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Sample records for totally implantable system

  1. Totally implantable total artificial heart and ventricular assist device with multipurpose miniature electromechanical energy system.

    Science.gov (United States)

    Takatani, S; Orime, Y; Tasai, K; Ohara, Y; Naito, K; Mizuguchi, K; Makinouchi, K; Damm, G; Glueck, J; Ling, J

    1994-01-01

    A multipurpose miniature electromechanical energy system has been developed to yield a compact, efficient, durable, and biocompatible total artificial heart (TAH) and ventricular assist device (VAD). Associated controller-driver electronics were recently miniaturized and converted into hybrid circuits. The hybrid controller consists of a microprocessor and controller, motor driver, Hall sensor, and commutation circuit hybrids. The sizing study demonstrated that all these components can be incorporated in the pumping unit of the TAH and VAD, particularly in the centerpiece of the TAH and the motor housing of the VAD. Both TAH and VAD pumping units will start when their power line is connected to either the internal power pack or the external battery unit. As a redundant driving and diagnostic port, an emergency port was newly added and will be placed in subcutaneous location. In case of system failure, the skin will be cut down, and an external motor drive or a pneumatic driver will be connected to this port to run the TAH. This will minimize the circulatory arrest time. Overall efficiency of the TAH without the transcutaneous energy transmission system was 14-18% to deliver pump outputs of 4-9 L/min against the right and left afterload pressures of 25 and 100 mm Hg. The internal power requirement ranged from 6 to 13 W. The rechargeable batteries such as NiCd or NiMH with 1 AH capacity can run the TAH for 30-45 min. The external power requirement, when TETS efficiency of 75% was assumed, ranged from 8 to 18 W. The accelerated endurance test in the 42 degrees C saline bath demonstrated stable performance over 4 months. Long-term endurance and chronic animal studies will continue toward a system with 5 years durability by the year 2000.

  2. System overview of the fully implantable destination therapy--ReinHeart-total artificial heart.

    Science.gov (United States)

    Pelletier, Benedikt; Spiliopoulos, Sotirios; Finocchiaro, Thomas; Graef, Felix; Kuipers, Kristin; Laumen, Marco; Guersoy, Dilek; Steinseifer, Ulrich; Koerfer, Reiner; Tenderich, Gero

    2015-01-01

    Owing to the lack of suitable allografts, the demand for long-term mechanical circulatory support in patients with biventricular end-stage heart failure is rising. Currently available Total Artificial Heart (TAH) systems consist of pump units with only limited durability, percutaneous tubes and bulky external equipment that limit the quality of life. Therefore we are focusing on the development of a fully implantable, highly durable destination therapy total artificial heart. The ReinHeart-TAH system consists of a passively filling pump unit driven by a low-wear linear drive between two artificial ventricles, an implantable control unit and a compliance chamber. The TAH is powered by a transcutaneous energy transmission system. The flow distribution inside the ventricles was analysed by fluid structure interaction simulation and particle image velocimetry measurements. Along with durability tests, the hydrodynamic performance and flow balance capability were evaluated in a mock circulation loop. Animal trials are ongoing. Based on fluid structure interaction simulation and particle image velocimetry, blood stagnation areas have been significantly reduced. In the mock circulation loop the ReinHeart-TAH generated a cardiac output of 5 l/min at an operating frequency of 120 bpm and an aortic pressure of 120/80 mmHg. The highly effective preload sensitivity of the passively filling ventricles allowed the sensorless integration of the Frank Starling mechanism. The ReinHeart-TAH effectively replaced the native heart's function in animals for up to 2 days. In vitro and in vivo testing showed a safe and effective function of the ReinHeart-TAH system. This has the potential to become an alternative to transplantation. However, before a first-in-man implant, chronic animal trials still have to be completed. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  3. A Comparison of Clinical Outcomes with Regular- and Low-Profile Totally Implanted Central Venous Port Systems

    International Nuclear Information System (INIS)

    Teichgraeber, Ulf Karl-Martin; Steitparth, Florian; Cho, Chie Hee; Benter, Thomas; Gebauer, Bernhard

    2009-01-01

    The purpose of this study was to evaluate whether low-profile totally implanted central venous port systems can reduce the late complication of skin perforation. Forty patients (age, 57 ± 13 years; 22 females, 18 males) were randomized for the implantation of a low-profile port system, and another 40 patients (age, 61 ± 14 years; 24 females, 16 males) received a regular port system as control group. Indications for port catheter implantation were malignant disease requiring chemotherapy. All port implantations were performed in the angiography suite using sonographically guided central venous puncture and fluoroscopic guidance of the catheter placement. Procedure time, number of complications (procedure-related immediate, early, and late complications), and number of explantations were assessed. Follow-up was performed for 6 months. All port implantations were successfully completed in both study groups. There were two incidents of skin perforation observed in the control group. One skin perforation occurred 13 weeks and the other 16 weeks after port implantation (incidence, 5%) in patients with regular-profile port systems. Two infections were observed, one port infection in each study group. Both infections were characterized as catheter-related infections (infection rate: 0.15 catheter-related infections per 1000 catheter days). In conclusion, low-profile port systems can be placed as safely as traditional chest ports and reduce the risk of developing skin perforations, which occurs when the port system is too tight within the port pocket.

  4. Higher complication risk of totally implantable venous access port systems in patients with advanced cancer - a single institution retrospective analysis.

    Science.gov (United States)

    Chang, Yi-Fang; Lo, An-Chi; Tsai, Chung-Hsin; Lee, Pei-Yi; Sun, Shen; Chang, Te-Hsin; Chen, Chien-Chuan; Chang, Yuan-Shin; Chen, Jen-Ruei

    2013-02-01

    Totally implantable port systems are generally recommended for prolonged central venous access in diverse settings, but their risk of complications remains unclear for patients with advanced cancer. The aim of this study was to assess the risk of port system failure in patients with advanced cancer. We conducted a retrospective cohort study in a comprehensive cancer centre. A detailed chart review was conducted among 566 patients with 573 ports inserted during January-June, 2009 (average 345.3 catheter-days). Cox regression analysis was applied to evaluate factors during insertion and early maintenance that could lead to premature removal of the port systems due to infection or occlusion. Port system-related infection was significantly associated with receiving palliative care immediately after implantation (hazard ratio, HR = 7.3, 95% confidence interval, 95% CI = 1.2-46.0), after adjusting for probable confounders. Primary cancer site also impacted the occurrence of device-related infection. Receiving oncologic/palliative care (HR = 3.0, P = 0.064), advanced cancer stage (HR = 6.5, P = 0.077) and body surface area above 1.71 m(2) (HR = 3.4, P = 0.029) increased the risk of port system occlusion. Our study indicates that totally implantable port systems yield a higher risk of complications in terminally ill patients. Further investigation should be carefully conducted to compare outcomes of various central venous access devices in patients with advanced cancer and to develop preventive strategies against catheter failure.

  5. Biomechanical evaluation of tibial bone adaptation after revision total knee arthroplasty: A comparison of different implant systems.

    Directory of Open Access Journals (Sweden)

    María Paz Quilez

    Full Text Available The best methods to manage tibial bone defects following total knee arthroplasty remain under debate. Different fixation systems exist to help surgeons reconstruct knee osseous bone loss (such as tantalum cones, cement, modular metal augments, autografts, allografts and porous metaphyseal sleeves However, the effects of the various solutions on the long-term outcome remain unknown. In the present work, a bone remodeling mathematical model was used to predict bone remodeling after total knee arthroplasty (TKA revision. Five different types of prostheses were analyzed: one with a straight stem; two with offset stems, with and without supplements; and two with sleeves, with and without stems. Alterations in tibia bone density distribution and implant Von Mises stresses were quantified. In all cases, the bone density decreased in the proximal epiphysis and medullary channels, and an increase in bone density was predicted in the diaphysis and around stem tips. The highest bone resorption was predicted for the offset prosthesis without the supplement, and the highest bone formation was computed for the straight stem. The highest Von Mises stress was obtained for the straight tibial stem, and the lowest was observed for the stemless metaphyseal sleeves prosthesis. The computational model predicted different behaviors among the five systems. We were able to demonstrate the importance of choosing an adequate revision system and that in silico models may help surgeons choose patient-specific treatments.

  6. Peripherally Placed Totally Implantable Venous-access Port Systems of the Forearm: Clinical Experience in 763 Consecutive Patients

    International Nuclear Information System (INIS)

    Goltz, Jan P.; Scholl, Anne; Ritter, Christian O.; Wittenberg, Guenther; Hahn, Dietbert; Kickuth, Ralph

    2010-01-01

    The aim of this study is to evaluate the effectiveness and safety of percutaneously placed totally implantable venous-access ports (TIVAPs) of the forearm. Between January 2006 and October 2008, peripheral TIVAPs were implanted in 763 consecutive patients by ultrasound and fluoroscopic guidance. All catheters were implanted under local anesthesia and were tunneled subcutaneously. Indication, technical success, and complications were retrospectively analyzed according to Society of Interventional Radiology (SIR) criteria. Presence of antibiotic prophylaxis, periprocedurally administered drugs (e.g., sedation), and laboratory results at the time of implantation were analyzed. Maintenance during the service interval was evaluated. In total, 327,499 catheter-days were analyzed. Technical success rate was 99.3%. Reasons for initial failure of implantation were either unexpected thrombosis of the subclavian vein, expanding tumor mass of the mediastinum, or failure of peripheral venous access due to fragile vessels. Mean follow-up was 430 days. There were 115 complications observed (15.1%, 0.03 per 100 catheter-days), of which 33 (4.3%) were classified as early (within 30 days from implantation) and 82 (10.7%) as late. Catheter-related venous thrombosis was found in 65 (8.5%) of 763 (0.02 per 100 catheter-days) TIVAPs. Infections were observed in 41 (5.4%) of 763 (0.01 per 100 catheter-days) devices. Other complications observed included dislocation of the catheter tip (0.8%), occlusion (0.1%), or rupture (0.1%) of the port catheter. Dislocated catheters were corrected during a second interventional procedure. In conclusion, implantation of percutaneously placed peripheral TIVAPs shows a high technical success rate and low risk of early complications when ultrasound and fluoroscopic guidance are used. Late complications are observed three times as often as early complications.

  7. Development and evaluation of totally implantable ventricular assist system using a vibrating flow pump and transcutaneous energy transmission system with amorphous fibers.

    Science.gov (United States)

    Yambe, T; Hashimoto, H; Kobayashi, S; Sonobe, T; Naganuma, S; Nanka, S S; Matsuki, H; Yoshizawa, M; Tabayashi, K; Takayasu, H; Takeda, H; Nitta, S

    1997-01-01

    We have developed a vibrating flow pump (VFP) that can generate oscillated blood flow with a relatively high frequency (10-50 Hz) for a totally implantable ventricular assist system (VAS). To evaluate the newly developed VAS, left heart bypasses, using the VFP, were performed in chronic animal experiments. Hemodynamic parameters were recorded in a data recorder in healthy adult goats during an awake condition and analyzed in a personal computer system through an alternating-direct current converter. Basic performance of the total system with a transcutaneous energy transmission system were satisfactory. During left ventricular assistance with the VFP, Mayer wave fluctuations of hemodynamics were decreased in the power spectrum, the fractal dimensions of the hemodynamics were significantly decreased, and peripheral vascular resistance was significantly decreased. These results suggest that cardiovascular regulatory nonlinear dynamics, which mediate the hemodynamics, may be affected by left ventricular bypass with oscillated flow. The decreased power of the Mayer wave in the spectrum caused the limit cycle attractor of the hemodynamics and decreased peripheral resistance. These results suggest that this newly developed VAS is useful for the totally implantable system with unique characteristics that can control hemodynamic properties.

  8. Sobredentadura total superior implantosoportada Superior total overdenture on implants

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.This is the case of a total maxilla edentulous patient seen in consultation of the "Pedro Ortíz" Clinic Implant of Habana del Este municipality in 2009 and con rehabilitation by prosthesis over osteointegration implants added to stomatology practice in Cuba as an alternative to conventional treatment in patients totally edentulous. We follow a protocol including a surgery or surgical phase, technique without or with flap creation and early or immediate load. This is a male patient aged 56 came to our multidisciplinary consultation worried because he had three prostheses in last two years and any fulfilled the requirements of retention to feel safe and comfortable with prostheses. The final result was the total satisfaction of rehabilitated patient improving its aesthetic and functional quality.

  9. Worldwide experience with a totally subcutaneous implantable defibrillator

    DEFF Research Database (Denmark)

    Lambiase, Pier D; Barr, Craig; Theuns, Dominic A M J

    2014-01-01

    AIMS: The totally subcutaneous implantable-defibrillator (S-ICD) is a new alternative to the conventional transvenous ICD system to minimize intravascular lead complications. There are limited data describing the long-term performance of the S-ICD. This paper presents the first large internationa...

  10. [A totally implantable venous access device. Implantation in general or local anaesthesia? A retrospective cost analysis].

    Science.gov (United States)

    Schuld, J; Richter, S; Moussavian, M R; Kollmar, O; Schilling, M K

    2009-08-01

    Implantation of venous access port systems can be performed in local or general anesthesia. In spite of the increasing rate of interventionally implanted systems, the surgical cut-down represents a safe alternative. Thus, the question arises whether--in context to the increasing health-economic pressure--open implantation in general anesthesia is still a feasible alternative to implantation in local anesthesia regarding OR efficiency and costs. In a retrospective analysis, 993 patients receiving a totally implantable venous access device between 2001 and 2007 were evaluated regarding OR utilization, turnover times, intraoperative data and costs. Implantations in local (LA) and general anesthesia (GA) were compared. GA was performed in 762 cases (76.6 %), LA was performed in 231 patients (23.3 %). Mean operation time was similar in both groups (LA 47.27 +/- 1.40 min vs. GA 45.41 +/- 0.75 min, p = 0.244). Patients receiving local anesthesia had a significantly shorter stay in the OR unit (LA 95.9 +/- 1.78 min vs. GA 105.92 +/- 0.92 min; p cut (LA 39.57 +/- 0.69 min vs. GA 50.46 +/- 0.52 min; p material costs were significantly lower in the LA group compared with the GA group (LA: 400.72 +/- 8.25 euro vs. GA: 482.86 +/- 6.23 euro; p systems in local anesthesia is superior in comparison to the implantation under general anesthesia regarding procedural times in the OR unit and costs. With the same operation duration, but less personnel and material expenditure, implantation in local anesthesia offers a potential economic advantage by permitting faster changing times. Implantation in GA only should be performed at a special request by the patient or in difficult venous conditions. Georg Thieme Verlag Stuttgart.New York.

  11. Ion implantation control system

    International Nuclear Information System (INIS)

    Gault, R. B.; Keutzer, L. L.

    1985-01-01

    A control system is disclosed for an ion implantation system of the type in which the wafers to be implanted are mounted around the periphery of a disk which rotates and also moves in a radial direction relative to an ion beam to expose successive sections of each wafer to the radiation. The control system senses beam current which passes through one or more apertures in the disk and is collected by a Faraday cup. This current is integrated to obtain a measure of charge which is compared with a calculated value based upon the desired ion dosage and other parameters. The resultant controls the number of incremental steps the rotating disk moves radially to expose the adjacent sections of each wafer. This process is continued usually with two or more traverses until the entire surface of each wafer has been implanted with the proper ion dosage

  12. Surgeons' Perspectives on Premium Implants in Total Joint Arthroplasty.

    Science.gov (United States)

    Wasterlain, Amy S; Bello, Ricardo J; Vigdorchik, Jonathan; Schwarzkopf, Ran; Long, William J

    2017-09-01

    Declining total joint arthroplasty reimbursement and rising implant prices have led many hospitals to restrict access to newer, more expensive total joint arthroplasty implants. The authors sought to understand arthroplasty surgeons' perspectives on implants regarding innovation, product launch, costs, and cost-containment strategies including surgeon gain-sharing and patient cost-sharing. Members of the International Congress for Joint Reconstruction were surveyed regarding attitudes about implant technology and costs. Descriptive and univariate analyses were performed. A total of 126 surgeons responded from all 5 regions of the United States. Although 76.9% believed new products advance technology in orthopedics, most (66.7%) supported informing patients that new implants lack long-term clinical data and restricting new implants to a small number of investigators prior to widespread market launch. The survey revealed that 66.7% would forgo gain-sharing incentives in exchange for more freedom to choose implants. Further, 76.9% believed that patients should be allowed to pay incremental costs for "premium" implants. Surgeons who believed that premium products advance orthopedic technology were more willing to forgo gain-sharing (P=.040). Surgeons with higher surgical volume (P=.007), those who believed implant companies should be allowed to charge more for new technology (Pnew implants with patients. Many surgeons support alternative payment models permitting surgeons and patients to retain implant selection autonomy. Most respondents prioritized patient beneficence and surgeon autonomy above personal financial gain. [Orthopedics. 2017; 40(5):e825-e830.]. Copyright 2017, SLACK Incorporated.

  13. Hip Implant Systems

    Science.gov (United States)

    ... Implants and Prosthetics Metal-on-Metal Hip Implants Hip Implants Share Tweet Linkedin Pin it More sharing options Linkedin Pin it Email Print Hip implants are medical devices intended to restore mobility ...

  14. Systemic Assessment of Patients Undergoing Dental Implant ...

    African Journals Online (AJOL)

    Background: Procedure‑related and patient‑related factors influence the prognosis of dental implants to a major extent. Hence, we aimed to evaluate and analyze various systemic factors in patients receiving dental implants. Materials and Methods: Fifty‑one patients were included in the study, in which a total of 110 dental ...

  15. Total Artificial Heart Implantation Blood Pressure Management as Resolving Treatment for Massive Hemolysis following Total Artificial Heart Implantation.

    Science.gov (United States)

    Ghodsizad, Ali; Koerner, Michael M; El-Banayosy, A; Zeriouh, Mohamed; Ruhparwar, Arjang; Loebe, Matthias

    2016-10-21

    The SynCardia Total Artificial Heart (TAH) has been used for patients with biventricular failure, who cannot be managed with implantation of a left ventricular (LV) assist device. Following TAH implantation, our patient developed severe hemolysis, which could only be managed successfully by aggressive blood pressure control [Ohashi 2003; Nakata 1998].

  16. Implant survival after total elbow arthroplasty

    DEFF Research Database (Denmark)

    Plaschke, Hans Christian; Thillemann, Theis M; Brorson, Stig

    2014-01-01

    in 234 patients at a mean follow-up of 8.7 years (range, 0-27 years). The overall 5-year survival was 90% (95% confidence interval [CI], 88%-94%), and 10-year survival was 81% (95% CI, 76%-86%). TEAs performed with the unlinked design had a relative risk of revision of 1.9 (95% CI, 1.1-3.2) compared...... was to evaluate implant survival and risk factors for revision of TEAs inserted in patients in the eastern part of Denmark in the period from 1980 until 2008. MATERIAL AND METHODS: The Danish National Patient Register provided personal identification numbers for patients who underwent TEA procedures from 1980...

  17. Two-stage implant systems.

    Science.gov (United States)

    Fritz, M E

    1999-06-01

    Since the advent of osseointegration approximately 20 years ago, there has been a great deal of scientific data developed on two-stage integrated implant systems. Although these implants were originally designed primarily for fixed prostheses in the mandibular arch, they have been used in partially dentate patients, in patients needing overdentures, and in single-tooth restorations. In addition, this implant system has been placed in extraction sites, in bone-grafted areas, and in maxillary sinus elevations. Often, the documentation of these procedures has lagged. In addition, most of the reports use survival criteria to describe results, often providing overly optimistic data. It can be said that the literature describes a true adhesion of the epithelium to the implant similar to adhesion to teeth, that two-stage implants appear to have direct contact somewhere between 50% and 70% of the implant surface, that the microbial flora of the two-stage implant system closely resembles that of the natural tooth, and that the microbiology of periodontitis appears to be closely related to peri-implantitis. In evaluations of the data from implant placement in all of the above-noted situations by means of meta-analysis, it appears that there is a strong case that two-stage dental implants are successful, usually showing a confidence interval of over 90%. It also appears that the mandibular implants are more successful than maxillary implants. Studies also show that overdenture therapy is valid, and that single-tooth implants and implants placed in partially dentate mouths have a success rate that is quite good, although not quite as high as in the fully edentulous dentition. It would also appear that the potential causes of failure in the two-stage dental implant systems are peri-implantitis, placement of implants in poor-quality bone, and improper loading of implants. There are now data addressing modifications of the implant surface to alter the percentage of

  18. Implantation of total body irradiation in radiotherapy

    International Nuclear Information System (INIS)

    Habitzreuter, Angela Beatriz

    2010-01-01

    Before implementing a treatment technique, the characteristics of the beam under irradiation conditions must be well acknowledged and studied. Each one of the parameters used to calculate the dose has to be measured and validated before its utilization in clinical practice. This is particularly necessary when dealing with special techniques. In this work, all necessary parameters and measurements are described for the total body irradiation implementation in facilities designed for conventional treatments that make use of unconventional geometries to generate desired enlarged field sizes. Furthermore, this work presents commissioning data of this modality at Hospital das Clinicas of Sao Paulo using comparison of three detectors types for measurements of entrance dose during total body irradiation treatment. (author)

  19. Totally implantable venous catheters for chemotherapy: experience in 500 patients

    Directory of Open Access Journals (Sweden)

    Nelson Wolosker

    Full Text Available CONTEXT: Totally implantable devices are increasingly being utilized for chemotherapy treatment of oncological patients, although few studies have been done in our environment to analyze the results obtained from the implantation and utilization of such catheters. OBJECTIVE: To study the results obtained from the implantation of totally implantable catheters in patients submitted to chemotherapy. TYPE OF STUDY: Prospective. SETTING: Hospital do Câncer A.C. Camargo, São Paulo, Brazil. METHODS: 519 totally implantable catheters were placed in 500 patients submitted to chemotherapy, with preference for the use of the right external jugular vein. Evaluations were made of the early and late-stage complications and patient evolution until removal of the device, death or the end of the treatment. RESULTS: The prospective analysis showed an average duration of 353 days for the catheters. There were 427 (82.2% catheters with no complications. Among the early complications observed, there were 15 pathway hematomas, 8 cases of thrombophlebitis of the distal stump of the external jugular vein and one case of pocket infection. Among the late-stage complications observed, there were 43 infectious complications (0.23/1000 days of catheter use, 11 obstructions (0.06/1000 days of catheter use and 14 cases of deep vein thrombosis (0.07/1000 days of catheter use. Removal of 101 catheters was performed: 35 due to complications and 66 upon terminating the treatment. A total of 240 patients died while the catheter was functioning and 178 patients are still making use of the catheter. CONCLUSION: The low rate of complications obtained in this study confirms the safety and convenience of the use of totally implantable accesses in patients undergoing prolonged chemotherapy regimes.

  20. Total artificial heart implantation in a young Marfan syndrome patient.

    Science.gov (United States)

    Rao, Prashant; Keenan, Jack B; Rajab, Taufiek K; Kim, Samuel; Smith, Richard; Amabile, Orazio; Khalpey, Zain

    2018-03-01

    Cardiovascular complications represent the leading cause of morbidity and mortality in patients with Marfan syndrome. Here, we describe a unique case where a total artificial heart was implanted in a young Marfan syndrome woman. A 22-year-old postpartum African American female with Marfan syndrome developed multiple severe valve dysfunction and biventricular failure that was refractory to medical management. She previously had a Bentall procedure for Type A aortic dissection and repair of a Type B dissection. We implanted a total artificial heart with a good outcome. Total artificial heart is a durable option for severe biventricular failure and multiple valvular dysfunction as a bridge to transplant in a young patient with Marfan syndrome.

  1. Does the Implantation Technique for Totally Implantable Venous Access Ports (TIVAPs) Influence Long-Term Outcome?

    Science.gov (United States)

    Biacchi, Daniele; Sammartino, Paolo; Sibio, Simone; Accarpio, Fabio; Cardi, Maurizio; Sapienza, Paolo; De Cesare, Alessandro; Atta, Joseph Maher Fouad; Impagnatiello, Alessio; Di Giorgio, Angelo

    2016-02-01

    Totally implantable venous access ports (TIVAP) are eventually explanted for various reasons, related or unrelated to the implantation technique used. Having more information on long-term explantation would help improve placement techniques. From a series of 1572 cancer patients who had TIVAPs implanted in our center with the cutdown technique or Seldinger technique, we studied the 542 patients who returned to us to have their TIVAP explanted after 70 days or more. As outcome measures we distinguished between TIVAPs explanted for long-term complications (infection, catheter-, reservoir-, and patient-related complications) and TIVAPs no longer needed. Univariate and multivariate analyses were run to investigate the reasons for explantation and their possible correlation with implantation techniques. The most common reason for explantation was infection (47.6 %), followed by catheter-related (20.8 %), patient-related (14.7 %), and reservoir-related complications (4.7 %). In the remaining 12.2 % of cases, the TIVAP was explanted complication free after the planned treatments ended. Infection correlated closely with longer TIVAP use. Univariate and multivariate analyses identified the Seldinger technique as a major risk factor for venous thrombosis and catheter dislocation. The need for long-term TIVAP explantation in about one-third of cancer patients is related to the implantation techniques used.

  2. [Total cervical disk replacement--implant-specific approaches: keel implant (Prodisc-C intervertebral disk prosthesis)].

    Science.gov (United States)

    Korge, Andreas; Siepe, Christoph J; Heider, Franziska; Mayer, H Michael

    2010-11-01

    Dynamic intervertebral support of the cervical spine via an anterolateral approach using a modular artificial disk prosthesis with end-plate fixation by central keel fixation. Cervical median or mediolateral disk herniations, symptomatic cervical disk disease (SCDD) with anterior osseous, ligamentous and/or discogenic narrowing of the spinal canal. Cervical fractures, tumors, osteoporosis, arthrogenic neck pain, severe facet degeneration, increased segmental instability, ossification of posterior longitudinal ligament (OPLL), severe osteopenia, acute and chronic systemic, spinal or local infections, systemic and metabolic diseases, known implant allergy, pregnancy, severe adiposity (body mass index > 36 kg/m2), reduced patient compliance, alcohol abuse, drug abuse and dependency. Exposure of the anterior cervical spine using the minimally invasive anterolateral approach. Intervertebral fixation of retainer screws. Intervertebral diskectomy. Segmental distraction with vertebral body retainer and vertebral distractor. Removal of end-plate cartilage. Microscopically assisted decompression of spinal canal. Insertion of trial implant to determine appropriate implant size, height and position. After biplanar image intensifier control, drilling for keel preparation using drill guide and drill bit, keel-cut cleaner to remove bone material from the keel cut, radiologic control of depth of the keel cut using the corresponding position gauge. Implantation of original implant under lateral image intensifier control. Removal of implant inserter. Functional postoperative care and mobilization without external support, brace not used routinely, soft brace possible for 14 days due to postoperative pain syndromes. Implantation of 100 cervical Prodisc-C disk prostheses in 78 patients (average age 48 years) at a single center. Clinical and radiologic follow-up 24 months postoperatively. Significant improvement based on visual analog scale and Neck Disability Index. Radiologic

  3. Total Artificial Heart Implantation after Excision of Right Ventricular Angiosarcoma.

    Science.gov (United States)

    Bruckner, Brian A; Abu Saleh, Walid K; Al Jabbari, Odeaa; Copeland, Jack G; Estep, Jerry D; Loebe, Matthias; Reardon, Michael J

    2016-06-01

    Primary cardiac sarcomas, although rare, are aggressive and lethal, requiring thorough surgical resection and adjuvant chemotherapy for the best possible outcome. We report the case of a 32-year-old woman who underwent total artificial heart implantation for right-sided heart failure caused by right ventricular angiosarcoma. For the first several weeks in intensive care, the patient recovered uneventfully. However, a postoperative liver biopsy indicated hepatocellular injury consistent with preoperative chemotherapy. She developed continuing liver failure, from which she died despite good cardiac function.

  4. Reverse Engineering Nature to Design Biomimetic Total Knee Implants.

    Science.gov (United States)

    Varadarajan, Kartik Mangudi; Zumbrunn, Thomas; Rubash, Harry E; Malchau, Henrik; Muratoglu, Orhun K; Li, Guoan

    2015-10-01

    While contemporary total knee arthroplasty (TKA) provides tremendous clinical benefits, the normal feel and function of the knee is not fully restored. To address this, a novel design process was developed to reverse engineer "biomimetic" articular surfaces that are compatible with normal soft-tissue envelope and kinematics of the knee. The biomimetic articular surface is created by moving the TKA femoral component along in vivo kinematics of normal knees and carving out the tibial articular surface from a rectangular tibial block. Here, we describe the biomimetic design process. In addition, we utilize geometric comparisons and kinematic simulations to show that; (1) tibial articular surfaces of conventional implants are fundamentally incompatible with normal knee motion, and (2) the anatomic geometry of the biomimetic surface contributes directly to restoration of normal knee kinematics. Such biomimetic implants may enable us to achieve the long sought after goal of a "normal" knee post-TKA surgery. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Implant retention systems for implant-retained overdentures.

    Science.gov (United States)

    Laverty, D P; Green, D; Marrison, D; Addy, L; Thomas, M B M

    2017-03-10

    Implant retained overdentures are being increasingly utilised in both general and specialist practice to rehabilitate patients with missing teeth, particularly those that are edentate. This article aims to inform the reader of a variety of retention systems that are available to retain an implant overdenture and to understand how these systems work, their advantages and disadvantages and to outline some of the clinical and treatment planning considerations involved in selecting the most appropriate retention system for patients.

  6. Total System Performance Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Yong Soo; Kang, Chul Hyung; Lee, Youn Myoung; Han, Ji Woong; Choi, Jong Won; Hahn, Pil Soo; Park, Jeong Hwa; Jeong, Mi Seon

    2007-06-15

    Based on the KAERI FEP list developed through the previous studies, the KAERI FEP Encyclopedia has been developed. Current version is 1.0 which includes all relevant FEPs to compose of two references and all alternative scenarios. Many interaction FEPs between scenario defining FEP(SDF) are created throughout the study. FEPs are classified into many Integrated FEP(IFEP) which eventually become the elements of the RES matrix. The FEAS program one of the component of the KAERI's CYPRUS information system is added to develop the FEP, RES, AC, AMF and finally scenarios. It assists to create transparent way to deal with assessment from the stage of the planning of the R and D to the final stage of the external audit and regulatory body review. Even though MASCOT-K and compartment analysis codes such as AMBER, GoldSim and Ecolego are excellent for TSPA they by in heritage possess a certain limitation especially to identify a proper migration cross sectional area when a relatively big component intersects with a tiny one such as a fracture. It is truly 3D phenomena in nature. MDPSA code is developed which is expected to overcome limitations in compartment models while successfully deals with natural disruptive events. The R and D target for the TSPA is to develop the sufficient scenarios and their variation cases to understand the safety of KRS in every possible aspect. For this, reference scenarios, alternative scenarios covering engineered barrier failure and natural events are developed and assessed respectively for around 100 cases. The stylized template to assess the Korean reference biosphere is developed using the AMBER. Three critical groups, agricultural, freshwater and marine water fishing groups are identified to assess the DCF following the guidelines of ICRP. Based on the QA principles of T2R3, the web based QA system is developed using the procedures in the USNRC 10CFR50 Appendix B. The QA system is combined with the PAID and FEAS to create the comprehensive

  7. Total System Performance Assessment

    International Nuclear Information System (INIS)

    Hwang, Yong Soo; Kang, Chul Hyung; Lee, Youn Myoung; Han, Ji Woong; Choi, Jong Won; Hahn, Pil Soo; Park, Jeong Hwa; Jeong, Mi Seon

    2007-06-01

    Based on the KAERI FEP list developed through the previous studies, the KAERI FEP Encyclopedia has been developed. Current version is 1.0 which includes all relevant FEPs to compose of two references and all alternative scenarios. Many interaction FEPs between scenario defining FEP(SDF) are created throughout the study. FEPs are classified into many Integrated FEP(IFEP) which eventually become the elements of the RES matrix. The FEAS program one of the component of the KAERI's CYPRUS information system is added to develop the FEP, RES, AC, AMF and finally scenarios. It assists to create transparent way to deal with assessment from the stage of the planning of the R and D to the final stage of the external audit and regulatory body review. Even though MASCOT-K and compartment analysis codes such as AMBER, GoldSim and Ecolego are excellent for TSPA they by in heritage possess a certain limitation especially to identify a proper migration cross sectional area when a relatively big component intersects with a tiny one such as a fracture. It is truly 3D phenomena in nature. MDPSA code is developed which is expected to overcome limitations in compartment models while successfully deals with natural disruptive events. The R and D target for the TSPA is to develop the sufficient scenarios and their variation cases to understand the safety of KRS in every possible aspect. For this, reference scenarios, alternative scenarios covering engineered barrier failure and natural events are developed and assessed respectively for around 100 cases. The stylized template to assess the Korean reference biosphere is developed using the AMBER. Three critical groups, agricultural, freshwater and marine water fishing groups are identified to assess the DCF following the guidelines of ICRP. Based on the QA principles of T2R3, the web based QA system is developed using the procedures in the USNRC 10CFR50 Appendix B. The QA system is combined with the PAID and FEAS to create the comprehensive

  8. Total System Performance Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Yong Soo; Kang, Chul Hyung; Lee, Youn Myoung; Han, Ji Woong; Choi, Jong Won; Hahn, Pil Soo; Park, Jeong Hwa; Jeong, Mi Seon

    2007-06-15

    Based on the KAERI FEP list developed through the previous studies, the KAERI FEP Encyclopedia has been developed. Current version is 1.0 which includes all relevant FEPs to compose of two references and all alternative scenarios. Many interaction FEPs between scenario defining FEP(SDF) are created throughout the study. FEPs are classified into many Integrated FEP(IFEP) which eventually become the elements of the RES matrix. The FEAS program one of the component of the KAERI's CYPRUS information system is added to develop the FEP, RES, AC, AMF and finally scenarios. It assists to create transparent way to deal with assessment from the stage of the planning of the R and D to the final stage of the external audit and regulatory body review. Even though MASCOT-K and compartment analysis codes such as AMBER, GoldSim and Ecolego are excellent for TSPA they by in heritage possess a certain limitation especially to identify a proper migration cross sectional area when a relatively big component intersects with a tiny one such as a fracture. It is truly 3D phenomena in nature. MDPSA code is developed which is expected to overcome limitations in compartment models while successfully deals with natural disruptive events. The R and D target for the TSPA is to develop the sufficient scenarios and their variation cases to understand the safety of KRS in every possible aspect. For this, reference scenarios, alternative scenarios covering engineered barrier failure and natural events are developed and assessed respectively for around 100 cases. The stylized template to assess the Korean reference biosphere is developed using the AMBER. Three critical groups, agricultural, freshwater and marine water fishing groups are identified to assess the DCF following the guidelines of ICRP. Based on the QA principles of T2R3, the web based QA system is developed using the procedures in the USNRC 10CFR50 Appendix B. The QA system is combined with the PAID and FEAS to create the

  9. Poorer survival after a primary implant during revision total knee arthroplasty

    NARCIS (Netherlands)

    Meijer, Marrigje F.; Reininga, Inge H. F.; Boerboom, Alexander L.; Stevens, Martin; Bulstra, Sjoerd K.

    Revision total knee arthroplasty (rTKA) is a complex procedure. Depending on the degree of ligament and bone damage, either primary or revision implants are used. The purpose of this study was to compare survival rates of primary implants with revision implants when used during rTKA. A retrospective

  10. A new system of implant abutment connection: how to improve a two piece implant system sealing.

    Science.gov (United States)

    Grecchi, F; DI Girolamo, M; Cura, F; Candotto, V; Carinci, F

    2017-01-01

    Implant dentistry has become one of the most successful dentistry techniques for replacing missing teeth. The success rate of implant dentistry is above 80%. However, peri-implantitis is a later complication of implant dentistry that if untreated, can lead to implant loss. One of the hypotized causes of peri-implantis is the bacterial leakage at the level of implant-abutment connection. Bacterial leakage is favored to the presence of a micro gap at the implant-abutment interface, allowing microorganisms to penetrate and colonize the inner part of the implant leading to biofilm accumulation and consequently to peri-implantitis development. To identify the capability of the implant to protect the internal space from the external environment, the passage of genetically modified Escherichia coli across implant-abutment interface was evaluated. Implants were immerged in a bacterial culture for twenty-four hours and then bacteria amount was measured inside implant-abutment interface with Real-time PCR. Bacteria were detected inside all studied implants, with a median percentage of 9%. The reported results are better to those of previous studies carried out on different implant systems. Until now, none implant-abutment system has been proven to seal the gap between implant and abutment.

  11. The Biolink Implantable Telemetry System

    Science.gov (United States)

    Betancourt-Zamora, Rafael J.

    1999-01-01

    Most biotelemetry applications deal with the moderated data rates of biological signals. Few people have studied the problem of transcutaneous data transmission at the rates required by NASA's Life Sciences-Advanced BioTelemetry System (LS-ABTS). Implanted telemetry eliminate the problems associated with wire breaking the skin, and permits experiments with awake and unrestrained subjects. Our goal is to build a low-power 174-216MHz Radio Frequency (RF) transmitter suitable for short range biosensor and implantable use. The BioLink Implantable Telemetry System (BITS) is composed of three major units: an Analog Data Module (ADM), a Telemetry Transmitter Module (TTM), and a Command Receiver Module (CRM). BioLink incorporates novel low-power techniques to implement a monolithic digital RF transmitter operating at 100kbps, using quadrature phase shift keying (QPSK) modulation in the 174-216MHz ISM band. As the ADM will be specific for each application, we focused on solving the problems associated with a monolithic implementation of the TTM and CRM, and this is the emphasis of this report. A system architecture based on a Frequency-Locked Loop (FLL) Frequency Synthesizer is presented, and a novel differential frequency that eliminates the need for a frequency divider is also shown. A self sizing phase modulation scheme suitable for low power implementation was also developed. A full system-level simulation of the FLL was performed and loop filter parameters were determined. The implantable antenna has been designed, simulated and constructed. An implant package compatible with the ABTS requirements is also being proposed. Extensive work performed at 200MHz in 0.5um complementary metal oxide semiconductors (CMOS) showed the feasibility of integrating the RF transmitter circuits in a single chip. The Hajimiri phase noise model was used to optimize the Voltage Controlled Oscillator (VCO) for minimum power consumption. Two test chips were fabricated in a 0.5pm, 3V CMOS

  12. Patient satisfaction with maxillary 3-implant overdentures using different attachment systems opposing mandibular 2-implant overdentures.

    Science.gov (United States)

    Al-Zubeidi, Mohammed I; Alsabeeha, Nabeel H M; Thomson, W Murray; Payne, Alan G T

    2012-05-01

    Patient-based outcomes with maxillary overdentures on a minimum number of implants, opposing mandibular 2-implant overdentures are not evident in the literature. To evaluate patient's satisfaction with maxillary 3-implant overdentures, opposing mandibular 2-implant overdentures, using two different attachment systems over the first 2 years of service. Forty participants wearing mandibular 2-implant overdentures for 3 years were randomly allocated to one of two similar implant system groups to receive maxillary 3-implant overdentures. Twenty participants were allocated to splinted and unsplinted attachment system treatment groups for each system. Patient satisfaction with pre-treatment complete maxillary dentures, with maxillary 3-implant overdentures at baseline and annually for 2 years, was measured using visual analogue scale questionnaires and the oral health impact profiles. Palatal coverage of the maxillary overdentures was reduced at the first annual recall. Data showed significant improvement in pain reduction, comfort, stability, and function variables of the visual analogue scale after treatment. Analysis by prosthodontic design using visual analogue scale showed no significant difference. The total oral health impact profile-14 scores after treatment for all participants, regardless of prosthodontic design, were significantly lower (more satisfied). The overall oral health impact profile-20E score at baseline was significantly higher (more satisfied) compared with pre-treatment conventional maxillary dentures. No significant changes were observed in the first or second years compared with baseline results. Twenty-two participants (84.6%) preferred reduced palatal coverage, regardless of prosthodontic design, after 1 year. Twenty participants (76.9%) still preferred reduced palatal coverage at the end of the second year. The provision of maxillary 3-implant overdentures to oppose mandibular 2-implant overdentures significantly improve levels of patient

  13. Systemic assessment of patients undergoing dental implant surgeries: A trans- and post-operative analysis

    OpenAIRE

    Sanjay Byakodi; Sachin Kumar; Rajesh Kumar Reddy; Vipin Kumar; Shipra Sepolia; Shivangi Gupta; Harkanwal Preet Singh

    2017-01-01

    Background: Procedure-related and patient-related factors influence the prognosis of dental implants to a major extent. Hence, we aimed to evaluate and analyze various systemic factors in patients receiving dental implants. Materials and Methods: Fifty-one patients were included in the study, in which a total of 110 dental implants were placed. Complete examination of the subjects was done before and after placement of dental implants. Implant surgery was planned, and osseointegrated dental i...

  14. Modified cementless total coxofemoral prosthesis: development, implantation and clinical evaluation

    Directory of Open Access Journals (Sweden)

    S.A. Arias

    2013-12-01

    Full Text Available The aim of this study was to modify canine coxofemoral prostheses and the clinical evaluation of the implantation. Fifteen canine hips and femora of cadavers were used in order to study the surface points of modification in prostheses and develop a perforation guide. Femoral stems and acetabular components were perforated and coated with biphasic calcium phosphate layer. Twelve young adult male mongrel dogs were implanted with coxofemoral prostheses. Six were operated upon and implanted with cemented canine modular hip prostheses, establishing the control group. The remaining six were implanted with a novel design of cementless porous tricalcic phosphate-hydroxyapatite coated hip prostheses. Clinical and orthopedic performance, complications, and thigh muscular hypotrophy were assessed up to the 120th post-operatory day. After 120 days, animals with cementless prostheses had similar clinical and orthopedic performance compared to the cemented group despite the increased pain thigh hypotrophy. Animals that underwent cementless hip prosthesis evidenced more pain, compared to animals with cemented hip prosthesis that required longer recuperation time. No luxations, two fractures and two isquiatic neurapraxies were identified in the course of the study. Using both the cemented and the bioactive coated cementless model were suitable to dogs, showing clinical satisfactory results. Osseointegration and biological fixation were observed in the animals with the modified cementless hip prosthesis.

  15. Electromagnetic Compatibility of Transcutaneous Energy Transmission Systemfor Totally Implantable Artificial Heart

    Science.gov (United States)

    Shiba, Kenji; Koshiji, Kohji

    Transcutaneous Energy Transmission (TET) is one way of providing the energy needed to power a totally implantable artificial heart (TIAH). In the present study, an externally coupled TET system was implanted in a prototype human phantom to evaluate emission and immunity. In the emission evaluation, measurements were conducted based on CISPR Pub.11 and VDE 0871 standards, while immunity tests were based on the standards of the IEC 61000-4 series. The magnetic field of the radiated emission was measured using a loop antenna. At 0.1[MHz], we found the greatest magnetic field of 47.8 [dBμA/m], somewhat less than CISPR’s upper limit of 54 [dBμA/m]. For the conducted emission, by installing a noise filter and ferrite beads in the input section of the DC-power supply, conducted emission could be kept within the allowable limits of CISPR Pub.11 and VDE 0871. Finally, the immunity tests against radiated and conducted emission, electrostatic discharge and voltage fluctuation proved that the prototype could withstand the maximum level of disturbance. These results confirmed that the TET system implanted in a human phantom could, through modification, meet the emission and immunity standards.

  16. Moderate hypothermia technique for chronic implantation of a total artificial heart in calves.

    Science.gov (United States)

    Karimov, Jamshid H; Grady, Patrick; Sinkewich, Martin; Sunagawa, Gengo; Dessoffy, Raymond; Byram, Nicole; Moazami, Nader; Fukamachi, Kiyotaka

    2017-06-01

    The benefit of whole-body hypothermia in preventing ischemic injury during cardiac surgical operations is well documented. However, application of hypothermia during in vivo total artificial heart implantation has not become widespread because of limited understanding of the proper techniques and restrictions implied by constitutional and physiological characteristics specific to each animal model. Similarly, the literature on hypothermic set-up in total artificial heart implantation has also been limited. Herein we present our experience using hypothermia in bovine models implanted with the Cleveland Clinic continuous-flow total artificial heart.

  17. Precision of fit between implant impression coping and implant replica pairs for three implant systems.

    Science.gov (United States)

    Nicoll, Roxanna J; Sun, Albert; Haney, Stephan; Turkyilmaz, Ilser

    2013-01-01

    The fabrication of an accurately fitting implant-supported fixed prosthesis requires multiple steps, the first of which is assembling the impression coping on the implant. An imprecise fit of the impression coping on the implant will cause errors that will be magnified in subsequent steps of prosthesis fabrication. The purpose of this study was to characterize the 3-dimensional (3D) precision of fit between impression coping and implant replica pairs for 3 implant systems. The selected implant systems represent the 3 main joint types used in implant dentistry: external hexagonal, internal trilobe, and internal conical. Ten impression copings and 10 implant replicas from each of the 3 systems, B (Brånemark System), R (NobelReplace Select), and A (NobelActive) were paired. A standardized aluminum test body was luted to each impression coping, and the corresponding implant replica was embedded in a stone base. A coordinate measuring machine was used to quantify the maximum range of displacement in a vertical direction as a function of the tightening force applied to the guide pin. Maximum angular displacement in a horizontal plane was measured as a function of manual clockwise or counterclockwise rotation. Vertical and rotational positioning was analyzed by using 1-way analysis of variance (ANOVA). The Fisher protected least significant difference (PLSD) multiple comparisons test of the means was applied when the F-test in the ANOVA was significant (α=.05). The mean and standard deviation for change in the vertical positioning of impression copings was 4.3 ±2.1 μm for implant system B, 2.8 ±4.2 μm for implant system R, and 20.6 ±8.8 μm for implant system A. The mean and standard deviation for rotational positioning was 3.21 ±0.98 degrees for system B, 2.58 ±1.03 degrees for system R, and 5.30 ±0.79 degrees for system A. The P-value for vertical positioning between groups A and B and between groups A and R was <.001. No significant differences were found for

  18. Quantification of in vivo implant wear in total knee replacement from dynamic single plane radiography

    Science.gov (United States)

    Teeter, Matthew G.; Seslija, Petar; Milner, Jaques S.; Nikolov, Hristo N.; Yuan, Xunhua; Naudie, Douglas D. R.; Holdsworth, David W.

    2013-05-01

    An in vivo method to measure wear in total knee replacements was developed using dynamic single-plane fluoroscopy. A dynamic, anthropomorphic total knee replacement phantom with interchangeable, custom-fabricated components of known wear volume was created, and dynamic imaging was performed. For each frame of the fluoroscopy data, the relative location of the femoral and tibial components were determined, and the apparent intersection of the femoral component with the tibial insert was used to calculate wear volume, wear depth, and frequency of intersection. No difference was found between the measured and true wear volumes. The precision of the measurements was ±39.7 mm3 for volume and ±0.126 mm for wear depth. The results suggest the system is capable of tracking wear volume changes across multiple time points in patients. As a dynamic technique, this method can provide both kinematic and wear measurements that may be useful for evaluating new implant designs for total knee replacements.

  19. Prototype Development of an Implantable Compliance Chamber for a Total Artificial Heart.

    Science.gov (United States)

    Schmitz, Stephanie; Unthan, Kristin; Sedlaczek, Marc; Wald, Felix; Finocchiaro, Thomas; Spiliopoulos, Sotirios; Koerfer, Reiner; Steinseifer, Ulrich

    2017-02-01

    At our institute a total artificial heart is being developed. It is directly actuated by a linear drive in between two ventricles, which comprise membranes to separate the drive and blood flow. A compliance chamber (CC) is needed to reduce pressure peaks in the ventricles and to increase the pump capacity. Therefore, the movement of the membrane is supported by applying a negative pressure to the air volume inside the drive unit. This study presents the development of the implantable CC which is connected to the drive unit of the total artificial hearts (TAH). The anatomical fit of the CC is optimized by analyzing CT data and adapting the outer shape to ensure a proper fit. The pressure peaks are reduced by the additional volume and the flexible membrane of the CC. The validation measurements of change in pressure peaks and flow are performed using the complete TAH system connected to a custom mock circulation loop. Using the CC, the pressure peaks could be damped below 5 mm Hg in the operational range. The flow output was increased by up to 14.8% on the systemic side and 18.2% on the pulmonary side. The described implantable device can be used for upcoming chronic animal trials. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  20. Complication-related removal of totally implantable venous access port systems: Does the interval between placement and first use and the neutropenia-inducing potential of chemotherapy regimens influence their incidence? A four-year prospective study of 4045 patients.

    Science.gov (United States)

    Kakkos, A; Bresson, L; Hudry, D; Cousin, S; Lervat, C; Bogart, E; Meurant, J P; El Bedoui, S; Decanter, G; Hannebicque, K; Regis, C; Hamdani, A; Penel, N; Tresch-Bruneel, E; Narducci, F

    2017-04-01

    Totally implantable venous access port systems are widely used in oncology, with frequent complications that sometimes necessitate device removal. The aim of this study is to investigate the impact of the time interval between port placement and initiation of chemotherapy and the neutropenia-inducing potential of the chemotherapy administered upon complication-related port removal. Between January 2010 and December 2013, 4045 consecutive patients were included in this observational, single-center prospective study. The chemotherapy regimens were classified as having a low (20%) risk for inducing neutropenia. The overall removal rate due to complications was 7.2%. Among them, port-related infection (2.5%) and port expulsion (1%) were the most frequent. The interval between port insertion and its first use was shown to be a predictive factor for complication-related removal rates. A cut-off of 6 days was statistically significant (p = 0.008), as the removal rate for complications was 9.4% when this interval was 0-5 days and 5.7% when it was ≥6 days. Another factor associated with port complication rate was the neutropenia-inducing potential of the chemotherapy regimens used, with removal for complications involved in 5.5% of low-risk regimens versus 9.4% for the intermediate- and high-risk regimens (p = 0.003). An interval of 6 days between placement and first use of the port reduces the removal rate from complications. The intermediate- and high-risk for neutropenia chemotherapy regimens are related to higher port removal rates from complications than low-risk regimens. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  1. Strategies for reducing implant costs in the revision total knee arthroplasty episode of care.

    Science.gov (United States)

    Elbuluk, Ameer M; Old, Andrew B; Bosco, Joseph A; Schwarzkopf, Ran; Iorio, Richard

    2017-12-01

    Implant price has been identified as a significant contributing factor to high costs associated with revision total knee arthroplasty (rTKA). The goal of this study is to analyze the cost of implants used in rTKAs and to compare this pricing with 2 alternative pricing models. Using our institutional database, we identified 52 patients from January 1, 2014 to December 31, 2014. Average cost of components for each case was calculated and compared to the total hospital cost for that admission. Costs for an all-component revision were then compared to a proposed "direct to hospital" (DTH) standardized pricing model and a fixed price revision option. Potential savings were calculated from these figures. On average, 28% of the total hospital cost was spent on implants for rTKA. The average cost for revision of all components was $13,640 and ranged from $3000 to $28,000. On average, this represented 32.7% of the total hospital cost. Direct to hospital implant pricing could potentially save approximately $7000 per rTKA, and the fixed pricing model could provide a further $1000 reduction per rTKA-potentially saving $8000 per case on implants alone. Alternative implant pricing models could help lower the total cost of rTKA, which would allow hospitals to achieve significant cost containment.

  2. Percutaneous dilatational tracheostomy following total artificial heart implantation.

    Science.gov (United States)

    Spiliopoulos, Sotirios; Dimitriou, Alexandros Merkourios; Serrano, Maria Rosario; Guersoy, Dilek; Autschbach, Ruediger; Goetzenich, Andreas; Koerfer, Reiner; Tenderich, Gero

    2015-07-01

    Coagulation disorders and an immune-altered state are common among total artificial heart patients. In this context, we sought to evaluate the safety of percutaneous dilatational tracheostomy in cases of prolonged need for mechanical ventilatory support. We retrospectively analysed the charts of 11 total artificial heart patients who received percutaneous dilatational tracheostomy. We focused on early and late complications. We observed no major complications and no procedure-related deaths. Early minor complications included venous oozing (45.4%) and one case of local infection. Late complications, including subglottic stenosis, stomal infection or infections of the lower respiratory tract, were not observed. In conclusion, percutaneous dilatational tracheostomy in total artificial heart patients is safe. Considering the well-known benefits of early tracheotomy over prolonged translaryngeal intubation, we advocate early timing of therapy in cases of prolonged mechanical ventilation. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  3. Report on the results of the FY 1999 R and D of the medical welfare equipment technology and the development of an implantable total artificial heart system using a non-pulsatile pump. R and D of an implantable total artificial heart system using a non-pulsatile pump (R and D of the functional/cure artificial heart); Iryo fukushi kiki gijutsu no kenkyu kaihatsu tainai umekomigata jinko shinzo system 1999 nendo seika hokokusho. 5. Renzokuryu pump wo mochiita tainai umekomigata jinko shinzo system no kenkyu kaihatsu (kinoteki chiryoteki jinko shinzo no kenkyu kaihatsu)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The R and D of element technology were made on non-pulsatile pump, drive/controller, energy supply storage system, structural coating materials, etc., and the prescribed target was achieved. In the R and D of a total system, a blood-removing conduit with movability was designed to avoid the functional inlet obstruction, and the animal experiment was carried out. In the short-term chronic animal experiment on the implantation of a single bypass model using this artificial conduit and in the animal experiment for implantation of functional/cure artificial heart, it was confirmed that the operation was conducted easily, the flow rate of the blood of the artificial heart is extremely stable, and the blood-removing conduit functions favorably. In the R and D on Tele-TAH with the aim of future home medical treatment, it became possible to acquire via monitor the pump drive information and blood circulation state information on the animals tested in the breeding farm. The remote medical simulation was made. (NEDO)

  4. Total dose hardening of buried insulator in implanted silicon-on-insulator structures

    International Nuclear Information System (INIS)

    Mao, B.Y.; Chen, C.E.; Pollack, G.; Hughes, H.L.; Davis, G.E.

