, David J; Afghanyar, Feroz; Rachwal-Czyzewicz, Izabela; Renovanz, Mirjam; Conrad, Jens; Wesp, Dominik M A; Kantelhardt, Sven R; Giese, Alf


    Robot-assisted percutaneous insertion of pedicle screws is a recent technique demonstrating high accuracy. The optimal treatment for spondylodiscitis is still a matter of debate. We performed a retrospective cohort study on surgical patients treated with pedicle screw/rod placement alone without the application of intervertebral cages. In this collective, we compare conventional open to a further minimalized percutaneous robot-assisted spinal instrumentation, avoiding a direct contact of implants and infectious focus. 90 records and CT scans of patients treated by dorsal transpedicular instrumentation of the infected segments with and without decompression and antibiotic therapy were analysed for clinical and radiological outcome parameters. 24 patients were treated by free-hand fluoroscopy-guided surgery (121 screws), and 66 patients were treated by percutaneous robot-assisted spinal instrumentation (341 screws). Accurate screw placement was confirmed in 90 % of robot-assisted and 73.5 % of free-hand placed screws. Implant revision due to misplacement was necessary in 4.95 % of the free-hand group compared to 0.58 % in the robot-assisted group. The average intraoperative X-ray exposure per case was 0.94 ± 1.04 min in the free-hand group vs. 0.4 ± 0.16 min in the percutaneous group (p = 0.000). Intraoperative adverse events were observed in 12.5 % of free-hand placed pedicle screws and 6.1 % of robot robot-assisted screws. The mean postoperative hospital stay in the free-hand group was 18.1 ± 12.9 days, and in percutaneous group, 13.8 ± 5.6 days (p = 0.012). This study demonstrates that the robot-guided insertion of pedicle screws is a safe and effective procedure in lumbar and thoracic spondylodiscitis with higher accuracy of implant placement, lower radiation dose, and decreased complication rates. Percutaneous spinal dorsal instrumentation seems to be sufficient to treat lumbar and thoracic spondylodiscitis.

  11. A study on factors of dissatisfaction and stress of the blacksmiths resulting from the organizational culture in the surgical instrument industry of India

    Tirthankar Ghosh


    Full Text Available Background: It is important to understand what motivates workers and the extent to which the organization and other contextual variables satisfy them. The aim of the study was to determine factors of dissatisfaction resulting from the organizational culture among the blacksmiths involved in the surgical instrument industry. Materials and Methods: Fifty male surgical blacksmiths each of the skilled and unskilled groups of the forging section were selected. Organizational Role Stress Scale was used to measure the individuals′ role stress and several forms of conflict within an organization. Also, the organizational culture and personal involvement in an organization was measured among the surgical blacksmiths. Results: The mean score for total role stress for Skilled was 71.7 and for unskilled was 77.2. The most frequent type of organizational culture was reported to be hierarchy, both by skilled and unskilled surgical blacksmiths, followed by market and clan culture. Conclusion: This study shows that the skilled surgical blacksmiths have lower level of stress and conflicts in comparison with unskilled surgical blacksmiths. Both skilled and unskilled surgical blacksmiths estimated their level of personal involvement as low and indicated insufficient involvement in work teams. The satisfaction of the employees with their status and role in the organizational culture was also poor for both skilled and unskilled surgical blacksmiths.

  12. Medical devices; general and plastic surgery devices; classification of the powered surgical instrument for improvement in the appearance of cellulite. Final order.


    The Food and Drug Administration (FDA) is classifying the powered surgical instrument for improvement in the appearance of cellulite into class II (special controls). The Agency is classifying the device into class II (special controls) in order to provide a reasonable assurance of safety and effectiveness of the device.

  13. Digital Education Governance: Data Visualization, Predictive Analytics, and "Real-Time" Policy Instruments

    Williamson, Ben


    Educational institutions and governing practices are increasingly augmented with digital database technologies that function as new kinds of policy instruments. This article surveys and maps the landscape of digital policy instrumentation in education and provides two detailed case studies of new digital data systems. The Learning Curve is a…

  14. Digital Education Governance: Data Visualization, Predictive Analytics, and "Real-Time" Policy Instruments

    Williamson, Ben


    Educational institutions and governing practices are increasingly augmented with digital database technologies that function as new kinds of policy instruments. This article surveys and maps the landscape of digital policy instrumentation in education and provides two detailed case studies of new digital data systems. The Learning Curve is a…

  15. New real-time MR image-guided surgical robotic system for minimally invasive precision surgery

    Hashizume, M.; Yasunaga, T.; Konishi, K. [Kyushu University, Department of Advanced Medical Initiatives, Faculty of Medical Sciences, Fukuoka (Japan); Tanoue, K.; Ieiri, S. [Kyushu University Hospital, Department of Advanced Medicine and Innovative Technology, Fukuoka (Japan); Kishi, K. [Hitachi Ltd, Mechanical Engineering Research Laboratory, Hitachinaka-Shi, Ibaraki (Japan); Nakamoto, H. [Hitachi Medical Corporation, Application Development Office, Kashiwa-Shi, Chiba (Japan); Ikeda, D. [Mizuho Ikakogyo Co. Ltd, Tokyo (Japan); Sakuma, I. [The University of Tokyo, Graduate School of Engineering, Bunkyo-Ku, Tokyo (Japan); Fujie, M. [Waseda University, Graduate School of Science and Engineering, Shinjuku-Ku, Tokyo (Japan); Dohi, T. [The University of Tokyo, Graduate School of Information Science and Technology, Bunkyo-Ku, Tokyo (Japan)


    To investigate the usefulness of a newly developed magnetic resonance (MR) image-guided surgical robotic system for minimally invasive laparoscopic surgery. The system consists of MR image guidance [interactive scan control (ISC) imaging, three-dimensional (3-D) navigation, and preoperative planning], an MR-compatible operating table, and an MR-compatible master-slave surgical manipulator that can enter the MR gantry. Using this system, we performed in vivo experiments with MR image-guided laparoscopic puncture on three pigs. We used a mimic tumor made of agarose gel and with a diameter of approximately 2 cm. All procedures were successfully performed. The operator only advanced the probe along the guidance device of the manipulator, which was adjusted on the basis of the preoperative plan, and punctured the target while maintaining the operative field using robotic forceps. The position of the probe was monitored continuously with 3-D navigation and 2-D ISC images, as well as the MR-compatible laparoscope. The ISC image was updated every 4 s; no artifact was detected. A newly developed MR image-guided surgical robotic system is feasible for an operator to perform safe and precise minimally invasive procedures. (orig.)

  16. Real-time Near-infrared Virtual Intraoperative Surgical Photoacoustic Microscopy

    Changho Lee


    Full Text Available We developed a near infrared (NIR virtual intraoperative surgical photoacoustic microscopy (NIR-VISPAM system that combines a conventional surgical microscope and an NIR light photoacoustic microscopy (PAM system. NIR-VISPAM can simultaneously visualize PA B-scan images at a maximum display rate of 45 Hz and display enlarged microscopic images on a surgeon's view plane through the ocular lenses of the surgical microscope as augmented reality. The use of the invisible NIR light eliminated the disturbance to the surgeon's vision caused by the visible PAM excitation laser in a previous report. Further, the maximum permissible laser pulse energy at this wavelength is approximately 5 times more than that at the visible spectral range. The use of a needle-type ultrasound transducer without any water bath for acoustic coupling can enhance convenience in an intraoperative environment. We successfully guided needle and injected carbon particles in biological tissues ex vivo and in melanoma-bearing mice in vivo.

  17. Monitoring biothreat agents (Francisella tularensis, Bacillus anthracis and Yersinia pestis) with a portable real-time PCR instrument.

    Mölsä, Markos; Hemmilä, Heidi; Katz, Anna; Niemimaa, Jukka; Forbes, Kristian M; Huitu, Otso; Stuart, Peter; Henttonen, Heikki; Nikkari, Simo


    In the event of suspected releases or natural outbreaks of contagious pathogens, rapid identification of the infectious agent is essential for appropriate medical intervention and disease containment. The purpose of this study was to compare the performance of a novel portable real-time PCR thermocycler, PikoReal™, to the standard real-time PCR thermocycler, Applied Biosystems® 7300 (ABI 7300), for the detection of three high-risk biothreat bacterial pathogens: Francisella tularensis, Bacillus anthracis and Yersinia pestis. In addition, a novel confirmatory real-time PCR assay for the detection of F. tularensis is presented and validated. The results show that sensitivity of the assays, based on a dilution series, for the three infectious agents ranged from 1 to 100 fg of target DNA with both instruments. No cross-reactivity was revealed in specificity testing. Duration of the assays with the PikoReal and ABI 7300 systems were 50 and 100 min, respectively. In field testing for F. tularensis, results were obtained with the PikoReal system in 95 min, as the pre-PCR preparation, including DNA extraction, required an additional 45 min. We conclude that the PikoReal system enables highly sensitive and rapid on-site detection of biothreat agents under field conditions, and may be a more efficient alternative to conventional diagnostic methods.

  18. Surgical Instrument Decontamination Unit


    against rhinovirus tested both in suspension and on carriers (Mentel; 1973). Hydrogen peroxide in r2atively high concentrations (10 to 25%) is also...ultrasonic cavitation does not rely solely upon a chemical reaction between the hydroxyl radical and bacterial cell structures or components, although...from textiles without damaging the textile structure . It is used as a gas generator for foam products and very large quantities are used annually for

  19. 牙膏清洗陈旧性污染器械的效果观察%The effects of cleaning old contaminated surgical instruments with toothpastes



    Objective:In order to improve the quality of surgical Instruments-cleaning to prevent infection in the hospital.Methods:First,scrub the seriously contaminated surgical instruments with the toothpaste, and then put them into the cleaning-disinfecting machine to be cleaned in a standard way.Result:The rate of standard-obtained surgical operation instrument cleaned with toothpaste reaches 90%and the rust-returning rate is 0;The rate of standard-obtained instrument cleaned with conventional method is 62%while the rust-returning rate reaches 37%.Conclusion:The way of removing stain/rust from the surgical operation instrument with the toothpaste is better, which saves cost ,so it is worth applying and popularizing.%目的:提高器械清洗质量,预防医院感染。方法:使用牙膏对污染严重的器械进行刷洗,再放入清洗消毒机进行规范化洗涤。结果:牙膏清洗合格率为90%,返锈率为0;常规清洗合格率为62%,返锈率为37%。结论:牙膏清洗去除污染器械的污渍和锈渍效果好,节约了成本,值得推广应用。

  20. 腹腔镜手术器械的维护保养及管理%Maintenance and Management of Laparoscopic Surgical Instruments



    该文对腹腔镜等精密手术器械实施规范的维护保养措施,加强其管理制度的落实,能够有效提升器械完好率,延长其使用寿命,保证器械使用安全性,避免因手术器械原因造成的医疗事故的发生。该文总结腹腔镜手术器械的维护、保养及管理措施,提高器械功能完好率。提出制定标准、规范的腹腔镜手术器械清洗、消毒、灭菌操作规程及维护保养措施,制定严格的腹腔镜器械管理制度,并严格落实。%The paper of laparoscopic surgical precision instrument implementation specification of maintenance and maintenance measures, strengthen the implementation of its management system, can effectively improve equipment intact rate, prolong the service life of and ensure the use safety of the equipment and avoid the occurrence of medical accidents caused by surgical instruments. This article summarized the maintenance, the maintenance and the management measure of the laparoscopic operation instrument, and improve the function of the instrument. Proposed to develop standards, norms of laparoscopic surgical instruments cleaning, disinfection, sterilization operation procedures and maintenance measures, strict implementation of the laparoscopic instrument management system, and strictly implement.

  1. Real-time computer-generated integral imaging and 3D image calibration for augmented reality surgical navigation.

    Wang, Junchen; Suenaga, Hideyuki; Liao, Hongen; Hoshi, Kazuto; Yang, Liangjing; Kobayashi, Etsuko; Sakuma, Ichiro


    Autostereoscopic 3D image overlay for augmented reality (AR) based surgical navigation has been studied and reported many times. For the purpose of surgical overlay, the 3D image is expected to have the same geometric shape as the original organ, and can be transformed to a specified location for image overlay. However, how to generate a 3D image with high geometric fidelity and quantitative evaluation of 3D image's geometric accuracy have not been addressed. This paper proposes a graphics processing unit (GPU) based computer-generated integral imaging pipeline for real-time autostereoscopic 3D display, and an automatic closed-loop 3D image calibration paradigm for displaying undistorted 3D images. Based on the proposed methods, a novel AR device for 3D image surgical overlay is presented, which mainly consists of a 3D display, an AR window, a stereo camera for 3D measurement, and a workstation for information processing. The evaluation on the 3D image rendering performance with 2560×1600 elemental image resolution shows the rendering speeds of 50-60 frames per second (fps) for surface models, and 5-8 fps for large medical volumes. The evaluation of the undistorted 3D image after the calibration yields sub-millimeter geometric accuracy. A phantom experiment simulating oral and maxillofacial surgery was also performed to evaluate the proposed AR overlay device in terms of the image registration accuracy, 3D image overlay accuracy, and the visual effects of the overlay. The experimental results show satisfactory image registration and image overlay accuracy, and confirm the system usability.

  2. Custom real-time ultrasonic instrumentation for simultaneous mixture and flow analysis of binary gases in the CERN ATLAS experiment

    Alhroob, M.; Berry, S.; Bitadze, A.; Bonneau, P.; Boyd, G.; Crespo-Lopez, O.; Degeorge, C.; Deterre, C.; Di Girolamo, B.; Doubek, M.; Favre, G.; Hallewell, G.; Hasib, A.; Katunin, S.; Lombard, D.; Madsen, A.; McMahon, S.; Nagai, K.; O'Rourke, A.; Pearson, B.; Robinson, D.; Rossi, C.; Rozanov, A.; Stanecka, E.; Strauss, M.; Vacek, V.; Vaglio, R.; Young, J.; Zwalinski, L.


    Custom ultrasonic instruments have been developed for simultaneous monitoring of binary gas mixture and flow in the ATLAS Inner Detector. Sound transit times are measured in opposite directions in flowing gas. Flow rate and sound velocity are respectively calculated from their difference and average. Gas composition is evaluated in real-time by comparison with a sound velocity/composition database, based on the direct dependence of sound velocity on component concentrations in a mixture at known temperature and pressure. Five devices are integrated into the ATLAS Detector Control System. Three instruments monitor coolant leaks into N2 envelopes of the silicon microstrip and Pixel detectors. Resolutions better than ±2×10−5±2×10−5 and ±2×10−4±2×10−4 are seen for C3F8 and CO2 leak concentrations in N2 respectively. A fourth instrument detects sub-percent levels of air ingress into the C3F8 condenser of the new thermosiphon coolant recirculator. Following extensive studies a fifth instrument was b...

  3. Comparison of real-time instruments and gravimetric method when measuring particulate matter in a residential building.

    Wang, Zuocheng; Calderón, Leonardo; Patton, Allison P; Sorensen Allacci, MaryAnn; Senick, Jennifer; Wener, Richard; Andrews, Clinton J; Mainelis, Gediminas


    This study used several real-time and filter-based aerosol instruments to measure PM2.5 levels in a high-rise residential green building in the Northeastern US and compared performance of those instruments. PM2.5 24-hr average concentrations were determined using a Personal Modular Impactor (PMI) with 2.5 µm cut (SKC Inc., Eighty Four, PA) and a direct reading pDR-1500 (Thermo Scientific, Franklin, MA) as well as its filter. 1-hr average PM2.5 concentrations were measured in the same apartments with an Aerotrak Optical Particle Counter (OPC) (model 8220, TSI, Inc., Shoreview, MN) and a DustTrak DRX mass monitor (model 8534, TSI, Inc., Shoreview, MN). OPC and DRX measurements were compared with concurrent 1-hr mass concentration from the pDR-1500. The pDR-1500 direct reading showed approximately 40% higher particle mass concentration compared to its own filter (n = 41), and 25% higher PM2.5 mass concentration compared to the PMI2.5 filter. The pDR-1500 direct reading and PMI2.5 in non-smoking homes (self-reported) were not significantly different (n = 10, R(2) = 0.937), while the difference between measurements for smoking homes was 44% (n = 31, R(2) = 0.773). Both OPC and DRX data had substantial and significant systematic and proportional biases compared with pDR-1500 readings. However, these methods were highly correlated: R(2) = 0.936 for OPC versus pDR-1500 reading and R(2) = 0.863 for DRX versus pDR-1500 reading. The data suggest that accuracy of aerosol mass concentrations from direct-reading instruments in indoor environments depends on the instrument, and that correction factors can be used to reduce biases of these real-time monitors in residential green buildings with similar aerosol properties.

  4. Web-enabled and real-time reporting: Cellular based instrumentation for coastal sea level and surge monitoring

    Joseph, A.; Desai, R.G.P.

    every 5 min in the form of an e-mail message. The resulting data are displayed on the NTSLF web pages. Chile established a network, which Tsunami Ch022.tex 27/9/2006 11: 56 Page 251 Web-enabled and real-time reporting: instrumentation and monitoring 251... Maldonaldo), Nor- way (Daniel Hareide), France (Guy Woppelman), UK (Peter Foden), Chile (Juan Fierro), and USA (Bernie Kilonsky) to provide advice and recommendations concerning technical aspects of sea-level observations such as station configuration, data...

  5. Precision of GNSS instruments by static method comparing in real time

    Slavomír Labant


    Full Text Available Tablet paper describes comparison of measuring accuracy two apparatus from the firm Leica. One of them recieve signals onlyfrom GPS satelites and another instrument is working with GPS and also with GLONASS satelites. Measuring is carry out by RTK staticmethod with 2 minutes observations. Measurement processing is separated to X, Y (position and h (heigh. Adjustment of directobservations is used as a adjusting method.

  6. Does the piezoelectric surgical technique produce fewer postoperative sequelae after lower third molar surgery than conventional rotary instruments? A systematic review and meta analysis.

    Al-Moraissi, E A; Elmansi, Y A; Al-Sharaee, Y A; Alrmali, A E; Alkhutari, A S


    A systematic review and meta-analysis was conducted to answer the clinical question "Does the piezoelectric surgical technique produce fewer postoperative sequelae after lower third molar surgery than conventional rotary instruments?" A systematic and electronic search of several databases with specific key words, a reference search, and a manual search were performed from respective dates of inception through November 2014. The inclusion criteria were clinical human studies, including randomized controlled trials (RCTs), controlled clinical trials (CCTs), and retrospective studies, with the aim of comparing the piezoelectric surgical osteotomy technique to the standard rotary instrument technique in lower third molar surgery. Postoperative sequelae (oedema, trismus, and pain), the total number of analgesics taken, and the duration of surgery were analyzed. A total of nine articles were included, six RCTs, two CCTs, and one retrospective study. Six studies had a low risk of bias and three had a moderate risk of bias. A statistically significant difference was found between piezoelectric surgery and conventional rotary instrument surgery for lower third molar extraction with regard to postoperative sequelae (oedema, trismus, and pain) and the total number of analgesics taken (P=0.0001, P=0.0001, Ppiezoelectric osteotomy group (Ppiezoelectric surgery significantly reduced the occurrence of postoperative sequelae (oedema, trismus, and pain) and the total number of analgesics taken compared to the conventional rotary instrument technique in lower third molar surgery, but required a longer surgery time.

  7. Vernier Caliper and Micrometer Computer Models Using Easy Java Simulation and Its Pedagogical Design Features--Ideas for Augmenting Learning with Real Instruments

    Wee, Loo Kang; Ning, Hwee Tiang


    This paper presents the customization of Easy Java Simulation models, used with actual laboratory instruments, to create active experiential learning for measurements. The laboratory instruments are the vernier caliper and the micrometer. Three computer model design ideas that complement real equipment are discussed. These ideas involve (1) a…

  8. Vernier Caliper and Micrometer Computer Models Using Easy Java Simulation and Its Pedagogical Design Features--Ideas for Augmenting Learning with Real Instruments

    Wee, Loo Kang; Ning, Hwee Tiang


    This paper presents the customization of Easy Java Simulation models, used with actual laboratory instruments, to create active experiential learning for measurements. The laboratory instruments are the vernier caliper and the micrometer. Three computer model design ideas that complement real equipment are discussed. These ideas involve (1) a…

  9. Real world instrumentation with Python automated data acquisition and control systems

    Hughes, John


    Learn how to develop your own applications to monitor or control instrumentation hardware. Whether you need to acquire data from a device or automate its functions, this practical book shows you how to use Python's rapid development capabilities to build interfaces that include everything from software to wiring. You get step-by-step instructions, clear examples, and hands-on tips for interfacing a PC to a variety of devices. Use the book's hardware survey to identify the interface type for your particular device, and then follow detailed examples to develop an interface with Python and C. O

  10. Development of a PTR-TOFMS instrument for real-time measurements of volatile organic compounds in air

    Tanimoto, Hiroshi; Aoki, Nobuyuki; Inomata, Satoshi; Hirokawa, Jun; Sadanaga, Yasuhiro


    A proton transfer reaction-time-of-flight mass spectrometer (PTR-TOFMS) has been developed for real-time measurements of volatile organic compounds in air. The instrument is designed to be operated with a hollow cathode discharge ion source and an ion drift tube at relatively high pressures. Each component of the system, an ion source, a drift tube, an ion transfer region, and a time-of-flight mass spectrometer, are in detail characterized by a number of laboratory experiments. The optimized instrumental configuration enables us to gain high intensities of hydronium (H3O+) ions, typically ~7 × 105 counts for 1-min integration at a drift tube pressure of ~5 Torr. It also suppresses background signals, and interferences from sample air (NO+ and O2+), which undergo fast reactions with volatile organic compounds, to ~0.5% of those of H3O+ ions. We find that the use of the custom-built discharge source show higher overall sensitivities than of a commercially available radioactive source. Potentials to detect oxygenated VOCs (aldehydes, ketones, and alcohols), halocarbons, and amines are also suggested. The detection limits for acetaldehyde, acetone, isoprene, benzene, toluene, and p-xylene were determined to be at the sub-ppbv levels for a 1-min integration time. A good linear response at trace levels is certified, but slight sensitivity dependency on water vapor contents is revealedE We finally demonstrate that the instrument can be used for on-line monitoring to detect large variations from emission sources in real-time.

  11. Citizen earthquake alert using near real time PGA estimation from a local array combining a variety of accelerometric instruments

    Melis, Nikolaos S.; Konstantinou, Konstantinos; Kalogeras, Ioannis; Sokos, Efthimios; Tselentis, G.-Akis


    It is of a great importance to assess rapidly the intensity of a felt event in a highly populated environment. Rapid and reliable information plays a key role to decision making responses, by performing correctly the first steps after a felt ground shaking. Thus, it is important to accurately respond to urgent societal demand using reliable information. A strong motion array is under deployment and trial operation in the area of Patras, Greece. It combines: (a) standard accelerometric stations operated by the National Observatory of Athens, Institute of Geodynamics (NOA), (b) QCN-type USB MEMS acceleration sensors deployed in schools and (c) P-alert MEMS acceleration devices deployed in public sector buildings as well as in private dwellings. The array intends to cover the whole city of Patras and the populated suburbs. All instruments are operating in near real time and they are linked to a combined Earthworm - SeisComP3 server at NOA, Athens. Rapid intensity estimation can be also performed by the P-alert accelerometers locally, but the performance of a near real time intensity estimation system is under operation at NOA. The procedure is based on observing the maximum PGA value at each instrument and empirically estimate the corresponding intensity. The values are also fed to a SeisComP3 based ShakeMap procedure that is served at NOA and uses the scwfparam module of SeisComP3. Earthquake activity has been recorded so far from the western Corinth Gulf, the Ionian Islands and Achaia-Elia area, western Peloponnesus. The first phase involves correlation tests of collocated instruments and assessment of their performance to low intensity as well as to strongly felt events in the Patras city area. Steps of expanding the array are also under consideration, in order to cover the wider area of northwestern Peloponnesus and Ionian islands.

  12. Development of Upgraded Magnetic Instrumentation for CERN Real-Time Reference Field Measurement Systems

    Buzio, M; Galbraith, P; Golluccio, G; Giloteaux, D; Gilardoni, S; Petrone, C; Walckiers, L


    The control of five of the accelerators in the CERN injector chain (PS, PS Booster, SPS, LEIR and AD) is based upon real-time measurements in a reference magnet. These so-called “B-train” systems include a field marker to signal the achievement of a given field value, complemented by one or more pick-up coils to integrate flux changes. Recently, some concerns were raised about long-term reliability and performance improvements, in terms of both resolution and operational flexibility, for these systems. This paper reports the status of three related R&D activities, namely: the development of a novel dynamic NMR field marker for the PS; a campaign aimed at the detailed measurement of the magnetic state of a PS main magnet; and the design of a standardized electronic signal acquisition and conditioning system.

  13. Minimally invasive surgical instruments with an accessory channel capable of integrating fibre-optic cable for optical biopsy: a review of the state of the art.

    Jelínek, Filip; Arkenbout, Ewout A; Sakes, Aimée; Breedveld, Paul


    This review article provides a comprehensive overview and classification of minimally invasive surgical instruments with an accessory channel incorporating fibreoptics or another auxiliary device for various purposes. More specifically, this review was performed with the focus on the newly emerging field of optical biopsy, its objective being to discuss primarily the instruments capable of carrying out the optical biopsy and subsequent tissue resection. Instruments housing the fibreoptics for other uses, as well as instruments with an accessory channel capable of housing the fibreoptics instead of their original auxiliary device after relevant design modifications, supplement the review. The entire Espacenet and Scopus databases were searched, yielding numerous patents and articles on conceptual and existing instruments satisfying the criteria. The instruments were categorised based on the function the fibreoptics or the auxiliary device serves. On the basis of their geometrical placement with respect to the tissue resector or manipulator, the subcategories were further defined. This subdivision was used to identify the feasibility of performing the optical biopsy and the tissue resection in an accurate and successive fashion. In general, the existing concepts or instruments are regarded as limited with regard to such a functionality, either due to the placement of their accessory channel with or without the fibreoptics or due to the operational restrictions of their tissue manipulators. A novel opto-mechanical biopsy harvester, currently under development at Delft University of Technology, is suggested as a promising alternative, ensuring a fast and accurate succession of the optical and the mechanical biopsies of a flat superficial tissue. © IMechE 2014.

  14. The importance of clinical semiotics and instrumental investigations in the diagnosis and surgical treatment of osteoid osteoma. A report of 6 cases.

    Carfagni, A; Moreschini, O; Billi, A


    The authors emphasize the importance of a complete examination, including history, symptomatology and instrumental tests in the diagnosis of osteoid osteoma (O.O.). This lesion is often difficult to diagnose, particularly at unusual sites. However, by the use of accurate radiography, stratigraphy, bone scan and CAT, a pre-operative accurate diagnosis is usually possible. The authors emphasize the importance of the least invasive surgical approach and the complete removal of the lesion with generous curettage. This is not always easy, as illustrated in the present study, which includes atypical sites, sometimes in delicate anatomical situations. They also illustrate a particular method used for removal.

  15. On Gamma Ray Instrument On-Board Data Processing Real-Time Computational Algorithm for Cosmic Ray Rejection

    Kizhner, Semion; Hunter, Stanley D.; Hanu, Andrei R.; Sheets, Teresa B.


    Richard O. Duda and Peter E. Hart of Stanford Research Institute in [1] described the recurring problem in computer image processing as the detection of straight lines in digitized images. The problem is to detect the presence of groups of collinear or almost collinear figure points. It is clear that the problem can be solved to any desired degree of accuracy by testing the lines formed by all pairs of points. However, the computation required for n=NxM points image is approximately proportional to n2 or O(n2), becoming prohibitive for large images or when data processing cadence time is in milliseconds. Rosenfeld in [2] described an ingenious method due to Hough [3] for replacing the original problem of finding collinear points by a mathematically equivalent problem of finding concurrent lines. This method involves transforming each of the figure points into a straight line in a parameter space. Hough chose to use the familiar slope-intercept parameters, and thus his parameter space was the two-dimensional slope-intercept plane. A parallel Hough transform running on multi-core processors was elaborated in [4]. There are many other proposed methods of solving a similar problem, such as sampling-up-the-ramp algorithm (SUTR) [5] and algorithms involving artificial swarm intelligence techniques [6]. However, all state-of-the-art algorithms lack in real time performance. Namely, they are slow for large images that require performance cadence of a few dozens of milliseconds (50ms). This problem arises in spaceflight applications such as near real-time analysis of gamma ray measurements contaminated by overwhelming amount of traces of cosmic rays (CR). Future spaceflight instruments such as the Advanced Energetic Pair Telescope instrument (AdEPT) [7-9] for cosmos gamma ray survey employ large detector readout planes registering multitudes of cosmic ray interference events and sparse science gamma ray event traces' projections. The AdEPT science of interest is in the

  16. Antibacterial effects of silver-coafed surgical instruments%新型表面镀银手术器械抗菌性能研究

    刘蕊; 沈蕾; 栗茜; 胡文艳; 李石宝; 杨聚才; 魏建华


    AIM; To evaluate the antibacterial effects of silver-coafed surgical instruments. METHODS;Enghty sets of surgical instruments were divided into silver-coafed and conventional groups (re =40). The surfaces of instruments in silver-coafed group were coated with silver according to standard protocols. The surfaces in conventional group received no treatments. After sterilization, the instruments were exposed to different surgical environments and bacterial contamination of the instrument surfaces in the two groups were observed and compared. The sterilized status of the two groups in different preservation environments was also inspected. RESULTS: No bacterial contamination was observed in both groups after 4 h exposure in laminar flow operation room. While after 8h exposure, the contamination rate of control group was 30% , which was significantly higher than the 10% of the silver-coafed group. The rate of contamination in control group was significantly high than that of the silver-coafed group when exposed to natural environment for 4 h and 8 h ( P <0.05). The sterilization status of the silver-coafed instruments was significantly longer than that of the control group. CONCLUSION: The silver-coafed surgical instruments show significant antibacterial effects.%目的:观察表面镀银手术器械抗菌性能.方法:选择80份相同的手术器械,随机分为镀银器械组和常规器械组(每组40份),镀银器械组手术器械表面按照标准镀银,制成表面含银手术器械;常规器械组手术器械表面则不作任何处理.两组均采用高压蒸汽消毒法灭菌后,分别置于洁净手术间和野战帐篷的不同环境中,比较两组器械在空气中暴露不同时间后的细菌检出率,以及无菌包装状态下保存时间的差异.结果:灭菌后在洁净手术间暴露状态下4h后两组均未检出细菌,8h后常规器械组细菌检出率30%,镀银器械组细菌检出率10%;野战帐篷空气

  17. An experimental evaluation of the instrumented flux synthesis method for the real-time estimation of reactivity. Final report

    Hughes, J.C.; Henry, A.F.; Lanning, D.D.; Bernard, J.A.


    One method of determining the flux density is flux synthesis which approximates the flux in the core by linear combinations of precomputed shape functions. In traditional flux synthesis, the unknown mixing coefficients are determined using a weighted residual method of solving the diffusion equation. In the instrumented synthesis method, the mixing coefficients are determined using count rates from neutron detectors in the core. In this way the mixing coefficients are linked to conditions in the reactor. Using the synthesized flux, kinetics parameters, notably reactivity, can be calculated in real time. An experimental evaluation has been performed in the Massachusetts Institute of Technology Reactor, MITR-II. Detector measurements have been collected using fission chambers placed at the periphery of the core. The reactor was put into a number of various conditions, both static and transient, and data were collected using a digital acquisition system for later combination with shape functions. Transients included increasing power, decreasing power, and a reactor scram. The shape functions were generated using Version 3.0 of the QUARTZ code, a quadratic nodal diffusion theory code in triangular-Z geometry. Supernodal analysis algorithms have been added to the original program, along with subroutines to guarantee diagonal dominance of the leakage matrix in the finite difference or quadratic current approximations in the coarse mesh. The agreement between coarse mesh and fine mesh in all cases is excellent, with finite difference coarse mesh solutions generally slightly better. The synthesis method has been shown to accurately reflect the changes from an initial condition by combining representative flux shapes. It can be concluded that, with proper calibration of the measurement system and inclusion of representative flux shapes, the instrumented synthesis method will properly predict the flux in the core under a number of conditions.

  18. Piezoelectric device vs. conventional rotative instruments in impacted third molar surgery: relationships between surgical difficulty and postoperative pain with histological evaluations.

    Rullo, Rosario; Addabbo, Francesco; Papaccio, Giampaolo; D'Aquino, Riccardo; Festa, Vincenzo Maria


    To investigate and compare the influence of surgical difficulty on postoperative pain after treatment of impacted mandibular third molars by rotatory osteotomy or Piezoelectric surgery. A prospective, randomized, split-mouth study was performed of 52 patients with bilateral and symmetrically oriented impacted mandibular third molars, who were surgically treated using a burr (Group A) on one random side of the lower jaw and a Piezoelectric device (Group B) on the contralateral side. Surgical difficulty was evaluated using a modified version of the Parant scale to categorize "simple extractions" and "complex extractions". Primary outcome parameters were the comparison of the postoperative pain evaluation rated on the Visual Analogue Scale from day 0 to day 6 postsurgery, and the assessment of differences in surgery time between the groups. Bone biopsies were taken during surgery to assess differences in bone tissue damage levels between the two different techniques. In "complex extractions" lower pain evaluation and significantly shorter surgery times were recorded when rotatory instruments were used. In "simple extractions", similar surgery times were observed for both techniques, but pain was greatest on the day of surgery when the burr was used. Bone heat osteonecrosis was observed only in the rotatory group and a high level of alkaline phosphatase was noted only in the Piezoelectric group. Pain after extraction of a mandibular third molar increases with increased surgical difficulty and especially in longer interventions. The integrity of the bony structure observed after the ultrasonic technique may favour the bone healing process. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  19. 医用手术吻(缝)合器的发展及术中应用%Research on development and surgical application of surgical stapling and stitching instrument

    常林凤; 刘宝林


    There was almost one hundred years since surgical stapler invention to now. Using stapler (stitching instrument) in surgery has many advantages, such as stitching fast, easy to operating, few side effects and complications. It makes tumor excision surgery can’t be cut focus in past possible and improving the curative effect of the surgery. Surgical staplers also give difficult surgery and new technology strong supports. In the last ten years, for cheap price and rapid development of the technology level, domestic staplers’ market share is increasing year by year and breaking the foreign monopoly product. In open surgery, domestic stapler has progressively more than foreign brands. In endoscopy surgery, domestic staplers also have a place. In current, surgical staplers are used more and more popular in the domestic tertiary medical institutions and becoming indispensable tools in many surgeries. Surgical staplers (stitching instrument) are broadly used in esophageal reconstruction, gastrointestinal tract reconstruction, endoscopic surgery in pulmonary bulla resection, uterus resection, pancreas resection, duodenum resection%医用吻(缝)合器具有缝合快速、操作简便、副作用小及术后并发症少等优点,使得以往无法切除的肿瘤手术得以病灶切除,提高了手术的疗效,为高难度手术和新技术的开展提供了有力支撑。近年来,国产医用手术缝(吻)合器以其低廉的价格和快速发展的工艺技术水平在市场占有率上逐年提高,在开放式手术的应用中已逐步超过国外品牌,在腔镜手术中,国产吻合器也争得一席之地。目前,吻(缝)合器在国内三级医疗机构中应用逐渐普及,广泛应用于食管、胃肠道重建,在内镜手术中完成肺大泡切除、脾脏、子宫、胰腺及十二指肠等部位手术。

  20. Combined anterior lumbar interbody fusion and instrumented posterolateral fusion for degenerative lumbar scoliosis: indication and surgical outcomes

    Hsieh, Ming-Kai; Chen, Lih-Huei; Niu, Chi-Chien; Fu, Tsai-Sheng; Lai, Po-Liang; Chen, Wen-Jer


    Background Traditional approaches to deformity correction of degenerative lumbar scoliosis include anterior-posterior approaches and posterior-only approaches. Most patients are treated with posterior-only approaches because the high complication rate of anterior approach. Our purpose is to compare and assess outcomes of combined anterior lumbar interbody fusion and instrumented posterolateral fusion with posterior alone approach for degenerative lumbar scoliosis with spinal stenosis. Methods...

  1. Advanced instrument system for real-time and time-series microbial geochemical sampling of the deep (basaltic) crustal biosphere

    Cowen, James P.; Copson, David A.; Jolly, James; Hsieh, Chih-Chiang; Lin, Huei-Ting; Glazer, Brian T.; Wheat, C. Geoffrey


    Integrated Ocean Drilling Program borehole CORK (Circulation Obviation Retrofit Kit) observatories provide long-term access to hydrothermal fluids circulating within the basaltic crust (basement), providing invaluable opportunities to study the deep biosphere. We describe the design and application parameters of the GeoMICROBE instrumented sled, an autonomous sensor and fluid sampling system. The GeoMICROBE system couples with CORK fluid delivery lines to draw large volumes of fluids from crustal aquifers to the seafloor. These fluids pass a series of in-line sensors and an in situ filtration and collection system. GeoMICROBE's major components include a primary valve manifold system, a positive displacement primary pump, sensors (e.g., fluid flow rate, temperature, dissolved O2, electrochemistry-voltammetry analyzer), a 48-port in situ filtration and fluid collection system, computerized controller, seven 24 V-40 A batteries and wet-mateable (ODI) communications with submersibles. This constantly evolving system has been successfully connected to IODP Hole 1301A on the eastern flank of the Juan de Fuca Ridge. Also described here is a mobile pumping system (MPS), which possesses many of the same components as the GeoMICROBE (e.g., pump, sensors, controller), but is directly powered and controlled in real time via submersible operations; the MPS has been employed repeatedly to collect pristine basement fluids for a variety of geochemical and microbial studies.

  2. Effect of fine management in sterilization of surgical instruments in disinfection supply center%精细化管理在消毒供应中心手术器械消毒灭菌中的应用



    目的:探讨精细化管理在消毒供应中心手术器械消毒灭菌中的应用效果。方法在1856包手术器械消毒灭菌中引入精细化管理理念。了解手术器械消毒灭菌合格率和手术室人员使用满意度。结果1856包手术器械灭菌合格率为100.0%,手术室人员满意度为99.7%。结论运用精细化管理加强对消毒供应中心手术器械的质量管理能有效提高器械灭菌的合格率,提高手术人员的满意度。%Objective To investigate the effect of fine management in disinfection and sterilization of surgical instruments in Disinfection Supply Center. Method The surgical instrument sterilization and disinfection pass rate differences and operating room personnel satisfaction were investigated. Result The pass rate of disinfection and sterilization in surgical instruments of observation group was 100.0%, the surgeon satisfaction in using surgical instruments was 99.7%. Conclusion Application of fine management in sterilization of surgical instruments in disinfection supply center can improve the passing rate of the sterilization, improve the satisfaction of the surgical staff, and also to ensure the quality of the surgical instrument in sterilization, reduce the risk of infection in patients, protect patient safety, which is worth further clinical application.

  3. Repeat surgical interventions following "definitive" instrumentation and fusion for idiopathic scoliosis: five-year update on a previously published cohort.

    Ramo, Brandon A; Richards, B Stephens


    A retrospective case series. To identify the overall reoperation rate and factors contributing to reoperation in a recent 5-year cohort of patients (2003-2007) undergoing spinal deformity surgery. These patients were compared with a previously published 15-year cohort of consecutive patients (1988-2002) from the same institution to assess for any significant differences in reoperation rates. In a previously published report from this institution, the reoperation rate for patients with idiopathic scoliosis treated during a 15-year period (1988-2002) was 12.9%. That group was predominantly treated with first-generation TSRH (Medtronic, Memphis, TN) implants and CD implants. Lower profile, more rigid implant systems are now used along with refined techniques for correction of scoliosis deformity. We hypothesized that these factors would lead to lower rates of reoperation. METHODS.: The medical records of 452 consecutive patients (older than 9 yr) surgically treated for idiopathic scoliosis at one institution during 5 years (2003-2007) were reviewed to identify those who required reoperation. The reoperation rate for this cohort was 7.5% (34 of 452 patients). Compared with the prior cohort, significant decreases were noted with regard to total reoperation rate as well as reoperation due to infection and pseudarthrosis. Trends were noted toward decreased rates of reoperation due to prominent implants, dislodged implants, and implant proximity to vital structures. Within the newer cohort, a trend toward decreased reoperation rate was also noted for lower profile implant systems compared with first-generation TSRH implants. With the evolution of newer lower profile segmental implant systems that provide more rigid fixation and with the advancements in techniques for deformity correction, the repeat surgical intervention rate for idiopathic scoliosis has decreased.

  4. Analysis of the learning curve for transurethral resection of the prostate. Is there any influence of musical instrument and video game skills on surgical performance?

    Yamaçake, Kleiton Gabriel Ribeiro; Nakano, Elcio Tadashi; Soares, Iva Barbosa; Cordeiro, Paulo; Srougi, Miguel; Antunes, Alberto Azoubel


    To evaluate the learning curve for transurethral resection of the prostate (TURP) among urology residents and study the impact of video game and musical instrument playing abilities on its performance. A prospective study was performed from July 2009 to January 2013 with patients submitted to TURP for benign prostatic hyperplasia. Fourteen residents operated on 324 patients. The following parameters were analyzed: age, prostate-specific antigen levels, prostate weight on ultrasound, pre- and postoperative serum sodium and hemoglobin levels, weight of resected tissue, operation time, speed of resection, and incidence of capsular lesions. Gender, handedness, and prior musical instrument and video game playing experience were recorded using survey responses. The mean resection speed in the first 10 procedures was 0.36 g/min and reached a mean of 0.51 g/min after the 20(th) procedure. The incidence of capsular lesions decreased progressively. The operation time decreased progressively for each subgroup regardless of the difference in the weight of tissue resected. Those experienced in playing video games presented superior resection speed (0.45 g/min) when compared with the novice (0.35 g/min) and intermediate (0.38 g/min) groups (p=0.112). Musical instrument playing abilities did not affect the surgical performance. Speed of resection, weight of resected tissue, and percentage of resected tissue improve significantly and the incidence of capsular lesions reduces after the performance of 10 TURP procedures. Experience in playing video games or musical instruments does not have a significant effect on outcomes.

  5. Development of an Educational Game to Set Up Surgical Instruments on the Mayo Stand or Back Table: Applied Research in Production Technology.

    Paim, Crislaine Pires Padilha; Goldmeier, Silvia


    Existing research suggests that digital games can be used effectively for educational purposes at any level of training. Perioperative nursing educators can use games to complement curricula, in guidance and staff development programs, to foster team collaboration, and to give support to critical thinking in nursing practice because it is a complex environment. To describe the process of developing an educational game to set up surgical instruments on the Mayo stand or back table as a resource to assist the instructor in surgical instrumentation training for students and nursing health professionals in continued education. The study was characterized by applied research in production technology. It included the phases of analysis and design, development, and evaluation. The objectives of the educational game were developed through Bloom's taxonomy. Parallel to the physical development of the educational game, a proposed model for the use of digital elements in educational game activities was applied to develop the game content. The development of the game called "Playing with Tweezers" was carried out in 3 phases and was evaluated by 15 participants, comprising students and professional experts in various areas of knowledge such as nursing, information technology, and education. An environment was created with an initial screen, menu buttons containing the rules of the game, and virtual tour modes for learning and assessment. The "digital" nursing student needs engagement, stimulation, reality, and entertainment, not just readings. "Playing with Tweezers" is an example of educational gaming as an innovative teaching strategy in nursing that encourages the strategy of involving the use of educational games to support theoretical or practical classroom teaching. Thus, the teacher does not work with only 1 type of teaching methodology, but with a combination of different methodologies. In addition, we cannot forget that skill training in an educational game does not

  6. Development of an Educational Game to Set Up Surgical Instruments on the Mayo Stand or Back Table: Applied Research in Production Technology


    Background Existing research suggests that digital games can be used effectively for educational purposes at any level of training. Perioperative nursing educators can use games to complement curricula, in guidance and staff development programs, to foster team collaboration, and to give support to critical thinking in nursing practice because it is a complex environment. Objective To describe the process of developing an educational game to set up surgical instruments on the Mayo stand or back table as a resource to assist the instructor in surgical instrumentation training for students and nursing health professionals in continued education. Methods The study was characterized by applied research in production technology. It included the phases of analysis and design, development, and evaluation. The objectives of the educational game were developed through Bloom’s taxonomy. Parallel to the physical development of the educational game, a proposed model for the use of digital elements in educational game activities was applied to develop the game content. Results The development of the game called “Playing with Tweezers” was carried out in 3 phases and was evaluated by 15 participants, comprising students and professional experts in various areas of knowledge such as nursing, information technology, and education. An environment was created with an initial screen, menu buttons containing the rules of the game, and virtual tour modes for learning and assessment. Conclusions The “digital” nursing student needs engagement, stimulation, reality, and entertainment, not just readings. “Playing with Tweezers” is an example of educational gaming as an innovative teaching strategy in nursing that encourages the strategy of involving the use of educational games to support theoretical or practical classroom teaching. Thus, the teacher does not work with only 1 type of teaching methodology, but with a combination of different methodologies. In addition, we

  7. Cleaning quality of loaner surgical instruments in orthopaedic department%骨科外来手术器械清洗质量观察

    陆蕾; 黄明芬; 高玲花


    目的 有效控制骨科外来手术器械的清洗消毒质量,保证手术患者的医疗安全.方法 将外院送人医院的已清洗灭菌但未使用的器械64件设为对照组,随机抽取已使用的外来器械186件,分成手工清洗组(观察1组)、机械清洗组(观察2组)和预处理十机械清洗十人工检查干预组(观察3组),清洗后用10倍放大镜目测加隐血试验检查清洗质量.结果 4组器械的放大镜目测不合格率分别为18.46%、25.81%、20.97%、1.61%,差异有统计学意义(P<0.01);隐血试验阳性率分别为13.85%、16.13%、11.29%、0,差异有统计学意义(P<0.05).结论 骨科外来手术器械的清洗质量不容乐观,必须加强外来器械的管理,通过规范清洗消毒流程及加强质量控制以保证外来器械的清洗质量,从而保障手术患者的医疗安全.%OBJECTIVE To effectively control cleaning and disinfection quality of loaner surgical instruments in orthopaedic department so as to ensure the medical safety of the patients. METHODS Totally 64 pieces of submitted instruments which have been cleaned and sterilized were selected as the control group, and 186 pieces of loaner instruments were randomly selected and divided into the manual cleaning group (observation group 1), mechanical cleaning group (observation group 2), and pre-disposal plus mechanical cleaning plus manual intervention (observation group 3), the cleaning quality of the instruments was examined by ten times magnifier plus occult blood test. RESULTS The unqualified rates of the cleaning quality of the four groups of instruments measured by the magnifier were 18. 46%, 25, 81%, 20. 97% and 1. 61%, respectively, the difference was statically significant (P<0. 01) , while the positive rates of the cleaning quality measured by occult blood test were 13.85% ,16. 13% ,11. 29% and 0, the difference was statistically significant (P<0. 05). CONCLUSION The current status of the cleaning quality of

  8. Surgical Navigation

    Azarmehr, Iman; Stokbro, Kasper; Bell, R. Bryan


    were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. Conclusions: SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure...... in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve....

  9. 外来手术器械使用后规范化处理探讨%Standardized treatment of foreign surgical instruments

    杨风; 赵自云; 杨杰书; 李璟; 江楠


    OBJECTIVE To improve the conventional treatment mode of the foreign surgical instruments that are frequently communicate among the hospitals so as to raise the effectiveness of the cleaning ,disinfection ,and steri‐lization of the instruments .METHODS A total of 300 foreign surgical instruments were randomly selected from Jan 2012 to Oct 2012 ,then 150 instruments were rinsed with running water and submitted to the central sterile supply department ,which were assigned as the control group ,while ,150 surgical instruments were preserved for a long period of time and cleaned and disinfected after the surgery ,which were set as the experimental group .The cleaning effect was observed and compared between the two groups ,and the statistical analysis of data was per‐formed with the use of SPSS 13 .0 software .RESULTS The detection rate of bacteria of the control group was 32 .00% before the cleaning ,higher than 6 .00% after the cleaning ;the positive rate of HBSAg of the control group was 7 .33% before the cleaning ,higher than 0 .67% after the cleaning ;the positive rate of occult blood of the control group was 43 .33% before the cleaning ,higher than 6 .67% after the cleaning .The detection rate of bacteria of the experimental group was 6 .67% before the cleaning ,higher than 1 .33% after the cleaning ;the pos‐itive rate of HBSAg of the experimental group was 1 .33% befoe the cleaning ,higher than 0 after the cleaning ;the positive rate of occult blood of the experimental group was 5 .33% before the cleaning ,higher than 2 .00% after the cleaning .The detection rate of bacteria and the positive rate of occult blood of the experimental group were lower than those of the control group , and the experimental group was superior to the control group . CONCLUSION The establishment of the standardized process management of the foreign instruments may ensure the quality of foreign surgical instruments ,improve the surgical safety and effectiveness ,and offer the

  10. Combining 3D tracking and surgical instrumentation to determine the stiffness of spinal motion segments: a validation study.

    Reutlinger, C; Gédet, P; Büchler, P; Kowal, J; Rudolph, T; Burger, J; Scheffler, K; Hasler, C


    The spine is a complex structure that provides motion in three directions: flexion and extension, lateral bending and axial rotation. So far, the investigation of the mechanical and kinematic behavior of the basic unit of the spine, a motion segment, is predominantly a domain of in vitro experiments on spinal loading simulators. Most existing approaches to measure spinal stiffness intraoperatively in an in vivo environment use a distractor. However, these concepts usually assume a planar loading and motion. The objective of our study was to develop and validate an apparatus, that allows to perform intraoperative in vivo measurements to determine both the applied force and the resulting motion in three dimensional space. The proposed setup combines force measurement with an instrumented distractor and motion tracking with an optoelectronic system. As the orientation of the applied force and the three dimensional motion is known, not only force-displacement, but also moment-angle relations could be determined. The validation was performed using three cadaveric lumbar ovine spines. The lateral bending stiffness of two motion segments per specimen was determined with the proposed concept and compared with the stiffness acquired on a spinal loading simulator which was considered to be gold standard. The mean values of the stiffness computed with the proposed concept were within a range of ±15% compared to data obtained with the spinal loading simulator under applied loads of less than 5 Nm.

  11. Towards real-time metabolic profiling of a biopsy specimen during a surgical operation by 1H high resolution magic angle spinning nuclear magnetic resonance: a case report

    Piotto Martial


    Full Text Available Abstract Introduction Providing information on cancerous tissue samples during a surgical operation can help surgeons delineate the limits of a tumoral invasion more reliably. Here, we describe the use of metabolic profiling of a colon biopsy specimen by high resolution magic angle spinning nuclear magnetic resonance spectroscopy to evaluate tumoral invasion during a simulated surgical operation. Case presentation Biopsy specimens (n = 9 originating from the excised right colon of a 66-year-old Caucasian women with an adenocarcinoma were automatically analyzed using a previously built statistical model. Conclusions Metabolic profiling results were in full agreement with those of a histopathological analysis. The time-response of the technique is sufficiently fast for it to be used effectively during a real operation (17 min/sample. Metabolic profiling has the potential to become a method to rapidly characterize cancerous biopsies in the operation theater.

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

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


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

  13. Evaluating levels and health risk of heavy metals in exposed workers from surgical instrument manufacturing industries of Sialkot, Pakistan.

    Junaid, Muhammad; Hashmi, Muhammad Zaffar; Malik, Riffat Naseem


    The study aimed to monitor heavy metal (chromium, Cr; cadmium, Cd; nickel, Ni; copper, Cu; lead, Pb; iron, Fe; manganese, Mn; and zinc, Zn) footprints in biological matrices (urine, whole blood, saliva, and hair), as well as in indoor industrial dust samples, and their toxic effects on oxidative stress and health risks in exposed workers. Overall, blood, urine, and saliva samples exhibited significantly higher concentrations of toxic metals in exposed workers (Cr; blood 16.30 μg/L, urine 58.15 μg/L, saliva 5.28 μg/L) than the control samples (Cr; blood 5.48 μg/L, urine 4.47 μg/L, saliva 2.46 μg/L). Indoor industrial dust samples also reported to have elevated heavy metal concentrations, as an example, Cr quantified with concentration of 299 mg/kg of dust, i.e., more than twice the level of Cr in household dust (136 mg/kg). Superoxide dismutase (SOD) level presented significant positive correlation (p ≤ 0.01) with Cr, Zn, and Cd (Cr > Zn > Cd) which is an indication of heavy metal's associated raised oxidative stress in exposed workers. Elevated average daily intake (ADI) of heavy metals resulted in cumulative hazard quotient (HQ) range of 2.97-18.88 in workers of different surgical units; this is an alarming situation of health risk implications. Principal component analysis-multiple linear regression (PCA-MLR)-based pie charts represent that polishing and cutting sections exhibited highest metal inputs to the biological and environmental matrices than other sources. Heavy metal concentrations in biological matrices and dust samples showed a significant positive correlation between Cr in dust, urine, and saliva samples. Current study will help to generate comprehensive base line data of heavy metal status in biomatrices and dust from scientifically ignored industrial sector. Our findings can play vital role for health departments and industrial environmental management system (EMS) authorities in policy making and implementation.

  14. Vernier caliper and micrometer computer models using Easy Java Simulation and its pedagogical design features—ideas for augmenting learning with real instruments

    Wee, Loo Kang; Tiang Ning, Hwee


    This paper presents the customization of Easy Java Simulation models, used with actual laboratory instruments, to create active experiential learning for measurements. The laboratory instruments are the vernier caliper and the micrometer. Three computer model design ideas that complement real equipment are discussed. These ideas involve (1) a simple two-dimensional view for learning from pen and paper questions and the real world; (2) hints, answers, different scale options and the inclusion of zero error; (3) assessment for learning feedback. The initial positive feedback from Singaporean students and educators indicates that these tools could be successfully shared and implemented in learning communities. Educators are encouraged to change the source code for these computer models to suit their own purposes; they have creative commons attribution licenses for the benefit of all.

  15. Vernier caliper and micrometer computer models using Easy Java Simulation and its pedagogical design feature-ideas to augment learning with real instruments

    Wee, Loo Kang


    This article presents the customization of EJS models, used together with actual laboratory instruments, to create an active experiential learning of measurements. The laboratory instruments are the vernier caliper and the micrometer. Three computer model design ideas that complement real equipment are discussed in this article. They are 1) the simple view and associated learning to pen and paper question and the real world, 2) hints, answers, different options of scales and inclusion of zero error and 3) assessment for learning feedback. The initial positive feedback from Singaporean students and educators points to the possibility of these tools being successfully shared and implemented in learning communities, and validated. Educators are encouraged to change the source codes of these computer models to suit their own purposes, licensed creative commons attribution for the benefit of all humankind. Video abstract:

  16. Accuracy of a direct drill-guiding system with minimal tolerance of surgical instruments used for implant surgery: a prospective clinical study


    PURPOSE A recently introduced direct drill-guiding implant surgery system features minimal tolerance of surgical instruments in the metal sleeve by using shank-modified drills and a sleeve-incorporated stereolithographic guide template. The purpose of this study was to evaluate the accuracy of this new guided surgery system in partially edentulous patients using geometric analyses. MATERIALS AND METHODS For the study, 21 implants were placed in 11 consecutive patients using the direct drill-guiding implant surgery system. The stereolithographic surgical guide was fabricated using cone-beam computed tomography, digital scanning, computer-aided design and computer-assisted manufacturing, and additive manufacturing processes. After surgery, the positional and angular deviations between planned and placed implants were measured at the abutment level using implant-planning software. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the deviations (α=.05). RESULTS The mean horizontal deviations were 0.593 mm (SD 0.238) mesiodistally and 0.691 mm (SD 0.344) buccolingually. The mean vertical deviation was 0.925 mm (SD 0.376) occlusogingivally. The vertical deviation was significantly larger than the horizontal deviation (P=.018). The mean angular deviation was 2.024 degrees (SD 0.942) mesiodistally and 2.390 degrees (SD 1.142) buccolingually. CONCLUSION The direct drill-guiding implant surgery system demonstrates high accuracy in placing implants. Use of the drill shank as the guiding component is an effective way for reducing tolerance. PMID:27350855

  17. 不同消毒方法对手术器械清洗质量的影响%Impact of the different sterilization methods on the cleaning quality of surgical instruments

    林秋霞; 谢碧娴; 林爱惜


    目的:探讨机械热力消毒法与含氯消毒剂浸泡消毒法在手术器械清洗中的应用效果.方法:将100件非特殊感染手术器械分为A组和B组各50件,A组采用机械热力消毒,B组采用含氯消毒剂浸泡消毒.比较两组清洗质量.结果:两组手术器械合格率目测法比较差异无统计学意义(P>0.05),细菌培养法比较A组合格率明显高于B组(P<0.05).结论:采用机械热力消毒法处理手术器械可提高清洗质量,值得推广.%Objective: To investigate the application effect of mechanical thermal disinfection and immersion disinfection with chlorine -containing disinfectant in the cleaning of surgical instruments.Methods: 100 pieces of surgical instruments with non - specific infection were divided into group A and group B ( 50 pieces for each group ).The mechanical thermal disinfection was used in the group A and immersion disinfection with chlorine - containing disinfectant was utilized in the group B.The cleaning quality was compared between the two groups.Results: The difference in the comparison of the qualified rate of disinfected surgical instruments by visual method was not statistically significant ( P > 0.05 ); the qualified rate of disinfected surgical instruments compared by bacterial culture method is markedly higher in the group A than the group B ( P < 0.05 ).Conclusion: Application of the mechanical thermal disinfection can improve the cleaning quality of surgical instruments, it is recommended to be widely used.

  18. Evolution of surgical skills training

    Kurt E Roberts; Robert L Bell; Andrew J Duffy


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

  19. Real-Time On-Board Airborne Demonstration of High-Speed On-Board Data Processing for Science Instruments (HOPS)

    Beyon, Jeffrey Y.; Ng, Tak-Kwong; Davis, Mitchell J.; Adams, James K.; Bowen, Stephen C.; Fay, James J.; Hutchinson, Mark A.


    The project called High-Speed On-Board Data Processing for Science Instruments (HOPS) has been funded by NASA Earth Science Technology Office (ESTO) Advanced Information Systems Technology (AIST) program since April, 2012. The HOPS team recently completed two flight campaigns during the summer of 2014 on two different aircrafts with two different science instruments. The first flight campaign was in July, 2014 based at NASA Langley Research Center (LaRC) in Hampton, VA on the NASA's HU-25 aircraft. The science instrument that flew with HOPS was Active Sensing of CO2 Emissions over Nights, Days, and Seasons (ASCENDS) CarbonHawk Experiment Simulator (ACES) funded by NASA's Instrument Incubator Program (IIP). The second campaign was in August, 2014 based at NASA Armstrong Flight Research Center (AFRC) in Palmdale, CA on the NASA's DC-8 aircraft. HOPS flew with the Multifunctional Fiber Laser Lidar (MFLL) instrument developed by Excelis Inc. The goal of the campaigns was to perform an end-to-end demonstration of the capabilities of the HOPS prototype system (HOPS COTS) while running the most computationally intensive part of the ASCENDS algorithm real-time on-board. The comparison of the two flight campaigns and the results of the functionality tests of the HOPS COTS are presented in this paper.

  20. Comparison of Enterococcus qPCR analysis results from fresh and marine water samples on two real-time instruments -

    EPA is currently considering a quantitative polymerase chain reaction (qPCR) method, targeting Enterococcus spp., for beach monitoring. Improvements in the method’s cost-effectiveness may be realized by the use of newer instrumentation such as the Applied Biosystems StepOneTM a...

  1. The dissection profile and mechanism of tissue-selective dissection of the piezo actuator-driven pulsed water jet as a surgical instrument: laboratory investigation using Swine liver.

    Yamada, Masato; Nakano, Toru; Sato, Chiaki; Nakagawa, Atsuhiro; Fujishima, Fumiyoshi; Kawagishi, Naoki; Nakanishi, Chikashi; Sakurai, Tadashi; Miyata, Go; Tominaga, Teiji; Ohuchi, Noriaki


    The water jet technique dissects tissue while sparing cord-like structures such as blood vessels. The mechanism of such tissue-selective dissection has been unknown. The novel piezo actuator-driven pulsed water jet (ADPJ) system can achieve dissection with remarkably reduced water consumption compared to the conventional water jet; however, the system's characteristics and dissection capabilities on any organ have not been clarified. The purposes of this study were to characterize the physical properties of the novel ADPJ system, evaluate the dissection ability in swine organs, and reveal the mechanism of tissue-selective dissection. The pulsed water jet system comprised a pump chamber driven by a piezo actuator, a stainless steel tube, and a nozzle. The peak pressure of the pulsed water jet was measured through a sensing hole using a pressure sensor. The pulsed water jet technique was applied on swine liver in order to dissect tissue on a moving table using one-way linear ejection at a constant speed. The dissection depth was measured with light microscopy and evaluated histologically. The physical properties of swine liver were evaluated by breaking strength tests using tabletop universal testing instruments. The liver parenchyma was also cut with three currently available surgical devices to compare the histological findings. The peak pressure of the pulsed water jet positively correlated with the input voltage (R(2) = 0.9982, p dissection depth. The dissection depth negatively correlated with the breaking strength of the liver parenchyma (R(2) = 0.6694, p dissected, preserving the hepatic veins and Glisson's sheaths in contrast to what is commonly observed with electrocautery or ultrasonic instruments. The dissection depth of liver tissue is well controlled by input voltage and is influenced by the moving velocity and the physical properties of the organ. We showed that the device can be used to assure liver resection with tissue selectivity due to tissue

  2. Evaluation of the effectiveness of a water lift system in the sinus membrane-lifting operation as a sinus surgical instrument.

    Kim, Dae Y; Itoh, Yusaku; Kang, Tae H


    The effectiveness of a Water Lift System in the sinus membrane-lifting operation was examined. This investigation focused on the capability of this equipment to reduce the risk of Schneiderian membrane perforation. A preliminary clinical study on the use of the Water Lift System in sinus membrane elevation to place implants through the sinus floor was conducted. A total of 70 sinus membrane-lifting operations were performed on patients with various bone heights ranging from 1.2 to 9.9 mm (most commonly in the range of 4-6 mm) through the lateral approach (four cases) or the crestal approach (66 cases). In all of the cases performed using the lateral approach, sinus membrane perforation did not occur. In the 66 cases performed using the crestal approach, Schneiderian membrane tearing occurred in two cases. The membrane tearing occurred during elevation of the Schneiderian membrane but not when a hole was drilled to access the Schneiderian membrane. One case of membrane tearing resulted from previous inflammation in the maxillary sinus, and the other case of membrane tearing was caused by application of excessive hydraulic pressure. In addition, similar outcomes were obtained and no microbial infections were observed in a total of 68 successful cases. In this study, the Water Lift System was confirmed to effectively reduce the risk of Schneiderian membrane perforation during the sinus membrane-lifting operation. We conclude that the Water Lift System deserves to be considered as a sinus surgical instrument, which ensures safety in the sinus membrane-lifting operation. © 2010 Wiley Periodicals, Inc.

  3. Investigation of Structural, Compositional and Anti-Microbial Properties of Copper Thin Film Using Direct Current Magnetron Sputtering for Surgical Instruments

    Kalaiselvam, S.; Sandhya, J.; Krishnan, K. V. Hari; Kedharnath, A.; Arulkumar, G.; Roseline, A. Ameelia

    Surgical instruments and other bioimplant devices, owing to their importance in the biomedical industry require high biocompatibility to be used in the human body. Nevertheless, issues of compatibility, bacterial infections are quite common in such devices. Hence development of surface coatings on various substrates for implant applications is a promising technique to combat the issues arising in these implant materials. The present investigation aims at coating copper on stainless steel substrate using DC Magnetron sputtering which is used to achieve film of required thickness (0.5-8μm). The deposition pressure, substrate temperature, power supply, distance between the specimen and target are optimized and maintained constant, while the sputtering time (30-110min) is varied. The sputtered copper thin film’s morphology, composition are characterized by SEM and EDAX. X-ray diffraction analysis shows copper oriented on (111) and (002) and copper oxide on (111) planes. The contact angle of copper thin film is 92∘ while AISI 316L shows 73∘. The antimicrobial studies carried in Staphylococcus aureus, Escherichia Coli, Klebsiella pneumonia and Candida albicans show that the maximum reduction was seen upto 35, 26, 54, 39CFU/mL, respectively after 24h. The cell viability is studied by MTT assay test on Vero cell line for 24h, 48h and 72h and average cell viability is 43.85%. The copper release from the thin film to the culture medium is 6691μg/L (maximum) is estimated from AAS studies. The copper coated substrate does not show much reaction with living Vero cells whereas the bacteria and fungi are found to be destroyed.

  4. Real-time Video-Streaming to Surgical Loupe Mounted Head-Up Display for Navigated Meningioma Resection.

    Diaz, Roberto; Yoon, Jang; Chen, Robert; Quinones-Hinojosa, Alfredo; Wharen, Robert; Komotar, Ricardo


    Wearable technology interfaces with normal human movement and function, thereby enabling more efficient and adaptable use.We developed a wearable display system for use with intra-operative neuronavigation for brain tumor surgery. The Google glass head-up display system was adapted to surgical loupes with a video-streaming integrated hardware and software device for display of the Stealth S7 navigation screen. Phantom trials of surface ventriculostomy were performed. The device was utilized as an alternative display screen during cranial surgery. Image-guided brain tumor resection was accomplished using Google Glass head-up display of Stealth S7 navigation images. Visual display consists of navigation video-streaming over a wireless network. The integrated system developed for video-streaming permits video data display to the operating surgeon without requiring movement of the head away from the operative field. Google Glass head-up display can be used for intra-operative neuronavigation in the setting of intracranial tumor resection.

  5. Real-Time Monitoring of Post-Surgical and Post-Traumatic Eye Injuries Using Multilayered Electrical Biosensor Chip.

    Khan, Muhammad S; Misra, Santosh K; Schwartz-Duval, Aaron S; Daza, Enrique; Ostadhossein, Fatemeh; Bowman, Matthew; Jain, Akshay; Taylor, Gina; McDonagh, Deana; Labriola, Leanne T; Pan, Dipanjan


    Lack of current techniques for the early monitoring of bleb leaks and other post-traumatic or post-surgical ocular injury has posed an unmet clinical need for the development of new techniques. Present evaluation techniques use either subjective or nonquantitative approaches. At present, there are no FDA approved ocular devices that can directly measure ascorbic acid (AA) concentration levels for both tear film (TF) and aqueous humor (AH) at point-of-care (POC) level. Toward this aim, we present a novel POC quantitative assay, called the ocular biosensor device, which can be used to evaluate the integrity of the anterior surface of the eye by measuring the concentration of AA in TF and AH. Herein, we utilize a novel scientific engineering approach for the development of a disposable paper based POC ocular biosensor strip. A grafted poly(styrene)-block-poly(acrylic acid) (PS-b-PAA) and graphene platelet composite with contour based μ-electrodes design (CBμE) exhibit a highly sensitive platform to perform electrochemical immunosensing technique to study clinical samples that have small volumes like tear fluid. Samples used in this study were collected clinically from subjects undergoing therapeutic anterior chamber paracentesis. The proposed biosensor reports the level of AA concentration on an electronic screen, making the results easy to read, efficient, and reliable.

  6. Research of Cleaning Quality of Surgical Instruments in Two Ways%两种方法清洗手术器械的质量研究



      目的:为提高医院手术污染器械清洗质量,选用科学合理的清洗方法。方法:将污染器械800件,随机分为实验组和对照组各400件,实验组器械清洗方法为,先将污染器械在超声波清洗槽内加多酶振荡洗涤10 min,然后放入全自动清洗消毒机内启动运行程序:加清洁剂清洗→漂洗→上润滑油保养→干燥;对照组器械清洗方法为:将污染器械放入含有效氯500 mg/L 的消毒剂溶液中浸泡30 min,然后手工逐个刷洗→上润滑油→烘干机干燥。结果:实验组污染器械清洗的洁净度合格率和隐血试验的合格率均达99%以上,HBsAg 检测合格率达94%,而对照组隐血试验合格率为94.5%,HBsAg 检测合格率仅为74%,两组清洗质量合格率有显著差异(P<0.05)。结论:实验组的清洗质量明显优于对照组。%  Objective:To improve cleaning quality of surgical instruments with pollution in the hospital,a scientific and reasonable method of cleaning was selected.Methods:800 polluted instruments were randomly divided into experimental and control groups,400 in each group.Cleaning methods of instruments for the experimental group,the first contaminated equipment was oscillated and washed with multi-enzyme in the tank of ultrasonic launder machine for 10 minutes, and then was placed in the fully automatic cleaning disinfection machine,start running the program:to be washed with detergent → to be rinsed → to be greased → to be dried;cleaning methods of equipment for the control group:pollution equipment chlorine soak in disinfectant solution containing chlorine 500 mg/L for 30 minutes,and then were manually scrubbed one by one → to be greased → to be dried with a dryer.Results:In the experimental group,pass rates of cleanliness of the contaminated equipment that had been cleaned and pass rates of the occult blood test were more than 99%,and pass rate of the detection of HBsAg was up to

  7. Thoracic surgery in the real world: does surgical specialty affect outcomes in patients having general thoracic operations?

    Ferraris, Victor A; Saha, Sibu P; Davenport, Daniel L; Zwischenberger, Joseph B


    Most general thoracic operations in the United States are performed by general surgeons. Results obtained by those identified as general surgeons are often compared with those identified as thoracic surgeons. We interrogated the American College of Surgeons National Surgical Quality Improvement Project database over a 5-year period to compare outcomes in patients who underwent similar operations by surgeons identified as either thoracic surgeons or general surgeons. We employed propensity-score matching to minimize confounding when estimating the effect of surgeon identity on postoperative outcomes. During the study period, thoracic surgeons performed 3,263 major pulmonary or esophageal operations, and general surgeons performed 15,057 similar operations. Compared with patients operated on by general surgeons, patients operated on by thoracic surgeons had significant excess multivariate comorbidities, including insulin-dependent diabetes mellitus, chronic obstructive pulmonary disease, concurrent pneumonia, congestive heart failure, previous cardiac surgery, dialysis-dependent renal failure, disseminated cancer, prior sepsis, and previous operation within 30 days. Likewise, patients in highest risk categories had operations performed by thoracic surgeons more commonly than by general surgeons. Unadjusted comparisons for mortality and serious morbidity showed significantly worse mortality and pulmonary complications in patients operated on by thoracic surgeons. However, with propensity matching according to surgeon type, thoracic surgeons had significantly fewer serious adverse outcomes compared with general surgeons, and this decreased morbidity occurred in a higher risk cohort. Our results show that patients operated on by thoracic surgeons have higher acuity compared with patients operated on by general surgeons. When patients are matched for comorbidities and serious preoperative risk factors, thoracic surgeons have improved outcomes, especially with regard to

  8. Autonomous in situ analysis and real-time chemical detection using a backpack miniature mass spectrometer: concept, instrumentation development, and performance.

    Hendricks, Paul I; Dalgleish, Jon K; Shelley, Jacob T; Kirleis, Matthew A; McNicholas, Matthew T; Li, Linfan; Chen, Tsung-Chi; Chen, Chien-Hsun; Duncan, Jason S; Boudreau, Frank; Noll, Robert J; Denton, John P; Roach, Timothy A; Ouyang, Zheng; Cooks, R Graham


    A major design objective of portable mass spectrometers is the ability to perform in situ chemical analysis on target samples in their native states in the undisturbed environment. The miniature instrument described here is fully contained in a wearable backpack (10 kg) with a geometry-independent low-temperature plasma (LTP) ion source integrated into a hand-held head unit (2 kg) to allow direct surface sampling and analysis. Detection of chemical warfare agent (CWA) simulants, illicit drugs, and explosives is demonstrated at nanogram levels directly from surfaces in near real time including those that have complex geometries, those that are heat-sensitive, and those bearing complex sample matrices. The instrument consumes an average of 65 W of power and can be operated autonomously under battery power for ca. 1.5 h, including the initial pump-down of the manifold. The maximum mass-to-charge ratio is 925 Th with mass resolution of 1-2 amu full width at half-maximun (fwhm) across the mass range. Multiple stages of tandem analysis can be performed to identify individual compounds in complex mixtures. Both positive and negative ion modes are available. A graphical user interface (GUI) is available for novice users to facilitate data acquisition and real-time spectral matching.

  9. 车载仪表真人发声提示技术的研究%Study of the Automotive Instrument with Real Voice Prompt Technology

    范维全; 邓华


    目前仪表发出的指示和报警信息主要是视觉信息。如数字显示、图形图像显示及文字显示。报警仪表在发送视觉信息的同时加上铃声这个听觉方式,但这仅仅是引起人们的注意。人们通过视觉了解的具体内容,如果在显示报警仪表上采用数字语音技术,使适合用听觉传送的信息用语音来传送,就可以发挥听觉的优势,弥补完全用视觉信号传送信息的不足。%At present, the instrument indication and alarm information is mainly the visual information, such as digital display, image display and text. When the alarm instrument is sending visual information, a bell also rings, i.e. an audio way, which can only attract people’s attention. If the visual information on the alarm instrument can be indicated by audio signals with real voice by using digital speech technology, the advantages of hearing can be utilized, which can make up for the inadequacy of visual signals alone.

  10. Design of an instrument for real-time detection of bioaerosols using simultaneous measurement of particle aerodynamic size and intrinsic fluorescence.

    Hairston, P P; Ho, J; Quant, F R


    A prototype instrument has been constructed to measure individual airborne particles based on their aerodynamic size and their intrinsic fluorescence at selected excitation and emission wavelength bands. The instrument combines features of an aerodynamic particle sizing device with capabilities similar to those of a liquid flow cytometer. The goal of the instrument is to provide real-time data indicative of particle characteristics, and it is especially targeted to respond to bioaerosols from 0.5 to 10 micrometers (aerodynamic diameter) with intrinsic fluorescence exited at a wavelength of 325 nm and emitting from 420 to 580 nm. This size range covers individual airborne bacteria and bacteria clusters, and the fluorescence sensitivity is selected for biological molecules commonly found in cellular systems, for example, reduced nicotinamide adenine dinucleotide phosphate [NAD(P)H] and riboflavin. Initial tests with nebulised Bacillus subtilis var. niger (BG, ATCC 9372) spores have shown that, for both individual spores and spore clumps, a low level of fluorescence is detected from 17% of the particles. This detection percentage is on the same order as previous experiments that have measured viability of about 12% for mechanically dispersed BG spores (Ho and Fisher (1993) Defense Research Establishment Suffield Memorandum 1421) and suggests a need for further investigation into the possible relationship between the detected fluorescence and viability of bacterial spores.

  11. Raman-shifted eye-safe aerosol lidar (REAL) in 2010: instrument status and two-component wind measurements

    Mayor, Shane D.


    This paper and corresponding seminar given on 20 September 2010 at the 16th International School for Quantum Electronics in Nesebar, Bulgaria, will describe the key hardware aspects of the Raman-shifted Eye-safe Aerosol Lidar (REAL) and recent advances in extracting two-component wind vector fields from the images it produces. The REAL is an eye-safe, ground-based, scanning, elastic aerosol backscatter lidar operating at 1.54 microns wavelength. Operation at this wavelength offers several advantages compared to other laser wavelengths including: (1) maximum eye-safety, (2) invisible beam, (3) superior performance photodetectors compared with those used at longer wavelengths, (4) low atmospheric molecular scattering when compared with operation at shorter wavelengths, (5) good aerosol backscattering, (6) atmospheric transparency, and (7) availability of optical and photonic components used in the modern telecommunations industry. A key issue for creating a high-performance direct-detection lidar at 1.5 microns is the use of InGaAs avalanche photodetectors that have active areas of at most 200 microns in diameter. The small active area imposes a maximum limitation on the field-of-view of the receiver (about 0.54 mrad full-angle for REAL). As a result, a key requirement is a transmitter that can produce a pulsed (>10 Hz) beam with low divergence (150 mJ), and short pulse-duration (lidars in that two components of motion can be sensed. (Doppler lidars can sense only the radial component of flow.) Two-component velocity estimation is done by computing two-dimensional cross-correlation functions (CCFs) and noting the displacement of the peak of the CCF with respect to the origin. Motion vectors derived from this method are compared with coincident sonic anemometer measurements at 1.6 km range. Preliminary results indicate the method performs best when the atmosphere is stable with light winds.

  12. ATP生物荧光技术在手术器械清洗效果评价中的应用研究%Study on application of ATP bioluminescence technique in surgical instruments cleaning effect monitoring

    张玉勤; 赵奇; 高丽君; 袁中良; 吕明洁; 刘吉起


    Objective To compare the difference in clean effect monitoring between ATP bioluminescence technique and other methods.Methods Naked eye observation,magnifying glass observation and ATP bioluminescence were used to monitor the clean effect of surgical instruments.Results 440 surgical instruments were examined by naked eye observation and magnifying glass observation,the qualified rate were 96.36% and 95.68% respectively.320 surgical instruments were examined by ATP bioluminescence technique after the observational methods and the qualified rate was 87.87%.The range of qualified rate was from 50% to 100% among the different kinds of surgical instruments.Conclusion ATP bioluminescence technique was a rapid,simple and effective method for monitoring the clean effect of surgical instruments.%目的 用ATP生物荧光技术评价全自动手术器械清洗机对各类手术器械的清洗效果,比较不同评价方法的差异.方法 采用肉眼裸视法、放大镜观察法与ATP生物荧光检测法监测各类手术器械清洗效果.结果 共监测手术器械440份,肉眼裸视法合格率为96.36%,放大镜法合格率为95.68%.有320份样品同时进行了ATP生物荧光检测,合格率为87.81%.各类手术器械的合格率范围为50% ~ 100%.结论 ATP生物荧光检测法是现场评价医疗器械清洗效果的一项快速、简便且有效的方法.

  13. CIB: an improved communication architecture for real-time monitoring of aerospace materials, instruments, and sensors on the ISS.

    Krasowski, Michael J; Prokop, Norman F; Flatico, Joseph M; Greer, Lawrence C; Jenkins, Phillip P; Neudeck, Philip G; Chen, Liangyu; Spina, Danny C


    The Communications Interface Board (CIB) is an improved communications architecture that was demonstrated on the International Space Station (ISS). ISS communication interfaces allowing for real-time telemetry and health monitoring require a significant amount of development. The CIB simplifies the communications interface to the ISS for real-time health monitoring, telemetry, and control of resident sensors or experiments. With a simpler interface available to the telemetry bus, more sensors or experiments may be flown. The CIB accomplishes this by acting as a bridge between the ISS MIL-STD-1553 low-rate telemetry (LRT) bus and the sensors allowing for two-way command and telemetry data transfer. The CIB was designed to be highly reliable and radiation hard for an extended flight in low Earth orbit (LEO) and has been proven with over 40 months of flight operation on the outside of ISS supporting two sets of flight experiments. Since the CIB is currently operating in flight on the ISS, recent results of operations will be provided. Additionally, as a vehicle health monitoring enabling technology, an overview and results from two experiments enabled by the CIB will be provided. Future applications for vehicle health monitoring utilizing the CIB architecture will also be discussed.

  14. Evaluation of a method for measuring vehicular PM with a composite filter and a real-time BC instrument

    Kamboures, Michael A.; Rieger, Paul L.; Zhang, Sherry; Sardar, Satya B.; Chang, M.-C. Oliver; Huang, Shiou-Mei; Dzhema, Inna; Fuentes, Mark; Benjamin, Michael T.; Hebert, Annette; Ayala, Alberto


    As part of the California Air Resources Board's effort to confirm the ability of the vehicular particulate matter (PM) reference method (RM) to measure PM emissions at sub-one milligram per mile (mg/mi), and to explore alternative methods, we evaluated a combination method (CM) that utilizes both gravimetric and real-time particle quantification. PM, collected on a single composite filter is apportioned to the three Federal Test Procedure (FTP) cycle phases using real-time equivalent black carbon (EBC) measurements, reducing the need to carry out separate gravimetric filter measurements for each of the test phases. Four light-duty gasoline vehicles, emitting PM at or below one mg/mi, were dynamometer tested repeatedly on the FTP cycle. PM was quantified by the RM and by two variants of the CM. One variant used photoacoustic spectroscopy to measure EBC (CM-MSS), and the other used an Aethalometer (CM-AE51). The CM was evaluated on repeatability, bias, and correlation with the RM. For the tested vehicles, the observed repeatability of the CM was superior to the RM regardless of the mode of EBC measurement or the test vehicle considered (σCM-MSS = 0.08 mg/mi, σCM-AE51 = 0.07 mg/mi, σRM ≈ 0.11 mg/mi). However, the CM was negatively biased by -0.08 mg/mi, versus the RM, in one of the test vehicles. We attribute the bias in this vehicle's data to organic carbon emissions that were not equivalently collected on the composite filter of the CM. When all data were combined, the correlation between the methods was good (R = 0.90 for CM-MSS vs. RM and R = 0.91 for CM-AE51 vs. RM).


    杨敏; 泮葵芬; 郭云萍; 叶媛媛


    目的 观察免手技术在外科器械运用中减少锐器损伤的效果,评估免手技术预防锐器损伤的实用价值.方法 通过手术因素与锐器伤发生风险分析方法,结合实际手术过程分析和评价了免手技术对降低锐器损伤效果.结果 经观察233例使用免手技术的手术过程,发生5例锐器损伤,发生率为2.1%;观察274例未使用免手技术的手术过程,发生14例锐器损伤,发生率为5.1%.两组手术过程锐器损伤发生率比较,具有显著统计学意义.结论 免手技术的使用可降低锐器伤发生率59%,效果明显,值得推广.%Objective To observe the hands - free technology in surgical instruments to reduce the effect of sharp instrument injury, assess the practical value of hands - free technology in prevention of sharp injuries.Methods The surgical operation and the risk of sharp injuries, combined with the actual process of analysis and evaluation of surgical hands - free technology to reduce the effect of sharp instrument injuries.Results 233 patients observed using hands - free technology in surgical procedures, sharp injuries occurred in 5 cases, the occurrence rate of 2.1%.274 patients not using hands free technology in surgical procedures, the occurrence of 14 cases of sharp injuries, the rate was 5.1%.Two surgical procedures incidence of sharp injuries have significant statistical difference.Conclusion Hands - free technology can reduce the incidence of sharp injuries by 59%, the effect was worthy of promotion.

  16. Problems and solutions of management of external surgical instruments in sterilization supply center%外来手术器械在消毒供应中心管理中的问题和对策

    武立娟; 刘春宇


    Objective: To introduce the problems and management strategies of taking over external surgical instruments by the sterilization supply center. Methods: The external surgical instruments were divided into the long-term fixed site storage and temporary outgoing delivery, of which both were included into the standardized management processes of the sterilization supply center entirely. The criteria for receiving, cleaning, disinfection, packaging, sterilization, storage, distri -bution and quality inspection were standardized, and the quality control management and quality retrospective registration system were established. Results: The air cleanliness of the operating room was promoted and the cleaning, packaging and sterilization quality of external surgical instruments were improved, which guaranteed the safe use of external instruments and the effective control of hospital infection. Conclusion: The sterilization supply center taking over external surgical instruments can make the best of the modern cleaning, disinfection and sterilization resources of the center, thereby making the nursing work more specialized and standardized.%目的:介绍消毒供应中心承接外来手术器械管理中存在的问题和管理对策.方法:将外来手术器械分为长期定点存放和临时外送两部分,并将这两部分器械全面纳入消毒供应中心标准化管理流程,规范了接收、清洗、消毒、包装、灭菌、存放、发放、质量检测标准,构建了质量监控管理、质量追溯登记制度.结果:提升了洁净手术室空气的洁净度,提高了外来手术器械清洗、包装、灭菌质量,确保外来器械的安全使用,有效控制医院感染的发生.结论:消毒供应中心承接外来手术器械管理,可充分利用中心供应室现代化清洗、消毒、灭菌资源,使护理工作更加专业化、标准化.