    1987-01-01

    Total dose characteristics of the buried insulator in implanted silicon-on-insulator (SOI) substrates have been studied using MOS transistors. The threshold voltage shift of the parasitic back channel transistor, which is controlled by charge trapping in the buried insulator, is reduced by lowering the oxygen dose as well as by an additional nitrogen implant, without degrading the front channel transistor characteristics. The improvements in the radiation characteristics of the buried insulator are attributed to the decrease in the buried oxide thickness or to the presence of the interfacial oxynitride layer formed by the oxygen and nitrogen implants

  5. Oral bisphosphonate use and total knee/hip implant survival

    DEFF Research Database (Denmark)

    Prieto-Alhambra, Daniel; Lalmohamed, Arief; Abrahamsen, Bo

    2014-01-01

    of disease-modifying antirheumatic drugs as well as patients with rheumatoid arthritis, Paget's disease, or hip fracture. Participants were classified as bisphosphonate users if they had been receiving treatment for ≥6 months. A time-varying exposure was used to avoid immortal time bias. Up to 6...... was conducted within the Danish nationwide registries (5.5 million residents). Using procedure codes of the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, we identified patients age ≥40 years undergoing total joint replacement in 1998-2007. We excluded users...

  6. Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    William D. Bugbee

    2013-01-01

    Full Text Available Customized patient instrumentation (CPI combines preoperative planning with customized cutting jigs to position and align implants during total knee arthroplasty (TKA. We compared postoperative implant alignment of patients undergoing surgery with CPI to traditional TKA instrumentation for accuracy of implant placement. Twenty-five consecutive TKAs using CPI were analyzed. Preoperative CT scans of the lower extremities were segmented using a computer program. Limb alignment and mechanical axis were computed. Virtual implantation of computer-aided design models was done. Postoperative coronal and sagittal view radiographs were obtained. Using 3D image-matching software, relative positions of femoral and tibial implants were determined. Twenty-five TKAs implanted using traditional instrumentation were also analyzed. For CPI, difference in alignment from the preoperative plan was calculated. In the CPI group, the mean absolute difference between the planned and actual femoral placements was 0.67° in the coronal plane and 1.2° in the sagittal plane. For tibial alignment, the mean absolute difference was 0.9° in the coronal plane and 1.3° in the sagittal plane. For traditional instrumentation, difference from ideal placement for the femur was 1.5° in the coronal plane and 2.3° in the sagittal plane. For the tibia, the difference was 1.8° in the coronal plane. CPI achieved accurate implant positioning and was superior to traditional TKA instrumentation.

  7. Choice of implant combinations in total hip replacement: systematic review and network meta-analysis.

    Science.gov (United States)

    López-López, José A; Humphriss, Rachel L; Beswick, Andrew D; Thom, Howard H Z; Hunt, Linda P; Burston, Amanda; Fawsitt, Christopher G; Hollingworth, William; Higgins, Julian P T; Welton, Nicky J; Blom, Ashley W; Marques, Elsa M R

    2017-11-02

    Objective  To compare the survival of different implant combinations for primary total hip replacement (THR). Design  Systematic review and network meta-analysis. Data sources  Medline, Embase, The Cochrane Library, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and the EU Clinical Trials Register. Review methods  Published randomised controlled trials comparing different implant combinations. Implant combinations were defined by bearing surface materials (metal-on-polyethylene, ceramic-on-polyethylene, ceramic-on-ceramic, or metal-on-metal), head size (large ≥36 mm or small meta-analysis for revision. There was no evidence that the risk of revision surgery was reduced by other implant combinations compared with the reference implant combination. Although estimates are imprecise, metal-on-metal, small head, cemented implants (hazard ratio 4.4, 95% credible interval 1.6 to 16.6) and resurfacing (12.1, 2.1 to 120.3) increase the risk of revision at 0-2 years after primary THR compared with the reference implant combination. Similar results were observed for the 2-10 years period. 31 studies (2888 patients) were included in the analysis of Harris hip score. No implant combination had a better score than the reference implant combination. Conclusions  Newer implant combinations were not found to be better than the reference implant combination (metal-on-polyethylene (not highly cross linked), small head, cemented) in terms of risk of revision surgery or Harris hip score. Metal-on-metal, small head, cemented implants and resurfacing increased the risk of revision surgery compared with the reference implant combination. The results were consistent with observational evidence and were replicated in sensitivity analysis but were limited by poor reporting across studies. Systematic review registration  PROSPERO CRD42015019435. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence

  8. Implantable intraocular pressure monitoring systems: Design considerations

    KAUST Repository

    Arsalan, Muhammad; Ouda, Mahmoud H.; Marnat, Loic; Shamim, Atif; Salama, Khaled N.

    2013-01-01

    Design considerations and limitations of implantable Intraocular Pressure Monitoring (IOPM) systems are presented in this paper. Detailed comparison with the state of the art is performed to highlight the benefits and challenges of the proposed design. The system-on-chip, presented here, is battery free and harvests energy from incoming RF signals. This low-cost design, in standard CMOS process, does not require any external components or bond wires to function. This paper provides useful insights to the designers of implantable wireless sensors in terms of design choices and associated tradeoffs. © 2013 IEEE.

  9. Implantable intraocular pressure monitoring systems: Design considerations

    KAUST Repository

    Arsalan, Muhammad

    2013-12-01

    Design considerations and limitations of implantable Intraocular Pressure Monitoring (IOPM) systems are presented in this paper. Detailed comparison with the state of the art is performed to highlight the benefits and challenges of the proposed design. The system-on-chip, presented here, is battery free and harvests energy from incoming RF signals. This low-cost design, in standard CMOS process, does not require any external components or bond wires to function. This paper provides useful insights to the designers of implantable wireless sensors in terms of design choices and associated tradeoffs. © 2013 IEEE.

  10. Total Artificial Heart Implantation After Undifferentiated High-Grade Sarcoma Excision.

    Science.gov (United States)

    Kremer, Jamila; Farag, Mina; Arif, Rawa; Brcic, Andreas; Sabashnikov, Anton; Schmack, Bastian; Popov, Aron-Frederik; Karck, Matthias; Dohmen, Pascal M; Ruhparwar, Arjang; Weymann, Alexander

    2016-11-02

    BACKGROUND Total artificial heart (TAH) implantation in patients with aggressive tumor infiltration of the heart can be challenging. CASE REPORT We report on a patient with a rare primary undifferentiated high-grade spindle cell sarcoma of the mitral valve and in the left atrium, first diagnosed in 2014. The referring center did a first resection in 2014. In the course of 17 months, computer tomography (CT) scan again showed massive invasion of the mitral valve and left atrium. Partial resection and mitral valve replacement was not an option. We did a subtotal heart excision with total artificial heart implantation. In this report we discuss complications, risk factors, and perioperative management of this patient. CONCLUSIONS Patients with aggressive tumors of the heart can be considered for TAH implantation.

  11. Quantification of in vivo implant wear in total knee replacement from dynamic single plane radiography

    International Nuclear Information System (INIS)

    Teeter, Matthew G; Naudie, Douglas D R; Holdsworth, David W; Seslija, Petar; Milner, Jaques S; Nikolov, Hristo N; Yuan Xunhua

    2013-01-01

    An in vivo method to measure wear in total knee replacements was developed using dynamic single-plane fluoroscopy. A dynamic, anthropomorphic total knee replacement phantom with interchangeable, custom-fabricated components of known wear volume was created, and dynamic imaging was performed. For each frame of the fluoroscopy data, the relative location of the femoral and tibial components were determined, and the apparent intersection of the femoral component with the tibial insert was used to calculate wear volume, wear depth, and frequency of intersection. No difference was found between the measured and true wear volumes. The precision of the measurements was ±39.7 mm 3 for volume and ±0.126 mm for wear depth. The results suggest the system is capable of tracking wear volume changes across multiple time points in patients. As a dynamic technique, this method can provide both kinematic and wear measurements that may be useful for evaluating new implant designs for total knee replacements. (paper)

  12. Systemic alendronate treatment improves fixation of press-fit implants: a canine study using nonloaded implants

    DEFF Research Database (Denmark)

    Jensen, Thomas B; Bechtold, Joan E; Chen, Xinqian

    2007-01-01

    of alendronate treatment. Bone ongrowth (bone in contact with implant surface) was estimated using the linear intercept technique and shear strength was calculated as the slope on a load-displacement curve. For the press fit implants, alendronate treatment significantly increased bone ongrowth from 24% to 29...... early implant stability is an important predictor of longevity, systemic alendronate treatment could be an important clinical tool to positively influence the early stages of implant incorporation. Udgivelsesdato: 2007-Jun...

  13. Failure of total hip implants: metals and metal release in 52 cases

    DEFF Research Database (Denmark)

    Jakobsen, Stig Storgaard; Lidén, Carola; Søballe, Kjeld

    2014-01-01

    Background . The pathogenesis of total joint replacement failure is multifactorial. One hypothesis suggests that corrosion and wear of alloys result in metal ion release, which may then cause sensitization and even implant failure, owing to the acquired immune reactivity. Objectives . To assess c...

  14. Anatomy of the bovine ascending aorta and brachiocephalic artery found unfavorable for total artificial heart implant.

    Science.gov (United States)

    Karimov, Jamshid H; Sunagawa, Gengo; Such, Kimberly A; Sale, Shiva; Golding, Leonard A R; Moazami, Nader; Fukamachi, Kiyotaka

    2015-12-01

    The biocompatibility assessment of the Cleveland Clinic continuous-flow total artificial heart is an important part of the device developmental program. Surgical and postoperative management are key factors in achieving optimal outcomes. However, the presence of vascular anatomical abnormalities in experimental animal models is often unpredictable and may worsen the expected outcomes. We report a technical impediment encountered during total artificial heart implantation complicated by unfavorable bovine anatomy of the ascending aorta and brachiocephalic arterial trunk.

  15. Patient - implant dimension mismatch in total knee arthroplasty: Is it worth worrying? An Indian scenario

    Directory of Open Access Journals (Sweden)

    Jai Thilak

    2016-01-01

    Full Text Available Background: The correct sizing of the components in both anteroposterior and mediolateral (ML dimensions is crucial for the success of a total knee arthroplasty (TKA. The size of the implants selected is based on the intraoperative measurements. The currently used TKA implants available to us are based on morphometric measurements obtained from a Western/Caucasian population. Hence, the risk of component ML mismatch is more common in Asian sub-population, as they are of a smaller built and stature. This study aims to look into the following aspects agnitude of the ML mismatch between the femoral component and the patient′s anatomical dimension, evaluation of gender variations in distal femur dimensions, and gender-wise and implant-wise correlation of ML mismatch. Materials and Methods: Intraoperatively, the distal femoral dimensions were measured using sterile calipers after removing the osteophytes and compared with the ML dimension of the implant used. ML mismatch length thus obtained is correlated with the various parameters. Results: Males showed larger distal femoral dimensions when compared to females. Males had larger ML mismatch. None of the implants used perfectly matched the patient′s anatomical dimensions. Patients with larger mismatch had lower scorings at 2 years postoperative followup. Conclusion: Implant manufacturers need to design more options of femoral implants for a better fit in our subset of patients. The exact magnitude of mismatch which can cause functional implications need to be made out. The mismatch being one of the important factors for the success of the surgery, we should focus more on this aspect.

  16. Ion implantation data acquisition system

    International Nuclear Information System (INIS)

    Struttmann, D.A.; Anderl, R.A.

    1989-01-01

    This paper describes a data acquisition system developed for hydrogen ion-driven permeation experiments for materials relevant to fusion technology. The system consists of an IMB PC-AT, CAMAC interface to diagnostic instrumentation and custom-developed software (BASIC) to provide time-history information for signals from several instruments including three quadrupole mass spectrometers. 4 refs., 5 figs

  17. Unconstrained tripolar implants for primary total hip arthroplasty in patients at risk for dislocation.

    Science.gov (United States)

    Guyen, Olivier; Pibarot, Vincent; Vaz, Gualter; Chevillotte, Christophe; Carret, Jean-Paul; Bejui-Hugues, Jacques

    2007-09-01

    We performed a retrospective study on 167 primary total hip arthroplasty (THA) procedures in 163 patients at high risk for instability to assess the reliability of unconstrained tripolar implants (press-fit outer metal shell articulating a bipolar polyethylene component) in preventing dislocations. Eighty-four percent of the patients had at least 2 risk factors for dislocation. The mean follow-up length was 40.2 months. No dislocation was observed. Harris hip scores improved significantly. Six hips were revised, and no aseptic loosening of the cup was observed. The tripolar implant was extremely successful in achieving stability. However, because of the current lack of data documenting polyethylene wear at additional bearing, the routine use of tripolar implants in primary THA is discouraged and should be considered at the present time only for selected patients at high risk for dislocation and with limited activities.

  18. Complications after percutaneous placement of totally implantable venous access ports in the forearm

    International Nuclear Information System (INIS)

    Goltz, J.P.; Petritsch, B.; Thurner, A.; Hahn, D.; Kickuth, R.

    2012-01-01

    This article focuses on radiological imaging of complications after interventional percutaneous insertion of totally implantable venous access ports (TIVAPs) which were placed in the forearm. Thus far most reviews have dealt with pectorally-placed TIVAPs. Compared with the pectoral approach, implantation in the forearm has been associated with certain complications owing to a longer route of the port catheter within a smaller vein, and owing to the route across the elbow joint, resulting in higher rates of catheter-associated thrombosis and possible mechanical complications. The purpose of this review is to describe the complications after implantation of TIVAPs in the forearm, and to make radiologists familiar with the key findings of the complications during radiological imaging, including colour-coded and compression Duplex ultrasound, computed tomography, and digital subtraction venography.

  19. Systemic Assessment of Patients Undergoing Dental Implant Surgeries: A Trans- and Post-operative Analysis.

    Science.gov (United States)

    Byakodi, Sanjay; Kumar, Sachin; Reddy, Rajesh Kumar; Kumar, Vipin; Sepolia, Shipra; Gupta, Shivangi; Singh, Harkanwal Preet

    2017-01-01

    Procedure-related and patient-related factors influence the prognosis of dental implants to a major extent. Hence, we aimed to evaluate and analyze various systemic factors in patients receiving dental implants. Fifty-one patients were included in the study, in which a total of 110 dental implants were placed. Complete examination of the subjects was done before and after placement of dental implants. Implant surgery was planned, and osseointegrated dental implants were placed in the subjects. Postoperative evaluation of the dental implant patients was done after 3 weeks. Anxiety levels were determined using State-Trait Anxiety Inventory (STAI) questionnaire on the surgery day and after 1 week of surgery. The participant describes how they feel at the moment by responding to twenty items as follows: (1) absolutely not, (2) slightly, (3) somewhat, or (4) very much. All the results were recorded and statistical analyzed by SPSS software. Out of 51, 29 patients were males while 22 were females, with ratio of 1.32:1. Female patients' mean age was 50.18 years while male patients' mean age was 52.71 years, with statistically nonsignificant difference between them. Functional rehabilitation was the main purpose of choosing dental implants in more than 90% of the subjects. Diameter of 3.75 mm was the shortest implants to be placed in the present study, whereas in terms of length, 8.5 mm was the shortest length of dental implant used in the present study. Tooth area in which maximum implants were placed in our study was 36 tooth region. Maximum implants were placed in Type II bone quality ( n = 38). Implants installed in the mandible were clamped more efficiently than implants placed in the maxilla ( P < 0.001). The difference of average STAI-State subscore before and after the surgery was statistically significant ( P < 0.05; significant). Mandibular dental implants show more clamping (torque) than maxillary dental implants.

  20. CLINICAL CONSIDERATIONS OF DENTAL IMPLANT SYSTEM IN IMMEDIATE LOADING IMPLANT CASES

    Directory of Open Access Journals (Sweden)

    Carolina Damayanti Marpaung

    2015-06-01

    Full Text Available Immediate loading of dental implant has been researched intensively in the development of Branemark’s early concept of 2 stages implant placement. This was embarked from both patients and practiitioner’s convenience towards a simpler protocol and shorter time frame. Many recent researchers later found that micromotions derived from occlusal loading for a certain degree, instead of resulting a fibrous tissue encapsulation, can enhance the osseointegration process. Dental Implant system enhancement towards maximizing the primary stability held a key factor in Branemark’s concept development. Surgical protocol and implant design was found to give a significant contribution to the prognosis of immediate-loading implants.

  1. [Design and application of implantable medical device information management system].

    Science.gov (United States)

    Cao, Shaoping; Yin, Chunguang; Zhao, Zhenying

    2013-03-01

    Through the establishment of implantable medical device information management system, with the aid of the regional joint sharing of resources, we further enhance the implantable medical device traceability management level, strengthen quality management, control of medical risk.

  2. Relation between total shock energy and mortality in patients with implantable cardioverter-defibrillator.

    Science.gov (United States)

    Tenma, Taro; Yokoshiki, Hisashi; Mitsuyama, Hirofumi; Watanabe, Masaya; Mizukami, Kazuya; Kamada, Rui; Takahashi, Masayuki; Sasaki, Ryo; Maeno, Motoki; Okamoto, Kaori; Chiba, Yuki; Anzai, Toshihisa

    2018-05-15

    Implantable Cardioverter-Defibrillator (ICD) shocks have been associated with mortality. However, no study has examined the relation between total shock energy and mortality. The aim of this study is to assess the association of total shock energy with mortality, and to determine the patients who are at risk of this association. Data from 316 consecutive patients who underwent initial ICD implantation in our hospital between 2000 and 2011 were retrospectively studied. We collected shock energy for 3 years from the ICD implantation, and determined the relation of shock energy on mortality after adjusting confounding factors. Eighty-seven ICD recipients experienced shock(s) within 3 years from ICD implantation and 43 patients had died during the follow-up. The amount of shock energy was significantly associated with all-cause death [adjusted hazard ratio (HR) 1.26 (per 100 joule increase), p energy accumulation (≥182 joule) was lower (p energy accumulation (energy accumulation and all-cause death was remarkable in the patients with low left ventricular ejection fraction (LVEF ≤40%) or atrial fibrillation (AF). Increase of shock energy was related to mortality in ICD recipients. This relation was evident in patients with low LVEF or AF. Copyright © 2018 Elsevier B.V. All rights reserved.

  3. Mandibular implant-supported overdentures: attachment systems, and number and locations of implants--Part I.

    Science.gov (United States)

    Warreth, Abdulhadi; Alkadhimi, Aslam Fadel; Sultan, Ahmed; Byrne, Caroline; Woods, Edel

    2015-01-01

    The use of dental implants in replacing missing teeth is an integral part of restorative dental treatment. Use of conventional complete dentures is associated with several problems such as lack of denture stability, support and retention. However, when mandibular complete dentures were used with two or more implants, an improvement in the patients' psychological and social well-being could be seen. There is general consensus that removable implant-supported overdentures (RISOs) with two implants should be considered as the first-choice standard of care for an edentulous mandible. This treatment option necessitates the use of attachment systems that connect the complete denture to the implant. Nevertheless, each attachment system has its inherent advantages and disadvantages, which should be considered when choosing a system. The first part of this article provides an overview on options available to restore the mandibular edentulous arch with dental implants. Different types of attachment systems, their features and drawbacks are also reviewed.

  4. Computer-navigated minimally invasive total knee arthroplasty for patients with retained implants in the femur

    Directory of Open Access Journals (Sweden)

    Sung-Yen Lin

    2014-08-01

    Full Text Available Total knee arthroplasty (TKA in patients with knee arthritis and retained implants in the ipsilateral femur is a challenge for knee surgeons. Use of a conventional intramedullary femoral cutting guide is not practical because of the obstruction of the medullary canal by implants. Previous studies have shown that computer-assisted surgery (CAS can help restore alignment in conventional TKA for patients with knee arthritis with retained femoral implants or extra-articular deformity, without the need for implant removal or osteotomy. However, little has been published regarding outcomes with the use of navigation in minimally invasive surgery (MIS-TKA for patients with this complex knee arthritis. MIS has been proven to provide less postoperative pain and faster recovery than conventional TKA, but MIS-TKA in patients with retained femoral implants poses a greater risk in limb malalignment. The purpose of this study is to report the outcome of CAS-MIS-TKA in patients with knee arthritis and retained femoral implants. Between April 2006 and March 2008, eight patients with knee arthritis and retained femoral implants who underwent the CAS-MIS-TKA were retrospectively reviewed. Three of the eight patients had extra-articular deformity, including two femur bones and one tibia bone, in the preoperative examination. The anteroposterior, lateral, and long-leg weight-bearing radiographs carried out at 3-month follow-up was used to determine the mechanical axis of lower limb and the position of components. The mean preoperative femorotibial angle in patients without extra-articular deformity was 3.8° of varus and was corrected to 4.6° of valgus. With the use of navigation in MIS-TKA, the two patients in this study with extra-articular femoral deformity also obtained an ideal postoperative mechanical axis within 2° of normal alignment. Overall, there was a good restoration of postoperative mechanical alignment in all cases, with a mean angle of 0.4° of

  5. Median Sternotomy or Right Thoracotomy Techniques for Total Artificial Heart Implantation in Calves.

    Science.gov (United States)

    Karimov, Jamshid H; Moazami, Nader; Sunagawa, Gengo; Kobayashi, Mariko; Byram, Nicole; Sale, Shiva; Such, Kimberly A; Horvath, David J; Golding, Leonard A R; Fukamachi, Kiyotaka

    2016-10-01

    The choice of optimal operative access technique for mechanical circulatory support device implantation ensures successful postoperative outcomes. In this study, we retrospectively evaluated the median sternotomy and lateral thoracotomy incisions for placement of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) in a bovine model. The CFTAH was implanted in 17 calves (Jersey calves; weight range, 77.0-93.9 kg) through a median sternotomy (n = 9) or right thoracotomy (n = 8) for elective chronic implantation periods of 14, 30, or 90 days. Similar preoperative preparation, surgical techniques, and postoperative care were employed. Implantation of the CFTAH was successfully performed in all cases. Both methods provided excellent surgical field visualization. After device connection, however, the median sternotomy approach provided better visualization of the anastomoses and surgical lines for hemostasis confirmation and repair due to easier device displacement, which is severely limited following right thoracotomy. All four animals sacrificed after completion of the planned durations (up to 90 days) were operated through full median sternotomy. Our data demonstrate that both approaches provide excellent initial field visualization. Full median sternotomy provides larger viewing angles at the anastomotic suture line after device connection to inflow and outflow ports. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  6. Placement of the stemless humeral component in the Total Evolutive Shoulder System (TESS).

    Science.gov (United States)

    Geurts, Ghislain F; van Riet, Roger P; Jansen, Nick; Declercq, Geert

    2010-12-01

    Humeral implant design in shoulder arthroplasty has evolved over the years. The third generation shoulder prostheses have an anatomic humeral stem that replicates the 3-dimensional parameters of the proximal humerus. The overall complication rate has decreased as a result of these changes in implant design. In contrast, the rate of periprosthetic humeral fractures has increased. To avoid stem-related complications while retaining the advantages of the third generation of shoulder implants, the stemless total evolutive shoulder system has been developed. The indications, the surgical technique, and the complications of this humeral implant in shoulder arthroplasty will be described.

  7. Feasibility and Safety of Endovascular Stripping of Totally Implantable Venous Access Devices

    International Nuclear Information System (INIS)

    Heye, Sam; Maleux, Geert; Goossens, G. A.; Vaninbroukx, Johan; Jerôme, M.; Stas, M.

    2012-01-01

    Purpose: To evaluate the safety and feasibility of percutaneous stripping of totally implantable venous access devices (TIVAD) in case of catheter-related sleeve and to report a technique to free the catheter tip from vessel wall adherence. Materials and Methods: A total of 37 stripping procedures in 35 patients (14 men, 40%, and 21 women, 60%, mean age 53 ± 14 years) were reviewed. Totally implantable venous access devices were implanted because of malignancy in most cases (85.7%). Catheter-related sleeve was confirmed as cause of persistent catheter dysfunction despite instillation of thrombolytics. A technique to mobilize the catheter tip from the vessel wall was used when stripping with the snare catheter was impossible. Technical success, complication rate, and outcome were noted. Results: A total of 55.9% (n = 19) of the 34 technically successful procedures (91.9%) could be done with the snare catheter. In 15 cases (44.1%), additional maneuvers to free the TIVAD’s tip from the vessel wall were needed. Success rate was not significantly lower before (72.4%) than after (96.7%) implementation of the new technique (P = 0.09). No complications were observed. Follow-up was available in 67.6% of cases. Recurrent catheter dysfunction was found in 17 TIVADs (78.3%) at a mean of 137.7 days and a median of 105 days. Conclusions: Stripping of TIVADs is technically feasible and safe, with an overall success rate of 91.9%. Additional endovascular techniques to mobilize the distal catheter tip from the wall of the superior vena cava or right atrium to allow encircling the TIVAD tip with the snare catheter may be needed in 44.1% of cases.

  8. Accuracy of various impression materials and methods for two implant systems: An effect size study.

    Science.gov (United States)

    Schmidt, Alexander; Häussling, Teresa; Rehmann, Peter; Schaaf, Heidrun; Wöstmann, Bernd

    2018-04-01

    An accurate impression is required for implant treatment. The aim of this in-vitro study was to determine the effect size of the impression material/method, implant system and implant angulation on impression transfer precision. An upper jaw model with three BEGO and three Straumann implants (angulations 0°, 15°, 20°) in the left and right maxilla was used as a reference model. One polyether (Impregum Penta) and two polyvinyl siloxanes (Flexitime Monophase/Aquasil Ultra Monophase) were examined with two impression techniques (open and closed tray). A total of 60 impressions were made. A coordinate measurement machine was used to measure the target variables for 3D-shift, implant axis inclination and implant axis rotation. All the data were subjected to a four-way ANOVA. The effect size (partial eta-squared [η 2 P ]) was reported. The impression material had a significant influence on the 3D shift and the implant axis inclination deviation (p-values=.000), and both factors had very large effect sizes (3D-shift [η 2 P ]=.599; implant axis inclination [η 2 P ]=.298). Impressions made with polyvinyl siloxane exhibited the highest transfer precision. When the angulation of the implants was larger, more deviations occurred for the implant axis rotational deviation. The implant systems and impression methods showed partially significant variations (p-values=.001-.639) but only very small effect sizes (η 2 P =.001-.031). The impression material had the greatest effect size on accuracy in terms of the 3D shift and the implant axis inclination. For multiunit restorations with disparallel implants, polyvinyl siloxane materials should be considered. In addition, the effect size of a multivariate investigation should be reported. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  9. Usefulness of Totally Implantable Central Venous Access Devices in Elderly Patients: A Retrospective Study.

    Science.gov (United States)

    Imaoka, Yuki; Kuranishi, Fumito; Ogawa, Yoshiteru

    2018-01-01

    The need for totally implantable central venous access devices (TICVADs) has increased with increased opportunities in the use of chemotherapy and parenteral nutrition. This study aimed to determine the outcomes of TICVAD implantation and use in patients aged ≥85 years. Between January 2010 and August 2016, 117 patients underwent TICVAD implantation and their records were retrospectively reviewed. Participants were divided into 2 groups (plus-85 and sub-85 groups). Fifty-five patients (47.0%) had solid organ cancer alone; 35 patients (29.9%) had cerebrovascular or cranial nerve disease. The average follow-up period was 201 (2-1,620) days. Major complications were identified in 6 (14.6%) plus-85 patients and 11 (14.5%) sub-85 patients (p = 0.9813). Catheter-related infections developed in 3 plus-85 (7.3%) and 4 sub-85 patients (5.3%; p = 0.6549). There were no significant group differences in hematoma, pneumothorax, occlusion, and removal rates. In plus-85 patients examined just before surgery and a month after surgery, increased rates of serum albumin and Onodera's prognostic nutritional index were observed in 48% (14/39) and 41% (12/39), respectively. The use of TICVADs in the plus-85 group resulted in effective outcomes. The results of this retrospective study support the wider use of TICVADs in patients aged ≥85 years. © 2018 S. Karger AG, Basel.

  10. Deairing Techniques for Double-Ended Centrifugal Total Artificial Heart Implantation.

    Science.gov (United States)

    Karimov, Jamshid H; Horvath, David J; Byram, Nicole; Sunagawa, Gengo; Grady, Patrick; Sinkewich, Martin; Moazami, Nader; Sale, Shiva; Golding, Leonard A R; Fukamachi, Kiyotaka

    2017-06-01

    The unique device architecture of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) requires dedicated and specific air-removal techniques during device implantation in vivo. These procedures comprise special surgical techniques and intraoperative manipulations, as well as engineering design changes and optimizations to the device itself. The current study evaluated the optimal air-removal techniques during the Cleveland Clinic double-ended centrifugal CFTAH in vivo implants (n = 17). Techniques and pump design iterations consisted of developing a priming method for the device and the use of built-in deairing ports in the early cases (n = 5). In the remaining cases (n = 12), deairing ports were not used. Dedicated air-removal ports were not considered an essential design requirement, and such ports may represent an additional risk for pump thrombosis. Careful passive deairing was found to be an effective measure with a centrifugal pump of this design. In this report, the techniques and design changes that were made during this CFTAH development program to enable effective residual air removal and prevention of air embolism during in vivo device implantation are explained. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  11. Total artificial heart implantation for biventricular failure due to eosinophilic myocarditis.

    Science.gov (United States)

    Kawabori, Masashi; Kurihara, Chitaru; Miller, Yair; Heck, Kent A; Bogaev, Roberta C; Civitello, Andrew B; Cohn, William E; Frazier, O H; Morgan, Jeffrey A

    2017-09-01

    Idiopathic hypereosinophilic syndrome is a condition of unknown etiology characterized by proliferation of eosinophils and their infiltration into tissues. Although cardiac involvement is rare, eosinophilic myocarditis can lead to life-threating fulminant congestive heart failure. Treatment of patients with eosinophilic myocarditis is challenging as heart failure can be caused by biventricular dysfunction. To our knowledge, this is the first case reported in the literature describing a patient with acute severe biventricular heart failure caused by eosinophilic myocarditis with mural left ventricular apical thrombus who was successfully treated with implantation of a total artificial heart as a bridge to heart transplant.

  12. Peri-implant bone strains and micro-motion following in vivo service: a postmortem retrieval study of 22 tibial components from total knee replacements.

    Science.gov (United States)

    Mann, Kenneth A; Miller, Mark A; Goodheart, Jacklyn R; Izant, Timothy H; Cleary, Richard J

    2014-03-01

    Biological adaptation following placement of a total knee replacements (TKRs) affects peri-implant bone mineral density (BMD) and implant fixation. We quantified the proximal tibial bone strain and implant-bone micro-motion for functioning postmortem retrieved TKRs and assessed the strain/micro-motion relationships with chronological (donor age and time in service) and patient (body weight and BMD) factors. Twenty-two tibial constructs were functionally loaded to one body weight (60% medial/40% lateral), and the bone strains and tray/bone micro-motions were measured using a digital image correlation system. Donors with more time in service had higher bone strains (p = 0.044), but there was not a significant (p = 0.333) contribution from donor age. Donors with lower peri-implant BMD (p = 0.0039) and higher body weight (p = 0.0286) had higher bone strains. Long term implants (>11 years) had proximal bone strains 900 µϵ that were almost twice as high as short term (implants 570 µϵ. Micro-motion was greater for younger donors (p = 0.0161) and longer time in service (p = 0.0008). Increased bone strain with long term in vivo service could contribute to loosening of TKRs by failure of the tibial peri-implant bone. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  13. Total energy system in the future

    International Nuclear Information System (INIS)

    Hijikata, K.

    1994-01-01

    The possibility of improving the thermal efficiency of energy systems from an exergy point of view is discussed. In total energy systems, we should employ multi-pass recycling consisting of thermal and chemical energies. The recycling system is supported by electrical energy, which is provided by a renewable energy source or by excess commercial electric power. This total energy system should be considered not only in one country, but all around the globe. (author). 6 figs., 4 tabs., 8 refs

  14. Retention systems for extraoral maxillofacial prosthetic implants: a critical review.

    Science.gov (United States)

    Cobein, M V; Coto, N P; Crivello Junior, O; Lemos, J B D; Vieira, L M; Pimentel, M L; Byrne, H J; Dias, R B

    2017-10-01

    We describe the techniques available for retention of implant-supported prostheses: bar-clips, O-rings, and magnets. We present reported preferences and, although this is limited by the heterogeneity of methods used and patients studied, we hope we have identified the best retention systems for maxillofacial prosthetic implants. If practitioners know the advantages and disadvantages of each system, they can choose the most natural and comfortable prosthesis. We searched the PubMed and Scopus databases, and restricted our search to papers published 2001-13. MeSH terms used were Maxillofacial prosthesis and Craniofacial prosthesis OR Craniofacial prostheses. We found a total of 2630 papers, and after duplicates had been removed we analysed the rest and found 25 papers for review. Of these, 12 were excluded because they were case reports or non-systematic reviews. Of the remaining 13, 10 described group analyses and seemed appropriate to find practitioner's choices, as cited in the abstract (n=1611 prostheses). Three papers did not mention the type of prosthetic connection used, so were excluded. The most popular choices for different conditions were analysed, though the sites and retention systems were not specified in all 10 papers. The bar-clip system was the most used in auricular (6/10 papers) and nasal prostheses (4/10). For the orbital region, 6/10 favoured magnets. Non-osseointegrated mechanical or adhesive retention techniques are the least expensive and have no contraindications. When osseointegrated implants are possible, each facial region has a favoured system. The choice of system is influenced by two factors: standard practice and the abilities of the maxillofacial surgeon and maxillofacial prosthetist. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  15. The Computer in a Programmable Implantable Medication System (PIMS)

    OpenAIRE

    Sanders, K. H.; Radford, W. E.

    1982-01-01

    The Programmable Implantable Medication System (PIMS) developed at APL can be used in the treatment of diabetes, reproductive hormone dysfunction, hypertension, cancer, chronic pain, thrombosis, and the delivery of growth hormone. The Implantable Programmable Infusion Pump (IPIP) is the implanted element of PIMS. Under control of a microprocessor, the IPIP administers medication and stores data pertaining to its operation. An external unit can read out the stored data, as well as program the ...

  16. Chronic multisite brain recordings from a totally implantable bidirectional neural interface: experience in 5 patients with Parkinson's disease.

    Science.gov (United States)

    Swann, Nicole C; de Hemptinne, Coralie; Miocinovic, Svjetlana; Qasim, Salman; Ostrem, Jill L; Galifianakis, Nicholas B; Luciano, Marta San; Wang, Sarah S; Ziman, Nathan; Taylor, Robin; Starr, Philip A

    2018-02-01

    OBJECTIVE Dysfunction of distributed neural networks underlies many brain disorders. The development of neuromodulation therapies depends on a better understanding of these networks. Invasive human brain recordings have a favorable temporal and spatial resolution for the analysis of network phenomena but have generally been limited to acute intraoperative recording or short-term recording through temporarily externalized leads. Here, the authors describe their initial experience with an investigational, first-generation, totally implantable, bidirectional neural interface that allows both continuous therapeutic stimulation and recording of field potentials at multiple sites in a neural network. METHODS Under a physician-sponsored US Food and Drug Administration investigational device exemption, 5 patients with Parkinson's disease were implanted with the Activa PC+S system (Medtronic Inc.). The device was attached to a quadripolar lead placed in the subdural space over motor cortex, for electrocorticography potential recordings, and to a quadripolar lead in the subthalamic nucleus (STN), for both therapeutic stimulation and recording of local field potentials. Recordings from the brain of each patient were performed at multiple time points over a 1-year period. RESULTS There were no serious surgical complications or interruptions in deep brain stimulation therapy. Signals in both the cortex and the STN were relatively stable over time, despite a gradual increase in electrode impedance. Canonical movement-related changes in specific frequency bands in the motor cortex were identified in most but not all recordings. CONCLUSIONS The acquisition of chronic multisite field potentials in humans is feasible. The device performance characteristics described here may inform the design of the next generation of totally implantable neural interfaces. This research tool provides a platform for translating discoveries in brain network dynamics to improved neurostimulation

  17. Systemic Assessment of Patients Undergoing Dental Implant ...

    African Journals Online (AJOL)

    These days, dental implants are becoming routinely used as a treatment option for rehabilitation of lost teeth. Conventionally, it is only after the completion of bone healing that the dental implants are loaded into the bone. Bone healing time is approximately 3 months and. 6 months for the mandible and maxilla, respectively.

  18. Cone-morse implant connection system significantly reduces bacterial leakage between implant and abutment: an in vitro study.

    Science.gov (United States)

    Baj, A; Bolzoni, A; Russillo, A; Lauritano, D; Palmieri, A; Cura, F; Silvestre, F J; Giannì, A B

    2017-01-01

    Osseointegrated implants are very popular dental treatments today in the world. In osseointegrated implants, the occlusal forces are transmitted from prosthesis through an abutment to a dental implant. The abutment is connected to the implant by mean of a screw. A screw is the most used mean for connecting an implant to an abutment. Frequently the screws break and are lost. There is an alternative to screw retained abutment systems: the cone-morse connection (CMC). The CMC, thanks to the absence of the abutment screw, guarantees no micro-gaps, no micro-movements, and a reduction of bacterial leakage between implant and abutment. As P. gingivalis and T. forsythia penetration might have clinical relevance, it was the purpose of this investigation to evaluate molecular leakage of these two bacteria in a new CMC implants systems (Leone Spa®, Florence, Italy). To identify the capability of the implant to protect the internal space from the external environment, the passage of genetically modified Escherichia coli across implant-abutment interface was evaluated. Four cone-morse Leone implants (Leone® Spa, Florence, Italy) were immerged in a bacterial culture for 24 h and bacteria amount was then measured inside implant-abutment interface with Real-time PCR. Bacteria were detected inside all studied implants, with a median percentage of 3% for P. gingivalis and 4% for T. forsythia. Cone-morse connection implant system has very low bacterial leakage percentage and is similar to one-piece implants.

  19. Bone remodelling of the proximal femur after total hip arthroplasty with 2 different hip implant designs

    DEFF Research Database (Denmark)

    Christiansen, Janus D.; Laursen, Mogens B; Ejaz, Ashir

    2018-01-01

    INTRODUCTION: The thrust plate prosthesis (TPP) was introduced to preserve bone in patients undergoing total hip arthroplasty. We assessed the long-term results of hip arthroplasty in patients who received the TPP compared to a traditional intramedullary stem (Bi-Metric). METHODS......: In this prospective observational cohort study, we evaluated bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA), radiological imaging and clinical outcome using Harris Hip Score (HHS). Twenty patients received the TPP (group A) and 18 patients received the Bi-Metric stem (group B). Baseline......% (95% confidence interval [CI], 4-16; p = 0.003) and 8% (95% CI, 1-15; p = 0.03) at 8 years. Regarding ROI4, group A had a lesser decrease in general compared to group B. The radiological findings did not reveal any subsidence or detectable implant migration. HHS improved from 53 (23-69) to 93 (55...

  20. Total Analysis System for Ship Structural Strength

    OpenAIRE

    Takuya, Yoneya; Hiroyuki, Kobayashi; Abdul M., Rahim; Yoshimichi, Sasaki; Masaki, Irisawa; Technical Investigation and Information Department, Research Center; Technical Investigation and Information Department, Research Center; Singapore Office; Technical Investigation and Information Department, Research Center; Technical Investigation and Information Department, Research Center

    2001-01-01

    This paper outlines a total analysis system for ship hull structures, which integrates a wide variety of analysis functions to realise practical applications of rational methods for assessing ship structural strength. It is based on direct calculation of wave-induced loads as well as three-dimensional structural analysis of an entire-ship or hold structure. Three major analysis functions of the total system are ship motion and wave load analysis, ship structural analysis and statistical analy...

  1. Systemic assessment of patients undergoing dental implant surgeries: A trans- and post-operative analysis

    Directory of Open Access Journals (Sweden)

    Sanjay Byakodi

    2017-01-01

    Full Text Available Background: Procedure-related and patient-related factors influence the prognosis of dental implants to a major extent. Hence, we aimed to evaluate and analyze various systemic factors in patients receiving dental implants. Materials and Methods: Fifty-one patients were included in the study, in which a total of 110 dental implants were placed. Complete examination of the subjects was done before and after placement of dental implants. Implant surgery was planned, and osseointegrated dental implants were placed in the subjects. Postoperative evaluation of the dental implant patients was done after 3 weeks. Anxiety levels were determined using State-Trait Anxiety Inventory (STAI questionnaire on the surgery day and after 1 week of surgery. The participant describes how they feel at the moment by responding to twenty items as follows: (1 absolutely not, (2 slightly, (3 somewhat, or (4 very much. All the results were recorded and statistical analyzed by SPSS software. Results: Out of 51, 29 patients were males while 22 were females, with ratio of 1.32:1. Female patients' mean age was 50.18 years while male patients' mean age was 52.71 years, with statistically nonsignificant difference between them. Functional rehabilitation was the main purpose of choosing dental implants in more than 90% of the subjects. Diameter of 3.75 mm was the shortest implants to be placed in the present study, whereas in terms of length, 8.5 mm was the shortest length of dental implant used in the present study. Tooth area in which maximum implants were placed in our study was 36 tooth region. Maximum implants were placed in Type II bone quality (n = 38. Implants installed in the mandible were clamped more efficiently than implants placed in the maxilla (P < 0.001. The difference of average STAI-State subscore before and after the surgery was statistically significant (P < 0.05; significant. Conclusion: Mandibular dental implants show more clamping (torque than maxillary

  2. Friction wear and dissolution of orthopedic implant systems

    International Nuclear Information System (INIS)

    Ektessabi, A.M.; Shikine, S.; Hamdi, M.; Kitamura, N.; Rokkum, M.; Johansson, C.

    2000-01-01

    Bio-medical implants release metallic elements during the long periods of time while inserted in the human body. The chemical interactions between the tissues and surface of the implants, and the mechanical friction of implants cause the release of metals into the human tissues. In this study we investigated the distribution and the chemical-state of the metallic elements in the tissues around a failed implant system using PIXE (proton induced x-ray emission) and SR-XRF (synchrotron radiation x-ray fluorescence) spectroscopies. The specimens were from the causes of patients with diagnosed arthritis. The implant consisted of a stem and a metal backing made of Ti-6Al-4V, an implant head made of stainless steel, and a polyethylene (PE) cup. Both the stem and the metal backing had a plasma-sprayed HAp surface coating. Distribution and concentration of dissolved elements in tissues surrounding implants were examined and quantified using PIXE analysis. Similar specimen from the same case was further investigated using SR-XRF analysis. Chemical-states of the dissolved elements were also studied by XAFS (x-ray absorption fine structure) analysis. From results of these measurements, it is confirmed that the tissues surrounding implants contained metallic elements such as Fe, Cr, Ni, and Ti. These elements are originated from the implant. Furthermore, it was made clear that the chemical-state of Fe had changed as a consequence of dissolution of Fe in the organic tissues. (author)

  3. Analytical and experimental position stability of the abutment in different dental implant systems with a conical implant?abutment connection

    OpenAIRE

    Semper-Hogg, Wiebke; Kraft, Silvan; Stiller, Sebastian; Mehrhof, Juergen; Nelson, Katja

    2012-01-01

    Objectives Position stability of the abutment should be investigated in four implant systems with a conical implant?abutment connection. Materials and methods Previously developed formulas and an established experimental setup were used to determine the position stability of the abutment in the four implant systems with a conical implant?abutment connection and different positional index designs: The theoretical rotational freedom was calculated by using the dimensions of one randomly selecte...

  4. Clinical evaluation of a novel dental implant system as single implants under immediate loading conditions - 4-month post-loading results from a multicentre randomised controlled trial.

    Science.gov (United States)

    Esposito, Marco; Trullenque-Eriksson, Anna; Blasone, Rodolfo; Malaguti, Giuliano; Gaffuri, Cristiano; Caneva, Marco; Minciarelli, Armando; Luongo, Giuseppe

    To evaluate the safety and clinical effectiveness of a novel dental implant system (GENESIS Implant System, Keystone Dental, Massachusetts, USA) using another dental implant system by the same manufacturer as a control (PRIMA Implant System, Keystone Dental). A total of 53 patients requiring at least two single crowns had their sites randomised according to a split-mouth design to receive both implant systems at six centres. If implants could be placed with a torque superior to 40 Ncm they were to be loaded immediately with provisional crowns, otherwise after 3 months of submerged healing. Provisional crowns were replaced by definitive crowns 4 months after initial loading, when the follow-up period for the initial part of this study was completed. Outcome measures were crown/implant failures, complications, pink esthetic score (PES), peri-implant marginal bone level changes, plaque score, marginal bleeding, patients and preference of the clinician. In total 53 PRIMA and 53 GENESIS implants were placed. Three patients dropped out but all of the remaining patients were followed up to 4-months post-loading. No PRIMA implant failed whereas four GENESIS implants failed. Only two complications were reported for PRIMA implants. There were no statistically significant differences for crown/implant failures (difference in proportions = 0.080; P (McNemar test) = 0.125) and complications (difference in proportions = -0.04; P (McNemar test) = 0.500) between the implant systems. There were no differences at 4-months post-loading for plaque (difference = -0.54, 95% CI: -3.01 to 1.93; P (Paired t-test) = 0.660), marginal bleeding (difference = -3.8, 95% CI: -7.63 to 0.019; P (Paired t-test) = 0.051), PES (difference = 0.47, 95% CI: -0.56 to 1.50; P (Paired t-test) = 0.365) and marginal bone level changes (difference in mm = -0.04, 95% CI: -0.33 to 0.26; P (Paired t-test) = 0.795). The majority of the patients (46) had no

  5. Cranial implant design using augmented reality immersive system.

    Science.gov (United States)

    Ai, Zhuming; Evenhouse, Ray; Leigh, Jason; Charbel, Fady; Rasmussen, Mary

    2007-01-01

    Software tools that utilize haptics for sculpting precise fitting cranial implants are utilized in an augmented reality immersive system to create a virtual working environment for the modelers. The virtual environment is designed to mimic the traditional working environment as closely as possible, providing more functionality for the users. The implant design process uses patient CT data of a defective area. This volumetric data is displayed in an implant modeling tele-immersive augmented reality system where the modeler can build a patient specific implant that precisely fits the defect. To mimic the traditional sculpting workspace, the implant modeling augmented reality system includes stereo vision, viewer centered perspective, sense of touch, and collaboration. To achieve optimized performance, this system includes a dual-processor PC, fast volume rendering with three-dimensional texture mapping, the fast haptic rendering algorithm, and a multi-threading architecture. The system replaces the expensive and time consuming traditional sculpting steps such as physical sculpting, mold making, and defect stereolithography. This augmented reality system is part of a comprehensive tele-immersive system that includes a conference-room-sized system for tele-immersive small group consultation and an inexpensive, easily deployable networked desktop virtual reality system for surgical consultation, evaluation and collaboration. This system has been used to design patient-specific cranial implants with precise fit.

  6. Biomechanical comparison of reverse total shoulder arthroplasty systems in soft tissue-constrained shoulders.

    Science.gov (United States)

    Henninger, Heath B; King, Frank K; Tashjian, Robert Z; Burks, Robert T

    2014-05-01

    Numerous studies have examined the biomechanics of isolated variables in reverse total shoulder arthroplasty. This study directly compared the composite performance of two reverse total shoulder arthroplasty systems; each system was designed around either a medialized or a lateralized glenohumeral center of rotation. Seven pairs of shoulders were tested on a biomechanical simulator. Center of rotation, position of the humerus, passive and active range of motion, and force to abduct the arm were quantified. Native arms were tested, implanted with a Tornier Aequalis or DJO Surgical Reverse Shoulder Prosthesis (RSP), and then retested. Differences from the native state were then documented. Both systems shifted the center of rotation medially and inferiorly relative to native. Medial shifts were greater in the Aequalis implant (P .05). Both reverse total shoulder arthroplasty systems exhibited adduction deficits, but the RSP implant deficit was smaller (P = .046 between implants). Both systems reduced forces to abduct the arm compared with native, although the Aequalis required more force to initiate motion from the resting position (P = .022). Given the differences in system designs and configurations, outcome variables were generally comparable. The RSP implant allowed slightly more adduction, had a more lateralized humeral position, and required less force to initiate elevation. These factors may play roles in limiting scapular notching, improving active external rotation by normalizing the residual rotator cuff length, and limiting excessive stress on the deltoid. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  7. Remote powering and data communication for implanted biomedical systems

    CERN Document Server

    Kilinc, Enver Gurhan; Maloberti, Franco

    2016-01-01

    This book describes new circuits and systems for implantable biomedical applications and explains the design of a batteryless, remotely-powered implantable micro-system, designed for long-term patient monitoring.  Following new trends in implantable biomedical applications, the authors demonstrate a system which is capable of efficient, remote powering and reliable data communication.  Novel architecture and design methodologies are used to transfer power with a low-power, optimized inductive link and data is transmitted by a reliable communication link.  Additionally, an electro-mechanical solution is presented for tracking and monitoring the implantable system, while the patient is mobile.  ·         Describes practical example of an implantable batteryless biomedical system; ·         Analyzes and compares various energy harvesting and power transfer methods; ·         Describes design of remote powering link and data communication of the implantable system, comparing differe...

  8. Image-guided navigation system for placing dental implants.

    Science.gov (United States)

    Casap, Nardy; Wexler, Alon; Lustmann, Joshua

    2004-10-01

    Navigation-guided surgery has recently been introduced into various surgical disciplines, including oral and maxillofacial surgery. Since the advent of dental implants, dental computed tomography (CT) scans have been used as a diagnostic tool for preoperative planning, but not as part of the surgical phase. This article explains the principles of computer-assisted surgery and describes the use of a computer-guided navigation system in dental implantology. The system uses preoperative dental CT scans for planning and as an integral part of the surgical procedure. This system allows continuous intraoperative coordination of the implantation phase with the preoperative plan, optimizing the accuracy of implant surgery. Deviations from the planned location of the implants are minimal. Several cases are discussed.

  9. Implant Angle Monitor System of MC3-II

    International Nuclear Information System (INIS)

    Sato, Fumiaki; Sano, Makoto; Nakaoka, Hiroaki; Fujii, Yoshito; Kudo, Tetuya; Nakanishi, Makoto; Koike, Masazumi; Fujino, Yasushi

    2008-01-01

    Precise implant angle control is required for the latest generation of ion implanters to meet further shrink semiconductor device requirements. Especially, the highest angle accuracy is required for Halo implant process of Logic devices. The Halo implant angle affects the device performance, because slight differences of beam divergence change the overlap profile towards the extension. Additionally, twist angle accuracy is demanded in case of channeling angle implant. Therefore monitoring beam angles and wafer twist angles is important. A new monitoring system for the MC3-II, SEN Corp.'s single wafer type medium current implanter has been developed. This paper describes the angle control performance and monitoring system of the MC3-II. For the twist angle control, we developed a wafer notch angle monitor. The system monitors the wafer notch image on the platen. And the notch angle variation is calculated by using image processing method. It is also able to adjust the notch angle according to the angle error. For the tilt angle control, we developed a vertical beam profile monitor. The monitor system can detect beam profile of vertical directions with horizontally scanning beam. It also measures beam angles of a tilt direction to a wafer. The system configuration and sample beam data are presented.

  10. Three-dimensional accuracy of plastic transfer impression copings for three implant systems.

    Science.gov (United States)

    Teo, Juin Wei; Tan, Keson B; Nicholls, Jack I; Wong, Keng Mun; Uy, Joanne

    2014-01-01

    The purpose of this study was to compare the three-dimensional accuracy of indirect plastic impression copings and direct implant-level impression copings from three implant systems (Nobel Biocare [NB], Biomet 3i [3i], and Straumann [STR]) at three interimplant buccolingual angulations (0, 8, and 15 degrees). Two-implant master models were used to simulate a three-unit implant fixed partial denture. Test models were made from Impregum impressions using direct implant-level impression copings (DR). Abutments were then connected to the master models for impressions using the plastic impression copings (INDR) at three different angulations for a total of 18 test groups (n = 5 in each group). A coordinate measuring machine was used to measure linear distortions, three-dimensional (3D) distortions, angular distortions, and absolute angular distortions between the master and test models. Three-way analysis of variance showed that the implant system had a significant effect on 3D distortions and absolute angular distortions in the x- and y-axes. Interimplant angulation had a significant effect on 3D distortions and absolute angular distortions in the y-axis. Impression technique had a significant effect on absolute angular distortions in the y-axis. With DR, the NB and 3i systems were not significantly different. With INDR, 3i appeared to have less distortion than the other systems. Interimplant angulations did not significantly affect the accuracy of NBDR, 3iINDR, and STRINDR. The accuracy of INDR and DR was comparable at all interimplant angulations for 3i and STR. For NB, INDR was comparable to DR at 0 and 8 degrees but was less accurate at 15 degrees. Three-dimensional accuracy of implant impressions varied with implant system, interimplant angulation, and impression technique.

  11. Development of an acoustic measurement protocol to monitor acetabular implant fixation in cementless total hip Arthroplasty: A preliminary study.

    Science.gov (United States)

    Goossens, Quentin; Leuridan, Steven; Henyš, Petr; Roosen, Jorg; Pastrav, Leonard; Mulier, Michiel; Desmet, Wim; Denis, Kathleen; Vander Sloten, Jos

    2017-11-01

    In cementless total hip arthroplasty (THA), the initial stability is obtained by press-fitting the implant in the bone to allow osseointegration for a long term secondary stability. However, finding the insertion endpoint that corresponds to a proper initial stability is currently based on the tactile and auditory experiences of the orthopedic surgeon, which can be challenging. This study presents a novel real-time method based on acoustic signals to monitor the acetabular implant fixation in cementless total hip arthroplasty. Twelve acoustic in vitro experiments were performed on three types of bone models; a simple bone block model, an artificial pelvic model and a cadaveric model. A custom made beam was screwed onto the implant which functioned as a sound enhancer and insertor. At each insertion step an acoustic measurement was performed. A significant acoustic resonance frequency shift was observed during the insertion process for the different bone models; 250 Hz (35%, second bending mode) to 180 Hz (13%, fourth bending mode) for the artificial bone block models and 120 Hz (11%, eighth bending mode) for the artificial pelvis model. No significant frequency shift was observed during the cadaveric experiment due to a lack of implant fixation in this model. This novel diagnostic method shows the potential of using acoustic signals to monitor the implant seating during insertion. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

  12. Predictors of clinical outcome in total hip and knee replacement : a methodological appraisal of implants and patient factors

    NARCIS (Netherlands)

    Keurentjes, Johan Christiaan

    2014-01-01

    In this thesis, we studied both implants and patient and surgeon factors as predictors of clinical outcome after total hip and knee replacement. Additionally, we studied a number of methodological aspects of orthopaedic research, such as competing risks in estimating the probability of revision

  13. Veno-venous extracorporeal membrane oxygenation using an innovative dual-lumen cannula following implantation of a total artificial heart.

    Science.gov (United States)

    Youdle, Jemma; Penn, Sarah; Maunz, Olaf; Simon, Andre

    2017-01-01

    We report our first clinical use of the new Protek Duo TM cannula for peripheral veno-venous extra-corporeal life support (ECLS). A 53-year-old male patient underwent implantation of a total artificial heart (TAH) for biventricular failure. However, due to the development of post-operative respiratory dysfunction, the patient required ECLS for six days.

  14. Implant survival of the most common cemented total hip devices from the Nordic Arthroplasty Register Association database

    DEFF Research Database (Denmark)

    Junnila, Mika; Laaksonen, Inari; Eskelinen, Antti

    2016-01-01

    Background and purpose - According to previous Nordic Arthroplasty Register Association (NARA) data, the 10-year implant survival of cemented total hip arthroplasties (THAs) is 94% in patients aged 65-74 and 96% in patients aged 75 or more. Here we report a brand-level comparison of cemented THA...

  15. Bicruciate-retaining Total Knee Replacement Provides Satisfactory Function and Implant Survivorship at 23 Years.

    Science.gov (United States)

    Pritchett, James W

    2015-07-01

    One of the goals of a TKA is to approximate the function of a normal knee. Preserving the natural ligaments might provide a method of restoring close to normal function. Sacrifice of the ACL is common and practical during a TKA. However, this ligament is functional in more than 60% of patients undergoing a TKA and kinematic studies support the concept of bicruciate-retaining (that is, ACL-preserving) TKA; however, relatively few studies have evaluated patients treated with bicruciate-retaining TKA implants. I asked: (1) what is the long-term (minimum 20-year) survivorship, (2) what are the functional results, and (3) what are the reasons for revision of bicruciate-retaining knee arthroplasty prostheses? From January 1989 to September 1992, I performed 639 total knee replacements in 537 patients. Of these, 489 were performed in 390 patients using a bicruciate-retaining, minimally constrained device. During the period in question, this knee prosthesis was used for all patients observed intraoperatively to have an intact, functional ACL with between 15° varus and 15° valgus joint deformity. There were 234 women and 156 men with a mean age at surgery of 65 years (range, 42-84 years) and a primary diagnosis of osteoarthritis in 89%. The patella was resurfaced in all knees. The mean followup was 23 years (range, 20-24 years). At the time of this review, 199 (51%) patients had died and 31 (8%) patients were lost to followup, leaving 160 (41%) patients (214 knees) available for review. Component survivorship was determined by competing-risks analysis and Kaplan Meier survivorship analysis with revision for any reason as the primary endpoint. Patients were evaluated every 2 years to assess ROM, joint laxity, knee stability, and to determine American Knee Society scores. The Kaplan-Meier survivorship was 89% (95% CI, 82%-93%) at 23 years with revision for any reason as the endpoint. Competing-risks survivorship was 94% (95% CI, 91%%-96 %) at 23 years. At followup, the mean

  16. EXPERIMENTAL RESEARCH OF REGENERATIVE FEATURES IN BONE TISSUES AROUND IMPLANTS AFTER ONE-STAGE BILATERAL TOTAL HIP REPLACEMENT

    Directory of Open Access Journals (Sweden)

    V. M. Mashkov

    2012-01-01

    Full Text Available Objective: to research the specific features of regenerative processes of bone tissue around implants after one-stage bilateral total hip replacement in experiment. Material and methods: 27 total hip replacement operations have been performed in 18 rabbits of breed "chinchilla" to which bipolar femoral endoprosthesis made of titanic alloy PT-38, one type-size, with friction pair metal-on-metal and neck-shaft angle 165 degrees have been implanted: total unilateral hip replacement operations have been performed in 9 animals (control group, one-stage bilateral total hip replacement operations have been performed in 9 animals (experimental group. During research they have been on radiological and clinical checking-up. After the experiment the animals had histological tests of the tissues around endoprosthesis components. Results and conclusions: After one-stage bilateral total hip replacement in early terms of research more expressed changes of bone tissue in the form of its thinning and decompaction were found around implants. One-stage bilateral total hip replacement did not essentially influence on the speed of osteogenesis around endoprothesis components in comparison with unilateral total hip replacement, so in late terms of observation in both groups the fixing of endoprothesis components did not differ.

  17. Sinking and fit of abutment of locking taper implant system

    Science.gov (United States)

    Moon, Seung-Jin; Kim, Hee-Jung; Son, Mee-Kyoung

    2009-01-01

    STATEMENT OF PROBLEM Unlike screw-retention type, fixture-abutment retention in Locking taper connection depends on frictional force so it has possibility of abutment to sink. PURPOSE In this study, Bicon® Implant System, one of the conical internal connection implant system, was used with applying loading force to the abutments connected to the fixture. Then the amount of sinking was measured. MATERIAL AND METHODS 10 Bicon® implant fixtures were used. First, the abutment was connected to the fixture with finger force. Then it was tapped with a mallet for 3 times and loads of 20 kg corresponding to masticatory force using loading application instrument were applied successively. The abutment state, slightly connected to the fixture without pressure was considered as a reference length, and every new abutment length was measured after each load's step was added. The amount of abutment sinking (mm) was gained by subtracting the length of abutment-fixture under each loading condition from reference length. RESULTS It was evident, that the amount of abutment sinking in Bicon® Implant System increased as loads were added. When loads of 20 kg were applied more than 5 - 7 times, sinking stopped at 0.45 ± 0.09 mm. CONCLUSION Even though locking taper connection type implant shows good adaption to occlusal force, it has potential for abutment sinking as loads are given. When locking taper connection type implant is used, satisfactory loads are recommended for precise abutment location. PMID:21165262

  18. Attachment systems for mandibular implant overdentures: a systematic review

    Science.gov (United States)

    Kim, Ha-Young; Lee, Jeong-Yol; Bryant, S. Ross

    2012-01-01

    PURPOSE The aim of this systematic review was to address treatment outcome according to attachment systems for mandibular implant overdentures in terms of implant survival rate, prosthetic maintenance and complications, and patient satisfaction. MATERIALS AND METHODS A systematic literature search was conducted using PubMed and hand searching of relevant journals considering inclusion and exclusion criteria. Clinical trial studies on mandibular implant overdentures until August, 2010 were selected if more than one type of overdenture attachment was reported. Twenty four studies from 1098 studies were finally included and the data on implant survival rate, prosthetic maintenance and complications, patient satisfaction were analyzed relative to attachment systems. RESULTS Four studies presented implant survival rates (95.8 - 97.5% for bar, 96.2 - 100% for ball, 91.7% for magnet) according to attachment system. Ten other studies presented an implant survival rate ranging from 93.3% to 100% without respect to the attachment groups. Common prosthetic maintenance and complications were replacement of an assay for magnet attachments, and activation of a matrix or clip for ball or bar attachments. Prosthetic maintenance and complications most commonly occurred in the magnet groups. Conflicting findings were found on the rate of prosthetic maintenance and complications comparing ball and bar attachments. Most studies showed no significant differences in patient satisfaction depending upon attachment systems. CONCLUSION The implant survival rate of mandibular overdentures seemed to be high regardless attachment systems. The prosthetic maintenance and complications may be influenced by attachment systems. However patient satisfaction may be independent of the attachment system. PMID:23236571

  19. Demikhov's "Mechanical Heart": The Circumstances Surrounding Creation of the World's First Implantable Total Artificial Heart in 1937.

    Science.gov (United States)

    Glyantsev, Sergey P; Tchantchaleishvili, Vakhtang; Bockeria, Leo A

    2016-01-01

    The world's first implantable total artificial heart was designed by Vladimir Demikhov as a fourth year biology student in Voronezh, Soviet Union, in 1937. As a prototype of his device, Demikhov must have used an apparatus for extracorporeal blood circulation invented by Sergei Bryukhonenko of Moscow. The device was the size of a dog's native heart and consisted of two diaphragm pumps brought into motion by an electric motor. A dog with an implanted device lived for 2.5 hours. In addition to having the prototype, the preconditions for Demikhov's artificial heart creation were his manual dexterity, expertise in animal physiology, and his mechanistic worldview.

  20. Comparative risk assessment of total energy systems

    International Nuclear Information System (INIS)

    Soerensen, B.

    1982-01-01

    The paper discusses a methodology for total impact assessment of energy systems, ideally evaluating all the impacts that a given energy system has on the society in which it is imbedded or into which its introduction is being considered. Impacts from the entire energy conversion chain ('fuel cycle' if the system is fuel-based), including energy storage, transport and transmission, as well as the institutions formed in order to manage the system, should be compared on the basis of the energy service provided. A number of impacts are considered, broadly classified as impacts on satisfaction of biological needs, on health, on environment, on social relations and on the structure of society. Further considerations include impacts related to cost and resilience, and, last but not least, impacts on global relations. The paper discusses a number of published energy studies in the light of the comparative impact assessment methodology outlined above. (author)

  1. Totally implantable vascular access device (TIVAD) placement: a modified technique that takes post-procedure aesthetic aspects into account.

    Science.gov (United States)

    Liberale, Gabriel

    2017-04-01

    Major progress has been made in breast cancer reconstruction surgery. The standard technique for totally implanted vascular access device (TIVAD) implantation generally requires an incision for port insertion on the anterior part of the thorax that leaves a scar in the middle of the neckline in patients who have undergone mastectomy with complex breast reconstruction. The aim of this technical note is to report our revised surgical technique for TIVAD placement. In patients with breast cancer, we take a lateralized approach, performing an oblique incision on the lowest part of the deltopectoral groove. This allows us to introduce the port and to place it on the anterolateral part of the thorax, thus avoiding an unaesthetic scar on the anterior part of the thorax. Our modified technique for TIVAD implantation is described.

  2. Complications of Central Venous Totally Implantable Access Port: Internal Jugular Versus Subclavian Access

    Directory of Open Access Journals (Sweden)

    Pil Young Jung

    Full Text Available Background: Totally implantable access port (TIAP provides reliable, long term vascular access with minimal risk of infection and allows patients normal physical activity. With wide use of ports, new complications have been encountered. We analyzed TIAP related complications and evaluated the outcomes of two different percutaneous routes of access to superior vena cava. Methods: All 172 patients who underwent port insertion with internal jugular approach (Group 1, n = 92 and subclavian approach (Group 2, n = 79 between August 2011 and May 2013 in a single center were analyzed, retrospectively. Medical records were analyzed to compare the outcomes and the occurrence of port related complications between two different percutaneous routes of access to superior vena cava. Results: Median follow-up for TIAP was 278 days (range, 1-1868. Twenty four complications were occurred (14.0%, including pneumothorax (n = 1, 0.6%, migration/malposition (n = 4, 2.3%, pinch-off syndrome (n = 4, 2.3%, malfunction (n = 2, 1.1%, infection (n = 8, 4.7%, and venous thrombosis (n = 5, 2.9%. The overall incidence was 8.7% and 20.3% in each group (p = 0.030. Mechanical complications except infectious and thrombotic complications were more often occurred in group 2 (p = 0.033. The mechanical complication free probability is significantly higher in group 1 (p = 0.040. Conclusions: We suggest that the jugular access should be chosen in patients who need long term catheterization because of high incidence of mechanical complication, such as pinch-off syndrome.

  3. Revision of failed shoulder hemiarthroplasty to reverse total arthroplasty: analysis of 157 revision implants.

    Science.gov (United States)

    Merolla, Giovanni; Wagner, Eric; Sperling, John W; Paladini, Paolo; Fabbri, Elisabetta; Porcellini, Giuseppe

    2018-01-01

    There remains a paucity of studies examining the conversion of failed hemiarthroplasty (HA) to reverse total shoulder arthroplasty (RTSA). Therefore, the purpose of this study was to examine a large series of revision HA to RTSA. A population of 157 patients who underwent conversion of a failed HA to a revision RTSA from 2006 through 2014 were included. The mean follow-up was 49 months (range, 24-121 months). The indications for revision surgery included instability with rotator cuff insufficiency (n = 127) and glenoid wear (n = 30); instability and glenoid wear were associated in 38 cases. Eight patients with infection underwent 2-stage reimplantation. Patients experienced significant improvements in their preoperative to postoperative pain and shoulder range of motion (P surgeries, secondary to glenoid component loosening (n = 3), instability (n = 3), humeral component disassembly (n = 2), humeral stem loosening (n = 1), and infection (n = 2). Implant survivorship was 95.5% at 2 years and 93.3% at 5 years. There were 4 reoperations including axillary nerve neurolysis (n = 2), heterotopic ossification removal (n = 1), and hardware removal for rupture of the metal cerclage for an acromial fracture (n = 1). At final follow-up, there were 5 "at-risk" glenoid components. Patients experience satisfactory pain relief and recovery of reasonable shoulder function after revision RTSA from a failed HA. There was a relatively low revision rate, with glenoid loosening and instability being the most common causes. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  4. Retrospective study investigating the clinical success of two provisional implant systems

    OpenAIRE

    Hotz, Nadine

    2011-01-01

    The use of dental implants allows a reliable stabilisation of prosthesis. Usually, definitive implants can´t be used for fixation of prosthesis during their healing period. Therefore, in many cases it is not possible to follow the demand of patients of an immediate loading of definitive implants to avoid a unfixed dental prosthesis. This is one domain of provisional dental implants. The present study of two provisional implant systems approves the benefit of provisional implants during...

  5. The Pathology of Orthopedic Implant Failure Is Mediated by Innate Immune System Cytokines

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2014-01-01

    Full Text Available All of the over 1 million total joint replacements implanted in the US each year are expected to eventually fail after 15–25 years of use, due to slow progressive subtle inflammation at the bone implant interface. This inflammatory disease state is caused by implant debris acting, primarily, on innate immune cells, that is, macrophages. This slow progressive pathological bone loss or “aseptic loosening” is a potentially life-threatening condition due to the serious complications in older people (>75 yrs of total joint replacement revision surgery. In some people implant debris (particles and ions from metals can influence the adaptive immune system as well, giving rise to the concept of metal sensitivity. However, a consensus of studies agrees that the dominant form of this response is due to innate reactivity by macrophages to implant debris where both danger (DAMP and pathogen (PAMP signalling elicit cytokine-based inflammatory responses. This paper discusses implant debris induced release of the cytokines and chemokines due to activation of the innate (and the adaptive immune system and the subsequent formation of osteolysis. Different mechanisms of implant-debris reactivity related to the innate immune system are detailed, for example, danger signalling (e.g., IL-1β, IL-18, IL-33, etc., toll-like receptor activation (e.g., IL-6, TNF-α, etc., apoptosis (e.g., caspases 3–9, bone catabolism (e.g., TRAP5b, and hypoxia responses (Hif1-α. Cytokine-based clinical and basic science studies are in progress to provide diagnosis and therapeutic intervention strategies.

  6. The Pathology of Orthopedic Implant Failure Is Mediated by Innate Immune System Cytokines

    Science.gov (United States)

    Landgraeber, Stefan; Jäger, Marcus; Jacobs, Joshua J.; Hallab, Nadim James

    2014-01-01

    All of the over 1 million total joint replacements implanted in the US each year are expected to eventually fail after 15–25 years of use, due to slow progressive subtle inflammation at the bone implant interface. This inflammatory disease state is caused by implant debris acting, primarily, on innate immune cells, that is, macrophages. This slow progressive pathological bone loss or “aseptic loosening” is a potentially life-threatening condition due to the serious complications in older people (>75 yrs) of total joint replacement revision surgery. In some people implant debris (particles and ions from metals) can influence the adaptive immune system as well, giving rise to the concept of metal sensitivity. However, a consensus of studies agrees that the dominant form of this response is due to innate reactivity by macrophages to implant debris where both danger (DAMP) and pathogen (PAMP) signalling elicit cytokine-based inflammatory responses. This paper discusses implant debris induced release of the cytokines and chemokines due to activation of the innate (and the adaptive) immune system and the subsequent formation of osteolysis. Different mechanisms of implant-debris reactivity related to the innate immune system are detailed, for example, danger signalling (e.g., IL-1β, IL-18, IL-33, etc.), toll-like receptor activation (e.g., IL-6, TNF-α, etc.), apoptosis (e.g., caspases 3–9), bone catabolism (e.g., TRAP5b), and hypoxia responses (Hif1-α). Cytokine-based clinical and basic science studies are in progress to provide diagnosis and therapeutic intervention strategies. PMID:24891761

  7. Current State and Future Perspectives of Energy Sources for Totally Implantable Cardiac Devices.

    Science.gov (United States)

    Bleszynski, Peter A; Luc, Jessica G Y; Schade, Peter; PhilLips, Steven J; Tchantchaleishvili, Vakhtang

    There is a large population of patients with end-stage congestive heart failure who cannot be treated by means of conventional cardiac surgery, cardiac transplantation, or chronic catecholamine infusions. Implantable cardiac devices, many designated as destination therapy, have revolutionized patient care and outcomes, although infection and complications related to external power sources or routine battery exchange remain a substantial risk. Complications from repeat battery replacement, power failure, and infections ultimately endanger the original objectives of implantable biomedical device therapy - eliminating the intended patient autonomy, affecting patient quality of life and survival. We sought to review the limitations of current cardiac biomedical device energy sources and discuss the current state and trends of future potential energy sources in pursuit of a lifelong fully implantable biomedical device.

  8. Retention system for implant-supported dentures used by brazilian dentists who work in implant dentistry

    Directory of Open Access Journals (Sweden)

    Saturnino Aparecido Ramalho

    2010-04-01

    Full Text Available Objective: To provide the dentists with support in the choice of the cement or screw type of retention for implant-supported dentures, according to the patient’s problem. Methods: An opinion questionnaire was applied to a sample of 468 participants, all dentists working in the field of Implant Dentistry, of whom 272 (58.1% participated in the 4th International Congress of Osseointegration of APCD, held in São Paulo (SP from 6 to 9 May 2004, 119 (25.4% participated in the 2nd International Congress of Implant Dentistry of Minas Gerais, between 10 and 12 June 2004 and 77 (16.5% were professors and specialization and master students from São Leopoldo Mandic. Results: The results showed that 254 participants opted for the screw-retained system while 214 opted for the cement-retained system. Conclusion: There was a preference for the use of the screw-retained system, and that both cemented and screw-retained systems have advantages and disadvantages, so that the dentist is left to decide and evaluate them in order to indicate and use them with confidence in different clinical cases.

  9. Influence of abutment materials on the implant-abutment joint stability in internal conical connection type implant systems

    OpenAIRE

    Jo, Jae-Young; Yang, Dong-Seok; Huh, Jung-Bo; Heo, Jae-Chan; Yun, Mi-Jung; Jeong, Chang-Mo

    2014-01-01

    PURPOSE This study evaluated the influence of abutment materials on the stability of the implant-abutment joint in internal conical connection type implant systems. MATERIALS AND METHODS Internal conical connection type implants, cement-retained abutments, and tungsten carbide-coated abutment screws were used. The abutments were fabricated with commercially pure grade 3 titanium (group T3), commercially pure grade 4 titanium (group T4), or Ti-6Al-4V (group TA) (n=5, each). In order to assess ...

  10. Three-Dimensional Implant Positioning with a Piezosurgery Implant Site Preparation Technique and an Intraoral Surgical Navigation System: Case Report.

    Science.gov (United States)

    Pellegrino, Gerardo; Taraschi, Valerio; Vercellotti, Tomaso; Ben-Nissan, Besim; Marchetti, Claudio

    This case report describes new implant site preparation techniques joining the benefits of using an intraoral navigation system to optimize three-dimensional implant site positioning in combination with an ultrasonic osteotomy. A report of five patients is presented, and the implant positions as planned in the navigation software with the postoperative scan image were compared. The preliminary results are useful, although further clinical studies with larger populations are needed to confirm these findings.

  11. Implementation and validation of an implant-based coordinate system for RSA migration calculation.

    Science.gov (United States)

    Laende, Elise K; Deluzio, Kevin J; Hennigar, Allan W; Dunbar, Michael J

    2009-10-16

    An in vitro radiostereometric analysis (RSA) phantom study of a total knee replacement was carried out to evaluate the effect of implementing two new modifications to the conventional RSA procedure: (i) adding a landmark of the tibial component as an implant marker and (ii) defining an implant-based coordinate system constructed from implant landmarks for the calculation of migration results. The motivation for these two modifications were (i) to improve the representation of the implant by the markers by including the stem tip marker which increases the marker distribution (ii) to recover clinical RSA study cases with insufficient numbers of markers visible in the implant polyethylene and (iii) to eliminate errors in migration calculations due to misalignment of the anatomical axes with the RSA global coordinate system. The translational and rotational phantom studies showed no loss of accuracy with the two new measurement methods. The RSA system employing these methods has a precision of better than 0.05 mm for translations and 0.03 degrees for rotations, and an accuracy of 0.05 mm for translations and 0.15 degrees for rotations. These results indicate that the new methods to improve the interpretability, relevance, and standardization of the results do not compromise precision and accuracy, and are suitable for application to clinical data.

  12. Implantation technique of the 50-cm3 SynCardia Total Artificial Heart: does size make a difference?

    Science.gov (United States)

    Spiliopoulos, Sotirios; Guersoy, Dilek; Dimitriou, Alexandros Merkourios; Koerfer, Reiner; Tenderich, Gero

    2015-01-01

    Despite downsizing, implantation technique of the 50-cm(3) SynCardia Total Artificial Heart and settings of the Companion driver remain unchanged. Owing to the absence of de-airing nipples, de-airing procedure is even more crucial and has to be performed carefully. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  13. Three-dimensional accuracy of a digitally coded healing abutment implant impression system.

    Science.gov (United States)

    Ng, Simon D; Tan, Keson B; Teoh, K H; Cheng, Ansgar C; Nicholls, Jack I

    2014-01-01

    This study examined the three-dimensional (3D) accuracy of the Encode Impression System (EN) in transferring the locations of two implants from master models to test models and compared this to the direct impression (DI) technique. The effect of interimplant angulation on the 3D accuracy of both impression techniques was also evaluated. Seven sectional polymethyl methacrylate mandibular arch master models were fabricated with implants in the first premolar and first molar positions. The implants were placed parallel to each other or angulated mesiodistally or buccolingually with total divergent angles of 10, 20, or 30 degrees. Each master model was secured onto an aluminum block containing a gauge block, which defined the local coordinate references. Encode healing abutments were attached to the implants before impressions were made for the EN test models; pickup impression copings were attached for the DI test models. For the seven test groups of each impression technique, a total of 70 test models were fabricated (n = 5). The EN test models were sent to Biomet 3i for implant analog placement. The centroid of each implant or implant analog and the angular orientation of the long axis relative to the x- and y-axes were measured with a coordinate measuring machine. Statistical analyses were performed. Impression technique had a significant effect on y distortion, global linear distortion, and absolute xz and yz angular distortions. Interimplant angulation had significant effects on x and y distortions. However, neither impression technique nor interimplant angulation had a significant effect on z distortion. Distortions were observed with both impression techniques. However, the results suggest that EN was less accurate than DI.

  14. Research on total-dose hardening for H-gate PD NMOSFET/SIMOX by ion implanting into buried oxide

    International Nuclear Information System (INIS)

    Qian Cong; Zhang Zhengxuan; Zhang Feng; Lin Chenglu

    2008-01-01

    In this work, we investigate the back-gate I-V characteristics for two kinds of NMOSFET/SIMOX transistors with H gate structure fabricated on two different SOI wafers. A transistors are made on the wafer implanted with Si + and then annealed in N 2 , and B transistors are made on the wafer without implantation and annealing. It is demonstrated experimentally that A transistors have much less back-gate threshold voltage shift ΔV th than B transistors under X-ray total close irradiation. Subthreshold charge separation technique is employed to estimate the build-up of oxide charge and interface traps during irradiation, showing that the reduced ΔV th for A transistors is mainly due to its less build-up of oxide charge than B transistors. Photo-luminescence (PL) research indicates that Si implantation results in the formation of silicon nanocrystalline (nanocluster) whose size increases with the implant dose. This structure can trap electrons to compensate the positive charge build-up in the buried oxide during irradiation, and thus reduce the threshold voltage negative shift. (authors)

  15. Wireless energizing system for an automated implantable sensor

    Energy Technology Data Exchange (ETDEWEB)

    Swain, Biswaranjan; Nayak, Praveen P.; Kar, Durga P.; Bhuyan, Satyanarayan; Mishra, Laxmi P. [Department of Electronics and Instrumentation Engineering, Siksha ‘O’ Anusandhan University, Bhubaneswar 751030 (India)

    2016-07-15

    The wireless drive of an automated implantable electronic sensor has been explored for health monitoring applications. The proposed system comprises of an automated biomedical sensing system which is energized through resonant inductive coupling. The implantable sensor unit is able to monitor the body temperature parameter and sends back the corresponding telemetry data wirelessly to the data recoding unit. It has been observed that the wireless power delivery system is capable of energizing the automated biomedical implantable electronic sensor placed over a distance of 3 cm from the power transmitter with an energy transfer efficiency of 26% at the operating resonant frequency of 562 kHz. This proposed method ensures real-time monitoring of different human body temperatures around the clock. The monitored temperature data have been compared with a calibrated temperature measurement system to ascertain the accuracy of the proposed system. The investigated technique can also be useful for monitoring other body parameters such as blood pressure, bladder pressure, and physiological signals of the patient in vivo using various implantable sensors.

  16. Wireless energizing system for an automated implantable sensor

    International Nuclear Information System (INIS)

    Swain, Biswaranjan; Nayak, Praveen P.; Kar, Durga P.; Bhuyan, Satyanarayan; Mishra, Laxmi P.

    2016-01-01

    The wireless drive of an automated implantable electronic sensor has been explored for health monitoring applications. The proposed system comprises of an automated biomedical sensing system which is energized through resonant inductive coupling. The implantable sensor unit is able to monitor the body temperature parameter and sends back the corresponding telemetry data wirelessly to the data recoding unit. It has been observed that the wireless power delivery system is capable of energizing the automated biomedical implantable electronic sensor placed over a distance of 3 cm from the power transmitter with an energy transfer efficiency of 26% at the operating resonant frequency of 562 kHz. This proposed method ensures real-time monitoring of different human body temperatures around the clock. The monitored temperature data have been compared with a calibrated temperature measurement system to ascertain the accuracy of the proposed system. The investigated technique can also be useful for monitoring other body parameters such as blood pressure, bladder pressure, and physiological signals of the patient in vivo using various implantable sensors.

  17. Wireless energizing system for an automated implantable sensor.

    Science.gov (United States)

    Swain, Biswaranjan; Nayak, Praveen P; Kar, Durga P; Bhuyan, Satyanarayan; Mishra, Laxmi P

    2016-07-01

    The wireless drive of an automated implantable electronic sensor has been explored for health monitoring applications. The proposed system comprises of an automated biomedical sensing system which is energized through resonant inductive coupling. The implantable sensor unit is able to monitor the body temperature parameter and sends back the corresponding telemetry data wirelessly to the data recoding unit. It has been observed that the wireless power delivery system is capable of energizing the automated biomedical implantable electronic sensor placed over a distance of 3 cm from the power transmitter with an energy transfer efficiency of 26% at the operating resonant frequency of 562 kHz. This proposed method ensures real-time monitoring of different human body temperatures around the clock. The monitored temperature data have been compared with a calibrated temperature measurement system to ascertain the accuracy of the proposed system. The investigated technique can also be useful for monitoring other body parameters such as blood pressure, bladder pressure, and physiological signals of the patient in vivo using various implantable sensors.

  18. Electroacoustic verification of frequency modulation systems in cochlear implant users.

    Science.gov (United States)

    Fidêncio, Vanessa Luisa Destro; Jacob, Regina Tangerino de Souza; Tanamati, Liége Franzini; Bucuvic, Érika Cristina; Moret, Adriane Lima Mortari

    2017-12-26

    The frequency modulation system is a device that helps to improve speech perception in noise and is considered the most beneficial approach to improve speech recognition in noise in cochlear implant users. According to guidelines, there is a need to perform a check before fitting the frequency modulation system. Although there are recommendations regarding the behavioral tests that should be performed at the fitting of the frequency modulation system to cochlear implant users, there are no published recommendations regarding the electroacoustic test that should be performed. Perform and determine the validity of an electroacoustic verification test for frequency modulation systems coupled to different cochlear implant speech processors. The sample included 40 participants between 5 and 18 year's users of four different models of speech processors. For the electroacoustic evaluation, we used the Audioscan Verifit device with the HA-1 coupler and the listening check devices corresponding to each speech processor model. In cases where the transparency was not achieved, a modification was made in the frequency modulation gain adjustment and we used the Brazilian version of the "Phrases in Noise Test" to evaluate the speech perception in competitive noise. It was observed that there was transparency between the frequency modulation system and the cochlear implant in 85% of the participants evaluated. After adjusting the gain of the frequency modulation receiver in the other participants, the devices showed transparency when the electroacoustic verification test was repeated. It was also observed that patients demonstrated better performance in speech perception in noise after a new adjustment, that is, in these cases; the electroacoustic transparency caused behavioral transparency. The electroacoustic evaluation protocol suggested was effective in evaluation of transparency between the frequency modulation system and the cochlear implant. Performing the adjustment of

  19. Sistema de fabrico rápido de implantes ortopédicos Rapid manufacturing system of orthopedics implants

    Directory of Open Access Journals (Sweden)

    Carlos Relvas

    2009-06-01

    /CAM system. After sterilization, the implant is able to be placed on the patient. The concept was developed using low cost technology and commercially available. The system has been tested in an in vivo hip arthroplasty performed on a sheep. The time increase of surgery was 80 minutes being 40 minutes the time of implant manufacturing. The system developed has been tested and the goals defined of the study achieved enabling the rapid manufacture of an implant in a time period compatible with the surgery time.

  20. Comparison of Venae Sectio vs. modified Seldinger Technique for Totally Implantable Access Ports; Portas-trial [ISRCTN:52368201

    Directory of Open Access Journals (Sweden)

    Luntz S

    2006-06-01

    Full Text Available Abstract Background The insertion of a Totally Implantable Access Port (TIAP is a routinely employed technique in patients who need a safe and permanent venous access. The number of TIAP implantations is increasing constantly mainly due to advanced treatment options for malignant diseases. Therefore it is important to identify the implantation technique which has the optimal benefit/risk ratio for the patient. Study design A single-centre, randomized, controlled superiority trial to compare two different TIAP implantation techniques. Sample size: 160 patients will be included and randomized intra-operatively. Eligibility criteria: Age equal or older than 18 years, patients scheduled for primary elective implantation of a TIAP in local anaesthesia and a signed informed consent. Primary endpoint: Primary success rate of the randomized technique. Intervention: Venae Sectio in combination with the Seldinger Technique (guide wire and a peel away sheath will be used to place a TIAP. Reference treatment: Conventional Venae Sectio will be used with a direct insertion of the TIAP without guide wire or peel away sheath. Duration of study: Approximately 20 months. Organisation/Responsibility The trial will be conducted in compliance with the protocol and in accordance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989 and Good Clinical Practice (GCP. The trial will also be carried out in keeping with local and regulatory requirements. The Klinisches Studienzentrum Chirurgie (KSC – Centre of Clinical Trials in Surgery at the Department of Surgery, University Hospital Heidelberg is responsible for planning and conduction of the trial. Documentation of patient's data will be accomplished via electronical Case Report Files (eCRF with MACRO®-Software by the KSC. Randomization, data management, monitoring and biometry are provided by the independent Koordinierungszentrum f

  1. Rehabilitation with implant-supported overdentures in total edentulous patients: A review

    OpenAIRE

    Martínez–Lage-Azorín, Juan F.; Segura-Andrés, Gustavo; Faus-López, Joan; Agustín-Panadero, Rubén

    2013-01-01

    Objectives: The main aim of this review article is to discuss implant-supported overdentures (ISOs) as treatment in edentulous patients. Besides, we will try to discuss among the different treatment options in such patients and to analyze their validity when ISOs are compared with other clinical modalities. At the same time, we will try to suggest clinical guidelines supported by current clinical studies. Material and methods: We performed a Medline search and review of pertinent articles on ...

  2. The KineSpring® Knee Implant System: an implantable joint-unloading prosthesis for treatment of medial knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Clifford AG

    2013-05-01

    Full Text Available Anton G Clifford,1 Stefan M Gabriel,1 Mary O’Connell,1 David Lowe,1 Larry E Miller,2,3 Jon E Block31Moximed, Inc, Hayward, CA, USA; 2Miller Scientific Consulting, Inc, Arden, NC, USA; 3The Jon Block Group, San Francisco, CA, USAAbstract: Symptomatic medial compartment knee osteoarthritis (OA is the leading cause of musculoskeletal pain and disability in adults. Therapies intended to unload the medial knee compartment have yielded unsatisfactory results due to low patient compliance with conservative treatments and high complication rates with surgical options. There is no widely available joint-unloading treatment for medial knee OA that offers clinically important symptom alleviation, low complication risk, and high patient acceptance. The KineSpring® Knee Implant System (Moximed, Inc, Hayward, CA, USA is a first-of-its-kind, implantable, extra-articular, extra-capsular prosthesis intended to alleviate knee OA-related symptoms by reducing medial knee compartment loading while overcoming the limitations of traditional joint-unloading therapies. Preclinical and clinical studies have demonstrated excellent prosthesis durability, substantial reductions in medial compartment and total joint loads, and clinically important improvements in OA-related pain and function. The purpose of this report is to describe the KineSpring System, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The KineSpring System has potential to bridge the gap between ineffective conservative treatments and irreversible surgical interventions for medial compartment knee OA.Keywords: KineSpring, knee, medial, osteoarthritis, prosthesis

  3. A Wireless Implantable Switched-Capacitor Based Optogenetic Stimulating System

    Science.gov (United States)

    Lee, Hyung-Min; Kwon, Ki-Yong; Li, Wen

    2015-01-01

    This paper presents a power-efficient implantable optogenetic interface using a wireless switched-capacitor based stimulating (SCS) system. The SCS efficiently charges storage capacitors directly from an inductive link and periodically discharges them into an array of micro-LEDs, providing high instantaneous power without affecting wireless link and system supply voltage. A custom-designed computer interface in LabVIEW environment wirelessly controls stimulation parameters through the inductive link, and an optrode array enables simultaneous neural recording along with optical stimulation. The 4-channel SCS system prototype has been implemented in a 0.35-μm CMOS process and combined with the optrode array. In vivo experiments involving light-induced local field potentials verified the efficacy of the SCS system. An implantable version of the SCS system with flexible hermetic sealing is under development for chronic experiments. PMID:25570099

  4. Total DNA of Glycyrrhiza uralensis transformed into Hansenula anomala by ion implantation:Preparing Glycyrrhizic acid in recombined yeasts

    International Nuclear Information System (INIS)

    Jin Xiang; Mao Peihong; Lu Jie; Ma Yuan

    2010-01-01

    Glycyrrhizic acid (GA) in Glycyrrhiza uralensis (G. uralensis) is physiologically active. In this study, the total DNA of wild G. uralensis was randomly transformed into Hansenula anomaly by implantation of low-energy Ar + and N + , to produce five recombinant yeast strains relating to biological synthesis of the GA or Glycyrrhetinic acid (GAs). After culturing in liquid medium for 96 h, the resultant GA, 18α-GAs and 18β-Gas were determined by reversed-phase high performance liquid chromatography (RP-HPLC), and the corresponding concentrations were 114.49, 0.56, and 0.81 mg·L -1 . After one hundred primers were analyzed with random amplified polymorphic DNA (RAPD), the seven different DNA fragments were produced by the N7059 strain of recombined yeasts, and, the polymerase chain reaction (PCR) verified that one of them came from the genome of G. uralensis, indicating a successful transfer of genetic information by ion implantation. (authors)

  5. Depth of valve implantation, conduction disturbances and pacemaker implantation with CoreValve and CoreValve Accutrak system for Transcatheter Aortic Valve Implantation, a multi-center study.

    Science.gov (United States)

    Lenders, Guy D; Collas, Valérie; Hernandez, José Maria; Legrand, Victor; Danenberg, Haim D; den Heijer, Peter; Rodrigus, Inez E; Paelinck, Bernard P; Vrints, Christiaan J; Bosmans, Johan M

    2014-10-20

    Transcatheter Aortic Valve Implantation (TAVI) is now considered an indispensable treatment strategy in high operative risk patients with severe, symptomatic aortic stenosis. However, conduction disturbances and the need for Permanent Pacemaker (PPM) implantation after TAVI with the CoreValve prosthesis still remain frequent. We aimed to evaluate the implantation depth, the incidence and predictors of new conduction disturbances, and the need for PPM implantation within the first month after TAVI, using the new Accutrak CoreValve delivery system (ACV), compared to the previous generation CoreValve (non-ACV). In 5 experienced TAVI-centers, a total of 120 consecutive non-ACV and 112 consecutive ACV patients were included (n=232). The mean depth of valve implantation (DVI) was 8.4±4.0 mm in the non-ACV group and 7.1±4.0 mm in the ACV group (p=0.034). The combined incidence of new PPM implantation and new LBBB was 71.2% in the non-ACV group compared to 50.5% in the ACV group (p=0.014). DVI (p=0.002), first degree AV block (p=0.018) and RBBB (p<0.001) were independent predictors of PPM implantation. DVI (p<0.001) and pre-existing first degree AV-block (p=0.021) were identified as significant predictors of new LBBB. DVI is an independent predictor of TAVI-related conduction disturbances and can be reduced by using the newer CoreValve Accutrak delivery system, resulting in a significantly lower incidence of new LBBB and new PPM implantation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Complication incidence of two implant systems up to six years: a comparison between internal and external connection implants.

    Science.gov (United States)

    Chae, Sung-Wook; Kim, Young-Sung; Lee, Yong-Moo; Kim, Won-Kyung; Lee, Young-Kyoo; Kim, Su-Hwan

    2015-02-01

    This study was conducted to compare the cumulative survival rates (CSRs) and the incidence of postloading complications (PLCs) between a bone-level internal connection system (ICS-BL) and an external connection system (ECS). The medical records of patients treated with either a ICS-BL or ECS between 2007 and 2010 at Asan Medical Center were reviewed. PLCs were divided into two categories: biological and technical. Biological complications included >4 mm of probing pocket depth, thread exposure in radiographs, and soft tissue complications, whereas technical complications included chipping of the veneering material, fracture of the implant, fracture of the crown, loosening or fracture of the abutment or screw, loss of retention, and loss of access hole filling material. CSRs were determined by a life-table analysis and compared using the log-rank chi-square test. The incidence of PLC was compared with the Pearson chi-squared test. A total of 2,651 implants in 1,074 patients (1,167 ICS-BLs in 551 patients and 1,484 ECSs in 523 patients) were analyzed. The average observation periods were 3.4 years for the ICS-BLs and 3.1 years for the ECSs. The six-year CSR of all implants was 96.1% (94.9% for the ICS-BLs and 97.1% for the ECSs, P=0.619). Soft tissue complications were more frequent with the ECSs (P=0.005) and loosening or fracture of the abutment or screw occurred more frequently with the ICS-BLs (Plimitations of this study, the ICS-BL was more prone to technical complications while the ECS was more vulnerable to biological complications.

  7. Usefullness of three-dimensional templating software to quantify the contact state between implant and femur in total hip arthroplasty.

    Science.gov (United States)

    Inoue, Daisuke; Kabata, Tamon; Maeda, Toru; Kajino, Yoshitomo; Fujita, Kenji; Hasegawa, Kazuhiro; Yamamoto, Takashi; Takagi, Tomoharu; Ohmori, Takaaki; Tsuchiya, Hiroyuki

    2015-12-01

    It would be ideal if surgeons could precisely confirm whether the planned femoral component achieves the best fit and fill of implant and femur. However, the cortico-cancellous interfaces can be difficult to standardize using plain radiography, and therefore, determining the contact state is a subjective decision by the examiner. Few reports have described the use of CT-based three-dimensional templating software to quantify the contact state of stem and femur in detail. The purpose of this study was to use three-dimensional templating software to quantify the implant-femur contact state and develop a technique to analyze the initial fixation pattern of a cementless femoral stem. We conducted a retrospective review of 55 hips in 53 patients using a short proximal fit-and-fill anatomical stem (APS Natural-Hip™ System). All femurs were examined by density mapping which can visualize and digitize the contact state. We evaluated the contact state of implant and femur by using density mapping. The varus group (cases that had changed varus 2° by 3 months after surgery) consisted of 11 hips. The varus group showed no significant difference with regard to cortical contact in the proximal medial portion (Gruen 7), but the contact area in the distal portion (Gruen 3 and Gruen 5) was significantly lower than that of non-varus group. Density mapping showed that the stem only has to be press-fit to the medial calcar, but also must fill the distal portion of the implant in order to achieve the ideal contact state. Our results indicated that quantifying the contact state of implant and femur by using density mapping is a useful technique to accurately analyze the fixation pattern of a cementless femoral stem.

  8. Architecture and control of a high current ion implanter system

    International Nuclear Information System (INIS)

    Bayer, E.H.; Paul, L.F.; Kranik, J.R.

    1979-01-01

    The design of an ion implant system for use in production requires that special attention be given to areas of design which normally are not emphasized on research or development type ion implanters. Manually operated, local controls are replaced by remote controls, automatic sequencing, and digital displays. For ease of maintenance and replication the individual components are designed as simply as possible and are contained in modules of separate identities, joined only by the beam line and electrical interconnections. A production environment also imposes requirements for the control of contamination and maintainability of clean room integrity. For that reason the major portion of the hardware is separated from the clean operator area and is housed in a maintenance core area. The controls of a production system should also be such that relatively unskilled technicians are able to operate the system with optimum repeatability and minimum operator intervention. An extensive interlock system is required. Most important, for use in production the ion implant system has to have a relatively high rate of throughput. Since the rate of throughput at a given dose is a function of beam current, pumpdown time and wafer handling capacity, design of components affecting these parameters has been optimized. Details of the system are given. (U.K.)

  9. [Comparative evaluation of two kinds of micro-implant system with different size].

    Science.gov (United States)

    Wang, Zhen-Dong; Li, Qing-Yi; Wang, Lin; Gu, Yong-Jia

    2009-04-01

    To offer some reference for micro-implant's development and population by analyzing clinical application of two kinds of micro-implant systems. 38 patients treated with MIA (micro-implant anchorage) and 28 patients treated with SDIA (self-driven titanium implant for orthodontic anchorage) were included. Analyzing the rate of lost implants, the gum's reactivity and the efficiency of moving teeth summarized the excellences and shortcomings of two systems. 1) Six of MIA implants fell off after being inserted. Seven of SDIA implants lost when they had been implanted for a month. But they were stable after being inserted again. 2) The gum around 12 SDIA implants got inflammation symptom, but the gum around MIA implants was normal. 3) Both MIA implants and SDIA implants could move teeth effectively and persistently when they were stable. When we apply micro-implant in clinic, we should prevent it from closing roots of teeth and choose the small tip micro-implant. The embedded position should be in area of attachment gum. At the same time, the areas around the tip of micro-implant should be keeping clean.

  10. [Bentall operation combined with total arch replacement and stented elephant trunk implantation for serious Debakey I aortic dissecting aneurysm].

    Science.gov (United States)

    Gu, Tian-Xiang; Wang, Chun; Zhang, Yu-Hai

    2008-12-01

    To summarize the clinical experience of Bentall operation combined with total arch replacement and stented elephant trunk implantation for serious Debakey I aortic dissecting aneurysm. Twelve patients with serious Debakey I aortic dissecting aneurysm underwent surgical treatment from January 2005 to December 2007. There were 10 male and 2 female with the mean age of (40.1 +/- 9.5) years old. There were acute aortic dissection in 9 cases, chronic aortic dissection in 3 cases. The inner diameter of aorta was (5.3 +/- 1.8) cm. There were Marfan syndrome in 4 cases, aortic regurgitation in all cases, severely persistent chest pain in 9 cases, acute left heart failure in 8 cases, and cardiac tamponade in 4 cases. Bentall operations combined with total arch replacement and stented elephant trunk implantation were performed by using deep hypothermic circulatory arrest and antegrade selective cerebral perfusion in all cases. Urgent surgery underwent in 9 cases. The mean interval between the onset of aortic dissection and the accomplishment of surgery was (41.0 +/- 15.9) hours. Cardiopulmonary bypass time was (191 +/- 26) min, average cross clamp time was (134 +/- 31) min, and average deep hypothermic circulatory arrest time was (50.0 +/- 14.5) min. One patient died in hospital. The time stayed in ICU was 3 to 27 d. Mental disorder in 6 cases, hemi-paralysis in 1 case, amputation in 1 case, hemorrhage of anastomosis in 1 case, hemorrhage of alimentary tract in 1 case, and pleural effusion in 4 cases were recorded. Eleven cases were followed-up for 8 weeks to 36 months. There were no bending of the stents and no obstruction in the vascular prosthesis.No re-operation was needed. One case died 6 months postoperatively. Bentall operation combined with total arch replacement and stented elephant trunk implantation is safe and effective for serious Debakey I aortic dissecting aneurysm, while good organs protection and consummate cardiopulmonary bypass were taken.

  11. Load-Bearing Capacity and Retention of Newly Developed Micro-Locking Implant Prosthetic System: An In Vitro Pilot Study

    Directory of Open Access Journals (Sweden)

    Jae-Won Choi

    2018-04-01

    Full Text Available The aim of this study was to introduce the newly developed micro-locking implant prosthetic system and to evaluate the resulting its characteristics. To evaluate load-bearing capacity, 25 implants were divided into five groups: external-hexagon connection (EH, internal-octagon connection (IO, internal-hexagon connection (IH, one-body implant (OB, micro-locking implant system (ML. The maximum compressive load was measured using a universal testing machine (UTM according to the ISO 14801. Retention was evaluated in two experiments: (1 a tensile test of the structure modifications of the components (attachment and implant and (2 a tensile test after cyclic loading (total 5,000,000 cycles, 100 N, 2 Hz. The load-bearing capacity of the ML group was not significantly different from the other groups (p > 0.05. The number of balls in the attachment and the presence of a hexagonal receptacle did not show a significant correlation with retention (p > 0.05, but the shape of the retentive groove in the implant post had a statistically significant effect on retention (p < 0.05. On the other hand, the retention loss was observed during the initial 1,000,000 cycles, but an overall constant retention was maintained afterward. Various preclinical studies on this novel micro-locking implant prosthetic system should continue so that it can be applied in clinical practice.

  12. AbioCor totally implantable artificial heart. How will it impact hospitals?

    Science.gov (United States)

    2002-09-01

    Although heart transplantation remains the most effective treatment for severe heart failure, there are far fewer donor hearts available than there are patients who could benefit from them. One approach to addressing this shortfall is the total artificial heart, or TAH. To date, however, no TAH design has been able to achieve one of the ultimate goals of heart replacement: to allow a patient to live a reasonably normal life without being connected to external machinery. A new design, the AbioCor TAH developed by Abiomed Inc., may make this goal achievable. Thanks to a power system that transfers energy through the skin without the aid of wires, the AbioCor--currently undergoing clinical trials in the United States--allows the patient to be completely mobile. The lack of transcutaneous wires also eliminates the primary source of the infections that have plagued TAH patients in the past. Though it is not without drawbacks, the AbioCor could represent a crucial advance in TAH technology. In this Technology Overview, we describe the operation of the AbioCor and discuss its likely impact on hospitals if it is approved for marketing in the United States. We also discuss a related cardiac-support technology: ventricular assist devices (VADs), which may also be used for permanent cardiac support someday.

  13. Embedded System for Prosthetic Control Using Implanted Neuromuscular Interfaces Accessed Via an Osseointegrated Implant.

    Science.gov (United States)

    Mastinu, Enzo; Doguet, Pascal; Botquin, Yohan; Hakansson, Bo; Ortiz-Catalan, Max

    2017-08-01

    Despite the technological progress in robotics achieved in the last decades, prosthetic limbs still lack functionality, reliability, and comfort. Recently, an implanted neuromusculoskeletal interface built upon osseointegration was developed and tested in humans, namely the Osseointegrated Human-Machine Gateway. Here, we present an embedded system to exploit the advantages of this technology. Our artificial limb controller allows for bioelectric signals acquisition, processing, decoding of motor intent, prosthetic control, and sensory feedback. It includes a neurostimulator to provide direct neural feedback based on sensory information. The system was validated using real-time tasks characterization, power consumption evaluation, and myoelectric pattern recognition performance. Functionality was proven in a first pilot patient from whom results of daily usage were obtained. The system was designed to be reliably used in activities of daily living, as well as a research platform to monitor prosthesis usage and training, machine-learning-based control algorithms, and neural stimulation paradigms.

  14. Translation of First North American 50 and 70 cc Total Artificial Heart Virtual and Clinical Implantations: Utility of 3D Computed Tomography to Test Fit Devices.

    Science.gov (United States)

    Ferng, Alice S; Oliva, Isabel; Jokerst, Clinton; Avery, Ryan; Connell, Alana M; Tran, Phat L; Smith, Richard G; Khalpey, Zain

    2017-08-01

    Since the creation of SynCardia's 50 cc Total Artificial Hearts (TAHs), patients with irreversible biventricular failure now have two sizing options. Herein, a case series of three patients who have undergone successful 50 and 70 cc TAH implantation with complete closure of the chest cavity utilizing preoperative "virtual implantation" of different sized devices for surgical planning are presented. Computed tomography (CT) images were used for preoperative planning prior to TAH implantation. Three-dimensional (3D) reconstructions of preoperative chest CT images were generated and both 50 and 70 cc TAHs were virtually implanted into patients' thoracic cavities. During the simulation, the TAHs were projected over the native hearts in a similar position to the actual implantation, and the relationship between the devices and the atria, ventricles, chest wall, and diaphragm were assessed. The 3D reconstructed images and virtual modeling were used to simulate and determine for each patient if the 50 or 70 cc TAH would have a higher likelihood of successful implantation without complications. Subsequently, all three patients received clinical implants of the properly sized TAH based on virtual modeling, and their chest cavities were fully closed. This virtual implantation increases our confidence that the selected TAH will better fit within the thoracic cavity allowing for improved surgical outcome. Clinical implantation of the TAHs showed that our virtual modeling was an effective method for determining the correct fit and sizing of 50 and 70 cc TAHs. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  15. Uniform implantation of CNTs on total activated carbon surfaces: a smart engineering protocol for commercial supercapacitor applications.

    Science.gov (United States)

    Jiang, Jian; Li, Linpo; Liu, Yani; Liu, Siyuan; Xu, Maowen; Zhu, Jianhui

    2017-04-07

    The main obstacles to building better supercapacitors are still trade-offs between energy and power parameters. To promote commercial supercapacitor behaviors, proper optimization toward electrode configurations/architectures may be a feasible and effective way. We herein propose a smart and reliable electrode engineering protocol, by in situ implantation of carbon nanotubes (CNTs) on total activated carbon (AC) surfaces via a mild chemical vapor deposition process at ∼550 °C, using nickel nitrate hydroxide (NNH) thin films and waste ethanol solvents as the catalyst and carbon sources, respectively. The direct and conformal growth of NNH layers onto carbonaceous scaffold guarantees the later uniform implantation of long and high-quality CNTs on total AC outer surfaces. Such fluffy and entangled CNTs preserve ionic diffusion channels, well connect neighboring ACs and function as superhighways for electrons transfer, endowing electrodes with outstanding capacitive behaviors including large output capacitances of ∼230 F g -1 in 1 M Na 2 SO 4 neutral solution and ∼502.5 F g -1 in 6 M KOH using Ni valence state variation, and very negligible capacity decay in long-term cycles. Furthermore, a full symmetric supercapacitor device of CNTs@ACs//CNTs@ACs has been constructed, capable of delivering both high specific energy and power densities (maximum values reaching up to ∼97.2 Wh kg -1 and ∼10.84 kW kg -1 ), which holds great potential in competing with current mainstream supercapacitors.

  16. Tribo-biological deposits on the articulating surfaces of metal-on-polyethylene total hip implants retrieved from patients

    Science.gov (United States)

    Cui, Zhiwei; Tian, Yi-Xing; Yue, Wen; Yang, Lei; Li, Qunyang

    2016-06-01

    Artificial total hip arthroplasty (THA) is one of the most effective orthopaedic surgeries that has been used for decades. However, wear of the articulating surfaces is one of the key failure causes limiting the lifetime of total hip implant. In this paper, Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS) and atomic force microscopy (AFM) were employed to explore the composition and formation mechanism of the tribo-layer on the articulating surfaces of metal-on-polyethylene (MoPE) implants retrieved from patients. Results showed that, in contrast to conventional understanding, the attached tribo-layer contained not only denatured proteins but also a fraction of polymer particles. The formation of the tribo-layer was believed to relate to lubrication regime, which was supposed to be largely affected by the nature of the ultra-high-molecule-weight-polyethylene (UHMWPE). Wear and formation of tribo-layer could be minimized in elasto-hydrodynamic lubrication (EHL) regime when the UHMWPE was less stiff and have a morphology containing micro-pits; whereas the wear was more severe and tribo-layer formed in boundary lubrication. Our results and analyses suggest that enhancing interface lubrication may be more effective on reducing wear than increasing the hardness of material. This finding may shed light on the design strategy of artificial hip joints.

  17. Ultrasound guided implantation of chest port systems via the lateral subclavian vein

    International Nuclear Information System (INIS)

    Zaehringer, M.; Hilgers, J.; Krueger, K.; Strohe, D.; Bangard, C.; Neumann, L.; Lackner, K.; Warm, M.; Reiser, M.; Toex, U.

    2006-01-01

    Purpose: Retrospective analysis of the success and complication rates of chest port implantation via the lateral subclavian vein. Materials and methods: Between January 2003 and June 2004, the lateral subclavian vein in 271 patients (186 women, 85 men, mean age 53.2 years) was punctured guided by ultrasound. This access was used to insert a port system, and the catheter tip was placed at the cavoatrial junction. The port reservoir was implanted in a subcutaneous infraclavicular pocket and fixed to the fascia of the pectoralis muscle. Indications for port implantation were chemotherapy (n=239), total parenteral nutrition (n=2) and intravenous medication (n=30). The patient follow-up was mainly performed either by the oncology division of the department of gynecology or by the department of internal medicine. Results: A chest port catheter system was successfully implanted in all patients. The catheter remained in place for a mean duration of 269.4 days (SD 192.3 days). No complications occurred during implantation. In the post-interventional period, 6 catheter dysfunctions were found (thrombotic 0.09 per 1000 catheter days; mechanic 0.05 per 1000 catheter days). While one local infection occurred in the early post-interventional period, 3 local and 15 systemic infections were independent of the port catheter placement (0.39 per 1000 catheter days). The rate of port catheter explantations due to dysfunction or infection was 0.07 per 1000 catheter days. Conclusion: Ultrasound-guided puncture of the lateral subclavian vein is a safe procedure for the insertion of central venous port catheter systems and had a very low complication rate in our study. For further evaluation of our port placement technique, prospective studies compared to placement through the internal jugular vein are necessary. (orig.)