  17. Automated kinematic generator for surgical robotic systems.

    Jung, David L; Dixon, Warren E; Pin, François G


    Unlike traditional assembly line robotic systems that have a fixed kinematic structure associated with a single tool for a structured task, next-generation robotic surgical assist systems will be required to use an array of end-effector tools. Once a robot is connected with a tool, the kinematic equations of motion are altered. Given the need to accommodate evolving surgical challenges and to alleviate the restrictions imposed by the confined minimally invasive environment, new surgical tools may resemble small flexible snakes rather than rigid, cable driven instruments. Connecting to these developing articulated tools will significantly alter the overall kinematic structure of a robotic system. In this paper we present a technique for real-time automated generation and evaluation of manipulator kinematic equations that exhibits the combined advantages of existing methods-speed and flexibility to kinematic change--without their disadvantages.

  18. Applicability and limitations of instruments for particle sizing and real time evaluation of airbone particulate matter; Applicabilita` e limiti di strumenti per la separazione granulometrica e per la valutazione in tempo reale del particolato in sospensione

    De Zaiacomo, T. [ENEA, Centro Ricerche `Ezio Clementel`, Bologna (Italy). Dip. Ambiente


    After a brief of difficulties in characterizing airbone particulates by means of particle sizing instruments, the accumulation mode of the atmospheric aerosol is highlighted as carrier of many noxious substances. Two different types of impactors are described in detail, and examples of particle size distributions obtainable by means of these instruments are shown; a miniaturized real-time aerosol monitor is briefly described too. Results of some tests are shown, carried on by sampling both a laboratory produced aerosol and ambient airbone particulate, by means of two identical impactors, with the aim of verifying their responses in term of collected ponderal mass; examples of the aerosol size distributions obtained are reported, together with some comments about problems arising when sampling morphologically complex (agglomerates) and hygroscopic urban particulate matter in different meteorological conditions. Then aerosol size distribution data are presented, obtained by simultaneously sampling airbone particulate matter both in an urban and extra-urban area, by means of the two cited impactors. Some proposals are finally made, in order to use a portable system, equipped with two optical monitors and a miniaturized personal-type impactor, to evaluate both fine and coarse mode of urban particulate matter, with the aim of better estimate the contribution of these two aerosol fractions both in personal exposures and in environmental monitoring data.

  19. Flight Testing and Real-Time System Identification Analysis of a UH-60A Black Hawk Helicopter with an Instrumented External Sling Load

    McCoy, Allen H.


    Helicopter external air transportation plays an important role in today's world. For both military and civilian helicopters, external sling load operations offer an efficient and expedient method of handling heavy, oversized cargo. With the ability to reach areas otherwise inaccessible by ground transportation, helicopter external load operations are conducted in industries such as logging, construction, and fire fighting, as well as in support of military tactical transport missions. Historically, helicopter and load combinations have been qualified through flight testing, requiring considerable time and cost. With advancements in simulation and flight test techniques there is potential to substantially reduce costs and increase the safety of helicopter sling load certification. Validated simulation tools make possible accurate prediction of operational flight characteristics before initial flight tests. Real time analysis of test data improves the safety and efficiency of the testing programs. To advance these concepts, the U.S. Army and NASA, in cooperation with the Israeli Air Force and Technion, under a Memorandum of Agreement, seek to develop and validate a numerical model of the UH-60 with sling load and demonstrate a method of near real time flight test analysis. This thesis presents results from flight tests of a U.S. Army Black Hawk helicopter with various external loads. Tests were conducted as the U.S. first phase of this MOA task. The primary load was a container express box (CONEX) which contained a compact instrumentation package. The flights covered the airspeed range from hover to 70 knots. Primary maneuvers were pitch and roll frequency sweeps, steps, and doublets. Results of the test determined the effect of the suspended load on both the aircraft's handling qualities and its control system's stability margins. Included were calculations of the stability characteristics of the load's pendular motion. Utilizing CIFER(R) software, a method for near-real

  20. 2 232 case reports of pressure steam sterilization for orthopedic surgical instruments%运用压力蒸汽灭菌法灭菌骨科手术器械2232例报道



    目的:运用压力蒸汽灭菌法灭菌,确保骨科手术器械灭菌质量,加强医院供应室灭菌质量管理,预防医院感染的发生。方法:采用回顾性分析方法对2232件骨科手术器械进行物理、化学、生物监测,严格控制发放标准。结果:2232件骨科手术器械,经物理监测、化学监测、快速生物监测均合格,但2件出现棉包布有破洞,2件出现无纺布高温炼成破洞,5件出现湿包,3件出现清洗质量不合格。结论:骨科手术器械大多为植入物,系为高度危险性物品,必须严格把握灭菌质量,细化过程管理,保证患者安全。%Objective:To use pressure steam sterilization in order to ensure the quality of orthopedic surgical instruments steri-lization, strengthen quality management of hospital supply room sterilization and prevent the occurrence of hospital infections. Meth-ods:2232 pieces of orthopedic surgical instruments were monitored physically, chemically and biologically by applying pressure steam sterilization, and the provision standard was controlled strictly. Results: 2232 pieces of orthopedic surgical instruments were qualified through the physical, chemical and rapid biological monitoring, however, the cotton cloth of 2 pieces had holes, non-woven fabric of 2 pieces had be heated into holes, 5 pieces had wet bags, and the cleaning quality of 3 pieces was not qualified. Conclusions: Most or-thopedic surgical instruments are implantable, as well as highly dangerous goods. Therefore, it must strictly grasp the quality of sterili-zation and refine process management so as to ensure the safety of patients.

  1. 品管圈活动在提高手术器械包装合格率中的应用%Application of Quality Control Circle activity to improve the qualiifed rate in surgical instruments packaging

    向艺; 郑宣冬


    目的:探索通过品管圈活动提高手术器械包装合格率的方法。方法:成立品管圈小组,针对消毒供应中心出现的手术器械包装合格率低的情况,运用品管圈手法进行现状把握、目标设定、要因分析、对策拟定并实施。结果:通过开展品管圈活动,手术器械包装合格率由活动前97.2%提高到99.8%,差异有统计学意义(P<0.01)。结论:开展品管圈活动对提高手术器械包装质量、加强科室间的协作、提升团队精神、快速适应消毒供应中心管理模式变化起到了积极的推动作用。%Objective:To explore the method of improving the rate of qualiifed surgical instruments packaging with the application of Quality Control Circle (QCC) activity. Methods:QCC group was established to grasp the current status, set goals, analyze major factors, form and implement countermeasures with QCC method for the low rate of qualiifed surgical instruments packaging in the disinfection supply center. Result:The rates of qualiifed surgical instruments packaging increased from 97.2%to 99.8%after conducting QCC activities. The difference was statistically significant (P<0.01). Conclusion:QCC activities played a positive role in improving packaging quality of surgical instruments, strengthening collaboration between departments, promoting team spirit, and timely adapting to changes in the management mode of disinfection supply center.

  2. 多酶清洗剂泡沫对手术器械清洗效果的影响%Influence of multiple enzyme detergents with or without foaming on cleaning effect of surgical instruments

    罗敏; 张应先


    目的 评价有与无泡沫的多酶清洗剂对手术器械的清洗效果.方法 将术后器械400件随机分成2组,试验组采用无泡沫多酶清洗剂,对照组采用有泡沫多酶清洗剂,清洗后的器械采用了5倍放大镜和白纱布擦拭检测清洁率;并采用卡方检验,比较2组清洗效果.结果 无泡沫多酶清洗剂的清洁合格率为97.5%,明显高于有泡沫多酶清洗剂的70.0%,差异有统计学意义(P<0.01).结论 有泡沫多酶清洗剂清洁效果低于无泡沫多酶消毒剂,且易对清洗机及手工清洗人员造成损伤,因此手术器械清洗应采用无泡沫多酶清洗剂.%OBJECTIVE To assess the cleaning effects of multiple enzyme detergents with or without foaming, METHODS Four hundred surgical instruments were randomly assigned into two groups. Experimental group used multiple enzyme detergent without foaming, while the control group used foaming multiple enzyme detergent to clean the surgical instruments. The cleaning effects of surgical instruments were examined by five-time magnifier and sterilized gauzes. Chi-square test was used to examine the difference of cleaning effects between two groups, RESULTS The cleaning effect of non-foaming multiple enzyme detergent is significantly better than that of foaming detergent (97. 5% vs 70. 0%, P<0. 001). CONCLUSION The non-foaming multiple enzyme detergent has more advantage than foaming detergent, when considering better cleaning effects, less harm to both washing machine and manual cleaners. Thus, non-foaming multiple enzyme detergent should be recommended for cleaning surgical instruments.

  3. Abortion - surgical

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

  4. Clinical application of real-time PCR to screening critically ill and emergency-care surgical patients for methicillin-resistant Staphylococcus aureus: a quantitative analytical study.

    Herdman, M Trent; Wyncoll, Duncan; Halligan, Eugene; Cliff, Penelope R; French, Gary; Edgeworth, Jonathan D


    The clinical utility of real-time PCR screening assays for methicillin (methicillin)-resistant Staphylococcus aureus (MRSA) colonization is constrained by the predictive values of their results: as MRSA prevalence falls, the assay's positive predictive value (PPV) drops, and a rising proportion of positive PCR assays will not be confirmed by culture. We provide a quantitative analysis of universal PCR screening of critical care and emergency surgical patients using the BD GeneOhm MRSA PCR system, involving 3,294 assays over six months. A total of 248 PCR assays (7.7%) were positive; however, 88 failed to be confirmed by culture, giving a PPV of 65%. Multivariate analysis was performed to compare PCR-positive culture-positive (P+C+) and PCR-positive culture-negative (P+C-) assays. P+C- results were positively associated with a history of methicillin-sensitive Staphylococcus aureus infection or colonization (odds ratio [OR], 3.15; 95% confidence interval [CI], 1.32 to 7.54) and high PCR thresholds of signal intensity, indicative of a low concentration of target DNA (OR, 1.19 per cycle; 95% CI, 1.11 to 1.26). P+C- results were negatively associated with a history of MRSA infection or colonization (OR, 0.19; 95% CI, 0.09 to 0.42) and male sex (OR, 0.40; 95% CI, 0.20 to 0.81). P+C+ patients were significantly more likely to have subsequent positive MRSA culture assays and microbiological evidence of clinical MRSA infection. The risk of subsequent MRSA infection in P+C- patients was not significantly different from that in case-matched PCR-negative controls. We conclude that, given the low PPV and poor correlation between a PCR-positive assay and the clinical outcome, it would be prudent to await culture confirmation before altering infection control measures on the basis of a positive PCR result.

  5. Surgical navigation with QR codes

    Katanacho Manuel


    Full Text Available The presented work is an alternative to established measurement systems in surgical navigation. The system is based on camera based tracking of QR code markers. The application uses a single video camera, integrated in a surgical lamp, that captures the QR markers attached to surgical instruments and to the patient.

  6. Improved cleaning methods for cleaning surgical instruments comparative study of quality%改进清洗方法对手术器械清洗质量的影响

    冷星红; 王晓东; 何本珍


    目的 探讨一种高效、实用、安全的手术器械清洗流程及方法,以提高清洗质量,保证灭菌效果,有效控制医院感染.方法 选择消毒供应中心回收的污染手术器械900件,分为改进后组(观察组)和改进前组(对照组),每组齿类器械300件,管腔器械150件;观察组采用手工配合全自动清洗机清洗,对照组采用全自动清洗机清洗,比较两组清洗后的目测、5倍放大镜、棉签检测、潜血试验合格率.结果 观察组与对照组目测合格率为98.3%、78.3%,5倍放大镜合格率为93.7%、72.3%,棉签检测合格率为93.3%、59.3%,潜血试验合格率为97.3%、64.7%,经统计检验,两组比较,差异均有统计学意义(P<0.01),即观察组优于对照组.结论 污染的手术器械先用多酶浸泡、刷洗再放入全自动清洗机按清洗流程清洗,这种采用手工配合全自动清洗机清洗手术器械效果理想,可明显提高清洗的质量.%OBJECTIVE To explore an efficient, practical, safe surgical instrument cleaning processes and methods to improve the quality of cleaning to ensure the sterilization effect and the effective control of hospital infections. METHODS A total of 900 pieces of contaminated surgical instrument were selected from the disinfection and supply department, those surgical instruments were assigned into the improved group (the observation group) and the pre-improvement group (the control group) with 300 pieces of tooth type devices and 150 pieces of lumen devices in each group; the observation group was treated with automatic washing machine combined with manual washing, while the control group was processed with automatic washing machine, the qualified rates were compared by respectively using the visual inspection, five times magnifying glass, cotton swab testing, and occult blood test. RESULTS The qualified rates of the visual inspection of the observation group and the control group were 98. 3% and 78. 3

  7. The Use of Islamic Real Estate Investment Trust (I-REITs as a Contemporary Instrument in Developing Waqf Assets: Potential Structure, Issues and Challenges

    Aznan Hasan


    Full Text Available The primary objective of this paper is to explore the potential of Islamic Real Estate Investment Trusts (I-REITs as an effective instrument for financing waqf development activities. This study employs legal research methodology, (the data used were largely library-based and documentary in nature, in which opinions of jurists, classical and contemporary are analysed in discussing the potential of I-REITs as a mechanism to develop waqf assets. Besides, several resolutions issued by relevant market authorities are referred to in this study. The study concludes that despite several challenges, with proper implementation, I-REITs may be adopted by a waqf institution as a mechanism to finance the development of their waqf assets. The novelty of this paper lies in the proposed structure of I-REITs, which can be a useful reference for the policy-makers and REITs issuers in establishing an enabling environment within which waqf I-REITs can potentially operate. Therefore, this study hopes to shed some light on the potential of waqf I-REIT to become an asset class to provide diversity for the public to give waqf.

  8. Surgical Lasers In Gynecology

    Schellhas, Helmut F.; Barnes, Alfonso E.


    Multipurpose surgical CO2 lasers marketed in the USA have been developed to be applicable to a variety of surgical procedures in many surgical fields. They are all suited for endoscopic surgical procedures and can be fitted to all standard surgical microscopes. They all can adjust the focal length of the laser beam to the different standard focal lengths of the surgical microscope which for instance in laryngoscopy is 400 mm and in colposcopy 300 mm. One laser instrument can even change the spot size in a given focal distance which is very advantageous for some microsurgical procedures (Merrimack Laboratories 820). All multipurpose surgical CO2 laser systems provide a multi-articulated surgical arm for free-hand surgery. The surgical arms are cumbersome to use but they are adapted to the surgeons needs with ingenuity. The practicality of the multi-articulated surgical arms depends mostly on the distance of the handpiece from the surgical console which now is also overbridged by the laser tube in most surgical laser system. The spot size of the beam is variable in most handpieces by interchangeable lenses which modify the focal distance of the beam and the power density. Another common feature in all systems is a coaxial He-Ne pilot light which provides a red spot which unfortunately becomes invisible in a bleeding surgical field. Most surgical laser systems have a spacial mode of TEM 00 which is essential for incisional surgery. The continuous mode of beam delivery is used for incisional surgery and also for most endoscopic procedures.

  9. Surgical Assisting

    ... Insert and remove Foley urinary bladder catheter Place pneumatic tourniquet Confirm procedure with surgeon Drape patient within ... Technology and Surgical Assisting (NBSTSA) offers the CertifiedSurgical First Assistant (CSFA) credential, and the National Surgical Assistant ...

  10. Development of an electronic control system for a real-time PCR instrument%实时PCR仪中电控系统的设计与实现

    王冬; 冯继宏; 张新磊


    In order to develop a real-tine PCR instrument with rapid temperature change rate and high accuracy, we design an electronic control system based on a DSP chip TMS320F2812. In order to sense the temperature, we utilize the voltage conditioning circuit, whose output is digitalized by the ADC module of TMS320F2812. Besides, the event manager is used to generate the complementary PWM and control the Peltier to complete heating or cooling. At the same time,we choose the PID algorithm to achieve the purpose of closed-loop control of the temperature. The test result shows that the average error rate of the ADC module is 0. 11%. The temperature change rate of the system is 3 ℃/s and the accuracy is 0. 1 ℃.%为了研制升降温速率快、温度控制精度高的实时PCR仪,设计并构建了实时PCR仪中的电控系统.该系统硬件部分以DSP2812为核心,利用DSP2812自带的ADC和电压调理电路构成数据采集输入通道,同时DSP2812的事件管理器输出互补PWM,实现驱动半导体加热制冷片的目的.系统软件部分利用PD算法实现温度的闭环控制.实验结果表明ADC模数转换的平均误差率为0.11%,整个系统的温度变化率达到3℃/s,精度达到0.1℃.

  11. Real-Time Measurement of the Tool-Tissue Interaction in Minimally Invasive Abdominal Surgery: The First Step to Developing the Next Generation of Smart Laparoscopic Instruments.

    Barrie, Jenifer; Jayne, David G; Neville, Anne; Hunter, Louise; Hood, Adrian J; Culmer, Peter R


    Introduction Analysis of force application in laparoscopic surgery is critical to understanding the nature of the tool-tissue interaction. The aim of this study is to provide real-time data about manipulations to abdominal organs. Methods An instrumented short fenestrated grasper was used in an in vivo porcine model, measuring force at the grasper handle. Grasping force and duration over 5 small bowel manipulation tasks were analyzed. Forces required to retract gallbladder, bladder, small bowel, large bowel, and rectum were measured over 30 seconds. Four parameters were calculated-T(hold), the grasp time; T(close), time taken for the jaws to close; F(max), maximum force reached; and F(rms), root mean square force (representing the average force across the grasp time). Results Mean F(max) to manipulate the small bowel was 20.5 N (±7.2) and F(rms) was 13.7 N (±5.4). Mean T(close) was 0.52 seconds (±0.26) and T(hold) was 3.87 seconds (±1.5). In individual organs, mean F(max) was 49 N (±15) to manipulate the rectum and 59 N (±13.4) for the colon. The mean F(max) for bladder and gallbladder retraction was 28.8 N (±7.4) and 50.7 N (±3.8), respectively. All organs exhibited force relaxation, the F(rms) reduced to below 25 N for all organs except the small bowel, with a mean F(rms) of less than 10 N. Conclusion This study has commenced the process of quantifying tool-tissue interaction. The static measurements discussed here should evolve to include dynamic measurements such as shear, torque, and retraction forces, and be correlated with evidence of histological damage to tissue.

  12. FY1995 development of a endoscopic surgical system utilizing multi-modal functional images; 1995 nendo tashu kino gazo wo mochiiru teishinshu naishikyo shujutsu system no kaihatsu



    The purpose of this study is to develop an endoscope system for neurosurgery that can provide not only conventional endoscopic images but also ultraviolet-visible spectra, fluorescence spectra, near infrared spectra, and ultra-soundimages of tissue aiming for real-time identification of pathological tissue. The system also incorporates surgical manipulator and devices such as micro forceps and laser surgical instruments for endoscopic image guided surgery. Surgical Manipulator should be a high performance and easy to operate surgical instrument as well as conventional surgical tools such as scissors and knife. Since living tissue deforms during surgical operation, pre-operative three dimensional information for registration of pathological tissue should be modified based on information obtained during surgery. Thus surgical manipulator should be operated under guidance of surgeon's observation. Consequently, surgical manipulator should have various types of imaging and measurement devices such as an endoscope and an ultrasound imaging probe at its end effectors. Based on this concept, a prototype of a new multi channel surgical manipulator system CM cube (CM3, Computer aided Micro Multichannel Manipulator) that has various types of imaging and measurement devices such as ultra-violet-visible camera for spectroscopic measurement, ultra-sound imaging probe, three dimensional endoscope, together with micro surgical instruments and laser surgical systems has been developed. Its performance was evaluated through in vitro/in vivo experiments and clinical application. (NEDO)

  13. 不同预处理方法对手术器械清洗效果的影响%Influence of different pretreatment methods on effect of cleaning of surgical instruments

    崔兴芬; 肖海荣; 王彩华


    目的:研究探讨使用不同预处理方法对于手术器械清洗效果的影响,为临床建立合理的手术器械清洗流程、提高手术器械清洗质量提供依据。方法选取450件手术器械随机分为3组,每组各150件;A组不进行预处理,B组放入清水浸泡6 min ,C组放入新鲜配置好的多酶清洗液中浸泡6 min ,然后将3组器械分别放入经过验证的清洗机中进行清洗,清洗后的器械先通过目测均合格后,再采用3M Clean‐T race表面蛋白测试棒对于每件器械进行蛋白测试。结果 A组器械使用蛋白测试棒检测后的合格率分别为后齿类器械73.3%、管腔类器械70.0%、咬骨钳67.7%、取瘤钳63.3%和活检钳73.3%,总合格率为69.3%;B组每类器械的合格率分别为后齿类器械90.0%、管腔类器械83.3%、咬骨钳93.3%、取瘤钳86.7%和活检钳86.7%,总合格率为88.0%;C组每类器械的合格率均为100.0%,总合格率为100.0%;3组比较差异有统计学意义( P<0.01)。结论对于回收的各类手术器械,先使用多酶浸泡进行预处理,对于优化清洗流程、提高器械清洗效果具有显著意义。%OBJECTIVE To explore the influence of different pretreatment measures on effect of cleaning of surgical instruments so as to establish reasonable cleaning procedures of surgical instruments and raise the cleaning quality . METHODS A total of 450 pieces of surgical instruments were randomly divided into three groups ,with 150 pieces in each ;the group A was not given the pretreatment ,the group B was soaked with clean water for 6 min ,the group C was soaked with fresh configured multi‐enzyme cleaning solution for 6 min ,then the three groups of sur‐gical instruments were placed in the validated cleaning machines for cleaning ,the visual inspection was employed to screen the qualified cleaned instruments ,and the protein test was

  14. Joseph-Frédéric-Benoît Charrière - How to Explain His Success as One of the Most Famous Surgical Instrument Makers Regarding His Life from Childhood to Death.

    Badawi, Jasmin Katrin


    We use the name 'Charrière' every day as a unit of measurement. This article explains his success as one of the most famous instrument makers who ever lived. A review of the literature was completed using PubMed. Additionally, material of historical sources like the museum of Bulle was used. Joseph-Frédéric-Benoît Charrière was born in Switzerland in 1803. At the age of 13, he moved to Paris and learned the profession of a cutler. In 1820, he took over the workshop of his teacher Vincent. Dupuytren was one of the most important people in Charrière's professional life. Charrière specialized in the fabrication of surgical instruments of such high quality that he was very sought after by famous surgeons. In 1837, Charrière went to Sheffield, England, to learn more about working with metals and alloys. In 1851, he was inducted into the Legion of Honour. Charrière died in 1876 in Paris. The patronage of Dupuytren was a very important supporting factor in Charrière's professional life, but mainly his great courage, the willingness to learn from others, his creativity and technical fantasy and his curiosity and broad interest in a lot of different fields explain his unmatched professional success. © 2016 S. Karger AG, Basel.

  15. Comparación de la dinámica en tiempo real de los métodos mínimos cuadrados y variable instrumental para estimación de parámetros

    Jesús Medel Juárez, José de; Guevara López, Pedro


    En este trabajo se presenta un análisis comparativo de la dinámica en Tiempo Real de los métodos de estimación: Mínimos Cuadrados (MC) y Variable Instrumental (VI), para sistemas lineales estacionarios e invariantes en el tiempo que contienen perturbaciones internas y externas, correlacionadas con el estado observable del tipo una entrada una salida. Al utilizar las teorías de procesos estocásticos y Filtrado en Tiempo Real dentro del análisis teórico, se presentan algunas diferencias bási...

  16. 碱性清洗剂保湿处理对手术器械防锈效果观察%Observation on antirust effect of alkaline detergent moisturizing treatment for surgi-cal instruments

    夏淑娇; 陈彩央; 张晔; 舒君美; 徐永仙; 钱旭聪


    目的:研究碱性清洗剂保湿处理对使用后手术器械防锈效果。方法通过肉眼裸视检测方法,观察一种碱性清洗剂用于夜间手术后器械保湿处理的防锈效果。结果普通手术组手术后器械经碱性清洗剂作保湿处理的观察组,有极个别器械出现变色但未出现锈斑,合格率为99.04%。感染性手术组使用后手术器械先经含氯消毒液浸泡后,再用碱性清洗剂作保湿处理的观察组,有极少数器械出现变色,合格率为98.52%;对照组使用后器械只用水浸泡保湿处理的出现多件3处及以上的锈斑,合格率为76.17%。结论使用后手术器械不论是否经含氯消毒液浸泡,使用碱性清洗剂作保湿处理均可有效保湿并可防止器械锈蚀。%Objective To study the antirust effect of alkaline detergent moisturizing treatment for surgical instruments. Methods Eyesight detection method,the antirust effect of a kind of alkaline cleaner used for night postoperative instru-ments moisturizing treatment was used to observed. Results The equipment after normal operation by using alkaline clean-ing agent for moisturizing treatment as observation group,only very few instruments appeared color change,but not rust spots,the qualified rate was 99. 04%. The equipment after infectious operation by using chlorine disinfectant soaking and then alkaline cleaning agent for moisturizing treatment as observation group,also only a handful of devices appeared color change,the pass rate was 98. 52%. The instruments only by using water soaking for moisturizing treatment as control group,many devices appeared three and more rusty spots,the pass rate was only 76. 17%. Conclusion For instrument after operation with or without chlorine disinfectant soaking,using alkaline detergent for moisturizing treatment can moistur-ize and prevent the equipment corrosion.

  17. [Intestinal occlusion secondary to a retained surgical item].

    Balcázar-Rincón, Luis Ernesto; Gordillo Gómez, Enrique Alejandro; Ramírez-Alcántara, Yunis Lourdes

    Retained surgical items after a surgical procedure is a real, existing, and preventable problem that affects the safety of the surgical patient. Its incidence is not exactly known due to under-reporting of occurrence, due to the potential risk of lawsuits. A 31 year-old women that had an elective caesarean, apparently without complications. In the immediate post-operative period, clinical features appeared that were compatible with intestinal obstruction, such as inability to channel gas, bloating, abdominal pain and vigorous peristalsis. The diagnosis is made by the recent history of abdominal-pelvic surgery and the finding of a foreign body on a simple x-ray of the abdomen. The patient was operated upon, with a satisfactory outcome, and was discharged 5 days later. A retained surgical instrument is an under-reported event that represents a medical-legal problem, leading to various complications, including death if it is not diagnosed and treated early. It is important to know the risk factors and adopt a culture of prevention through perioperative monitoring of equipment and instruments used during the surgical act. Copyright © 2015 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  18. 应用持续质量改进减少外科护士锐器伤的发生率%To reduce incidence of sharp instrument injury in surgical nurses by using continuous quality improvement

    余儒; 黄爱微; 谢少华; 李艳艳; 赵秀芬; 陈丽芬


    OBJECTIVE To evaluate the effect of using continues quality improvement (CQI) to reduce the incidence of sharp instrument injury in surgical nurses. METHODS The PDCA (plan-do-check-act) cycle was used to execute the CQI. The precautions were stressed, the process of administration and prevention was paid attention to. The guide line was made and executed to reduce the incidence of sharp instrument injury. RESULTS After practicing the CQI for 1 year, the ratio of injury (by ampoule) decreased from 92.9% to 60.7%; the frequency of sharp instrument injury (except the injury by ampoule) decreased form 2.32 times per person to 1.46 times per person. CONCLUSION Applying the CQI and more prevention measures can reduce the incidence of sharp instrument injury, consequently decrease the incidence of occupational infection and blood transmitted diseases.%目的 通过持续质量改进的实施与效果评价,减少外科护士锐器伤的发生率.方法 应用PDCA循环进行持续质量改进,强调预防为主,注重过程管理,设定并执行减少外科护士锐器伤发生率的流程.结果 经过1年的实践,护士发生安瓿破裂致伤所占总人数比例由92.9%降至60.7%;护士发生锐器伤(除外安瓿裂伤)人均次数由2.3次降至1.5次.结论应用持续质量改进的方法,采取预防为主、注重过程管理,能减少护士锐器伤的发生率从而减少了职业感染的机会及降低血源性传播疾病的发生率.

  19. Multistep prediction of physiological tremor for surgical robotics applications.

    Veluvolu, Kalyana C; Tatinati, Sivanagaraja; Hong, Sun-Mog; Ang, Wei Tech


    Accurate canceling of physiological tremor is extremely important in robotics-assisted surgical instruments/procedures. The performance of robotics-based hand-held surgical devices degrades in real time due to the presence of phase delay in sensors (hardware) and filtering (software) processes. Effective tremor compensation requires zero-phase lag in filtering process so that the filtered tremor signal can be used to regenerate an opposing motion in real time. Delay as small as 20 ms degrades the performance of human-machine interference. To overcome this phase delay, we employ multistep prediction in this paper. Combined with the existing tremor estimation methods, the procedure improves the overall accuracy by 60% for tremor estimation compared to single-step prediction methods in the presence of phase delay. Experimental results with developed methods for 1-DOF tremor estimation highlight the improvement.

  20. Causes of wet packages of surgical instruments under centralized supply and the countermeasures%集中供应手术器械灭菌湿包原因分析及对策

    吴佳伟; 周染云; 张莹; 杨春燕; 徐丽丽; 王国权


    OBJECTIVE To explore the causes of the wet packages of the surgical instruments and the dressing sterilization bags in central sterile supply department so as to put forward the solutions to ensure the sterilization quality. METHODS The surgical instrument packages and dressing kits packed by textile cotton or non-woven fabric were placed into the sterilizer after weighing all of them to run a sterilization cycle in accordance with the standard operation procedure of pulsating vacuum pressure steam sterilizer. The water stains, water droplets, and watermark were observed after the sterilization to see whether they remained on the packages, then all of the packages were weighed after being placed for 10min or 20min, a consecutive monitoring for 3 days. RESULTS Of all the instrument packages, there were two packages being wet at corners, and of all the dressing packages, there were two packages with water droplets remaining outside the packages; demonstrated by the weighing before and after the sterilization, the overweight dressing packages and instrument packages were prone to be wet; the non-woven fabric packages were easier than the textile cotton ones to be wet; 73. 0% of the packages were overweight when weighing immediately after the sterilization, 17. 3% overweight after being placed for 10 min, and none overweight after being placed for 20min. CONCLUSION The wet packages can be reduced by lessening the weight of the packages and by using the textile cotton packages instead of the non-woven fabric packages as well as extending the time of the packages placement in the sterilizer.%目的 探索供应室集中供应手术器械和敷料灭菌包湿包的原因,并讨论解决方法以保证灭菌质量.方法 将使用纺织棉布或无纺布包装的手术器械包和敷料包称重随后放人灭菌器,按脉动真空压力蒸汽灭菌器的正常操作流程运行1个灭菌周期,观察灭菌后的器械包和敷料包是否有

  1. Cleaning qualities of different cleaning methods for surgical instruments at night%夜间手术器械不同清洗方法的质量比较

    殷秀娟; 肖丽妹; 沈玉琴; 祝慧琴


    目的 探讨安全、有效的夜间手术器械清洗流程和方法,提高夜间手术器械的清洗质量.方法 将夜间使用后的手术器械1680件(咬合类器械1200件、管腔类器械480件),随机分为A、B、C、D组,采用4种不同的清洗方法;A组:立即清洗法;B组:干式保存法;C组:刷洗保存法;D组:酶液保存法,比较各组目测、5倍放大镜、特殊棉签检测、残留血检测、菌落数及内毒素检测合格率.结果 A、B、C、D组合格率目测为78.3%、86.9%、94.5%、96.4%;5倍放大镜为71.9%、81.9%、92.6%、93.8%;特殊棉签检测为59.2%、74.2%、90.8%、93.3%;残留血检测为64.2%、85.8%、96.7%、98.3%;菌落数为46.7%、93.3%、100.0%、100.0%;内毒素为43.3%、93.3%、100.0%、100.0%.经统计学检验,4组比较差异有统计学意义(P<0.05).结论 使用后的夜间手术器械采用刷洗保存法和酶液保存法,均能明显提高器械的清洗质量及残留血检测合格率,但酶液保存法,具有安全性,可操作性强.%OBJECTIVE To explore the safety and effective process or methods for cleaning surgical instruments at night, and also to improve the cleaning quality of surgical instruments at night.METHODS A total of 1680 pieces surgical instruments (occlusal class device 1200, the lumen type device 480) were divided into A, B, C, D groups randomly, using four different cleaning methods to clean them.Four cleaning methods were A group (immediate cleaning method); B group (dry stored); C group (scrub save); D group (save the enzyme solution), then six standards, such as visual, five times magnifying glass, special swab testing, residue testing of blood, colony count and endotoxin detection to were used to test the pass rate of these four cleaning methods.RESULTS The pass rates of A, B, C, D group: in visual were 78.3%, 86.9%, 94.5% and 96.4%; five times magnifying glass were 71.9%, 81.9%, 92.6% and 93.8%; white gauze were 59.2%, 74.2%, 90.8% and 93

  2. 不同预处理方法对手术器械清洗质量的效果观察%Effect of Different Pretreatment Methods on Cleaning Surgical Instruments

    葛多云; 陈付华; 张淑琴; 马民


    Objective To explore the best cleaning method,improve the cleaning quality,and guarantee the quality of the final cleaning from observing the influence of different pretreatment methods on cleaning quality of surgical instruments.Methods 1000 light pollution surgical instruments were randomly divided into experimental group and control group,each group of 500,pollution degree and type between the two groups had no significant difference.The experimental group was soaked 5-10minutes by RUHOF multi-enzyme cleaning solution after irrigated with flowing water,then cleaning and disinfection machine.Control group was cleaned by full automatic cleaning and disinfection machine directly after irrigated with flowing water.The cleaning quality of the instruments was reassessed by eye,magnifying glass,and STF detection card.Results The cleaning quality of experimental group was better than that of the control group,the difference was statistically significant (P < 0.05).Conclusion Multi-enzyme cleaning solution with full automatic cleaning and disinfection machine can effectively remove the blood,organic pollution,improve cleaning quality,ensure the sterilization quality,and avoid sterilization failure for not thorough cleaning.The method had strong operability.%目的 观察不同预处理方法对手术器械清洗质量的影响,寻求最佳的清洗方法,提高手术器械清洗质量,保证灭菌效果.方法 将1000件手术后污染器械随机分成实验组与对照组,每组500件,两组之间的手术器械污染程度、种类无显著差异性.实验组将回收的手术器械用流动水冲洗后放在1∶270鲁沃夫全效型多酶清洗液中浸泡5~10min,再进行全自动清洗消毒机清洗;对照组将回收的手术器械用流动水冲洗后直接放在全自动清洗消毒机清洗.对1000件手术器械逐一进行目测和放大镜检查,并借助于STF检测卡模拟检测清洗质量.结果 实验组清洗质量明显优于对照

  3. Surgical management for Stanford type A aortic dissection: direct cannulation of real lumen at the level of the Botallo's ligament by Seldinger technique.

    Göbölös, Laszlo; Philipp, Alois; Foltan, Maik; Wiebe, Karsten


    A 50-year-old man was diagnosed with Stanford type A acute aortic dissection with cerebral malperfusion and unconsciousness. This clinical presentation was investigated by computed tomography which revealed a severe type A dissection involving all limb arteries. Successful operative treatment based on the direct arterial cannulation of the real lumen of dissected aorta at the level of Botallo's ligament by Seldinger technique achieves an appropriate perfusion and rapid cooling of the instable patient. To our knowledge this is the first reported case in the literature.

  4. Advancements in Actuated Musical Instruments

    Overholt, Daniel; Berdahl, Edgar; Hamilton, Robert


    are physical instruments that have been endowed with virtual qualities controlled by a computer in real-time but which are nevertheless tangible. These instruments provide intuitive and engaging new forms of interaction. They are different from traditional (acoustic) and fully automated (robotic) instruments...

  5. Back to Basics: Instrument Cleaning.

    Spruce, Lisa


    Adequately cleaning and processing surgical instruments may be challenging for perioperative team members; however, the cleaning and processing of instruments are critical steps in making instruments safe to use on patients and achieving an appropriately safe OR environment. Instruments that are cleaned properly have had organic debris and soil removed, rendering them ready for sterilization or disinfection. This Back to Basics article covers the basic steps and considerations for cleaning and processing instruments before sterilization. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  6. Research for Real-Time Remote Controller of Industrial X-Ray Instrument%工业X射线机现场实时遥控装置研制

    李绪丰; 蔡创明; 林平来


    This paper introduces a kind of reabtime remote controller of industrial X-ray instrument. The controller adopts the information from the controller of X-ray instrument with the PLC(programmable logic controller). Via a wireless data communication, the X-ray instrument can be turned on and off by a PDA(wireless palmtop computer), and its real-time working situation be displayed on the PDA. So the operator can be far away from X-ray, resulting to high safety of operating personnel and improvement of working efficiency.%介绍了一种工业X射线机现场实时遥控装置。该装置采用PLC(可编程控制器)采集射线机控制箱的信息,通过无线数据通讯方法,在PDA(无线掌上电脑)上实现遥控功能,实时远程显示X射线机的工作状态,从而实现遥控射线机高压开关,使操作人员远离X射线现场进行操作,从而达到保护操作人员安全、提高工作效率的目的。

  7. 外来手术器械全程质量管理在消毒供应中心医院感染控制中的应用%Application of total quality management of foreign surgical instruments in nosocomial infection control in the sterilization and supply center

    焦丽玲; 耿汇涓; 刘根生


    Objective To investigate the effect of total quality management of foreign surgical instruments in nosocomial infection control in the sterilization and supply center. Methods The effect before and after the application of total quality management for foreign surgical instruments in the control of nosocomial infection in the sterilization and supply center was comparatively analyzed. Results The results showed that after the application of total quality management for foreign surgical instruments,the onetime passing rate of sterilization and limits of microbial detection of surgical instruments increased significantly compared with that before application.The passing rate after application was significantly higher than before.The difference was significant.The implementation rate of planed surgery depending on foreign surgical instruments was 98.3%,the rate was 92.4% before application.There was a significant difference before and after application,the nosocomial infection rate after surgery depending on foreign surgical instruments was 0.88%,before the application was 6.50%,there was a significant difference before and after application. Conclusions Application of total quality management of foreign surgical instruments can significantly improve the efficiency of the use of foreign equipment and working efficiency of the operation room,reduce costs and the incidence of nosocomial infection significantly.It should be applied in the management of foreign surgical instruments in the sterilization and supply center.%目的 探讨全程质量管理用于消毒供应中心外来手术器械管理控制医院感染(简称院感)中的效果.方法 对比分析消毒供应中心将全程质量管理理念引入对外来手术器械管理以控制院感前后的效果,综合评价全程质量管理在控制外来手术器械引发院感方面的作用.结果 结果显示,对外来手术器械实施全程质量管理后,外来手术器械无菌或微生物限度

  8. Use of an instrumented treadmill for real-time gait symmetry evaluation and feedback in normal and trans-tibial amputee subjects.

    Dingwell, J B; Davis, B L; Frazier, D M


    The purpose of this research was to evaluate a newly developed system for assessing and providing feedback of gait symmetry information in real time to subjects walking on a motorised treadmill (the CCF Treadmill). The advantages of the system are that it allows the rapid collection and comparison of temporal and kinetic parameters of gait for multiple successive strides, at a constant known speed, without forcing subjects to target their footsteps. Gait asymmetries of six normal (mean age 42.7 years) and six unilateral transtibial amputee subjects (mean age 41.7, and average 6.0 years using a prosthesis) were quantified. The amputee group was the reevaluated after receiving five minutes of training with each of three different types of real-time visual feedback (RTVF). Asymmetries in the measured parameters before feedback were 4.6 times greater in the amputee population than in the normal group, and were consistent with the finding of previous authors. Significant decreases in gait asymmetry were demonstrated for all forms of feedback after amputees received feedback training. Results, however, indicated that gait asymmetries for different variables are not necessarily related, and that more work needs to be done to identify those variables for which attaining a more symmetrical gait pattern is most beneficial. Further work also needs to be done to determine the long term effects of such RTVF training. The CCF Treadmill and RTVF were shown to be potentially useful tools both for defining rehabilitation targets and for quantifying patients' progress towards those goals.

  9. Radioisotope instruments

    Cameron, J F; Silverleaf, D J


    International Series of Monographs in Nuclear Energy, Volume 107: Radioisotope Instruments, Part 1 focuses on the design and applications of instruments based on the radiation released by radioactive substances. The book first offers information on the physical basis of radioisotope instruments; technical and economic advantages of radioisotope instruments; and radiation hazard. The manuscript then discusses commercial radioisotope instruments, including radiation sources and detectors, computing and control units, and measuring heads. The text describes the applications of radioisotop

  10. pH环境改变对手术器械氧化损伤的观察及控制%Variance in pH environment to oxidation damage of surgical instruments

    宋敏; 胡珊珊; 王平; 贾凤琴


    目的 探讨pH环境的改变对手术器械氧化损伤及控制方法,达到手术器械清洁质量稳定、清洁效率提高、物资损耗降低.方法 A组:分别测试清水、健之素泡腾片、蓝鹰牌消毒粉、碱性清洗剂、医用除锈剂稀释液的pH值,然后将新手术刀片放入各组溶液中,观察手术刀片氧化开始时间;B组:分别在不同时间段观察手术刀片在各组的氧化及干沽血污止血钳去污情况;C组:预冲洗后的血污止血钳,分别采用清水冲洗后沥干、清水浸泡、蓝鹰牌消毒粉稀释液浸泡3种方式存放血污止血钳,观察各组存放18 h的隐血试验及存放48 h的细菌监测.结果 A组:清水、健之素、除锈剂稀释液pH值为中性偏酸和酸性,浸泡手术刀片5 min~1 h开始出现氧化,而蓝鹰牌消毒粉稀释液pH值为10~11,浸泡手术刀片30 d均未出现氧化反应;B组:pH值为10~11的蓝鹰牌消毒粉稀释液,既抗氧化又去污;C组:与干放和清水浸泡比较,蓝鹰牌消毒粉稀释液浸泡血污止血钳无论是存放18 h的隐血试验还是存放48 h的细菌监测,其合格率均为100.0%.结论血污手术器械在pH值为中性偏酸和酸性时,氧化活性强烈;而血污手术器械在碱性剂-蓝鹰牌消毒粉稀释液中,几乎无氧化活性,且其去污效果与浸泡时间成正比;对于不能及时回收或需要在临床科室过夜的部分体液、血液污染器械,选择有防锈、去污、消毒3种功效的蓝鹰牌消毒粉稀释液,作为临床科室初步的预清洁,能达到手术器械清洁质量稳定、清洁效率提高、物资损耗降低.%OBJECTIVE To study the controlling method of the surgical instruments' oxidation damage by changing the solvent pH value. METHODS Group A:Test the pH value of the water, Jian Zhi Shu, disinfectant solvent with brand of Lan Ying, alkaline solvent and medical rust remover solvent respectively, put new surgical blades into the above solvents and observed

  11. 3D Surgical Simulation

    Cevidanes, Lucia; Tucker, Scott; Styner, Martin; Kim, Hyungmin; Chapuis, Jonas; Reyes, Mauricio; Proffit, William; Turvey, Timothy; Jaskolka, Michael


    This paper discusses the development of methods for computer-aided jaw surgery. Computer-aided jaw surgery allows us to incorporate the high level of precision necessary for transferring virtual plans into the operating room. We also present a complete computer-aided surgery (CAS) system developed in close collaboration with surgeons. Surgery planning and simulation include construction of 3D surface models from Cone-beam CT (CBCT), dynamic cephalometry, semi-automatic mirroring, interactive cutting of bone and bony segment repositioning. A virtual setup can be used to manufacture positioning splints for intra-operative guidance. The system provides further intra-operative assistance with the help of a computer display showing jaw positions and 3D positioning guides updated in real-time during the surgical procedure. The CAS system aids in dealing with complex cases with benefits for the patient, with surgical practice, and for orthodontic finishing. Advanced software tools for diagnosis and treatment planning allow preparation of detailed operative plans, osteotomy repositioning, bone reconstructions, surgical resident training and assessing the difficulties of the surgical procedures prior to the surgery. CAS has the potential to make the elaboration of the surgical plan a more flexible process, increase the level of detail and accuracy of the plan, yield higher operative precision and control, and enhance documentation of cases. Supported by NIDCR DE017727, and DE018962 PMID:20816308

  12. Adjacent segment disease in degenerative pathologies with posterior instrumentation

    Ana Guadalupe Ramírez Olvera


    Full Text Available OBJECTIVE: To establish the real incidence of adjacent segment disease after fusion, and to identify the levels and predisposing factors for the pathology, as well as the functional results. METHODS: a retrospective case series study with level of evidence IIB, in a sample of 179 patients diagnosed with stenosis of the lumbar spine, spondylolisthesis and degenerative scoliosis, submitted to surgery in the period 2005 to December 2013, with posterior instrumentation and posterolateral fusion, with follow-up from 2007 until May 2014, in which the symptomology and radiographic findings were evaluated, to establish the diagnosis and treatment. RESULTS: the study included 179 patients diagnosed with stenosis of the lumbar spine (n=116, isthmic and degenerative spondylolisthesis (n=50 and degenerative scoliosis (n=13; during the study, 20 cases of adjacent level segment were identified, 80% of which were treated surgically with extension of the instrumentation, while 20% were treated conservatively with NSAIDs and therapeutic blocks. CONCLUSION: An incidence of 11% was found, with an average of 3.25 years in diagnosis and treatment, a prevalence of females and diagnosis of stenosis of the lumbar canal on posterior instrumentation, a predominance of levels L4-L5; 80% were treated with extension of the instrumentation. The complications were persistent radiculopathy, infection of the surgical wound, and one death due to causes not related to the lumbar pathology.

  13. Advancements in Actuated Musical Instruments

    Overholt, Daniel; Berdahl, Edgar; Hamilton, Robert


    This article presents recent developments in actuated musical instruments created by the authors, who also describe an ecosystemic model of actuated performance activities that blur traditional boundaries between the physical and virtual elements of musical interfaces. Actuated musical instrument...... that these instruments enable. We look at some of the conceptual and perceptual issues introduced by actuated musical instruments, and finally we propose some directions in which such research may be headed in the future.......This article presents recent developments in actuated musical instruments created by the authors, who also describe an ecosystemic model of actuated performance activities that blur traditional boundaries between the physical and virtual elements of musical interfaces. Actuated musical instruments...... are physical instruments that have been endowed with virtual qualities controlled by a computer in real-time but which are nevertheless tangible. These instruments provide intuitive and engaging new forms of interaction. They are different from traditional (acoustic) and fully automated (robotic) instruments...

  14. Creating a Super Instrument

    Kallionpää, Maria; Gasselseder, Hans-Peter


    Thanks to the development of new technology, musical instruments are no more tied to their existing acoustic or technical limitations as almost all parameters can be augmented or modified in real time. An increasing number of composers, performers, and computer programmers have thus become intere...

  15. Specification for Instrumentation

    Margheritini, Lucia; Kofoed, Jens Peter

    This paper is intended to give an overview on instrumentation for monitoring the efficiency of the Converter and the performance of the device. Real-time control of plant and data monitoring and storage are the main objectives of the control system....

  16. An Evaluation of the Romanian Fruits and Vegetables Producers Access to Different Types of Common Agricultural Policy Instruments. Is there Any Real Consistency with the Policy Objectives?

    Nicu MARCU


    Full Text Available Fruits and vegetables sectors are considered to be strategic in the European Union due to their contribution to a better human health. Among others positive effects, their intake increase reduce mortality and obesity, assuring in the same time harmonised development for young children. The present study thus focused to reveal the consistency of the measure implemented in the Common Agricultural Policy to support fruits and vegetables production in Romania in liaison with the policy objectives. The country is one of the main ten important European producers of horticultural products in terms of production volumes and acreage. Results showed that over the last seven years (2007-2014, the sectorial production drawbacks have not been ameliorated very much. Both sectors are dominated by small-size farms that can produce only seasonally and mainly for short-market chains. In the same time, the greenhouses area shrink to levels that made the country extremely dependent to imports especially for tomatoes. The analysis of the pillar one payments schemes revealed that the fruits and vegetables producers could have access to only one payment that was half from European averages. Moreover, almost half of the producers had low sizes that left them outside the eligible criteria. The measures designed for the second pillar also penalized producers through the selection criteria. These results showed that for Romania there was not a real consistency between the actual policy measures and the objectives assumed by policy makers. The future measures (2014-2020 seem to correct these negative findings being better tailored to the situation of the local fruits and vegetables producers.

  17. Augmented microscopy: real-time overlay of bright-field and near-infrared fluorescence images.

    Watson, Jeffrey R; Gainer, Christian F; Martirosyan, Nikolay; Skoch, Jesse; Lemole, G Michael; Anton, Rein; Romanowski, Marek


    Intraoperative applications of near-infrared (NIR) fluorescent contrast agents can be aided by instrumentation capable of merging the view of surgical field with that of NIR fluorescence. We demonstrate augmented microscopy, an intraoperative imaging technique in which bright-field (real) and electronically processed NIR fluorescence (synthetic) images are merged within the optical path of a stereomicroscope. Under luminance of 100,000 lx, representing typical illumination of the surgical field, the augmented microscope detects 189 nM concentration of indocyanine green and produces a composite of the real and synthetic images within the eyepiece of the microscope at 20 fps. Augmentation described here can be implemented as an add-on module to visualize NIR contrast agents, laser beams, or various types of electronic data within the surgical microscopes commonly used in neurosurgical, cerebrovascular, otolaryngological, and ophthalmic procedures.

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

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


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

  19. Microscope-integrated optical coherence tomography: A new surgical tool in vitreoretinal surgery

    Chaitra Jayadev


    Full Text Available Optical coherence tomography (OCT has revolutionized imaging of ocular structures and various disease conditions. Though it has been used in the clinic for some decades, the OCT has only recently found its way into the operating theater. Early attempts at intraoperative OCT, hand-held and microscope mounted, have already improved our understanding of the surgical pathology and the role it might play in surgical decision-making. The microscope-integrated OCT now allows seamless, high-resolution, real-time imaging of surgical maneuvers from the incision to wound closure. Visualization of instruments and intraoperative tissue manipulation are possible with this in vivo modality and, therefore, help improve the outcome of surgery. In this article, we describe the advantages it offers during various vitreoretinal procedures.

  20. Clinical observation of Coflex interspious instrumentation in the surgical treatment of lumbar degenerative disease%Coflex治疗腰椎退行性疾患的临床疗效分析

    李忠海; 王诗媛; 付强; 王聪; 唐昊; 马辉


    [Objective]To treat degenerative lumbar spinal disorders by Coflex interspinous instrumentation and fusion fixation, and evaluate the clinical effect and influence on the adjacent segments.[Methods]Forty -two consecutive patients with one level ( L4、5 ) lumbar degenerative disease treated in our study between June 2007 and June 2009 were included in.They were randomly and evenfly assigned into an experimental group of decompression and interspinous instrumentation with the Coflex system (n = 21 ) and a control group of traditional interbody fusion (n = 21 ).A score of VAS and the Oswestry Disability Index were used to assess clinical outcome preoperatively and postoperatively.All patients experienced flexion/extension radiographs before surgery and at the latest follow - up.ROM was assessed at the index level ( L4、5 ), the cranial/caudal adjacent levels ( L3、4/L5S1 ), and at the lumbar spine from L2 to S1.[Results]All cases were followed up for 24 months averagely.The postoperative VAS and ODI showed a significant postoperative reduction of disability during the whole period of follow - up.There was a signifcant reduction of the global ROM of the lumbar spine ( L2S1 ) and the segmental ROM at the index level ( L4、5 ) in the fusion group, whereas adjacent level ROM did not change signifcantly.In the Coflex group, there was a signifcant improvement of the global ROM of the lumbar spine ( L2S1 ) and the segmental ROM at the index level ( L3、4 ).No signifcant changes of L4、5 and L5S1 were noted.[Conclusion]This study shows that monosegmental posterior interspinous stabilization with the Coflex system demonstrates excellent outcome for improvement in back pain, neurogenic claudication and patient satisfaction in short and mid - term follow - up duration.At present, there is no overwhelming evidence to suggest that the system performs better than traditional fusion as far as the long - term results are concerned.The selection of suitable surgical candidates

  1. Evaluation of the application effect of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital%医院消毒供应中心实施手术医疗器械清洗包装的效果评价

    焦丽玲; 刘文红; 赵俊霞


    目的 探讨医院消毒供应中心实施手术医疗器械清洗包装的效果.方法 对我院消毒供应中心实施手术医疗器械清洗包装前后的清洗质量一次合格率、包装质量一次合格率、无菌检查一次合格率、院内感染发生率等指标进行比较,综合评价医院消毒供应中心实施手术医疗器械清洗包装的效果.结果 消毒供应中心实施手术医疗器械清洗包装后,手术器械清洗质量检查一次合格率、包装质量一次合格率、无菌检查合格率均较实施前有明显提高,前后比较差异显著;比较实施前后的院内感染发生率,实施后的院内感染率为1.5%,实施前为5.5%,前后比较差异显著.结论 医院消毒供应中心实施手术医疗器械的清洗包装,可有效控制手术器械的清洗质量及包装质量,保证了后续消毒灭菌的彻底性,大大降低了因手术器械质量不过关而导致的院内感染发生率,为患者创造了可靠、值得信赖的医疗环境,取得了良好的社会效益和经济效益,值得推广应用.%Objective To investigate the application effect of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital. Methods The first-time qualification rate of cleaning,packaging and sterility test and incidence rate of nosocomial infection before and after the application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital.The application effect was comprehensively evaluated. Results The first-time qualification rate of cleaning,packaging and sterility test after the application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center were significantly increased.The incidence rate of nosocomial infection was 1.5% before and 5.5% after the application of cleaning packaging of surgical medical apparatus and instruments,the difference

  2. Instrumentation Facility

    Federal Laboratory Consortium — Provides instrumentation support for flight tests of prototype weapons systems using a vast array of airborne sensors, transducers, signal conditioning and encoding...

  3. Estudo anatômico da cóclea para confecção de instrumental para a cirurgia de implante coclear com 2 feixes de eletrodos em cócleas ossificadas Cochlear anatomy study used to design surgical instruments for cochlear implants with two bundles of electrodes in ossified cochleas

    Mariana Bogar


    distances between cochleostomies and ICA in cadaver temporal bones. 2 Design an instrument that can be used in cochlear implant surgery to introduce an implant with two bundles of electrodes. STUDY DESIGN: Experimental prospective. MATERIALS AND METHODS: In 21 temporal bones from cadavers we performed: 1 canal wall down mastoidectomy; 2 cochleostomy in the cochlear basal and middle turns; 3 ICA identification; 4 Length determination between the cochleostomies and the artery. RESULTS: the average distance ± standard deviation obtained for the upper tunnel was of 8.2 ± 1.1 mm and for the lower tunnel it was of 8.1± 1.3 mm. The shortest distance found was of 6.5 mm for the upper tunnel and 6.0 mm for the lower tunnel. CONCLUSION: Despite the values calculated, we concluded that the best value to be considered in creating a surgical instrument are the minimum lengths obtained for each one of the cochlear turns, because this is the safest way to avoid damaging the ICA, that can be fatal.

  4. Effect evaluation of applying two dimensional bar code on quality tracking in the sterilization process of surgical instrument%二维条形码信息管理在手术灭菌器械质量追溯管理中的应用

    梁飞凤; 刘海燕; 李彩婷; 张洁芳


      目的探讨应用二维条形码信息管理对手术灭菌器械进行质量追溯的效果。方法将16857件手术灭菌器械分为实验组8356件和对照组8501件,模拟实验组有276件和对照组有288件灭菌器械不合格,实验组使用二维条形码信息管理,对照组采用传统方法对手术灭菌不合格器械质量进行追溯。比较两组器械质量追溯花费时间的差异。结果实验组质量追溯时间短于对照组,两组比较,t=-244.09,t=P<0.001,差异具有统计学意义。结论使用二维条形码信息管理对手术灭菌器械进行质量追溯,不仅能提高工作效率,同时保证手术病人的安全。%Objective To investigate the application of two dimensional bar code on the quality tracking of surgical instrument. Methods Sixty cases of surgical instrument packets without sterilization in sterilization and supply center were selected.The parkets were divided into the observation group and the control group with 30 cases in each group.The observation group was applied two dimensional bar code on the surgical instrument packets.We eraluated the effect of quality tracking according to the using time that started from discorering sterilization items unqualified to tracking to the patient who use this item.The control group was applied traditional methods.Results The quality tracking time of experiment group was significantly shorter than the time of control group. The difference was statistically significant(P<0.001).The staff satisfaction of the observation group was better than that of the control group.The difference was statistically significant(P<0.001).Conclusion Applying two dimensional bar code can improve the work efficiency,the sterilization quality of surgical instrument packet and guarantee the operation safety of patients.

  5. Triple quadrupole tandem mass spectrometry: A real alternative to high resolution magnetic sector instrument for the analysis of polychlorinated dibenzo-p-dioxins, furans and dioxin-like polychlorinated biphenyls.

    García-Bermejo, Ángel; Ábalos, Manuela; Sauló, Jordi; Abad, Esteban; González, María José; Gómara, Belén


    This paper reports on the optimisation, characterisation, validation and applicability of gas chromatography coupled to triple quadrupole mass spectrometry in its tandem operation mode (GC-QqQ(MS/MS) for the quantification of polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs, dioxins) and dioxin-like polychlorinated biphenyls (DL-PCBs) in environmental and food matrices. MS/MS parameters were selected to achieve the high sensitivity and selectivity required for the analysis of this type of compounds and samples. Good repeatability for areas (RSD = 1-10%, for PCDD/Fs and DL-PCBs) and for ion transition ratios (RSD = 0.3-10%, for PCDD/Fs, and 0.2-15%, for DL-PCBs) and low instrumental limits of detection, 0.07-0.75 pg μL(-1) (for dioxins) and 0.05-0.63 pg μL(-1) (for DL-PCBs), were obtained. A comparative study of the congener specific determination using both GC-QqQ(MS/MS) and gas chromatography-high resolution mass spectrometry (GC-HRMS) was also performed by analysing several fortified samples and certified reference materials (CRMs) with low (feed and foodstuffs), median (sewage sludge) and high (fly ash) toxic equivalency (TEQ) concentration levels, i.e. 0.60, 1.83, 72.9 and 3609 pg WHO-TEQ(PCDD/Fs) g(-1). The agreement between the results obtained for the total TEQs (dioxins) on GC-QqQ(MS/MS) and GC-HRMS in all the investigated samples were within the range of ±4%, and that of DL-PCBs at concentration levels of 0.84 pg WHO-TEQs (DL-PCBs) g(-1), in the case of feedstuffs, was 0.11%. Both instrumental methods have similar and comparable linearity, precision and accuracy. The GC-QqQ(MS/MS) sensitivity, lower than that of GC-HRMS, is good enough (iLODs in the down to low pg levels) to detect the normal concentrations of these compounds in food and environmental samples. These results make GC-QqQ(MS/MS) suitable for the quantitative analysis of dioxins and DL-PCBs and a real alternative tool to the reference sector HRMS instruments. Copyright © 2015 Elsevier

  6. Evaluating the Relational Coordination instrument

    Edwards, Kasper; Lundstrøm, Sanne Lykke


    and surgical performance. This has prompted the attention of both practitioners and politicians some of who perceive relational coordination as a means to attain better performance. The relational coordination instrument has been validated as a measure of teamwork from the following perspectives: internal...... consistency, interrater agreement and reliability, structural validity, content validity. However as relational coordination is being used as a diagnostics tool it is important to examine further if the instrument can measure changes. Indeed we need to know how precise and sensitive the instrument is when...

  7. Real-time reliability analysis for different operational phases of safety instrument system%安全仪表系统的不同运行阶段实时可靠性分析

    王丽君; 左信; 潘高峰


    Reliability of safety instrument system (SIS) is an important indicator to ensure safe production, and it is measured by average probability of failure on demand (PFDavg). However, PFDavg cannot guarantee SIS meets the target safety integrity level (SIL) at any operational time. Real-time reliability calculation model PFD(t) can provide a better analysis. This paper introduced the real-time reliability calculation model PFD(Moon)(t) for four operational phases of SIS. This model is simulated by MATLAB in order to analyze the real-time reliability of SIS. Finally, the High integrity pressure protection system (HIPPS) application examples indicates that SIS meets target SIL throughout the operational phase only if PFDSYS(t) of t=TP+RT+n×TI meets the target SIL.%安全仪表系统(SIS)的可靠性是保障安全生产的重要指标,由平均要求时失效概率(PFDavg)衡量.然而,PFDavg计算结果并不能保障SIS在运行阶段的任意时刻均满足目标安全完整性水平(SIL),实时可靠性计算模型PFD(t)可提供更好的分析结果.本文在A.C.Torres-Echeverria等人的研究基础上,对SIS的4个运行阶段建立了实时可靠性计算模型PFD(mooN)(t),并运用MATLAB对该模型进行仿真和分析.最后,通过高完整性压力保护系统(HIPPS)应用实例,得到以下结论:即使PFDavg SYS计算结果满足目标SIL,PFDSYS(t)也可能在运行阶段的某个时间段内达不到目标SIL;只有当t=Tp+RT+n×TI时刻的PFDSYS(t)值满足目标SIL时,才能保障SIS在整个运行阶段均能满足目标SIL.该可靠性计算模型的建立,能更好的对SIS进行实时可靠性分析,并为保障SIS在整个运行阶段满足目标SIL提供了有力依据.

  8. Real-time vehicle emissions monitoring using a compact LiDAR system and conventional instruments: first results of an experimental campaign in a suburban area in southern Italy

    Parracino, Stefano; Richetta, Maria; Gelfusa, Michela; Malizia, Andrea; Bellecci, Carlo; De Leo, Leonardo; Perrimezzi, Carlo; Fin, Alessandro; Forin, Marco; Giappicucci, Francesca; Grion, Massimo; Marchese, Giuseppe; Gaudio, Pasquale


    Urban air pollution causes deleterious effects on human health and the environment. To meet stringent standards imposed by the European Commission, advanced measurement methods are required. Remote sensing techniques, such as light detection and ranging (LiDAR), can be a valuable option for evaluating particulate matter (PM), emitted by vehicles in urban traffic, with high sensitivity and in shorter time intervals. Since air quality problems persist not only in large urban areas, a measuring campaign was specifically performed in a suburban area of Crotone, Italy, using both a compact LiDAR system and conventional instruments for real-time vehicle emissions monitoring along a congested road. First results reported in this paper show a strong dependence between variations of LiDAR backscattering signals and traffic-related air pollution levels. Moreover, time-resolved LiDAR data averaged in limited regions, directly above conventional monitoring stations at the border of an intersection, were found to be linearly correlated to the PM concentration levels with a correlation coefficient between 0.75 and 0.84.

  9. 21 CFR 882.4535 - Nonpowered neurosurgical instrument.


    ... (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4535 Nonpowered neurosurgical instrument. (a) Identification. A nonpowered neurosurgical instrument is a hand instrument or an accessory to a hand instrument used during neurosurgical procedures to cut, hold, or manipulate tissue....

  10. Modeling of a flexible instrument to study its sliding behavior inside a curved endoscope

    Khatait, Jitendra; Brouwer, Dannis Michel; Aarts, Ronald G.K.M.; Herder, Justus Laurens


    Flexible instruments are increasingly used to carry out surgical procedures. The instrument tip is remotely controlled by the surgeon. The flexibility of the instrument and the friction inside the curved endoscope jeopardize the control of the instrument tip. Characterization of the surgical

  11. Luminescence Instrumentation

    Jain, Mayank; Bøtter-Jensen, Lars


    This chapter gives an introduction to instrumentation for stimulated luminescence studies, with special focus on luminescence dating using the natural dosimeters, quartz and feldspars. The chapter covers basic concepts in luminescence detection, and thermal and optical stimulation, and reference...

  12. A Preliminary Real-Time and Realistic Simulation Environment for Percutaneous Coronary Intervention

    Jianhuang Wu


    Full Text Available Percutaneous coronary intervention (PCI is a minimally invasive surgery procedure that is widely used in the treatment of coronary artery disease. This procedure requires interventional cardiologists to have high proficiency and therefore demands an extensive training period in order to ensure successful surgical outcome. In this paper, a realistic and real-time interactive simulator for training PCI procedure is presented. A set of new approaches for core simulation components is devised and integrated into the simulator. Trainees can interact with the virtual simulation environment with real instruments and essential maneuvers encountered in real PCI procedure. Although presently targeted at PCI, our simulator could be easily extended to mimic the necessities of any vascular interventional radiology procedures by updating vascular anatomy. Preliminary validation of the proposed physical model of instruments is conducted on vascular phantom to demonstrate its performance and effectiveness.

  13. Aethalometer™ Instrument Handbook

    Sedlacek, Arthur J [Brookhaven National Lab. (BNL), Upton, NY (United States)


    The Aethalometer is an instrument that provides a real-time readout of the concentration of “Black” or “Elemental” carbon aerosol particles (BC or E) in an air stream (see Figure 1 and Figure 2). It is a self-contained instrument that measures the rate of change of optical transmission through a spot on a filter where aerosol is being continuously collected and uses the information to calculate the concentration of optically absorbing material in the sampled air stream. The instrument measures the transmitted light intensities through the “sensing” portion of the filter, on which the aerosol spot is being collected, and a “reference” portion of the filter as a check on the stability of the optical source. A mass flowmeter monitors the sample air flow rate. The data from these three measurements is used to determine the mean BC content of the air stream.

  14. Virtual Sensor Test Instrumentation

    Wang, Roy


    Virtual Sensor Test Instrumentation is based on the concept of smart sensor technology for testing with intelligence needed to perform sell-diagnosis of health, and to participate in a hierarchy of health determination at sensor, process, and system levels. A virtual sensor test instrumentation consists of five elements: (1) a common sensor interface, (2) microprocessor, (3) wireless interface, (4) signal conditioning and ADC/DAC (analog-to-digital conversion/ digital-to-analog conversion), and (5) onboard EEPROM (electrically erasable programmable read-only memory) for metadata storage and executable software to create powerful, scalable, reconfigurable, and reliable embedded and distributed test instruments. In order to maximize the efficient data conversion through the smart sensor node, plug-and-play functionality is required to interface with traditional sensors to enhance their identity and capabilities for data processing and communications. Virtual sensor test instrumentation can be accessible wirelessly via a Network Capable Application Processor (NCAP) or a Smart Transducer Interlace Module (STIM) that may be managed under real-time rule engines for mission-critical applications. The transducer senses the physical quantity being measured and converts it into an electrical signal. The signal is fed to an A/D converter, and is ready for use by the processor to execute functional transformation based on the sensor characteristics stored in a Transducer Electronic Data Sheet (TEDS). Virtual sensor test instrumentation is built upon an open-system architecture with standardized protocol modules/stacks to interface with industry standards and commonly used software. One major benefit for deploying the virtual sensor test instrumentation is the ability, through a plug-and-play common interface, to convert raw sensor data in either analog or digital form, to an IEEE 1451 standard-based smart sensor, which has instructions to program sensors for a wide variety of

  15. 标识卡与清单盒在供应室手术器械清单管理中的应用%Application of identification card and list box in the inventory management of surgical instruments in the supply room

    陈春蓉; 宋祥金; 杨小丽


    目的::探讨标识卡与清单盒在消毒供应中心手术器械清单管理中的应用效果。方法:将传统手术器械清单管理方法作为对照组,而用标识卡与清单盒对手术器械清单管理方法作为观察组,对两种方法的工作效率、找清单所需时间、环境整理时间、工作人员满意度等方面进行比较。结果:观察组找清单及整理清单时间短于对照组(P<0.05),观察组工作人员满意度优于对照组(P<0.05)。结论:标识卡与清单盒的研制在消毒供应中心手术器械清单管理中的应用,可大大减少包装前找手术器械清单的时间,提高了手术器械包装的质量管理和工作效率及工作人员满意度,与传统管理方法相比,有一定优势。%Objective:To explore the application effect of identification card and list box in the inventory management of surgical instruments in the disinfec-tion supply center. Methods:The traditional list management method of surgical instruments was used as the control group. The management method of in-struments by application of identification card and list box was used as the observation group. The working efficiency, time of finding the list, time of finish-ing the environment organization, staff satisfaction and other aspects of the two methods were compared. Results:Time of finding the list and file the list of the observation group was shorter than that of the control group (P<0. 05). The satisfaction degree of the observation group was better than that of the con-trol group (P<0. 05). Conclusion:The application of identification card and list box in the inventory management of surgical instruments in the disinfection supply center can greatly reduce the time of searching the list of instruments before packaging and improve the quality management and efficiency of the sur-gical instruments packaging and the staff’ s satisfaction. Compared with the traditional management methods, there

  16. Real-time navigation in transoral robotic nasopharyngectomy utilizing on table fluoroscopy and image overlay software: a cadaveric feasibility study.

    Tsang, Raymond K; Sorger, Jonathan M; Azizian, Mahdi; Holsinger, Christopher F


    Inability to integrate surgical navigation systems into current surgical robot is one of the reasons for the lack of development of robotic endoscopic skull base surgery. We describe an experiment to adapt current technologies for real-time navigation during transoral robotic nasopharyngectomy. A cone-beam CT was performed with a robotic C-arm after the injecting contrast into common carotid artery. 3D reconstruction of the skull images with the internal carotid artery (ICA) highlighted red was projected on the console. Robotic nasopharyngectomy was then performed. Fluoroscopy was performed with the C-arm. Fluoroscopic image was then overlaid on the reconstructed skull image. The relationship of the robotic instruments with the bony landmarks and ICA could then been viewed in real-time, acting as a surgical navigation system. Navigation during robotic skull base surgery is feasible with available technologies and can increase the safety of robotic skull base surgery.

  17. Instrumented SSH

    Campbell, Scott; Campbell, Scott


    NERSC recently undertook a project to access and analyze Secure Shell (SSH) related data. This includes authentication data such as user names and key fingerprints, interactive session data such as keystrokes and responses, and information about noninteractive sessions such as commands executed and files transferred. Historically, this data has been inaccessible with traditional network monitoring techniques, but with a modification to the SSH daemon, this data can be passed directly to intrusion detection systems for analysis. The instrumented version of SSH is now running on all NERSC production systems. This paper describes the project, details about how SSH was instrumented, and the initial results of putting this in production.

  18. Surgical attire and the operating room: role in infection prevention.

    Salassa, Tiare E; Swiontkowski, Marc F


    ➤ Although there is some evidence that scrubs, masks, and head coverings reduce bacterial counts in the operating room, there is no evidence that these measures reduce the prevalence of surgical site infection.➤ The use of gloves and impervious surgical gowns in the operating room reduces the prevalence of surgical site infection.➤ Operating-room ventilation plays an unclear role in the prevention of surgical site infection.➤ Exposure of fluids and surgical instruments to the operating-room environment can lead to contamination. Room traffic increases levels of bacteria in the operating room, although the role of this contamination in surgical site infection is unclear.

  19. Active instruments

    Lim, Miguel Antonio; Ørberg, Jakob Williams


    ) show the dynamic nature of policy processes, and (3) consider the search for policy reference points among the different actors. We present rankers in motion, policies in motion, and finally the complex nature of the ranking device that needs to be both a relevant and malleable policy instrument...

  20. Observation on the Efficacy of Air Pressure Instrument Combined with Surgical Debridement for the Treatment of Diabetic Foot Infection%气压治疗仪联合外科清创术治疗糖尿病足感染的疗效观察

    莫建勋; 叶烨; 莫申荣; 唐盛发; 莫剑锋; 莫春荣; 熊红; 杨灵红


    [Objective] To explore the efficacy of air pressure instrument combined surgical debridement for the treatment of diabetic foot infection .[Methods] Totally 97 patients with diabetic foot infection were ran-domly divided into observation group( n=52) and control group( n=45) .All patients in two groups received routine blood sugar control ,anti-infection therapy and surgical debridement of wound weekly .The observation group was additionally treated with air pressure instrument at the same time .[Results] The foot ulcer healing rate of observation group was significantly higher than that of control group ( P<0 .05) ,and the regression of foot edema was obviously better than control group ( P <0 .05) .[Conclusion] Air pressure instrument com-bined with surgical debridement for the treatment of diabetic foot can alleviate limb edema and improve the healing rate of diabetic foot infection in patients with diabetes mellitus after debridement effectively .%[目的]探讨气压治疗仪联合外科清创术治疗糖尿病足感染的疗效。[方法]对97例糖尿病足感染患者随机分为观察组(52例)和对照组(45例),两组患者均常规控制血糖、抗感染、每周伤口进行外科清创等处理,观察组同时加用气压治疗仪联合治疗。[结果]观察组足溃疡愈合率显著高于对照组( P <0.05),且足部水肿消退明显优于对照组( P <0.05)。[结论]气压治疗仪联合外科清创术治疗糖尿病足感染能够减轻肢体水肿,有效提高糖尿病患者足部感染清创术后的愈合率。

  1. The MEPHISTO scientific space instrument

    Cambon, G.; Cadet, G.; Favier, J. J.


    A furnace to study solidification on Earth and in orbit was developed. Design and performances in Bridgman-Stockbarger directional solidification are given in terms of thermal gradient achievables, thermal gradient stability, back-melting mastering, and quenching capabilities. In-situ measurements in real time of fundamental parameters for the solidification process control, associated with a possible interactivity between the principal investigator on ground and the instrument in orbit, are among the main features of the space instrument.

  2. Sequential dual Kalman filtering approach for non-contact temperature measurement in real-time PCR instrument%串联双卡尔曼滤波器在PCR非接触测温中的应用

    陈旭海; 杜民


    传统PCR仪对试剂样品进行接触式测温时,存在测量迟滞大、无法直接测量试剂温度以及只能测量局部点温度的缺点,采用红外温度传感器对样品进行非接触测量可以克服以上局限.但红外温度传感器测量噪声较大,为此提出一种串联式双卡尔曼滤波算法来对红外温度传感器采集到的温度数据进行实时滤波.滤波过程中迭代卡尔曼滤波器(IEKF)与线性卡尔曼滤波器(KF)顺序运行,前者利用少量观测数据对热交换模型中的参数进行在线辨识,后者利用辨识后的系统对采样数据进行实时滤波,该算法结合了IEKF非线性估计收敛快与KF计算简单、实时性高的优点.最后建立平滑度、偏差度和准确度指标来评价该算法与KF、EKF、FIR数字滤波器的滤波效果.实验表明,该算法与其他滤波器输出具有相当的平滑度,且偏差度为0.510 6,远小于其他滤波器,准确度指标也由滤波估计前6.8711提高到0.1502.%Traditionally, PCR instrument detects the temperature of reagent by contact measurement, which has several limitations such as thermal hysteresis, reagent contamination and point- measurement. Thus the infra red thermometer is applied to non-contact measure the temperature of reagent. But the infra red thermometer has the defect of relatively high measurement noise. Therefore, we propose a sequential dual Kalman Filters (Seq-DKF), which consists of an Iterated Extended Kalman Filter (IEKF) and a linear Kalman Filter (KF), to remove the measurement noise from infra red thermometer signals in real-time. In this algorithm, IEKF and KF executes sequentially. The former filter rapidly identifies the parameter of heat exchange model by using a small number of observations. The latter filters the temperature signal based on the identified model. After specifying the heat exchange model and the Seq-DKF, we apply, the algorithm to the PCR instrument for testing. Finally, The other

  3. Development of a surgical navigation system based on augmented reality using an optical see-through head-mounted display.

    Chen, Xiaojun; Xu, Lu; Wang, Yiping; Wang, Huixiang; Wang, Fang; Zeng, Xiangsen; Wang, Qiugen; Egger, Jan


    The surgical navigation system has experienced tremendous development over the past decades for minimizing the risks and improving the precision of the surgery. Nowadays, Augmented Reality (AR)-based surgical navigation is a promising technology for clinical applications. In the AR system, virtual and actual reality are mixed, offering real-time, high-quality visualization of an extensive variety of information to the users (Moussa et al., 2012) [1]. For example, virtual anatomical structures such as soft tissues, blood vessels and nerves can be integrated with the real-world scenario in real time. In this study, an AR-based surgical navigation system (AR-SNS) is developed using an optical see-through HMD (head-mounted display), aiming at improving the safety and reliability of the surgery. With the use of this system, including the calibration of instruments, registration, and the calibration of HMD, the 3D virtual critical anatomical structures in the head-mounted display are aligned with the actual structures of patient in real-world scenario during the intra-operative motion tracking process. The accuracy verification experiment demonstrated that the mean distance and angular errors were respectively 0.809±0.05mm and 1.038°±0.05°, which was sufficient to meet the clinical requirements. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Prototyping a Hybrid Cooperative and Tele-robotic Surgical System for Retinal Microsurgery

    Balicki, Marcin; Xia, Tian; Jung, Min Yang; Deguet, Anton; Vagvolgyi, Balazs; Kazanzides, Peter; Taylor, Russell


    This paper presents the design of a tele-robotic microsurgical platform designed for development of cooperative and tele-operative control schemes, sensor based smart instruments, user interfaces and new surgical techniques with eye surgery as the driving application. The system is built using the distributed component-based cisst libraries and the Surgical Assistant Workstation framework. It includes a cooperatively controlled EyeRobot2, a da Vinci Master manipulator, and a remote stereo visualization system. We use constrained optimization based virtual fixture control to provide Virtual Remote-Center-of-Motion (vRCM) and haptic feedback. Such system can be used in a hybrid setup, combining local cooperative control with remote tele-operation, where an experienced surgeon can provide hand-over-hand tutoring to a novice user. In another scheme, the system can provide haptic feedback based on virtual fixtures constructed from real-time force and proximity sensor information. PMID:24398557

  5. Retained Surgical Foreign Bodies after Surgery

    Valon A. Zejnullahu


    Full Text Available The problem of retained surgical bodies (RSB after surgery is an issue for surgeons, hospitals and the entire medical team. They have potentially harmful consequences for the patient as they can be life threatening and usually, a further operation is necessary. The incidence of RSB is between 0.3 to 1.0 per 1,000 abdominal operations, and they occur due to a lack of organisation and communication between surgical staff during the process. Typically, the RSB are surgical sponges and instruments located in the abdomen, retroperitoneum and pelvis.

  6. Dexterity testing and residents' surgical performance.

    Kirby, T J


    1. With some exceptions, those who choose ophthalmology as a career may approximate the general population in innate manual dexterity. 2. Many factors other than manual dexterity influence the development of surgical skills by residents. 3. If dexterity testing is to be used, the addition or inclusion of tests for spatial aptitudes may be more helpful than simple dexterity tests alone. The predictive value of such tests for surgical performance would need vertification. 4. The development of a special test directly related to handling surgical instruments, to cutting, and to sewing (the criteria) may be more practical than the ones used in this study.

  7. Beam Instrumentation and Diagnostics

    Strehl, Peter


    This treatise covers all aspects of the design and the daily operations of a beam diagnostic system for a large particle accelerator. A very interdisciplinary field, it involves contributions from physicists, electrical and mechanical engineers and computer experts alike so as to satisfy the ever-increasing demands for beam parameter variability for a vast range of operation modi and particles. The author draws upon 40 years of research and work, most of them spent as the head of the beam diagnostics group at GSI. He has illustrated the more theoretical aspects with many real-life examples that will provide beam instrumentation designers with ideas and tools for their work.

  8. Comparação do poder de correção do instrumental de Luque-Galveston e do parafuso pedicular no tratamento cirúrgico da escoliose neuromuscular Comparación del poder de corrección del instrumental de Luque-Galveston y del tornillo pedicular en el tratamiento quirúrgico de la escoliosis neuromuscular Comparison between deformity correction of Luque-Galveston instrumentation and pedicle screw fixation in the surgical treatment of neuromuscular scoliosis

    Murilo Tavares Daher


    (p=0.045. CONCLUSIONS: postoperative major curve correction was similar with pedicle screws and Luque-Galveston instrumentation, but pelvic obliquity correction was greater when pedicle screw was used in the surgical treatment of neuromuscular scoliosis.

  9. 21 CFR 872.4565 - Dental hand instrument.


    ... chisel, endodontic broach, dental wax carver, endodontic pulp canal file, hand instrument for calculus... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental hand instrument. 872.4565 Section 872.4565...) MEDICAL DEVICES DENTAL DEVICES Surgical Devices § 872.4565 Dental hand instrument. (a) Identification....

  10. 21 CFR 882.4275 - Dowel cutting instrument.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dowel cutting instrument. 882.4275 Section 882...) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Surgical Devices § 882.4275 Dowel cutting instrument. (a) Identification. A dowel cutting instrument is a device used to cut dowels of bone for bone grafting....

  11. Micro-surgical endodontics.

    Eliyas, S; Vere, J; Ali, Z; Harris, I


    Non-surgical endodontic retreatment is the treatment of choice for endodontically treated teeth with recurrent or residual disease in the majority of cases. In some cases, surgical endodontic treatment is indicated. Successful micro-surgical endodontic treatment depends on the accuracy of diagnosis, appropriate case selection, the quality of the surgical skills, and the application of the most appropriate haemostatic agents and biomaterials. This article describes the armamentarium and technical procedures involved in performing micro-surgical endodontics to a high standard.

  12. Surgical innovation as sui generis surgical research.

    Lotz, Mianna


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

  13. Magnifying absolute instruments for optically homogeneous regions

    Tyc, Tomas


    We propose a class of magnifying absolute optical instruments with a positive isotropic refractive index. They create magnified stigmatic images, either virtual or real, of optically homogeneous three-dimensional spatial regions within geometrical optics.

  14. Sushruta: Foundation for Surgical Practice

    Siddharth P. Dubhashi


    Full Text Available Sushruta was an ancient Indian surgeon (600 B.C. who resided in Varanasi.The teachings and work of Sushruta is compiled in a treatise called Sushruta Samhita (Sushruta's compendium, which is believed to be a part of Atharvaveda. It contains 184 chapters, descriptions of 1,120 illnesses, 300 surgical procedures, classification of human surgery in 8 categories, over 120 surgical instruments and around 700 drugs of animal, plant and mineral origin. Sushruta was one of the earliest exponents of surgery as an art and science. Sushruta's principles and teachings took surgery in ancient India to a noteworthy pedestal, making it the Golden Age of Surgery. He is truly the “Father of Surgery” and “Father of Plastic Surgery”. It is extremely essential that we put his principles into practice, and preserve the dignity of our noble profession. That would be the ideal tribute to this legendary figure.

  15. Transanal polypectomy using single incision laparoscopic instruments.

    Dardamanis, Dimitrios; Theodorou, Dimitrios; Theodoropoulos, George; Larentzakis, Andreas; Natoudi, Maria; Doulami, Georgia; Zoumpouli, Christina; Markogiannakis, Haridimos; Katsaragakis, Stylianos; Zografos, George C


    Transanal excision of rectal polyps with laparoscopic instrumentation and a single incision laparoscopic port is a novel technique that uses technology originally developed for abdominal procedures from the natural orifice of the rectum. Transanal endoscopic microsurgery (TEM) is a well established surgical approach for certain benign or early malignant lesions of the rectum, under specific indications. Our technique is a hybrid technique of transanal surgery, a reasonable method for polyp resection without the need of the sophisticated and expensive instrumentation of TEM which can be applied whenever endoscopic or conventional transanal surgical removal is not feasible.