  18. Recent progress in the development of Terumo implantable left ventricular assist system.

    Science.gov (United States)

    Nojiri, C; Kijima, T; Maekawa, J; Horiuchi, K; Kido, T; Sugiyama, T; Mori, T; Sugiura, N; Asada, T; Shimane, H; Ozaki, T; Suzuki, M; Akamatsu, T; Akutsu, T

    1999-01-01

    The research group of the Terumo Corporation, the NTN Corporation, and Setsunan University (T. Akamatsu) has been developing an implantable left ventricular assist system (ILVAS) featuring a centrifugal blood pump with a magnetically suspended impeller (MSCP). The impeller of the MSCP is suspended by a magnetic bearing, providing contact-free rotation of the impeller inside the pump housing. Thus the MSCP is expected to provide years of long-term durability. Ex vivo chronic sheep experiments using the extracorporeal model (Model I) demonstrated long-term durability, nonthrombogenicity, and a low hemolysis rate (plasma free Hb model (Model II; 196 ml, 400 g) was evaluated ex vivo in 2 sheep and intrathoracically implanted in a small sheep (45 kg). These experiments were terminated at 70, 79, and 17 days, respectively, because of blood leakage through the connector system within the housing of Model II. There was no thrombus formation on the retrieved pump surfaces. A new connector system was introduced to the Model II pump (modified Model II), and the pump was intrathoracically implanted in a sheep. Pump flow rate was maintained at 3-7 L/min at 1700-1800 rpm. The temperature elevation on the surfaces of the motor and the electromagnet inside the pump casing was kept less than 6 degrees C. The temperature of the tissue adjacent to the pump casing became normal 10 days postoperatively. The sheep survived for more than 5 months without any sign of mechanical failure or thromboembolic complication. In vitro real-time endurance tests of motor bearings made of stainless steel and silicone nitride have been conducted for more than 1 year without any sign of bearing wear. The next prototype system (Model III), with an implantable controller and a new MSCP with reduced input power, has been developed with a view toward a totally implantable LVAS.

  19. 21 CFR 862.1710 - Total triiodothyronine test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Total triiodothyronine test system. 862.1710... Systems § 862.1710 Total triiodothyronine test system. (a) Identification. A total triiodothyronine test system is a device intended to measure the hormone triiodothyronine in serum and plasma. Measurements...

  20. Optimization of scan time in MRI for total hip prostheses. SEMAC tailoring for prosthetic implants containing different types of metals

    Energy Technology Data Exchange (ETDEWEB)

    Deligianni, X. [University of Basel Hospital, Basel (Switzerland). Div. of Radiological Physics; Merian Iselin Klinik, Basel (Switzerland). Inst. of Radiology; Bieri, O. [University of Basel Hospital, Basel (Switzerland). Div. of Radiological Physics; Elke, R. [Orthomerian, Basel (Switzerland); Wischer, T.; Egelhof, T. [Merian Iselin Klinik, Basel (Switzerland). Inst. of Radiology

    2015-12-15

    Magnetic resonance imaging (MRI) of soft tissues after total hip arthroplasty is of clinical interest for the diagnosis of various pathologies that are usually invisible with other imaging modalities. As a result, considerable effort has been put into the development of metal artifact reduction MRI strategies, such as slice encoding for metal artifact correction (SEMAC). Generally, the degree of metal artifact reduction with SEMAC directly relates to the overall time spent for acquisition, but there is no specific consensus about the most efficient sequence setup depending on the implant material. The aim of this article is to suggest material-tailored SEMAC protocol settings. Five of the most common total hip prostheses (1. Revision prosthesis (S-Rom), 2. Titanium alloy, 3. Mueller type (CoNiCRMo alloy), 4. Old Charnley prosthesis (Exeter/Stryker), 5. MS-30 stem (stainless-steel)) were scanned on a 1.5 T MRI clinical scanner with a SEMAC sequence with a range of artifact-resolving slice encoding steps (SES: 2 - 23) along the slice direction (yielding a total variable scan time ranging from 1 to 10 min). The reduction of the artifact volume in comparison with maximal artifact suppression was evaluated both quantitatively and qualitatively in order to establish a recommended number of steps for each case. The number of SES that reduced the artifact volume below approximately 300 mm{sup 3} ranged from 3 to 13, depending on the material. Our results showed that although 3 SES steps can be sufficient for artifact reduction for titanium prostheses, at least 11 SES should be used for prostheses made of materials such as certain alloys of stainless steel. Tailoring SES to the implant material and to the desired degree of metal artifact reduction represents a simple tool for workflow optimization of SEMAC imaging near total hip arthroplasty in a clinical setting.

  1. Optimization of scan time in MRI for total hip prostheses. SEMAC tailoring for prosthetic implants containing different types of metals

    International Nuclear Information System (INIS)

    Deligianni, X.; Wischer, T.; Egelhof, T.

    2015-01-01

    Magnetic resonance imaging (MRI) of soft tissues after total hip arthroplasty is of clinical interest for the diagnosis of various pathologies that are usually invisible with other imaging modalities. As a result, considerable effort has been put into the development of metal artifact reduction MRI strategies, such as slice encoding for metal artifact correction (SEMAC). Generally, the degree of metal artifact reduction with SEMAC directly relates to the overall time spent for acquisition, but there is no specific consensus about the most efficient sequence setup depending on the implant material. The aim of this article is to suggest material-tailored SEMAC protocol settings. Five of the most common total hip prostheses (1. Revision prosthesis (S-Rom), 2. Titanium alloy, 3. Mueller type (CoNiCRMo alloy), 4. Old Charnley prosthesis (Exeter/Stryker), 5. MS-30 stem (stainless-steel)) were scanned on a 1.5 T MRI clinical scanner with a SEMAC sequence with a range of artifact-resolving slice encoding steps (SES: 2 - 23) along the slice direction (yielding a total variable scan time ranging from 1 to 10 min). The reduction of the artifact volume in comparison with maximal artifact suppression was evaluated both quantitatively and qualitatively in order to establish a recommended number of steps for each case. The number of SES that reduced the artifact volume below approximately 300 mm 3 ranged from 3 to 13, depending on the material. Our results showed that although 3 SES steps can be sufficient for artifact reduction for titanium prostheses, at least 11 SES should be used for prostheses made of materials such as certain alloys of stainless steel. Tailoring SES to the implant material and to the desired degree of metal artifact reduction represents a simple tool for workflow optimization of SEMAC imaging near total hip arthroplasty in a clinical setting.

  2. Effects of implant system, impression technique, and impression material on accuracy of the working cast.

    Science.gov (United States)

    Wegner, Kerstin; Weskott, Katharina; Zenginel, Martha; Rehmann, Peter; Wöstmann, Bernd

    2013-01-01

    This in vitro study aimed to identify the effects of the implant system, impression technique, and impression material on the transfer accuracy of implant impressions. The null hypothesis tested was that, in vitro and within the parameters of the experiment, the spatial relationship of a working cast to the placement of implants is not related to (1) the implant system, (2) the impression technique, or (3) the impression material. A steel maxilla was used as a reference model. Six implants of two different implant systems (Standard Plus, Straumann; Semados, Bego) were fixed in the reference model. The target variables were: three-dimensional (3D) shift in all directions, implant axis direction, and rotation. The target variables were assessed using a 3D coordinate measuring machine, and the respective deviations of the plaster models from the nominal values of the reference model were calculated. Two different impression techniques (reposition/pickup) and four impression materials (Aquasil Ultra, Flexitime, Impregum Penta, P2 Magnum 360) were investigated. In all, 80 implant impressions for each implant system were taken. Statistical analysis was performed using multivariate analysis of variance. The implant system significantly influenced the transfer accuracy for most spatial dimensions, including the overall 3D shift and implant axis direction. There was no significant difference between the two implant systems with regard to rotation. Multivariate analysis of variance showed a significant effect on transfer accuracy only for the implant system. Within the limits of the present study, it can be concluded that the transfer accuracy of the intraoral implant position on the working cast is far more dependent on the implant system than on the selection of a specific impression technique or material.

  3. Ion beam system for implanting industrial products of various shapes

    International Nuclear Information System (INIS)

    Denholm, A.S.; Wittkower, A.

    1985-01-01

    Implantation of metals and ceramics with ions of nitrogen and other species has improved surface properties such as friction, wear and corrosion in numerous industrial applications. Zymet has built a production machine to take advantage of this process which can implant a 2 x 10 17 ions/cm 2 dose of nitrogen ions into a 20 cm x 20 cm area in about 30 min using a 100 keV beam. Treatment is accomplished by mounting the product on a cooled, tiltable, turntable which rotates continuously, or is indexed in 15 0 steps to expose different surfaces in fixed position. Product cooling is accomplished by using a chilled eutectic metal to mount and grip the variously shaped objects. A high voltage supply capable of 10 mA at 100 kV is used, and the equipment is microcomputer controlled via serial light links. All important machine parameters are presented in sequenced displays on a CRT. Uniformity of treatment and accumulated dose are monitored by a Faraday cup system which provides the microprocessor with data for display of time to completion on the process screen. For routine implants the operator requires only two buttons; one for chamber vacuum control, and the other for process start and stop. (orig.)

  4. Patient satisfaction and dissatisfaction with mandibular two-implant overdentures using different attachment systems: 5-year outcomes.

    Science.gov (United States)

    Al-Zubeidi, Mohammed I; Alsabeeha, Nabeel H M; Thomson, W Murray; Payne, Alan G T

    2012-10-01

    Different attachment systems for mandibular two-implant overdentures could influence levels of patient satisfaction. Positive consensus of the majority of patients being satisfied does not preclude the possibility of dissatisfaction for some. To evaluate patient satisfaction and dissatisfaction before and after 5 years of wearing mandibular two implant overdentures using different attachment systems ; to determine the prognostic relevance of pretreatment complete denture complaints to treatment outcomes. A total of 106 edentulous participants enrolled in a clinical trial completed a preliminary self-report inventory of their original complete denture complaints.New complete maxillary dentures and mandibular two-implant overdentures were provided to each participant using one of six different attachment systems. Patient satisfaction was determined at pretreatment; at baseline with mandibular two-implant overdenture insertion; and then annually for 5 years, using visual analogue and Likert-type scales. Patient satisfaction with mandibular two-implant overdentures showed significant changes pre- to posttreatment(baseline) in all domains, but these were significant immediately and maintained without further significance for 5 years, other than pain with the overdenture. After 5 years, no significant differences were observed with all the attachment systems. Highly significant differences were found with some social and psychological aspects by the fifth year compared to baseline. Diagnostic and prognostic indicators from a pretreatment inventory identified 12 participants (13.5%) who were dissatisfied. These indicators revealed a maladaptive predisposition to mandibular two-implant overdentures. The provision of mandibular two-implant overdentures will, in the majority of patients, significantly enhance levels of patient satisfaction for 5 years, as compared to complete mandibular dentures, regardless of the attachment system. Careful evaluation of pretreatment

  5. Microstructure and mechanical properties of open-cellular biomaterials prototypes for total knee replacement implants fabricated by electron beam melting.

    Science.gov (United States)

    Murr, L E; Amato, K N; Li, S J; Tian, Y X; Cheng, X Y; Gaytan, S M; Martinez, E; Shindo, P W; Medina, F; Wicker, R B

    2011-10-01

    Total knee replacement implants consisting of a Co-29Cr-6Mo alloy femoral component and a Ti-6Al-4V tibial component are the basis for the additive manufacturing of novel solid, mesh, and foam monoliths using electron beam melting (EBM). Ti-6Al-4V solid prototype microstructures were primarily α-phase acicular platelets while the mesh and foam structures were characterized by α(')-martensite with some residual α. The Co-29Cr-6Mo containing 0.22% C formed columnar (directional) Cr(23)C(6) carbides spaced ~2 μm in the build direction, while HIP-annealed Co-Cr alloy exhibited an intrinsic stacking fault microstructure. A log-log plot of relative stiffness versus relative density for Ti-6Al-4V and Co-29Cr-6Mo open-cellular mesh and foams resulted in a fitted line with a nearly ideal slope, n = 2.1. A stress shielding design graph constructed from these data permitted mesh and foam implant prototypes to be fabricated for compatible bone stiffness. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. Evaluation of the perceptions and cosmetic satisfaction of breast cancer patients undergoing totally implantable vascular access device (TIVAD) placement.

    Science.gov (United States)

    Liberale, Gabriel; El Houkayem, Michel; Viste, Claire; Bouazza, Fikri; Moreau, Michel; El Nakadi, Issam; Veys, Isabelle

    2016-12-01

    Totally implantable vascular access devices (TIVADs) are widely used to administer chemotherapy to cancer patients. While great progress has been made with respect to breast surgical reconstruction to take into account both aesthetics and patients' perceptions of body integrity, these aspects have not been considered with regard to the impact of TIVAD. In order to address this practice gap, we have adapted our TIVAD implantation technique to improve cosmetic results. The aim of this study was to assess breast cancer patients' comfort level and aesthetic satisfaction with regard to TIVAD insertion. Patients with breast cancer admitted for chemotherapy at an outpatient clinic completed a previously validated survey evaluating three main domains: symptoms (pain, discomfort) related to the TIVAD itself in daily activity, information received before and during the surgical procedure, and cosmetic aspects regarding the port insertion site (scar, port, and catheter location). Between September 2010 and June 2011, 232 patients were evaluated. Cosmetic satisfaction with scar location was high (93.3 %). Information given to patients before and during the procedure had a major impact on both symptom perception in daily activity and on cosmetic satisfaction. Obtaining a more aesthetic scar by placing the TIVAD in the deltopectoral groove contributed to a high rate of cosmetic satisfaction. Furthermore, the relevance of information given to patients before and/or during surgery had a major impact on symptom perception. Therefore, we suggest including a pre-operative information session in the care pathway.

  7. 5th Total System Performance Assessment Workshop

    International Nuclear Information System (INIS)

    Hwang, Yong Soo; Lee, Youn Myoung; Kang, Chul Hyung; Lee, Sung Ho

    2009-07-01

    Research items on safety assessment of high-level waste repository have been proposed by external invited experts outside KAERI and discussed extensively during the annual 5th performance assessment workshop prepared by safety assessment group in KAERI. This could be useful to set up R and D plans necessary for the next phase of mid- and long-term reaserch area regarding the safety assessment of high-level waste repository. Through the research and the presentation, HLW-related research and development area including such specific research items as current status of HLW safety assessment research, current requirement for the licensing of the repository system, priority on research area, data base building for the safety assessment, source-term modeling as well as safety case, among many others, have been discussed and summarized

  8. Ultrasound guided implantation of chest port systems via the lateral subclavian vein; Die sonographisch gezielte Implantation von Portkathetersystemen ueber die laterale Vena subclavia

    Energy Technology Data Exchange (ETDEWEB)

    Zaehringer, M.; Hilgers, J.; Krueger, K.; Strohe, D.; Bangard, C.; Neumann, L.; Lackner, K. [Inst. fuer Radiologische Diagnostik, Univ. zu Koeln (Germany); Warm, M. [Gynaekologie, Univ. zu Koeln (Germany); Reiser, M. [Medizinische Klinik I, Univ. zu Koeln (Germany); Toex, U. [Medizinische Klinik IV, Univ. zu Koeln (Germany)

    2006-03-15

    Purpose: Retrospective analysis of the success and complication rates of chest port implantation via the lateral subclavian vein. Materials and methods: Between January 2003 and June 2004, the lateral subclavian vein in 271 patients (186 women, 85 men, mean age 53.2 years) was punctured guided by ultrasound. This access was used to insert a port system, and the catheter tip was placed at the cavoatrial junction. The port reservoir was implanted in a subcutaneous infraclavicular pocket and fixed to the fascia of the pectoralis muscle. Indications for port implantation were chemotherapy (n=239), total parenteral nutrition (n=2) and intravenous medication (n=30). The patient follow-up was mainly performed either by the oncology division of the department of gynecology or by the department of internal medicine. Results: A chest port catheter system was successfully implanted in all patients. The catheter remained in place for a mean duration of 269.4 days (SD 192.3 days). No complications occurred during implantation. In the post-interventional period, 6 catheter dysfunctions were found (thrombotic 0.09 per 1000 catheter days; mechanic 0.05 per 1000 catheter days). While one local infection occurred in the early post-interventional period, 3 local and 15 systemic infections were independent of the port catheter placement (0.39 per 1000 catheter days). The rate of port catheter explantations due to dysfunction or infection was 0.07 per 1000 catheter days. Conclusion: Ultrasound-guided puncture of the lateral subclavian vein is a safe procedure for the insertion of central venous port catheter systems and had a very low complication rate in our study. For further evaluation of our port placement technique, prospective studies compared to placement through the internal jugular vein are necessary. (orig.)

  9. The pharmacokinetics and safety of an intraoperative bupivacaine-collagen implant (XaraColl® for postoperative analgesia in women following total abdominal hysterectomy

    Directory of Open Access Journals (Sweden)

    Cusack SL

    2013-03-01

    Full Text Available Susan L Cusack,1 Philip Reginald,2 Lisa Hemsen,3 Emmanuel Umerah21Cusack Pharmaceutical Consulting, Burlington, NJ, USA; 2Departments of Gynaecology and Anaesthetics, Wexham Park Hospital, Slough, SL2 4HL, UK; 3Innocoll Technologies, Athlone, IrelandBackground: XaraColl®, a collagen-based intraoperative implant that delivers bupivacaine to the site of surgical trauma, is under development for postoperative analgesia. We examined the pharmacokinetics, safety and efficacy of XaraColl following implantation in women undergoing total abdominal hysterectomy.Methods: Three XaraColl implants, each containing 50 mg bupivacaine hydrochloride, were implanted in 12 women undergoing total abdominal hysterectomy for a benign condition. Serum samples were obtained through 96 hours for pharmacokinetic analysis. Patients received acetaminophen 1000 mg every 6 hours, diclofenac 50 mg every 8 hours, and were given access to intravenous morphine for breakthrough pain via patient-controlled analgesia during the first 24 hours. Pain intensity was assessed at regular intervals using a 100 mm visual analog scale. Safety was assessed through 30 days.Results: The pharmacokinetic profile displayed a double peak in bupivacaine concentration with the second peak occurring up to 24 hours after the first and at a generally higher concentration. The time to maximum concentration (tmax varied from 0.5 to 24 hours (median 12 hours according to which peak predominated. The mean maximum concentration (Cmax was 0.22 µg/mL and the maximum individual Cmax was 0.44 µg/mL, which are well below the established systemic toxicity threshold. Morphine use was generally low (mean 16.8 mg; median 6.5 mg and compared favorably with institutional experience. At 6 hours post-surgery, 11 patients recorded pain scores ≤ 20 mm, 6 recorded ≤ 10 mm, and 2 reported no pain. Scores continued to decline throughout the study. The product was considered safe and well tolerated.Conclusion: Xara

  10. An image-guided planning system for endosseous oral implants.

    Science.gov (United States)

    Verstreken, K; Van Cleynenbreugel, J; Martens, K; Marchal, G; van Steenberghe, D; Suetens, P

    1998-10-01

    A preoperative planning system for oral implant surgery was developed which takes as input computed tomographies (CT's) of the jaws. Two-dimensional (2-D) reslices of these axial CT slices orthogonal to a curve following the jaw arch are computed and shown together with three-dimensional (3-D) surface rendered models of the bone and computer-aided design (CAD)-like implant models. A technique is developed for scanning and visualizing an eventual existing removable prosthesis together with the bone structures. Evaluation of the planning done with the system shows a difference between 2-D and 3-D planning methods. Validation studies measure the benefits of the 3-D approach by comparing plans made in 2-D mode only with those further adjusted using the full 3-D visualization capabilities of the system. The benefits of a 3-D approach are then evident where a prosthesis is involved in the planning. For the majority of the patients, clinically important adjustments and optimizations to the 2-D plans are made once the 3-D visualization is enabled, effectively resulting in a better plan. The alterations are related to bone quality and quantity (p biomechanics (p < 0.005), and esthetics (p < 0.005), and are so obvious that the 3-D plan stands out clearly (p < 0.005). The improvements often avoid complications such as mandibular nerve damage, sinus perforations, fenestrations, or dehiscences.

  11. The impact of glucocorticosteroids administered for systemic diseases on the osseointegration and survival of dental implants placed without bone grafting-A retrospective study in 31 patients.

    Science.gov (United States)

    Petsinis, Vassilis; Kamperos, Georgios; Alexandridi, Foteini; Alexandridis, Konstantinos

    2017-08-01

    To evaluate the impact of glucocorticosteroids, administered for the treatment of systemic diseases, on the osseointegration and survival of dental implants placed without bone grafting. A retrospective study was conducted in search of patients treated with dental implants while receiving glucocorticosteroid therapy for various systemic diseases. In these cases, a conventional two-stage surgical protocol was used, without bone regeneration procedures. The osseointegration was clinically and radiographically tested at the uncovering of the implants. The follow-up after loading was set at a minimum of 3 years. A total of 31 patients were included in the study. Of the 105 dental implants placed, 104 were osseointegrated (99%). No bone absorption was radiographically noted at the uncovering of the osseointegrated implants. All of the osseointegrated implants were successfully loaded for the prosthetic restoration. The mean follow-up period after loading was 71 months, with an implant survival rate of 99%. Glucocorticosteroid intake for systemic diseases does not have a significant impact on the osseointegration and the 3-year survival of dental implants placed with a conventional two-stage surgical protocol and without bone grafting. Therefore, it should not be considered a contraindication for dental implant placement. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  12. Low Complication Rates With Totally Implantable Access Port Use in Epoprostenol Treatment of Pulmonary Hypertension

    NARCIS (Netherlands)

    Dickinson, Michael G.; Scholvinck, Elisabeth H.; Boonstra, Anco; Vonk-Noordegraaf, Anton; Snijder, Repke J.; Berger, Rolf M. F.

    Background: Among patients with advanced pulmonary arterial hypertension (PAH) who are receiving epoprostenol treatment, complications due to the delivery system are known to be a cause of serious morbidity and mortality. In this study, we aimed to outline the complications associated with the use

  13. The Pathology of Orthopedic Implant Failure Is Mediated by Innate Immune System Cytokines

    OpenAIRE

    Landgraeber, Stefan; Jäger, Marcus; Jacobs, Joshua J.; Hallab, Nadim James

    2014-01-01

    All of the over 1 million total joint replacements implanted in the US each year are expected to eventually fail after 15–25 years of use, due to slow progressive subtle inflammation at the bone implant interface. This inflammatory disease state is caused by implant debris acting, primarily, on innate immune cells, that is, macrophages. This slow progressive pathological bone loss or “aseptic loosening” is a potentially life-threatening condition due to the serious complications in older peop...

  14. Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty.

    Science.gov (United States)

    Leitner, Lukas; Musser, Ewald; Kastner, Norbert; Friesenbichler, Jörg; Hirzberger, Daniela; Radl, Roman; Leithner, Andreas; Sadoghi, Patrick

    2016-08-04

    Red blood cell concentrates (RCC) substitution after total knee arthroplasty (TKA) is correlated with multifold of complications and an independent predictor for higher postoperative mortality. TKA is mainly performed in elderly patients with pre-existing polymorbidity, often requiring permanent preoperative antithrombotic therapy (PAT). The aim of this retrospective analysis was to investigate the impact of demand for PAT on inpatient blood management in patients undergoing TKA. In this study 200 patients were retrospectively evaluated after TKA for differences between PAT and non-PAT regarding demographic parameters, preoperative ASA score > 2, duration of operation, pre-, and intraoperative hemoglobin level, and postoperative parameters including amount of wound drainage, RCC requirement, and inpatient time. In a multivariate logistic regression analysis the independent influences of PAT, demographic parameters, ASA score > 2, and duration of the operation on RCC demand following TKA were analyzed. Patients with PAT were significantly older, more often had an ASA > 2 at surgery, needed a higher number of RCCs units and more frequently and had lower perioperative hemoglobin levels. Multivariate logistic regression revealed PAT was an independent predictor for RCC requirement. PAT patients are more likely to require RCC following TKA and should be accurately monitored with respect to postoperative blood loss.

  15. Totally implantable central venous access port infections in patients with digestive cancer: incidence and risk factors.

    Science.gov (United States)

    Touré, Abdoulaye; Vanhems, Philippe; Lombard-Bohas, Catherine; Cassier, Philippe; Péré-Vergé, Denis; Souquet, Jean-Christophe; Ecochard, René; Chambrier, Cécile

    2012-12-01

    Central venous access port-related bloodstream infection (CVAP-BSI) is associated with morbidity and mortality in patients with cancer. This study examined the incidence rates and risk factors for CVAP-BSI in adult patients with digestive cancer. This prospective observational cohort study was performed from 2007 to 2011 in 2 oncology units of a university hospital. Incidence rate was expressed as number of CVAP-BSI per 1,000 catheter-days. A Cox regression model was used to identify risk factors for CVAP-BSI. A total of 315 patients were included. CVAP-BSI occurred in 41 patients (13.0%). The overall incidence rate was 0.76/1,000 catheter-days. The rate was higher in patients with esophageal cancer (1.28. P = .05) and pancreatic cancer (1.24; P = .007). Risk factors independently associated with CVAP-BSI were World Health Organization performance status between 2 and 4, catheter utilization-days in the previous month, pancreatic cancer, and parenteral nutrition. Coagulase-negative Staphylococci and enterobacteria were the main microorganisms isolated. In adult patients with digestive cancer, pancreatic cancer, cumulative catheter utilization-days, World Health Organization performance status, and parenteral nutrition were identified as independent risk factors for CVAP-BSI. Patients with any of these risk factors could be candidates for preventive strategies. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  16. Metastatic spread from squamous cell carcinoma of the hypopharynx to the totally implantable venous access port insertion site: Case report and review of literature.

    Science.gov (United States)

    Mangla, Ankit; Agarwal, Nikki; Mullane, Michael Russell

    2017-12-01

    The totally implantable venous access port plays a crucial role in delivering chemotherapy in the outpatient setting. Here, we report the first case of a patient with hypopharyngeal tumor who developed chest wall metastasis over the totally implantable venous access port inserted in the internal jugular vein. Our patient, a 58-year-old man with a hypopharyngeal tumor presented with a lump over the totally implantable venous access port site. The port was removed and the lump was biopsied. The CT studies showed that the tumor had spread along the catheter from the hypopharynx to the chest wall. The pathology from the biopsy showed squamous cell carcinoma (SCC). The patient had poor performance status and opted for hospice care. We present a novel case of metastasis over the totally implantable venous access port implanted in a patient with a hypopharyngeal tumor. We also reviewed relevant literature comparing the data from percutaneous endoscopic gastrostomy (PEG) tube site metastasis with our patient and other similar case reports. © 2017 Wiley Periodicals, Inc.

  17. Zero-fluoroscopy permanent pacemaker implantation using Ensite NavX system: Clinical viability or fanciful technique?

    Science.gov (United States)

    Guo, Ping; Qiu, Jie; Wang, Yan; Chen, Guangzhi; Proietti, Riccardo; Fadhle, Al-Selmi; Zhao, Chunxia; Wen Wang, Dao

    2018-02-01

    Fluoroscopy is the imaging modality routinely used for cardiac device implantation and electrophysiological procedures. Due to the rising concern regarding the harmful effects of radiation exposure to both the patients and operation staffs, novel 3D mapping systems have been developed and implemented in electrophysiological procedure for the navigation of catheters inside the heart chambers. Their applicability in cardiac device implantation has been rarely reported. Our aim is to evaluate the feasibility and safety of permanent pacemaker implantation without fluoroscopy. From January 2012 to June 2016, six patients (50 ± 15 years, four of six were female, one of who was at the 25th week of gestation) who underwent permanent pacemaker implantation were included (zero-fluoroscopy group). Data from 20 consecutive cases of implantation performed under fluoroscopy guidance were chosen as a control group (fluoroscopy group). Total implantation procedure time for single-chamber pacemaker was 51.3 ± 13.1 minutes in the zero-fluoroscopy group and 42.6 ± 7.4 minutes in the fluoroscopy group (P  =  0.155). The implantation procedural time for a dual-chamber pacemaker was 88.3 ± 19.6 minutes and 67.3 ± 7.6 minutes in the zero-fluoroscopy and fluoroscopy groups (P  =  0.013), respectively. No complications were observed during the procedure and the follow-up in the two groups, and all pacemakers worked with satisfactory parameters. Ensite NavX system can be used as a reliable and safe zero-fluoroscopy approach for the implantation of single- or dual-chamber permanent pacemakers in specific patients, such as pregnant women or in extreme situations when the x-ray machine is not available. © 2017 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals, Inc.

  18. [Review of wireless energy transmission system for total artificial heart].

    Science.gov (United States)

    Zhang, Chi; Yang, Ming

    2009-11-01

    This paper sums up the fundamental structure of wireless energy transmission system for total artificial heart, and compares the key parameters and performance of some representative systems. After that, it is discussed that the future development trend of wireless energy transmission system for total artificial heart.

  19. Clinical application of single-tooth replacement with ankylos implant system

    International Nuclear Information System (INIS)

    Yang Xu; Liu Xue; Zhang Heng; Deng Yan; Guo Zhaozhong; Zhang Yufeng

    2011-01-01

    Objective: To evaluate the clinical effects of Ankylos implant system to restore the loss of single-tooth. Methods: 90 cases with loss of single-tooth were selected and treated with routinely two-stage surgery. When the patients presented with deficient alveolar ridge, guided bone regeneration (GBR), osteotome sinus floor elevation, lateral antrostomy surgery with simultaneous placement of implant were applied. They were restored with platinum ceramic crown. All the implants were followed up, and the records were kept about stability of the implant and abutment, the status of surrounding soft tissue, sealability of implant abutment junction and the marginal bone lossing through X-ray checking,and satisfaction of the patients to mastication and aspect of the restorations. The follow-up time was 1-2.5 years. Results: Among the cases,one case had peri-implant inflammation, and one case had porcelain dropped. No loosening occurred in the other implants and abuments. Implant abutment junction was sealed well. The marginal bone loss 1 year after final restoration was less than 1 mm. Soft tissue surrounding implants was healthy. The satisfaction rate was 98.9% (89/90). According to standard of implant success, 88 cases were successful, the 2.5-year cumulative success rate was 97.8%, 2 cases failed, and the failure rate was 2.2 %. Conclusion: A satisfactory treatment effects could be gotten by using Ankylos implant system to restore the loss of single-tooth. (authors)

  20. Energy transmission and power sources for mechanical circulatory support devices to achieve total implantability.

    Science.gov (United States)

    Wang, Jake X; Smith, Joshua R; Bonde, Pramod

    2014-04-01

    Left ventricular assist device therapy has radically improved congestive heart failure survival with smaller rotary pumps. The driveline used to power today's left ventricular assist devices, however, continues to be a source of infection, traumatic damage, and rehospitalization. Previous attempts to wirelessly power left ventricular assist devices using transcutaneous energy transfer systems have been limited by restrictions on separation distance and alignment between the transmit and receive coils. Resonant electrical energy transfer allows power delivery at larger distances without compromising safety and efficiency. This review covers the efforts to wirelessly power mechanical circulatory assist devices and the progress made in enhancing their energy sources. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. The Cost-Effectiveness of Dual Mobility Implants for Primary Total Hip Arthroplasty: A Computer-Based Cost-Utility Model.

    Science.gov (United States)

    Barlow, Brian T; McLawhorn, Alexander S; Westrich, Geoffrey H

    2017-05-03

    Dislocation remains a clinically important problem following primary total hip arthroplasty, and it is a common reason for revision total hip arthroplasty. Dual mobility (DM) implants decrease the risk of dislocation but can be more expensive than conventional implants and have idiosyncratic failure mechanisms. The purpose of this study was to investigate the cost-effectiveness of DM implants compared with conventional bearings for primary total hip arthroplasty. Markov model analysis was conducted from the societal perspective with use of direct and indirect costs. Costs, expressed in 2013 U.S. dollars, were derived from the literature, the National Inpatient Sample, and the Centers for Medicare & Medicaid Services. Effectiveness was expressed in quality-adjusted life years (QALYs). The model was populated with health state utilities and state transition probabilities derived from previously published literature. The analysis was performed for a patient's lifetime, and costs and effectiveness were discounted at 3% annually. The principal outcome was the incremental cost-effectiveness ratio (ICER), with a willingness-to-pay threshold of $100,000/QALY. Sensitivity analyses were performed to explore relevant uncertainty. In the base case, DM total hip arthroplasty showed absolute dominance over conventional total hip arthroplasty, with lower accrued costs ($39,008 versus $40,031 U.S. dollars) and higher accrued utility (13.18 versus 13.13 QALYs) indicating cost-savings. DM total hip arthroplasty ceased being cost-saving when its implant costs exceeded those of conventional total hip arthroplasty by $1,023, and the cost-effectiveness threshold for DM implants was $5,287 greater than that for conventional implants. DM was not cost-effective when the annualized incremental probability of revision from any unforeseen failure mechanism or mechanisms exceeded 0.29%. The probability of intraprosthetic dislocation exerted the most influence on model results. This model

  2. The bacterial sealing capacity of morse taper implant-abutment systems in vitro.

    Science.gov (United States)

    Ranieri, Rogerio; Ferreira, Andreia; Souza, Emmanuel; Arcoverde, Joao; Dametto, Fabio; Gade-Neto, Cicero; Seabra, Flavio; Sarmento, Carlos

    2015-05-01

    The use of Morse taper systems in dental implantology has been associated widely with a more precise adaptation between implants and their respective abutments. This may lead to an increase in the stability of the implant system and may also prevent microbial invasion through the implant-abutment interface. The aim of this study was to investigate in vitro the ability of four commercially available Morse taper system units to impede bacterial penetration through their implant-abutment interfaces. Abutments were screwed onto the implants, and the units were subsequently immersed in Streptococcus sanguinis bacterial broth (1 × 10(8) colony forming units/mL) for 48 hours. The units were examined by scanning electron microscopy (SEM) under three conditions: 1) with the implant-abutment components assembled as units to investigate for both the existence of microgaps and the presence of bacteria; 2) with the implants and abutments separated for examination of internal surfaces; and 3) with the implant-abutment components again assembled as units to measure any microgaps detected. The mean size of the microgaps in each unit was determined by measuring, under SEM, their width in four equidistant points. Microgaps were detected in all units with no significant differences in dimension (Kruskal-Wallis test, P >0.05). Within all units, the presence of bacteria was also observed. The seals provided by the interfaces of the commercially available Morse taper implant-abutment units tested were not sufficiently small to shield the implant from bacterial penetration.

  3. Effects on cuytoskeleton system in pollen tube of pinus thunbergii induced by ion beam implantation

    International Nuclear Information System (INIS)

    Huang Qunce; Liang Qiuxia; Li Guopin

    2008-01-01

    The damage of the cytoskeleton system in the pollen and the pollen tube of Pinus thunbergii induced by ion beam implantation were researched. The results showed that the disorganization of the micro-tubules in the pollen tube was produced by N + implantation. The abnormal states of the pollen tube in morphology were very correlative with the abnormality of the cytoskeleton system. N + implantation was responsible for morphological abnormalities in the pollen tubes. There was a distinct correlation between the damage effects and the ion implantation dose. The add of dose caused more obvious damage effects. Furthermore, the state of the cytoskeleton system in the pollen tube was influenced by the ion implantation. The impact grade depended also on the ion implantation dose. (authors)

  4. Total Quality Management and the System Safety Secretary

    Science.gov (United States)

    Elliott, Suzan E.

    1993-01-01

    The system safety secretary is a valuable member of the system safety team. As downsizing occurs to meet economic constraints, the Total Quality Management (TQM) approach is frequently adopted as a formula for success and, in some cases, for survival.

  5. Immediate and early function of Brånemark System implants placed in the esthetic zone: a 1-year prospective clinical multicenter study.

    Science.gov (United States)

    Maló, Paulo; Friberg, Bertil; Polizzi, Giovanni; Gualini, Federico; Vighagen, Torbjörn; Rangert, Bo

    2003-01-01

    Immediate/early implant function means great benefits for patients and therapists because treatment time and cost can be substantially reduced. This concept has become an accepted alternative for complete arch fixed restorations in the mandible, and clinical documentation is emerging for other indications. The purpose of this prospective clinical multicenter study was to evaluate the outcome of implants placed in incisor, canine, and premolar regions in maxillas or mandibles. Implants were loaded with provisional crowns and bridges on the same day or within a few days and were followed up for 1 year during function. Four centers treated 76 patients each in need of an implant-retained prosthesis in the anterior and premolar regions in the maxilla or mandible. A total of 116 titanium implants with machined surfaces (Brånemark System , Nobel Biocare AB, Gothenburg, Sweden) were placed: 74 in maxillas and 42 in mandibles. Eighty-seven prostheses were made, of which 63 were single crowns and 24 were bridges (supported by 53 splinted implants). Twenty-two implants in 14 patients were placed in fresh extraction sites. The goal with the preparation and insertion technique was to achieve good primary implant stability and a minimum implant insertion torque of 30 Ncm before the implant was completely seated. The occlusion was adjusted to eliminate direct contact with the provisional prostheses. After 6 months, the patients received their permanent prostheses. Sixty-seven patients were followed for 1 year. Five implants were lost in five patients, three in the maxilla and two in the mandible. Four of the lost implants were single-tooth replacements and one was splinted. The cumulative survival rate (CSR) was 95.7% for all implants after 1 year and 93.7% and 98.1% for single-tooth and splinted implants, respectively. There were no implant losses in the extraction sites. The CSR of 96% at 1 year indicates that immediate function of Brånemark System implants placed in incisor

  6. Patient risk taking and spending habits correlate with willingness to pay for novel total joint arthroplasty implants

    Directory of Open Access Journals (Sweden)

    Ran Schwarzkopf, MD, MSc

    2015-03-01

    Full Text Available In this study, we compare patients' risk-taking and spending behaviors to their willingness to pay (WTP for novel implants in a joint arthroplasty. 210 patients were surveyed regarding risk-taking and spending behavior, and WTP for novel implants with either increased-longevity, increased-longevity with higher risk of complications, or decreased risk of complications compared to a standard implant. Patients with increased recreational risk-taking behavior were more WTP for increased-longevity. Patients who “rarely“ take health-risks were more WTP for decreased risk of complications. Patients with higher combined risk scores were more WTP for all novel implants. Patients who paid more than $50,000 for their current car were more WTP for decreased complications. This study shows that patients' risk taking and spending behavior influences their WTP for novel implants.

  7. [Catheter fracture and pulmonary embolization of the distal fragment: a rare complication of the totally implantable venous access port].

    Science.gov (United States)

    Rebahi, H; El Adib, A G; Mouaffak, Y; El Hattaoui, M; Chaara, A; Sadek, H; Khouchani, M; Mahmal, L; Younous, S

    2015-01-01

    Totally implantable venous access port plays a crucial role in the treatment of patients in oncology. However, its use can result sporadically in catheter fracture with catheter tip embolization into pulmonary arteries. We report this unusual but potentially serious complication in four patients. In these patients, the port had been inserted percutaneously into the subclavian vein using the infra-clavicular approach. This side effect occurred late in three patients. In all patients, the catheter fracture was asymptomatic or pauci-symptomatic and was caused by the pinch-off syndrome. The retrieval of the embolized fragments was successfully performed by transcatheter procedure in the cardiac catheterisation laboratory. We reviewed the literature and the newest guidelines and recommendations to detail the clinico-radiological features, the possible causes of this complication and discussed means to recognize, manage and prevent it. Copyright © 2013 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

  8. Impact of systemic diseases on oral health related quality of life after implant-prosthodontic rehabilitation

    Directory of Open Access Journals (Sweden)

    Tina Pretnar

    2014-08-01

    Full Text Available Background: Implant-prosthodontic rehabilitation improves oral health related quality of life (OHRQoL, but the presence of systemic diseases can also affect the well-being of an individual.The study was carried out to determine the relationship between systemic diseases and OHRQoL after implant-prosthodontic rehabilitation on the basis of psychometric testing by a standardized questionnaire »Oral Health Impact Profile« (OHIP.Methods: 130 patients, who received one to eight Ankylos® implants (on average 2.6 ± 1.8 were included in this retrospective study in which all aspects of the OHRQoL construct were evaluated with a Slovenian version of the OHIP questionnaire. Data on all present systemic diseases were obtained from the existing health records. Dental status and dental restorations were identified on the basis of orthopantomographic images.Results: The majority of subjects had a cardiovascular disease (N = 37; 28.5 %, followed by a headache (N = 15, 11.5 %, allergies and asthma (n = 13, 10 %, and a rheumatic disease (N = 11, 8.5 %. Only osteoporosis was statistically significantly related to OHRQoL after implant-prosthodontic rehabilitation (p = 0.024. The best multiple linear regression model for the summary score for the questionnaire »Oral Health Impact Profile« for Slovenia (OHIP, and taking into account gender and age as confounding factors, included the number of remaining teeth and the presence of osteoporosis (p = 0.003, adjusted R2 = 0.104.Conclusions: The total number of remaining teeth in the oral cavity (p = 0.031, the presence of osteoporosis (p = 0.024, and taking into account the subject’s gender and age, are the most important clinical factors that affect the functioning of the SGS as well as psychosocial behavior of the patients after an implant-prosthodontic rehabilitation (adjusted R2 = 0.104. Other systemic diseases (cardiovascular disease, headache, allergies and

  9. Comparative evaluation of the effectiveness of the implantation in the lateral part of the mandible between short tissue level (TE) and bone level (BL) implant systems.

    Science.gov (United States)

    Hadzik, Jakub; Botzenhart, Ute; Krawiec, Maciej; Gedrange, Tomasz; Heinemann, Friedhelm; Vegh, Andras; Dominiak, Marzena

    2017-09-01

    Short dental implants can be an alternative method of treatment to a vertical bone augmentation procedure at sites of reduced alveolar height. However, for successful treatment, an implant system that causes a minimal marginal bone loss (MBL) should be taken into consideration. The aim of the study has been to evaluate implantation effectiveness for bone level and tissue level short implants provided in lateral aspects of partially edentulous mandible and limited alveolar ridge height. The MBL and primary as well as secondary implant stability were determined in the study. Patients were randomly divided into two groups according to the method of treatment provided. Sixteen short Bone Level Implants (OsseoSpeed TX, Astra tech) and 16 short Tissue Level Implants (RN SLActive ® , Straumann) were successfully placed in the edentulous part of the mandible. The determination of the marginal bone level was based on radiographic evaluation after 12 and 36 weeks. Implant stability was measured immediately after insertion and after 12 weeks. The marginal bone level of Bone Level Implants was significantly lower compared to Tissue Level Implants. Furthermore, the Bone Level Implants had greater primary and secondary stability in comparison with Tissue Level Implants (Primary: 77.8 ISQ versus 66.5 ISQ; Secondary: 78.9 ISQ versus 73.9 ISQ, respectively). Since short Bone Level Implants showed a significantly decreased MBL 12 and 36 weeks after implantation as well as better results for the primary stability compared to Tissue Level Implants, they should preferentially be used for this mentioned indication. Copyright © 2017 Elsevier GmbH. All rights reserved.

  10. Retention system for implant-supported dentures used by brazilian dentists who work in implant dentistry

    OpenAIRE

    Saturnino Aparecido Ramalho; Fábio Pontes Dantas

    2010-01-01

    Objective: To provide the dentists with support in the choice of the cement or screw type of retention for implant-supported dentures, according to the patient’s problem. Methods: An opinion questionnaire was applied to a sample of 468 participants, all dentists working in the field of Implant Dentistry, of whom 272 (58.1%) participated in the 4th International Congress of Osseointegration of APCD, held in São Paulo (SP) from 6 to 9 May 2004, 119 (25.4%) participated in the 2nd International ...

  11. Intraoperative implant rod three-dimensional geometry measured by dual camera system during scoliosis surgery.

    Science.gov (United States)

    Salmingo, Remel Alingalan; Tadano, Shigeru; Abe, Yuichiro; Ito, Manabu

    2016-05-12

    Treatment for severe scoliosis is usually attained when the scoliotic spine is deformed and fixed by implant rods. Investigation of the intraoperative changes of implant rod shape in three-dimensions is necessary to understand the biomechanics of scoliosis correction, establish consensus of the treatment, and achieve the optimal outcome. The objective of this study was to measure the intraoperative three-dimensional geometry and deformation of implant rod during scoliosis corrective surgery.A pair of images was obtained intraoperatively by the dual camera system before rotation and after rotation of rods during scoliosis surgery. The three-dimensional implant rod geometry before implantation was measured directly by the surgeon and after surgery using a CT scanner. The images of rods were reconstructed in three-dimensions using quintic polynomial functions. The implant rod deformation was evaluated using the angle between the two three-dimensional tangent vectors measured at the ends of the implant rod.The implant rods at the concave side were significantly deformed during surgery. The highest rod deformation was found after the rotation of rods. The implant curvature regained after the surgical treatment.Careful intraoperative rod maneuver is important to achieve a safe clinical outcome because the intraoperative forces could be higher than the postoperative forces. Continuous scoliosis correction was observed as indicated by the regain of the implant rod curvature after surgery.

  12. A simple ion implantation system for solar cells

    International Nuclear Information System (INIS)

    Kenny, M.J.; Bird, J.R.; Broe, H.G.

    1982-11-01

    A project has been initiated to investigate simple but effective ion implantation and pulsed annealing techniques for the fabrication of high efficiency silicon solar cells. In particular, the method aims to eliminate the mass analyser and associated components from the implanter. A solid feed source is used in a clean ultra high vacuum environment to minimise impurities

  13. SIMPLANT: analytic calculation of ion implantation within the Tadpance system

    International Nuclear Information System (INIS)

    Fawcett, R.J.

    1988-04-01

    An analytic method for calculating the concentration distribution of dopant atoms introduced into a multilayer semiconductor device by ion beam implantation is explained. Computer software written to apply the method is described. The operation of the software within a semiconductor process and device modelling package is outlined. Implantation distributions generated by the software are illustrated. (author)

  14. Influence of abutment materials on the implant-abutment joint stability in internal conical connection type implant systems.

    Science.gov (United States)

    Jo, Jae-Young; Yang, Dong-Seok; Huh, Jung-Bo; Heo, Jae-Chan; Yun, Mi-Jung; Jeong, Chang-Mo

    2014-12-01

    This study evaluated the influence of abutment materials on the stability of the implant-abutment joint in internal conical connection type implant systems. Internal conical connection type implants, cement-retained abutments, and tungsten carbide-coated abutment screws were used. The abutments were fabricated with commercially pure grade 3 titanium (group T3), commercially pure grade 4 titanium (group T4), or Ti-6Al-4V (group TA) (n=5, each). In order to assess the amount of settlement after abutment fixation, a 30-Ncm tightening torque was applied, then the change in length before and after tightening the abutment screw was measured, and the preload exerted was recorded. The compressive bending strength was measured under the ISO14801 conditions. In order to determine whether there were significant changes in settlement, preload, and compressive bending strength before and after abutment fixation depending on abutment materials, one-way ANOVA and Tukey's HSD post-hoc test was performed. Group TA exhibited the smallest mean change in the combined length of the implant and abutment before and after fixation, and no difference was observed between groups T3 and T4 (P>.05). Group TA exhibited the highest preload and compressive bending strength values, followed by T4, then T3 (Pabutment material can influence the stability of the interface in internal conical connection type implant systems. The strength of the abutment material was inversely correlated with settlement, and positively correlated with compressive bending strength. Preload was inversely proportional to the frictional coefficient of the abutment material.

  15. Therapeutic interaction of systemically-administered mesenchymal stem cells with peri-implant mucosa.

    Directory of Open Access Journals (Sweden)

    Ryosuke Kondo

    Full Text Available OBJECTIVES: The objective of this study was to investigate the effect of systemically transplanted mesenchymal stem cells (MSCs on the peri-implant epithelial sealing around dental implants. MATERIALS AND METHODS: MSCs were isolated from bone marrow of donor rats and expanded in culture. After recipient rats received experimental titanium dental implants in the bone sockets after extraction of maxillary right first molars, donor rat MSCs were intravenously transplanted into the recipient rats. RESULTS: The injected MSCs were found in the oral mucosa surrounding the dental implants at 24 hours post-transplantation. MSC transplantation accelerated the formation of the peri-implant epithelium (PIE-mediated mucosa sealing around the implants at an early stage after implantation. Subsequently, enhanced deposition of laminin-332 was found along the PIE-implant interface at 4 weeks after the replacement. We also observed enhanced attachment and proliferation of oral mucous epithelial cells. CONCLUSION: Systemically transplanted MSCs might play a critical role in reinforcing the epithelial sealing around dental implants.

  16. Subclavian Vein Versus Arm Vein for Totally Implantable Central Venous Port for Patients with Head and Neck Cancer: A Retrospective Comparative Analysis

    International Nuclear Information System (INIS)

    Akahane, Akio; Sone, Miyuki; Ehara, Shigeru; Kato, Kenichi; Tanaka, Ryoichi; Nakasato, Tatsuhiko

    2011-01-01

    Purpose: This study was designed to compare central venous ports (CVP) from two different routes of venous access―the subclavian vein and arm vein―in terms of safety for patients with head and neck cancer (HNC). Methods: Patients with HNC who underwent image-guided implantations of CVPs were retrospectively evaluated. All CVPs were implanted under local anesthesia. Primary outcome measurements were rates and types of adverse events (AEs). Secondary outcomes included technical success and rate and reason of CVP removal. Results: A total of 162 patients (subclavian port group, 47; arm port group, 115) were included in this study. Technical success was achieved in all patients. The median follow-up period was 94 (range, 1–891) days. Two patients in the subclavian port group experienced periprocedural complications. Postprocedural AEs were observed in 8.5 and 22.6% of the subclavian port and arm port group patients, respectively (P = 0.044). Phlebitis and system occlusions were observed only in the arm port group. The rate of infection was not significantly different between the two groups. The CVP was removed in 34 and 39.1% of the subclavian port and arm port patients, respectively. Conclusions: Both subclavian and arm CVPs are feasible in patients with HNC. AEs were more frequent in the arm port group; thus, the arm port is not recommended as the first choice for patients with HNC. However, further experience is needed to improve the placement technique and the maintenance of CVPs and a prospective analysis is warranted.

  17. Enclosed Electronic System for Force Measurements in Knee Implants

    Directory of Open Access Journals (Sweden)

    David Forchelet

    2014-08-01

    Full Text Available Total knee arthroplasty is a widely performed surgical technique. Soft tissue force balancing during the operation relies strongly on the experience of the surgeon in equilibrating tension in the collateral ligaments. Little information on the forces in the implanted prosthesis is available during surgery and post-operative treatment. This paper presents the design, fabrication and testing of an instrumented insert performing force measurements in a knee prosthesis. The insert contains a closed structure composed of printed circuit boards and incorporates a microfabricated polyimide thin-film piezoresistive strain sensor for each condylar compartment. The sensor is tested in a mechanical knee simulator that mimics in-vivo conditions. For characterization purposes, static and dynamic load patterns are applied to the instrumented insert. Results show that the sensors are able to measure forces up to 1.5 times body weight with a sensitivity fitting the requirements for the proposed use. Dynamic testing of the insert shows a good tracking of slow and fast changing forces in the knee prosthesis by the sensors.

  18. Application of Total Quality Management System in Thai Primary Schools

    Science.gov (United States)

    Prueangphitchayathon, Setthiya; Tesaputa, Kowat; Somprach, Kanokorn

    2015-01-01

    The present study seeks to develop a total quality management (TQM) system that can be applied to primary schools. The approach focuses on customer orientation, total involvement of all constituencies and continuous improvement. TQM principles were studied and synthesized according to case studies of the best practices in 3 primary schools (small,…

  19. Methods of multicriterion estimations in system total quality management

    Directory of Open Access Journals (Sweden)

    Nikolay V. Diligenskiy

    2011-05-01

    Full Text Available In this article the method of multicriterion comparative estimation of efficiency (Data Envelopment Analysis and possibility of its application in system of total quality management is considered.

  20. A case-control study to identify risk factors for totally implantable central venous port-related bloodstream infection.

    Science.gov (United States)

    Lee, Guk Jin; Hong, Sook Hee; Roh, Sang Young; Park, Sa Rah; Lee, Myung Ah; Chun, Hoo Geun; Hong, Young Seon; Kang, Jin Hyoung; Kim, Sang Il; Kim, Youn Jeong; Chun, Ho Jong; Oh, Jung Suk

    2014-07-01

    To date, the risk factors for central venous port-related bloodstream infection (CVPBSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.

  1. Mortality After Total Knee and Total Hip Arthroplasty in a Large Integrated Health Care System.

    Science.gov (United States)

    Inacio, Maria C S; Dillon, Mark T; Miric, Alex; Navarro, Ronald A; Paxton, Elizabeth W

    2017-01-01

    The number of excess deaths associated with elective total joint arthroplasty in the US is not well understood. To evaluate one-year postoperative mortality among patients with elective primary and revision arthroplasty procedures of the hip and knee. A retrospective analysis was conducted of hip and knee arthroplasties performed in 2010. Procedure type, procedure volume, patient age and sex, and mortality were obtained from an institutional total joint replacement registry. An integrated health care system population was the sampling frame for the study subjects and was the reference group for the study. Standardized 1-year mortality ratios (SMRs) and 95% confidence intervals (CIs) were calculated. A total of 10,163 primary total knee arthroplasties (TKAs), 4963 primary total hip arthroplasties (THAs), 606 revision TKAs, and 496 revision THAs were evaluated. Patients undergoing primary THA (SMR = 0.6, 95% CI = 0.4-0.7) and TKA (SMR = 0.4, 95% CI = 0.3-0.5) had lower odds of mortality than expected. Patients with revision TKA had higher-than-expected mortality odds (SMR = 1.8, 95% CI = 1.1-2.5), whereas patients with revision THA (SMR = 0.9, 95% CI = 0.4-1.5) did not have higher-than-expected odds of mortality. Understanding excess mortality after joint surgery allows clinicians to evaluate current practices and to determine whether certain groups are at higher-than-expected mortality risk after surgery.

  2. Development of total medical material distribution management system.

    Science.gov (United States)

    Uto, Y; Kumamoto, I

    1994-07-01

    Since September 1992, attempts have been made at Kagoshima University Hospital to develop the Medical Material Distribution Management System which helps to realize optimal hospital management as a subsystem of the Total Hospital Information System of Kagoshima University (THINK). As this system has been established, it has become possible for us to have an accurate grasp of the flow and stock of medical materials at our hospital. Furthermore, since September 1993, the Medical Material Distribution Management System has been improved and the Total Medical Material Distribution Management System has been smoothly introduced into the site of clinical practice. This system enables automatic demands for fees for treatment with specific instruments and materials covered by health insurance. It was difficult to predict the effect of this system, because no similar system had been developed in Japan. However, more satisfactory results than expected have been obtained since its introduction.

  3. An implantable thermoresponsive drug delivery system based on Peltier device.

    Science.gov (United States)

    Yang, Rongbing; Gorelov, Alexander V; Aldabbagh, Fawaz; Carroll, William M; Rochev, Yury

    2013-04-15

    Locally dropping the temperature in vivo is the main obstacle to the clinical use of a thermoresponsive drug delivery system. In this paper, a Peltier electronic element is incorporated with a thermoresponsive thin film based drug delivery system to form a new drug delivery device which can regulate the release of rhodamine B in a water environment at 37 °C. Various current signals are used to control the temperature of the cold side of the Peltier device and the volume of water on top of the Peltier device affects the change in temperature. The pulsatile on-demand release profile of the model drug is obtained by turning the current signal on and off. The work has shown that the 2600 mAh power source is enough to power this device for 1.3 h. Furthermore, the excessive heat will not cause thermal damage in the body as it will be dissipated by the thermoregulation of the human body. Therefore, this simple novel device can be implanted and should work well in vivo. Copyright © 2013 Elsevier B.V. All rights reserved.

  4. An implantable centrifugal blood pump with a recirculating purge system (Cool-Seal system).

    Science.gov (United States)

    Yamazaki, K; Litwak, P; Tagusari, O; Mori, T; Kono, K; Kameneva, M; Watach, M; Gordon, L; Miyagishima, M; Tomioka, J; Umezu, M; Outa, E; Antaki, J F; Kormos, R L; Koyanagi, H; Griffith, B P

    1998-06-01

    A compact centrifugal blood pump has been developed as an implantable left ventricular assist system. The impeller diameter is 40 mm, and pump dimensions are 55 x 64 mm. This first prototype, fabricated from titanium alloy, resulted in a pump weight of 400 g including a brushless DC motor. The weight of a second prototype pump was reduced to 280 g. The entire blood contacting surface is coated with diamond like carbon (DLC) to improve blood compatibility. Flow rates of over 7 L/min against 100 mm Hg pressure at 2,500 rpm with 9 W total power consumption have been measured. A newly designed mechanical seal with a recirculating purge system (Cool-Seal) is used for the shaft seal. In this seal system, the seal temperature is kept under 40 degrees C to prevent heat denaturation of blood proteins. Purge fluid also cools the pump motor coil and journal bearing. Purge fluid is continuously purified and sterilized by an ultrafiltration unit which is incorporated in the paracorporeal drive console. In vitro experiments with bovine blood demonstrated an acceptably low hemolysis rate (normalized index of hemolysis = 0.005 +/- 0.002 g/100 L). In vivo experiments are currently ongoing using calves. Via left thoracotomy, left ventricular (LV) apex descending aorta bypass was performed utilizing an expanded polytetrafluoroethylene (ePTFE) vascular graft with the pump placed in the left thoracic cavity. In 2 in vivo experiments, the pump flow rate was maintained at 5-9 L/min, and pump power consumption remained stable at 9-10 W. All plasma free Hb levels were measured at less than 15 mg/dl. The seal system has demonstrated good seal capability with negligible purge fluid consumption (<0.5 ml/day). In both calves, the pumps demonstrated trouble free continuous function over 6 month (200 days and 222 days).

  5. Implant Surface Temperature Changes during Er:YAG Laser Irradiation with Different Cooling Systems.

    Directory of Open Access Journals (Sweden)

    Abbas Monzavi

    2014-04-01

    Full Text Available Peri-implantitis is one of the most common reasons for implant failure. Decontamination of infected implant surfaces can be achieved effectively by laser irradiation; although the associated thermal rise may cause irreversible bone damage and lead to implant loss. Temperature increments of over 10ºC during laser application may suffice for irreversible bone damage.The purpose of this study was to evaluate the temperature increment of implant surface during Er:YAG laser irradiation with different cooling systems.Three implants were placed in a resected block of sheep mandible and irradiated with Er:YAG laser with 3 different cooling systems namely water and air spray, air spray alone and no water or air spray. Temperature changes of the implant surface were monitored during laser irradiation with a K-type thermocouple at the apical area of the fixture.In all 3 groups, the maximum temperature rise was lower than 10°C. Temperature changes were significantly different with different cooling systems used (P<0.001.Based on the results, no thermal damage was observed during implant surface decontamination by Er:YAG laser with and without refrigeration. Thus, Er:YAG laser irradiation can be a safe method for treatment of periimplantitis.

  6. ["Let me tell you about my little box": phenomenological study on the experience of living with a totally implantable central venous catheter].

    Science.gov (United States)

    Mutti, Carolina; Fumagalli, Anna; Monni, Pierina; Rancati, Stefania; Rosi, Ivana Maria

    2016-01-01

    . "Let me tell you about my little box": phenomenological study on the experience of living with a totally implantable central venous catheter. Many variables impact on the choice to implant a totally implantable long-term central venous catheter's (Port), in spite of its proven efficacy. The patients' perception is pivotal, and only few qualitative studies dig deep into patients' feelings and experiences. To understand if, and how, the Port affects the patient's life. Qualitative phenomenological study based on semi-structured interviews on a convenience sample of patients implanted a Port, selected in an oncohematology Day Hospital in Milan. The analysis was carried out by three researchers with a phenomenological method. Four main themes, and sub-themes, emerged from twenty interviews. Relief, both physical and psychological; the process of the choice of inserting the Port and the importance of thinking about its positioning since the beginning of the treatment course; the symbol- the device reminds of the disease and its removal is of utmost importance; the technology progresses- the need of trust in the health care personnel and in their competences. The Port improved the patients' quality of life. The study allows some reflections on the need of considering the actual and future conditions of the patient to make a shared and informed choice.

  7. Development of a microcontroller-based automatic control system for the electrohydraulic total artificial heart.

    Science.gov (United States)

    Kim, H C; Khanwilkar, P S; Bearnson, G B; Olsen, D B

    1997-01-01

    An automatic physiological control system for the actively filled, alternately pumped ventricles of the volumetrically coupled, electrohydraulic total artificial heart (EHTAH) was developed for long-term use. The automatic control system must ensure that the device: 1) maintains a physiological response of cardiac output, 2) compensates for an nonphysiological condition, and 3) is stable, reliable, and operates at a high power efficiency. The developed automatic control system met these requirements both in vitro, in week-long continuous mock circulation tests, and in vivo, in acute open-chested animals (calves). Satisfactory results were also obtained in a series of chronic animal experiments, including 21 days of continuous operation of the fully automatic control mode, and 138 days of operation in a manual mode, in a 159-day calf implant.

  8. A system architecture, processor, and communication protocol for secure implants

    NARCIS (Netherlands)

    C. Strydis (Christos); R.M. Seepers (Robert); P. Peris-Lopez (Pedro); D. Siskos (Dimitrios); I. Sourdis (Ioannis)

    2013-01-01

    textabstractSecure and energy-efficient communication between Implantable Medical Devices (IMDs) and authorized external users is attracting increasing attention these days. However, there currently exists no systematic approach to the problem, while solutions from neighboring fields, such as

  9. Cutaneous and systemic hypersensitivity reactions to metallic implants

    DEFF Research Database (Denmark)

    Basko-Plluska, Juliana L; Thyssen, Jacob P; Schalock, Peter C

    2011-01-01

    ) following the insertion of intravascular stents, dental implants, cardiac pacemakers, or implanted gynecologic devices. Despite repeated attempts by researchers and clinicians to further understand this difficult area of medicine, the association between metal sensitivity and cutaneous allergic reactions......Cutaneous reactions to metal implants, orthopedic or otherwise, are well documented in the literature. The first case of a dermatitis reaction over a stainless steel fracture plate was described in 1966. Most skin reactions are eczematous and allergic in nature, although urticarial, bullous......, and vasculitic eruptions may occur. Also, more complex immune reactions may develop around the implants, resulting in pain, inflammation, and loosening. Nickel, cobalt, and chromium are the three most common metals that elicit both cutaneous and extracutaneous allergic reactions from chronic internal exposure...

  10. Systemic conditions and treatments as risk for therapy with dental implants

    International Nuclear Information System (INIS)

    Arguedas Vega, Natalia; Alfaro Mayorga, Erika

    2013-01-01

    The possible risks for osseointegration are described in patients with specific systemic conditions, medical treatment such as radiation, cardiovascular diseases, HIV and smoking habit. The principal complications for osseointegration of diseases and systemic treatments are exposed. The review and search of the available literature are realized in databases. The scientific literature obtained from human studies has reported the survival of patients with dental implants. The implants are placed in patients with at least one of the conditions studied. The risks of the surgical procedures required for the placement of implants are analyzed in systemically compromised patients. Comparisons of patients with and without systemic conditions in controlled form have remained without analyzing. The level of evidence of absolute and relative contraindications has been low for the therapy with implants in patients with systemic diseases. The revised information is detailed according the systemic conditions, and each of them are evaluated separately [es

  11. The influence of micro and macro-geometry in term of bone-implant interface in two implant systems: an histomorphometrical study.

    Science.gov (United States)

    Rocci, A; Calcaterra, R; DI Girolamo, M; Rocci, M; Rocci, C; Baggi, L

    2015-01-01

    Many factors could affect the osseous healing of implants such as surface topography of biomaterial, the status of the bone/implant site, implant loading conditions, surgical technique and implant design. The aim of this study was to analyze the BIC of 2 different implants systems characterized by different micro and macrogeometry, that were placed in the posterior maxillary and mandibular jaws of humans, clinically unloaded and retrieved for histomorphometric analyses after 12 weeks. The patients were divided in two groups (Group I and II); group I was composed by 4 patients that each received in the posterior areas of mandible one type A implant [GTB-Plan1Health Amaro (UD) Italy] one type B implant (OsseoSpeed Astra Tech, Dentsply Molndal, Sweden). Group II was composed by 3 patients that each received in the posterior areas of jawsbone one type A implant [GTB-Plan1Health Amaro (UD) Italy] one type B implant (OsseoSpeed Astra Tech, Dentsply Molndal, Sweden). After 12 weeks of healing all the implants of both groups were harvested with the peri-implant bone tissues. Osseointegration process was evaluated throughout measurements of BIC. No statistical significance differences were found among the mean percentage of BIC of Group I - type A were 66,51% versus 49,96% in Group I - type B, as well as among the mean percentage of BIC of Group II - type A were 43.7% versus 60.02% in Group II - type B. Our results highlight that the mean percentage of BIC after 12 weeks from the implants placement without functional loading is not influenced by the composition of the implant surface.

  12. Artery Soft-Tissue Modelling for Stent Implant Training System

    Directory of Open Access Journals (Sweden)

    Giovanni Aloisio

    2004-08-01

    Full Text Available Virtual reality technology can be utilised to provide new systematic training methods for surgical procedures. Our aim is to build a simulator that allows medical students to practice the coronary stent implant procedure and avoids exposing patients to risks. The designed simulation system consists of a virtual environment and a haptic interface, in order to provide both the visualization of the coronary arteries and the tactile and force feedback generated during the interactions of the surgical instruments in the virtual environment. Since the arteries are soft tissues, their shape may change during an operation; for this reason physical modelling of the organs is necessary to render their behaviour under the influence of surgeon's instruments. The idea is to define a model that computes the displacement of the tissue versus time; from the displacement it is possible to calculate the response of the tissue to the surgical tool external stimuli. Information about tools displacements and tissue responses are also used to graphically model the artery wall and virtual surgical instrument deformations generated as a consequence of their coming into contact. In order to obtain a realistic simulation, the Finite Element Method has been used to model the soft tissues of the artery, using linear elasticity to reduce computational time and speed up interaction rates.

  13. Three-Dimensional Electroanatomic Mapping System-Enhanced Cardiac Resynchronization Therapy Device Implantation: Results From a Multicenter Registry.

    Science.gov (United States)

    Del Greco, Maurizio; Maines, Massimiliano; Marini, Massimiliano; Colella, Andrea; Zecchin, Massimo; Vitali-Serdoz, Laura; Blandino, Alessandro; Barbonaglia, Lorella; Allocca, Giuseppe; Mureddu, Roberto; Marenna, Biondino; Rossi, Paolo; Vaccari, Diego; Chianca, Roberto; Indiani, Stefano; DI Matteo, Irene; Angheben, Carlo; Zorzi, Alessandro

    2017-01-01

    Cardiac resynchronization therapy (CRT) device implantation guided by an electroanatomic mapping system (EAMS) is an emerging technique that may reduce fluoroscopy and angiography use and provide information on coronary sinus (CS) electrical activation. We evaluated the outcome of the EAMS-guided CRT implantation technique in a multicenter registry. During the period 2011-2014 we enrolled 125 patients (80% males, age 74 [71-77] years) who underwent CRT implantation by using the EnSite system to create geometric models of the patient's cardiac chambers, build activation mapping of the CS, and guide leads positioning. Two hundred and fifty patients undergoing traditional CRT implantation served as controls. Success and complication rates, fluoroscopy and total procedure times in the overall study population and according to center experience were collected. Centers that performed ≥10 were defined as highly experienced. Left ventricular lead implantation was successful in 122 (98%) cases and 242 (97%) controls (P = 0.76). Median fluoroscopy time was 4.1 (0.3-10.4) minutes in cases versus 16 (11-26) minutes in controls (P < 0.001). Coronary sinus angiography was performed in 33 (26%) cases and 208 (83%) controls (P < 0.001). Complications occurred in 5 (4%) cases and 17 (7%) controls (P = 0.28). Median fluoroscopy time (median 11 minutes vs. 3 minutes, P < 0.001) and CS angiography rate (55% vs. 21%, P < 0.001) were significantly higher in low experienced centers, while success rate and complications rate were similar. EAMS-guided CRT implantation proved safe and effective in both high- and low-experienced centers and allowed to reduce fluoroscopy use by ≈75% and angiography rate by ≈70%. © 2016 Wiley Periodicals, Inc.

  14. Preliminary installment of total picture archiving and communication systems

    International Nuclear Information System (INIS)

    Takenaka, E.; Takanashi, S.; Suda, Y.; Furui, S.; Yoshida, H.; Hosaka, Y.; Fukui, T.

    1990-01-01

    This paper studied the image quality of various medical digital images and to install a small but total image management and communication system to file images. The system consists of a filing system with a laser scanning digitizer (2,000 x 2,000 x 8 bits), an optical disk (3.8 GB), two HD CRTs, and a 1.6 GB magnetic disk. This system can file on-line the images from a second filing system with FCR (on-line) and a Konica direct imaging system during treatment and follow-up, a CCD TV simulator system for a remote after-loading system, a dose map on CT and MR images through a self-made treatment planning system on the PC level, a CCD TV (RGB) system for local lesions, and portal images, through the imaging plate, for brachytherapy

  15. Clinical and radiological results of patients treated with three treatment modalities for overdentures on implants of the ITI (R) Dental Implant System - A randomized controlled clinical trial

    NARCIS (Netherlands)

    Wismeijer, D; van Waas, MAJ; Mulder, J; Vermeeren, JIJF; Kalk, W

    In a randomized controlled clinical trial carried out at the Ignatius teaching hospital in Breda, The Netherlands, 110 edentulous patients with severe mandibular bone loss were treated with implants of the ITI(R) Dental Implant System using 3 different treatment strategies: a mandibular overdenture

  16. Total-System Performance Assessment for the Yucca Mountain Site

    International Nuclear Information System (INIS)

    Wilson, M.L.

    2001-01-01

    Yucca Mountain, Nevada, is under consideration as a potential site for a repository for high-level radioactive waste. Total-system performance-assessment simulations are performed to evaluate the safety of the site. Features, events, and processes have been systematically evaluated to determine which ones are significant to the safety assessment. Computer models of the disposal system have been developed within a probabilistic framework, including both engineered and natural components. Selected results are presented for three different total-system simulations, and the behavior of the disposal system is discussed. The results show that risk is dominated by igneous activity at early times, because the robust waste-package design prevents significant nominal (non-disruptive) releases for tens of thousands of years or longer. The uncertainty in the nominal performance is dominated by uncertainties related to waste-package corrosion at early times and by uncertainties in the natural system, most significantly infiltration, at late times

  17. Functional adaptation of the masticatory system to implant-supported mandibular overdentures.

    Science.gov (United States)

    Giannakopoulos, Nikolaos Nikitas; Corteville, Frédéric; Kappel, Stefanie; Rammelsberg, Peter; Schindler, Hans Jürgen; Eberhard, Lydia

    2017-05-01

    The purpose of this study was to investigate the adaptation behavior of the stomatognathic system after immediate loading (24 to 72 h after surgery) of two implants supporting mandibular overdentures, assessed on insertion and three months later. The study hypothesis was that insertion of the overdentures would significantly change masticatory performance and muscle activity at both times. Thirty subjects (nine female, mean age 69.64 ± 11.81 years; 21 male, mean age 68.67 ± 7.41 years) who participated in a randomized clinical trial were included in the study. Each patient was examined three times: (i) at baseline, after already having worn new dentures for three months (T1); (ii) immediately after insertion of the overdentures on the implants (T2); and (iii) after an adaptation period of three months (T3). Examination comprised assessment of masticatory performance with artificial test food (Optocal), and simultaneous bilateral surface EMG recording of the masseter and anterior temporalis muscles. Particle-size distribution (representative value X 50 ), maximum muscle contraction (MVC), and total muscle work (TMW; area under the curve) were compared by use of repeated-measures analysis of variance (ANOVA). At T3, all measured variables (i.e., masticatory performance and muscle activity) were significantly different from those at T1. At T2, no significant changes were observed. The study hypothesis had to be rejected for T2 but accepted for T3. Functional rehabilitation (in terms of masticatory performance and masticatory muscle activity) does not occur immediately after immediate loading of two implants with mandibular overdentures, but requires a significant time for functional improvement. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  18. ISHTE deep-ocean corers and heater-implant system. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Olson, L. O.; Harrison, J. G.

    1982-09-01

    Seafloor instrumentation systems are being developed for the In-Situ Heat Transfer Experiment (ISHTE) to determine the thermal conductivity of deep ocean sediments. As part of the experiment, a heat canister will be implanted into the sediment. Also, after about one year on the seafloor, core samplers are to be actuated to gather sediment samples. This report describes the deep ocean piston corers and the heater-implant drive system.

  19. Total-System Analyzer for performance assessment of Yucca Mountain

    International Nuclear Information System (INIS)

    Wilson, M.L.; Lauffer, F.C.; Cummings, J.C.; Zieman, N.B.

    1990-01-01

    The Total-System Analyzer is a modular computer program for probabilistic total-system performance calculations. The code employs stratified random sampling from model parameter distribution functions to generate multiple realizations of the system. The results of flow and transport calculations for each realization are combined into a probability distribution function of the system response as indicated by the performance measure. We give a detailed description of the code and present results for four example problems simulating the release of radionuclides from a proposed high-level-waste repository at Yucca Mountain, Nevada. The example simulations illustrate the impact of significant variation of percolation flux and sorption on radionuclide releases. We discuss the effects of numerical sampling error and of correlations among the model parameters. 20 refs., 7 figs., 2 tabs

  20. Total anomalous systemic venous drainage in left heterotaxy syndrome.

    Science.gov (United States)

    Khandenahally, Ravindranath S; Deora, Surender; Math, Ravi S

    2013-04-01

    Total anomalous systemic venous drainage is an extremely rare congenital heart defect. In this study we describe an 11-year-old girl who presented with a history of fatigue and central cyanosis that she had had since early childhood with unremarkable precordial examination results. Investigations revealed left heterotaxy with all systemic venous drainage to the left-sided atrium with non-compaction of the left ventricle.

  1. Optimized design of total energy systems: The RETE project

    Science.gov (United States)

    Alia, P.; Dallavalle, F.; Denard, C.; Sanson, F.; Veneziani, S.; Spagni, G.

    1980-05-01

    The RETE (Reggio Emilia Total Energy) project is discussed. The total energy system (TES) was developed to achieve the maximum quality matching on the thermal energy side between plant and user and perform an open scheme on the electrical energy side by connection with the Italian electrical network. The most significant qualitative considerations at the basis of the plant economic energy optimization and the selection of the operating criterion most fitting the user consumption characteristics and the external system constraints are reported. The design methodology described results in a TES that: in energy terms achieves a total efficiency evaluated on a yearly basis to be equal to about 78 percent and a fuel saving of about 28 percent and in economic terms allows a recovery of the investment required as to conventional solutions, in about seven years.

  2. Accuracy of a digital impression system based on parallel confocal laser technology for implants with consideration of operator experience and implant angulation and depth.

    Science.gov (United States)

    Giménez, Beatriz; Özcan, Mutlu; Martínez-Rus, Francisco; Pradíes, Guillermo

    2014-01-01

    To evaluate the accuracy of a digital impression system based on parallel confocal red laser technology, taking into consideration clinical parameters such as operator experience and angulation and depth of implants. A maxillary master model with six implants (located bilaterally in the second molar, second premolar, and lateral incisor positions) was fitted with six polyether ether ketone scan bodies. One second premolar implant was placed with 30 degrees of mesial angulation; the opposite implant was positioned with 30 degrees of distal angulation. The lateral incisor implants were placed 2 or 4 mm subgingivally. Two experienced and two inexperienced operators performed intraoral scanning. Five different interimplant distances were then measured. The files obtained from the scans were imported with reverse-engineering software. Measurements were then made with a coordinate measurement machine, with values from the master model used as reference values. The deviations from the actual values were then calculated. The differences between experienced and inexperienced operators and the effects of different implant angulations and depths were compared statistically. Overall, operator 3 obtained significantly less accurate results. The angulated implants did not significantly influence accuracy compared to the parallel implants. Differences were found in the amount of error in the different quadrants. The second scanned quadrant had significantly worse results than the first scanned quadrant. Impressions of the implants placed at the tissue level were less accurate than implants placed 2 and 4 mm subgingivally. The operator affected the accuracy of measurements, but the performance of the operator was not necessarily dependent on experience. Angulated implants did not decrease the accuracy of the digital impression system tested. The scanned distance affected the predictability of the accuracy of the scanner, and the error increased with the increased length of the

  3. 21 CFR 862.1470 - Lipid (total) test system.

    Science.gov (United States)

    2010-04-01

    ... used in the diagnosis and treatment of various diseases involving lipid metabolism and atherosclerosis... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Lipid (total) test system. 862.1470 Section 862.1470 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED...

  4. Micro Total Analysis Systems: Microfluidic aspects, integration concept and applications

    NARCIS (Netherlands)

    van den Berg, Albert; Lammerink, Theodorus S.J.

    1997-01-01

    In this contribution three aspects of miniaturized total analysis systems (µTAS) are described and discussed in detail. First, an overview of microfabricated components for fluid handling is given. A description of the importance of sampling- and fluid-handling techniques is followed by details of

  5. Total Water Management, the New Paradigm for Urban Water Systems

    Science.gov (United States)

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current resource management practices put different stresses on local water resources and urban infrastructure. Total Water Manag...

  6. The effect of a single infusion of zoledronic acid on early implant migration in total hip arthroplasty. A randomized, double-blind, controlled trial.

    Science.gov (United States)

    Friedl, Gerald; Radl, Roman; Stihsen, Christoph; Rehak, Peter; Aigner, Reingard; Windhager, Reinhard

    2009-02-01

    Aseptic loosening is the most frequent cause of implant failure in total hip arthroplasty. While a direct link between aseptic loosening and periprosthetic bone loss remains elusive, there is plentiful evidence for a close association with early implant migration. The present trial was primarily designed to evaluate whether a single infusion of 4 mg of zoledronic acid prevented early implant migration in patients with osteonecrosis of the femoral head. Fifty patients were consecutively enrolled to receive either zoledronic acid or saline solution after cementless total hip arthroplasty. Radiographs, biochemical parameters of bone turnover, and the Harris hip-rating score were determined preoperatively and at each follow-up examination at seven weeks, six months, one year, and yearly thereafter. The median follow-up period was 2.8 years. We found a significant subsidence of the stem of up to a mean (and standard deviation) of -1.2 +/- 0.6 mm at two years within the control group, and the cups had a mean medialization of 0.6 +/- 1.0 mm and a mean cranialization of 0.6 +/- 0.8 mm (p < 0.001). Treatment with zoledronic acid effectively minimized the migration of the cups in both the transverse and the vertical direction (mean, 0.15 +/- 0.6 mm and 0.06 +/- 0.6 mm, respectively; p < 0.05), while only a trend to decreased subsidence of the stem was detected. Finally, the Harris hip score rapidly increased over time in both treatment groups, although this increase was significantly more pronounced in the zoledronate-treated group than in the control group (analysis of variance, p = 0.008). A single infusion of zoledronic acid shows promise in improving initial fixation of a cementless implant, which may improve the clinical outcome of total hip arthroplasty in patients with osteonecrosis of the femoral head.

  7. The impact of a total reward system of work engagement

    Directory of Open Access Journals (Sweden)

    Crystal Hoole

    2016-11-01

    Research purpose: The overall purpose of this study was to explore the relationship between total rewards and work engagement in a South African context and to determine which reward categories predict work engagement. The study further endeavoured to determine whether gender and age had a moderating effect on the relationship between total rewards and engagement. Motivation for the study: Statistics report that less than 30% of all working people are optimally engaged in their work. Considering that individuals spend more than a third of their lives at work committing themselves emotionally, physically and psychologically – research indicates that employees are no longer satisfied with traditional reward systems and want to feel valued and appreciated. Research approach, design and method: In this quantitative, cross-sectional research design using a non-probability convenience and purposive sampling strategy, 318 questionnaires were collected and analysed from financial institutions in Gauteng in which opinions were sought on the importance of different types of rewards structures and preferences, and how engaged they are in their workplace. The 17-item UWES and Nienaber total reward preference model were the chosen measuring instruments. Main findings: A small statistically significant correlation (r = 0.25; p < 0.05; small effect was found between total rewards and work engagement, and 12% of the variance of work engagement was explained. Only performance and career management significantly predicted work engagement. Practical/Managerial implications: Although small, the significant correlation between total rewards and work engagement implies that total rewards are important motivators for employees in the workplace. Of the total rewards scales tested, only performance and career management significantly predicted work engagement, suggesting that more research is needed. Organisations seeking to implement total reward strategies should pay specific

  8. Processing of microCT implant-bone systems images using Fuzzy Mathematical Morphology

    International Nuclear Information System (INIS)

    Bouchet, A; Pastore, J; Colabella, L; Omar, S; Ballarre, J

    2016-01-01

    The relationship between a metallic implant and the existing bone in a surgical permanent prosthesis is of great importance since the fixation and osseointegration of the system leads to the failure or success of the surgery. Micro Computed Tomography is a technique that helps to visualize the structure of the bone. In this study, the microCT is used to analyze implant-bone systems images. However, one of the problems presented in the reconstruction of these images is the effect of the iron based implants, with a halo or fluorescence scattering distorting the micro CT image and leading to bad 3D reconstructions. In this work we introduce an automatic method for eliminate the effect of AISI 316L iron materials in the implant-bone system based on the application of Compensatory Fuzzy Mathematical Morphology for future investigate about the structural and mechanical properties of bone and cancellous materials. (paper)

  9. [Technical feasibility of the implantation of a monorail stent system into the renal arteries without pre-dilatation].

    Science.gov (United States)

    Neumann, C; Gschwendtner, M; Karnel, F; Mair, J; Dorffner, G; Dorffner, R

    2005-01-01

    To evaluate the technical feasibility of the implantation of the monorail RX Herculink system into the renal arteries without pre-dilatation. Forty-two patients (mean age 71 years) from four centers with a total of 44 renal artery stenoses underwent implantation of the RX Herculink stent. The mean grade of the stenosis was 83.8 %, the mean length 7.5 mm. The stenoses were ostial in 38 cases and in immediate proximity to the ostium in 6 cases. The mean follow-up-period was 57 weeks (24 - 176 weeks). In 42 cases, the implantation was successful without pre-dilatation. In 2 cases, pre-dilatation was carried out. In none of the cases, detachment of the stent from the balloon was observed. In one stenosis with a length of 17 mm, implantation of two stents was performed. In 9 cases, post-dilatation with a larger balloon or higher balloon pressure was necessary. Residual stenoses exceeding 30 % were not observed. Two patients developed local bleeding at the puncture site. During the follow-up, restenoses were observed in 5 stents after 26 to 126 weeks, which necessitated a second intervention in 3 cases (PTA in 2 cases, re-stenting in 1 case). The primary patency rate after 6 and 12 months was 0.92 +/- 0.056 according to Kaplan-Meier, the secondary patency rate after 6 and 12 months was 1.0 +/- 0.0. Implantation of the RX Herculink stent system into the renal arteries without pre-dilatation is technically feasible and safe. Even without pre-dilatation, the stent-system can be advanced through the stenosis without detachment. The complication rate is low. Our clinical results are comparable to previous studies.

  10. Technical feasibility of the implantation of a monorail stent system into the renal arteries without pre-dilatation

    International Nuclear Information System (INIS)

    Neumann, C.; Dorffner, R.; Gschwendtner, M.; Karnel, F.; Mair, J.; Dorffner, G.

    2005-01-01

    Purpose: to evaluate the technical feasibility of the implantation of the monorail RX Herculink trademark system into the renal arteries without pre-dilatation. Materials and methods: forty-two patients (mean age 71 years) from four centers with a total of 44 renal artery stenoses underwent implantation of the RX Herculink trademark stent. The mean grade of the stenosis was 83.8%, the mean length 7.5 mm. The stenoses were ostial in 38 cases and in immediate proximity to the ostium in 6 cases. The mean follow-up-period was 57 weeks (24 - 176 weeks). Results: in 42 cases, the implantation was successful without pre-dilatation. In 2 cases, pre-dilatation was carried out. In none of the cases, detachment of the stent from the balloon was observed. In one stenosis with a length of 17 mm, implantation of two stents was performed. In 9 cases, post-dilatation with a larger balloon or higher balloon pressure was necessary. Residual stenoses exceeding 30% were not observed. Two patients developed local bleeding at the puncture site. During the follow-up, restenoses were observed in 5 stents after 26 to 126 weeks, which necessitated a second intervention in 3 cases (PTA in 2 cases, re-stenting in 1 case). The primary patency rate after 6 and 12 months was 0.92 ± 0.056 according to Kaplan-Meier, the secondary patency rate after 6 and 12 months was 1.0 ± 0.0. Conclusion: implantation of the RX Herculink trademark stent system into the renal arteries without pre-dilatation is technically feasible and safe. Even without pre-dilatation, the stent-system can be advanced through the stenosis without detachment. The complication rate is low. Our clinical results are comparable to previous studies. (orig.)

  11. Computer-based anthropometrical system for total body irradiation.

    Science.gov (United States)

    Sánchez-Nieto, B; Sánchez-Doblado, F; Terrón, J A; Arráns, R; Errazquin, L

    1997-05-01

    For total body irradiation (TBI) dose calculation requirements, anatomical information about the whole body is needed. Despite the fact that video image grabbing techniques are used by some treatment planning systems for standard radiotherapy, there are no such systems designed to generate anatomical parameters for TBI planning. The paper describes an anthropometrical computerised system based on video image grabbing which was purpose-built to provide anatomical data for a PC-based TBI planning system. Using software, the system controls the acquisition and digitalisation of the images (external images of the patient in treatment position) and the measurement procedure itself (on the external images or the digital CT information). An ASCII file, readable by the TBI planning system, is generated to store the required parameters of the dose calculation points, i.e. depth, backscatter tissue thickness, thickness of inhomogeneity, off-axis distance (OAD) and source to skin distance (SSD).

  12. Phase change thermal storage for a solar total energy system

    Science.gov (United States)

    Rice, R. E.; Cohen, B. M.

    1978-01-01

    An analytical and experimental program is being conducted on a one-tenth scale model of a high-temperature (584 K) phase-change thermal energy storage system for installation in a solar total energy test facility at Albuquerque, New Mexico, U.S.A. The thermal storage medium is anhydrous sodium hydroxide with 8% sodium nitrate. The program will produce data on the dynamic response of the system to repeated cycles of charging and discharging simulating those of the test facility. Data will be correlated with a mathematical model which will then be used in the design of the full-scale system.

  13. Economic analysis model for total energy and economic systems

    International Nuclear Information System (INIS)

    Shoji, Katsuhiko; Yasukawa, Shigeru; Sato, Osamu

    1980-09-01

    This report describes framing an economic analysis model developed as a tool of total energy systems. To prospect and analyze future energy systems, it is important to analyze the relation between energy system and economic structure. We prepared an economic analysis model which was suited for this purpose. Our model marks that we can analyze in more detail energy related matters than other economic ones, and can forecast long-term economic progress rather than short-term economic fluctuation. From view point of economics, our model is longterm multi-sectoral economic analysis model of open Leontief type. Our model gave us appropriate results for fitting test and forecasting estimation. (author)

  14. Intra-arterial port implantation for intra-arterial chemotherapy : comparison between PIPS(Percutaneously Implantable Port System) and port system

    International Nuclear Information System (INIS)

    Yoon, Sang Jin; Shim, Hyung Jin; Jung, Hun Young; Choi, Yong Ho; Kim, Yang Soo; Song, In Sup; Kwak, Byung Kook

    1999-01-01

    To compare the techniques and complications of intra-arterial port implantation for intra-arterial chemotherapy between PIPS and the port system. For intra-arterial port implantation, 27 cases in 27 patients were retrospectively evaluated using PIPS(PIPS-200, William Cook Europe, Denmark) while for 21 cases in 19 patients a pediatric venous port system(Port-A-Cath, 5.8F, SIMS Deltec, U. S. A.) was used. All intra-arterial port implantation was performed percuteneously in an angiographic ward. Hepatocellular carcinoma was diagnosed in 18 patients and hepatic metastasis in 16. Peripheral cholangiocarcinoma, and pancreatic gastric, ovarian, renal cell and colon carcinoma were included. We compared the techniques and complications between PIPS and the port system. The follow up period ranged from 23 to 494(mean, 163) days in PIPS and from 12 to 431(mean, 150) days in the port system. In all cases, intra-arterial port implantations were technically successful. Port catheter tips were located in the common hepatic artery(n=8), proper hepatic artery(n=7), right hepatic artery(n=5), gastroduodenal artery(n=2), left hepatic artery(n=1), pancreaticoduodenal artery(n=1), inferior mesenteric artery(n=1), lumbar artery(n=1), and renal artery(n=1) in PIPS, and in the proper hepatic artery(n=6), gastroduodenal artery(n=6), common hepatic artery(n=3), right hepatic artery(n=4), inferior mesenteric artery(n=1), and internal iliac artery(n=1) in the port system. Port chambers were buried in infrainguinal subcutaneous tissue. Using PIPS, complications developed in seven cases(25.9%) and of these, four (57.1%) were catheter or chamber related. In the port system, catheter or chamber related complications developed in four cases(19.0%). Because PIPS and the port system have relative merits and demetrits, successful intra-arterial port implantation is possible if equipment is properly selected

  15. Cutaneous and systemic hypersensitivity reactions to metallic implants.

    Science.gov (United States)

    Basko-Plluska, Juliana L; Thyssen, Jacob P; Schalock, Peter C

    2011-01-01

    Cutaneous reactions to metal implants, orthopedic or otherwise, are well documented in the literature. The first case of a dermatitis reaction over a stainless steel fracture plate was described in 1966. Most skin reactions are eczematous and allergic in nature, although urticarial, bullous, and vasculitic eruptions may occur. Also, more complex immune reactions may develop around the implants, resulting in pain, inflammation, and loosening. Nickel, cobalt, and chromium are the three most common metals that elicit both cutaneous and extracutaneous allergic reactions from chronic internal exposure. However, other metal ions as well as bone cement components can cause such hypersensitivity reactions. To complicate things, patients may also develop delayed-type hypersensitivity reactions to metals (ie, in-stent restenosis, prosthesis loosening, inflammation, pain, or allergic contact dermatitis) following the insertion of intravascular stents, dental implants, cardiac pacemakers, or implanted gynecologic devices. Despite repeated attempts by researchers and clinicians to further understand this difficult area of medicine, the association between metal sensitivity and cutaneous allergic reactions remains to be fully understood. This review provides an update of the current knowledge in this field and should be valuable to health care providers who manage patients with conditions related to this field.

  16. Fiscal 2000 achievement report on the research and development of medical and welfare apparatus/technology. Totally implantable artificial heart for clinical use; 2000 nendo iryo fukushi kiki gijutsu kenkyu kaihatsu seika hokokusho. Rinsho oyo ni muketa tainai umekomigata jinko shinzo system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-05-01

    In the development of control technologies for a pulsatile pump, studies proceeded with a view to using a mixed venous blood oxygen saturation sensor, an ultrasonic sensor, and an absolute pressure sensor. Efforts were started to downsize the hydraulic actuator and to enhance its efficiency. In the development of a non-pulsatile artificial heart, the GyroP1710 series of artificial heart systems of Japanese make was developed, which employed a curved inlet known to be highly compatible from the anatomical point of view. In the development of a total system, a pulsatile auxiliary artificial heart was given a chronic animal test which continued approximately three weeks, when it yielded a flow of approximately 4 liters/minute showing that it would be practical as an auxiliary heart. As for the non-pulsatile artificial heart, a cardiopulmonary bypass test was conducted, when the blood circulation behavior was normal and organ functions were sustained. The free hemoglobin level was 9.3mg/dl achieving the target value, and the test animal lived as long as 50 days. (NEDO)

  17. Implantable power generation system utilizing muscle contractions excited by electrical stimulation.

    Science.gov (United States)

    Sahara, Genta; Hijikata, Wataru; Tomioka, Kota; Shinshi, Tadahiko

    2016-06-01

    An implantable power generation system driven by muscle contractions for supplying power to active implantable medical devices, such as pacemakers and neurostimulators, is proposed. In this system, a muscle is intentionally contracted by an electrical stimulation in accordance with the demands of the active implantable medical device for electrical power. The proposed system, which comprises a small electromagnetic induction generator, electrodes with an electrical circuit for stimulation and a transmission device to convert the linear motion of the muscle contractions into rotational motion for the magneto rotor, generates electrical energy. In an ex vivo demonstration using the gastrocnemius muscle of a toad, which was 28 mm in length and weighed 1.3 g, the electrical energy generated by the prototype exceeded the energy consumed for electrical stimulation, with the net power being 111 µW. It was demonstrated that the proposed implantable power generation system has the potential to replace implantable batteries for active implantable medical devices. © IMechE 2016.

  18. Implantable electronics of a closed-loop system for controlling prosthetic hands

    Directory of Open Access Journals (Sweden)

    Nikas Antonios

    2017-09-01

    Full Text Available This paper presents the design of implantable electronics as a part of a system for prosthetic hand control. Purpose of the implant is the sensing of electrical signals originating from biological tissue and the actuation of the same, therefore closing the loop and allowing for an improved control of the prosthetic hand. The implant contains two integrated circuits for eight channel EMG monitoring and four channel stimulation, respectively. An on-board microcontroller allows for local pre-processing. All intracorporeal to extracorporeal communications are running through and are directed by the main processing platform. The external components of the control system include, in addition to the main processing and control platform, the inductive power transfer circuits and the pressure sensors for the sensory feedback. Different assembly and encapsulation options are taken into account for the implantable electronics and are unified in a single PCB design.

  19. A total system approach to sustainable pest management

    Science.gov (United States)

    Lewis, W. J.; van Lenteren, J. C.; Phatak, Sharad C.; Tumlinson, J. H.

    1997-01-01

    A fundamental shift to a total system approach for crop protection is urgently needed to resolve escalating economic and environmental consequences of combating agricultural pests. Pest management strategies have long been dominated by quests for “silver bullet” products to control pest outbreaks. However, managing undesired variables in ecosystems is similar to that for other systems, including the human body and social orders. Experience in these fields substantiates the fact that therapeutic interventions into any system are effective only for short term relief because these externalities are soon “neutralized” by countermoves within the system. Long term resolutions can be achieved only by restructuring and managing these systems in ways that maximize the array of “built-in” preventive strengths, with therapeutic tactics serving strictly as backups to these natural regulators. To date, we have failed to incorporate this basic principle into the mainstream of pest management science and continue to regress into a foot race with nature. In this report, we establish why a total system approach is essential as the guiding premise of pest management and provide arguments as to how earlier attempts for change and current mainstream initiatives generally fail to follow this principle. We then draw on emerging knowledge about multitrophic level interactions and other specific findings about management of ecosystems to propose a pivotal redirection of pest management strategies that would honor this principle and, thus, be sustainable. Finally, we discuss the potential immense benefits of such a central shift in pest management philosophy. PMID:9356432

  20. Bandwidth Efficient Overlapped FSK Coded Secure Command Transmission for Medical Implant Communication Systems

    Directory of Open Access Journals (Sweden)

    Selman KULAÇ

    2018-06-01

    Full Text Available Nowadays, wireless communication systems are exploited in most health care systems. Implantable Medical Systems (IMS also have wireless communication capability. However, it is very important that secure wireless communication should be provided in terms of both patient rights and patient health. Therefore, wireless transmission systems of IMS should also be robust against to eavesdroppers and adversaries. In this study, a specific overlapped and coded frequency shift keying (FSK modulation technique is developed and security containing with low complexity is provided by this proposed technique. The developed method is suitable for wireless implantable medical systems since it provides low complexity and security as well as bandwidth efficiency.

  1. Total System Performance Assessment-License Application Methods and Approach

    Energy Technology Data Exchange (ETDEWEB)

    J. McNeish

    2002-09-13

    ''Total System Performance Assessment-License Application (TSPA-LA) Methods and Approach'' provides the top-level method and approach for conducting the TSPA-LA model development and analyses. The method and approach is responsive to the criteria set forth in Total System Performance Assessment Integration (TSPAI) Key Technical Issue (KTI) agreements, the ''Yucca Mountain Review Plan'' (CNWRA 2002 [158449]), and 10 CFR Part 63. This introductory section provides an overview of the TSPA-LA, the projected TSPA-LA documentation structure, and the goals of the document. It also provides a brief discussion of the regulatory framework, the approach to risk management of the development and analysis of the model, and the overall organization of the document. The section closes with some important conventions that are utilized in this document.

  2. Total System Performance Assessment - License Application Methods and Approach

    International Nuclear Information System (INIS)

    McNeish, J.

    2003-01-01

    ''Total System Performance Assessment-License Application (TSPA-LA) Methods and Approach'' provides the top-level method and approach for conducting the TSPA-LA model development and analyses. The method and approach is responsive to the criteria set forth in Total System Performance Assessment Integration (TSPAI) Key Technical Issues (KTIs) identified in agreements with the U.S. Nuclear Regulatory Commission, the ''Yucca Mountain Review Plan'' (YMRP), ''Final Report'' (NRC 2003 [163274]), and the NRC final rule 10 CFR Part 63 (NRC 2002 [156605]). This introductory section provides an overview of the TSPA-LA, the projected TSPA-LA documentation structure, and the goals of the document. It also provides a brief discussion of the regulatory framework, the approach to risk management of the development and analysis of the model, and the overall organization of the document. The section closes with some important conventions that are used in this document

  3. Total lymphoid irradiation in refractory systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Ben-Chetrit, E.; Gross, D.J.; Braverman, A.; Weshler, Z.; Fuks, Z.; Slavin, S.; Eliakim, M.

    1986-01-01

    In two patients with systemic lupus erythematosus, conventional therapy was considered to have failed because of persistent disease activity and unacceptable side effects. Both were treated with total lymphoid irradiation without clinical benefit, despite adequate immunosuppression as documented by markedly reduced numbers of circulating T lymphocytes and T-lymphocyte-dependent proliferative responses in vitro. The first patient developed herpes zoster, gram-negative septicemia, neurologic symptoms, and deterioration of lupus nephritis. The second patient developed massive bronchopneumonia, necrotic cutaneous lesions, and progressive nephritis and died 2 weeks after completion of radiotherapy. These observations, although limited to two patients, indicate that total lymphoid irradiation in patients with severe systemic lupus erythematosus should be regarded as strictly experimental

  4. FY 1983 annual report on the research and development of automatic sewing systems. Total systems; 1983 nendo jido hosei system no kenkyu kaihatsu seika hokokusho. Total system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1984-03-01

    The automatic sewing system technique research association has been commissioned by the Agency of Industrial Science and Technology for (research and development of automatic sewing systems). This program covers R and D of the elementary techniques for total systems and sewing preparation/processing, sewing/assembling, cloth handling, and system management/control. This report describes the results of the R and D efforts for the total systems. The basic data are collected for a total of 5 representative types of apparels. The technical problems involved in the current and automatic sewing systems are clarified for each apparel type, to collect the data for studying the test plant plans. The automatic sewing system for each apparel type is illustrated by images, for expressing the system concepts. The concept for the basic designs of the total system is drawn for FMS. For achieving the objective of reducing time for producing unit quantity of diversified types of clothes in small quantities at least by 50% from the current level, the study is focused on how the works are (flown) in the system, for which configuration of each device is studied. The basic specifications are drawn, viewed from development of the total system. (NEDO)

  5. Economics of human performance and systems total ownership cost.

    Science.gov (United States)

    Onkham, Wilawan; Karwowski, Waldemar; Ahram, Tareq Z

    2012-01-01

    Financial costs of investing in people is associated with training, acquisition, recruiting, and resolving human errors have a significant impact on increased total ownership costs. These costs can also affect the exaggerate budgets and delayed schedules. The study of human performance economical assessment in the system acquisition process enhances the visibility of hidden cost drivers which support program management informed decisions. This paper presents the literature review of human total ownership cost (HTOC) and cost impacts on overall system performance. Economic value assessment models such as cost benefit analysis, risk-cost tradeoff analysis, expected value of utility function analysis (EV), growth readiness matrix, multi-attribute utility technique, and multi-regressions model were introduced to reflect the HTOC and human performance-technology tradeoffs in terms of the dollar value. The human total ownership regression model introduces to address the influencing human performance cost component measurement. Results from this study will increase understanding of relevant cost drivers in the system acquisition process over the long term.

  6. Development of a totally integrated severe accident training system

    International Nuclear Information System (INIS)

    Kim, Ko Ryu; Park, Sun Hee; Choi, Young; Kim, Dong Ha

    2006-01-01

    Recently KAERI has developed the severe accident management guidance to establish the Korea standard severe accident management system. On the other hand the PC-based severe accident training simulator SATS has been developed, which uses the MELCOR code as the simulation engine. The simulator SATS graphically displays and simulates the severe accidents with interactive user commands. Especially the control capability of SATS could make a severe accident training course more interesting and effective. In this paper we will describe the development and functions of the electrical guidance module, HyperKAMG, and the SATS-HyperKAMG linkage system designed for a totally integrated and automated severe accident training. (author)

  7. Internal Logistics System Selection with Total Cost of Ownership Analysis

    Science.gov (United States)

    Araújo, Inês; Pimentel, Carina; Godina, Radu; Matias, João C. O.

    2017-06-01

    In this paper a methodology was followed in order to support the decision-making of one industrial unit regarding its internal logistics system. The addressed factory was facing issues with their internal logistics approach. Some alternatives were pointed out and a proper total cost of ownership (TCO) analysis was developed. This analysis was taken in order to demonstrate the more cost-effective solution for the internal logistics system. This tool is more and more valued by the companies, due to their willing to reduce the costs that are associated with the way of doing business. Despite the proposal of the best choice for the internal logistics system of the enterprise, this study also intends to present some conclusions about the match between the nature of the industrial unit and the logistics systems that best fit the requirements of those.

  8. A Total Information Management System For All Medical Images

    Science.gov (United States)

    Ouimette, Donald; Nudelman, Sol; Ramsby, Gale; Spackman, Thomas

    1985-09-01

    A PACS has been designed for the University of Connecticut Health Center to serve all departments acquiring images for diagnosis, surgery and therapy. It incorporates a multiple community communications architecture to provide complete information management for medical images, medical data and departmental administrative matter. The system is modular and expandable. It permits an initial installation for radiology and subsequent expansion to include other departments at the Health Center, beginning with internal medicine, surgery, ophthalmology and dentistry. The design permits sufficient expansion to offer the potential for accepting the additional burden of a hospital information system. Primary parameters that led to this system design were based on the anticipation that departments in time could achieve generating 60 to 90% of their images suited to insertion in a PACS, that a high network throughput for large block image transfers would be essen-tial and that total system reliability was fundamental to success.

  9. Total analysis systems with Thermochromic Etching Discs technology.

    Science.gov (United States)

    Avella-Oliver, Miquel; Morais, Sergi; Carrascosa, Javier; Puchades, Rosa; Maquieira, Ángel

    2014-12-16

    A new analytical system based on Thermochromic Etching Discs (TED) technology is presented. TED comprises a number of attractive features such as track independency, selective irradiation, a high power laser, and the capability to create useful assay platforms. The analytical versatility of this tool opens up a wide range of possibilities to design new compact disc-based total analysis systems applicable in chemistry and life sciences. In this paper, TED analytical implementation is described and discussed, and their analytical potential is supported by several applications. Microarray immunoassay, immunofiltration assay, solution measurement, and cell culture approaches are herein addressed in order to demonstrate the practical capacity of this system. The analytical usefulness of TED technology is herein demonstrated, describing how to exploit this tool for developing truly integrated analytical systems that provide solutions within the point of care framework.

  10. Finite element analysis to compare complete denture and implant-retained overdentures with different attachment systems.

    Science.gov (United States)

    Barão, Valentim Adelino Ricardo; Assunção, Wirley Gonçalves; Tabata, Lucas Fernando; Delben, Juliana Aparecida; Gomes, Erica Alves; de Sousa, Edson Antonio Capello; Rocha, Eduardo Passos

    2009-07-01

    This finite element analysis compared stress distribution on complete dentures and implant-retained overdentures with different attachment systems. Four models of edentulous mandible were constructed: group A (control), complete denture; group B, overdenture retained by 2 splinted implants with bar-clip system; group C, overdenture retained by 2 unsplinted implants with o'ring system; and group D, overdenture retained by 2 splinted implants with bar-clip and 2 distally placed o'ring system. Evaluation was performed on Ansys software, with 100-N vertical load applied on central incisive teeth. The lowest maximum general stress value (in megapascal) was observed in group A (64.305) followed by groups C (119.006), D (258.650), and B (349.873). The same trend occurred in supporting tissues with the highest stress value for cortical bone. Unsplinted implants associated with the o'ring attachment system showed the lowest maximum stress values among all overdenture groups. Furthermore, o'ring system also improved stress distribution when associated with bar-clip system.

  11. Total Artificial Heart Implantation as a Bridge to Heart Transplantation in an Active Duty Service Member With Amyloid Cardiomyopathy.

    Science.gov (United States)

    Scully, Michael S; Wessman, Dylan E; McKee, James M; Francisco, Gregory M; Nayak, Keshav R; Kobashigawa, Jon A

    2017-03-01

    Cardiac involvement by light-chain (AL) amyloid occurs in up to 50% of patients with primary AL amyloidosis. The prognosis of amyloid heart disease is poor with 1-year survival rates of 35 to 40%. Historically, heart transplantation was considered controversial for patients with AL amyloid cardiomyopathy (CM) given the systemic nature of the disease and poor survival. We present a case report of an active duty service member diagnosed with advanced cardiac amyloid who underwent total artificial heart transplant as a bridge to heart transplant and eventual autologous stem cell transplant. A 47-year-old active duty male initially evaluated for atypical chest pain was found to have severe concentric left ventricular hypertrophy on echocardiogram but normal voltage on electrocardiogram. Cardiac magnetic resonance imaging, laboratory studies, and bone marrow biopsy established the diagnosis of cardiac amyloidosis. At the time of diagnosis, the patient's prognosis was very poor with a median survival of 5 months on the basis of the Mayo Clinic revised prognostic staging system for amyloidosis. The patient developed rapidly progressive left ventricular dysfunction and heart failure leading to cardiac arrest. The patient received a total artificial heart as a bridge to orthotopic heart and kidney transplantation and eventual stem cell transplant. He continues to be in remission and has a fair functional capacity without restriction in activities of daily living or moderate exercise. Amyloid CM is a rare and devastating disease. The natural course of the disease has made heart transplant in these patients controversial. Modern advancements in chemotherapies and advanced heart failure treatments have improved outcomes for select patients with AL amyloid CM undergoing heart transplantation. There is ongoing research seeking improvement in treatment options and outcomes for patients with this deadly disease. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  12. Aseptic loosening of the femoral implant after cemented total hip arthroplasty in dogs: 11 cases in 10 dogs (1991-1995)

    International Nuclear Information System (INIS)

    Edwards, M.R.; Egger, E.L.; Schwarz, P.D.

    1997-01-01

    Objective-To determine clinical signs, radiographic findings, results of surgical management, and potential causes of aseptic loosening of the femoral implant (ALFI) in dogs that have undergone cemented total hip arthroplasty (THA). Design-Retrospective study. Animals-11 cases of ALFI in 10 dogs. Procedure-Medical records of all dogs undergoing THA revision surgery were reviewed. Only dogs with ALFI were included. The prosthesis and cement were removed by creating a longitudinal osteotomy of the cranial femoral cortex. Postoperative radiographs of all dogs that underwent THA during the study period were reviewed. Results-The most common clinical sign was intermittent, subtle. or non-weight-bearing lameness. On radiographs obtained after THA, contact of the distal stem tip with cortical endosteum was evident in all dogs. Radiographic changes at the time of diagnosis of ALFI included asymmetric periosteal reaction along the femoral diaphysis, radiolucent lines between the prosthesis and cement, altered implant position, and femoral fracture. Surgical revision yielded good or excellent results in 9 cases. In 1 dog. the implant became infected; in another, aseptic loosening recurred. Aseptic loosening was significantly more common in dogs in which there was contact between the distal stem tip and cortical endosteum than in dogs in which there was no contact. Clinical Implications-ALFI is an uncommon, but important, complication of THA, and radiography is warranted in dogs with clinical signs of ALFI. Initial centering of the prosthetic stem within the femoral shaft may reduce the incidence of ALFI

  13. Design of an end station for a high current ion implantation system

    International Nuclear Information System (INIS)

    Kranik, J.R.