  16. Chemical Microsensor Instrument for UAV Airborne Atmospheric Measurements Project

    National Aeronautics and Space Administration — Makel Engineering, Inc. (MEI) proposes to develop a miniaturized Airborne Chemical Microsensor Instrument (ACMI) suitable for real-time, airborne measurements of...

  17. Development of AR Surgical Navigation Systems for Multiple Surgical Regions.

    Suzuki, Naoki; Hattori, Asaki; Iimura, Jiro; Otori, Nobuyoshi; Onda, Shinji; Okamoto, Tomoyoshi; Yanaga, Katsuhiko


    The purpose of our research is to develop surgical navigation systems to enhance surgical safety. Our systems make use of augmented reality technology to superimpose, on the surgery screen on a real time basis, patients' organ models reconstructed in 3D from their X-ray CT data taken before surgery. By doing so, the systems display anatomical risk materials, tumors and blood vessels which surgeons cannot see with their naked eyes. This will in turn lead to surgeons intuitively grasping the inner structures of the operational fields. We so far have been developing navigation systems that can conduct surgeries in various fields. The basic structure of the navigation systems are the same. The navigation systems uses different peripheral equipment and different methods to display navigation images which best meet the demands of each type of surgery. In this thesis, we report on our navigation systems for 2 types of surgery - endoscopic sinus surgery and hepatobilialy-pancreatic surgery.

  18. Real-time surgery simulation of intracranial aneurysm clipping with patient-specific geometries and haptic feedback

    Fenz, Wolfgang; Dirnberger, Johannes


    Providing suitable training for aspiring neurosurgeons is becoming more and more problematic. The increasing popularity of the endovascular treatment of intracranial aneurysms leads to a lack of simple surgical situations for clipping operations, leaving mainly the complex cases, which present even experienced surgeons with a challenge. To alleviate this situation, we have developed a training simulator with haptic interaction allowing trainees to practice virtual clipping surgeries on real patient-specific vessel geometries. By using specialized finite element (FEM) algorithms (fast finite element method, matrix condensation) combined with GPU acceleration, we can achieve the necessary frame rate for smooth real-time interaction with the detailed models needed for a realistic simulation of the vessel wall deformation caused by the clamping with surgical clips. Vessel wall geometries for typical training scenarios were obtained from 3D-reconstructed medical image data, while for the instruments (clipping forceps, various types of clips, suction tubes) we use models provided by manufacturer Aesculap AG. Collisions between vessel and instruments have to be continuously detected and transformed into corresponding boundary conditions and feedback forces, calculated using a contact plane method. After a training, the achieved result can be assessed based on various criteria, including a simulation of the residual blood flow into the aneurysm. Rigid models of the surgical access and surrounding brain tissue, plus coupling a real forceps to the haptic input device further increase the realism of the simulation.

  19. [Objective assessment of symptoms and informing patients of surgical risks].

    de Tayrac, Renaud; Letouzey, Vincent; Marès, Pierre


    Genital prolapse is a functional pathology presenting with numerous urinary, genito-sexual, and anorectal symptoms. These symptoms are responsible for an alteration of the quality of life, sometimes associated to a real anxiety-depressive syndrome. Because of these complex intricacies, the management of these disorders became multidisciplinary. Tools to measure the impact of prolapse symptoms on the quality of life became a necessity. Such instruments should allow a correlation of the functional symptomatology at the anatomic stage, raise a surgical indication based on the functional disturbance and evaluate the effectiveness and tolerance of the various therapeutic procedures. Two validated self-questionnaires in French (short versions of the Pelvic Floor Distress Inventory [PFDI-20] and the Pelvic Floor Impact Questionnaire [PFIQ-7]) are presently available. Moreover, the physician has the legal obligation to provide detailed presurgical information on frequent and severe hazards, expected benefits, functional consequences, therapeutic alternatives and the consequences of nonintervention. Before surgery takes place, the surgical approach, the benefit of using synthetic prostheses, the possibility of uterine and/or ovarian conservation, and some risky conditions such as smoking, obesity and estrogen deficiency should be discussed.

  20. Building a framework for ergonomic research on laparoscopic instrument handles.

    Li, Zheng; Wang, Guohui; Tan, Juan; Sun, Xulong; Lin, Hao; Zhu, Shaihong


    Laparoscopic surgery carries the advantage of minimal invasiveness, but ergonomic design of the instruments used has progressed slowly. Previous studies have demonstrated that the handle of laparoscopic instruments is vital for both surgical performance and surgeon's health. This review provides an overview of the sub-discipline of handle ergonomics, including an evaluation framework, objective and subjective assessment systems, data collection and statistical analyses. Furthermore, a framework for ergonomic research on laparoscopic instrument handles is proposed to standardize work on instrument design.

  1. Optical Instruments


    Precision Lapping and Optical Co. has developed a wide variety of hollow retroreflector systems for applications involving the entire optical spectrum; they are, according to company literature, cheaper, more accurate, lighter and capable of greater size than solid prisms. Precision Lapping's major customers are aerospace and defense companies, government organizations, R&D and commercial instrument companies. For example, Precision Lapping supplies hollow retroreflectors for the laser fire control system of the Army's Abrams tank, and retroreflectors have been and are being used in a number of space tests relative to the Air Force's Strategic Defense Initiative research program. An example of a customer/user is Chesapeake Laser Systems, producer of the Laser Tracker System CMS-2000, which has applications in SDI research and industrial robotics. Another customer is MDA Scientific, Inc., manufacturer of a line of toxic gas detection systems used to monitor hazardous gases present in oil fields, refineries, offshore platforms, chemical plants, waste storage sites and other locations where gases are released into the environment.

  2. Hernia Surgical Mesh Implants

    ... Prosthetics Hernia Surgical Mesh Implants Hernia Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine) ...

  3. Urogynecologic Surgical Mesh Implants

    ... Prosthetics Urogynecologic Surgical Mesh Implants Urogynecologic Surgical Mesh Implants Share Tweet Linkedin Pin it More sharing options ... majority of tissue used to produce these mesh implants are from a pig (porcine) or cow (bovine). ...

  4. American Pediatric Surgical Association

    American Pediatric Surgical Association Search for: Login Resources + For Members For Professionals For Training Program Directors For Media For ... Surgical Outcomes Surveys & Results Publications Continuing Education + ExPERT Pediatric Surgery NaT Annual Meeting CME MOC Requirements Residents / ...

  5. Optimizing surgical f

    Sabry Mohamed Amin


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

  6. Abortion - surgical - aftercare

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

  7. Ready for the OR? - Clinical anatomy and basic surgical skills for students in their preclinical education.

    Böckers, Anja; Lippold, Dominique; Fassnacht, Ulrich; Schelzig, Hubert; Böckers, Tobias M


    Medical students' first experience in the operating theatre often takes place during their electives and is therefore separated from the university's medical curriculum. In the winter term 2009/10, the Institute of Anatomy and Cell Biology at the University of Ulm implemented an elective called "Ready for the OR" for 2nd year medical students participating in the dissection course. We attempted to improve learning motivation and examination results by transferring anatomical knowledge into a surgical setting and teaching basic surgical skills in preparation of the students' first participation in the OR. Out of 69 online applicants, 50 students were randomly assigned to the Intervention Group (FOP) or the Control Group. In 5 teaching session students learned skills like scrubbing, stitching or the identification of frequently used surgical instruments. Furthermore, students visited five surgical interventions which were demonstrated by surgical colleagues on donated bodies that have been embalmed using the Thiel technique. The teaching sessions took place in the institute's newly built "Theatrum Anatomicum" for an ideal simulation of a surgical setting. The learning outcomes were verified by OSPE. In a pilot study, an intervention group and a control group were compared concerning their examination results in the dissection course and their learning motivation through standardized SELLMO-test for students. Participants gained OSPE results between 60.5 and 92% of the maximum score. "Ready for the OR" was successfully implemented and judged an excellent add-on to anatomy teaching by the participants. However, we could not prove a significant difference in learning motivation or examination results. Future studies should focus on the learning orientation, the course's long-term learning effects and the participants' behavior in a real surgery setting.

  8. Virtual reality simulation in endovascular surgical training.

    Tsang, J S


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

  9. Comparison in the cleaning efficacy of surgical instruments by solid deter-gent and multi-enzymatic detergent%固体清洗剂和多酶清洗剂清洗手术器械的效果比较

    傅珺; 沈蓉蓉; 胡仕翔


    Objective To compare the cleaning efficacy of surgical instruments by solid detergent and Liguid multi-enzymatic detergent,and conduct cost-effectiveness analysis,so as to provide new cleaning technique for central sterile supply department(CSSD).Methods Four washer-disinfectors in CSSD were randomly divided into experi-mental and control group,experimental group adopted new solid detergent for cleaning surgical instruments,control group used liquid enzymatic detergent.Cleaning efficacy of two groups were evaluated by visual observation(naked syesight and 10 ×magnifier with light),ATP bioluminescence assay and residual protein test.Cleaning cost and medical waste generated by different detergents during the same period were analyzed statistically.Results Qualified rate of cleaning observed by naked syesight was 97.70% (4 678/4 788)in experimental group and 92.01%(5 075/5 516) in control group;qualified rate of cleaning observed by 10×magnifier with light was 94.30%(2 546/2 700)in experimen-tal group and 88.72%(2 453/2 765)in control group ;qualified rate in experimental group were both higher than in con-trol group (P =0.000).ATP bioluminescence assay showed that qualified rate of cleaning of experimental group and control group was 84.41%(996/ 1 180)and 86.83%(1 042/1 200)respectively,there was no statistical difference between two groups(P =0.092).Residual protein test positive of experimental group and control group was 3.71% (26/700)and 16.31%(106/650))respectively,experimental group was lower than control group (P =0.000).Cleaning cost of experi-mental group was 2/3 of control group;medical waste produced in experimental group (plastic film)and control group (empty barrel)was 0.40kg and 12.30kg respectively.Conclusion Solid detergent cleaning can efficiently eliminate the protein soil on surgical instruments,reduce cleaning cost and production of medical waste,it is a novel technology applied to surgical instrument cleaning.%目的:比较固体清洗剂

  10. Real Language Meets Real Business

    Muirhead, Muirhead; Schechter, Sarah


    The Real Business Language Challenge was a collaborative pilot project between Coca-Cola Enterprises (CCE) and Routes into Languages East for Year 9 and 10 pupils. It was based on CCE's award-winning Real Business Challenge, part of its highly acclaimed education programme. The Real Business Language Challenge transformed the project into a…

  11. Indirect investment in real estate: Listed companies and funds

    Suarez, Jose L.; Vassalo, Amparo


    In Europe today, there are two main vehicles for indirect investment in real estate; real estate investment funds, on the one hand, and, on the other, listed real estate companies. With these instruments, not only does the investor take a position in the real estate market, he/she also acquires different risk/return structures which may vary according to the instrument being used. In some European countries, real estate companies have modified their financial structure and tax position by ado...

  12. Instrumental variables and Mendelian randomization with invalid instruments

    Kang, Hyunseung

    Instrumental variables (IV) methods have been widely used to determine the causal effect of a treatment, exposure, policy, or an intervention on an outcome of interest. The IV method relies on having a valid instrument, a variable that is (A1) associated with the exposure, (A2) has no direct effect on the outcome, and (A3) is unrelated to the unmeasured confounders associated with the exposure and the outcome. However, in practice, finding a valid instrument, especially those that satisfy (A2) and (A3), can be challenging. For example, in Mendelian randomization studies where genetic markers are used as instruments, complete knowledge about instruments' validity is equivalent to complete knowledge about the involved genes' functions. The dissertation explores the theory, methods, and application of IV methods when invalid instruments are present. First, when we have multiple candidate instruments, we establish a theoretical bound whereby causal effects are only identified as long as less than 50% of instruments are invalid, without knowing which of the instruments are invalid. We also propose a fast penalized method, called sisVIVE, to estimate the causal effect. We find that sisVIVE outperforms traditional IV methods when invalid instruments are present both in simulation studies as well as in real data analysis. Second, we propose a robust confidence interval under the multiple invalid IV setting. This work is an extension of our work on sisVIVE. However, unlike sisVIVE which is robust to violations of (A2) and (A3), our confidence interval procedure provides honest coverage even if all three assumptions, (A1)-(A3), are violated. Third, we study the single IV setting where the one IV we have may actually be invalid. We propose a nonparametric IV estimation method based on full matching, a technique popular in causal inference for observational data, that leverages observed covariates to make the instrument more valid. We propose an estimator along with

  13. Virtual instrumentation: Introduction of virtual

    Ödlund, Erika


    The Large Hadron Collider (LHC) is the next large particle accelerator developed at CERN, constructed to enable studies of particles. The acceleration of the particles is carried out using magnets operating at about 1.9 K, a temperature achieved by regulating flow of superfluid helium. For economical reasons, control of the helium flow is based on feedback of virtual flow meter (VFT) estimates instead of real instrumentation. The main purpose of this work is to develop a virtual flow meter wi...

  14. Real Talk on Real Estate


    What’s hot and what’s not in China’s property market The Beijing 2008 Olympics is a giant magnet for real estate investment, but how far-reaching is its pull? Is it a good time to buy real estate in second-tier cities? And could a bal- looning worldwide real estate bubble have ramifications for China? Inquiring minds want to know the answers to all these questions in real estate circles. Experts may not always answer harmoniously, but unless you have a villa empire, their advice could help you conquer this tricky market more successfully. No bubble in Beijing or beyond The Olympic effect will cause real

  15. Modeling of tool-tissue interactions for computer-based surgical simulation: a literature review

    Misra, Sarthak; Ramesh, K.T.; Okamura, Allison M.


    Surgical simulators present a safe and potentially effective method for surgical training, and can also be used in robot-assisted surgery for pre- and intra-operative planning. Accurate modeling of the interaction between surgical instruments and organs has been recognized as a key requirement in th

  16. Surgical management of cervical spondylotic myelopathy

    N Muthukumar


    Full Text Available Cervical spondylotic myelopathy (CSM is emerging as the most common cause of spinal cord dysfunction in the elderly worldwide. In the past decade, our understanding of the biomechanics of the spine has improved along with advances in spinal instrumentation and this has led to significant changes in the surgical management of CSM. This review will discuss the indications, advantages and limitations of different operative approaches as well as the complications and prognosis of surgery for cervical spondylotic myelopathy. Choice of surgical approach for CSM should be based on the clinical and radiological characteristics of the individual patient and not on the preferences of the surgeon.

  17. Instrument repair for remote eye units

    Sam Powdrill


    Full Text Available Many skilled eye surgeons in remote hospitals face the frustration that a simple instrument, once in good working order, is now bent or broken. Many eye units have a box containing instruments needing repair, hidden away in a stock room cupboard, in the hope that someone, someday, will be able to redeem them. This article gives guidelines on: 1 How to assess instruments and identify those that can be repaired locally, those that should be sent to a professional repair service and those that cannot be repaired at all. 2 How to make adjustments and carry out basic maintenance and repairs of surgical instruments. The article will refer primarily to instruments in an extracapsular cataract extraction set.

  18. Application of Advanced Manufacturing Techniques to Forged Surgical Instruments.


    PR Cameron Station Alexandria, ’i,’ 2304-610( A Contract DLA 900.-34-C-1508 Approved for public rele ; "etriLbutlon Unlimited A Department of Defense...respect to this program, ASTMI F921 "Standard Definition of Terms Relatino to Hemostatic Forceps" notes "...that the box lock construction defined in

  19. From pre-operative cardiac modeling to intra-operative virtual environments for surgical guidance: an in vivo study

    Linte, Cristian A.; Wierzbicki, Marcin; Moore, John; Wedlake, Christopher; Wiles, Andrew D.; Bainbridge, Daniel; Guiraudon, Gérard M.; Jones, Douglas L.; Peters, Terry M.


    As part of an ongoing theme in our laboratory on reducing morbidity during minimally-invasive intracardiac procedures, we developed a computer-assisted intervention system that provides safe access inside the beating heart and sufficient visualization to deliver therapy to intracardiac targets while maintaining the efficacy of the procedure. Integrating pre-operative information, 2D trans-esophageal ultrasound for real-time intra-operative imaging, and surgical tool tracking using the NDI Aurora magnetic tracking system in an augmented virtual environment, our system allows the surgeons to navigate instruments inside the heart in spite of the lack of direct target visualization. This work focuses on further enhancing intracardiac visualization and navigation by supplying the surgeons with detailed 3D dynamic cardiac models constructed from high-resolution pre-operative MR data and overlaid onto the intra-operative imaging environment. Here we report our experience during an in vivo porcine study. A feature-based registration technique previously explored and validated in our laboratory was employed for the pre-operative to intra-operative mapping. This registration method is suitable for in vivo interventional applications as it involves the selection of easily identifiable landmarks, while ensuring a good alignment of the pre-operative and intra-operative surgical targets. The resulting augmented reality environment fuses the pre-operative cardiac model with the intra-operative real-time US images with approximately 5 mm accuracy for structures located in the vicinity of the valvular region. Therefore, we strongly believe that our augmented virtual environment significantly enhances intracardiac navigation of surgical instruments, while on-target detailed manipulations are performed under real-time US guidance.

  20. Development of a vision integration framework for laparoscopic surgical robot.

    Shin, Jung W; Park, Jun W; Lee, Chul H; Hong, Soyoung; Jo, Yungho; Choi, Jaesoon


    In order to realize intelligent laparoscopic surgical robot, a vision integrated system constitutes one of the fundamental components. The authors have constructed a vision framework in the current version of NCC (National Cancer Center) laparoscopic surgical robot controlled on a real-time OS (RTLinux-Pro, FSMLabs Inc., U.S.A.). Adding vision framework, we have been applying and testing image processing algorithms- edge detection of object for positioning surgical tool, Watersheds for recognizing object. This paper documents the implementation of the framework and preliminary results of the image segmentation using Watersheds algorithm. Finally the real-time processing capability of our vision system is discussed.

  1. Augmenting traditional instruments with a motion capture system

    Götzen, Amalia De; Vidolin, Alvise; Bernardini, Nicola


    This paper describes some composition works where the real instruments have been augmented through a motion capture system (Phasespace). While playing his instrument in the traditional way, the player is also controlling some other sound effects by moving his hands: the instrument becomes totally...

  2. Augmenting traditional instruments with a motion capture system

    Götzen, Amalia De; Vidolin, Alvise; Bernardini, Nicola


    This paper describes some composition works where the real instruments have been augmented through a motion capture system (Phasespace). While playing his instrument in the traditional way, the player is also controlling some other sound effects by moving his hands: the instrument becomes totally...

  3. Cost assessment of instruments for single-incision laparoscopic cholecystectomy

    Henriksen, Nadia A; Al-Tayar, Haytham; Rosenberg, Jacob;


    Specially designed surgical instruments have been developed for single-incision laparoscopic surgery, but high instrument costs may impede the implementation of these procedures. The aim of this study was to compare the cost of operative implements used for elective cholecystectomy performed...... as conventional laparoscopic 4-port cholecystectomy or as single-incision laparoscopic cholecystectomy....

  4. A novel instrumented retractor to monitor tissue-disruptive forces during lateral thoracotomy.

    Bolotin, Gil; Buckner, Gregory D; Jardine, Nicholas J; Kiefer, Aaron J; Campbell, Nigel B; Kocherginsky, Masha; Raman, Jai; Jeevanandam, Valluvan


    Acute and chronic pain after thoracotomy, post-thoracotomy pain syndrome, is well documented. The mechanical retractors used for the thoracotomy exert significant forces on the skeletal cage. Our hypothesis was that instrumented retractors could be developed to enable real-time monitoring and control of retraction forces. This would provide equivalent exposure with significantly reduced forces and tissue damage and thus less post-thoracotomy pain. A novel instrumented retractor was designed and fabricated to enable real-time force monitoring during surgical retraction. Eight mature sheep underwent bilateral thoracotomy. One lateral thoracotomy was retracted at a standard clinical pace of 5.93 +/- 0.80 minutes to 7.5 cm without real-time monitoring of retraction forces. The other lateral thoracotomy was retracted to the same exposure with real-time visual force feedback and a consequently more deliberate pace of 9.87 +/- 1.89 minutes (P = .006). Retraction forces, blood pressure, and heart rate were monitored throughout the procedure. Full lateral retraction resulted in an average force of 102.88 +/- 50.36 N at the standard clinical pace, versus 77.88 +/- 38.85 N with force feedback (a 24.3% reduction, P = .006). Standard retraction produced peak forces of 450.01 +/- 129.58 N, whereas force feedback yielded peak forces of 323.99 +/- 127.79 N (a 28.0% reduction, P = .009). Systolic blood pressure was significantly higher during standard clinical retraction (P = .0097), and rib fracture occurrences were reduced from 5 to 1 with force feedback (P = .04). Use of the novel instrumented retractor resulted in significantly lower average and peak retraction forces during lateral thoracotomy. Moreover, these reduced retraction forces were correlated with reductions in animal stress and tissue damage, as documented by lower systolic blood pressures and fewer rib fractures.

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

    M. Erol Demirseren


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

  6. A clarity clinic for surgical writing.

    Derish, Pamela; Eastwood, Susan


    Although writing and publishing are key to career development and academic success for surgeons, learning the skills needed to write publishable research reports is an often neglected aspect of surgical training. This report distills several lessons from scientific writing courses for surgeons taught at the University of California, San Francisco, to give a wider audience of academic surgeons tools they can use to write scientific prose more clearly. Drawing extensively on real examples of surgical writing, we cover techniques that are indispensable for achieving clarity, including choosing words carefully, designing well-constructed sentences, building structured paragraphs, and displaying your thinking clearly by using topic sentences and transitions.

  7. [Surgical wound healing in oral surgery].

    Bocca, M; Coscia, D; Bottalico, L; Libro, D


    Aim of this study is to improve the in vivo knowledge about the real effects and the physiologic repair by a detached stitches silk suture in the 8th zone. The study has been carried out on 44 patients submitted to surgical extraction of the impacted 8th (19 upper and 25 lower) teeth. Clinical and histological controls have demonstrated the usefulness of this suture procedure, since it gives a good histological reaction and in easy and safe. Histological and clinical results have confirmed the usefulness of silk suture, presenting however the inconvenience of stitches removal and bacterial plaque on the surgical wound.

  8. In vivo virtual intraoperative surgical photoacoustic microscopy

    Han, Seunghoon, E-mail:; Kim, Sehui, E-mail:; Kim, Jeehyun, E-mail:, E-mail: [School of Electrical Engineering and Computer Science, Kyungpook National University, Daegu 702-701 (Korea, Republic of); Lee, Changho, E-mail:; Jeon, Mansik, E-mail: [Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang 790-784 (Korea, Republic of); Kim, Chulhong, E-mail:, E-mail: [Department of Creative IT Engineering, Pohang University of Science and Technology (POSTECH), Pohang 790-784 (Korea, Republic of); Department of Biomedical Engineering, The State University of New York at Buffalo, Buffalo, New York 14221 (United States)


    We developed a virtual intraoperative surgical photoacoustic microscopy system by combining with a commercial surgical microscope and photoacoustic microscope (PAM). By sharing the common optical path in the microscope and PAM system, we could acquire the PAM and microscope images simultaneously. Moreover, by employing a beam projector to back-project 2D PAM images onto the microscope view plane as augmented reality, the conventional microscopic and 2D cross-sectional PAM images are concurrently mapped on the plane via an ocular lens of the microscope in real-time. Further, we guided needle insertion into phantom ex vivo and mice skins in vivo.

  9. Evaluating musical instruments

    Campbell, D. Murray


    Scientific measurements of sound generation and radiation by musical instruments are surprisingly hard to correlate with the subtle and complex judgments of instrumental quality made by expert musicians.

  10. VLT Instruments Pipeline System Overview

    Jung, Y.; Ballester, P.; Banse, K.; Hummel, W.; Izzo, C.; McKay, D. J.; Kiesgen, M.; Lundin, L. K.; Modigliani, A.; Palsa, R. M.; Sabet, C.


    Since the beginning of the VLT operations in 1998, substantial effort has been put in the development of automatic data reduction tools for the VLT instruments. A VLT instrument pipeline is a complex system that has to be able to identify and classify each produced FITS file, optionally retrieve calibration files from a database, use an image processing software to reduce the data, compute and log quality control parameters, produce FITS images or tables with the correct headers, optionally display them in the control room and send them to the archive. Each instrument has its own dedicated pipeline, based on a common infrastructure and installed with the VLT Data Flow System (DFS). With the increase in the number and the complexity of supported instruments and in the rate of produced data, these pipelines are becoming vital for both the VLT operations and the users, and request more and more resources for development and maintenance. This paper describes the different pipeline tasks with some real examples. It also explains how the development process has been improved to both decrease its cost and increase the pipelines quality using the lessons learned from the first instruments pipelines development.

  11. Computer-Assisted Technique for Surgical Tooth Extraction.

    Hamza, Hosamuddin


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

  12. Computer-Assisted Technique for Surgical Tooth Extraction

    Hosamuddin Hamza


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

  13. Pre-Clinical Evaluation of a Real-Time PCR Assay on a Portable Instrument as a Possible Field Diagnostic Tool: Experiences from the Testing of Clinical Samples for African and Classical Swine Fever Viruses.

    Liu, L; Luo, Y; Accensi, F; Ganges, L; Rodríguez, F; Shan, H; Ståhl, K; Qiu, H-J; Belák, S


    African swine fever (ASF) and classical swine fever (CSF) are two highly infectious transboundary animal diseases (TADs) that are serious threats to the pig industry worldwide, including in China, the world's largest pork producer. In this study, a duplex real-time PCR assay was developed for the rapid detection and differentiation of African swine fever virus (ASFV) and classical swine fever virus (CSFV). The assay was performed on a portable, battery-powered PCR thermocycler with a low sample throughput (termed as 'T-COR4 assay'). The feasibility and reliability of the T-COR4 assay as a possible field method was investigated by testing clinical samples collected in China. When evaluated with reference materials or samples from experimental infections, the assay performed in a reliable manner, producing results comparable to those obtained from stationary PCR platforms. Of 59 clinical samples, 41 had results identical to a two-step CSFV real-time PCR assay. No ASFV was detected in these samples. The T-COR4 assay was technically easy to perform and produced results within 3 h, including sample preparation. In combination with a simple sample preparation method, the T-COR4 assay provides a new tool for the field diagnosis and differentiation of ASF and CSF, which could be of particular value in remote areas.

  14. Fluorescence lifetime technique for surgical imaging, guidance and augmented reality (Conference Presentation)

    Marcu, Laura


    The surgeon's limited ability to accurately delineate the tumor margin during surgical interventions is one key challenge in clinical management of cancer. New methods for guiding tumor resection decisions are needed. Numerous studies have shown that tissue autofluorescence properties have the potential to asses biochemical features associates with distinct pathologies in tissue and to distinguish various cancers from normal tissues. However, despite these promising reports, autofluorescence techniques were sparsely adopted in clinical settings. Moreover, when adopted they were primarily used for pre-operative diagnosis rather than guiding interventions. To address this need, we have researched and engineered instrumentation that utilizes label-free fluorescence lifetime contrast to characterize tissue biochemical features in vivo in patients and methodologies conducive to real-time (few seconds) diagnosis of tissue pathologies during surgical procedures. This presentation overviews clinically-compatible multispectral fluorescence lifetime imaging techniques developed in our laboratory and their ability to operate as stand-alone tools, integrated in a biopsy needle and in conjunction with the da Vinci surgical robot. We present pre-clinical and clinical studies in patients that demonstrate the potential of these techniques for intraoperative assessment of brain tumors and head and neck cancer. Current results demonstrate that intrinsic fluorescence signals can provide useful contrast for delineation distinct types of tissues including tumors intraoperatively. Challenges and solutions in the clinical implementation of these techniques are discussed.

  15. Surgical ethics and the challenge of surgical innovation.

    Angelos, Peter


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

  16. Real Forestry for Real Estate

    Gagnon, Jennifer; Fisher, Jason


    Virginia is poised to see an unprecedented change in forest land ownership. To provide new landowners with information on sustainable forest management, we developed a two-part program, Real Forestry for Real Estate. First, we assembled New Landowner Packets, which contain a variety of sustainable forest management resources. Second, two…

  17. Real Forestry for Real Estate

    Gagnon, Jennifer; Fisher, Jason


    Virginia is poised to see an unprecedented change in forest land ownership. To provide new landowners with information on sustainable forest management, we developed a two-part program, Real Forestry for Real Estate. First, we assembled New Landowner Packets, which contain a variety of sustainable forest management resources. Second, two…

  18. PACS-based interface for 3D anatomical structure visualization and surgical planning

    Koehl, Christophe; Soler, Luc; Marescaux, Jacques


    The interpretation of radiological image is routine but it remains a rather difficult task for physicians. It requires complex mental processes, that permit translation from 2D slices into 3D localization and volume determination of visible diseases. An easier and more extensive visualization and exploitation of medical images can be reached through the use of computer-based systems that provide real help from patient admission to post-operative followup. In this way, we have developed a 3D visualization interface linked to a PACS database that allows manipulation and interaction on virtual organs delineated from CT-scan or MRI. This software provides the 3D real-time surface rendering of anatomical structures, an accurate evaluation of volumes and distances and the improvement of radiological image analysis and exam annotation through a negatoscope tool. It also provides a tool for surgical planning allowing the positioning of an interactive laparoscopic instrument and the organ resection. The software system could revolutionize the field of computerized imaging technology. Indeed, it provides a handy and portable tool for pre-operative and intra-operative analysis of anatomy and pathology in various medical fields. This constitutes the first step of the future development of augmented reality and surgical simulation systems.

  19. Recognizing surgical patterns

    Bouarfa, L.


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

  20. Surgical medical record

    Bulow, S.


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

  1. The Journey to Fielded BioInstrumentation

    Jr., R M


    Over the last ten years, a team at Lawrence Livermore National Laboratory created fieldable instruments that performed identification/quantification via bioassays. These instruments have been based on molecular surface-recognition assays, such as immunoassays, and on nucleic-acid-based assays, such as the polymerase chain reaction. In 1996, we participated in the Joint Field Trials 3, employing both immunoassays as well as the polymerase chair reaction. In 1998, we participated in the Joint Field Trials 4, using only the real-time polymerase chain reaction, as implemented on a 10-chamber instrument. Our hand-held, real-time PCR instrument, known as HANAA has been commercialized as the Bioseeq{reg_sign}, by Smiths Detection. More recently, teams from LLNL have built and fielded an autonomous pathogen detection system (APDS).

  2. Safety and Tumor-specificity of Cetuximab-IRDye800 for Surgical Navigation in Head and Neck Cancer

    Rosenthal, Eben L; Warram, Jason M; de Boer, Esther; Chung, Thomas K; Korb, Melissa L; Brandwein-Gensler, Margie; Strong, Theresa V; Schmalbach, Cecelia E; Morlandt, Anthony B; Agarwal, Garima; Hartman, Yolanda E; Carroll, William R; Richman, Joshua S; Clemons, Lisa K; Nabell, Lisle M; Zinn, Kurt R


    Purpose Positive margins dominate clinical outcomes after surgical resections in most solid cancer types including head and neck squamous cell carcinoma. Unfortunately, surgeons remove cancer in the same manner they have for a century with complete dependence on subjective tissue changes to identify cancer in the operating room. To effect change, we hypothesize that epidermal growth factor receptor (EGFR) can be targeted for safe and specific real-time localization of cancer. Experimental design A dose escalation study of cetuximab conjugated to IRDye800 was performed in patients (n=12) undergoing surgical resection of squamous cell carcinoma arising in the head and neck. Safety and pharmacokinetic data were obtained out to 30 days post-infusion. Multi-instrument fluorescence imaging was performed in the operating room and in surgical pathology. Results There were no grade 2 or higher adverse events attributable to cetuximab-IRDye800. Fluorescence imaging with an intraoperative, wide-field device successfully differentiated tumor from normal tissue during resection with an average tumor-to-background ratio of 5.2 in the highest dose range. Optical imaging identified opportunity for more precise identification of tumor during the surgical procedure and during the pathological analysis of tissues ex-vivo. Fluorescence levels positively correlated with EGFR levels. Conclusion We demonstrate for the first time that commercially available antibodies can be fluorescently labeled and safely administered to humans to identify cancer with sub-millimeter resolution, which has the potential to improve outcomes in clinical oncology. PMID:25904751

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

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


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

  4. Instrumentation, sterilization, and preparation of robot

    A Bhandari


    Full Text Available The da Vinci surgical system is being used for a wide range of surgical tasks. As the applications of this robot increase, more and more surgeons would like to acquire this piece of equipment. There are a wide range of expensive and sophisticated accessories and instruments that come along with this machine, that need special care and attention. The aim of this chapter is the make the user familiar with the various parts of the robot and to provide guidelines for the safe usage of this equipment.

  5. [Living donor transplantation. Surgical complications].

    Karam, Georges


    Although nephrectomy by open surgery is the most used technique for the extraction of kidney transplants in the living donor, nephrectomy under laparaoscopy is increasingly practiced. Laparoscopic nephrectomy is less invasive and performed under videoscopy control, after insufflation of the peritoneal cavity. Three to four incisions are done in order to enter the surgical instruments. The kidney is extracted through a horizontal sus-pubic incision. The exposition is either exclusively transperitoneal, retroperitoneal or hand assisted. The advantages of laparoscopy are esthetical, financial due to a shorter hospitalisation and a quicker recovery, as well a confort for the donor. The disadvantages are a longer warm ischemia time and possibly a higher risk of delayed graft function. Randomised studies having compared laparoscopy and open surgery in the living donor have not find any significant difference regarding the per- and perioperative in the complications.

  6. Real analysis

    McShane, Edward James


    This text surveys practical elements of real function theory, general topology, and functional analysis. Discusses the maximality principle, the notion of convergence, the Lebesgue-Stieltjes integral, function spaces and harmonic analysis. Includes exercises. 1959 edition.

  7. IOT Overview: IR Instruments

    Mason, E.

    In this instrument review chapter the calibration plans of ESO IR instruments are presented and briefly reviewed focusing, in particular, on the case of ISAAC, which has been the first IR instrument at VLT and whose calibration plan served as prototype for the coming instruments.

  8. Performance of the BD MAX™ instrument with Check-Direct CPE real-time PCR for the detection of carbapenemase genes from rectal swabs, in a setting with endemic dissemination of carbapenemase-producing Enterobacteriaceae.

    Antonelli, Alberto; Arena, Fabio; Giani, Tommaso; Colavecchio, Olga Lorenza; Valeva, Stoyanka Valentinova; Paule, Suzanne; Boleij, Peter; Rossolini, Gian Maria


    Carbapenemase-producing Enterobacteriaceae (CPE) represent an increasing public health issue and the early detection of colonization by CPE can help the implementation of infection control measures among inpatients. In this study, BD MAX Check-Direct CPE screen, with two different Master Mixes (BDMix and CPMix), using the automatic BD MAX(™) instrument, was evaluated for the detection of blaKPC, blaOXA-48, blaVIM and blaNDM genes, in comparison to selective broth enrichment and direct culture from rectal swabs. Among a total of 557 rectal swabs samples, 29 (5.2%) tested positive for CPE (23 for blaKPC, 5 for blaVIM and one for blaOXA-48). The sensitivity, specificity, positive and negative likelihood ratios values were 93.1%, 97.3%, 34.5 and 0.07, for BMix, and 100%, 97.1 %, 34.5 and 0 for CPMix, respectively. Five samples were positive with molecular methods only. The turn-around time was reduced from 18-24 hours (direct culture), or 48 h (broth enrichment) to only 3 h.

  9. Real time production optimization

    Saputelli, Luigi; Otavio, Joao; Araujo, Turiassu; Escorcia, Alvaro [Halliburton, Houston, TX (United States). Landmark Division


    Production optimization encompasses various activities of measuring, analyzing, modeling, prioritizing and implementing actions to enhance productivity of a field. We present a state-of-the-art framework for optimizing production on a continuous basis as new sensor data is acquired in real time. Permanently acquired data is modeled and analyzed in order to create predictive models. A model based control strategy is used to regulate well and field instrumentation. The optimum field operating point, which changes with time, satisfies the maximum economic return. This work is a starting point for further development in automatic, intelligent reservoir technologies which get the most out of the abilities of permanent, instrumented wells and remotely activated downhole completions. The strategy, tested with history-matched data from a compartmentalised giant field, proved to reduce operating costs while increasing oil recovery by 27% in this field. (author)

  10. Real time production optimization

    Saputelli, Luigi; Otavio, Joao; Araujo, Turiassu; Escorcia, Alvaro [Halliburton, Houston, TX (United States). Landmark Division


    Production optimization encompasses various activities of measuring, analyzing, modeling, prioritizing and implementing actions to enhance productivity of a field. We present a state-of-the-art framework for optimizing production on a continuous basis as new sensor data is acquired in real time. Permanently acquired data is modeled and analyzed in order to create predictive models. A model based control strategy is used to regulate well and field instrumentation. The optimum field operating point, which changes with time, satisfies the maximum economic return. This work is a starting point for further development in automatic, intelligent reservoir technologies which get the most out of the abilities of permanent, instrumented wells and remotely activated downhole completions. The strategy, tested with history-matched data from a compartmentalised giant field, proved to reduce operating costs while increasing oil recovery by 27% in this field. (author)

  11. Ready for the OR? – Clinical anatomy and basic surgical skills for students in their preclinical education

    Böckers, Anja; Lippold, Dominique; Fassnacht, Ulrich; Schelzig, Hubert; Böckers, Tobias M.


    Medical students’ first experience in the operating theatre often takes place during their electives and is therefore separated from the university’s medical curriculum. In the winter term 2009/10, the Institute of Anatomy and Cell Biology at the University of Ulm implemented an elective called “Ready for the OR” for 2nd year medical students participating in the dissection course. We attempted to improve learning motivation and examination results by transferring anatomical knowledge into a surgical setting and teaching basic surgical skills in preparation of the students’ first participation in the OR. Out of 69 online applicants, 50 students were randomly assigned to the Intervention Group (FOP) or the Control Group. In 5 teaching session students learned skills like scrubbing, stitching or the identification of frequently used surgical instruments. Furthermore, students visited five surgical interventions which were demonstrated by surgical colleagues on donated bodies that have been embalmed using the Thiel technique. The teaching sessions took place in the institute’s newly built “Theatrum Anatomicum” for an ideal simulation of a surgical setting. The learning outcomes were verified by OSPE. In a pilot study, an intervention group and a control group were compared concerning their examination results in the dissection course and their learning motivation through standardized SELLMO-test for students. Participants gained OSPE results between 60.5 and 92% of the maximum score. “Ready for the OR” was successfully implemented and judged an excellent add-on to anatomy teaching by the participants. However, we could not prove a significant difference in learning motivation or examination results. Future studies should focus on the learning orientation, the course’s long-term learning effects and the participants’ behavior in a real surgery setting. PMID:21866247

  12. Surgical ethics: surgical virtue and more.

    Vercler, Christian J


    The encounter between a patient and her surgeon is unique for several reasons. The surgeon inflicts pain upon a patient for the patient's own good. An operative intervention is irreducibly personal, such that the decisions about and performance of operations are inseparable from the idiosyncrasies of the individual surgeon. Furthermore, there is a chasm of knowledge between the patient and surgeon that is difficult to cross. Hence, training in the discipline of surgery includes the inculcation of certain virtues and practices to safeguard against abuses of this relationship and to make sure that the best interests of the patient are prioritized. The stories in this issue are evidence that in contemporary practice this is not quite enough, as surgeons reflect on instances they felt were ethically challenging. Common themes include the difficulty in communicating surgical uncertainty, patient-surgeon relationships, ethical issues in surgical training, and the impact of the technological imperative on caring for dying patients.

  13. A Real Time Supervise System Based on Virtual Instrument for an Vertical Type Aluminum Electro-Coating Production Line%基于虚拟仪器的立式电泳生产线监控系统

    廖世昌; 熊红云; 陈争晖


    Based on the overall arrangement structure of an aluminum electro-coating workshop and DH+ based PLC control network, a real time supervise system is developed with LabWindows/CVI software. The data communication between the PLC and LabWindows/CVI is served by Rslinx C SDK. The supervise system has an effective and user-friendly human-machine interface, and is capable of performing on-line monitoring, including data acquisition, transmission, display, and control, as well as data archiving.%根据电泳涂装生产车问的布局结构及工艺要求,构建基于DH+的PL.C控制网络.开发基J.于LabWindows/CVI的实时监控系统.系统通过RSI,inx C SDK提供的库函数,实现LabWindows/CVI与ABRockwell公司SLC500型PLC的通信.将采集的数据进行处理后实现对生产线的实时显示、控制、报警及数据存档等.系统用户界面友好,动态响应快,满足生产线监控的实时性和动态性要求.

  14. Characterization (environmental Signature) and Function of the Main Instrumented (monitoring Water Quality Network in Real Time) Rivers Atoyac and Zahuapan in High Atoyac Basin; in Dry, Rain and Winter Season 2013-2014; Puebla-Tlaxcala Mexico

    Tavera, E. M.; Rodriguez-Espinosa, P. F.; Morales-Garcia, S. S.; Muñoz-Sevilla, N. P.


    The Zahuapan and Atoyac rivers were characterized in the Upper Atoyac through the integration of physical and chemical parameters (environmental firm) determining the behavior and function of the basin as a tool for measuring and monitoring the quality and management of water resources of the water in one of the most polluted rivers in Mexico. For the determination of the environmental signature proceeded to characterize the water through 11 physicochemical parameters: temperature (T), potential hydrogen (pH), dissolved oxygen (DO), spectral absorption coefficient (SAC), the reduction of oxide potential (ORP), turbidity (Turb), conductivity (l), biochemical oxygen demand in 5 days (BOD5), chemical oxygen demand (COD), total suspended solids (TSS) and total dissolved solids (TDS ), which were evaluated in 49 sites in the dry season, 47 for the rainy season and 23 for the winter season in the basin and Atoyac Zahuapan Alto Atoyac, Puebla-Tlaxcala, Mexico river; finding a mathematical algorithm to assimilate and better represent the information obtained. The algorithm allows us to estimate correlation greater than 0.85. The results allow us to propose the algorithm used in the monitoring stations for purposes of processing information assimilated form.This measurement and monitoring of water quality supports the project, the monitoring network in real time and the actions to clean up Atoyac River, in the urban area of the city of Puebla.

  15. Multiscale Surgical Telerobots

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


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

  16. Enhanced mission performance from autonomous instrument guidance

    Jørgensen, John Leif; Jørgensen, Peter Siegbjørn; Betto, Maurizio


    examples of such autonomous space instrumentation. With its full autonomy, this star tracker is capable of providing, in real-time, the absolute orientation with respect to the celestial reference frame with an accuracy of a few arc seconds. This high accuracy along with the robust operations, low weight...... and power consumption makes the mu ASC an ideal instrument for small, high yielding satellite missions. The ASC has hitherto been used by the satellite AOCS and the high accuracy scientific instrument for attitude recovery (among others onboard ORSTED, CHAMP, and GRACE), and satellite high accuracy target...

  17. GIPP: Geophysical Instrument Pool Potsdam

    Christian Haberland


    Full Text Available The Geophysical Instrument Pool Potsdam (GIPP consists of field instruments, sensors and equipment for temporary seismological studies (both controlled source and earthquake seismology as well as for magnetotelluric (electromagnetic experiments. These instruments are mainly mobile digital recorders, broadband seis­mometers and short period sensors, and they are used to reveal the subsurface structure and to investigate earth­quakes. Sensors for magnetotellurics include induction coil and fluxgate magnetometers and non-polarizing silver / silver-chloride electrodes. It is operated by the Helmholtz Centre Potsdam GFZ German Research Centre for Geosciences. The instru­ment facility is open to all academic applicants, both national and international. Instrument applications are evalu­ated and ranked by an external steering board. Currently, for seismological applications >850 geophysical recorders, >170 broadband seis­mo­meters and >1300 short period geophones are available (among others. Available for magnetotelluric experiments are > 50 real-time data-loggers, >150 induction coils, and >500 electrodes. User guidelines and data policy are in force and data archives are provided (standard exchange formats.

  18. Níveis de ansiedade de alunos de graduação em enfermagem frente à primeira instrumentação cirúrgica Niveles de ansiedad de los alumnos de pregrado en enfermería delante de la primera instrumentación quirúrgica Nursing undergraduates' anxiety about the first surgical instrumentation

    Rachel de Carvalho


    ' anxiety about the first surgical instrumentation. The sample consisted of 30 sixth-period students who were enrolled in the subject Surgical Nursing. Data were collected through the STAI (State-Trait Anxiety Inventory. We identified that 90% of the students demonstrated low levels of trait anxiety. As to state anxiety, the most frequent observations were: low anxiety level on the first day of theoretical class (76.7%. medium anxiety level at the lab (53% and medium anxiety level during supervised training (80%. Furthermore, we identified a small number of students with high anxiety levels. The statistical analysis shows significant differences among the mean levels of state-anxiety during the three data collection phases.

  19. Real analysis

    Loeb, Peter A


    This textbook is designed for a year-long course in real analysis taken by beginning graduate and advanced undergraduate students in mathematics and other areas such as statistics, engineering, and economics. Written by one of the leading scholars in the field, it elegantly explores the core concepts in real analysis and introduces new, accessible methods for both students and instructors. The first half of the book develops both Lebesgue measure and, with essentially no additional work for the student, general Borel measures for the real line. Notation indicates when a result holds only for Lebesgue measure. Differentiation and absolute continuity are presented using a local maximal function, resulting in an exposition that is both simpler and more general than the traditional approach. The second half deals with general measures and functional analysis, including Hilbert spaces, Fourier series, and the Riesz representation theorem for positive linear functionals on continuous functions with compact support....

  20. Guide to Surgical Specialists

    ... have expertise in the following areas of responsibility: neonatal surgery (specialized knowledge in the surgical repair of ... and non-operative management of certain types of pain. Common conditions managed by neurologic surgeons include disorders ...

  1. Surgical Critical Care Initiative

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

  2. Ambulatory Surgical Measures - National

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

  3. Ambulatory Surgical Measures - Facility

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

  4. Surgical site infections

    and mortality as well as significant financial implications. Worldwide it has ... common nosocomial infection amongst surgical patients with up to 38% .... antibiotics as soon as the sensitivity results are available. ... Breast surgery. Staph Aureus/ ...

  5. The application of digital surgical diagnosis and treatment technology: a promising strategy for surgical reconstruction of craniomaxillofacial defect and deformity.

    Wang, Li-ya; Du, Hong-ming; Zhang, Gang; Tang, Wei; Liu, Lei; Jing, Wei; Long, Jie


    The craniomaxillofacial defect and deformity always leads to serious dysfunction in mastication and facial contour damage, significantly reducing patients' quality of life. However, surgical reconstruction of a craniomaxillofacial hard tissue defect or deformity is extremely complex and often does not result in desired facial morphology. Improving the result for patients with craniomaxillofacial defect and deformity remains a challenge for surgeons. Using digital technology for surgical diagnosis and treatment may help solve this problem. Computer-assisted surgical technology and surgical navigation technology are included in the accurate digital diagnosis and treatment system we propose. These technologies will increase the accuracy of the design of the operation plan. In addition, the intraoperative real-time navigating location system controlling the robotic arm or advanced intelligent robot will provide accurate, individualized surgical treatment for patients. Here we propose the hypothesis that a digital surgical diagnosis and treatment technology may provide a new approach for precise surgical reconstruction of complicated craniomaxillofacial defect and deformity. Our hypothesis involves modern digital surgery, a three-dimensional navigation surgery system and modern digital imaging technology, and our key aim is to establish a technological platform for customized digital surgical design and surgical navigation for craniomaxillofacial defect and deformity. If the hypothesis is proven practical, this novel therapeutic approach could improve the result of surgical reconstruction for craniomaxillofacial defect and deformity for many patients.

  6. 21 CFR 884.4520 - Obstetric-gynecologic general manual instrument.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric-gynecologic general manual instrument... Surgical Devices § 884.4520 Obstetric-gynecologic general manual instrument. (a) Identification. An obstetric-gynecologic general manual instrument is one of a group of devices used to perform...

  7. 21 CFR 888.5980 - Manual cast application and removal instrument.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual cast application and removal instrument... SERVICES (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Surgical Devices § 888.5980 Manual cast application and removal instrument. (a) Identification. A manual cast application and removal instrument is...

  8. Haptic feedback and control of a flexible surgical endoscopic robot.

    Wang, Zheng; Sun, Zhenglong; Phee, Soo Jay


    A flexible endoscope could reach the potential surgical site via a single small incision on the patient or even through natural orifices, making it a very promising platform for surgical procedures. However, endoscopic surgery has strict spatial constraints on both tool-channel size and surgical site volume. It is therefore very challenging to deploy and control dexterous robotic instruments to conduct surgical procedures endoscopically. Pioneering endoscopic surgical robots have already been introduced, but the performance is limited by the flexible neck of the robot that passes through the endoscope tool channel. In this article we present a series of new developments to improve the performance of the robot: a force transmission model to address flexibility, elongation study for precise position control, and tissue property modeling for haptic feedback. Validation experiment results are presented for each sector. An integrated control architecture of the robot system is given in the end. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Recognition of surgical skills using hidden Markov models

    Speidel, Stefanie; Zentek, Tom; Sudra, Gunther; Gehrig, Tobias; Müller-Stich, Beat Peter; Gutt, Carsten; Dillmann, Rüdiger


    Minimally invasive surgery is a highly complex medical discipline and can be regarded as a major breakthrough in surgical technique. A minimally invasive intervention requires enhanced motor skills to deal with difficulties like the complex hand-eye coordination and restricted mobility. To alleviate these constraints we propose to enhance the surgeon's capabilities by providing a context-aware assistance using augmented reality techniques. To recognize and analyze the current situation for context-aware assistance, we need intraoperative sensor data and a model of the intervention. Characteristics of a situation are the performed activity, the used instruments, the surgical objects and the anatomical structures. Important information about the surgical activity can be acquired by recognizing the surgical gesture performed. Surgical gestures in minimally invasive surgery like cutting, knot-tying or suturing are here referred to as surgical skills. We use the motion data from the endoscopic instruments to classify and analyze the performed skill and even use it for skill evaluation in a training scenario. The system uses Hidden Markov Models (HMM) to model and recognize a specific surgical skill like knot-tying or suturing with an average recognition rate of 92%.

  10. Instrument Modeling and Synthesis

    Horner, Andrew B.; Beauchamp, James W.

    During the 1970s and 1980s, before synthesizers based on direct sampling of musical sounds became popular, replicating musical instruments using frequency modulation (FM) or wavetable synthesis was one of the “holy grails” of music synthesis. Synthesizers such as the Yamaha DX7 allowed users great flexibility in mixing and matching sounds, but were notoriously difficult to coerce into producing sounds like those of a given instrument. Instrument design wizards practiced the mysteries of FM instrument design.

  11. Performing the Super Instrument

    Kallionpaa, Maria


    The genre of contemporary classical music has seen significant innovation and research related to new super, hyper, and hybrid instruments, which opens up a vast palette of expressive potential. An increasing number of composers, performers, instrument designers, engineers, and computer programmers...... provides the performer extensive virtuoso capabilities in terms of instrumental range, harmony, timbre, or spatial, textural, acoustic, technical, or technological qualities. The discussion will be illustrated by a composition case study involving augmented musical instrument electromagnetic resonator...

  12. Performing the Super Instrument

    Kallionpaa, Maria


    provides the performer extensive virtuoso capabilities in terms of instrumental range, harmony, timbre, or spatial, textural, acoustic, technical, or technological qualities. The discussion will be illustrated by a composition case study involving augmented musical instrument electromagnetic resonator......The genre of contemporary classical music has seen significant innovation and research related to new super, hyper, and hybrid instruments, which opens up a vast palette of expressive potential. An increasing number of composers, performers, instrument designers, engineers, and computer programmers...

  13. Aeroacoustics of Musical Instruments

    Fabre, B.; Gilbert, J.; Hirschberg, A.; Pelorson, X.


    We are interested in the quality of sound produced by musical instruments and their playability. In wind instruments, a hydrodynamic source of sound is coupled to an acoustic resonator. Linear acoustics can predict the pitch of an instrument. This can significantly reduce the trial-and-error process

  14. Thermal processes identification using virtual instrumentation

    Iosif OLAH


    Full Text Available In this paper the experimental identification problem of thermal processes is presented, in order to establish their mathematical models which permit the adoption of the automation solutions, respectively the specification of a suitable control law. With this aim in view, the authors resorted to use Virtual Instrumentation with the aid of the LabVIEW development medium. In order to solve the problem of acquisition and processing data from physical real processes, Virtual Instruments which provide at the end a mathematical model which is basis of choosing the automation equipment of the aim followed was designed and achieved. The achieved Virtual Instruments get the opportunity to be used either in student instruction field with the virtual processes identification techniques or to put the identification of some real processes to good use of diverse beneficiaries. The results of some experimental attempts which were achieved during different thermal processes, illustrate the utility of the demarches performed in this paper.

  15. Real Time Conference 2016 Overview

    Luchetta, Adriano


    This is a special issue of the IEEE Transactions on Nuclear Science containing papers from the invited, oral, and poster presentation of the 20th Real Time Conference (RT2016). The conference was held June 6-10, 2016, at Centro Congressi Padova “A. Luciani,” Padova, Italy, and was organized by Consorzio RFX (CNR, ENEA, INFN, Università di Padova, Acciaierie Venete SpA) and the Istituto Nazionale di Fisica Nucleare. The Real Time Conference is multidisciplinary and focuses on the latest developments in real-time techniques in high-energy physics, nuclear physics, astrophysics and astroparticle physics, nuclear fusion, medical physics, space instrumentation, nuclear power instrumentation, general radiation instrumentation, and real-time security and safety. Taking place every second year, it is sponsored by the Computer Application in Nuclear and Plasma Sciences technical committee of the IEEE Nuclear and Plasma Sciences Society. RT2016 attracted more than 240 registrants, with a large proportion of young researchers and engineers. It had an attendance of 67 students from many countries.

  16. Novel Instrumentation for Lunar Regolith Oxygen Production Facilities Project

    National Aeronautics and Space Administration — The objective of the Phase I is to develop, demonstrate and test novel instrumentation based on ultrasensitive laser absorption spectroscopy for sensitive real-time...

  17. Real analysis

    DiBenedetto, Emmanuele


    The second edition of this classic textbook presents a rigorous and self-contained introduction to real analysis with the goal of providing a solid foundation for future coursework and research in applied mathematics. Written in a clear and concise style, it covers all of the necessary subjects as well as those often absent from standard introductory texts. Each chapter features a “Problems and Complements” section that includes additional material that briefly expands on certain topics within the chapter and numerous exercises for practicing the key concepts. The first eight chapters explore all of the basic topics for training in real analysis, beginning with a review of countable sets before moving on to detailed discussions of measure theory, Lebesgue integration, Banach spaces, functional analysis, and weakly differentiable functions. More topical applications are discussed in the remaining chapters, such as maximal functions, functions of bounded mean oscillation, rearrangements, potential theory, a...

  18. Anxiety in veterinary surgical students

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


    The surgical educational environment is potentially stressful and this can negatively affect students' learning. The aim of this study was to investigate whether veterinary students' level of anxiety is higher in a surgical course than in a non-surgical course and if pre-surgical training...... in a Surgical Skills Lab (SSL) has an anxiety reducing effect. Investigations were carried out as a comparative study and a parallel group study. Potential participants were fourth-year veterinary students who attended a surgical course (Basic Surgical Skills) and a non-surgical course (Clinical Examination...... and 28 students from 2010). Our results show that anxiety levels in veterinary students are significantly higher in a surgical course than in a non-surgical course (p...

  19. Malnutrition in hospitalised patients; a real concern in surgical outcomes

    Chandrashekhar C. Mahakalkar


    Conclusions: The change in various parameter of nutritional status was observed in hospitalized patients. The treatment should be aimed at treating specific disorders along with nutritional correction. It is recommended to have dietary plans at the time of admission in consultation with the dietician. [Int J Res Med Sci 2014; 2(1.000: 250-257

  20. Challenging Residual Contamination of Instruments for Robotic Surgery in Japan.

    Saito, Yuhei; Yasuhara, Hiroshi; Murakoshi, Satoshi; Komatsu, Takami; Fukatsu, Kazuhiko; Uetera, Yushi


    BACKGROUND Recently, robotic surgery has been introduced in many hospitals. The structure of robotic instruments is so complex that updating their cleaning methods is a challenge for healthcare professionals. However, there is limited information on the effectiveness of cleaning for instruments for robotic surgery. OBJECTIVE To determine the level of residual contamination of instruments for robotic surgery and to develop a method to evaluate the cleaning efficacy for complex surgical devices. METHODS Surgical instruments were collected immediately after operations and/or after in-house cleaning, and the level of residual protein was measured. Three serial measurements were performed on instruments after cleaning to determine the changes in the level of contamination and the total amount of residual protein. The study took place from September 1, 2013, through June 30, 2015, in Japan. RESULTS The amount of protein released from robotic instruments declined exponentially. The amount after in-house cleaning was 650, 550, and 530 µg/instrument in the 3 serial measurements. The overall level of residual protein in each measurement was much higher for robotic instruments than for ordinary instruments (Probotic surgery. Infect Control Hosp Epidemiol 2017;38:143-146.

  1. Surgical bleeding in microgravity

    Campbell, M. R.; Billica, R. D.; Johnston, S. L. 3rd


    A surgical procedure performed during space flight would occur in a unique microgravity environment. Several experiments performed during weightlessness in parabolic flight were reviewed to ascertain the behavior of surgical bleeding in microgravity. Simulations of bleeding using dyed fluid and citrated bovine blood, as well as actual arterial and venous bleeding in rabbits, were examined. The high surface tension property of blood promotes the formation of large fluid domes, which have a tendency to adhere to the wound. The use of sponges and suction will be adequate to prevent cabin atmosphere contamination with all bleeding, with the exception of temporary arterial droplet streams. The control of the bleeding with standard surgical techniques should not be difficult.

  2. Surgical management of presbyopia

    Torricelli AA


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

  3. Surgical Treatment of Atrial Fibrillation: A Review

    Nadine Hiari


    Full Text Available Atrial fibrillation is the most commonly sustained arrhythmia in man. While it affects millions of patients worldwide, its incidence will markedly increase with an aging population. Primary goals of AF therapy are to (1 reduce embolic complications, particularly stroke, (2 alleviate symptoms, and (3 prevent long-term heart remodelling. These have been proven to be a challenge as there are major limitations in our knowledge of the pathological and electrophysiological mechanisms underlying AF. Although advances continue to be made in the medical management of this condition, pharmacotherapy is often unsuccessful. Because of the high recurrence rate of AF despite antiarrhythmic drug therapy for maintenance of sinus rhythm and the adverse effects of these drugs, there has been growing interest in nonpharmacological strategies. Surgery for treatment of AF has been around for some time. The Cox-Maze procedure is the gold standard for the surgical treatment of atrial fibrillation and has more than 90% success in eliminating atrial fibrillation. Although the cut and sew maze is very effective, it has been superseded by newer operations that rely on alternate energy sources to create lines of conduction block. In addition, the evolution of improved ablation technology and instrumentation has facilitated the development of minimally invasive approaches. In this paper, the rationale for surgical ablation for atrial fibrillation and the different surgical techniques that were developed will be explored. In addition, it will detail the new approaches to surgical ablation of atrial fibrillation that employ alternate energy sources.

  4. Sample Analysis at Mars Instrument Simulator

    Benna, Mehdi; Nolan, Tom


    The Sample Analysis at Mars Instrument Simulator (SAMSIM) is a numerical model dedicated to plan and validate operations of the Sample Analysis at Mars (SAM) instrument on the surface of Mars. The SAM instrument suite, currently operating on the Mars Science Laboratory (MSL), is an analytical laboratory designed to investigate the chemical and isotopic composition of the atmosphere and volatiles extracted from solid samples. SAMSIM was developed using Matlab and Simulink libraries of MathWorks Inc. to provide MSL mission planners with accurate predictions of the instrument electrical, thermal, mechanical, and fluid responses to scripted commands. This tool is a first example of a multi-purpose, full-scale numerical modeling of a flight instrument with the purpose of supplementing or even eliminating entirely the need for a hardware engineer model during instrument development and operation. SAMSIM simulates the complex interactions that occur between the instrument Command and Data Handling unit (C&DH) and all subsystems during the execution of experiment sequences. A typical SAM experiment takes many hours to complete and involves hundreds of components. During the simulation, the electrical, mechanical, thermal, and gas dynamics states of each hardware component are accurately modeled and propagated within the simulation environment at faster than real time. This allows the simulation, in just a few minutes, of experiment sequences that takes many hours to execute on the real instrument. The SAMSIM model is divided into five distinct but interacting modules: software, mechanical, thermal, gas flow, and electrical modules. The software module simulates the instrument C&DH by executing a customized version of the instrument flight software in a Matlab environment. The inputs and outputs to this synthetic C&DH are mapped to virtual sensors and command lines that mimic in their structure and connectivity the layout of the instrument harnesses. This module executes

  5. Analysis of exfoliated gastric carcinoma cells attached on surgical supplies

    Yu XF


    Full Text Available Xiao-Fen Yu,1 Ying-Yu Ma,2 Xian-Qin Hu,1 Qin-Fang Zhang,1 Zai-Yuan Ye3 1Operating Theatre, Zhejiang Provincial People’s Hospital, 2Key Laboratory of Gastroenterology of Zhejiang Province, Zhejiang Provincial People’s Hospital, 3Department of Gastrointestinal Surgery, Zhejiang Provincial People’s Hospital, Hangzhou, People’s Republic of China Abstract: Surgery is considered to have a leading role in the treatment of gastric carcinoma. Surgical supplies are used to cut, divide, and ligate during surgery, and are not only in close contact with normal tissues, but may also be contaminated by pathological tissues and cells. This study sought to determine the presence of exfoliated tumor cells on surgical supplies at different stages during the surgical procedure. We collected five types of surgical supplies from 90 patients who underwent D2 radical gastrectomy to find out if there was any cancer cells attached to them. Highest numbers of cancer cells were found on gauze used to clean the surgical instruments and on the gloves of scrub nurses. The likelihood of finding cancer cells increased with advancing clinical stage of disease, lower differentiation of cancer cells, increasing frequency of use of supplies and extent of contact, and was also associated with the characteristic of surgical supplies. Dissemination of tumor cells could be prevented by using a number of methods, depending on the type of surgical supply items. Keywords: exfoliated tumor cells, surgical supplies, gastric carcinoma, metastasis, prevention

  6. Funciones reales

    Acevedo Frías, Bernardo


    Este trabajo pretende ser un punto de apoyo para el desarrollo del tema y proporcionar un complemento para estudiantes de ingeniería. Este trabajo comprende los conceptos básicos de las funciones reales, sus clases, las propiedades más importantes con algunas demostraciones, ejemplos teóricos y gráficos; con ello se permite al lector conocer con mayor seguridad y rapidez, lo referente a funciones. Comprende temas relacionados con funciones tales como: producto cartesiano, relación, dominio ...

  7. [Spinal instrumentation, source of progress, but also revealing pitfalls].

    Dubousset, Jean


    The second half of the XXo century and especially the last 30 years have been the source of a great improvement for surgical treatment of spinal pathology essentially in 3 directions:--First, for the patient himself and his comfort by suppression for most of the cases of any post operative external support thanks to the rigidity, security and strength of segmental fixation given by the hooks, screws and rods systems, as well for posterior as anterior instrumentation. In addition, these new techniques allow the patient to return quickly to standing and walking activity and subsequently the surgery for adult people increased dramatically especially for all kind of degenerative diseases and more and more extended spinal deformities.--The second major improvement came from the real and new understanding of the 3 dimensions for all the physiology and pathology of the spine leading to practical applications for the design and surgical strategies for correction. The exploding expansion of the era of computer technology brought a lot of help in such understanding as well as for the development of spinal instrumentation.--Finally the impressive development of medical imaging with CT scan and less and less invasive techniques like MRI allow a much better vision of spinal cord and roots (a major concern for the spinal surgeon). All this occurs also because simultaneous revolution occurred in the field of anesthesia and intensive care especially post operatively, but also because the big progress for monitoring of vital function as well as neurological monitoring during surgery. The consequence of that was an improvement for the results concerning the patient for functional quality of life as well as for cosmesis. The subsequent failures resulting of these improvements came from various fields even if we exclude infection or neurological complications more and more controlled now.--At the level of the indications because of these lack of post operative external immobilization

  8. [Optimizing surgical hand disinfection].

    Kampf, G; Kramer, A; Rotter, M; Widmer, A


    For more than 110 years hands of surgeons have been treated before a surgical procedure in order to reduce the bacterial density. The kind and duration of treatment, however, has changed significantly over time. Recent scientific evidence suggests a few changes with the aim to optimize both the efficacy and the dermal tolerance. Aim of this article is the presentation and discussion of new insights in surgical hand disinfection. A hand wash should be performed before the first disinfection of a day, ideally at least 10 min before the beginning of the disinfection as it has been shown that a 1 min hand wash significantly increases skin hydration for up to 10 min. The application time may be as short as 1.5 min depending on the type of hand rub. Hands and forearms should be kept wet with the hand rub for the recommended application time in any case. A specific rub-in procedure according to EN 12791 has been found to be suitable in order to avoid untreated skin areas. The alcohol-based hand rub should have a proven excellent dermal tolerance in order to ensure appropriate compliance. Considering these elements in clinical practice can have a significant impact to optimize the high quality of surgical hand disinfection for prevention of surgical site infections.

  9. VIRUS instrument enclosures

    Prochaska, T.; Allen, R.; Mondrik, N.; Rheault, J. P.; Sauseda, M.; Boster, E.; James, M.; Rodriguez-Patino, M.; Torres, G.; Ham, J.; Cook, E.; Baker, D.; DePoy, Darren L.; Marshall, Jennifer L.; Hill, G. J.; Perry, D.; Savage, R. D.; Good, J. M.; Vattiat, Brian L.


    The Visible Integral-Field Replicable Unit Spectrograph (VIRUS) instrument will be installed at the Hobby-Eberly Telescope† in the near future. The instrument will be housed in two enclosures that are mounted adjacent to the telescope, via the VIRUS Support Structure (VSS). We have designed the enclosures to support and protect the instrument, to enable servicing of the instrument, and to cool the instrument appropriately while not adversely affecting the dome environment. The system uses simple HVAC air handling techniques in conjunction with thermoelectric and standard glycol heat exchangers to provide efficient heat removal. The enclosures also provide power and data transfer to and from each VIRUS unit, liquid nitrogen cooling to the detectors, and environmental monitoring of the instrument and dome environments. In this paper, we describe the design and fabrication of the VIRUS enclosures and their subsystems.

  10. Gemini Instrument Upgrade Program

    Diaz, Ruben; Goodsell, Stephen; Kleinman, Scot


    The Gemini Observatory* remains committed to keeping its operational instrumentation competitive and serving the needs of its user community. Currently the observatory operates a 4 instruments + 1 AO system at each site. At Gemini North the GMOS-N, GNIRS, NIFS and NIRI instruments are offered supported by the ALTAIR AO system. In the south, GMOS-S, F-2, GPI and GSAOI are offered instrumentation and GeMS is the provided AO System. This paper reviews our strategy to keep our instrumentation suite competitive, examines both our current funded upgrade projects and our potential future enhancements. We summarize the work done and the results so far obtained within the instrument upgrade program.

  11. Instrumentation a reader

    Pope, P


    This book contains a selection of papers and articles in instrumentation previously pub­ lished in technical periodicals and journals of learned societies. Our selection has been made to illustrate aspects of current practice and applications of instrumentation. The book does not attempt to be encyclopaedic in its coverage of the subject, but to provide some examples of general transduction techniques, of the sensing of particular measurands, of components of instrumentation systems and of instrumentation practice in two very different environments, the food industry and the nuclear power industry. We have made the selection particularly to provide papers appropriate to the study of the Open University course T292 Instrumentation. The papers have been chosen so that the book covers a wide spectrum of instrumentation techniques. Because of this, the book should be of value not only to students of instrumen­ tation, but also to practising engineers and scientists wishing to glean ideas from areas of instrumen...

  12. Surgical Robotics Research in Cardiovascular Disease

    Pohost, Gerald M; Guthrie, Barton L; Steiner, Charles


    This grant is to support a research in robotics at three major medical centers: the University of Southern California-USC- (Project 1); the University of Alabama at Birmingham-UAB-(Project 2); and the Cleveland Clinic Foundation-CCF-(Project 3). Project 1 is oriented toward cardiovascular applications, while projects 2 and 3 are oriented toward neurosurgical applications. The main objective of Project 1 is to develop an approach to assist patients in maintaining a constant level of stress while undergoing magnetic resonance imaging or spectroscopy. The specific project is to use handgrip to detect the changes in high energy phosphate metabolism between rest and stress. The high energy phosphates, ATP and phosphocreatine (PCr) are responsible for the energy of the heart muscle (myocardium) responsible for its contractile function. If the blood supply to the myocardium in insufficient to support metabolism and contractility during stress, the high energy phosphates, particularly PCr, will decrease in concentration. The high energy phosphates can be tracked using phosphorus-31 magnetic resonance spectroscopy ({sup 31}P MRS). In Project 2 the UAB Surgical Robotics project focuses on the use of virtual presence to assist with remote surgery and surgical training. The goal of this proposal was to assemble a pilot system for proof of concept. The pilot project was completed successfully and was judged to demonstrate that the concept of remote surgical assistance as applied to surgery and surgical training was feasible and warranted further development. The main objective of Project 3 is to develop a system to allow for the tele-robotic delivery of instrumentation during a functional neurosurgical procedure (Figure 3). Instrumentation such as micro-electrical recording probes or deep brain stimulation leads. Current methods for the delivery of these instruments involve the integration of linear actuators to stereotactic navigation systems. The control of these delivery

  13. Hydraulic Robotic Surgical Tool Changing Manipulator.

    Pourghodrat, Abolfazl; Nelson, Carl A; Oleynikov, Dmitry


    Natural orifice transluminal endoscopic surgery (NOTES) is a surgical technique to perform "scarless" abdominal operations. Robotic technology has been exploited to improve NOTES and circumvent its limitations. Lack of a multitasking platform is a major limitation. Manual tool exchange can be time consuming and may lead to complications such as bleeding. Previous multifunctional manipulator designs use electric motors. These designs are bulky, slow, and expensive. This paper presents design, prototyping, and testing of a hydraulic robotic tool changing manipulator. The manipulator is small, fast, low-cost, and capable of carrying four different types of laparoscopic instruments.

  14. Aircrew Screening Instruments Review


    available tools . Several vendors indicated that they will have new selection instruments available within a few months. These are not listed. As noted...AFCAPS-FR-2011-0012 AIRCREW SCREENING INSTRUMENTS REVIEW Diane L. Damos Damos Aviation Services, Inc...June 2007 – August 2007 4. TITLE AND SUBTITLE Aircrew Screening Instruments Review 5a. CONTRACT NUMBER FA3089-06-F-0385 5b. GRANT NUMBER 5c

  15. Instrumentation in Earthquake Seismology

    Havskov, Jens; Alguacil, Gerardo

    Here is unique and comprehensive coverage of modern seismic instrumentation, based on the authors' practical experience of a quarter-century in seismology and geophysics. Their goal is to provide not only detailed information on the basics of seismic instruments but also to survey equipment on the market, blending this with only the amount of theory needed to understand the basic principles. Seismologists and technicians working with seismological instruments will find here the answers to their practical problems.

  16. [da Vinci surgical system].

    Watanabe, Gou; Ishikawa, Norihiro


    The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

  17. [Controlling instruments in radiology].

    Maurer, M


    Due to the rising costs and competitive pressures radiological clinics and practices are now facing, controlling instruments are gaining importance in the optimization of structures and processes of the various diagnostic examinations and interventional procedures. It will be shown how the use of selected controlling instruments can secure and improve the performance of radiological facilities. A definition of the concept of controlling will be provided. It will be shown which controlling instruments can be applied in radiological departments and practices. As an example, two of the controlling instruments, material cost analysis and benchmarking, will be illustrated.

  18. Ocean Optics Instrumentation Systems

    Federal Laboratory Consortium — FUNCTION: Provides instrumentation suites for a wide variety of measurements to characterize the ocean’s optical environment. These packages have been developed to...

  19. Networked Instrumentation Element

    National Aeronautics and Space Administration — Armstrong researchers have developed a networked instrumentation system that connects modern experimental payloads to existing analog and digital communications...

  20. Satellite oceanography - The instruments

    Stewart, R. H.


    It is pointed out that no instrument is sensitive to only one oceanographic variable; rather, each responds to a combination of atmospheric and oceanic phenomena. This complicates data interpretation and usually requires that a number of observations, each sensitive to somewhat different phenomena, be combined to provide unambiguous information. The distinction between active and passive instruments is described. A block diagram illustrating the steps necessary to convert data from satellite instruments into oceanographic information is included, as is a diagram illustrating the operation of a radio-frequency radiometer. Attention is also given to the satellites that carry the various oceanographic instruments.

  1. Marketing instruments of foreign trade promotion

    Bjelić Predrag


    Full Text Available Instruments of promotion as a part of marketing mix are usually associated with companies but more and more countries use this instrument in order to boost their exports. These foreign trade promotion instruments are now popular in many countries in the world since their use is not opposed to any World Trade Organization rules. Marketing instruments of trade promotions are the most important. They include National Exhibitions and National labels of origin and quality. In order to coordinate the application of these instruments countries have established national bodies for trade promotion. Many studies in the past had argued that national Agencies established to promote export did not had any real success, but recent studies indicate that they could have a significant impact on country export promotion. The result of this rise in impact of national export promotion agencies is due to international effort spearheaded by International Trade Center. The aim of this paper is to point out types and methods of marketing instruments application in trade promotion and to present the effectiveness of these instruments applications.

  2. LR-Spring Mass Model for Cardiac Surgical Simulation

    Mosegaard, Jesper


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

  3. [Non-surgical treatment of hemorrhoids].

    Libeskind, M


    The treatment of hemorrhoids includes a vast array of medical and instrumental means. If there is no true medical treatment, there are numerous products in order to act on the symptoms or one of the factors of the hemorrhoidal complex. Thus, phlebotonics, local topical agents, anti-infectious and anti-inflammatory agents, myorelaxants, transit regulators. Instrumental means are essentially represented by sclerosing injections, infra-red photocoagulation, cryotherapy, and mainly elastic rubber bands. All these treatments, some of which were offered as a substitute to surgery, often give interesting results, but are not devoid of danger. The attitude of the medico-surgical proctologist is then to find a happy medium between a procedure which is insufficient and one which may become unnecessarily aggressive.

  4. An ultrasound image-guided surgical workflow model

    Guo, Bing; Lemke, Heinz; Liu, Brent; Huang, H. K.; Grant, Edward G.


    A 2003 report in the Journal of Annual Surgery predicted an increase in demand for surgical services to be as high as 14 to 47% in the workload of all surgical fields by 2020. Medical difficulties which are already now apparent in the surgical OR (Operation Room) will be amplified in the near future and it is necessary to address this problem and develop strategies to handle the workload. Workflow issues are central to the efficiency of the OR and in response to today's continuing workforce shortages and escalating costs. Among them include: Inefficient and redundant processes, System Inflexibility, Ergonomic deficiencies, Scattered Data, Lack of Guidelines, Standards, and Organization. The objective of this research is to validate the hypothesis that a workflow model does improve the efficiency and quality of surgical procedure. We chose to study the image-guided surgical workflow for US as a first proof of concept by minimizing the OR workflow issues. We developed, and implemented deformable workflow models using existing and projected future clinical environment data as well as a customized ICT system with seamless integration and real-time availability. An ultrasound (US) image-guided surgical workflow (IG SWF) for a specific surgical procedure, the US IG Liver Biopsy, was researched to find out the inefficient and redundant processes, scattered data in clinical systems, and improve the overall quality of surgical procedures to the patient.




    Full Text Available To meet the present stringent emission norms. These systems are enerally termed as Electronic Fuel Injection (EFI systems. The fuel is injected into the throttle body or into the inlet manifold through an electronic fuel injector, which is controlled by an Electronic Control Unit (ECU. The quantity of fuel injected by the injector plays a vital role as far as performance and emission characteristics of spark ignition engines are concerned. This paper deals with the static and dynamic fuel injection characteristics of two gasoline fuelinjectors. The effect of different injection parameters like fuel injection pressure, injection duration, supply voltage to injector and engine speed on the quantity of fuel injected have been studied for two injectors. The injection dead time and its variation with respect to fuel pressure and supply voltage to injector have beenanalyzed. Based on the analysis of results, an empirical formula has been obtained to determine the dynamic fuel injection quantity from the static fuel injection characteristics and it was compared with the measured values. It is found that the empirical formula developed in this work gives reasonably good results and therefore, it can be used with confidence for predicting the dynamic characteristics of any given injector from its static injection characteristics.

  6. Qualitative Analysis after Instrumentation Using Manual Stainless Steel and Rotary Nickel Titanium Instruments

    Key Fabiano Souza PEREIRA


    Full Text Available Objective: To compare qualitatively the instrumentation (areastouched by the endodontic instruments with manual stainless steeland rotary nickel titanium files.Method: 32 mesiobuccal roots of maxillary molars with a singlecanal and a single apical foramen were examined in vitro. Thecanals were instrumented by the crown-down technique using Ktypefiles and taper .04 Profile files, obtaining a surgical diametercorresponding to a #30 instrument. Next, impression material wasinjected into the root canals. After material setting, the teeth weredecalcified to obtain canal impression. To evaluate the quality ofroot canal instrumentation, the images of the impressions weretransmitted to a 29-inch tv using a video camera coupled to anoperative microscope at ×20 magnification and moderate lightintensity. The examined surfaces were classified as EXCELLENT(smooth surfaces indicating that the walls were touched by theinstrument, GOOD (surfaces with irregularities and REGULAR(surfaces with irregularities, presence of anatomic complexities,like isthmuses, accessory canals, delta, etc.Results: The analysis of the root thirds and surfaces showed apredominance of the REGULAR classification of instrumentationfor both types of instruments. The worst results were found on thepalatal surface and apical third.Conclusion: There was no statistically significant difference(p>0.05 between the manual stainless steel and rotary nickeltitanium instrumentation techniques when the impressions of theroot thirds and surfaces were analyzed qualitatively.

  7. Practice management education during surgical residency.

    Jones, Kory; Lebron, Ricardo A; Mangram, Alicia; Dunn, Ernest


    Surgical education has undergone radical changes in the past decade. The introductions of laparoscopic surgery and endovascular techniques have required program directors to alter surgical training. The 6 competencies are now in place. One issue that still needs to be addressed is the business aspect of surgical practice. Often residents complete their training with minimal or no knowledge on coding of charges or basic aspects on how to set up a practice. We present our program, which has been in place over the past 2 years and is designed to teach the residents practice management. The program begins with a series of 10 lectures given monthly beginning in August. Topics include an introduction to types of practices available, negotiating a contract, managed care, and marketing the practice. Both medical and surgical residents attend these conferences. In addition, the surgical residents meet monthly with the business office to discuss billing and coding issues. These are didactic sessions combined with in-house chart reviews of surgical coding. The third phase of the practice management plan has the coding team along with the program director attend the outpatient clinic to review in real time the evaluation and management coding of clinic visits. Resident evaluations were completed for each of the practice management lectures. The responses were recorded on a Likert scale. The scores ranged from 4.1 to 4.8 (average, 4.3). Highest scores were given to lectures concerning negotiating employee agreements, recruiting contracts, malpractice insurance, and risk management. The medical education department has tracked resident coding compliance over the past 2 years. Surgical coding compliance increased from 36% to 88% over a 12-month period. The program director who participated in the educational process increased his accuracy from 50% to 90% over the same time period. When residents finish their surgical training they need to be ready to enter the world of business

  8. A cost evaluation methodology for surgical technologies.

    Ismail, Imad; Wolff, Sandrine; Gronfier, Agnes; Mutter, Didier; Swanström, Lee L; Swantröm, Lee L


    To create and validate a micro-costing methodology that surgeons and hospital administrators can use to evaluate the cost of implementing innovative surgical technologies. Our analysis is broken down into several elements of fixed and variable costs which are used to effectively and easily calculate the cost of surgical operations. As an example of application, we use data from 86 robot assisted gastric bypass operations made in our hospital. To validate our methodology, we discuss the cost reporting approaches used in 16 surgical publications with respect to 7 predefined criteria. Four formulas are created which allow users to import data from their health system or particular situation and derive the total cost. We have established that the robotic surgical system represents 97.53 % of our operating room's medical device costs which amounts to $4320.11. With a mean surgery time of 303 min, personnel cost per operation amounts to $1244.73, whereas reusable instruments and disposable costs are, respectively, $1539.69 and $3629.55 per case. The literature survey demonstrates that the cost of surgery is rarely reported or emphasized, and authors who do cover this concept do so with variable methodologies which make their findings difficult to interpret. Using a micro-costing methodology, it is possible to identify the cost of any new surgical procedure/technology using formulas that can be adapted to a variety of operations and healthcare systems. We hope that this paper will provide guidance for decision makers and a means for surgeons to harmonise cost reporting in the literature.

  9. Instrumentation Design and Development Facilities

    Federal Laboratory Consortium — RTTC has facilities for design, development and fabrication of: custominstrumentation, mobile instrumentation, miniaturized instrumentation, wirelessinstrumentation,...

  10. Surgical phantom for off-pump mitral valve replacement

    McLeod, A. Jonathan; Moore, John; Guiraudon, Gerard M.; Jones, Doug L.; Campbell, Gordon; Peters, Terry M.


    Off-pump, intracardiac, beating heart surgery has the potential to improve patient outcomes by eliminating the need for cardiopulmonary bypass and aortic cross clamping but it requires extensive image guidance as well as the development of specialized instrumentation. Previously, developments in image guidance and instrumentation were validated on either a static phantom or in vivo through porcine models. This paper describes the design and development of a surgical phantom for simulating off-pump mitral valve replacement inside the closed beating heart. The phantom allows surgical access to the mitral annulus while mimicking the pressure inside the beating heart. An image guidance system using tracked ultrasound, magnetic instrument tracking and preoperative models previously developed for off-pump mitral valve replacement is applied to the phantom. Pressure measurements and ultrasound images confirm the phantom closely mimics conditions inside the beating heart.

  11. Evaluation of Instrumentation and Dynamic Thermal Ratings for Overhead Lines

    Phillips, A. [New York Power Authority, White Plains, NY (United States)


    In 2010, a project was initiated through a partnership between the Department of Energy (DOE) and the New York Power Authority (NYPA) to evaluate EPRI's rating technology and instrumentation that can be used to monitor the thermal states of transmission lines and provide the required real-time data for real-time rating calculations. The project included the installation and maintenance of various instruments at three 230 kV line sites in northern New York. The instruments were monitored, and data collection and rating calculations were performed for about a three year period.