    1979-01-01

    During the last 4 to 5 years IBM has been involved in an effort to develop a high current Ion Implantation system with pre-deposition capabilities. The system is dedicated to Arsenic implants, involving doses > 1 x 10 15 ions/cm 2 in the energy range of 30 to 60 keV. A major portion of this effort involved the design of an associated end station capable of producing high uniformity implants with beam currents in the 0.5 to 6.0 mA range. The end station contains all components from the exit of the analyzing magnet, including the exit beamline, process chamber, scan system, wafer handling system, high vacuum pumping package, beam optics, dosimetry system, and associated electronic controls. The unit was restricted to a six wafer (82 mm) batch size to maintain process line compatibility. In addition, implant dose non-uniformity objectives were established at +- 3% (2σ) within a wafer and +- 2% (2σ) wafer-to-wafer. Also, the system was to be capable of implanting 24 wafers/hour at a dose of 7.5 x 10 15 ions/cm 2 . Major consideration in the design was afforded to high reliability, ease of maintenance and production level throughput capabilities. The rationale and evolution of the final end station design is described. (author)

  14. The Syed temporary interstitial iridium gynaecological implant: an inverse planning system

    International Nuclear Information System (INIS)

    Fung, Albert Y.C.

    2002-01-01

    Patients with advanced gynaecological cancer are often treated with a temporary interstitial implant using the Syed template and Ir-192 ribbons at the Memorial Sloan-Kettering Cancer Center. Urgency in planning is great. We created a computerized inverse planning system for the Syed temporary gynaecological implant, which optimized the ribbon strengths a few seconds after catheter digitization. Inverse planning was achieved with simulated annealing. We discovered that hand-drawn target volumes had drawbacks; hence instead of producing a grid of points based on target volume, the optimization points were generated directly from the catheter positions without requiring an explicit target volume. Since all seeds in the same ribbon had the same strength, the minimum doses were located at both ends of the implant. Optimization points generated at both ends ensured coverage of the whole implant. Inverse planning took only a few seconds, and generated plans that provide a good starting point for manual improvement. (author)

  15. Indicators of soil quality in the implantation of no-till system with winter crops

    Directory of Open Access Journals (Sweden)

    Marco Antonio Nogueira

    Full Text Available We assessed the effect of different winter crops on indicators of soil quality related to C and N cycling and C fractions in a Rhodic Kandiudult under no-till system at implantation, during two growing seasons, in Londrina PR Brazil. The experimental design was randomized blocks with split-plot in time arrangement, with four replications. The parcels were the winter crops: multicropping of cover crops with black oat (Avena strigosa, hairy vetch (Vicia villosa and fodder radish (Raphanus sativus; sunflower (Heliantus annuus intercropped with Urochloa ruziziensis; corn (Zea mays intercropped with Urochloa; and corn; fodder radish; or wheat (Triticum aestivum as sole crops. The subplots were the years: 2008 and 2009. Determinations consisted of total organic C, labile and resistant C, total N, microbial biomass C and N, the C/N ratio of soil organic matter, and the microbial quotient (qMic, besides microbiological and biochemical attributes, assessed only in 2009. The attributes significantly changed with the winter crops, especially the multicropping of cover crops and fodder radish, as well as effect of years. Despite stimulating the microbiological/biochemical activity, fodder radish cropping decreased the soil C in the second year, likewise the wheat cropping. The multicropping of cover crops in winter is an option for management in the establishment of no-till system, which contributes to increase the concentrations of C and stimulate the soil microbiological/biochemical activity.

  16. Geotechnical Issues in Total System Performance Assessments of Yucca Mountain

    International Nuclear Information System (INIS)

    HO, CLIFFORD K.; HOUSEWORTH, JIM; WILSON, MICHAEL L.

    1999-01-01

    A Total System Performance Assessment (TSPA) of Yucca Mountain consists of integrated sub-models and analyses of natural and engineered systems. Examples of subsystem models include unsaturated-zone flow and transport, seepage into drifts, coupled thermal hydrologic processes, transport through the engineered barrier system, and saturated-zone flow and transport. The TSPA evaluates the interaction of important processes among these subsystems, and it determines the impact of these processes on the overall performance measures (e.g., dose rate to humans). This paper summarizes the evaluation, abstraction, and combination of these subsystem models in a TSPA calculation, and it provides background on the individual TSPA subsystem components that are most directly impacted by geotechnical issues. The potential impact that geologic features, events, and processes have on the overall performance is presented, and an evaluation of the sensitivity of TSPA calculations to these issues is also provided

  17. Protocol of an expertise based randomized trial comparing surgical Venae Sectio versus radiological Puncture of Vena Subclavia for insertion of Totally Implantable Access Port in oncological patients

    Directory of Open Access Journals (Sweden)

    Radeleff Boris

    2008-10-01

    Full Text Available Abstract Background Totally Implantable Access Ports (TIAP are being extensively used world-wide and can be expected to gain further importance with the introduction of new neoadjuvant and adjuvant treatments in oncology. Two different techniques for the implantation can be selected: A direct puncture of a central vein and the utilization of a Seldinger device or the surgical Venae sectio. It is still unclear which technique has the optimal benefit/risk ratio for the patient. Design A single-center, expertise based randomized, controlled superiority trial to compare two different TIAP implantation techniques. 100 patients will be included and randomized pre-operatively. All patients aged 18 years or older scheduled for primary elective implantation of a TIAP under local anesthesia who signed the informed consent will be included. The primary endpoint is the primary success rate of the randomized technique. Control Intervention: Venae Sectio will be employed to insert a TIAP by a surgeon; Experimental intervention: Punction of V. Subclavia will be used to place a TIAP by a radiologist. Duration of study: Approximately 10 months, follow up time: 90 days. Organisation/Responsibility The PORTAS 2 – Trial will be conducted in accordance with the protocol and in compliance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989 and Good Clinical Practice (GCP. The Center of Clinical Trials at the Department of Surgery, University Hospital Heidelberg is responsible for design and conduct of the trial including randomization and documentation of patients' data. Data management and statistical analysis will be performed by the independent Institute for Medical Biometry and Informatics (IMBI, University of Heidelberg. Trial Registration The trial is registered at ClinicalTrials.gov (NCT00600444.

  18. Postoperative spinal infection mimicking systemic vasculitis with titanium-spinal implants

    Directory of Open Access Journals (Sweden)

    Stathopoulos Konstantinos

    2011-09-01

    Full Text Available Abstract Background Secondary systemic vasculitis after posterior spinal fusion surgery is rare. It is usually related to over-reaction of immune-system, to genetic factors, toxicity, infection or metal allergies. Case Description A 14 year-old girl with a history of extended posterior spinal fusion due to idiopathic scoliosis presented to our department with diffuse erythema and nephritis (macroscopic hemuresis and proteinuria 5 months post surgery. The surgical trauma had no signs of inflammation or infection. The blood markers ESR and CRP were increased. Skin tests were positive for nickel allergy, which is a content of titanium alloy. The patient received corticosteroids systematically (hydrocortisone 10 mg for 6 months, leading to total recess of skin and systemic reaction. However, a palpable mass close to the surgical wound raised the suspicion of a late infection. The patient had a second surgery consisting of surgical debridement and one stage revision of posterior spinal instrumentation. Intraoperative cultures were positive to Staphylococcus aureus. Intravenous antibiotics were administered. The patient is now free of symptoms 24 months post revision surgery without any signs of recurrence of either vasculitis or infection. Literature Review Systemic vasculitis after spinal surgery is exceptionally rare. Causative factors are broad and sometimes controversial. In general, it is associated with allergy to metal ions. This is usually addressed with metal on metal total hip bearings. In spinal surgery, titanium implants are considered to be inert and only few reports have presented cases with systemic vasculitides. Therefore, other etiologies of immune over-reaction should always be considered, such as drug toxicity, infection, or genetic predisposition. Purposes and Clinical Relevance Our purpose was to highlight the difficulties during the diagnostic work-up for systemic vasculitis and management in cases of posterior spinal surgery.

  19. Safety of implantable pacemakers and cardioverter defibrillators in the magnetic field of a novel remote magnetic navigation system.

    Science.gov (United States)

    Jilek, Clemens; Tzeis, Stylianos; Reents, Tilko; Estner, Heidi-Luise; Fichtner, Stephanie; Ammar, Sonia; Wu, Jinjin; Hessling, Gabriele; Deisenhofer, Isabel; Kolb, Christof

    2010-10-01

    Electromagnetic interference with pacemaker and implantable cardioverter defibrillator (ICD) systems may cause temporary or permanent system malfunction of implanted devices. The aim of this study was to evaluate potential interference of a novel magnetic navigation system with implantable rhythm devices. A total of 121 devices (77 pacemakers, 44 ICDs) were exposed to an activated NIOBE II® Magnetic Navigation System (Stereotaxis, St. Louis, MO, USA) at the maximal magnetic field strength of 0.1 Tesla and evaluated in vitro with respect to changes in parameter settings of the device, changes of the battery status/detection of elective replacement indication, or alterations of data stored in the device. A total of 115 out of 121 (95%) devices were free of changes in parameter settings, battery status, and internally stored data after repeated exposition to the electromagnetic field of the remote magnetic navigation system. Interference with the magnetic navigation field was observed in 6 pacemakers, resulting in reprogramming to a power-on-reset mode with or without detection of the elective replacement indication in 5 devices and abnormal variance of battery status in one device. All pacemakers could be reprogrammed to the initial modes and the battery status proved to be normal some minutes after the pacemakers had been removed from the magnetic field. Interference of a remote magnetic navigation system (at maximal field strength) with pacemakers and ICDs not connected to leads with antitachycardic detection and therapies turned off is rare. Occurring functional abnormalities could be reprogrammed in our sample. An in vitro study will give information about interference of devices connected to leads. © 2010 Wiley Periodicals, Inc.

  20. Cutaneous and systemic hypersensitivity reactions to metallic implants

    DEFF Research Database (Denmark)

    Basko-Plluska, Juliana L; Thyssen, Jacob P; Schalock, Peter C

    2011-01-01

    Cutaneous reactions to metal implants, orthopedic or otherwise, are well documented in the literature. The first case of a dermatitis reaction over a stainless steel fracture plate was described in 1966. Most skin reactions are eczematous and allergic in nature, although urticarial, bullous....... However, other metal ions as well as bone cement components can cause such hypersensitivity reactions. To complicate things, patients may also develop delayed-type hypersensitivity reactions to metals (ie, in-stent restenosis, prosthesis loosening, inflammation, pain, or allergic contact dermatitis...

  1. The Failure Envelope Concept Applied To The Bone-Dental Implant System.

    Science.gov (United States)

    Korabi, R; Shemtov-Yona, K; Dorogoy, A; Rittel, D

    2017-05-17

    Dental implants interact with the jawbone through their common interface. While the implant is an inert structure, the jawbone is a living one that reacts to mechanical stimuli. Setting aside mechanical failure considerations of the implant, the bone is the main component to be addressed. With most failure criteria being expressed in terms of stress or strain values, their fulfillment can mean structural flow or fracture. However, in addition to those effects, the bony structure is likely to react biologically to the applied loads by dissolution or remodeling, so that additional (strain-based) criteria must be taken into account. While the literature abounds in studies of particular loading configurations, e.g. angle and value of the applied load to the implant, a general study of the admissible implant loads is still missing. This paper introduces the concept of failure envelopes for the dental implant-jawbone system, thereby defining admissible combinations of vertical and lateral loads for various failure criteria of the jawbone. Those envelopes are compared in terms of conservatism, thereby providing a systematic comparison of the various failure criteria and their determination of the admissible loads.

  2. Miniature Coplanar Implantable Antenna on Thin and Flexible Platform for Fully Wireless Intracranial Pressure Monitoring System

    Directory of Open Access Journals (Sweden)

    M. Waqas A. Khan

    2017-01-01

    Full Text Available Minimally invasive approach to intracranial pressure monitoring is desired for long-term diagnostics. The monitored pressure is transmitted outside the skull through an implant antenna. We present a new miniature (6 mm × 5 mm coplanar implant antenna and its integration on a sensor platform to establish a far-field data link for the sensor readout at distances of 0.5 to 1 meter. The implant antenna was developed using full-wave electromagnetic simulator and measured in a liquid phantom mimicking the dielectric properties of the human head. It achieved impedance reflection coefficient better than −10 dB from 2.38 GHz to 2.54 GHz which covers the targeted industrial, scientific, and medical band. Experiments resulted in an acceptable peak gain of approximately −23 dBi. The implant antenna was submerged in the liquid phantom and interfaced to a 0.5 mW voltage controlled oscillator. To verify the implant antenna performance as a part of the ICP monitoring system, we recorded the radiated signal strength using a spectrum analyzer. Using a half-wavelength dipole as the receiving antenna, we captured approximately −58.7 dBm signal at a distance of 1 m from the implant antenna which is well above for the reader with sensitivity of −80 dBm.

  3. Total hydrocarbon content (THC) testing in liquid oxygen (LOX) systems

    Science.gov (United States)

    Meneghelli, B. J.; Obregon, R. E.; Ross, H. R.; Hebert, B. J.; Sass, J. P.; Dirschka, G. E.

    2015-12-01

    The measured Total Hydrocarbon Content (THC) levels in liquid oxygen (LOX) systems at Stennis Space Center (SSC) have shown wide variations. Examples of these variations include the following: 1) differences between vendor-supplied THC values and those obtained using standard SSC analysis procedures; and 2) increasing THC values over time at an active SSC test stand in both storage and run vessels. A detailed analysis of LOX sampling techniques, analytical instrumentation, and sampling procedures will be presented. Additional data obtained on LOX system operations and LOX delivery trailer THC values during the past 12-24 months will also be discussed. Field test results showing THC levels and the distribution of the THC's in the test stand run tank, modified for THC analysis via dip tubes, will be presented.

  4. Issues associated with a total systems approach to designing dependable systems

    International Nuclear Information System (INIS)

    Chisholm, G.H.

    1995-01-01

    A total system approach, developed by the nuclear-reactor-safety community, is extrapolated to the design of complex, critical systems. The essential properties of these systems are described, and a generic paradigm for subsequent designs is proposed

  5. Electrophysiology Catheter-Facilitated coronary sinus cannulation and implantation of cardiac resynchronization therapy systems

    Directory of Open Access Journals (Sweden)

    Antonis S. Manolis, MD, FESC, FACC, FHRS

    2018-01-01

    Full Text Available Background: Cardiac resynchronization therapy (CRT device implantation is hampered by difficult placement of the left ventricular (LV lead. We have routinely used a steerable electrophysiology catheter to guide coronary sinus (CS cannulation and facilitate LV lead positioning. The aim of this prospective study is to present our results with this approach in 138 consecutive patients receiving a CRT device over 10 years. Methods: The study included 120 men and 18 women, aged 64.8±11.4 years, with coronary disease (n=63, cardiomyopathy (n=72, or other disease (n=3, and mean ejection fraction of 24.5±4.5%. Devices were implanted for refractory heart failure and dyssynchrony, all but 2 in the presence of left bundle branch block. Implanted devices included biventricular pacemakers (CRT-P (n=33 and cardioverter defibrillators (CRT-D (n=105. Results: Using the electrophysiology catheter, the CS could be engaged in 134 (97.1% patients. In 4 patients failing CS cannulation, a dual-chamber device was implanted in 2, and bifocal right ventricular pacing was effected in 2. Bifocal (n=2 or conventional (n=1 systems were implanted in another 3 patients, in whom the LV lead got dislodged (n=2 or removed because of local dissection (n=1. Thus, finally, a CRT system was successfully established in 131 (94.9% patients. There were 3 patients with CS dissection, of whom 1 was complicated by cardiac tamponade managed with pericardiocentesis. There were no perioperative deaths. During follow-up (31.0±21.2 months, clinical improvement was reported by 108 (82.4% patients. Conclusion: Routine use of an electrophysiology catheter greatly facilitated CS cannulation and successful LV lead placement in ∼95% of patients undergoing CRT system implantation. Keywords: heart failure, cardiac resynchronization therapy, implantable cardioverter defibrillator, coronary sinus, left ventricular lead

  6. Total System Performance Assessment - License Application Methods and Approach

    Energy Technology Data Exchange (ETDEWEB)

    J. McNeish

    2003-12-08

    ''Total System Performance Assessment-License Application (TSPA-LA) Methods and Approach'' provides the top-level method and approach for conducting the TSPA-LA model development and analyses. The method and approach is responsive to the criteria set forth in Total System Performance Assessment Integration (TSPAI) Key Technical Issues (KTIs) identified in agreements with the U.S. Nuclear Regulatory Commission, the ''Yucca Mountain Review Plan'' (YMRP), ''Final Report'' (NRC 2003 [163274]), and the NRC final rule 10 CFR Part 63 (NRC 2002 [156605]). This introductory section provides an overview of the TSPA-LA, the projected TSPA-LA documentation structure, and the goals of the document. It also provides a brief discussion of the regulatory framework, the approach to risk management of the development and analysis of the model, and the overall organization of the document. The section closes with some important conventions that are used in this document.

  7. Approaches and Challenges of Engineering Implantable Microelectromechanical Systems (MEMS Drug Delivery Systems for in Vitro and in Vivo Applications

    Directory of Open Access Journals (Sweden)

    Ken-Tye Yong

    2012-11-01

    Full Text Available Despite the advancements made in drug delivery systems over the years, many challenges remain in drug delivery systems for treating chronic diseases at the personalized medicine level. The current urgent need is to develop novel strategies for targeted therapy of chronic diseases. Due to their unique properties, microelectromechanical systems (MEMS technology has been recently engineered as implantable drug delivery systems for disease therapy. This review examines the challenges faced in implementing implantable MEMS drug delivery systems in vivo and the solutions available to overcome these challenges.

  8. 21 CFR 880.6300 - Implantable radiofrequency transponder system for patient identification and health information.

    Science.gov (United States)

    2010-04-01

    ... patient identification and health information. 880.6300 Section 880.6300 Food and Drugs FOOD AND DRUG... radiofrequency transponder system for patient identification and health information. (a) Identification. An implantable radiofrequency transponder system for patient identification and health information is a device...

  9. Periodontal ligament formation around different types of dental titanium implants. I. The self-tapping screw type implant system

    DEFF Research Database (Denmark)

    Warrer, K; Karring, T; Gotfredsen, K

    1993-01-01

    The aim of this study was to determine if a periodontal ligament can form around self-tapping, screw type titanium dental implants. Implants were inserted in contact with the periodontal ligament of root tips retained in the mandibular jaws of 7 monkeys. In each side of the mandible, 1 premolar......, a periodontal ligament can form on self-tapping, screw type titanium dental implants in areas where a void is present between the surrounding bone and the implant at the time of insertion....... and 2 molars were removed in such a manner that in approximately half the cases, the root tips were retained. Following healing, the experimental areas were examined on radiographs, and sites were selected for the insertion of the implants, so that every second implant would have a close contact...

  10. Effect of implant position, angulation, and attachment height on peri-implant bone stress associated with mandibular two-implant overdentures: a finite element analysis.

    Science.gov (United States)

    Hong, Hae Ryong; Pae, Ahran; Kim, Yooseok; Paek, Janghyun; Kim, Hyeong-Seob; Kwon, Kung-Rock

    2012-01-01

    The aim of this study was to analyze and compare the level and distribution of peri-implant bone stresses associated with mandibular two-implant overdentures with different implant positions. Mathematical models of mandibles and overdentures were designed using finite element analysis software. Two intraosseous implants and ball attachment systems were placed in the interforaminal region. The overdenture, which was supported by the two implants, was designed to withstand bilateral and unilateral vertical masticatory loads (total 100 N). In all, eight types of models, which differed according to assigned implant positions, height of attachments, and angulation, were tested: MI (model with implants positioned in the lateral incisor sites), MC (implants in canine sites), MP (implants in premolar sites), MI-Hi (greater height of attachments), MC-M (canine implants placed with mesial inclination), MC-D (canine implants placed with distal inclination), MC-B (canine implants placed with buccal inclination), and MC-L (canine implants placed with lingual inclination). Peri-implant bone stress levels associated with overdentures retained by lateral incisor implants resulted in the lowest stress levels and the highest efficiency in distributing peri-implant stress. MI-Hi showed increased stress levels and decreased efficiency in stress distribution. As the implants were inclined, stress levels increased and the efficiency of stress distribution decreased. Among the inclined models, MC-B showed the lowest stress level and best efficiency in stress distribution. The lowest stress and the best stability of implants in mandibular two-implant overdentures were obtained when implants were inserted in lateral incisor areas with shorter attachments and were placed parallel to the long axes of the teeth.

  11. Bioelectric analyses of an osseointegrated intelligent implant design system for amputees.

    Science.gov (United States)

    Isaacson, Brad M; Stinstra, Jeroen G; MacLeod, Rob S; Webster, Joseph B; Beck, James P; Bloebaum, Roy D

    2009-07-15

    The projected number of American amputees is expected to rise to 3.6 million by 2050. Many of these individuals depend on artificial limbs to perform routine activities, but prosthetic suspensions using traditional socket technology can prove to be cumbersome and uncomfortable for a person with limb loss. Moreover, for those with high proximal amputations, limited residual limb length may prevent exoprosthesis attachment all together. Osseointegrated implant technology is a novel operative procedure which allows firm skeletal attachment between the host bone and an implant. Preliminary results in European amputees with osseointegrated implants have shown improved clinical outcomes by allowing direct transfer of loads to the bone-implant interface. Despite the apparent advantages of osseointegration over socket technology, the current rehabilitation procedures require long periods of restrictive load bearing prior which may be reduced with expedited skeletal attachment via electrical stimulation. The goal of the osseointegrated intelligent implant design (OIID) system is to make the implant part of an electrical system to accelerate skeletal attachment and help prevent periprosthetic infection. To determine optimal electrode size and placement, we initiated proof of concept with computational modeling of the electric fields and current densities that arise during electrical stimulation of amputee residual limbs. In order to provide insure patient safety, subjects with retrospective computed tomography scans were selected and three dimensional reconstructions were created using customized software programs to ensure anatomical accuracy (Seg3D and SCIRun) in an IRB and HIPAA approved study. These software packages supported the development of patient specific models and allowed for interactive manipulation of electrode position and size. Preliminary results indicate that electric fields and current densities can be generated at the implant interface to achieve the

  12. Total System Performance Assessment for the Site Recommendation

    Energy Technology Data Exchange (ETDEWEB)

    None

    2000-10-02

    As mandated in the Nuclear Waste Policy Act of 1982, the U.S. Department of Energy (DOE) has been investigating a candidate site at Yucca Mountain, Nevada, to determine whether it is suitable for development of the nation's first repository for permanent geologic disposal of spent nuclear fuel (SNF) and high-level radioactive waste (HLW). The Nuclear Waste Policy Amendments Act of 1987 directed that only Yucca Mountain be characterized to evaluate the site's suitability. Three main components of the DOE site characterization program are testing, design, and performance assessment. These program components consist of: Investigation of natural features and processes by analyzing data collected from field tests conducted above and below ground and from laboratory tests of rock, gas, and water samples Design of a repository and waste packages tailored to the site features, supported by laboratory testing of candidate materials for waste packages and design related testing in the underground tunnels where waste would be emplaced Quantitative estimates of the performance of the total repository system, over a range of possible conditions and for different repository configurations, by means of computer modeling techniques that are based on site and materials testing data and accepted principles of physics and chemistry. To date, DOE has completed and documented four major iterations of total system performance assessment (TSPA) for the Yucca Mountain site: TSPA-91 (Barnard et al. 1992), TSPA-93 (Wilson et al. 1994; CRWMS M and O 1994), TSPA-95 (CRWMS M and O 1995), and the Total System Performance Assessment-Viability Assessment (TSPA-VA) (DOE 1998a, Volume 3). Each successive TSPA iteration has advanced the technical understanding of the performance attributes of the natural features and processes and enhanced engineering designs. The next major iteration of TSPA is to be conducted in support of the next major programmatic milestone for the DOE, namely the

  13. Outcomes of different bearings in total hip arthroplasty - implant survival, revision causes, and patient-reported outcome

    DEFF Research Database (Denmark)

    Varnum, Claus

    2017-01-01

    ceramic-on-ceramic (CoC) THAs comparing them to those of "standard" metal-on-polyethylene (MoP) THAs. Study II: To compare the six-year revision risk for metal-on-metal (MoM) with that for MoP bearings in cementless stemmed THA, and further to study the revision risk for different designs of stemmed Mo...... for the outcome of THA is the type of bearings. This PhD thesis focuses on the influence of different types of bearings on implant survival, revision causes, PROMs, and noises from THA. The aims of the thesis were: Study I: To examine the revision risk and to investigate the causes of revision of cementless......M THAs and the causes of revision. Study III: To examine the association between CoC, MoM, and MoP bearings and both generic and disease-specific PROMs, and furthermore to examine the incidence and types of noises from the three types of bearings and identify the effect of noises on PROM scores. In study...

  14. Twelve-month discontinuation rates of levonorgestrel intrauterine system 13.5 mg and subdermal etonogestrel implant in women aged 18-44: A retrospective claims database analysis.

    Science.gov (United States)

    Law, Amy; Liao, Laura; Lin, Jay; Yaldo, Avin; Lynen, Richard

    2018-04-21

    To investigate the 12-month discontinuation rates of levonorgestrel intrauterine system 13.5 mg (LNG-IUS 13.5) and subdermal etonogestrel (ENG) implant in the US. We identified women aged 18-44 who had an insertion of LNG-IUS 13.5 or ENG implant from the MarketScan Commercial claims database (7/1/2013-9/30/2014). Women were required to have 12 months of continuous insurance coverage prior to the insertion (baseline) and at least 12-months after (follow-up). Discontinuation was defined as presence of an insurance claim for pregnancy-related services, hysterectomy, female sterilization, a claim for another contraceptive method, or removal of the index contraceptive without re-insertion within 30 days. Using Cox regression we examined the potential impact of ENG implant vs. LNG-IUS 13.5 on the likelihood for discontinuation after controlling for patient characteristics. A total of 3680 (mean age: 25.4 years) LNG-IUS 13.5 and 23,770 (mean age: 24.6 years) ENG implant users met the selection criteria. Prior to insertion, 56.6% of LNG-IUS 13.5 and 42.1% of ENG implant users had used contraceptives, with oral contraceptives being most common (LNG-IUS 13.5: 42.1%; ENG implant: 28.5%). Among users of LNG-IUS 13.5 and ENG implant, rates of discontinuation were similar during the 12-month follow-up (LNG-IUS 13.5: 24.9%; ENG implant: 24.0%). Regression results showed that women using LNG-IUS 13.5 vs. ENG implant had similar likelihood for discontinuation (hazard ratio: 0.97, 95% confidence interval: 0.90-1.05, p=.41). In the real-world US setting, women aged 18-44 using LNG-IUS 13.5 and ENG implant have similar discontinuation rates after 12 months. In the United States, women aged 18-44 using levonorgestrel intrauterine system (13.5 mg) and subdermal etonogestrel implant have similar discontinuation rates after 12 months. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. Resultados de artroplastia total de joelho com e sem implante de recapeamento (resurfacing patelar Results of total knee replacement with/without resurfacing of the patella

    Directory of Open Access Journals (Sweden)

    Abdul Khan

    2012-01-01

    Full Text Available OBJETIVO: Estudar a diferença de dor, estalido e crepitação patelofemoral no pós-operatório em pacientes com ou sem recapeamento patelar após 5 anos, os quais tinham dor patelofemoral antes da cirurgia. Estudar a incidência de dor, estalido e crepitação patelofemoral depois de pateloplastia em ambos os grupos. MÉTODOS: Revisão retrospectiva de 765 pacientes submetidos a artroplastia total do joelho (ATJ com ou sem recapeamento patelar. Os pacientes foram perguntados sobre dor pré e pós-operatória, 5 anos depois da cirurgia. Foram examinados por enfermeiro especializado 5 anos, após a cirurgia para verificar estalidos ou crepitação patelofemoral (PF. RESULTADOS: 688 pacientes (89,9% tinham dor PF pré-operatória. De 688 pacientes, 449 tinham recapeamento patelar (R e 239 não tinham (NR. Trinta e seis pacientes do grupo NR tinham pateloplastia. A incidência de dor PF pós-operatória foi 13,3% no grupo R e 13,6% no grupo NR. A incidência de estalido PF pós-operatório no grupo R foi 10,4% e apenas 1,3% no grupo NR (estatisticamente significante, p OBJECTIVE: To study the difference of post-op patellofemoral pain, clunk and crepitus in patients with/without resurfacing at 5 years who had pre-op patellofemoral pain. To study the incidence of post-operative patellofemoral pain, clunk and crepitus following patelloplasty in both the groups. METHODS: Retrospective review of 765 patients who had total knee replacement with/without resurfacing.Patients were asked about both pre-operative pain and also post-operative pain 5 years after the operation. Patients were examined by a specialist nurse at 5 years post-operatively to check for any patellofemoral clunk/crepitus. RESULTS: 688 patients (89.9% had preoperative PF pain. Of 688 patients, 449 had patellar resurfacing and 239 had not (NR. Thirty-six patients from the NR group had patelloplasty. The incidence of postoperative PF pain was 13.3% in the R group and 13.6% in the NR group

  16. PAIN RELIEF MEDIATED BY IMPLANTABLE DRUG-DELIVERY DEVICES

    NARCIS (Netherlands)

    HOEKSTRA, A

    Various totally implantable drug delivery systems from single access ports to micropumps are now available for administration of repeated boluses, and continuous or programmable infusions. In this respect, emphasis is given to a relatively cheap, totally implantable system for self-administering

  17. Systemic antibiotics and the risk of superinfection in peri-implantitis.

    Science.gov (United States)

    Verdugo, Fernando; Laksmana, Theresia; Uribarri, Agurne

    2016-04-01

    Peri-implantitis has emerged in the last few years as a complication difficult to resolve. The etiopathogenesis consensus is mainly attributed to bacteria. Following the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, a PubMed/Medline literature search was performed using the US National Library of Medicine database up to 2015 to analyze available scientific data on the rationale and risk of superinfection associated to systemic antimicrobials in human peri-implant disease. A hand search was also conducted on relevant medical and microbiology journals. The methodological index for non-randomized studies (MINORS) was independently assessed for quality on the selected papers. Proposed combined therapies use broad-spectrum antibiotics to halt the disease progression. A major associated risk, particularly when prescribed empirically without microbiological follow-up, is the undetected development of superinfections and overgrowth of opportunistic pathogens difficult to eradicate. Peri-implant superinfections with opportunistic bacteria, yeast and viruses, are plausible risks associated to the use of systemic antibiotics in immunocompetent individuals. Lack of microbiological follow-up and antibiotic susceptibility testing may lead to ongoing microbial challenges that exacerbate the disease progression. The increased proliferation of antimicrobial resistance, modern implant surface topography and indiscriminative empiric antibiotic regimens may promote the escalation of peri-implant disease in years to come. A personalized 3-month supportive therapy may help prevent risks by sustaining a normal ecological balance, decreasing specific pathogen proportions and maintaining ideal plaque control. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Influence of implant properties and local delivery systems on the outcome in operative fracture care.

    Science.gov (United States)

    Metsemakers, W-J; Moriarty, T F; Nijs, S; Pape, H C; Richards, R G

    2016-03-01

    Fracture fixation devices are implanted into a growing number of patients each year. This may be attributed to an increase in the popularity of operative fracture care and the development of ever more sophisticated implants, which may be used in even the most difficult clinical cases. Furthermore, as the general population ages, fragility fractures become more frequent. With the increase in number of surgical interventions, the absolute number of complications of these surgical treatments will inevitably rise. Implant-related infection and compromised fracture healing remain the most challenging and prevalent complications in operative fracture care. Any strategy that can help to reduce these complications will not only lead to a faster and more complete resumption of activities, but will also help to reduce the socio-economic impact. In this review we describe the influence of implant design and material choice on complication rates in trauma patients. Furthermore, we discuss the importance of local delivery systems, such as implant coatings and bone cement, and how these systems may have an impact on the prevalence, prevention and treatment outcome of these complications. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. FY 1984 annual report on the research and development of automatic sewing systems. Total systems; 1984 nendo jido hosei system no kenkyu kaihatsu seika hokokusho. Total system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1985-03-01

    The automatic sewing system technique research association has been commissioned by the Agency of Industrial Science and Technology for (research and development of automatic sewing systems). This program covers R and D of the elementary techniques for total systems and sewing preparation/processing, sewing/assembling, cloth handling, and system management/control. This report describes the results of the R and D efforts for the total systems. For producing diversified products in small quantities, which is the object of this R and D program, the target is set to reduce processing time by at least 50% from the current level. The efforts to achieve this target by solving the problems involved therein are made from the side of developing FMS and FA procedures, and apparel side. The program for the former investigates the required functions of individual sub-systems that constitute the total system, to clarify the technical targets of the core elementary techniques for each sub-system. The program for the latter analyzes the sewing steps for producing diversified clothes types, specifications for automatic operation, integration, standardization and coding of the steps, and so on, based on the results of studies on basic apparel types. (NEDO)

  20. Local and systemic changes associated with long-term, percutaneous, static implantation with titanium alloys in rhesus macaques (Macaca mulatta)

    Energy Technology Data Exchange (ETDEWEB)

    Frydman, Galit F.; Marini, Robert P.; Bakthavatchalu, Vasudevan; Biddle, Kathleen; Muthupalani, Sureshkumar; Vanderburg, Charles R.; Lai, Barry; Bendapudi, Pavan K.; Tompkins, Ronald G.; Fox, James G.

    2017-04-01

    Metal alloys are frequently used as implant materials in veterinary medicine. Recent studies suggest that many types of metal alloys may induce both local and systemic inflammatory responses. In this study, 37 rhesus macaques with long-term skull-anchored percutaneous titanium alloy implants (0-14 years duration) were evaluated for changes in their hematology, coagulation and serum chemistry profiles. Negative controls (n=28) did not have implants. All of the implanted animals were on IACUC-approved protocols and were not implanted for the purpose of this study. Animals with implants had significantly higher plasma D-dimer and lower antithrombin III concentrations compared with nonimplanted animals (p-values < 0.05). Additionally, animals with implants had significantly higher globulin, and lower albumin and calcium concentrations compared with nonimplanted animals (p-values < 0.05). Many of these changes were positively correlated with duration of implantation as well as the number of implants. Chronic bacterial infection was observed on the skin around many of the implant sites, and within deeper tissues. Representative histopathology around the implant site of two implanted animals revealed chronic suppurative to pyogranulomatous inflammation extending from the skin to the dura mater. X-ray fluorescence microscopy of tissue biopsies from the implant site of the same two animals revealed significant increases in free metal ions within the tissue, including titanium and iron. Free metal ions persisted in the tissues up to 6 months postexplant. These results suggest that long-term skull-anchored percutaneous titanium alloy implants results in localized inflammation, chronic infection, and leaching of metal ions into local tissues.

  1. Laser-Modified Surface Enhances Osseointegration and Biomechanical Anchorage of Commercially Pure Titanium Implants for Bone-Anchored Hearing Systems

    Science.gov (United States)

    Omar, Omar; Simonsson, Hanna; Palmquist, Anders; Thomsen, Peter

    2016-01-01

    Osseointegrated implants inserted in the temporal bone are a vital component of bone-anchored hearing systems (BAHS). Despite low implant failure levels, early loading protocols and simplified procedures necessitate the application of implants which promote bone formation, bone bonding and biomechanical stability. Here, screw-shaped, commercially pure titanium implants were selectively laser ablated within the thread valley using an Nd:YAG laser to produce a microtopography with a superimposed nanotexture and a thickened surface oxide layer. State-of-the-art machined implants served as controls. After eight weeks’ implantation in rabbit tibiae, resonance frequency analysis (RFA) values increased from insertion to retrieval for both implant types, while removal torque (RTQ) measurements showed 153% higher biomechanical anchorage of the laser-modified implants. Comparably high bone area (BA) and bone-implant contact (BIC) were recorded for both implant types but with distinctly different failure patterns following biomechanical testing. Fracture lines appeared within the bone ~30–50 μm from the laser-modified surface, while separation occurred at the bone-implant interface for the machined surface. Strong correlations were found between RTQ and BIC and between RFA at retrieval and BA. In the endosteal threads, where all the bone had formed de novo, the extracellular matrix composition, the mineralised bone area and osteocyte densities were comparable for the two types of implant. Using resin cast etching, osteocyte canaliculi were observed directly approaching the laser-modified implant surface. Transmission electron microscopy showed canaliculi in close proximity to the laser-modified surface, in addition to a highly ordered arrangement of collagen fibrils aligned parallel to the implant surface contour. It is concluded that the physico-chemical surface properties of laser-modified surfaces (thicker oxide, micro- and nanoscale texture) promote bone bonding

  2. Implementation of wireless power transfer and communications for an implantable ocular drug delivery system.

    Science.gov (United States)

    Tang, T B; Smith, S; Flynn, B W; Stevenson, J T M; Gundlach, A M; Reekie, H M; Murray, A F; Renshaw, D; Dhillon, B; Ohtori, A; Inoue, Y; Terry, J G; Walton, A J

    2008-09-01

    A wireless power transfer and communication system based on near-field inductive coupling has been designed and implemented. The feasibility of using such a system to remotely control drug release from an implantable drug delivery system is addressed. The architecture of the wireless system is described and the signal attenuation over distance in both water and phosphate buffered saline is studied. Additionally, the health risk due to exposure to radio frequency (RF) radiation is examined using a biological model. The experimental results demonstrate that the system can trigger the release of drug within 5 s, and that such short exposure to RF radiation does not produce any significant (system could replace a chemical battery in an implantable system, eliminating the risks associated with battery failure and leakage and also allowing more compact designs for applications such as drug delivery.

  3. A new three-dimensional, print-on-demand temporomandibular prosthetic total joint replacement system: Preliminary outcomes.

    Science.gov (United States)

    Dimitroulis, George; Austin, Stephen; Sin Lee, Peter Vee; Ackland, David

    2018-05-16

    The aim of this study is to present the preliminary clinical data on the OMX Temporomandibular Joint (TMJ) Prosthetic total joint replacement system. A prospective, cohort, clinical study was undertaken of consecutive adult patients with Category 5 end-stage joint disease who were implanted with the OMX TMJ prosthesis between May 2015 and April 2017. A total of 50 devices were implanted in 38 patients, with 12 patients receiving bilateral prosthetic joints. There were 31 females and 7 males in this cohort, who ranged in age from 20 to 66 years, with a mean of 43.8 years (±14.0 years). Ten of the 50 prosthetic joints (20%) were fully customized, while the remaining were patient matched using virtual planning software. Based on a mean follow-up period of 15.3 months (range 12-24 months) following the TMJ total joint replacement, preliminary results suggest the OMX TMJ prosthesis has made a positive impact on clinical outcomes, with a mean 74.4% reduction in joint pain levels and significant improvements (p < 0.05) in jaw function as measured by the visual analogue scales for mouth opening (30.8%), diet (77.1%), and function (59.2%). No device failures were reported during the study period. This study suggests that the print-on-demand OMX TMJ prosthesis, designed for rapid delivery of both patient-matched and fully customize devices, represents a safe, reliable and versatile implantable joint replacement system for the treatment of category 5 end-stage TMJ disease. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  4. Feasibility of power contrast injections and bolus triggering during CT scans in oncologic patients with totally implantable venous access ports of the forearm

    International Nuclear Information System (INIS)

    Goltz, Jan Peter; Machann, Wolfram; Noack, Claudia; Hahn, Dietbert; Kickuth, Ralph

    2011-01-01

    Background: Conventional totally implantable venous access ports (TIVAPs) are not approved for power contrast injections but often remain the only venous access site in oncologic patients. Therefore, these devices can play an important role if patients with a TIVAP are scheduled for a contrast-enhanced computed tomography (ceCT) as vascular access may become more difficult during the course of chemotherapy. Purpose: To evaluate the feasibility and safety of power injections in conventional TIVAPs in the forearm and to analyze the feasibility of bolus triggering during CT scans. Material and Methods: In this retrospective study we analyzed 177 power injections in 141 patients with TIVAPs in the forearm. Between October 2008 and March 2010 all patients underwent power injections (1.5 mL/s, 150 psi) via the TIVAP for ceCT because conventional vascular access via a peripheral vein had failed. Adequate functioning and catheter's tip location after injection were evaluated. Peak injection pressure and attenuation levels of aorta, liver and spleen were analyzed and compared with results of 50 patients who were injected via classical peripheral cannulas (3 mL/s, 300 psi). Feasibility of automatic scan initiation was evaluated. In vitro the port was stressed with 5 mL/s (300 psi). Results: One TIVAP showed tip dislocation with catheter rupture. Three (2.1%) devices were explanted owing to assumed infection within 4 weeks after the injection. Mean injection pressure was 121.9 ±24.1 psi. Triggering with automatic scan initiation succeeded in 13/44 (29.6%) scans. Injection via classical cannulas resulted in significantly higher enhancement (p < 0.05). In vitro the port system tolerated flow rates of up to 5 mL/s, injection pressures of up to 338 psi. Conclusion: Power injection is a safe alternative for patients with TIVAPs in the forearm if classic vascular access ultimately fails. Triggering was successful in one-third of the attempts. Image quality in the arterial phase

  5. Lipidic profile among rats submitted to total splenectomy isolated or combined with splenic autotransplant Perfil lipídico em ratos submetidos a esplenectomia total isolada ou combinada com auto-implante esplênico

    Directory of Open Access Journals (Sweden)

    Fernanda Correia Simões

    2007-01-01

    Full Text Available PURPOSE: To evaluate the alterations on plasmatic lipids levels among rats submitted to total splenectomy isolated or combined with splenic autotransplant receiving standard chow during the postoperative period. METHODS: Thirty Wistar rats were divided into three groups: control (C - sham-operated, total splenectomy - isolated (TS or combined with splenic autotransplantation (SA. Since the postoperative period, all animals received standard rat chow manipulated in accordance to the American Institute of Nutrition Rodents Diets (1993. The plasmatic levels of total cholesterol (TC, triglycerides (TG, high-density lipoprotein (HDL, low-density lipoprotein (LDL, very-low-density lipoprotein (VLDL, and glucose (GLUC were analyzed before the surgical procedure and after 6 and 12 weeks. RESULTS: All the animals presented significant increase of TG and VLDL levels. In relation to the other parameters there was no difference among the weeks 0 and 12 in the animals of group C. In TS group significant increase was observed in TC and GLUC levels during the experiment. In SA group TC, HDL, and GLUC levels remained unaffected while HDL levels increased. CONCLUSION: Our findings suggest that isolated total splenectomy alters lipids metabolism in rats fed with standard chow and splenic autotransplantation is effective in restoring its control.OBJETIVO: Avaliar as alterações nos níveis de lipídios plasmáticos em ratos submetidos a esplenectomia total isolada ou combinada com auto-implante esplênico, recebendo dieta padrão no período pós-operatório. MÉTODOS: Trinta ratos Wistar foram distribuídos em três grupos: controle (C - operação simulada, esplenectomia total isolada (ET ou combinada com auto-implante esplênico (AE. A partir do período pós-operatório, todos os animais receberam ração padrão, manipulada segundo o American Institute of Nutrition (1993. Os níveis plasmáticos de colesterol total (CT, triglicerídeos (TG, lipoproteína de

  6. Quality control of system of imaging for rectal ultrasound for implants seed prostate low rate

    International Nuclear Information System (INIS)

    Luquero Llopis, N.; Ferrer Gracia, C.; Huertas Martinez, C.; Huerga Cabrerizo, C.; Corredoira Silva, E.; Serrada Hierro, A.

    2013-01-01

    In this work, the objective is the evaluation of the image system used in implants of prostate of low rate held at our hospital, for maximum control on the placement of the seeds in the patient and therefore carried out dosimetry. (Author)

  7. Impaction grafting in the femur in cementless modular revision total hip arthroplasty: a descriptive outcome analysis of 243 cases with the MRP-TITAN revision implant

    Directory of Open Access Journals (Sweden)

    Wimmer Matthias D

    2013-01-01

    Full Text Available Abstract Background We present a descriptive and retrospective analysis of revision total hip arthroplasties (THA using the MRP-TITAN stem (Peter Brehm, Weisendorf, GER with distal diaphyseal fixation and metaphyseal defect augmentation. Our hypothesis was that the metaphyseal defect augmentation (Impaction Bone Grafting improves the stem survival. Methods We retrospectively analyzed the aggregated and anonymized data of 243 femoral stem revisions. 68 patients with 70 implants (28.8% received an allograft augmentation for metaphyseal defects; 165 patients with 173 implants (71.2% did not, and served as controls. The mean follow-up was 4.4 ± 1.8 years (range, 2.1–9.6 years. There were no significant differences (p > 0.05 between the study and control group regarding age, body mass index (BMI, femoral defects (types I-III as described by Paprosky, and preoperative Harris Hip Score (HHS. Postoperative clinical function was evaluated using the HHS. Postoperative radiologic examination evaluated implant stability, axial implant migration, signs of implant loosening, periprosthetic radiolucencies, as well as bone regeneration and resorption. Results There were comparable rates of intraoperative and postoperative complications in the study and control groups (p > 0.05. Clinical function, expressed as the increase in the postoperative HHS over the preoperative score, showed significantly greater improvement in the group with Impaction Bone Grafting (35.6 ± 14.3 vs. 30.8 ± 15.8; p ≤ 0.05. The study group showed better outcome especially for larger defects (types II C and III as described by Paprosky and stem diameters ≥ 17 mm. The two groups did not show significant differences in the rate of aseptic loosening (1.4% vs. 2.9% and the rate of revisions (8.6% vs. 11%. The Kaplan-Meier survival for the MRP-TITAN stem in both groups together was 93.8% after 8.8 years. [Study group 95.7% after 8.54 years ; control group 93

  8. Total System Performance Assessment: Enhanced Design Alternative V

    International Nuclear Information System (INIS)

    N. Erb; S. Miller; V. Vallikat

    1999-01-01

    This calculation documents the total system performance assessment modeling of Enhanced Design Analysis (EDA) V. EDA V is based on the TSPA-VA base design which has been modified with higher thermal loading, a quartz sand invert, and line loading with 21 PWR waste packages that have 2-cm thick titanium grade 7 corrosion resistance material (CRM) drip shields placed over dual-layer waste packages composed of 'inside out' VA reference material (CRWMS M and O 1999a). This document details the changes and assumptions made to the VA reference Performance Assessment Model (CRWMS M and O 1998a) to incorporate the design changes detailed for EDA V. The performance measure for this evaluation is expected value dose-rate history. Time histories of dose rate are presented for EDA V and a Defense in Depth (DID) analysis base on EDA V. Additional details concerning the Enhanced Design Alternative II are provided in the 'LADS 3-12 Requests' interoffice correspondence (CRWMS M and O 1999a)

  9. Age at implantation and auditory memory in cochlear implanted children.

    Science.gov (United States)

    Mikic, B; Miric, D; Nikolic-Mikic, M; Ostojic, S; Asanovic, M

    2014-05-01

    Early cochlear implantation, before the age of 3 years, provides the best outcome regarding listening, speech, cognition an memory due to maximal central nervous system plasticity. Intensive postoperative training improves not only auditory performance and language, but affects auditory memory as well. The aim of this study was to discover if the age at implantation affects auditory memory function in cochlear implanted children. A total of 50 cochlear implanted children aged 4 to 8 years were enrolled in this study: early implanted (1-3y) n = 27 and late implanted (4-6y) n = 23. Two types of memory tests were used: Immediate Verbal Memory Test and Forward and Backward Digit Span Test. Early implanted children performed better on both verbal and numeric tasks of auditory memory. The difference was statistically significant, especially on the complex tasks. Early cochlear implantation, before the age of 3 years, significantly improve auditory memory and contribute to better cognitive and education outcomes.

  10. Ion implantation

    International Nuclear Information System (INIS)

    Johnson, E.

    1986-01-01

    It is the purpose of the present paper to give a review of surface alloy processing by ion implantation. However, rather than covering this vast subject as a whole, the survey is confined to a presentation of the microstructures that can be found in metal surfaces after ion implantation. The presentation is limited to alloys processed by ion implantation proper, that is to processes in which the alloy compositions are altered significantly by direct injection of the implanted ions. The review is introduced by a presentation of the processes taking place during development of the fundamental event in ion implantation - the collision cascade, followed by a summary of the various microstructures which can be formed after ion implantation into metals. This is compared with the variability of microstructures that can be achieved by rapid solidification processing. The microstructures are subsequently discussed in the light of the processes which, as the implantations proceed, take place during and immediately after formation of the individual collision cascades. These collision cascades define the volumes inside which individual ions are slowed down in the implanted targets. They are not only centres for vigorous agitation but also the sources for formation of excess concentrations of point defects, which will influence development of particular microstructures. A final section presents a selection of specific structures which have been observed in different alloy systems. (orig./GSCH)

  11. Automatic postural response systems in individuals with congenital total blindness.

    Science.gov (United States)

    Nakata, H; Yabe, K

    2001-07-01

    This study examined the effects of the absence of vision from birth on automatic postural responses to platform displacements during stance. Postural responses were induced by producing randomly four types of perturbations which consisted of forward and backward translations, and toe up and down rotations. Nine congenitally totally blind and nine sighted adults served as subjects. EMG signals were recorded from four muscles in the right leg, and reaction time to somatosensory stimuli generated by platform displacements was measured by pushing a hand-held button. To assess the ability to control postural balance, the root mean square (RMS) values for lateral and antero-posterior sway before, during, and after perturbations were calculated. The EMG amplitude in the gastrocnemius muscle of a blind subject was smaller than that of a sighted subject with eyes closed. No significant differences were found between blind and sighted subjects in EMG latencies of the lower extremity muscles in response to perturbations. The blind subjects had significantly faster reaction times to somatosensory stimuli triggered by platform displacements, but in toe down rotations no significant difference was found between blind and sighted subjects. The difference in the EMG latencies and reaction times between the two groups suggests that blindness from birth may not affect the spinal stretch reflex, but may affect a volitional act mediated through the motor cortex. There were also no significant differences in the RMS values for postural sway between blind and sighted subjects with eyes open or closed, although blind subjects swayed more after backward translations than did sighted subjects with eyes open. Results suggest that the ability to control postural balance during perturbations was not affected by vision loss from birth. Our findings suggest that the automatic postural response systems of humans are unaffected by the absence of vision from birth and are rather hard wired.

  12. In-vitro characterization of a cochlear implant system for recording of evoked compound action potentials

    Science.gov (United States)

    2012-01-01

    Background Modern cochlear implants have integrated recording systems for measuring electrically evoked compound action potentials of the auditory nerve. The characterization of such recording systems is important for establishing a reliable basis for the interpretation of signals acquired in vivo. In this study we investigated the characteristics of the recording system integrated into the MED-EL PULSARCI100 cochlear implant, especially its linearity and resolution, in order to develop a mathematical model describing the recording system. Methods In-vitro setup: The cochlear implant, including all attached electrodes, was fixed in a tank of physiologic saline solution. Sinusoidal signals of the same frequency but with different amplitudes were delivered via a signal generator for measuring and recording on a single electrode. Computer simulations: A basic mathematical model including the main elements of the recording system, i.e. amplification and digitalization stage, was developed. For this, digital output for sinusoidal input signals of different amplitudes were calculated using in-vitro recordings as reference. Results Using an averaging of 100 measurements the recording system behaved linearly down to approximately -60 dB of the input signal range. Using the same method, a system resolution of 10 μV was determined for sinusoidal signals. The simulation results were in very good agreement with the results obtained from in-vitro experiments. Conclusions The recording system implemented in the MED-EL PULSARCI100 cochlear implant for measuring the evoked compound action potential of the auditory nerve operates reliably. The developed mathematical model provides a good approximation of the recording system. PMID:22531599

  13. Ion implantation for semiconductors

    International Nuclear Information System (INIS)

    Grey-Morgan, T.

    1995-01-01

    Full text: Over the past two decades, thousands of particle accelerators have been used to implant foreign atoms like boron, phosphorus and arsenic into silicon crystal wafers to produce special embedded layers for manufacturing semiconductor devices. Depending on the device required, the atomic species, the depth of implant and doping levels are the main parameters for the implantation process; the selection and parameter control is totally automated. The depth of the implant, usually less than 1 micron, is determined by the ion energy, which can be varied between 2 and 600 keV. The ion beam is extracted from a Freeman or Bernas type ion source and accelerated to 60 keV before mass analysis. For higher beam energies postacceleration is applied up to 200 keV and even higher energies can be achieved by mass selecting multiplycharged ions, but with a corresponding reduction in beam output. Depending on the device to be manufactured, doping levels can range from 10 10 to 10 15 atoms/cm 2 and are controlled by implanter beam currents in the range up to 30mA; continuous process monitoring ensures uniformity across the wafer of better than 1 % . As semiconductor devices get smaller, additional sophistication is required in the design of the implanter. The silicon wafers charge electrically during implantation and this charge must be dissipated continuously to reduce the electrical stress in the device and avoid destructive electrical breakdown. Electron flood guns produce low energy electrons (below 10 electronvolts) to neutralize positive charge buildup and implanter design must ensure minimum contamination by other isotopic species and ensure low internal sputter rates. The pace of technology in the semiconductor industry is such that implanters are being built now for 256 Megabit circuits but which are only likely to be widely available five years from now. Several specialist companies manufacture implanter systems, each costing around US$5 million, depending on the

  14. OUTCOMES REVIEW OF TOTAL KNEE REPLACEMENT WITH GENESIS II TOTAL KNEE SYSTEM: AUSTRALIAN ORTHOPAEDIC ASSOCIATION NATIONAL JOINT REPLACEMENT REGISTRY DATA

    Directory of Open Access Journals (Sweden)

    N. L. Logvinov

    2014-01-01

    Full Text Available ABSTRACT. The goal of the article was to review Genesis II Total Knee System use according to AoA NJRR report. Genesis II has been widely used in Russian Federation since 1996. The AoA NJRR report was studied in order to learn connection between number of revision procedures and surgeon’s skills or type of the System, adequate choice among cemented, cementless and hybrid fixation, number of surgeries using Genesis II Total Knee System annually, average revision rate for Genesis II and early cumulative revision rate.CONCLUSION. The systematic study of AoA NJRR allows us to make a conclusion that cemented fixation of Genesis II Total Knee System is mostly effective, and this fact is confirmed by domestic experience. 

  15. Comparative analysis of von Willebrand factor profiles after implantation of left ventricular assist device and total artificial heart.