  12. Suggested Tips and Tricks to Enhance Surgical Video Production.

    Fisher, Nina; Kaplan, Daniel; Egol, Kenneth A


    Surgical video production is an important skill that can be of valuable use as an educational tool. However, it is important that surgical videos be filmed and edited in a methodological way to maximize its potential. In this video, we describe our preference for producing quality surgical videos. There are many important factors to consider during the filming process, including vantage point of the videographer, lighting, and visualization of instruments. During the editing process, certain techniques can be used to make the video more stimulating and thus more engaging to the viewer. This video presents the filming and editing of a single case. In addition, we provide examples of acceptable and poor footage and editing techniques. Surgical videos can be a valuable educational tool when properly executed. In this video, we describe techniques to ensure quality production.

  13. BAA instrument no. 93

    Marriott, R. A.


    Instrument no. 93 has been in almost continual use for more than a hundred years. Since it left the workshop of its maker, George Calver, it has kept company with several other notable instruments and has been used by many eminent astronomers. It was added to the Association's collection in 1945.

  14. Instrumentation in endourology

    Khanna, Rakesh; Monga,Manoj


    Success with endourological procedures requires expertise and instrumentation. This review focuses on the instrumentation required for ureteroscopy and percutaneous nephrolithotomy, and provides a critical assessment of in vitro and clinical studies that have evaluated the comparative effectiveness of these medical devices.

  15. Fuzzy-logic-assisted surgical planning in adolescent idiopathic scoliosis.

    Nault, Marie-Lyne; Labelle, Hubert; Aubin, Carl-Eric; Sangole, Archana; Balazinski, Marek


    Selection of appropriate curve fusion levels for surgery in adolescent idiopathic scoliosis (AIS) is a complex and difficult task and, despite numerous publications, still remains a highly controversial topic. To evaluate a fuzzy-logic-based surgical planning tool by comparing the results suggested by the software with the average outcome recommended by a panel of 5 expert spinal deformity surgeons. It is hypothesized that, given the same information, the fuzzy-logic tool will perform as favorably as the surgeons. Proof-of-concept study evaluating the use of a fuzzy-logic-assisted surgical planning tool in AIS to select the appropriate spinal curve to be instrumented. A cohort of 30 AIS surgical cases with a main thoracic curve was used. Each case included standard measurements recorded from preoperative standing postero-anterior and lateral, supine side bending, and 1-year postoperative standing radiographs. Five experienced spinal deformity surgeons evaluated each case independently and gave their preferred levels of instrumentation and fusion. The cases were then presented to the fuzzy-logic tool to determine whether the high thoracic and/or lumbar curves were to be instrumented. For each case, a percentage value was obtained indicating inclusion/exclusion of the respective curves in the surgical instrumentation procedure. Kappa statistics was used to compare the model output and the average decision of the surgeons. Kappa values of 0.71 and 0.64 were obtained, respectively, for the proximal thoracic and lumbar curves models, thus suggesting a good agreement of the fusion recommendations made by the fuzzy-logic tool and the surgeons. Given the same information, the fuzzy-logic-assisted recommendation of the curve to be instrumented compared favorably with the collective decision of the surgeons. The findings thus suggest that a fuzzy-logic approach is helpful in assisting surgeons with the preoperative selection of curve instrumentation and fusion levels in AIS.

  16. Vitiligo- A surgical approach

    Deepti Ghia


    Full Text Available Aims and objective- To describe the spectrum of surgical modalities for stable vitiligo patients Methods- Patients having stable vitiligo since past 2 years with no improvement with medical line of treatment were enrolled for surgery after informed consent. Depending upon the size and location of vitiligo patch different modalities were performed. Suction blister, mini-punch grafting, split thickness skin grafting, trypsinised melanocyte-keratinocyte transfer and non-trypsinised melanocyte- keratinocyte transfer (Jodhpur technique and follicular grafting technique have been described photographically which have been performed at a tertiary care hospital. Conclusion- Vitiligo is often difficult to treat, stable patches resistant to medical line of management do respond to surgical treatment; however it is very important to choose the modality of surgery according location of the patch, size of the lesion and available resources.

  17. Spacecraft surgical scrub system

    Abbate, M.


    Ease of handling and control in zero gravity and minimizing the quantity of water required were prime considerations. The program tasks include the selection of biocidal agent from among the variety used for surgical scrub, formulation of a dispensing system, test, and delivery of flight dispensers. The choice of an iodophore was based on effectiveness on single applications, general familiarity among surgeons, and previous qualification for space use. The delivery system was a choice between the squeeze foamer system and impregnated polyurethane foam pads. The impregnated foam pad was recommended because it is a simpler system since the squeeze foamer requires some applicator to effectively clean the skin surfaces, whereas the form pad is the applicator and agent combined. Testing demonstrated that both systems are effective for use as surgical scrubs.

  18. Gossypiboma—Retained Surgical Sponge

    Hung-Shun Sun


    Full Text Available Intra-abdominal retained surgical sponge is an uncommon surgical error. Herein, we report a 92-year-old woman who was brought to the emergency room for acute urinary retention. She had a history of vaginal hysterectomy for uterine prolapse 18 years previously, performed at our hospital. Retained surgical sponge in the pelvic cavity was suspected by abdominal computed tomography. The surgical gauze was removed by laparotomy excision and the final diagnosis was gossypiboma.

  19. Hepatic surgical anatomy.

    Skandalakis, John E; Skandalakis, Lee J; Skandalakis, Panajiotis N; Mirilas, Petros


    The liver, the largest organ in the body, has been misunderstood at nearly all levels of organization, and there is a tendency to ignore details that do not fit the preconception. A complete presentation of the surgical anatomy of the liver includes the study of hepatic surfaces, margins, and fissures; the various classifications of lobes and segments; and the vasculature and lymphatics. A brief overview of the intrahepatic biliary tract is also presented.

  20. Postoperative Surgical Infection After Spinal Surgery in Rheumatoid Arthritis.

    Koyama, Kensuke; Ohba, Tetsuro; Ebata, Shigeto; Haro, Hirotaka


    Individuals with rheumatoid arthritis are at higher risk for infection than the general population, and surgical site infection after spinal surgery in this population can result in clinically significant complications. The goal of this study was to identify risk factors for acute surgical site infection after spinal surgery in patients with rheumatoid arthritis who were treated with nonbiologic (conventional) disease-modifying antirheumatic drugs (DMARDs) alone or with biologic DMARDs. All patients treated with biologic agents were treated with nonbiologic agents as well. The authors performed a retrospective, single-center review of 47 consecutive patients with rheumatoid arthritis who underwent spinal surgery and had follow-up of 3 months or longer. The incidence of surgical site infection was examined, and multivariate logistic regression analysis was performed to test the association of surgical site infection with putative risk factors, including the use of biologic agents, methotrexate, and prednisolone, as well as the duration of rheumatoid arthritis, the presence of diabetes, patient age, length of surgery, and number of operative levels. After spinal surgery, 14.89% (7 of 47) of patients had surgical site infection. Use of methotrexate and/or prednisolone, patient age, diabetes, duration of rheumatoid arthritis, length of surgery, number of operative levels, and use of biologic DMARDs did not significantly increase the risk of infection associated with spinal surgery. All patients who had surgical site infection had undergone spinal surgery with instrumentation. The findings show that greater attention to preventing surgical site infection may be needed in patients with rheumatoid arthritis who undergo spinal surgery with instrumentation. To the authors' knowledge, this is the first study to show that the use of biologic agents did not increase the incidence of surgical site infection after spinal surgery in patients with rheumatoid arthritis

  1. Louis Pasteur surgical revolution.

    Toledo-Pereyra, Luis H


    Louis Pasteur (1822-1895) is considered the most notable medical scientist of his time and perhaps one of the most distinguished of all times in the history of medicine. From Dole in France to Paris, from a student of crystals to "living ferments," and from chemistry to biology and medicine, Pasteur changed the world for the benefit of humanity. The genius of Pasteur dealt with the most pressing issues of his time, basing the germ theory on the effects that microorganisms had on fermentation and putrefaction of organic matter, which gave birth to the science of bacteriology. Many other difficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacular results seen with the treatment of rabies. Surgery was no exception to the scientific conquests of Pasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister that were based on the germ theory of the disease, which had been derived from the germ theory of fermentation and putrefaction discovered by Pasteur. The acceptance of these principles represented the surgical revolution brought on by the science of Pasteur, a revolution that is now accepted in our daily care of surgical patients.

  2. Guideline implementation: Surgical attire.

    Cowperthwaite, Liz; Holm, Rebecca L


    Surgical attire helps protect patients from microorganisms that may be shed from the hair and skin of perioperative personnel. The updated AORN "Guideline for surgical attire" provides guidance on scrub attire, shoes, head coverings, and masks worn in the semirestricted and restricted areas of the perioperative setting, as well as how to handle personal items (eg, jewelry, backpacks, cell phones) that may be taken into the perioperative suite. This article focuses on key points of the guideline to help perioperative personnel adhere to facility policies and regulatory requirements for attire. The key points address the potential benefits of wearing scrub attire made of antimicrobial fabric, covering the arms when in the restricted area of the surgical suite, removing or confining jewelry when wearing scrub attire, disinfecting personal items that will be taken into the perioperative suite, and sending reusable attire to a health care-accredited laundry facility after use. Perioperative RNs should review the complete guideline for additional information and for guidance when writing and updating policies and procedures.

  3. Good experiences with interactive temporal bone surgical simulator

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


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

  4. Low-cycle fatigue of surgical cements

    A. Balin


    Full Text Available Purpose: In case when surgical cement is used to fix endoprostheses of joints the fatigue character of mechanicalinterraction in the cement seems to be a significant importance. The paper suggests to adapt the research methodof low cycle fatigue for modelling the loads on surgical cements in an artificial hip joint. Surgical cements havealso been modified in order to improve their functional properties.Design/methodology/approach: Low cycle fatigue tests were conducted on samples made from Palamedcement without an addition and on samples modified with glassy carbon and titanium. The tests were conductedon a servohydraulic fatigue testing machine, MTS-810, with displacement control.Findings: Fatigue tests proved viscoelastic character of all the tested materials. During the fatigue tests, thephenomenon of stress cyclic relaxation was observed.Research limitations/implications: Modelling the loadings of cement in endoprostheses of joints with the lowcycle fatigue method takes into account all high value stresses, while cement is being used for endoprosthesesfor many years in the conditions of random stress and deformation courses. Therefore the obtained stress anddeformation values are bigger than those which would have been obtained in real conditions in the same time.Practical implications: The low cycle fatigue tests carried out showed how important is the factor of timefor the behavior of surgical cement in the conditions of changeable loadings. This fact is essential to assessits usability for endoprosthesoplasty of joints, specially of a hip joint. Post deformation return which is acharacteristic feature for material viscoelasticity enables its regeneration conditioning expected durability ofendoprosthesis of joints.Originality/value: Low cycle fatigue testing method for modelling of loads on surgical cement in artificial hipjoint enables to carry out the tests in a shorter period of time.

  5. Surgical Clipping versus Endovascular Intervention for the Treatment of Subarachnoid Hemorrhage Patients in New York State.

    Kimon Bekelis

    Full Text Available Randomized trials have demonstrated a survival benefit for endovascular treatment of ruptured cerebral aneurysms. We investigated the association of surgical clipping and endovascular coiling with outcomes in subarachnoid hemorrhage (SAH patients in a real-world regional cohort.We performed a cohort study involving patients with ruptured cerebral aneurysms, who underwent surgical clipping, or endovascular coiling from 2009-2013 and were registered in the Statewide Planning and Research Cooperative System (SPARCS database. An instrumental variable analysis was used to investigate the association of treatment technique with outcomes.Of the 4,098 patients undergoing treatment, 2,585 (63.1% underwent coiling, and 1,513 (36.9% underwent clipping. Using an instrumental variable analysis, we did not identify a difference in inpatient mortality [marginal effect (ME, -0.56; 95% CI, -1.03 to 0.02], length of stay (LOS (ME, 1.72; 95% CI, -3.39 to 6.84, or the rate of 30-day readmissions (ME, -0.30; 95% CI, -0.82 to 0.22 between the two treatment techniques for patients with SAH. Clipping was associated with a higher rate of discharge to rehabilitation (ME, 0.63; 95% CI, 0.24 to 1.01. In sensitivity analysis, mixed effect regression, and propensity score adjusted regression models demonstrated identical results.Using a comprehensive all-payer cohort of patients in New York State presenting with aneurysmal SAH we did not identify an association of treatment method with mortality, LOS or 30-day readmission. Clipping was associated with a higher rate of discharge to rehabilitation.

  6. Manual Control for Medical Instruments in Minimally Invasive Surgery

    Fan, C.


    With the introduction of new technologies, surgical procedures have been varying from free access in open surgery towards limited access in minimal invasive surgery. During such procedures, surgeons have to manoeuver the instruments from outside the patient while looking at the monitor. Long and sle

  7. Application of Fiber Optic Instrumentation

    Richards, William Lance; Parker, Allen R., Jr.; Ko, William L.; Piazza, Anthony; Chan, Patrick


    Fiber optic sensing technology has emerged in recent years offering tremendous advantages over conventional aircraft instrumentation systems. The advantages of fiber optic sensors over their conventional counterparts are well established; they are lighter, smaller, and can provide enormous numbers of measurements at a fraction of the total sensor weight. After a brief overview of conventional and fiber-optic sensing technology, this paper presents an overview of the research that has been conducted at NASA Dryden Flight Research Center in recent years to advance this promising new technology. Research and development areas include system and algorithm development, sensor characterization and attachment, and real-time experimentally-derived parameter monitoring for ground- and flight-based applications. The vision of fiber optic smart structure technology is presented and its potential benefits to aerospace vehicles throughout the lifecycle, from preliminary design to final retirement, are presented.

  8. Debridement for surgical wounds.

    Dryburgh, Nancy; Smith, Fiona; Donaldson, Jayne; Mitchell, Melloney


    Surgical wounds that become infected are often debrided because clinicians believe that removal of this necrotic or infected tissue will expedite wound healing. There are numerous methods available but no consensus on which one is most effective for surgical wounds. The aim of this review is to determine the effect of different methods of debridement on the rate of debridement and healing of surgical wounds. We developed a search strategy to search the following electronic databases: Wounds Group Specialised Trials Register (searched 3/3/08) , Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2008, issue 1), MEDLINE (1950 to February Week 3 2008 ), EMBASE (1980 to 2008 Week 09) and CINHAL (1982 to February Week 4 2008). We checked the citations within obtained studies to identify additional papers and also relevant conference proceedings. We contacted manufactures of wound debridement agents to ascertain the existence of published, unpublished and ongoing trials. Our search was not limited by language or publication status. We included relevant randomised controlled trials (RCT) with outcomes including at least one of the following: time to complete debridement, or time to complete healing. Two authors independently reviewed the abstracts and titles obtained from the search, two extracted data independently using a standardised extraction sheet, and two independently assessed methodological quality. One author was involved in all stages of the data collection and extraction process, thus ensuring continuity. Five RCTs were eligible for inclusion; all compared treatments for infected surgical wounds and reported time required to achieve a clean wound bed (complete debridement). One trial compared an enzymatic agent (Streptokinase/streptodornase) with saline-soaked dressings and reported the time to complete debridement. Four of the trials compared the effectiveness of dextranomer beads or paste with other products (different comparator

  9. The effect of music on robot-assisted laparoscopic surgical performance.

    Siu, Ka-Chun; Suh, Irene H; Mukherjee, Mukul; Oleynikov, Dmitry; Stergiou, Nick


    Music is often played in the operating room to increase the surgeon's concentration and to mask noise. It could have a beneficial effect on surgical performance. Ten participants with limited experience with the da Vinci robotic surgical system were recruited to perform two surgical tasks: suture tying and mesh alignment when classical, jazz, hip-hop, and Jamaican music were presented. Kinematics of the instrument tips of the surgical robot and surface electromyography of the subjects were recorded. Results revealed that a significant music effect was found for both tasks with decreased time to task completion (P = .005) and total travel distance (P = .021) as well as reduced muscle activations ( P = .016) and increased median muscle frequency (P = .034). Subjects improved their performance significantly when they listened to either hip-hop or Jamaican music. In conclusion, music with high rhythmicity has a beneficial effect on robotic surgical performance. Musical environment may benefit surgical training and make acquisition of surgical skills more efficient.

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

    Niti Khunger


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

  11. Management of postoperative instrumented spinal wound infection

    FANG Xiu-tong; Kirkham B.Wood


    Background Wound infection following spinal instrumented surgery is a frequent complication.The optimal treatment of acute deep wound infection following spinal instrumentation fusion remains controversial because of variability in cohort identification,definition of an infection,and the instrument used to measure outcomes.This retrospective study evaluated the clinical curative effect for postoperative spinal infection after instrumented spine fusion with extensive debridement,or implant removal.Methods From January 2004 to October 2009,851 patients were identified who underwent surgical treatment of spinal diseases.The medical records of patients who developed infections were reviewed in detail.Results Of 851 patients,41 (4.9%) developed an infection.Thirty-three were acute,and eight were delayed.Acute infected cases were managed with antibiotic therapy,and aggressive debridement of the wound and soft tissues leaving all instrumentation in situ in all but one patient.The most common symptoms of acute infection included:posterior incisional drainage (26 of 33 patients),back pain (22 of 33 patients) and fever (13 of 33 patients).Among patients with delayed onset infection,five of eight patients had local pain,four of eight patients had incision drainage,and one patient had a prolonged period of intermittent fever.The most frequent causative organism for postoperative spinal infection following spine surgery is Staphylococcus aureus.Pseudarthrosis was noted in long-term follow-up in four of 41 patients.Conclusions We recommend irrigation and debridement,no instrumentation removal,and,if necessary,repeat debridement followed by delayed primary closure for the treatment of acute deep infection with instrumentation.

  12. Endoscopic vidian neurectomy assisted by power instrumentation and coblation.

    Hsu, Chao-Yuan; Shen, Ping-Hung; Weitzel, Erik Kent


    Vidian neurectomy has been used to manage intractable vasomotor rhinitis for decades. After the introduction of endoscopic sinus surgery in the 1980s, transnasal endoscopic vidian neurectomy (EVN) was subsequently reported. The most common problem in performing EVN was excessive bleeding from the pterygopalatine fossa. The complexity and vascularity of the pterygopalatine fossa can cause bloody surgical fields and prevent complete neurectomy. In response to this surgical problem, a procedure was developed to use powered instrumentation and coblation during EVN. There were eight cases of EVNs (16 neurectomies) assisted by power instrumentation and coblation from December 2011 to May 2012. The average blood loss of these cases was 37.5 mL (range, 25-50 mL). The average surgical time of each neurectomy was 27.4 minutes (range, 20-35 minutes). No complications occurred in any of the eight cases. Very limited bleeding and less thermal damage were noted while achieving a complete neurectomy.

  13. Surgical Tourniquets in Orthopaedics


    much the pressure could be reduced by ap- plying a wide contoured cuff instead of a standard cuff 26. Pa- tients undergoing foot and ankle surgery...risk factor50. In the setting of intramedullary instrumentation, cementation, or insertion of a prosthesis in the lower limb, deflation of a pneumatic

  14. The importance of protecting surgical instrument tables from intraoperative contamination in clean surgeries Importancia de la protección de la mesa de instrumentos quirúrgicos en la contaminación intraoperatoria de cirugías limpias Importância da proteção da mesa de instrumentais cirúrgicos na contaminação intraoperatória de cirurgias limpas

    Aline Mesquita Amaral


    Full Text Available OBJECTIVE: to compare the degree of bacterial contamination of surgical instrument tables used in clean surgical procedures, either protected with plastic fields, sterilized with ethylene oxide, or disinfected with 70% alcohol and 1% iodine solutions. This is a randomized clinical trial in which samples were collected from the surfaces of surgical instrument tables before and after each procedure. Microbiological analysis was performed to identify microorganisms and their respective antimicrobial resistance. RESULTS: Bacterial growth in the surgeries using sterilized plastic was 5.71% before and 28.6% after surgery and, 2.9% and 45.7% respectively in surgeries using disinfection with 70% alcohol and 1% iodine solutions; no statistical difference was found between the methods. CONCLUSION: both methods present similar protection, however, 70% alcohol and 1% iodine do not generate solid waste.El objetivo del estudio fue analizar el grado de contaminación bacteriana de la mesa de instrumentos quirúrgicos en dos casos, después del uso: cubierta protectora plástico de la mesa quirúrgica esterilizada con óxido de etileno o desinfección con solución de alcohol a 70% y yodo a 1%, en procedimientos quirúrgicos limpios. Se trata de un experimento clínico aleatorio, con recolección de muestras de las superficies de las mesas de instrumentos quirúrgicos, antes y después de cada procedimiento, con posterior análisis microbiológica para identificar los microorganismos y la resistencia antimicrobiana. En las cirugías en que el plástico esterilizado fue utilizado, el crecimiento bacteriano fue de 5,71% antes y 28,6% después de la cirugía, en cuanto que en las desinfecciones con solución de alcohol a 70% y yodo a 1%, el crecimiento fue de 2,9% antes y 45,7% después, lo que indica que no hubo diferencia significativa entre los métodos empleados. Los dos métodos tienen poder de protección semejante, considerando que el alcohol a 70% y yodo a

  15. [Changing surgical therapy because of clinical studies?].

    Schwenk, W; Haase, O; Müller, J M


    The randomised controlled clinical trial (RCT) is a powerful instrument to evaluate different therapeutic regimens. In a survey among 115 physicians visiting the 25th annual meeting of the Surgical Society of Berlin and Brandenburg, the RCT was judged to be very important when changes of therapeutic strategies are discussed. 90 % of all participants claimed to use data from RCTs in the clinical routine and 89 % would participate in such a trial. In official (e. g. discussions during coffee breaks at scientific meetings) or non-medical (e. g. non-scientific press or media) sources of information were assessed as irrelevant for decisions regarding therapeutic strategies. However, in contrast to this view laparoscopic cholecystectomy was introduced into clinical practice rapidly because patients informed by external (non-medical) sources preferred to be operated on with the "modern" technique. Clinical trials with a high level of evidence had no relevant influence on the rapid distribution of laparoscopic cholecystectomy. Controversial discussions concerning the extent of lymphadenectomy with gastric resection for carcinoma demonstrate that the value of excellent clinical RCTs is low if their results challenge a stable paradigma of the surgical scientific society. To allow a rational judgement, new surgical technologies should undergo a scientific gradual evaluation in agreement with the principles of evidence based medicine.

  16. Increased Science Instrumentation Funding Strengthens Mars Program

    Graham, Lee D.; Graff, T. G.


    As the strategic knowledge gaps mature for the exploration of Mars, Mars sample return (MSR), and Phobos/Deimos missions, one approach that becomes more probable involves smaller science instrumentation and integrated science suites. Recent technological advances provide the foundation for a significant evolution of instrumentation; however, the funding support is currently too small to fully utilize these advances. We propose that an increase in funding for instrumentation development occur in the near-term so that these foundational technologies can be applied. These instruments would directly address the significant knowledge gaps for humans to Mars orbit, humans to the Martian surface, and humans to Phobos/ Deimos. They would also address the topics covered by the Decadal Survey and the Mars scientific goals, objectives, investigations and priorities as stated by the MEPAG. We argue that an increase of science instrumentation funding would be of great benefit to the Mars program as well as the potential for human exploration of the Mars system. If the total non-Earth-related planetary science instrumentation budget were increased 100% it would not add an appreciable amount to the overall NASA budget and would provide the real potential for future breakthroughs. If such an approach were implemented in the near-term, NASA would benefit greatly in terms of science knowledge of the Mars, Phobos/Deimos system, exploration risk mitigation, technology development, and public interest.

  17. New Frontiers in Surgical Innovation.

    Jackson, Ryan S; Schmalbach, Cecelia E


    It is an exciting time for head and neck surgical innovation with numerous advances in the perioperative planning and intraoperative management of patients with cancer, trauma patients, and individuals with congenital defects. The broad and rapidly changing realm of head and neck surgical innovation precludes a comprehensive summary. This article highlights some of the most important innovations from surgical planning with sentinel node biopsy and three-dimensional, stereolithic modeling to intraoperative innovations, such as transoral robotic surgery and intraoperative navigation. Future surgical innovations, such as intraoperative optical imaging of surgical margins, are also highlighted. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Instrumentation reference book

    Boyes, Walt


    Instrumentation is not a clearly defined subject, having a 'fuzzy' boundary with a number of other disciplines. Often categorized as either 'techniques' or 'applications' this book addresses the various applications that may be needed with reference to the practical techniques that are available for the instrumentation or measurement of a specific physical quantity or quality. This makes it of direct interest to anyone working in the process, control and instrumentation fields where these measurements are essential.* Comprehensive and authoritative collection of technical information* Writte

  19. Jones' instrument technology

    Jones, Ernest Beachcroft; Kingham, Edward G; Radnai, Rudolf


    Jones' Instrument Technology, Volume 5: Automatic Instruments and Measuring Systems deals with general trends in automatic instruments and measuring systems. Specific examples are provided to illustrate the principles of such devices. A brief review of a considerable number of standards is undertaken, with emphasis on the IEC625 Interface System. Other relevant standards are reviewed, including the interface and backplane bus standards. This volume is comprised of seven chapters and begins with a short introduction to the principles of automatic measurements, classification of measuring system

  20. Medical instruments in museums

    Söderqvist, Thomas; Arnold, Ken


    This essay proposes that our understanding of medical instruments might benefit from adding a more forthright concern with their immediate presence to the current historical focus on simply decoding their meanings and context. This approach is applied to the intriguingly tricky question of what...... actually is meant by a "medical instrument." It is suggested that a pragmatic part of the answer might lie simply in reconsidering the holdings of medical museums, where the significance of the physical actuality of instruments comes readily to hand....

  1. Mass spectrometers: instrumentation

    Cooks, R. G.; Hoke, S. H., II; Morand, K. L.; Lammert, S. A.


    Developments in mass spectrometry instrumentation over the past three years are reviewed. The subject is characterized by an enormous diversity of designs, a high degree of competition between different laboratories working with either different or similar techniques and by extremely rapid progress in improving analytical performance. Instruments can be grouped into genealogical charts based on their physical and conceptual interrelationships. This is illustrated using mass analyzers of different types. The time course of development of particular instrumental concepts is illustrated in terms of the s-curves typical of cell growth. Examples are given of instruments which are at the exponential, linear and mature growth stages. The prime examples used are respectively: (i) hybrid instruments designed to study reactive collisions of ions with surfaces: (ii) the Paul ion trap; and (iii) the triple quadrupole mass spectrometer. In the area of ion/surface collisions, reactive collisions such as hydrogen radical abstraction from the surface by the impinging ion are studied. They are shown to depend upon the chemical nature of the surface through the use of experiments which utilize self-assembled monolayers as surfaces. The internal energy deposited during surface-induced dissociation upon collision with different surfaces in a BEEQ instrument is also discussed. Attention is also given to a second area of emerging instrumentation, namely technology which allows mass spectrometers to be used for on-line monitoring of fluid streams. A summary of recent improvements in the performance of the rapidly developing quadrupole ion trap instrument illustrates this stage of instrument development. Improvements in resolution and mass range and their application to the characterization of biomolecules are described. The interaction of theory with experiment is illustrated through the role of simulations of ion motion in the ion trap. It is emphasized that mature instruments play a

  2. Biomedical Sensors and Instruments

    Tagawa, Tatsuo


    The living body is a difficult object to measure: accurate measurements of physiological signals require sensors and instruments capable of high specificity and selectivity that do not interfere with the systems under study. As a result, detailed knowledge of sensor and instrument properties is required to be able to select the "best" sensor from one of the many designed to meet these challenges. From the underlying principles to practical applications, this updated edition of Biomedical Sensors and Instruments provides an easy-to-understand introduction to the various kinds of biome

  3. Surgical fidelity: comparing the microscope and the endoscope.

    Cote, Martin; Kalra, Ricky; Wilson, Taylor; Orlandi, Richard R; Couldwell, William T


    Both the microscope and the endoscope are widely used as visualization tools in neurosurgery; however, surgical dexterity when operating with each may differ. The aim of this study was to compare the surgical fidelity when using each of these visualization tools. Junior residents and expert surgeons performed standardized motor tasks under microscopic and endoscopic visualization. Demerits for inaccuracy and time needed to complete the tasks were used to compare the surgeons' performance with the microscope and the endoscope. The participants also performed a motor task under direct vision using different instruments to evaluate whether the shape of the instrument had any impact on the surgical fidelity. For the junior residents, the number of demerits accrued was lower with the microscope than with the endoscope, and the time needed to complete the tasks was also lower with the microscope. There was no difference in the number of demerits between the microscopic and the endoscopic experts, but the microscopic expert completed the task in a shorter time. There was no difference in demerits or performance time when comparing a short, straight instrument and a longer, bayoneted one. For junior residents, surgical fidelity is higher with the microscope than with the endoscope. This difference vanishes with experience, but a slower speed of execution is observed with endoscopic visualization, both in junior and expert surgeons.

  4. Real-time systems

    Badr, Salah M.; Bruztman, Donald P.; Nelson, Michael L.; Byrnes, Ronald Benton


    This paper presents an introduction to the basic issues involved in real-time systems. Both real-time operating sys and real-time programming languages are explored. Concurrent programming and process synchronization and communication are also discussed. The real-time requirements of the Naval Postgraduate School Autonomous Under Vehicle (AUV) are then examined. Autonomous underwater vehicle (AUV), hard real-time system, real-time operating system, real-time programming language, real-time sy...

  5. Visual tracking of da Vinci instruments for laparoscopic surgery

    Speidel, S.; Kuhn, E.; Bodenstedt, S.; Röhl, S.; Kenngott, H.; Müller-Stich, B.; Dillmann, R.


    Intraoperative tracking of laparoscopic instruments is a prerequisite to realize further assistance functions. Since endoscopic images are always available, this sensor input can be used to localize the instruments without special devices or robot kinematics. In this paper, we present an image-based markerless 3D tracking of different da Vinci instruments in near real-time without an explicit model. The method is based on different visual cues to segment the instrument tip, calculates a tip point and uses a multiple object particle filter for tracking. The accuracy and robustness is evaluated with in vivo data.

  6. Analysis of surgical intervention populations using generic surgical process models.

    Neumuth, Thomas; Jannin, Pierre; Schlomberg, Juliane; Meixensberger, Jürgen; Wiedemann, Peter; Burgert, Oliver


    According to differences in patient characteristics, surgical performance, or used surgical technological resources, surgical interventions have high variability. No methods for the generation and comparison of statistical 'mean' surgical procedures are available. The convenience of these models is to provide increased evidence for clinical, technical, and administrative decision-making. Based on several measurements of patient individual surgical treatments, we present a method of how to calculate a statistical 'mean' intervention model, called generic Surgical Process Model (gSPM), from a number of interventions. In a proof-of-concept study, we show how statistical 'mean' procedure courses can be computed and how differences between several of these models can be quantified. Patient individual surgical treatments of 102 cataract interventions from eye surgery were allocated to an ambulatory or inpatient sample, and the gSPMs for each of the samples were computed. Both treatment strategies are exemplary compared for the interventional phase Capsulorhexis. Statistical differences between the gSPMs of ambulatory and inpatient procedures of performance times for surgical activities and activity sequences were identified. Furthermore, the work flow that corresponds to the general recommended clinical treatment was recovered out of the individual Surgical Process Models. The computation of gSPMs is a new approach in medical engineering and medical informatics. It supports increased evidence, e.g. for the application of alternative surgical strategies, investments for surgical technology, optimization protocols, or surgical education. Furthermore, this may be applicable in more technical research fields, as well, such as the development of surgical workflow management systems for the operating room of the future.

  7. Challenges in marine instrumentation

    Afzulpurkar, S.; Desa, E.; Joseph, A.; Chakraborty, B.; Nayak, M.R.; Ranade, G.

    . Acoustic and optical instrumentation combined on the same platform would be able to address these problems. For this autonomous vehicles with extremely low power requirements, long term deployment and data transmission capability via satellites after...

  8. UV and EUV Instruments

    Werner, K


    We describe telescopes and instruments that were developed and used for astronomical research in the ultraviolet (UV) and extreme ultraviolet (EUV) regions of the electromagnetic spectrum. The wavelength ranges covered by these bands are not uniquely defined. We use the following convention here: The EUV and UV span the regions ~100-912 and 912-3000 Angstroem respectively. The limitation between both ranges is a natural choice, because the hydrogen Lyman absorption edge is located at 912 Angstroem. At smaller wavelengths, astronomical sources are strongly absorbed by the interstellar medium. It also marks a technical limit, because telescopes and instruments are of different design. In the EUV range, the technology is strongly related to that utilized in X-ray astronomy, while in the UV range the instruments in many cases have their roots in optical astronomy. We will, therefore, describe the UV and EUV instruments in appropriate conciseness and refer to the respective chapters of this volume for more technic...

  9. Fiber Optics Instrumentation Development

    Chan, Patrick Hon Man; Parker, Allen R., Jr.; Richards, W. Lance


    This is a general presentation of fiber optics instrumentation development work being conducted at NASA Dryden for the past 10 years and recent achievements in the field of fiber optics strain sensors.

  10. Instrumentation for Materials Research

    Claassen, Richard S.


    Discusses how sophisticated instrumentation techniques yield practical results in three typical materials problems: fracture analysis, joining, and compatibility. Describes techniques such as scanning and transmission electron microscopy, and Auger spectroscopy. (MLH)

  11. Hetdex: Virus Instrument

    Lee, Hanshin; Hill, G. J.; DePoy, D. L.; Tuttle, S.; Marshall, J. L.; Vattiat, B. L.; Prochaska, T.; Chonis, T. S.; Allen, R.; HETDEX Collaboration


    The Visible Integral-field-unit Replicable Unit Spectrograph (VIRUS) instrument is made up of 150+ individually compact and identical spectrographs, each fed by a fiber integral-field unit. The instrument provides integral field spectroscopy at wavelengths between 350nm and 550nm of over 33,600 spatial elements per observation, each 1.8 sq. arcsec on the sky, at R 700. The instrument will be fed by a new wide-field corrector (WFC) of the Hobby-Eberly Telescope (HET) with increased science field of view as large as 22arcmin diameter and telescope aperture of 10m. This will enable the HETDEX, a large area blind survey of Lyman-alpha emitting galaxies at redshift z VIRUS instrument construction is summarized.

  12. Economic Effects Real Estate Tax

    Tadić Milan


    Full Text Available The real estate tax is usually a fiscal instrument which performs the property tax. When it comes to real property or immovable this term include: apartments, houses, land, cottages, excess housing landscape and more. The real estate tax as a form of the fiscal charges ownership or use of certain forms of real estate, and the revenue from this tax is levied on the area where the property is located regardless of the place of residence of its owner. The tax base for the calculation of this tax usually consists of the market, estimated or annuity value of certain real estate. This form of taxation in the Republic of Serbian applies from 1.1.2012., and its introduction has been replaced by former property taxes. The differences between the two concepts mentioned taxes are numerous and significant. Among the more important are: subject to taxation under the new concept of the real estate rather than law, a taxpayer is any property owner rather than the holder of rights to immovable property tax base is the market value of real estate which is replaced by the payment of taxes per square meter of usable area, the rate of property tax is determined local government, which can not be lower than 0.05% of the estimated value of the real estate nor higher than 0.5% of the appraised value of real estate. The last change, ie. The new law on Property Tax from 5.11.2015. was determined by the tax rate to 20%. The fact that local governments each of them determines the tax rate on real estate which range from high to low rates of multiple, makes this tax is progressive. Progression is particularly expressed in the distinction applied tax rates of developed and undeveloped municipalities, where we have a case that less developed tolerate a higher tax burden, which leads to negative economic effects. However, real estate tax has its own economic and social characteristics which must be aligned with the objectives of tax policy. This means that the real estate tax

  13. Instrumentation to Enhance Advanced Test Reactor Irradiations

    J. L. Rempe; D. L. Knudson; K. G. Condie; J. E. Daw; S. C. Taylor


    The Department of Energy (DOE) designated the Advanced Test Reactor (ATR) as a National Scientific User Facility (NSUF) in April 2007 to support U.S. leadership in nuclear science and technology. By attracting new research users - universities, laboratories, and industry - the ATR will support basic and applied nuclear research and development, further advancing the nation's energy security needs. A key component of the ATR NSUF effort is to prove new in-pile instrumentation techniques that are capable of providing real-time measurements of key parameters during irradiation. To address this need, an assessment of instrumentation available and under-development at other test reactors has been completed. Based on this review, recommendations are made with respect to what instrumentation is needed at the ATR and a strategy has been developed for obtaining these sensors. Progress toward implementing this strategy is reported in this document. It is anticipated that this report will be updated on an annual basis.

  14. VIRUS instrument collimator assembly

    Marshall, Jennifer L.; DePoy, Darren L.; Prochaska, Travis; Allen, Richard D.; Williams, Patrick; Rheault, Jean-Philippe; Li, Ting; Nagasawa, Daniel Q.; Akers, Christopher; Baker, David; Boster, Emily; Campbell, Caitlin; Cook, Erika; Elder, Alison; Gary, Alex; Glover, Joseph; James, Michael; Martin, Emily; Meador, Will; Mondrik, Nicholas; Rodriguez-Patino, Marisela; Villanueva, Steven; Hill, Gary J.; Tuttle, Sarah; Vattiat, Brian; Lee, Hanshin; Chonis, Taylor S.; Dalton, Gavin B.; Tacon, Mike


    The Visual Integral-Field Replicable Unit Spectrograph (VIRUS) instrument is a baseline array 150 identical fiber fed optical spectrographs designed to support observations for the Hobby-Eberly Telescope Dark Energy Experiment (HETDEX). The collimator subassemblies of the instrument have been assembled in a production line and are now complete. Here we review the design choices and assembly practices used to produce a suite of identical low-cost spectrographs in a timely fashion using primarily unskilled labor.

  15. Modeling of Musical Instruments

    Bader, Rolf; Hansen, Uwe

    Signal processing techniques in acoustics address many concerns. Included are such things as wave propagation variables, amplitude considerations, spectral content, wavelength, and phase. Phase is primarily of concern when waves interact with each other, as well as with a medium, and the imposition of boundary conditions leads to normal mode vibrations. Such conditions are prevalent in all musical instruments, and thus relevant signal processing techniques are essential to both understanding and modeling the structure of musical instruments and the sound radiated.

  16. [Duane vertical surgical treatment].

    Merino, M L; Gómez de Liaño, P; Merino, P; Franco, G


    We report 3 cases with a vertical incomitance in upgaze, narrowing of palpebral fissure, and pseudo-overaction of both inferior oblique muscles. Surgery consisted of an elevation of both lateral rectus muscles with an asymmetrical weakening. A satisfactory result was achieved in 2 cases, whereas a Lambda syndrome appeared in the other case. The surgical technique of upper-insertion with a recession of both lateral rectus muscles improved vertical incomitance in 2 of the 3 patients; however, a residual deviation remains in the majority of cases. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  17. Diverticulitis: selective surgical management.

    Rugtiv, G M


    The surgical treatment of complications of diverticulitis remains most challenging. A review of twenty years' experience with one hundred fifteen cases is presented with one proved anastomotic leak and no deaths. Interval primary resection with anastomosis for chronic recurrent disease including colovesical fistula and mesocolic abscess was proved sate with low morbidity. The three-stage procedure for perforated diverticulitis with spreading peritonitis or pericolic abscess was associated with a high rate of complications and morbidity. An aggressive approach with resection without anastomosis in two stages is indicated.

  18. Work group I: Measures of the food and physical activity environment: instruments.

    Saelens, Brian E; Glanz, Karen


    A work group was convened to identify the core challenges, content gaps, and corresponding possible solutions for improving food- and physical activity-environment instrumentation. Identified challenges included instrument proliferation, the scaling or grain of instruments and appropriate aggregation to the neighborhood or community level, and unknown sensitivity to change of most instruments. Solutions for addressing these challenges included establishing an interactive and real-time instrument repository, developing and enforcing high standards for instrument reporting, increasing community-researcher collaborations, and implementing surveillance of food and physical activity environment. Solid instrumentation will accelerate a better understanding of food- and physical activity-environment effects on eating and physical activity behaviors.


    S. V. Vissarionov


    Full Text Available The results of surgical treatment of 263 patients with thoracic scoliosis from 13 to 18 years old with deformity 50-152° (Cobb are presented. It was used three tactical variants with dorsal instrumentation Cotrel-Dubousset (CDI. Operation correction in idiopathic thoracic scoliosis varies within in limits from 46,2 to 95%. Lost of correction in 10 years follow up period was 5,10-10,15%. Authors concluded that tactic of surgical treatment of idiopathic thoracic scoliosis should be individual and depends on patient's age, growth potential, and degree of deformation and mobility of the curve.

  20. Scientific Symbiosis Represents the Mutual Benefit of Iteratively Adopting the Perspective of Realism and Instrumentalism

    Cacioppo, John T.; Berntson, Gary G.; Semin, Gu R.


    This article presents comments on "Psychology Needs Realism not Instrumentalism" by B. Haig, "Ontological and Epistemic Claims of Realism and Instrumentalism" by Lau and "The Scientific Denial of the Real and the Dialectic of Scientism and Humanism" by Ramey and Chrysikou which were all comments on the original article "Realism, Instrumentalism,…

  1. Minimally invasive surgical technique for tethered surgical drains

    Shane R Hess


    Full Text Available A feared complication of temporary surgical drain placement is from the technical error of accidentally suturing the surgical drain into the wound. Postoperative discovery of a tethered drain can frequently necessitate return to the operating room if it cannot be successfully removed with nonoperative techniques. Formal wound exploration increases anesthesia and infection risk as well as cost and is best avoided if possible. We present a minimally invasive surgical technique that can avoid the morbidity associated with a full surgical wound exploration to remove a tethered drain when other nonoperative techniques fail.

  2. The methodological quality of systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment

    Vasconcelos Belmiro CE


    Full Text Available Abstract Background Temporomandibular joint disorders (TMJD are multifactor, complex clinical problems affecting approximately 60–70% of the general population, with considerable controversy about the most effective treatment. For example, reports claim success rates of 70% and 83% for non-surgical and surgical treatment, whereas other reports claim success rates of 40% to 70% for self-improvement without treatment. Therefore, the purpose of this study was to (1 identify systematic reviews comparing temporomandibular joint disorder surgical and non-surgical treatment, (2 evaluate their methodological quality, and (3 evaluate the evidence grade within the systematic reviews. Methods A search strategy was developed and implemented for MEDLINE, Cochrane Library, LILACS, and Brazilian Dentistry Bibliography databases. Inclusion criteria were: systematic reviews (± meta-analysis comparing surgical and non-surgical TMJD treatment, published in English, Spanish, Portuguese, Italian, or German between the years 1966 and 2007(up to July. Exclusion criteria were: in vitro or animal studies; narrative reviews or editorials or editorial letters; and articles published in other languages. Two investigators independently selected and evaluated systematic reviews. Three different instruments (AMSTAR, OQAQ and CASP were used to evaluate methodological quality, and the results averaged. The GRADE instrument was used to evaluate the evidence grade within the reviews. Results The search strategy identified 211 reports; of which 2 were systematic reviews meeting inclusion criteria. The first review met 23.5 ± 6.0% and the second met 77.5 ± 12.8% of the methodological quality criteria (mean ± sd. In these systematic reviews between 9 and 15% of the trials were graded as high quality, and 2 and 8% of the total number of patients were involved in these studies. Conclusion The results indicate that in spite of the widespread impact of TMJD, and the multitude of

  3. Surgical scar revision: An overview

    Shilpa Garg


    Full Text Available Scar formation is an inevitable consequence of wound healing from either a traumatic or a surgical intervention. The aesthetic appearance of a scar is the most important criteria to judge the surgical outcome. An understanding of the anatomy and wound healing along with experience, meticulous planning and technique can reduce complications and improve the surgical outcome. Scar revision does not erase a scar but helps to make it less noticeable and more acceptable. Both surgical and non-surgical techniques, used either alone or in combination can be used for revising a scar. In planning a scar revision surgeon should decide on when to act and the type of technique to use for scar revision to get an aesthetically pleasing outcome. This review article provides overview of methods applied for facial scar revision. This predominantly covers surgical methods.

  4. The keyboard instruments.

    Manchester, Ralph A


    Now that the field of performing arts medicine has been in existence for over three decades, we are approaching a key point: we should start to see more articles that bring together the data that have been collected from several studies in order to draw more robust conclusions. Review articles and their more structured relative, the meta-analysis, can help to improve our understanding of a particular topic, comparing and synthesizing the results of previous research that has been done on that subject area. One way this could be done would be to review the research that has been carried out on the performance-related problems associated with playing a particular instrument or group of instruments. While I am not going to do that myself, I hope that others will. In this editorial, I will do a very selective review of the playing-related musculoskeletal disorders (PRMDs) associated with one instrument group (the keyboard instruments), focusing on the most played instrument in that group (the piano;).

  5. Teaching Analytical Instrument Design with LabVIEW

    Gostowski, Rudy


    Chemists may be required to setup, troubleshoot, repair and sometimes construct the instruments they use for analytical measurements. Many students are intimidated when first "looking under the hood" of a modern instrument. This curriculum was devised to provide hands-on experience with the theory and design of modern instruments. A background in electronics is considered fundamental to this goal. This course extensively utilizes LabVIEW to economically provide basic electronic instrumentation and to serve in data acquisition and manipulation for a student design project. LabVIEW provides many built-in functions including a graphical user interface (GUI) and has universal acceptance in research and manufacturing settings. Programming is accomplished by placing and connecting icons that represent various functions. Virtual instruments produced by combining data acquisition boards with the language are functional equivalent to their real counterparts. The course culminates in construction of a computer-controlled electrochemical instrument capable of cyclic voltammetry and anodic stripping experiments.

  6. Biochemistry Instrumentation Core Technology Center

    Federal Laboratory Consortium — The UCLA-DOE Biochemistry Instrumentation Core Facility provides the UCLA biochemistry community with easy access to sophisticated instrumentation for a wide variety...

  7. Heat Flux Instrumentation Laboratory (HFIL)

    Federal Laboratory Consortium — Description: The Heat Flux Instrumentation Laboratory is used to develop advanced, flexible, thin film gauge instrumentation for the Air Force Research Laboratory....

  8. Tophi - surgical treatment.

    Słowińska, Iwona; Słowiński, Radosław; Rutkowska-Sak, Lidia


    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A "clinical mask" suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient's life improved significantly.

  9. Tophi – surgical treatment

    Słowińska, Iwona; Słowiński, Radosław


    Gout is an inflammatory joint disease associated with deposition of monosodium urate crystals in the bones forming the joints, in periarticular tissues and in other organs. The disease is one of the most frequent causes of disability. This paper presents the case of a 57-year-old male patient treated for generalised gout. A “clinical mask” suggesting another disease was the cause of making the correct diagnosis only six years after the occurrence of the first manifestations. The patient, with high values of inflammatory markers, severe pain and advanced joint destruction, was given an aggressive anti-inflammatory treatment. The unsatisfactory effect of the conservative treatment forced the authors to perform surgical resection of the gouty nodules in the hands. After several operations the function of the hand joints operated on, appearance of the hands and the quality of the patient’s life improved significantly. PMID:27994273

  10. Neuronavigation. Principles. Surgical technique.

    Ivanov, Marcel; Ciurea, Alexandru Vlad


    Neuronavigation and stereotaxy are techniques designed to help neurosurgeons precisely localize different intracerebral pathological processes by using a set of preoperative images (CT, MRI, fMRI, PET, SPECT etc.). The development of computer assisted surgery was possible only after a significant technological progress, especially in the area of informatics and imagistics. The main indications of neuronavigation are represented by the targeting of small and deep intracerebral lesions and choosing the best way to treat them, in order to preserve the neurological function. Stereotaxis also allows lesioning or stimulation of basal ganglia for the treatment of movement disorders. These techniques can bring an important amount of confort both to the patient and to the neurosurgeon. Neuronavigation was introduced in Romania around 2003, in four neurosurgical centers. We present our five-years experience in neuronavigation and describe the main principles and surgical techniques.

  11. Surgical education in Mexico.

    Cervantes, Jorge


    Surgical education in Mexico basically follows the same model as in the United States, with a selection process resembling the matching program. There is a 4-year training period during which residents in their third year spend 4 months as the sole surgeon in a rural community. During the senior year they are entitled to an elective period in a place of their choosing. After completion of the 4 years, residents have to present a thesis and undergo an oral examination before getting a university diploma. They are then encouraged to pass the written and oral examination of the Mexican Board of Surgery before they are fully certified to enter practice in a public or private hospital.

  12. 3D Spectroscopic Instrumentation

    Bershady, Matthew A


    In this Chapter we review the challenges of, and opportunities for, 3D spectroscopy, and how these have lead to new and different approaches to sampling astronomical information. We describe and categorize existing instruments on 4m and 10m telescopes. Our primary focus is on grating-dispersed spectrographs. We discuss how to optimize dispersive elements, such as VPH gratings, to achieve adequate spectral resolution, high throughput, and efficient data packing to maximize spatial sampling for 3D spectroscopy. We review and compare the various coupling methods that make these spectrographs ``3D,'' including fibers, lenslets, slicers, and filtered multi-slits. We also describe Fabry-Perot and spatial-heterodyne interferometers, pointing out their advantages as field-widened systems relative to conventional, grating-dispersed spectrographs. We explore the parameter space all these instruments sample, highlighting regimes open for exploitation. Present instruments provide a foil for future development. We give an...

  13. Micro mushroom instrumentation system

    Davidson, W. F.


    An electronics circuit which provides for the recording of instrumentation data on an optical disk is disclosed. The optical disk is formatted in a spiral format instead of concentric tracks. The spiral format allows data to be recorded without the gaps that would be associated with concentric tracks. The instrumentation system provides each channel with a program instrumentation amplifier, a six pole lowpass switched capacitor filter, a sample and hold amplifier, and a digital to analog converter to provide automatic offset capability. Since each channel has its own components, simultaneous samples of every channel can be captured. All of the input signal's channel variables can be captured. All of the input signal's channel variables can be changed under software control without hardware changes. A single board computer is used for a system controller.


    Cristian GHEORGHE


    Full Text Available The rules laid down by Romanian Capital Market Law and the regulations put in force for its implementation apply to issuers of financial instruments admitted to trading on the regulated market established in Romania. But the issuers remain companies incorporated under Company Law of 1990. Such dual regulations need increased attention in order to observe the legal status of the issuers/companies and financial instruments/shares. Romanian legislator has chosen to implement in Capital Market Law special rules regarding the administration of the issuers of financial instruments, not only rules regarding admitting and maintaining to a regulated market. Thus issuers are, in Romanian Law perspective, special company that should comply special rule regarding board of administration and general shareholders meeting.

  15. Calibration of Geodetic Instruments

    Marek Bajtala


    Full Text Available The problem of metrology and security systems of unification, correctness and standard reproducibilities belong to the preferred requirements of theory and technical practice in geodesy. Requirements on the control and verification of measured instruments and equipments increase and the importance and up-to-date of calibration get into the foreground. Calibration possibilities of length-scales (of electronic rangefinders and angle-scales (of horizontal circles of geodetic instruments. Calibration of electronic rangefinders on the linear comparative baseline in terrain. Primary standard of planar angle – optical traverse and its exploitation for calibration of the horizontal circles of theodolites. The calibration equipment of the Institute of Slovak Metrology in Bratislava. The Calibration process and results from the calibration of horizontal circles of selected geodetic instruments.

  16. Standard NIM instrumentation system


    NIM is a standard modular instrumentation system that is in wide use throughout the world. As the NIM system developed and accommodations were made to a dynamic instrumentation field and a rapidly advancing technology, additions, revisions and clarifications were made. These were incorporated into the standard in the form of addenda and errata. This standard is a revision of the NIM document, AEC Report TID- 20893 (Rev 4) dated July 1974. It includes all the addenda and errata items that were previously issued as well as numerous additional items to make the standard current with modern technology and manufacturing practice.

  17. Animation of MARDI Instrument


    [figure removed for brevity, see original site] Click on image to view the animation This animation shows a zoom into the Mars Descent Imager (MARDI) instrument onboard NASA's Phoenix Mars Lander. The Phoenix team will soon attempt to use a microphone on the MARDI instrument to capture sounds of Mars. The Phoenix Mission is led by the University of Arizona, Tucson, on behalf of NASA. Project management of the mission is by NASA's Jet Propulsion Laboratory, Pasadena, Calif. Spacecraft development is by Lockheed Martin Space Systems, Denver.

  18. Virtual Reality Musical Instruments

    Serafin, Stefania; Erkut, Cumhur; Kojs, Juraj


    The rapid development and availability of low-cost technologies have created a wide interest in virtual reality. In the field of computer music, the term “virtual musical instruments” has been used for a long time to describe software simulations, extensions of existing musical instruments......, and ways to control them with new interfaces for musical expression. Virtual reality musical instruments (VRMIs) that include a simulated visual component delivered via a head-mounted display or other forms of immersive visualization have not yet received much attention. In this article, we present a field...

  19. Spectroelectrochemical Instrument Measures TOC

    Kounaves, Sam


    A spectroelectrochemical instrument has been developed for measuring the total organic carbon (TOC) content of an aqueous solution. Measurements of TOC are frequently performed in environmental, clinical, and industrial settings. Until now, techniques for performing such measurements have included, various ly, the use of hazardous reagents, ultraviolet light, or ovens, to promote reactions in which the carbon contents are oxidized. The instrument now being developed is intended to be a safer, more economical means of oxidizing organic carbon and determining the TOC levels of aqueous solutions and for providing a low power/mass unit for use in planetary missions.

  20. [Hardening of dental instruments].

    Gerasev, G P


    The possibility of prolonging the service life of stomatological instruments by the local hardening of their working parts is discussed. Such hardening should be achieved by using hard and wear-resistant materials. The examples of hardening dental elevators and hard-alloy dental drills are given. New trends in the local hardening of instruments are the treatment of their working parts with laser beams, the application of coating on their surface by the gas-detonation method. The results of research work and trials are presented.

  1. Celadon Figurines Play Instruments


    This group of figurines, each 0.15m tall, were unearthed from a Tang Dynasty tomb in Changsha in 1977. Music was very developed in the Tang Dynasty. Colorful musical instruments and dances were popular both among the people and in the palace. These vivid-looking figurines wear pleated skirts with small sleeves and open chest, a style influenced by the non-Han nationalities living in the north and west of China. Some of the musical instruments were brought from the Western Regions. The figurines are playing the xiao (a vertical bamboo flute), the konghou (an

  2. Virtual Reality Musical Instruments

    Serafin, Stefania; Erkut, Cumhur; Kojs, Juraj


    The rapid development and availability of low-cost technologies have created a wide interest in virtual reality. In the field of computer music, the term “virtual musical instruments” has been used for a long time to describe software simulations, extensions of existing musical instruments......, and ways to control them with new interfaces for musical expression. Virtual reality musical instruments (VRMIs) that include a simulated visual component delivered via a head-mounted display or other forms of immersive visualization have not yet received much attention. In this article, we present a field...

  3. Monetary Policy Frameworks and Real Equilibrium Determinacy

    Jensen, Henrik


    In a simple "prototype" model of monetary policymaking, I examine the issue of real equilibrium determinacy under targeting and instrument rules. The former framework involves minimization of a loss function (under discretion or commitment), whereas the latter involves commitment to an interest......'s stability properties. Instead, they could reveal whether targeting-rule based policy is performed under discretion or commitment...

  4. Monetary Policy Frameworks and Real Equilibrium Determinacy

    Jensen, Henrik


    In a simple "prototype" model of monetary policymaking, I examine the issue of real equilibrium determinacy under targeting and instrument rules. The former framework involves minimization of a loss function (under discretion or commitment), whereas the latter involves commitment to an interest......'s stability properties. Instead, they could reveal whether targeting-rule based policy is performed under discretion or commitment...

  5. Minimally invasive surgical treatment of valvular heart disease.

    Goldstone, Andrew B; Joseph Woo, Y


    Cardiac surgery is in the midst of a practice revolution. Traditionally, surgery for valvular heart disease consisted of valve replacement via conventional sternotomy using cardiopulmonary bypass. However, over the past 20 years, the increasing popularity of less-invasive procedures, accompanied by advancements in imaging, surgical instrumentation, and robotic technology, has motivated and enabled surgeons to develop and perform complex cardiac surgical procedures through small incisions, often eliminating the need for sternotomy or cardiopulmonary bypass. In addition to the benefits of improved cosmesis, minimally invasive mitral valve surgery was pioneered with the intent of reducing morbidity, postoperative pain, blood loss, hospital length of stay, and time to return to normal activity. This article reviews the current state-of-the-art of minimally invasive approaches to the surgical treatment of valvular heart disease.

  6. Strategic planning ensures surgical success in cases of proliferative vitreoretinopathy.

    Lakhanpal, R Ross; Hariprasad, Seenu M


    For this Practical Retina column, Dr. Ross Lakhanpal from Baltimore was asked to comment on the current state of thinking and management options for proliferative vitreoretinopathy (PVR) after retinal detachment (RD) surgery.We are all aware that PVR continues to be an important cause of recurrent RD after successful repair. This feared complication has been reported to occur in up to 8% of patients after undergoing RD repair. Despite the historic progress made in managing various vitreoretinal diseases over the past decade, most retina specialists will agree that an unmet need remains in this landscape. Fortunately, advances in various surgical technologies such as instrumentation, lighting, and visualization have improved the outcomes after PVR management.Dr. Lakhanpal discusses causes of PVR, management goals, surgical techniques, and pearls to avoid complications after managing PVR. His experience working in an urban tertiary surgical retina practice enables him to offer insights that will be highly valued by our community.

  7. Unsupervised Trajectory Segmentation for Surgical Gesture Recognition in Robotic Training.

    Despinoy, Fabien; Bouget, David; Forestier, Germain; Penet, Cedric; Zemiti, Nabil; Poignet, Philippe; Jannin, Pierre


    Dexterity and procedural knowledge are two critical skills that surgeons need to master to perform accurate and safe surgical interventions. However, current training systems do not allow us to provide an in-depth analysis of surgical gestures to precisely assess these skills. Our objective is to develop a method for the automatic and quantitative assessment of surgical gestures. To reach this goal, we propose a new unsupervised algorithm that can automatically segment kinematic data from robotic training sessions. Without relying on any prior information or model, this algorithm detects critical points in the kinematic data that define relevant spatio-temporal segments. Based on the association of these segments, we obtain an accurate recognition of the gestures involved in the surgical training task. We, then, perform an advanced analysis and assess our algorithm using datasets recorded during real expert training sessions. After comparing our approach with the manual annotations of the surgical gestures, we observe 97.4% accuracy for the learning purpose and an average matching score of 81.9% for the fully automated gesture recognition process. Our results show that trainees workflow can be followed and surgical gestures may be automatically evaluated according to an expert database. This approach tends toward improving training efficiency by minimizing the learning curve.

  8. A projective surgical navigation system for cancer resection

    Gan, Qi; Shao, Pengfei; Wang, Dong; Ye, Jian; Zhang, Zeshu; Wang, Xinrui; Xu, Ronald


    Near infrared (NIR) fluorescence imaging technique can provide precise and real-time information about tumor location during a cancer resection surgery. However, many intraoperative fluorescence imaging systems are based on wearable devices or stand-alone displays, leading to distraction of the surgeons and suboptimal outcome. To overcome these limitations, we design a projective fluorescence imaging system for surgical navigation. The system consists of a LED excitation light source, a monochromatic CCD camera, a host computer, a mini projector and a CMOS camera. A software program is written by C++ to call OpenCV functions for calibrating and correcting fluorescence images captured by the CCD camera upon excitation illumination of the LED source. The images are projected back to the surgical field by the mini projector. Imaging performance of this projective navigation system is characterized in a tumor simulating phantom. Image-guided surgical resection is demonstrated in an ex-vivo chicken tissue model. In all the experiments, the projected images by the projector match well with the locations of fluorescence emission. Our experimental results indicate that the proposed projective navigation system can be a powerful tool for pre-operative surgical planning, intraoperative surgical guidance, and postoperative assessment of surgical outcome. We have integrated the optoelectronic elements into a compact and miniaturized system in preparation for further clinical validation.

  9. Economic Policy Instruments

    Klemmensen, Børge


    Økonomiske instrumenter begrundes med behovet for politiske indgreb, der muliggør internaliseringen af omkostningerne ved de miljøpåvirkninger, produktion and levevis afstedkommer, således at hensyntagen til miljøet bliver en del af virksomheders og husholdningers omkostninger og dermed en tilsky...

  10. The ozone monitoring instrument

    Levelt, P.F.; Oord, G.H.J. van den; Dobber, M.R.; Mälkki, A.; Visser, H.; Vries, J. de; Stammes, P.; Lundell, J.O.V.; Saari, H.


    The Ozone Monitoring Instrument (OMI) flies on the National Aeronautics and Space Adminsitration's Earth Observing System Aura satellite launched in July 2004. OMI is a ultraviolet/visible (UV/VIS) nadir solar backscatter spectrometer, which provides nearly global coverage in one day with a spatial

  11. Neutron instrumentation for biology

    Mason, S.A. [Institut Laue-Langevin, Grenoble (France)


    In the October 1994 round of proposals at the ILL, the external biology review sub- committee was asked to allocate neutron beam time to a wide range of experiments, on almost half the total number of scheduled neutron instruments: on 3 diffractometers, on 3 small angle scattering instruments, and on some 6 inelastic scattering spectrometers. In the 3.5 years since the temporary reactor shutdown, the ILL`s management structure has been optimized, budgets and staff have been trimmed, the ILL reactor has been re-built, and many of the instruments up-graded, many powerful (mainly Unix) workstations have been introduced, and the neighboring European Synchrotron Radiation Facility has established itself as the leading synchrotron radiation source and has started its official user program. The ILL reactor remains the world`s most intense dedicated neutron source. In this challenging context, it is of interest to review briefly the park of ILL instruments used to study the structure and energetics of small and large biological systems. A brief summary will be made of each class of experiments actually proposed in the latest ILL proposal round.

  12. Advanced instrumentation and teleoperation

    Decreton, M


    SCK-CEN's advanced instrumentation and teleoperation project aims at evaluating the potential of a telerobotic approach in a nuclear environment and, in particular, the use of remote-perception systems. Main achievements in 1997 in the areas of R and D on radiation tolerance for remote sensing, optical fibres and optical-fibre sensors, and computer-aided teleoperation are reported.

  13. Economic Policy Instruments

    Klemmensen, Børge


    Økonomiske instrumenter begrundes med behovet for politiske indgreb, der muliggør internaliseringen af omkostningerne ved de miljøpåvirkninger, produktion and levevis afstedkommer, således at hensyntagen til miljøet bliver en del af virksomheders og husholdningers omkostninger og dermed en...

  14. Instrument for assaying radiation

    Coleman, Jody Rustyn; Farfan, Eduardo B.


    An instrument for assaying radiation includes a flat panel detector having a first side opposed to a second side. A collimated aperture covers at least a portion of the first side of the flat panel detector. At least one of a display screen or a radiation shield may cover at least a portion of the second side of the flat panel detector.

  15. Integrating Nephelometer Instrument Handbook

    Uin, J. [Brookhaven National Lab. (BNL), Upton, NY (United States)


    The Integrating Nephelometer (Figure 1) is an instrument that measures aerosol light scattering. It measures aerosol optical scattering properties by detecting (with a wide angular integration – from 7 to 170°) the light scattered by the aerosol and subtracting the light scattered by the carrier gas, the instrument walls and the background noise in the detector (zeroing). Zeroing is typically performed for 5 minutes every day at midnight UTC. The scattered light is split into red (700 nm), green (550 nm), and blue (450 nm) wavelengths and captured by three photomultiplier tubes. The instrument can measure total scatter as well as backscatter only (from 90 to 170°) (Heintzenberg and Charlson 1996; Anderson et al. 1996; Anderson and Ogren 1998; TSI 3563 2015) At ARM (Atmospheric Radiation Measurement), two identical Nephelometers are usually run in series with a sample relative humidity (RH) conditioner between them. This is possible because Nephelometer sampling is non-destructive and the sample can be passed on to another instrument. The sample RH conditioner scans through multiple RH values in cycles, treating the sample. This kind of setup allows to study how aerosol particles’ light scattering properties are affected by humidification (Anderson et al. 1996). For historical reasons, the two Nephelometers in this setup are labeled “wet” and “dry”, with the “dry” Nephelometer usually being the one before the conditioner and sampling ambient air (the names are switched for the MAOS measurement site due to the high RH of the ambient air).

  16. Instruments of Transformative Governance

    Borrás, Susana

    production and distribution channels. PDPs aim at overcoming current market and government failures by pooling resources in the attempt to solve this global social challenge. Thus, PDPs are a case of instruments of transformative research and innovation, operating in a transnational governance context...

  17. The tropospheric monitoring instrument

    Voert, M.J. te; Brakel, R. van; Witvoet, G.


    Thermal and opto-mechanical design and analysis work has been done on the Tropospheric Monitoring Instrument (TROPOMI), a spectrometer on the Copernicus Sentinel 5 Precursor satellite. To verify compliance with the stringent opto-mechanical stability requirements, detailed thermal and thermo-mechani

  18. Virtual reality musical instruments

    Serafin, Stefania; Erkut, Cumhur; Kojs, Juraj


    The rapid development and availability of low cost technologies has created a wide interest in virtual reality (VR), but how to design and evaluate multisensory interactions in VR remains as a challenge. In this paper, we focus on virtual reality musical instruments, present an overview of our...

  19. The ozone monitoring instrument

    Levelt, P.F.; Oord, G.H.J. van den; Dobber, M.R.; Mälkki, A.; Visser, H.; Vries, J. de; Stammes, P.; Lundell, J.O.V.; Saari, H.


    The Ozone Monitoring Instrument (OMI) flies on the National Aeronautics and Space Adminsitration's Earth Observing System Aura satellite launched in July 2004. OMI is a ultraviolet/visible (UV/VIS) nadir solar backscatter spectrometer, which provides nearly global coverage in one day with a spatial

  20. Payment Instrument Characteristics

    Holst, Jacques; Kjeldsen, Martin; Hedman, Jonas


    payment innovations. Using the Repertory Grid technique to explore 15 payers’ perception of six payment instruments, including coins, banknotes, debit cards, credit cards, mobile payments, and on-line banking, we identify 16 payment characteristics. The characteristics aggregate seventy-six unique...

  1. Acquiring minimally invasive surgical skills

    Hiemstra, Ellen


    Many topics in surgical skills education have been implemented without a solid scientific basis. For that reason we have tried to find this scientific basis. We have focused on training and evaluation of minimally invasive surgical skills in a training setting and in practice in the operating room.

  2. Surgical innovations in canine gonadectomy

    Van Goethem, Bart


    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated n

  3. Surgical treatment of acquired tracheocele.

    Porubsky, Edward A; Gourin, Christine G


    Acquired tracheoceles are rare clinical entities that can cause a variety of chronic and recurrent aerodigestive tract symptoms. The management of acquired tracheoceles is primarily conservative, but surgical intervention may be indicated for patients with refractory symptoms. We present a case of acquired tracheocele and describe a method of successful surgical management.

  4. Surgical innovations in canine gonadectomy

    Van Goethem, Bart


    In this thesis some recent technological developments in human surgery are evaluated for their potential use in veterinary medicine by introducing them as surgical innovations for canine gonadectomy. Barbed sutures achieve wound apposition without surgical knot tying and thus avoid knot-associated n

  5. Instrumentation and Fluorescent Chemistries Used in qPCR

    Josefsen, Mathilde Hartmann; Löfström, Charlotta; Hansen, Trine


    The polymerase chain reaction has revolutionized the world of scientific research and its broad application has caused a tremendous development of versatile PCR instruments and chemistries to fit its purpose. This chapter provides the reader with a general introduction to the basics of real-time ...... applied chemistries. The fluorophores and quenchers used for primer and probe labeling and their compatibility will be presented, and finally the future challenges and trends within the field of qPCR instrumentation will be discussed....

  6. The Science of String Instruments

    Rossing, Thomas D


    Many performing musicians, as well as instrument builders, are coming to realize the importance of understanding the science of musical instruments. This book explains how string instruments produce sound. It presents basic ideas in simple language, and it also translates some more sophisticated ideas in non-technical language. It should be of interest to performers, researchers, and instrument makers alike.

  7. Thermal Measurements of Resonant Ultrasonic Surgical Horn

    Manandhar, Prakash; Gupta, Saurav V.; Kosenko, Igor V.; Cotter, Daniel J.

    Temperatures at the distal end of the tip in ultrasonic surgical instruments are of interest because this is the applied part to a patient. It is difficult to directly measure these temperatures using contacting temperature sensors due to high vibration levels. Non-contact infrared (IR) thermography could be an important tool to experimentally determine the tip temperature. However, the low emissivity and polished cylindrical geometry of the tips complicate accurate IR thermography. In this study, we use Cr2O3 high emissivity paint to coat the tip for increased accuracy in IR measurements. Temperature measurements are consistent with heat generation models based on mechanical quality factor of about 5000 for the titanium tip material. It was found that no heat is generated at the tip distal end where strain is low. Air cooling by aspiration is effective at keeping tip distal end temperatures at near ambient levels even with heat transfer by conduction from warmer parts of the tip.

  8. Irrigants in non-surgical endodontic treatment.

    Regan, John D; Fleury, Alex A P


    This paper highlights that one of the main goals of root canal treatment is the elimination of microorganisms from the contaminated root canal system. Instrumentation alone will not allow for adequate debridement and disinfection of the complex and diverse root canal system. Chemomechanical debridement is required. The importance of the use of irrigants during non-surgical root canal treatment has frequently been neglected both during instruction of dental students and later in the clinical practice of endodontics. The article highlights 'shape, clean and fill' vs. 'clean, shape and fill' to enable chemomechanical debridement. Our protocol advises mechanical debridement and copious irrigation for a minimum of twenty minutes with 2.5% to 6% solutions of sodium hypochlorite, followed by a rinse with a 17% solution of ethylenediaminetetraacetic acid and a final rinse with 2% chlorhexidine. The canals are dried with high volume aspirators and sterile paper points.

  9. Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: A prospective randomised controlled trial [NTR1300

    M.P. Arts (Mark); M.J.T. Verstegen (Marco); R. Brand (René); B.W. Koes (Bart); M.E. van den Akker (Elske); W.C. Peul (Wilco)


    textabstractBackground. Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure, i

  10. Cost-effectiveness of decompression according to Gill versus instrumented spondylodesis in the treatment of sciatica due to low grade spondylolytic spondylolisthesis: A prospective randomised controlled trial [NTR1300

    M.P. Arts (Mark); M.J.T. Verstegen (Marco); R. Brand (René); B.W. Koes (Bart); M.E. van den Akker (Elske); W.C. Peul (Wilco)


    textabstractBackground. Nerve root decompression with instrumented spondylodesis is the most frequently performed surgical procedure in the treatment of patients with symptomatic low-grade spondylolytic spondylolisthesis. Nerve root decompression without instrumented fusion, i.e. Gill's procedure, i

  11. Program Instrumentation and Trace Analysis

    Havelund, Klaus; Goldberg, Allen; Filman, Robert; Rosu, Grigore; Koga, Dennis (Technical Monitor)


    Several attempts have been made recently to apply techniques such as model checking and theorem proving to the analysis of programs. This shall be seen as a current trend to analyze real software systems instead of just their designs. This includes our own effort to develop a model checker for Java, the Java PathFinder 1, one of the very first of its kind in 1998. However, model checking cannot handle very large programs without some kind of abstraction of the program. This paper describes a complementary scalable technique to handle such large programs. Our interest is turned on the observation part of the equation: How much information can be extracted about a program from observing a single execution trace? It is our intention to develop a technology that can be applied automatically and to large full-size applications, with minimal modification to the code. We present a tool, Java PathExplorer (JPaX), for exploring execution traces of Java programs. The tool prioritizes scalability for completeness, and is directed towards detecting errors in programs, not to prove correctness. One core element in JPaX is an instrumentation package that allows to instrument Java byte code files to log various events when executed. The instrumentation is driven by a user provided script that specifies what information to log. Examples of instructions that such a script can contain are: 'report name and arguments of all called methods defined in class C, together with a timestamp'; 'report all updates to all variables'; and 'report all acquisitions and releases of locks'. In more complex instructions one can specify that certain expressions should be evaluated and even that certain code should be executed under various conditions. The instrumentation package can hence be seen as implementing Aspect Oriented Programming for Java in the sense that one can add functionality to a Java program without explicitly changing the code of the original program, but one rather writes an

  12. Surgical infection in art.

    Meakins, J L


    The earliest images of medicine and surgery in Western art are from the late Middle Ages. Although often attractive, at that time they were illustrative and mirrored the text on how to diagnose or treat a specific condition. These drawings in medieval manuscripts represent management of abscesses, perianal infection and fistulas, amputation, and wound dressings. With the Renaissance, art in all its forms flourished, and surgeons were represented at work draining carbuncles, infected bursae, and mastoiditis; managing ulcers, scrofula, and skin infections; and performing amputations. Specific diagnosis can be made, such as streptococcal infection in the discarded leg of the miraculous transplantation performed by Saints Cosmas and Damian and in the works of Rembrandt van Rijn and Frederic Bazille. Evocations of cytokine activity are evident in works by Albrecht Dürer, Edvard Munch, and James Tissot. The iconography of society's view of a surgeon is apparent and often not complimentary. The surgeon's art is a visual art. Astute observation leads to early diagnosis and better results in surgical infection and the septic state. Learning to see what we look at enhances our appreciation of the world around us but, quite specifically, makes us better clinicians.

  13. UC Merced NMR Instrumentation Acquisition


    UC Merced NMR Instrumentation Acquisition For the UC Merced NMR Instrumentation Acquisition proposal, a new 400 MHz and an upgraded 500 MHz NMR ...UC Merced NMR Instrumentation Acquisition Report Title For the UC Merced NMR Instrumentation Acquisition proposal, a new 400 MHz and an upgraded 500...MHz NMR have been delivered, installed, and incorporated into research and two lab courses. While no results from these instruments have been

  14. Surgical glove perforation among nurses in ophthalmic surgery: a case-control study.

    Shek, Karen Mei-Yan; Chau, Janita Pak-Chun


    Many of the ophthalmic surgical instruments are extremely fine and sharp. Due to the dim light environment required for ophthalmic surgical procedures, the passing of sharp instruments among surgeons and scrub nurses also poses a risk for glove perforations. A case-control study was performed to determine the number and site of perforations in the surgical gloves used by a group of scrub nurses during ophthalmic surgery. All six nurses working in an eye and refractive surgery centre in Hong Kong participated in the study. A total of 100 (50 pairs) used surgical gloves were collected following 50 ophthalmic surgeries. Fifty pairs of new surgical gloves were also collected. Every collected surgical glove underwent the water leak test. The surgical procedure perforation rate was 8%, and none of the perforations were detected by the scrub nurses. No perforations were found in any unused gloves. The findings indicate that glove perforations for scrub nurses during ophthalmic surgery do occur and mostly go unnoticed. Future studies should continue to explore factors contributing to surgical glove perforation.

  15. netherland hydrological modeling instrument

    Hoogewoud, J. C.; de Lange, W. J.; Veldhuizen, A.; Prinsen, G.


    Netherlands Hydrological Modeling Instrument A decision support system for water basin management. J.C. Hoogewoud , W.J. de Lange ,A. Veldhuizen , G. Prinsen , The Netherlands Hydrological modeling Instrument (NHI) is the center point of a framework of models, to coherently model the hydrological system and the multitude of functions it supports. Dutch hydrological institutes Deltares, Alterra, Netherlands Environmental Assessment Agency, RWS Waterdienst, STOWA and Vewin are cooperating in enhancing the NHI for adequate decision support. The instrument is used by three different ministries involved in national water policy matters, for instance the WFD, drought management, manure policy and climate change issues. The basis of the modeling instrument is a state-of-the-art on-line coupling of the groundwater system (MODFLOW), the unsaturated zone (metaSWAP) and the surface water system (MOZART-DM). It brings together hydro(geo)logical processes from the column to the basin scale, ranging from 250x250m plots to the river Rhine and includes salt water flow. The NHI is validated with an eight year run (1998-2006) with dry and wet periods. For this run different parts of the hydrology have been compared with measurements. For instance, water demands in dry periods (e.g. for irrigation), discharges at outlets, groundwater levels and evaporation. A validation alone is not enough to get support from stakeholders. Involvement from stakeholders in the modeling process is needed. There fore to gain sufficient support and trust in the instrument on different (policy) levels a couple of actions have been taken: 1. a transparent evaluation of modeling-results has been set up 2. an extensive program is running to cooperate with regional waterboards and suppliers of drinking water in improving the NHI 3. sharing (hydrological) data via newly setup Modeling Database for local and national models 4. Enhancing the NHI with "local" information. The NHI is and has been used for many

  16. Developments in analytical instrumentation

    Petrie, G.

    The situation regarding photogrammetric instrumentation has changed quite dramatically over the last 2 or 3 years with the withdrawal of most analogue stereo-plotting machines from the market place and their replacement by analytically based instrumentation. While there have been few new developments in the field of comparators, there has been an explosive development in the area of small, relatively inexpensive analytical stereo-plotters based on the use of microcomputers. In particular, a number of new instruments have been introduced by manufacturers who mostly have not been associated previously with photogrammetry. Several innovative concepts have been introduced in these small but capable instruments, many of which are aimed at specialised applications, e.g. in close-range photogrammetry (using small-format cameras); for thematic mapping (by organisations engaged in environmental monitoring or resources exploitation); for map revision, etc. Another innovative and possibly significant development has been the production of conversion kits to convert suitable analogue stereo-plotting machines such as the Topocart, PG-2 and B-8 into fully fledged analytical plotters. The larger and more sophisticated analytical stereo-plotters are mostly being produced by the traditional mainstream photogrammetric systems suppliers with several new instruments and developments being introduced at the top end of the market. These include the use of enlarged photo stages to handle images up to 25 × 50 cm format; the complete integration of graphics workstations into the analytical plotter design; the introduction of graphics superimposition and stereo-superimposition; the addition of correlators for the automatic measurement of height, etc. The software associated with this new analytical instrumentation is now undergoing extensive re-development with the need to supply photogrammetric data as input to the more sophisticated G.I.S. systems now being installed by clients, instead

  17. Endoluminal surgical triangulation 2.0: A new flexible surgical robot. Preliminary pre-clinical results with colonic submucosal dissection.

    Légner, András; Diana, Michele; Halvax, Péter; Liu, Yu-Yin; Zorn, Lucile; Zanne, Philippe; Nageotte, Florent; De Mathelin, Michel; Dallemagne, Bernard; Marescaux, Jacques


    Complex intraluminal surgical interventions of the gastrointestinal tract are challenging due to the limitation of existing instruments. Our group has developed a master-slave robotic flexible endoscopic platform that provides instrument triangulation in an endoluminal environment. Colonic endoscopic submucosal dissections (ESD) were carried out in eight pigs. The robot was introduced transanally. A combination of adapted tele-operated instruments was used. Specimens were inspected and measured. Out of 18 ESDs in total, 12 were successfully completed. Among the completed procedures, two perforations and one system failure occurred and were managed intraoperatively. There was no major bleeding. Mean size of the removed specimens was 18.2 ± 9.8 cm(2) and mean total procedure time was 73 ± 35.5 min. Experimental colorectal ESDs using the flexible surgical robot were feasible and reflected a short learning curve. After some technical improvements the system might allow for a wider adoption of complex endoluminal surgical procedures. Copyright © 2017 John Wiley & Sons, Ltd.

  18. Micobatteriological control of diagnostic instrumentation

    Valeria Olivo


    Full Text Available Introduction: In addition to sterility testings for common bacteria, from 2006 on we have introduced in our laboratory sterility tests for mycobacteria on surgical instruments such as bronchoscope and lava-endoscope fluid used for their sterilization as well. Methods: Bronchology and Pneumology SUN departments, doing bronchoscopies, regularly send to our laboratory bronchoscopes washing fluids. Bronchology department also sends liquids used in lavaendoscopes. Our standard protocol consists of liquids inoculation directly on Lowenstein - Jensen (LJ solid ground and on Middlebrook 7H9 liquid medium into Mgit test tubes, both produced by Becton Dickinson, within 42 days (1, 5, 6. Results: When growth of acid-alcohol resistant bacilli was detected, they were identified through probes or Accuprobe bioMérieux Inno- LIPA Mycobacteria by Innogenetics. All positivite results were related to M. Gordonae. As for the liquids examined, we found one positivite result in liquid medium in 2006 and none in 2007. On the contrary, in 2008 and the first 6 months of 2009, we have identified the following positive results: 2008 - 2009 (6m LJ pos TOT 20 C. Lavaendoscope 8 V. 12 FBS We linked the positive findings on equipment with positivity for M. gordonae observed in patients undergoing bronchoscopy. Conclusions: Data analysis indicates within the period 2008-2009 we observed a recurring positivity for M. gordonae on equipment and therefore in some patients. On a careful evaluation, they showed no signs of clinical infection, also considering that this mycobacteria is usually a saprophyte (2, 3, 4. However, the protocol we adopted allowed us to recognize equipment contamination at birth and to urge fellow users to review sterilization protocols.

  19. How to improve instrument disinfection by ultrasound.

    Jatzwauk, L; Schöne, H; Pietsch, H


    Ultrasound technologies have a wide range of hospital and dental applications which include cleaning and disinfection of surgical and dental instruments. We measured the germicidal efficacy of sonication, with or without chemical disinfectants, in an ultrasonic bath delivering a frequency of 35 kHz and an intensity of 0.66 W/cm2. Cultures of Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans were exposed to ultrasound and to an amine-based disinfectant in non-bactericidal concentrations. Ultrasonication for 60 min alone did not cause a significant killing of the bacteria and yeast. However, we were able to show that sonication can act as a powerful synergistic agent to increase the cidal efficacy of the disinfectant against S. aureus and P. aeruginosa. C. albicans was more resistant to the combination of ultrasound and chemical disinfection. The key role in the action of ultrasound in cleaning of instruments and perhaps in enhanced disinfection is played by cavitation phenomena. The distribution of cavitations in an ultrasonic bath is not homogenous. We found a similar synergistic effect of ultrasound and disinfectant in positions with low cavitation. The synergistic effect was not reduced inside rubber tubes. Before ultrasound can be accepted as an integral part of the cleaning and disinfection process of medical instruments, the influence of intensity and frequency of sonication and the effects of cavitation must be clarified.

  20. Dilemmas in autoimmune pancreatitis. Surgical resection or not?

    Hoffmanova, I; Gurlich, R; Janik, V; Szabo, A; Vernerova, Z

    Surgical treatment is not commonly recommended in the management of autoimmune pancreatitis. The article describes a dilemma in diagnostics and treatment of a 68-year old man with the mass in the head of the pancreas that mimicked pancreatic cancer and that was diagnosed as a type 1 autoimmune pancreatitis (IgG4-related pancreatitis) after a surgical resection. Diagnosis of the autoimmune pancreatitis is a real clinical challenge, as in the current diagnostic criteria exists some degree of overlap in the findings between autoimmune pancreatitis and pancreatic cancer (indicated by the similarity in radiologic findings, elevation of IgG4, sampling errors in pancreatic biopsy, and the possibility of synchronous autoimmune pancreatitis and pancreatic cancer). Despite the generally accepted corticosteroids as the primary treatment modality in autoimmune pancreatitis, we believe that surgical resection remains necessary in a specific subgroup of patients with autoimmune pancreatitis (Fig. 4, Ref. 37).