    Science.gov (United States)

    Reich, H J; Morgan, J; Arabia, F; Czer, L; Moriguchi, J; Ramzy, D; Esmailian, F; Lam, L; Dunhill, J; Volod, O

    2017-08-01

    Essentials Bleeding is a major source of morbidity during mechanical circulatory support. von Willebrand factor (VWF) multimer loss may contribute to bleeding. Different patterns of VWF multimer loss were seen with the two device types. This is the first report of total artificial heart associated VWF multimer loss. Background Bleeding remains a challenge during mechanical circulatory support and underlying mechanisms are incompletely understood. Functional von Willebrand factor (VWF) impairment because of loss of high-molecular-weight multimers (MWMs) produces acquired von Willebrand disease (VWD) after left ventricular assist device (LVAD). Little is known about VWF multimers with total artificial hearts (TAHs). Here, VWF profiles with LVADs and TAHs are compared using a VWD panel. Methods VWD evaluations for patients with LVAD or TAH (2013-14) were retrospectively analyzed and included: VWF activity (ristocetin cofactor, VWF:RCo), VWF antigen (VWF:Ag), ratio of VWF:RCo to VWF:Ag, and quantitative VWF multimeric analysis. Results Twelve patients with LVADs and 12 with TAHs underwent VWD evaluation. All had either normal (47.8%) or elevated (52.2%) VWF:RCo, normal (26.1%) or elevated (73.9%) VWF:Ag and 50.0% were disproportional (ratio ≤ 0.7). Multimeric analysis showed abnormal patterns in all patients with LVADs: seven with high MWM loss; five with highest MWM loss. With TAH, 10/12 patients had abnormal patterns: all with highest MWM loss. High MWM loss correlated with presence of LVAD and highest MWM loss with TAH. Increased low MWMs were detected in 22/24. Conclusion Using VWF multimeric analysis, abnormalities after LVAD or TAH were detected that would be missed with measurements of VWF level alone: loss of high MWM predominantly in LVAD, loss of highest MWM in TAH, and elevated levels of low MWM in both. This is the first study to describe TAH-associated highest MWM loss, which may contribute to bleeding. © 2017 International Society on Thrombosis and

  16. Evaluation of an expence of materials during ion implantation

    International Nuclear Information System (INIS)

    Bannikov, M.G.; Zlobin, N.; Zotov, A.V.; Vasilev, V.I.; Vasilev, I.P.

    2003-01-01

    Ion implantation is used for a surface modification. The implantation dose must be sufficient to obtain the required properties of a processed surface, but should not be exceeded to prevent over-expenditure of implanted materials. The latter is especially important when noble metals are used as an implanted material. The ion implanter includes a vacuum chamber, source of metal ions (target) and a vacuum pumping-out system. Ions of a plasma-forming gas sputter the target and ions of metal are then accelerated and implanted into surface treated. Ion implantation dose can be calculated from operation parameters such as ion beam current density and duration of implanting. The presence of the plasma-forming gas in the ion flow makes it difficult to determine the expenditure of an implanted metal itself. The objective of this paper is the more accurate definition of an expense of an implanted metal. Mass- spectrometric analysis of an ion beam together with the weighing of the target was used to determine the expense of an implanted metal. It was found that, depending on the implantation parameters, on average around 50% of a total ion flow are metal ions. Results obtained allow more precise definition of an implantation dose. Thus, over- expenditure of implanted metals can be eliminated. (author)

  17. An Implantable Wireless Neural Interface System for Simultaneous Recording and Stimulation of Peripheral Nerve with a Single Cuff Electrode.

    Science.gov (United States)

    Shon, Ahnsei; Chu, Jun-Uk; Jung, Jiuk; Kim, Hyungmin; Youn, Inchan

    2017-12-21

    Recently, implantable devices have become widely used in neural prostheses because they eliminate endemic drawbacks of conventional percutaneous neural interface systems. However, there are still several issues to be considered: low-efficiency wireless power transmission; wireless data communication over restricted operating distance with high power consumption; and limited functionality, working either as a neural signal recorder or as a stimulator. To overcome these issues, we suggest a novel implantable wireless neural interface system for simultaneous neural signal recording and stimulation using a single cuff electrode. By using widely available commercial off-the-shelf (COTS) components, an easily reconfigurable implantable wireless neural interface system was implemented into one compact module. The implantable device includes a wireless power consortium (WPC)-compliant power transmission circuit, a medical implant communication service (MICS)-band-based radio link and a cuff-electrode path controller for simultaneous neural signal recording and stimulation. During in vivo experiments with rabbit models, the implantable device successfully recorded and stimulated the tibial and peroneal nerves while communicating with the external device. The proposed system can be modified for various implantable medical devices, especially such as closed-loop control based implantable neural prostheses requiring neural signal recording and stimulation at the same time.

  18. An Implantable Wireless Neural Interface System for Simultaneous Recording and Stimulation of Peripheral Nerve with a Single Cuff Electrode

    Directory of Open Access Journals (Sweden)

    Ahnsei Shon

    2017-12-01

    Full Text Available Recently, implantable devices have become widely used in neural prostheses because they eliminate endemic drawbacks of conventional percutaneous neural interface systems. However, there are still several issues to be considered: low-efficiency wireless power transmission; wireless data communication over restricted operating distance with high power consumption; and limited functionality, working either as a neural signal recorder or as a stimulator. To overcome these issues, we suggest a novel implantable wireless neural interface system for simultaneous neural signal recording and stimulation using a single cuff electrode. By using widely available commercial off-the-shelf (COTS components, an easily reconfigurable implantable wireless neural interface system was implemented into one compact module. The implantable device includes a wireless power consortium (WPC-compliant power transmission circuit, a medical implant communication service (MICS-band-based radio link and a cuff-electrode path controller for simultaneous neural signal recording and stimulation. During in vivo experiments with rabbit models, the implantable device successfully recorded and stimulated the tibial and peroneal nerves while communicating with the external device. The proposed system can be modified for various implantable medical devices, especially such as closed-loop control based implantable neural prostheses requiring neural signal recording and stimulation at the same time.

  19. Variable-temperature sample system for ion implantation at -192 to +5000C

    International Nuclear Information System (INIS)

    Fuller, C.T.

    1978-04-01

    A variable-temperature sample system based on exchange-gas coupling was developed for ion-implantation use. The sample temperature can be controlled from -192 0 C to +500 0 C with rapid cooling. The system also has provisions for focusing and alignment of the ion beam, electron suppression, temperature monitoring, sample current measuring, and cryo-shielding. Design considerations and operating characteristics are discussed. 5 figures

  20. Low-Gain, Low-Noise Integrated Neuronal Amplifier for Implantable Artifact-Reduction Recording System

    OpenAIRE

    Zbrzeski, Adeline; Lewis, Noëlle; Rummens, Francois; Jung, Ranu; N'Kaoua, Gilles; Benazzouz, Abdelhamid; Renaud, Sylvie

    2013-01-01

    Brain neuroprostheses for neuromodulation are being designed to monitor the neural activity of the brain in the vicinity of the region being stimulated using a single macro-electrode. Using a single macro-electrode, recent neuromodulation studies show that recording systems with a low gain neuronal amplifier and successive amplifier stages can reduce or reject stimulation artifacts. These systems were made with off-the-shelf components that are not amendable for future implant design. A low-g...

  1. TOTAL QUALITY MANAGEMENT SYSTEM (TQMS IN SMALL WINERY AND BAKERY IN CYPRUS. A CASE STUDY.

    Directory of Open Access Journals (Sweden)

    ANTONIS A. ZORPAS

    2012-06-01

    Full Text Available Quality of products and production affects the welfare, efficiency and competitiveness of the business entity. Total Quality Management System (TQMS represent the organizational structure of enterprise, application of methods, tools and processes used for the implantation, maintenance and improvement of activities and their outcomes as well as the organization takes all the necessary actions for its environmental performance and safety.The aim of the implementing TQMS in company is to create a good relation of employees to quality and safety as a fundamental category of the market economy and make them produce this quality and on the other and to provide good relationbetween SMEs and governmental authorities. QMS determine the prior characteristics of products, through which the company meets the identified needs of the market. The paper presents a case study of the implementation of aTQMS in small winery and bakery industry from Cyprus. The TQMS include the implementation of ISO 9001:2008, ISO 14001:2004 and ISO 22000:2005.

  2. Influence of implant abutment material on the color of different ceramic crown systems.

    Science.gov (United States)

    Dede, Doğu Ömür; Armağanci, Arzu; Ceylan, Gözlem; Celik, Ersan; Cankaya, Soner; Yilmaz, Burak

    2016-11-01

    Ceramics are widely used for anterior restorations; however, clinical color reproduction still constitutes a challenge particularly when the ceramic crowns are used on titanium implant abutments. The purpose of this in vitro study was to investigate the effect of implant abutment material on the color of different ceramic material systems. Forty disks (11×1.5 mm, shade A2) were fabricated from medium-opacity (mo) and high-translucency (ht) lithium disilicate (IPS e.max) blocks, an aluminous ceramic (VITA In-Ceram Alumina), and a zirconia (Zirkonzahn) ceramic system. Disks were fabricated to represent 3 different implant abutments (zirconia, gold-palladium, and titanium) and dentin (composite resin, A2 shade) as background (11×2 mm). Disk-shaped composite resin specimens in A2 shade were fabricated to represent the cement layer. The color measurements of ceramic specimens were made on composite resin abutment materials using a spectrophotometer. CIELab color coordinates were recorded, and the color coordinates measured on composite resin background served as the control group. Color differences (ΔE 00 ) between the control and test groups were calculated. The data were analyzed with 2-way analysis of variance (ANOVA) and compared with the Tukey HSD test (α=.05). The ceramics system, abutment material, and their interaction were significant for ΔE 00 values (P2.25) were observed for lithium disilicate ceramics on titanium abutments (2.46-2.50). The ΔE 00 values of lithium disilicate ceramics for gold-palladium and titanium abutments were significantly higher than for other groups (P2.25) of an implant-supported lithium disilicate ceramic restoration may be clinically unacceptable if it is fabricated over a titanium abutment. Zirconia may be a more suitable abutment material for implant-supported ceramic restorations. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  3. 21 CFR 862.1110 - Bilirubin (total or direct) test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bilirubin (total or direct) test system. 862.1110... Systems § 862.1110 Bilirubin (total or direct) test system. (a) Identification. A bilirubin (total or direct) test system is a device intended to measure the levels of bilirubin (total or direct) in plasma...

  4. Reconstructed image of human heart for total artificial heart implantation, based on MR image and cast silicone model of heart

    International Nuclear Information System (INIS)

    Komoda, Takashi; Maeta, Hajime; Uyama, Chikao.

    1991-01-01

    Based on transverse (TRN) and LV long axis (LAX) MR images of two cadaver hearts, three-dimensional (3-D) computer models of the connecting interface between remaining heart and total artificial heart, i.e., mitral and tricuspid valvular annuli (MVA and TVA), ascending aorta (Ao) and pulmonary artery (PA), were reconstructed to compare the shape and the size of MVA and those of TVA, the distance between the center of MVA and TVA (D G ), the angle between the plane of MVA and that of TVA (R T ), and the angles of Ao and PA, respectively, to the plane of MVA (R A , R P ), with those obtained in cast silicone models. It was found that based on LAX rather than TRN MR image, MVA and TVA might be more precisely reconstructed. The data obtained in 3-D images of MVA, TVA, Ao and PA based on silicone models of 32 hearts were as follows: D G (cm): 4.17±0.43, R T (degrees): 22.1±11.3, R A (degrees): 54.9±15.3, R P (degrees): 30.8±17.1. (author)

  5. A detection system for charged-particle decay studies with a continuous-implantation method

    Energy Technology Data Exchange (ETDEWEB)

    Sun, L.J. [China Institute of Atomic Energy, Beijing 102413 (China); Xu, X.X., E-mail: xuxinxing@ciae.ac.cn [China Institute of Atomic Energy, Beijing 102413 (China); Lin, C.J., E-mail: cjlin@ciae.ac.cn [China Institute of Atomic Energy, Beijing 102413 (China); Wang, J.S. [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); Fang, D.Q. [Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800 (China); Li, Z.H. [School of Physic and State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871 (China); Wang, Y.T. [Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800 (China); Li, J. [School of Physic and State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871 (China); Yang, L.; Ma, N.R. [China Institute of Atomic Energy, Beijing 102413 (China); Wang, K. [Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800 (China); Zang, H.L. [School of Physic and State Key Laboratory of Nuclear Physics and Technology, Peking University, Beijing 100871 (China); Wang, H.W.; Li, C.; Shi, C.Z.; Nie, M.W.; Li, X.F.; Li, H. [Shanghai Institute of Applied Physics, Chinese Academy of Sciences, Shanghai 201800 (China); Ma, J.B.; Ma, P. [Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou 730000 (China); and others

    2015-12-21

    A new detection system with high detection efficiency and low detection threshold has been developed for charged-particle decay studies, including β-delayed proton, α decay or direct proton emission from proton-rich nuclei. The performance was evaluated by using the β-delayed proton emitter {sup 24}Si produced by projectile fragmentation at the First Radioactive Ion Beam Line in Lanzhou. Under a continuous-beam mode, the isotopes of interest were implanted into two double-sided silicon strip detectors, where the subsequent decays were measured and correlated to the preceding implantations by using position and time information. The system allows us to measure protons with energies down to about 200 keV without obvious β background in the proton spectrum. Further application of the detection system can be extended to the measurements of β-delayed proton decay and the direct proton emission of more exotic proton-rich nuclei.

  6. DRUGAS: implantable telemetric system for measuring the portal venous pressure: assembly aspects

    Directory of Open Access Journals (Sweden)

    Fischer Roland

    2017-09-01

    Full Text Available Developing an implantable, telemetric pressure measuring system for venous applications makes a high degree of miniaturization necessary. Thus the influence on the measurement environment is minimized and the risk of thrombosis at small flow blood velocities is decreased. But these systems are limited in terms of accuracy and resolution. The asked system requirements could only be reached by optimising the assembly and encapsulation techniques. To achieve the high degree of miniaturization numerical simulations were performed on the shape and size of the implant and led to the development of a specific metal housing consisting of two main components. A small measuring chamber will be placed into the portal vein and is rigidly fixed to a flat circular part that contains the pressure sensor chip and a transponder board and will be located outside on top of the vein. The main focus of the assembly process was based on a stress-free design and mounting of the components.

  7. A low power flash-FPGA based brain implant micro-system of PID control.

    Science.gov (United States)

    Lijuan Xia; Fattah, Nabeel; Soltan, Ahmed; Jackson, Andrew; Chester, Graeme; Degenaar, Patrick

    2017-07-01

    In this paper, we demonstrate that a low power flash FPGA based micro-system can provide a low power programmable interface for closed-loop brain implant inter- faces. The proposed micro-system receives recording local field potential (LFP) signals from an implanted probe, performs closed-loop control using a first order control system, then converts the signal into an optogenetic control stimulus pattern. Stimulus can be implemented through optoelectronic probes. The long term target is for both fundamental neuroscience applications and for clinical use in treating epilepsy. Utilizing our device, closed-loop processing consumes only 14nJ of power per PID cycle compared to 1.52μJ per cycle for a micro-controller implementation. Compared to an application specific digital integrated circuit, flash FPGA's are inherently programmable.

  8. A direct plasma injection system into an RFQ for clean and safe ion implantation

    International Nuclear Information System (INIS)

    Takeuchi, T.; Katayama, T.; Okamura, M.; Yano, K.; Sakumi, A.; Hattori, T.; Hayashizaki, N.; Jameson, R.A.

    2002-01-01

    A new injection system, direct plasma injection system, was tested and its principle was proved successfully. We found that one of advantages of this injection system was efficient consumption of source materials. Large portions of induced ions can be injected into a first stage accelerator. This feature is quite useful for ion implantation applications, because toxic exhaust gas can be eliminated. In order to utilize this system for industrial application, the feasibility of a boron injection scheme using a Nd:YAG laser system was investigated

  9. A Computer Navigation System Analysis of the Accuracy of the Extramedullary (Tibial Alignment Technique in Total Knee Arthroplasty (TKA

    Directory of Open Access Journals (Sweden)

    EK Chee

    2010-07-01

    Full Text Available In total knee arthroplasty, mechanical alignment guides have improved the accuracy of implant alignment, but errors are not uncommon. In the present study, an image-free computer-assisted navigation system was used to analyse the accuracy of an extramedullary (tibial alignment system, which is based on predetermined, fixed anatomical landmarks. Comparisons were made between two surgeons, with different levels of competency in order to determine if experience affected the accuracy of extramedullary tibial jig placement, in either the coronal and sagittal planes or both planes. The results showed that the accuracy of the extramedullary tibial alignment system, in the coronal plane (in up to 80-87% of cases was much better than for posterior slope, and sagittal plane. Surgeon experience was not a significant factor.

  10. A wireless power transmission system for implantable devices in freely moving rodents.

    Science.gov (United States)

    Eom, Kyungsik; Jeong, Joonsoo; Lee, Tae Hyung; Kim, Jinhyung; Kim, Junghoon; Lee, Sung Eun; Kim, Sung June

    2014-08-01

    Reliable wireless power delivery for implantable devices in animals is highly desired for safe and effective experimental use. Batteries require frequent replacement; wired connections are inconvenient and unsafe, and short-distance inductive coupling requires the attachment of an exterior transmitter to the animal's body. In this article, we propose a solution by which animals with implantable devices can move freely without attachments. Power is transmitted using coils attached to the animal's cage and is received by a receiver coil implanted in the animal. For a three-dimensionally uniform delivery of power, we designed a columnar dual-transmitter coil configuration. A resonator-based inductive link was adopted for efficient long-range power delivery, and we used a novel biocompatible liquid crystal polymer substrate as the implantable receiver device. Using this wireless power delivery system, we obtain an average power transfer efficiency of 15.2% (minimum efficiency of 10% and a standard deviation of 2.6) within a cage of 15×20×15 cm3.

  11. Dose perturbation in the presence of metallic implants: treatment planning system versus Monte Carlo simulations

    International Nuclear Information System (INIS)

    Wieslander, Elinore; Knoeoes, Tommy

    2003-01-01

    An increasing number of patients receiving radiation therapy have metallic implants such as hip prostheses. Therefore, beams are normally set up to avoid irradiation through the implant; however, this cannot always be accomplished. In such situations, knowledge of the accuracy of the used treatment planning system (TPS) is required. Two algorithms, the pencil beam (PB) and the collapsed cone (CC), are implemented in the studied TPS. Comparisons are made with Monte Carlo simulations for 6 and 18 MV. The studied materials are steel, CoCrMo, Orthinox(a stainless steel alloy and registered trademark of Stryker Corporation), TiAlV and Ti. Monte Carlo simulated depth dose curves and dose profiles are compared to CC and PB calculated data. The CC algorithm shows overall a better agreement with Monte Carlo than the PB algorithm. Thus, it is recommended to use the CC algorithm to get the most accurate dose calculation both for the planning target volume and for tissues adjacent to the implants when beams are set up to pass through implants

  12. An Electronic System for Ultra-low Power Hearing Implants

    Science.gov (United States)

    2013-02-15

    Battery Charger Circuit ," IEEE Transactions on Biomedical Circuits and Systems, Vol. 5, No.2, pp. 131-137,2011. [6] K. H. Wee, L. Turicchia, and R...analyzers [1], [2], useful in several hearing systems. 4) We have designed and built a lithium-ion battery -recharging circuit that exploits a novel analog...lab and the use of intelligent low-power filters and circuits have been successful in reducing noise exposure while improving speech intelligibility

  13. Systems Science in Support of Total Quality Management,

    Science.gov (United States)

    Quality Management (TQM). This paper bridges the gap between these two subjects to illustrate specific means by which systems science can begin to augment TQM. This construction is based upon the consideration of two topics. First, a brief introduction to systems science is provided. Second, systems science is applied through the concept of the Conant-Ashby

  14. Evolving Systems of Care with Total Clinical Outcomes Management

    Science.gov (United States)

    Lyons, John S.; Epstein, Richard A.; Jordan, Neil

    2010-01-01

    The current article proposes that further specification of the system of care concept is required. Based on the assertions that the system of care concept (a) refers to an ideal as opposed to an observable phenomenon, and (b) is engaged in offering transformational experiences, the authors propose that the system of care definition must be…

  15. [Operative treatment of proximal humeral four-part fractures in elderly patients: comparison of two angular-stable implant systems].

    Science.gov (United States)

    Kuhlmann, T; Hofmann, T; Seibert, O; Gundlach, G; Schmidt-Horlohé, K; Hoffmann, R

    2012-04-01

    Although being one of the most common fractures in elderly patients, there is still no standardised treatment protocol for four-part fractures of the proximal humerus. However, a wide variety of angular-stable implants is available. The present retrospective study compares the clinical and radiological outcome following operative treatment of four-part fractures of the proximal humerus with the Philos system (Philos, proximal humeral internal locking system, Synthes GmbH, Umkirch Germany) and the angular-stable Königsee plate system (Königsee Implantate GmbH, Allendorf, Germany) in patients older than 65 years. From July 2005 until December 2007 we identified 77 patients with a four-part fracture of the proximal humerus who were treated operatively with one of the two implant systems. Of the patients, 17 could not be located so that in total 60 patients (78 %) participated in this study. The mean age of the 30 patients (10 m, 20 f) in the Philos group was 69 years (65-92), whereas the mean age of the 30 patients (11 m, 19 f) in the Königsee group was 71 years (65-93). A comprehensive assessment was performed after a median of 17 months (12-24), including physical examination, radiographic examination and completion of the disabilities of the arm, shoulder and hand score (DASH) and the Constant score (CS) as patient-oriented, limb-specific questionnaires. Neither in the Philos nor in the Königsee group could excellent results be achieved. Using the CS 13 patients (43 %) of the Philos group achieved a good and 15 (50 %) a satisfactory result. Bad results were found in 2 patients (7 %). The mean CS was 61.53 points. In the Königsee group mean CS was 61.76 points. In detail, 14 patients (47 %) treated with the Königsee implant were rated as good and 15 (50 %) as satisfactory. Only 1 patient (3 %) was rated as poor. No significant statistical differences were found between the groups. Mean DASH score in the Philos group was 56.30 points and 55.37 points in the K

  16. 'Managing' the immune system with total lymphoid irradiation

    International Nuclear Information System (INIS)

    Strober, S.

    1981-01-01

    Total lymphoid irradiation (TLI), which in the past was limited to the treatment of malignant disease, is now emerging as a practical technique in the management of unwanted immune reactions in the areas of transplant tolerance and various autoimmune diseases. Current studies are particularly promising for application of TLI in rheumatoid arthritis and lupus nephritis

  17. Eyelid reanimation with gold weight implant and tendon sling suspension: evaluation of excursion and velocity using the FACIAL CLIMA system.

    Science.gov (United States)

    Hontanilla, Bernardo; Marre, Diego

    2013-04-01

    This study aims to analyse the efficacy of static techniques, namely gold weight implant and tendon sling, in the reanimation of the paralytic eyelid. Upper eyelid rehabilitation in terms of excursion and blinking velocity is performed using the automatic motion capture system, FACIAL CLIMA. Seventy-four patients underwent a total of 101 procedures including 58 upper eyelid gold weight implants and 43 lower eyelid tendon suspension with 27 patients undergoing both procedures. The presence of lagophtalmos, eye dryness, corneal ulcer, epiphora and lower lid ptosis/ectropion was assessed preoperatively. The Wilcoxon signed-rank test was used to compare preoperative versus postoperative measurements of upper eyelid excursion and blinking velocity determined with FACIAL CLIMA. Significance was set at p CLIMA revealed significant improvement of eyelid excursion and velocity of blinking (p CLIMA system is a reliable method to quantify upper eyelid excursion and blinking velocity and to detect the exact position of the lower eyelid. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Wireless Power Transfer System Architectures for Portable or Implantable Applications

    Directory of Open Access Journals (Sweden)

    Yan Lu

    2016-12-01

    Full Text Available This paper discusses the near-field inductive coupling wireless power transfer (WPT at the system level, with detailed analyses on each state-of-the-art WPT output voltage regulation topologies. For device miniaturization and power loss reduction, several novel architectures for efficient WPT were proposed in recent years to reduce the number of passive components as well as to improve the system efficiency or flexibility. These schemes are systematically studied and discussed in this paper. The main contribution of this paper is to provide design guidelines for WPT system design. In addition, possible combinations of the WPT building block configurations are summarized, compared, and investigated for potential new architectures.

  19. Intraoperative Cochlear Implant Device Testing Utilizing an Automated Remote System: A Prospective Pilot Study.

    Science.gov (United States)

    Lohmann, Amanda R; Carlson, Matthew L; Sladen, Douglas P

    2018-03-01

    Intraoperative cochlear implant device testing provides valuable information regarding device integrity, electrode position, and may assist with determining initial stimulation settings. Manual intraoperative device testing during cochlear implantation requires the time and expertise of a trained audiologist. The purpose of the current study is to investigate the feasibility of using automated remote intraoperative cochlear implant reverse telemetry testing as an alternative to standard testing. Prospective pilot study evaluating intraoperative remote automated impedance and Automatic Neural Response Telemetry (AutoNRT) testing in 34 consecutive cochlear implant surgeries using the Intraoperative Remote Assistant (Cochlear Nucleus CR120). In all cases, remote intraoperative device testing was performed by trained operating room staff. A comparison was made to the "gold standard" of manual testing by an experienced cochlear implant audiologist. Electrode position and absence of tip fold-over was confirmed using plain film x-ray. Automated remote reverse telemetry testing was successfully completed in all patients. Intraoperative x-ray demonstrated normal electrode position without tip fold-over. Average impedance values were significantly higher using standard testing versus CR120 remote testing (standard mean 10.7 kΩ, SD 1.2 vs. CR120 mean 7.5 kΩ, SD 0.7, p automated testing with regard to the presence of open or short circuits along the array. There were, however, two cases in which standard testing identified an open circuit, when CR120 testing showed the circuit to be closed. Neural responses were successfully obtained in all patients using both systems. There was no difference in basal electrode responses (standard mean 195.0 μV, SD 14.10 vs. CR120 194.5 μV, SD 14.23; p = 0.7814); however, more favorable (lower μV amplitude) results were obtained with the remote automated system in the apical 10 electrodes (standard 185.4 μV, SD 11.69 vs. CR

  20. The implantation of a grid-connected PV system at CEPEL

    Energy Technology Data Exchange (ETDEWEB)

    Galdino, Marco Antonio, E-mail: marcoag@cepel.br

    2003-07-01

    This technical report presents the experience undertaken by CEPEL for implantation of a grid connected PV system at its headquarters, located in Rio de Janeiro, RJ, Brazil. This technology, although considered far from Brazilian reach, is expected to grow significantly in the near future. The paper describes briefly several aspects concerning the PV system and the DAS (data acquisition system) implemented in order to allow the continuous evaluation of its performance and operational conditions. The system was installed in December, 2002, and the data are still preliminary. (author)

  1. An image guidance system for positioning robotic cochlear implant insertion tools

    Science.gov (United States)

    Bruns, Trevor L.; Webster, Robert J.

    2017-03-01

    Cochlear implants must be inserted carefully to avoid damaging the delicate anatomical structures of the inner ear. This has motivated several approaches to improve the safety and efficacy of electrode array insertion by automating the process with specialized robotic or manual insertion tools. When such tools are used, they must be positioned at the entry point to the cochlea and aligned with the desired entry vector. This paper presents an image guidance system capable of accurately positioning a cochlear implant insertion tool. An optical tracking system localizes the insertion tool in physical space while a graphical user interface incorporates this with patient- specific anatomical data to provide error information to the surgeon in real-time. Guided by this interface, novice users successfully aligned the tool with an mean accuracy of 0.31 mm.

  2. Columnar transmitter based wireless power delivery system for implantable device in freely moving animals.

    Science.gov (United States)

    Eom, Kyungsik; Jeong, Joonsoo; Lee, Tae Hyung; Lee, Sung Eun; Jun, Sang Bum; Kim, Sung June

    2013-01-01

    A wireless power delivery system is developed to deliver electrical power to the neuroprosthetic devices that are implanted into animals freely moving inside the cage. The wireless powering cage is designed for long-term animal experiments without cumbersome wires for power supply or the replacement of batteries. In the present study, we propose a novel wireless power transmission system using resonator-based inductive links to increase power efficiency and to minimize the efficiency variations. A columnar transmitter coil is proposed to provide lateral uniformity of power efficiency. Using this columnar transmitter coil, only 7.2% efficiency fluctuation occurs from the maximum transmission efficiency of 25.9%. A flexible polymer-based planar type receiver coil is fabricated and assembled with a neural stimulator and an electrode. Using the designed columnar transmitter coil, the implantable device successfully operates while it moves freely inside the cage.

  3. 3-Coil resonance-based wireless power transfer system for implantable electronic

    KAUST Repository

    Yi, Ying

    2013-05-01

    This paper presents a 3-coil resonance-based wireless power transfer (R-WPT) system using a single layer of inductor coil windings, in a pancake configuration, in order to obtain a compact system for implantable electronic applications. A theoretical analysis and experimental measurements in terms of quality factor Q and power transfer efficiency (PTE), was done. Our proposed 3-coil scheme can achieve a high PTE with a resonance frequency of 2.46 MHz over a transfer distance of up to 30 mm, by using two 15-mm radius implant coils. The achieved experimental PTE is more than 85%at a 5 mm separation distance, and about 50% PTE at a distance of 20 mm. © 2013 IEEE.

  4. 3-Coil resonance-based wireless power transfer system for implantable electronic

    KAUST Repository

    Yi, Ying; Buttner, Ulrich; Fan, Yiqiang; Foulds, Ian G.

    2013-01-01

    This paper presents a 3-coil resonance-based wireless power transfer (R-WPT) system using a single layer of inductor coil windings, in a pancake configuration, in order to obtain a compact system for implantable electronic applications. A theoretical analysis and experimental measurements in terms of quality factor Q and power transfer efficiency (PTE), was done. Our proposed 3-coil scheme can achieve a high PTE with a resonance frequency of 2.46 MHz over a transfer distance of up to 30 mm, by using two 15-mm radius implant coils. The achieved experimental PTE is more than 85%at a 5 mm separation distance, and about 50% PTE at a distance of 20 mm. © 2013 IEEE.

  5. Assessment of total evacuation systems for tall buildings

    CERN Document Server

    Ronchi, Enrico

    2014-01-01

    This SpringerBrief focuses on the use of egress models to assess the optimal strategy for total evacuation in high-rise buildings. It investigates occupant relocation and evacuation strategies involving the exit stairs, elevators, sky bridges and combinations thereof. Chapters review existing information on this topic and describe case study simulations of a multi-component exit strategy. This review provides the architectural design, regulatory and research communities with a thorough understanding of the current and emerging evacuation procedures and possible future options. A model case study simulates seven possible strategies for the total evacuation of two identical twin towers linked with two sky-bridges at different heights. The authors present the layout of the building and the available egress components including both vertical and horizontal egress components, namely stairs, occupant evacuation elevators (OEEs), service elevators, transfer floors and sky-bridges. The evacuation strategies employ a ...

  6. Monitoring total mixed rations and feed delivery systems.

    Science.gov (United States)

    Oelberg, Thomas J; Stone, William

    2014-11-01

    This article is intended to give practitioners a method to evaluate total mixed ration (TMR) consistency and to give them practical solutions to improve TMR consistency that will improve cattle performance and health. Practitioners will learn how to manage the variation in moisture and nutrients that exists in haylage and corn silage piles and in bales of hay, and methods to reduce variation in the TMR mixing and delivery process. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Indicators of soil quality in the implantation of no-till system with winter crops.

    OpenAIRE

    NOGUEIRA, M. A.; TELLES, T. S.; FAGOTTI, D. dos S. L.; BRITO, O. R.; PRETE, C. E. C.; GUIMARÃES, M. de F.

    2014-01-01

    We assessed the effect of different winter crops on indicators of soil quality related to C and N cycling and C fractions in a Rhodic Kandiudult under no-till system at implantation, during two growing seasons, in Londrina PR Brazil. The experimental design was randomized blocks with split-plot in time arrangement, with four replications. The parcels were the winter crops: multicropping of cover crops with black oat (Avena strigosa), hairy vetch (Vicia villosa) and fodder radish (Raphanus sat...

  8. Absolute total cross sections for noble gas systems

    International Nuclear Information System (INIS)

    Kam, P. van der.

    1981-01-01

    This thesis deals with experiments on the elastic scattering of Ar, Kr and Xe, using the molecular beam technique. The aim of this work was the measurement of the absolute value of the total cross section and the behaviour of the total cross section, Q, as function of the relative velocity g of the scattering partners. The author gives an extensive analysis of the glory structure in the total cross section and parametrizes the experimental results using a semiclassical model function. This allows a detailed comparison of the phase and amplitude of the predicted and measured glory undulations. He indicates how the depth and position of the potential well should be changed in order to come to an optimum description of the glory structure. With this model function he has also been able to separate the glory and attractive contribution to Q, and using the results from the extrapolation measurements he has obtained absolute values for Qsub(a). From these absolute values he has calculated the parameter C 6 that determines the strength of the attractive region of the potential. In two of the four investigated gas combinations the obtained values lie outside the theoretical bounds. (Auth.)

  9. Security Analysis of the Electronic Management System for a Total Site Utility System

    DEFF Research Database (Denmark)

    Manso Cortes, Oscar

    2016-01-01

    This paper presents the Security Analysis of the Electronic Management System (EMS) of a Total Site Utility System as proposed under the scope of the Efenis project. The Efenis project has been funded by the European Commission via the seventh framework programme (EC FP7) with the aim to improve ...

  10. An Implantable Cardiovascular Pressure Monitoring System with On-Chip Antenna and RF Energy Harvesting

    Directory of Open Access Journals (Sweden)

    Yu-Chun Liu

    2015-08-01

    Full Text Available An implantable wireless system with on-chip antenna for cardiovascular pressure monitor is studied. The implantable device is operated in a batteryless manner, powered by an external radio frequency (RF power source. The received RF power level can be sensed and wirelessly transmitted along with blood pressure signal for feedback control of the external RF power. The integrated electronic system, consisting of a capacitance-to-voltage converter, an adaptive RF powering system, an RF transmitter and digital control circuitry, is simulated using a TSMC 0.18 μm CMOS technology. The implanted RF transmitter circuit is combined with a low power voltage-controlled oscillator resonating at 5.8 GHz and a power amplifier. For the design, the simulation model is setup using ADS and HFSS software. The dimension of the antenna is 1 × 0.6 × 4.8 mm3 with a 1 × 0.6 mm2 on-chip circuit which is small enough to place in human carotid artery.

  11. Mutual-Information-Based Incremental Relaying Communications for Wireless Biomedical Implant Systems

    Directory of Open Access Journals (Sweden)

    Yangzhe Liao

    2018-02-01

    Full Text Available Network lifetime maximization of wireless biomedical implant systems is one of the major research challenges of wireless body area networks (WBANs. In this paper, a mutual information (MI-based incremental relaying communication protocol is presented where several on-body relay nodes and one coordinator are attached to the clothes of a patient. Firstly, a comprehensive analysis of a system model is investigated in terms of channel path loss, energy consumption, and the outage probability from the network perspective. Secondly, only when the MI value becomes smaller than the predetermined threshold is data transmission allowed. The communication path selection can be either from the implanted sensor to the on-body relay then forwards to the coordinator or from the implanted sensor to the coordinator directly, depending on the communication distance. Moreover, mathematical models of quality of service (QoS metrics are derived along with the related subjective functions. The results show that the MI-based incremental relaying technique achieves better performance in comparison to our previous proposed protocol techniques regarding several selected performance metrics. The outcome of this paper can be applied to intra-body continuous physiological signal monitoring, artificial biofeedback-oriented WBANs, and telemedicine system design.

  12. In Vitro Evaluation of Leakage at Implant-Abutment Connection of Three Implant Systems Having the Same Prosthetic Interface Using Rhodamine B

    Directory of Open Access Journals (Sweden)

    Antoine Berberi

    2014-01-01

    Full Text Available Objectives. Hollow space between implant and abutment may act as reservoir for commensal and/or pathogenic bacteria representing a potential source of tissue inflammation. Microbial colonization of the interfacial gap may ultimately lead to infection and bone resorption. Using Rhodamine B, a sensitive fluorescent tracer dye, we aim in this study to investigate leakage at implant-abutment connection of three implant systems having the same prosthetic interface. Materials and Methods. Twenty-one implants (seven Astra Tech, seven Euroteknika, and seven Dentium with the same prosthetic interface were connected to their original abutments, according to the manufacturers’ recommendation. After determination of the inner volume of each implant systems, the kinetic quantification of leakage was evaluated for each group using Rhodamine B (10−2 M. For each group, spectrophotometric analysis was performed to detect leakage with a fluorescence spectrophotometer at 1 h (T0 and 48 h (T1 of incubation time at room temperature. Results. Astra Tech had the highest inner volume (6.8 μL, compared to Dentium (4 μL and Euroteknika (2.9 μL. At T0 and T1, respectively, the leakage volume and percentage of each system were as follows: Astra Tech 0.043 μL or 1.48% (SD 0.0022, 0.08 μL or 5.56% (SD 0.0074, Euroteknika 0.09 μL or 6.93% (SD 0.0913, 0.21 μL or 20.55% (SD 0.0035, and Dentium 0.07 μL or 4.6% (SD 0.0029, 0.12 μL or 10.47% (SD 0.0072. Conclusion. The tested internal conical implant-abutment connections appear to be unable to prevent leakage. In average, Astra Tech implants showed the highest inner volume and the least leakage.

  13. total electron content derived from global positioning system during ...

    African Journals Online (AJOL)

    SULUNGU

    POSITIONING SYSTEM DURING SOLAR MAXIMUM OF 2012-2013. OVER THE ..... diffusion of the transported electrons from the equator (Panda et al. 2015). As the sun rises, the ..... Wang M and Christensen AB 2008 Features of annual and ...

  14. Total system for manufacture of nuclear vessels by computer: VECTRON

    International Nuclear Information System (INIS)

    Inagawa, Jin; Ueno, Osamu; Hanai, Yoshiharu; Ohkawa, Isao; Washizu, Hideyuki

    1980-01-01

    VECTRON (Vessel Engineering by Computer Tool and Rapid Operating for the N/C System) is a CAM (Computer Aided Manufacturing) system that has been developed to produce high quality and highly accurate vessels for nuclear power plants and other industrial plants. Outputs of this system are design drawings, manufacturing information and magnetic tapes of the N/C marking machine for vessel shell plates including their attachments. And it can also output information at each stage of designing, marking, cutting, forming and assembling by treating the vessels in three dimensions and by using data filing systems and plotting program for general use. The data filing systems consist of functional and manufacturing data of each part of vessels. This system not only realizes a change from manual work to computer work, but also leads us to improve production engineering and production jigs for safety and high quality. At present, VECTRON is being applied to the manufacture of the shell plates of primary containment vessels in the Kashiwazaki-Kariwa Nuclear Power Station Unit 1 (K-1) and the Fukushima Daini Nuclear Power Station Unit 3 (2F-3), to realize increased productivity. (author)

  15. A two-microphone noise reduction system for cochlear implant users with nearby microphones. Part II: Performance Evaluation

    OpenAIRE

    Kompis, Martin; Bertram, Matthias; Senn, Pascal; Müller, Joachim; Pelizzone, Marco; Häusler, Rudolf

    2008-01-01

    Users of cochlear implants (auditory aids, which stimulate the auditory nerve electrically at the inner ear) often suffer from poor speech understanding in noise. We evaluate a small (intermicrophone distance 7 mm) and computationally inexpensive adaptive noise reduction system suitable for behind-the-ear cochlear implant speech processors. The system is evaluated in simulated and real, anechoic and reverberant environments. Results from simulations show improvements of 3.4 to 9.3 dB in signa...

  16. Risk factors for central line-associated bloodstream infection in pediatric oncology patients with a totally implantable venous access port: A cohort study.

    Science.gov (United States)

    Viana Taveira, Michelle Ribeiro; Lima, Luciana Santana; de Araújo, Cláudia Corrêa; de Mello, Maria Júlia Gonçalves

    2017-02-01

    Totally implantable venous access ports (TIVAPs) are used for prolonged central venous access, allowing the infusion of chemotherapy and other fluids and improving the quality of life of children with cancer. TIVAPs were developed to reduce the infection rates associated with central venous catheters; however, infectious events remain common and have not been fully investigated in pediatric oncology patients. A retrospective cohort was formed to investigate risk factors for central line-associated bloodstream infection (CLABSI) in pediatric cancer patients. Sociodemographic, clinical, and TIVAP insertion-related variables were evaluated, with the endpoint being the first CLABSI. A Kaplan-Meier analysis was performed to determine CLABSI-free catheter survival. Overall, 188 children were evaluated over 77,541 catheter days, with 94 being diagnosed with CLABSI (50%). Although coagulase-negative staphylococci were the pathogens most commonly isolated, Gram-negative microorganisms (46.8%) were also prevalent. In the multivariate analysis, factors that increased the risk for CLABSI were TIVAP insertion prior to chemotherapy (risk ratio [RR] = 1.56; P Risk factors for CLABSI in pediatric cancer patients with a TIVAP may be related to the severity of the child's condition at catheter insertion. Insertion of the catheter before chemotherapy and unfavorable conditions such as malnutrition and bone marrow aplasia can increase the risk of CLABSI. Protocols must be revised and surveillance increased over the first 10 weeks of treatment. © 2016 Wiley Periodicals, Inc.

  17. On the annealing behaviour of dysprosium ion implanted nickel: a combined study using Rutherford backscattering, transmission electron microscopy, and total current spectroscopy

    International Nuclear Information System (INIS)

    Chadderton, L.T.; Johnson, E.

    1977-01-01

    Despite continuing improvements in applications of the analytical method of Rutherford backscattering (RBS) to solid state physics it is recognized that more complete information can be obtained if other techniques - for example transmission electron microscopy (TEM) - are employed simultaneously. Experiments are described in which a combined RBS and TEM study of the annealing of nickel, rendered amorphous by implantation of 20 keV dysprosium ions is supplemented with a completely new technique - total current spectroscopy (TCS). In TCS low energy electrons (0-15 eV) are used to probe the damaged nickel. Observations have been made during annealing of both the reappearance of the bulk band structure of the metal and of a 'surface peak' which is highly sensitive to the recovery process. Changes in the height of the surface peak reveal three sharp annealing stages, the first two being preceded by reverse annealing which correlates well with RBS and TEM results. The first annealing stage - following the amorphous to crystalline transition - may be associated with electronic effects in the vicinity of the Curie point. Changes in the position of the surface peak allow one to trace the diffusion of dysprosium to the surface. Quantum mechanical resonances at the damage/crystal interface have also been followed throughout annealing. The initially amorphous layer (approximately 2.2nm) increases in thickness slightly during recovery. (Auth.)

  18. Injectable systems and implantable conduits for peripheral nerve repair

    International Nuclear Information System (INIS)

    Lin, Yen-Chih; Marra, Kacey G

    2012-01-01

    Acute sensory problems following peripheral nerve injury include pain and loss of sensation. Approximately 360 000 people in the United States suffer from upper extremity paralytic syndromes every year. Restoration of sufficient functional recovery after long-gap peripheral nerve damage remains a clinical challenge. Potential nerve repair therapies have increased in the past decade as the field of tissue engineering expands. The following review describes the use of biomaterials in nerve tissue engineering. Namely, the use of both synthetic and natural biomaterials, including non-degradable and degradable nerve grafts, is addressed. The enhancement of axonal regeneration can be achieved by further modification of the nerve guides. These approaches include injectable hydrogel fillers, controlled drug delivery systems, and cell incorporation. Hydrogels are a class of liquid–gel biomaterials with high water content. Injectable and gelling hydrogels can serve as growth factor delivery vehicles and cell carriers for tissue engineering applications. While natural hydrogels and polymers are suitable for short gap nerve repair, the use of polymers for relatively long gaps remains a clinical challenge. (paper)

  19. Description of the condition of the implant-prosthesis system: a transverse study

    International Nuclear Information System (INIS)

    Salazar Salgado, Walter

    2008-01-01

    Current condition of the implant-prosthesis system of the patients attended in the Facultad de Odontologia de la Universidad de Costa Rica is described, in the included period from January 2001 to December 2006. Parameters of comparison will be established for future evaluations. An appointment was scheduled with each patient to review. A radiovisiograph was used for digital radiography with parallel technique and radiographic positioners, for anterior and posterior sector. In addition, a questionnaire was applied to all patients. The percentage of survival of the implants placed in the years 2001-2006, is 95.2 % and 92.4 % of the patients are satisfied with the aesthetic aspect of their restoration [es

  20. Randomized study on the effect of single-implant versus two-implant retained overdentures on implant loss and muscle activity: a 12-month follow-up report.

    Science.gov (United States)

    Alqutaibi, A Y; Kaddah, A F; Farouk, M

    2017-06-01

    The objective was to evaluate and compare single- and two-implant retained overdentures for the rehabilitation of the edentulous mandible. Fifty-six edentulous subjects were eligible for inclusion. Using a random sampling system, a single implant or two implants were placed in the mandible. After 3 months, locator attachments were connected to the implants and the denture delivered with the retentive components incorporated in the denture base. Implant failure and muscle activity were evaluated at the 3-, 6-, and 12-month follow-up examinations. The study sample comprised 56 patients (32 male, 24 female), with a mean age of 58.2 years. A total of 84 implants were placed (28 in the single-implant group and 56 in the two-implant group). All patients completed the 12 months of follow-up. No significant differences were found between subjects in the two groups with respect to implant failure. With regard to improvements in muscle activity, the two-implant group showed statistically significant but perhaps not clinically important differences. Single-implant mandibular overdentures may be suggested as an alternative treatment modality for the rehabilitation of edentulous patients who cannot afford the cost of a two-implant overdenture. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Clinical Evaluation of Efficacy and Performance of All-Poly Tibial Freedom® Total Knee System for Treating Osteoarthritis Patients: Three-Year Follow Up Study.

    Science.gov (United States)

    Singh, Avatar; Singh, Kanwar Kulwinder

    2017-09-01

    Advancement in technology in terms of design and building materials has made Total Knee Replacement (TKR) a highly effective, safe, and predictable orthopedic procedure. To review the clinical outcomes for efficacy and performance of Freedom Total Knee System for the management of Osteoarthritis (OA), at a minimum of three years follow up. For this retrospective, post-marketing study, clinical data of patients treated with Freedom Total Knee System was retrieved from the clinical records after approval from the Institutional Ethics Committee . All the patients above the age of 18 years who completed at least three years after TKR were observed for the study purpose. Patients treated for OA were included while the patients who received the implant for treatment of rheumatoid arthritis and traumatic injury were excluded. Factors such as aseptic loosening, implant failure, and need for revision surgery were observed to evaluate implant performance. Cases were recruited for clinical assessment of primary efficacy endpoint in terms of post-surgery maximun range of motion. Secondary efficacy endpoint was to determine the clinical and social quality of life as per the American Knee Society Score (AKSS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and stiffness scores. A total of 158 patients who had 191 TKR were observed for performance. The mean age of the patients was 67.67 years; mean BMI was 28.97±3.33, and the group comprised of 43% men and 57% women. Telephonic follow up at three years of 158 patients identified that none of them required revision surgery or had aseptic loosening suggesting excellent performance. Final clinical follow up at three years was available for only 35 patients (41 knee implants). The range of motion significantly improved from preoperative 104°±5.67° (range, 85°-119°) to 119.8°±11.05° (98°-123°) at follow-up (ppain, and improved functionality.

  2. Materials directed to implants for repairing Central Nervous System

    Directory of Open Access Journals (Sweden)

    Canillas, M.

    2014-12-01

    Full Text Available Central Nervous System (CNS can be damaged by a wide range of injuries and disorders which entail permanent disability in some cases. Moreover, CNS repairing process presents some complications. The natural repair mechanism, which consists on the glial scar formation, is triggered by the inflammatory process. Molecules delivered during these processes, inflammation and glial scar formation as well as oxygen and glucose deficiencies due to the injury, create an inhibitory environment for axon regeneration and remyelination which is known as “secondary injury”. Biomaterials are taking up an even more important role in repairing CNS. Physicochemical properties of some ceramic materials have inspired different applications to repair CNS as substrates, electrodes or molecule vehicles. Based on their biocompatibility, capability to neutralize reactive species involved in the inflammatory processes and their versatile processing to obtain scaffolds with different shapes and sizes, ceramics are a succulent offer in nervous tissue engineering. Furthermore, their possibilities have been increased with polymeric-ceramics composites development, which have given rise to new interesting horizon.Existen diferentes tipos de lesiones o desordenes del Sistema Nervioso Central (SNC que pueden provocar graves secuelas e incluso en algunos casos una discapacidad permanente. Además, el proceso de reparación del SNC tiene algunas complicaciones. El mecanismo natural de reacción a una lesión, el cual consiste en la formación de una cicatriz glial, es desencadenado por un proceso inflamatorio. Las moléculas liberadas durante estos procesos, la inflamación y formación de la cicatriz glial, así como la deficiencia en oxígeno y glucosa debidos a la lesión, crean un ambiente que inhibe la regeneración axonal creando la llamada “lesión secundaria”. Los biomateriales están adquiriendo un papel cada vez más importante en la reparación de SNC. Las

  3. A system and approach for total pipeline integrity management

    Energy Technology Data Exchange (ETDEWEB)

    Porter, Todd; Neidhardt, Dietmar [Tuboscope Pipeline Services, Houston, TX (United States); Gonzalez, Oscar [Tuboscope Mexico S.A. de C.V., Mexico, D.F. (Mexico)

    2005-07-01

    Pipeline rehabilitation and maintenance decisions are made using a wide variety of data, criteria, and expertise. The goal is to arrive at an optimal plan that considers risk and best return on Repair and Maintenance (R and M) expenditures for aging pipeline systems in both regulated and non-regulated environments. In order to achieve these goals, historical, operations, and assessment data is gathered, aligned and integrated as part of a baseline assessment. Integrity threats are identified based on operations and industry experience, and combined with potential consequences to public safety, the environment, and business to clearly delineate high risk exposure segments in the system. Integrity assessments are conducted in a prioritized manner, using the most appropriate technology and methods to address the threats. These include In Line Inspection technologies: MFL, Deformation, UT, INS (combinations thereof), Direct Assessment for EC and SCC threats, Hydro testing, and other indirect methods. From these results, decisions are made and R and M plans developed. To arrive at an optimal R and M plan, proper use of existing data, new integrity assessment data, and decision risk models is required. This paper presentation will detail the tactical aspect of an effective integrity management platform. Experience in decision support, operations priorities and execution of a rehabilitation plan using LinaView Pro{sup TM} integrity management system with risk-based integrity tools and maintenance planning will be presented. A process overview, results, and benefits will be given using these examples from operating oil and gas transmission pipelines. (author)

  4. Current state of total artificial heart therapy and introduction of the most important total artificial heart systems.

    Science.gov (United States)

    Spiliopoulos, Sotirios; Hergesell, Vera; Wasler, Andrae; Dapunt, Otto

    2018-06-14

    Due to the declining instances of organ donation, total artificial heart (TAH) therapy is of increasing importance for the management of end-stage biventricular heart failure. We introduce the currently most important established and novel TAH systems (SynCardia, CARMAT, ReinHeart, BiVACOR), report clinical outcomes and discuss technical requirements for the successful implementation of TAH therapy as an alternative to cardiac transplantation.

  5. Solar-system Education for the 2017 Total Solar Eclipse

    Science.gov (United States)

    Pasachoff, Jay M.

    2017-10-01

    I describe an extensive outreach program about the Sun, the silhouette of the Moon, and the circumstances both celestial and terrestrial of the August 21, 2017, total solar eclipse. Publications included a summary of the last decade of solar-eclipse research for Nature Astronomy, a Resource Letter on Observing Solar Eclipses for the American Journal of Physics, and book reviews for Nature and for Phi Beta Kappa's Key Reporter. Symposia arranged include sessions at AAS, APS, AGU, and AAAS. Lectures include all ages from pre-school through elementary school to high school to senior-citizen residences. The work, including the scientific research about the solar corona that is not part of this abstract, was supported by grants from the Solar Terrestrial Program of the Atmospheric and Geospace Sciences Division of NSF and from the Committee for Research and Exploration of the National Geographic Society. Additional student support was received from NSF, NASA's Massachusetts Space Grant Consortium, the Honorary Research Society Sigma Xi, the Clare Booth Luce Foundation, and funds at Williams College.

  6. Long-term amnioinfusion through a subcutaneously implanted amniotic fluid replacement port system for treatment of PPROM in humans.

    Science.gov (United States)

    Tchirikov, Michael; Steetskamp, Joscha; Hohmann, Manfred; Koelbl, Heinz

    2010-09-01

    To introduce a novel method for the treatment of PPROM (preterm premature rupture of membranes) using continuous amnioinfusion via a subcutaneously implanted port system. After development and testing since 2001 in a fetal sheep model, the port system has been successfully implanted in two humans with PPROM. In the first case, the subcutaneous port system was implanted during the 23rd week of gestation in a 39-year-old 5th-gravida with PPROM since the 18th week of gestation; in the second case, the port system was implanted during the 24th week of gestation in a 27-year-old 3rd gravida with PPROM since the 21st week of gestation. After port implantation, 100ml/h saline solution was infused intermittently into the amniotic cavity. The whole course of treatment was supported by tocolysis. In the cases presented, gestation was terminated by cesarean section, in one case in the 29th week of gestation, and in the other case in the 30th week. The newborns showed no signs of lung hypoplasia and were successfully extubated on the 1st or 2nd day after delivery. Six months later the children did not exhibit any deviation from the normal development. Long-term amnioinfusion via a subcutaneously implanted port system could be used in humans with PPROM for prolongation of pregnancy and to avoid lung hypoplasia. Prospective randomized studies are ongoing. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  7. Systemic Sclerosis and Silicone Breast Implant: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Antonios Psarras

    2014-01-01

    Full Text Available Environmentally induced systemic sclerosis is a well-recognized condition, which is correlated with exposure to various chemical compounds or drugs. However, development of scleroderma-like disease after exposure to silicone has always been a controversial issue and, over time, it has triggered spirited debate whether there is a certain association or not. Herein, we report the case of a 35-year-old female who developed Raynaud’s phenomenon and, finally, systemic sclerosis shortly after silicone breast implantation surgery.

  8. A wireless transmission system powered by an enzyme biofuel cell implanted in an orange.

    Science.gov (United States)

    MacVittie, Kevin; Conlon, Tyler; Katz, Evgeny

    2015-12-01

    A biofuel cell composed of catalytic electrodes made of "buckypaper" modified with PQQ-dependent glucose dehydrogenase and FAD-dependent fructose dehydrogenase on the anode and with laccase on the cathode was used to activate a wireless information transmission system. The cathode/anode pair was implanted in orange pulp extracting power from its content (glucose and fructose in the juice). The open circuit voltage, Voc, short circuit current density, jsc, and maximum power produced by the biofuel cell, Pmax, were found as ca. 0.6 V, ca. 0.33 mA·cm(-2) and 670 μW, respectively. The voltage produced by the biofuel cell was amplified with an energy harvesting circuit and applied to a wireless transmitter. The present study continues the research line where different implantable biofuel cells are used for the activation of electronic devices. The study emphasizes the biosensor and environmental monitoring applications of implantable biofuel cells harvesting power from natural sources, rather than their biomedical use. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Spiral-Shaped Piezoelectric MEMS Cantilever Array for Fully Implantable Hearing Systems

    Directory of Open Access Journals (Sweden)

    Péter Udvardi

    2017-10-01

    Full Text Available Fully implantable, self-powered hearing aids with no external unit could significantly increase the life quality of patients suffering severe hearing loss. This highly demanding concept, however, requires a strongly miniaturized device which is fully implantable in the middle/inner ear and includes the following components: frequency selective microphone or accelerometer, energy harvesting device, speech processor, and cochlear multielectrode. Here we demonstrate a low volume, piezoelectric micro-electromechanical system (MEMS cantilever array which is sensitive, even in the lower part of the voice frequency range (300–700 Hz. The test array consisting of 16 cantilevers has been fabricated by standard bulk micromachining using a Si-on-Insulator (SOI wafer and aluminum nitride (AlN as a complementary metal-oxide-semiconductor (CMOS and biocompatible piezoelectric material. The low frequency and low device footprint are ensured by Archimedean spiral geometry and Si seismic mass. Experimentally detected resonance frequencies were validated by an analytical model. The generated open circuit voltage (3–10 mV is sufficient for the direct analog conversion of the signals for cochlear multielectrode implants.

  10. Impact of Different Surgeons on Dental Implant Failure.

    Science.gov (United States)

    Chrcanovic, Bruno Ramos; Kisch, Jenö; Albrektsson, Tomas; Wennerberg, Ann

    To assess the influence of several factors on the prevalence of dental implant failure, with special consideration of the placement of implants by different dental surgeons. This retrospective study is based on 2,670 patients who received 10,096 implants at one specialist clinic. Only the data of patients and implants treated by surgeons who had inserted a minimum of 200 implants at the clinic were included. Kaplan-Meier curves were stratified with respect to the individual surgeon. A generalized estimating equation (GEE) method was used to account for the fact that repeated observations (several implants) were placed in a single patient. The factors bone quantity, bone quality, implant location, implant surface, and implant system were analyzed with descriptive statistics separately for each individual surgeon. A total of 10 surgeons were eligible. The differences between the survival curves of each individual were statistically significant. The multivariate GEE model showed the following variables to be statistically significant: surgeon, bruxism, intake of antidepressants, location, implant length, and implant system. The surgeon with the highest absolute number of failures was also the one who inserted the most implants in sites of poor bone and used turned implants in most cases, whereas the surgeon with the lowest absolute number of failures used mainly modern implants. Separate survival analyses of turned and modern implants stratified for the individual surgeon showed statistically significant differences in cumulative survival. Different levels of failure incidence could be observed between the surgeons, occasionally reaching significant levels. Although a direct causal relationship could not be ascertained, the results of the present study suggest that the surgeons' technique, skills, and/or judgment may negatively influence implant survival rates.

  11. Implante con el sistema de reparación herniaria inguinal de prolene (Prolene hernia system

    Directory of Open Access Journals (Sweden)

    José Goderich Lalán

    2002-04-01

    Full Text Available Se realizó un estudio clinicodescriptivo y prospectivo del seguimiento de 21 pacientes a los que se les realizó implante sistema de reparación herniaria inguinal de prolene en hernias inguinales, reproducidas entre el 15 de octubre de 1998 y el 31 de marzo de 1999, con el objetivo de evaluar sus resultados. En todos los casos se utilizó el método de cirugía de corta estadía, anestesia local y sedación o espinal y antibioticoterapia profiláctica. En el seguimiento a muy corto plazo no se reportan recidivas y ninguna complicación posoperatoria. Más de la mitad de los pacientes había recibido más de 2 operaciones. La media de edad fue 49 años y el sexo predominante el masculino. La técnica que se utilizó para implante fue la recomendada por los fabricantesA clinical descriptive and prospective study of the follow-up of 21 patients who received implant of the Prolene inguinal hernia repair system in inguinal hernias reproduced between October l5th, 1998, and March 31st, 1999, was conducted aimed at evaluating the results. The short-stay surgery method, local anesthesia and sedation, or spinal anesthesia and prophylactic antibiotic therapy were used in all cases. No relapses or postoperative complications were reported in a very short-term follow-up. More than half of the patients had undergone more than 2 operations. Average age was 49 and there was a predominance of males. The technique used for the implant was the one recommended by the manufacturers

  12. Accuracy of two digital implant impression systems based on confocal microscopy with variations in customized software and clinical parameters.

    Science.gov (United States)

    Giménez, Beatriz; Pradíes, Guillermo; Martínez-Rus, Francisco; Özcan, Mutlu

    2015-01-01

    To evaluate the accuracy of two digital impression systems based on the same technology but different postprocessing correction modes of customized software, with consideration of several clinical parameters. A maxillary master model with six implants located in the second molar, second premolar, and lateral incisor positions was fitted with six cylindrical scan bodies. Scan bodies were placed at different angulations or depths apical to the gingiva. Two experienced and two inexperienced operators performed scans with either 3D Progress (MHT) or ZFX Intrascan (Zimmer Dental). Five different distances between implants (scan bodies) were measured, yielding five data points per impression and 100 per impression system. Measurements made with a high-accuracy three-dimensional coordinate measuring machine (CMM) of the master model acted as the true values. The values obtained from the digital impressions were subtracted from the CMM values to identify the deviations. The differences between experienced and inexperienced operators and implant angulation and depth were compared statistically. Experience of the operator, implant angulation, and implant depth were not associated with significant differences in deviation from the true values with both 3D Progress and ZFX Intrascan. Accuracy in the first scanned quadrant was significantly better with 3D Progress, but ZFX Intrascan presented better accuracy in the full arch. Neither of the two systems tested would be suitable for digital impression of multiple-implant prostheses. Because of the errors, further development of both systems is required.

  13. Finite Element Analysis of Stress Distribution in Three Commonly Used Implant Systems in D2 and D4 Bone Densities

    Directory of Open Access Journals (Sweden)

    C Radha

    2016-01-01

    Materials and Methods : Pro-engineer 3-0 software was used to create the geometric models of the three implant systems (Nobel biocare, Biohorizon, Adin and two bone densities D2 and D4. Six 3D models were created to simulate each one of the three implant systems supporting a metal ceramic crown placed in two different densities of bone D2 and D4. The Poisson′s ratio(΅ and Youngs modulus(E of elasticity were assigned to different materials used for the models. Vertical and oblique loads of 450N each were applied on all six models. Von Mises stress analysis was done with ANSYS software. Results : Von Mises stresses were more within D4 type bone than D2 type, for all the three systems of implants and less stresses were seen in Biohorizon implant followed by Nobel Biocare and Adin implant particularly in D4 bone. Conclusion: The study concluded that the selection of a particular implant system should be based on the scientific research rather than on popularity.

  14. Intra- and intersubject comparison of cochlear implant systems using the Esprit and the Tempo+ behind-the-ear speech processor.

    Science.gov (United States)

    Kompis, Martin; Jenk, Martin; Vischer, Mattheus W; Seifert, Eberhard; Häusler, Rudolf

    2002-12-01

    A patient with bilateral profound deafness was implanted with a Nucleus CI24M cochlear implant (CI) and used an Esprit behind-the-ear (BTE) speech processor. Thirteen months later, the implant had to be removed because of a cholesteatoma. As the same electrode could not be reinserted, a Medel combi40s CI was implanted in the same ear, and the patient used a Tempo+ BTE processor. After 1 year of use of the Combi40s/Tempo+ system, speech recognition was better and was rated better subjectively than with the CI24M/Esprit system. Speech recognition and subjective ratings were also assessed for two matched groups of nine CI users each, using either an Esprit or a Tempo+ processor. On average, speech recognition scores were higher for the group of Tempo+ users, but the difference was not statistically significant. Users of the Esprit processors rated their device higher in terms of cosmetic appearance and comfort of wearing.

  15. Long-Term Primary Patency Rate After Nitinol Self-Expandable Stents Implantation in Long, Totally Occluded Femoropopliteal (TASC II C & D) Lesions.

    Science.gov (United States)

    Elmahdy, Mahmoud Farouk; Buonamici, Piergiovanni; Trapani, Maurizio; Valenti, Renato; Migliorini, Angela; Parodi, Guido; Antoniucci, David

    2017-06-01

    Endovascular therapy for long femoropopliteal lesions using percutaneous transluminal balloon angioplasty or first-generation of peripheral stents has been associated with unacceptable one-year restenosis rates. However, with recent advances in equipment and techniques, a better primary patency rate is expected. This study was conducted to detect the long-term primary patency rate of nitinol self-expandable stents implanted in long, totally occluded femoropopliteal lesions TransAtlantic Inter-Society Census (TASC II type C & D), and determine the predictors of reocclusion or restenosis in the stented segments. The demographics, clinical, anatomical, and procedural data of 213 patients with 240 de novo totally occluded femoropopliteal (TASC II type C & D) lesions treated with nitinol self-expandable stents were retrospectively analysed. Of these limbs, 159 (66.2%) presented with intermittent claudication, while 81 (33.8%) presented with critical limb ischaemia. The mean-time of follow-up was 36±22.6 months, (range: 6.3-106.2 months). Outcomes evaluated were, primary patency rate and predictors of reocclusion or restenosis in the stented segments. The mean age of the patients was 70.9±9.3 years, with male gender 66.2%. Mean pre-procedural ABI was 0.45±0.53. One-hundred-and-seventy-five (73%) lesions were TASC II type C, while 65 (27%) were type D lesions. The mean length of the lesions was 17.9±11.3mm. Procedure related complications occurred in 10 (4.1%) limbs. There was no periprocedural mortality. Reocclusion and restenosis were detected during follow-up in 45 and 30 limbs respectively, and all were re-treated by endovascular approach. None of the patients required major amputation. Primary patency rates were 81.4±1.1%, 77.7±1.9% and 74.4±2.8% at 12, 24, and 36 months respectively. Male gender, severe calcification, and TASC II D lesion were independent predictors for reocclusion, while predictors of restenosis were DM, smoking and TASC II D lesions

  16. Osseointegration of zirconia implants: an SEM observation of the bone-implant interface.

    Science.gov (United States)

    Depprich, Rita; Zipprich, Holger; Ommerborn, Michelle; Mahn, Eduardo; Lammers, Lydia; Handschel, Jörg; Naujoks, Christian; Wiesmann, Hans-Peter; Kübler, Norbert R; Meyer, Ulrich

    2008-11-06

    The successful use of zirconia ceramics in orthopedic surgery led to a demand for dental zirconium-based implant systems. Because of its excellent biomechanical characteristics, biocompatibility, and bright tooth-like color, zirconia (zirconium dioxide, ZrO2) has the potential to become a substitute for titanium as dental implant material. The present study aimed at investigating the osseointegration of zirconia implants with modified ablative surface at an ultrastructural level. A total of 24 zirconia implants with modified ablative surfaces and 24 titanium implants all of similar shape and surface structure were inserted into the tibia of 12 Göttinger minipigs. Block biopsies were harvested 1 week, 4 weeks or 12 weeks (four animals each) after surgery. Scanning electron microscopy (SEM) analysis was performed at the bone implant interface. Remarkable bone attachment was already seen after 1 week which increased further to intimate bone contact after 4 weeks, observed on both zirconia and titanium implant surfaces. After 12 weeks, osseointegration without interposition of an interfacial layer was detected. At the ultrastructural level, there was no obvious difference between the osseointegration of zirconia implants with modified ablative surfaces and titanium implants with a similar surface topography. The results of this study indicate similar osseointegration of zirconia and titanium implants at the ultrastructural level.

  17. Evaluating Carbonate System Algorithms in a Nearshore System: Does Total Alkalinity Matter?

    Science.gov (United States)

    Jones, Jonathan M; Sweet, Julia; Brzezinski, Mark A; McNair, Heather M; Passow, Uta

    2016-01-01

    Ocean acidification is a threat to many marine organisms, especially those that use calcium carbonate to form their shells and skeletons. The ability to accurately measure the carbonate system is the first step in characterizing the drivers behind this threat. Due to logistical realities, regular carbonate system sampling is not possible in many nearshore ocean habitats, particularly in remote, difficult-to-access locations. The ability to autonomously measure the carbonate system in situ relieves many of the logistical challenges; however, it is not always possible to measure the two required carbonate parameters autonomously. Observed relationships between sea surface salinity and total alkalinity can frequently provide a second carbonate parameter thus allowing for the calculation of the entire carbonate system. Here, we assessed the rigor of estimating total alkalinity from salinity at a depth sampling water from a pier in southern California for several carbonate system parameters. Carbonate system parameters based on measured values were compared with those based on estimated TA values. Total alkalinity was not predictable from salinity or from a combination of salinity and temperature at this site. However, dissolved inorganic carbon and the calcium carbonate saturation state of these nearshore surface waters could both be estimated within on average 5% of measured values using measured pH and salinity-derived or regionally averaged total alkalinity. Thus we find that the autonomous measurement of pH and salinity can be used to monitor trends in coastal changes in DIC and saturation state and be a useful method for high-frequency, long-term monitoring of ocean acidification.

  18. Bridging the osteoarthritis treatment gap with the KineSpring Knee Implant System: early evidence in 100 patients with 1-year minimum follow-up

    Directory of Open Access Journals (Sweden)

    London NJ

    2013-09-01

    Full Text Available Nicholas J London,1 Jon Smith,2 Larry E Miller,3,4 Jon E Block4 1Department of Orthopaedic Surgery, Harrogate District Foundation Trust, Harrogate, UK; 2The Mid Yorkshire Hospitals NHS Trust, Yorkshire, UK; 3Miller Scientific Consulting, Arden, NC, USA; 4The Jon Block Group, San Francisco, CA, USA Abstract: Almost 4 million Americans are within the knee osteoarthritis (OA treatment gap, the period from unsuccessful exhaustion of conservative treatment to major surgical intervention. New treatment alternatives for symptomatic knee OA are greatly needed. The purpose of this report was to assess outcomes of a joint-unloading implant (KineSpring® Knee Implant System in patients with symptomatic medial knee OA. A total of 100 patients enrolled in three clinical trials were treated with the KineSpring System and followed for a minimum of 1 year. All devices were successfully implanted and activated, with no operative complications. Knee pain severity improved 60% (P < 0.001 at 1 year, with 76% of patients reporting a minimum 30% improvement in pain severity. All Western Ontario and McMaster Universities Arthritis Index (WOMAC subscores significantly improved at 1 year, with a 56% improvement in pain, 57% improvement in function, and a 39% improvement in stiffness (all P < 0.001. The percentage of patients experiencing a minimum 20% improvement in WOMAC subscores was 74% for pain, 83% for function, and 67% for stiffness. During follow-up, six (6% patients required additional surgery, including four total knee arthroplasties and two high tibial osteotomies. The KineSpring System effectively bridges the treatment gap between failed conservative care and surgical joint-modifying procedures. Keywords: implant, KineSpring, knee, medial, osteoarthritis, unloading

  19. Development of a simple, low cost, indirect ion beam fluence measurement system for ion implanters, accelerators

    Science.gov (United States)

    Suresh, K.; Balaji, S.; Saravanan, K.; Navas, J.; David, C.; Panigrahi, B. K.

    2018-02-01

    We developed a simple, low cost user-friendly automated indirect ion beam fluence measurement system for ion irradiation and analysis experiments requiring indirect beam fluence measurements unperturbed by sample conditions like low temperature, high temperature, sample biasing as well as in regular ion implantation experiments in the ion implanters and electrostatic accelerators with continuous beam. The system, which uses simple, low cost, off-the-shelf components/systems and two distinct layers of in-house built softwarenot only eliminates the need for costly data acquisition systems but also overcomes difficulties in using properietry software. The hardware of the system is centered around a personal computer, a PIC16F887 based embedded system, a Faraday cup drive cum monitor circuit, a pair of Faraday Cups and a beam current integrator and the in-house developed software include C based microcontroller firmware and LABVIEW based virtual instrument automation software. The automatic fluence measurement involves two important phases, a current sampling phase lasting over 20-30 seconds during which the ion beam current is continuously measured by intercepting the ion beam and the averaged beam current value is computed. A subsequent charge computation phase lasting 700-900 seconds is executed making the ion beam to irradiate the samples and the incremental fluence received by the sampleis estimated usingthe latest averaged beam current value from the ion beam current sampling phase. The cycle of current sampling-charge computation is repeated till the required fluence is reached. Besides simplicity and cost-effectiveness, other important advantages of the developed system include easy reconfiguration of the system to suit customisation of experiments, scalability, easy debug and maintenance of the hardware/software, ability to work as a standalone system. The system was tested with different set of samples and ion fluences and the results were verified using

  20. A Wireless Magnetic Resonance Energy Transfer System for Micro Implantable Medical Sensors

    Directory of Open Access Journals (Sweden)

    Tianyang Yang

    2012-07-01

    Full Text Available Based on the magnetic resonance coupling principle, in this paper a wireless energy transfer system is designed and implemented for the power supply of micro-implantable medical sensors. The entire system is composed of the in vitro part, including the energy transmitting circuit and resonant transmitter coils, and in vivo part, including the micro resonant receiver coils and signal shaping chip which includes the rectifier module and LDO voltage regulator module. Transmitter and receiver coils are wound by Litz wire, and the diameter of the receiver coils is just 1.9 cm. The energy transfer efficiency of the four-coil system is greatly improved compared to the conventional two-coil system. When the distance between the transmitter coils and the receiver coils is 1.5 cm, the transfer efficiency is 85% at the frequency of 742 kHz. The power transfer efficiency can be optimized by adding magnetic enhanced resonators. The receiving voltage signal is converted to a stable output voltage of 3.3 V and a current of 10 mA at the distance of 2 cm. In addition, the output current varies with changes in the distance. The whole implanted part is packaged with PDMS of excellent biocompatibility and the volume of it is about 1 cm3.

  1. Polymer-based wireless implantable sensor and platform for systems biology study

    Science.gov (United States)

    Xue, Ning

    Wireless implantable MEMS (microelectromechanical systems) devices have been developed over the past decade based on the combination of bio-MEMS and Radio frequency (RF) MEMS technology. These devices require the components of wireless telemetric antenna and the corresponding circuit. In the meanwhile, biocompatible material needs to be involved in the devices design. To supply maximum power upon the implantable device at given power supply from the external coil circuit, this dissertation theoretically analyzed the mutual inductance under the positions of variety of vertical distances, lateral displacements and angular misalignments between two coils in certain surgical coils misalignment situations. A planar spiral coil has been developed as the receiver coil of the coupling system. To get maximum induced voltage over the receiver circuit, different geometries of the power coil, system operation frequencies were investigated. An intraocular pressure (IOP) sensor has been developed consisting of only biocompatible matierials-SU-8 and gold. Its size is sufficiently small to be implanted in the eye. The measurement results showed that it has relatively linear pressure response, high resolution and relatively long working stability in saline environment. Finally, a simple and low cost micro-wells bio-chip has been developed with sole polydimethylsiloxane (PDMS) to be used for single cell or small group cells isolation. By performing atomic force microscopy (AFM), contact angle and x-ray photoelectron spectroscopy (XPS) measurements on the PDMS surfaces under various surface treatment conditions, the physical and chemical surface natures were thoroughly analyzed as the basis of study of cells attachment and isolation to the surfaces.

  2. Immediate occlusal loading of single lower molars using Brånemark System® Wide Platform TiUnite™ implants: a 5-year follow-up report of a prospective clinical multicenter study.

    Science.gov (United States)

    Calandriello, Roberto; Tomatis, Massimiliano

    2011-12-01

    Although not essential, molars hold their importance in terms of functional jaw stability, antagonist opposition, and support of facial height. Therefore, implant therapy is an attractive concept in molar areas. However, especially in the posterior mandible, the conventional two-stage surgical approach to implant therapy was reported to cause higher bone loss and/or higher implant failures with machined implants because of the peculiar anatomic and physiologic conditions of this area. As the TiUnite™ (Nobel Biocare AB, Göteborg, Sweden) surface results in faster bone healing than with machined-surface implants, it was hypothesized that this surface would also improve the performance of wide implants in posterior mandibles. Based on these assumptions, a protocol for immediately loaded implants for single molar replacement was developed. This paper aimed to report on the clinical and radiological performance of Brånemark System® TiUnite Wide Platform implants supporting single molars in the lower jaw, loaded immediately and followed for up to 5 years, and to assess if the benefit delivered by oxidized surfaces in the short run is also present after 5 years. The study includes 33 consecutive patients treated between March 2001 and September 2003 and monitored until September 2008 in two private dental offices. A total of 40 Brånemark System TiUnite Wide Platform MK III implants were placed. All implants were provided with provisional crowns in full centric occlusion at the time of surgery. Patients were clinically and radiologically followed up for up to 5 years. Two implant failed so that the cumulative success rate at 5 years was 95.0%. The mean marginal bone remodeling (n = 38) expressed as mesial plus distal value averages was -1.17 mm (SD ± 0.90) at the 5-year time point. Although limited by the number of patients treated in accordance with the protocol described, 5-year results encourage the use of immediately loaded single lower molars supported by Br

  3. Stabilization of a percutaneously implanted port catheter system for hepatic artery chemotherapy infusion

    International Nuclear Information System (INIS)

    Shindoh, Noboru; Ozaki, Yutaka; Kyogoku, Shinsuke; Yamana, Daigo; Sumi, Yukiharu; Katayama, Hitoshi

    1999-01-01

    A port catheter system for hepatic artery infusion chemotherapy was implanted percutaneously via the left subclavian artery in 41 patients for treatment of unresectable liver metastases. The catheter tip was inserted into the gastroduodenal artery (GDA), the end hole was occluded with a guidewire fragment, and a side-hole for infusion was positioned at the bifurcation of the proper hepatic artery and the GDA. The GDA was embolized with steel coils around the infusion catheter tip via a transfemoral catheter. This procedure is designed to reduce the incidence of hepatic artery occlusion and infusion catheter dislocation.

  4. Low-Gain, Low-Noise Integrated Neuronal Amplifier for Implantable Artifact-Reduction Recording System

    Directory of Open Access Journals (Sweden)

    Abdelhamid Benazzouz

    2013-09-01

    Full Text Available Brain neuroprostheses for neuromodulation are being designed to monitor the neural activity of the brain in the vicinity of the region being stimulated using a single macro-electrode. Using a single macro-electrode, recent neuromodulation studies show that recording systems with a low gain neuronal amplifier and successive amplifier stages can reduce or reject stimulation artifacts. These systems were made with off-the-shelf components that are not amendable for future implant design. A low-gain, low-noise integrated neuronal amplifier (NA with the capability of recording local field potentials (LFP and spike activity is presented. In vitro and in vivo characterizations of the tissue/electrode interface, with equivalent impedance as an electrical model for recording in the LFP band using macro-electrodes for rodents, contribute to the NA design constraints. The NA occupies 0.15 mm2 and dissipates 6.73 µW, and was fabricated using a 0.35 µm CMOS process. Test-bench validation indicates that the NA provides a mid-band gain of 20 dB and achieves a low input-referred noise of 4 µVRMS. Ability of the NA to perform spike recording in test-bench experiments is presented. Additionally, an awake and freely moving rodent setup was used to illustrate the integrated NA ability to record LFPs, paving the pathway for future implantable systems for neuromodulation.

  5. Stress Distribution in Single Dental Implant System: Three-Dimensional Finite Element Analysis Based on an In Vitro Experimental Model.

    Science.gov (United States)

    Rezende, Carlos Eduardo Edwards; Chase-Diaz, Melody; Costa, Max Doria; Albarracin, Max Laurent; Paschoeto, Gabriela; Sousa, Edson Antonio Capello; Rubo, José Henrique; Borges, Ana Flávia Sanches

    2015-10-01

    This study aimed to analyze the stress distribution in single implant system and to evaluate the compatibility of an in vitro model with finite element (FE) model. The in vitro model consisted of Brånemark implant; multiunit set abutment of 5 mm height; metal-ceramic screw-retained crown, and polyurethane simulating the bone. Deformations were recorded in the peri-implant region in the mesial and distal aspects, after an axial 300 N load application at the center of the occlusal aspect of the crown, using strain gauges. This in vitro model was scanned with micro CT to design a three-dimensional FE model and the strains in the peri-implant bone region were registered to check the compatibility between both models. The FE model was used to evaluate stress distribution in different parts of the system. The values obtained from the in vitro model (20-587 με) and the finite element analysis (81-588 με) showed agreement among them. The highest stresses because of axial and oblique load, respectively were 5.83 and 40 MPa for the cortical bone, 55 and 1200 MPa for the implant, and 80 and 470 MPa for the abutment screw. The FE method proved to be effective for evaluating the deformation around single implant. Oblique loads lead to higher stress concentrations.

  6. Classification system on the selection of number of implants and superstructure design on the basis available vertical restorative space and interforaminal distance for implant supported mandibular overdenture

    Directory of Open Access Journals (Sweden)

    Akshay Bhargava

    2016-01-01

    Full Text Available Purpose: The rehabilitation of the edentulous mandible is a challenge due to various limiting factors, of which the available vertical restorative space (AVRS has been well understood in the literature. However, other anatomic variations such as arch form, arch size, and also the interforaminal distance (IFD (due to the presence of mandibular nerve are influential in the selection of size and position of implants, and thereby the prosthetic design. Materials and Method: In the present study, 30 edentulous patients from a group of 300 edentulous patients, representing all the three jaw relations (Class I, II, and III were evaluated for designing a classification that could help in a comprehensive treatment plan for the edentulous mandible. Dental panoramic radiographs of each individual with a trial or final prosthesis were made. The horizontal IFD and AVRS values were calculated. Results: One-way analysis of variance followed by post-hoc test (multiple comparison and Bonferroni method having P < 0.05 as significant value showed an overall mean of 38.9 mm for horizontal distance and 13.69 mm for the AVRS in 30 edentulous patients. Conclusion: The results showed that in the majority of cases (90% there is insufficient space to place a bar attachment supported by five implants for mandibular overdentures. This suggests that a universal treatment plan cannot be followed due to varying anatomic factors. Hence, it becomes imperative to have a set of clinical guidelines based on the AVRS and IFD, for the selection of implant number and type of attachment. The article proposes a simple classification system based on the AVRS and IFD for establishing guidelines in the treatment planning of the edentulous mandible, to aid in selection of implant size, number, and position along with the associated prosthetic design.

  7. A Meta-Analysis of the Incidence of Patient-Reported Dysphagia After Anterior Cervical Decompression and Fusion with the Zero-Profile Implant System.

    Science.gov (United States)

    Yang, Yi; Ma, Litai; Liu, Hao; Xu, MangMang

    2016-04-01

    Dysphagia is a well-known complication following anterior cervical surgery. It has been reported that the Zero-profile Implant System can decrease the incidence of dysphagia following surgery, however, dysphagia after anterior cervical decompression and fusion (ACDF) with the Zero-profile Implant System remains controversial. Previous studies only focus on small sample sizes. The objective of this study was to determine the incidence of dysphagia after ACDF with the Zero-profile Implant System. Studies were collected from PubMed, EMBASE, the Cochrane library and the China Knowledge Resource Integrated Database using the keywords "Zero-profile OR Zero-p) AND (dysphagia OR [swallowing dysfunction]". The software STATA (Version 13.0) was used for statistical analysis. Statistical heterogeneity across the various trials, a test of publication bias and sensitivity analysis was performed. 30 studies with a total of 1062 patients were included in this meta-analysis. The occurrence of post-operative transient dysphagia ranged from 0 to 76 % whilst the pooled incidence was 15.6 % (95 % CI, 12.6, 18.5 %). 23 studies reported no persistent dysphagia whilst seven studies reported persistent dysphagia ranging from 1 to 7 %). In summary, the present study observed a low incidence of both transient and persistent dysphagia after ACDF using the Zero-profile Implant System. Most of the dysphagia was mild and gradually decreased during the following months. Moderate or severe dysphagia was uncommon. Future randomized controlled multi-center studies and those focusing on the mechanisms of dysphagia and methods to reduce its incidence are required.

  8. Determining Threshold Distance Providing Less Interference for Wireless Medical Implant Communication Systems in Coexisting Environments under Shadow Fading Conditions

    Directory of Open Access Journals (Sweden)

    Selman KULAÇ

    2017-08-01

    Full Text Available Important interference problems will be able to be encountered especially close areas to the hospitals where wireless implantable medical systems' communication traffic occurs heavily in near future. It is possible that these interferences could cause wireless implant devices to malfunction and harmful effects on patients. In this study, it is proposed to determine threshold distance in order to get less interference for wireless implantable medical systems under shadow fading conditions where MICS band and MetAids band users coexist intensely simultaneously. In this method, threshold power according to the \\cite{FCC} is pulled down by adding extra distance margin in order to minimize the interference effects to the MICS systems using confidence interval calculations. Because received signal strength just below the monitoring threshold power according to the \\cite{FCC} brings about much more interferences for the MICS systems even if listen-before-talk technique is applied.

  9. Development of high impedance measurement system for water leakage detection in implantable neuroprosthetic devices.

    Science.gov (United States)

    Yousif, Aziz; Kelly, Shawn K

    2016-08-01

    There has been a push for a greater number of channels in implantable neuroprosthetic devices; but, that number has largely been limited by current hermetic packaging technology. Microfabricated packaging is becoming reality, but a standard testing system is needed to prepare these devices for clinical trials. Impedance measurements of electrodes built into the packaging layers may give an early warning of device failure and predict device lifetime. Because the impedance magnitudes of such devices can be on the order of gigaohms, a versatile system was designed to accommodate ultra-high impedances and allow future integrated circuit implementation in current neural prosthetic technologies. Here we present the circuitry, control software, and preliminary testing results of our designed system.

  10. A generic miniature multi-feature programmable wireless powering headstage ASIC for implantable biomedical systems.

    Science.gov (United States)

    Kubendran, Rajkumar; Krishnan, Harish; Manola, Bhupendra; John, Simon W M; Chappell, William J; Irazoqui, Pedro P

    2011-01-01

    Wireless powering holds immense promise to enable a variety of implantable biomedical measurement systems with different power supply and current budget requirements. Effective power management demands more functionality in the headstage design like power level detection for range estimation and power save modes for sleep-wake operation. This paper proposes a single chip ASIC solution that addresses these problems by incorporating digitally programmable features and thus has the potential to enable wireless powering for many implantable systems. The ASIC includes an RF rectifier which has a peak efficiency of 17.9% at 900 MHz and 11.0% at 2.4 GHz, a robust 1 V bandgap reference and LDO voltage regulator whose output can be programmed in the range of 1 V-1.5 V, and can drive upto 4 mA of load current. The input RF power level detector has a threshold of 1.6 V and the power management block can be programmed to give a 6%, 12.5% or 25% duty cycle power line to the transmitter resulting in upto 60% reduction in average power. The ASIC was fabricated using the TSMC 65 nm process, occupies 1mm(2) die area and the headstage consumes ~300 μA at 1.2V regulated supply.

  11. A wirelessly controlled implantable LED system for deep brain optogenetic stimulation

    Science.gov (United States)

    Rossi, Mark A.; Go, Vinson; Murphy, Tracy; Fu, Quanhai; Morizio, James; Yin, Henry H.

    2015-01-01

    In recent years optogenetics has rapidly become an essential technique in neuroscience. Its temporal and spatial specificity, combined with efficacy in manipulating neuronal activity, are especially useful in studying the behavior of awake behaving animals. Conventional optogenetics, however, requires the use of lasers and optic fibers, which can place considerable restrictions on behavior. Here we combined a wirelessly controlled interface and small implantable light-emitting diode (LED) that allows flexible and precise placement of light source to illuminate any brain area. We tested this wireless LED system in vivo, in transgenic mice expressing channelrhodopsin-2 in striatonigral neurons expressing D1-like dopamine receptors. In all mice tested, we were able to elicit movements reliably. The frequency of twitches induced by high power stimulation is proportional to the frequency of stimulation. At lower power, contraversive turning was observed. Moreover, the implanted LED remains effective over 50 days after surgery, demonstrating the long-term stability of the light source. Our results show that the wireless LED system can be used to manipulate neural activity chronically in behaving mice without impeding natural movements. PMID:25713516

  12. Implantation of Martian Materials in the Inner Solar System by a Mega Impact on Mars

    Science.gov (United States)

    Hyodo, Ryuki; Genda, Hidenori

    2018-04-01

    Observations and meteorites indicate that the Martian materials are enigmatically distributed within the inner solar system. A mega impact on Mars creating a Martian hemispheric dichotomy and the Martian moons can potentially eject Martian materials. A recent work has shown that the mega-impact-induced debris is potentially captured as the Martian Trojans and implanted in the asteroid belt. However, the amount, distribution, and composition of the debris has not been studied. Here, using hydrodynamic simulations, we report that a large amount of debris (∼1% of Mars’ mass), including Martian crust/mantle and the impactor’s materials (∼20:80), are ejected by a dichotomy-forming impact, and distributed between ∼0.5–3.0 au. Our result indicates that unmelted Martian mantle debris (∼0.02% of Mars’ mass) can be the source of Martian Trojans, olivine-rich asteroids in the Hungarian region and the main asteroid belt, and some even hit the early Earth. The evidence of a mega impact on Mars would be recorded as a spike of 40Ar–39Ar ages in meteorites. A mega impact can naturally implant Martian mantle materials within the inner solar system.

  13. 21 CFR 862.1270 - Estrogens (total, in pregnancy) test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Estrogens (total, in pregnancy) test system. 862.1270 Section 862.1270 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... Test Systems § 862.1270 Estrogens (total, in pregnancy) test system. (a) Identification. As estrogens...

  14. Microbiological outcome of two screw-shaped titanium implant systems placed following a split-mouth randomised protocol, at the 12th year of follow-up after loading.

    Science.gov (United States)

    Van Assche, Nele; Pittayapat, Pisha; Jacobs, Reinhilde; Pauwels, Martine; Teughels, Wim; Quirynen, Marc

    2011-01-01

    To compare the subgingival microbiota around two differently designed implant systems that were in function for more than 12 years in a randomised split-mouth study design, and to compare the outcome with natural dentition. A total of 18 partially edentulous patients received at least two TiOblast™ (Astra Tech) and two Brånemark (Nobel Biocare) implants following a split-mouth design. At the last follow-up visit, periodontal parameters (probing depth, bleeding on probing and plaque) were recorded and intraoral radiographs were taken to calculate bone loss. Subgingival plaque samples were collected for culture, qPCR and checkerboard DNA-DNA hybridisation analysis. These data were related to implant design and bone loss. This study setup allowed a comparison of 34 Astra Tech (Impl A) with 32 Brånemark (Impl B) implants. During the 12-year follow up, five patients dropped out. One Brånemark implant was lost before abutment connection in a dropout patient. Mean bone loss between loading and year 12 was 0.7 mm (range: -0.8-5.8) (Impl A), and 0.4 mm (range: -1.1-4.1) (Impl B). No significant microbiological differences (qualitative and quantitative) could be observed between both implant types. Compared to teeth, subgingival plaque samples from implants did not reach the concentration of pathogens, even after 12 years of function. These data show that both implant systems (with differences in macro-design and surface characteristics), in patients with good oral hygiene and a stable periodontal condition, can maintain a successful treatment outcome without significant subgingival microbiological differences after 12 years of loading. The presence of periodontopathogens did not necessarily result in bone loss.

  15. Trends in cochlear implants.

    Science.gov (United States)

    Zeng, Fan-Gang

    2004-01-01

    More than 60,000 people worldwide use cochlear implants as a means to restore functional hearing. Although individual performance variability is still high, an average implant user can talk on the phone in a quiet environment. Cochlear-implant research has also matured as a field, as evidenced by the exponential growth in both the patient population and scientific publication. The present report examines current issues related to audiologic, clinical, engineering, anatomic, and physiologic aspects of cochlear implants, focusing on their psychophysical, speech, music, and cognitive performance. This report also forecasts clinical and research trends related to presurgical evaluation, fitting protocols, signal processing, and postsurgical rehabilitation in cochlear implants. Finally, a future landscape in amplification is presented that requires a unique, yet complementary, contribution from hearing aids, middle ear implants, and cochlear implants to achieve a total solution to the entire spectrum of hearing loss treatment and management.

  16. Mechanical fatigue resistance of an implantable branched lead system for a distributed set of longitudinal intrafascicular electrodes.

    Science.gov (United States)

    Pena, A E; Kuntaegowdanahalli, S S; Abbas, J J; Patrick, J; Horch, K W; Jung, R

    2017-12-01

    A neural interface system has been developed that consists of an implantable stimulator/recorder can with a 15-electrode lead that trifurcates into three bundles of five individual wire longitudinal intrafascicular electrodes. This work evaluated the mechanical fatigue resistance of the branched lead and distributed electrode system under conditions designed to mimic anticipated strain profiles that would be observed after implantation in the human upper arm. Custom test setups and procedures were developed to apply linear or angular strain at four critical stress riser points on the lead and electrode system. Each test was performed to evaluate fatigue under a high repetition/low amplitude paradigm designed to test the effects of arm movement on the leads during activities such as walking, or under a low repetition/high amplitude paradigm designed to test the effects of more strenuous upper arm activities. The tests were performed on representative samples of the implantable lead system for human use. The specimens were fabricated using procedures equivalent to those that will be used during production of human-use implants. Electrical and visual inspections of all test specimens were performed before and after the testing procedures to assess lead integrity. Measurements obtained before and after applying repetitive strain indicated that all test specimens retained electrical continuity and that electrical impedance remained well below pre-specified thresholds for detection of breakage. Visual inspection under a microscope at 10×  magnification did not reveal any signs of damage to the wires or silicone sheathing at the stress riser points. These results demonstrate that the branched lead of this implantable neural interface system has sufficient mechanical fatigue resistance to withstand strain profiles anticipated when the system is implanted in an arm. The novel test setups and paradigms may be useful in testing other lead systems.

  17. Mechanical fatigue resistance of an implantable branched lead system for a distributed set of longitudinal intrafascicular electrodes

    Science.gov (United States)

    Pena, A. E.; Kuntaegowdanahalli, S. S.; Abbas, J. J.; Patrick, J.; Horch, K. W.; Jung, R.

    2017-12-01

    Objective. A neural interface system has been developed that consists of an implantable stimulator/recorder can with a 15-electrode lead that trifurcates into three bundles of five individual wire longitudinal intrafascicular electrodes. This work evaluated the mechanical fatigue resistance of the branched lead and distributed electrode system under conditions designed to mimic anticipated strain profiles that would be observed after implantation in the human upper arm. Approach. Custom test setups and procedures were developed to apply linear or angular strain at four critical stress riser points on the lead and electrode system. Each test was performed to evaluate fatigue under a high repetition/low amplitude paradigm designed to test the effects of arm movement on the leads during activities such as walking, or under a low repetition/high amplitude paradigm designed to test the effects of more strenuous upper arm activities. The tests were performed on representative samples of the implantable lead system for human use. The specimens were fabricated using procedures equivalent to those that will be used during production of human-use implants. Electrical and visual inspections of all test specimens were performed before and after the testing procedures to assess lead integrity. Main results. Measurements obtained before and after applying repetitive strain indicated that all test specimens retained electrical continuity and that electrical impedance remained well below pre-specified thresholds for detection of breakage. Visual inspection under a microscope at 10×  magnification did not reveal any signs of damage to the wires or silicone sheathing at the stress riser points. Significance. These results demonstrate that the branched lead of this implantable neural interface system has sufficient mechanical fatigue resistance to withstand strain profiles anticipated when the system is implanted in an arm. The novel test setups and paradigms may be useful in

  18. Association between socioeconomic factors and ICD implantation in a publicly financed health care system

    DEFF Research Database (Denmark)

    Winther-Jensen, Matilde; Hassager, Christian; Lassen, Jens Flensted

    2017-01-01

    Aims: For patients surviving out-of-hospital cardiac arrest (OHCA) with a shockable rhythm, implantable cardioverter defibrillator (ICD) is recommended for non-reversible causes of arrest. We aimed to determine factors associated with implantation of ICD and survival in patients surviving non...... admission. Association to ICD implantation during index admission was analysed in logistic regression, survival was assessed using Cox regression. Implantable cardioverter defibrillator implantation increased during the study period [odds ratio (OR) 1-year increase: 1.04, 95% confidence intervals (95% CI...

  19. Dental implants in medically complex patients-a retrospective study.

    Science.gov (United States)

    Manor, Yifat; Simon, Roy; Haim, Doron; Garfunkel, Adi; Moses, Ofer

    2017-03-01

    Dental implant insertion for oral rehabilitation is a worldwide procedure for healthy and medically compromised patients. The impact of systemic disease risks on the outcome of implant therapy is unclear, since there are few if any published randomized controlled trials (RCTs). The objective of this study is to investigate the rate of complications and failures following dental implantation in medically compromised patients in order to elucidate risk factors and prevent them. A retrospective cohort study was conducted from patient files treated with dental implantation between the years 2008-2014. The study group consisted of medically complex patients while the control group consisted of healthy patients. Preoperative, intraoperative, and post operative clinical details were retrieved from patients' files. The survival rate and the success rate of the dental implants were evaluated clinically and radiographically. A total of 204 patients (1003 dental implants) were included in the research, in the study group, 93 patients with 528 dental implants and in the control group, 111 patients with 475 dental implants. No significant differences were found between the groups regarding implant failures or complications. The failure rate of dental implants among the patients was 11.8 % in the study group and 16.2 % in the control group (P = 0.04). It was found that patients with a higher number of implants (mean 6.8) had failures compared with patients with a lower number of implants (mean 4.2) regardless of their health status (P dental implantation in medically complex patients and in healthy patients. Medically complex patients can undergo dental implantation. There are similar rates of complications and failures of dental implants in medically complex patients and in healthy patients.

  20. Design and optimization of resonance-based efficient wireless power delivery systems for biomedical implants.

    Science.gov (United States)

    Ramrakhyani, A K; Mirabbasi, S; Mu Chiao

    2011-02-01

    Resonance-based wireless power delivery is an efficient technique to transfer power over a relatively long distance. This technique typically uses four coils as opposed to two coils used in conventional inductive links. In the four-coil system, the adverse effects of a low coupling coefficient between primary and secondary coils are compensated by using high-quality (Q) factor coils, and the efficiency of the system is improved. Unlike its two-coil counterpart, the efficiency profile of the power transfer is not a monotonically decreasing function of the operating distance and is less sensitive to changes in the distance between the primary and secondary coils. A four-coil energy transfer system can be optimized to provide maximum efficiency at a given operating distance. We have analyzed the four-coil energy transfer systems and outlined the effect of design parameters on power-transfer efficiency. Design steps to obtain the efficient power-transfer system are presented and a design example is provided. A proof-of-concept prototype system is implemented and confirms the validity of the proposed analysis and design techniques. In the prototype system, for a power-link frequency of 700 kHz and a coil distance range of 10 to 20 mm, using a 22-mm diameter implantable coil resonance-based system shows a power-transfer efficiency of more than 80% with an enhanced operating range compared to ~40% efficiency achieved by a conventional two-coil system.

  1. Development and implantation of application systems for reduction and analysis of experimental data in Nuclear Physics area

    International Nuclear Information System (INIS)

    Cardoso Junior, J.L.; Schelin, H.R.; Lemos, B.J.K.C.; Tanaka, E.H.; Castro, A.T.C.G.

    1984-01-01

    Several application systems for reduction and analysis of experimental data are described. These codes were development and/or implanted in tee IEAv/CTA CYBER 170/750 system. A brief description of the experimental data acquisition modes and the necessary reduction for analysis is given. Information on the purposes, uses and access of the codes are given [pt

  2. Implantation and use of a version of the GAMALTA computer code in the 3.500 M Lecroy system

    International Nuclear Information System (INIS)

    Auler, L.T.

    1984-05-01

    The GAMALTA computer code was implanted in the 3.500 M Le Croy system, for creating an optional analysis function which is charged in RAM memory from a discket. The mode to construct functions to make part of the menu of the system is explained and a procedure to use the GAMALTA code is done. (M.C.K.) [pt

  3. Ion implantation

    International Nuclear Information System (INIS)

    Dearnaley, Geoffrey

    1975-01-01

    First, ion implantation in semiconductors is discussed: ion penetration, annealing of damage, gettering, ion implanted semiconductor devices, equipement requirements for ion implantation. The importance of channeling for ion implantation is studied. Then, some applications of ion implantation in metals are presented: study of the corrosion of metals and alloys; influence or ion implantation on the surface-friction and wear properties of metals; hyperfine interactions in implanted metals

  4. Symmetric Encryption Relying on Chaotic Henon System for Secure Hardware-Friendly Wireless Communication of Implantable Medical Systems

    Directory of Open Access Journals (Sweden)

    Taha Belkhouja

    2018-05-01

    Full Text Available Healthcare remote devices are recognized as a promising technology for treating health related issues. Among them are the wireless Implantable Medical Devices (IMDs: These electronic devices are manufactured to treat, monitor, support or replace defected vital organs while being implanted in the human body. Thus, they play a critical role in healing and even saving lives. Current IMDs research trends concentrate on their medical reliability. However, deploying wireless technology in such applications without considering security measures may offer adversaries an easy way to compromise them. With the aim to secure these devices, we explore a new scheme that creates symmetric encryption keys to encrypt the wireless communication portion. We will rely on chaotic systems to obtain a synchronized Pseudo-Random key. The latter will be generated separately in the system in such a way that avoids a wireless key exchange, thus protecting patients from the key theft. Once the key is defined, a simple encryption system that we propose in this paper will be used. We analyze the performance of this system from a cryptographic point of view to ensure that it offers a better safety and protection for patients.

  5. Toward a distributed free-floating wireless implantable neural recording system.

    Science.gov (United States)

    Pyungwoo Yeon; Xingyuan Tong; Byunghun Lee; Mirbozorgi, Abdollah; Ash, Bruce; Eckhardt, Helmut; Ghovanloo, Maysam

    2016-08-01

    To understand the complex correlations between neural networks across different regions in the brain and their functions at high spatiotemporal resolution, a tool is needed for obtaining long-term single unit activity (SUA) across the entire brain area. The concept and preliminary design of a distributed free-floating wireless implantable neural recording (FF-WINeR) system are presented, which can enabling SUA acquisition by dispersedly implanting tens to hundreds of untethered 1 mm3 neural recording probes, floating with the brain and operating wirelessly across the cortical surface. For powering FF-WINeR probes, a 3-coil link with an intermediate high-Q resonator provides a minimum S21 of -22.22 dB (in the body medium) and -21.23 dB (in air) at 2.8 cm coil separation, which translates to 0.76%/759 μW and 0.6%/604 μW of power transfer efficiency (PTE) / power delivered to a 9 kΩ load (PDL), in body and air, respectively. A mock-up FF-WINeR is implemented to explore microassembly method of the 1×1 mm2 micromachined silicon die with a bonding wire-wound coil and a tungsten micro-wire electrode. Circuit design methods to fit the active circuitry in only 0.96 mm2 of die area in a 130 nm standard CMOS process, and satisfy the strict power and performance requirements (in simulations) are discussed.

  6. Influences of microgap and micromotion of implant-abutment interface on marginal bone loss around implant neck.

    Science.gov (United States)

    Liu, Yang; Wang, Jiawei

    2017-11-01

    To review the influences and clinical implications of micro-gap and micro-motion of implant-abutment interface on marginal bone loss around the neck of implant. Literatures were searched based on the following Keywords: implant-abutment interface/implant-abutment connection/implant-abutment conjunction, microgap, micromotion/micromovement, microleakage, and current control methods available. The papers were then screened through titles, abstracts, and full texts. A total of 83 studies were included in the literature review. Two-piece implant systems are widely used in clinics. However, the production error and masticatory load result in the presence of microgap and micromotion between the implant and the abutment, which directly or indirectly causes microleakage and mechanical damage. Consequently, the degrees of microgap and micromotion further increase, and marginal bone absorption finally occurs. We summarize the influences of microgap and micromotion at the implant-abutment interface on marginal bone loss around the neck of the implant. We also recommend some feasible methods to reduce their effect. Clinicians and patients should pay more attention to the mechanisms as well as the control methods of microgap and micromotion. To reduce the corresponding detriment to the implant marginal bone, suitable Morse taper or hybrid connection implants and platform switching abutments should be selected, as well as other potential methods. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Reliability of implant placement after virtual planning of implant positions using cone beam CT data and surgical (guide) templates.

    Science.gov (United States)

    Nickenig, Hans-Joachim; Eitner, Stephan

    2007-01-01

    We assessed the reliability of implant placement after virtual planning of implant positions using cone-beam CT data and surgical guide templates. A total of 102 patients (250 implants, 55.4% mandibular; mean patient age, 40.4 years) who had undergone implant treatment therapy in an armed forces dental clinic (Cologne, Germany) between July 1, 2005 and December 1, 2005. They were treated with a system that allows transfer of virtual planning to surgical guide templates. Only in eight cases the surgical guides were not used because a delayed implant placement was necessary. In four posterior mandibular cases, handling was limited because of reduced interocclusal distance, requiring 50% shortening of the drill guides. The predictability of implant size was high: only one implant was changed to a smaller diameter (because of insufficient bone). In all cases, critical anatomical structures were protected and no complications were detected in postoperative panoramic radiographs. In 58.1% (147) of the 250 implants, a flapless surgery plan was realized. Implant placement after virtual planning of implant positions using cone beam CT data and surgical templates can be reliable for preoperative assessment of implant size, position, and anatomical complications. It is also indicative of cases amenable to flapless surgery.

  8. Training Requirements and Training Delivery in the Total Army School System

    National Research Council Canada - National Science Library

    Winkler, John

    1999-01-01

    This report analyzes training requirements and school delivery of training in the Total Army School System, focusing on the system's ability to meet its training requirements in Reserve Component Training Institutions...

  9. Aspects of an automatic system of implants of radioactive seeds and anatomic object simulator for tests in prostate brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Leonardo S.M.; Braga, Viviane V.B.; Campos, Tarcísio P. R. de, E-mail: leonardosantiago.lsms@gmail.com, E-mail: vitoriabraga06@gmail.com, E-mail: tprcampos@yahoo.com.br [Universidade Federal de Minas Gerais (PCTN/UFMG), Belo Horizonte (Brazil). Pós-Graduação em Ciências e Técnicas Nucleares. Departamento de Engenharia Nuclear

    2017-07-01

    This work presents the state of the art of the research and development of an automatic radioactive seed implantation system (PSIS). PSIS may assist in the procedure of testing permanent implants in the prostate. These tests will be important in measurements of absorbed doses in the pelvic structures, involving the organs and tissues at risk to improve planning, seed positioning and dosimetry. The automated Prostate Seed Implant System (PSIS) has been designed to meet operational needs, which offers the freedom of positioning of the brachytherapy needle within the treatment area and ensures repeatability and fidelity to the planned treatment. Both the ultrasound probe and the seed implant needle are driven by step motors, Atmega microcontroller, bearings, aluminum shafts and a GUI (Graphical User Interface). Movement of both the probe and the needle holder was performed by fixed spindle on a threaded rod rushing to the step motors by a coupling. The step motors used to move the system consist of step motors used in CNC (Computer Numeric Control) machine. The choice of these engines occurred due to the precision in the movements that can be obtained with these types of motors. The ultrasound probe serves to help, through the images acquired during the longitudinal movement, to monitor the application of the seeds. The parts that make up the system infrastructure were made of aluminum and translucent acrylic and cylindrical aluminum bars of different diameters. All these pieces were fixed and adjusted trough screws, washers, nuts and adhesive to metal, composing the final prototype of the PSIS. The project was developed and the PSIS prototype was assembled. The prototype presented acceptable operating characteristics for prostate implants. The advantage of this system is the automation of the application that provides an accurate positioning and movement of both probe and seed application. In addition to this study, seeds implantation tests will be performed, and

  10. Aspects of an automatic system of implants of radioactive seeds and anatomic object simulator for tests in prostate brachytherapy

    International Nuclear Information System (INIS)

    Silva, Leonardo S.M.; Braga, Viviane V.B.; Campos, Tarcísio P. R. de

    2017-01-01

    This work presents the state of the art of the research and development of an automatic radioactive seed implantation system (PSIS). PSIS may assist in the procedure of testing permanent implants in the prostate. These tests will be important in measurements of absorbed doses in the pelvic structures, involving the organs and tissues at risk to improve planning, seed positioning and dosimetry. The automated Prostate Seed Implant System (PSIS) has been designed to meet operational needs, which offers the freedom of positioning of the brachytherapy needle within the treatment area and ensures repeatability and fidelity to the planned treatment. Both the ultrasound probe and the seed implant needle are driven by step motors, Atmega microcontroller, bearings, aluminum shafts and a GUI (Graphical User Interface). Movement of both the probe and the needle holder was performed by fixed spindle on a threaded rod rushing to the step motors by a coupling. The step motors used to move the system consist of step motors used in CNC (Computer Numeric Control) machine. The choice of these engines occurred due to the precision in the movements that can be obtained with these types of motors. The ultrasound probe serves to help, through the images acquired during the longitudinal movement, to monitor the application of the seeds. The parts that make up the system infrastructure were made of aluminum and translucent acrylic and cylindrical aluminum bars of different diameters. All these pieces were fixed and adjusted trough screws, washers, nuts and adhesive to metal, composing the final prototype of the PSIS. The project was developed and the PSIS prototype was assembled. The prototype presented acceptable operating characteristics for prostate implants. The advantage of this system is the automation of the application that provides an accurate positioning and movement of both probe and seed application. In addition to this study, seeds implantation tests will be performed, and

  11. Novel cemented cup-holding technique while performing total hip arthroplasty with navigation system

    OpenAIRE

    Hirokazu Takai, MD; Tomoki Takahashi, MD, PhD

    2017-01-01

    Recently, navigation systems have been more widely utilized in total hip arthroplasty. However, almost all of these systems have been developed for cementless cups. In the case of cemented total hip arthroplasty using a navigation system, a special-ordered cemented holder is needed. We propose a novel cemented cup-holding technique for navigation systems using readily available articles. We combine a cementless cup holder with an inverted cementless trial cup. The resulting apparatus is used ...

  12. Support for total hip replacement surgery: Structures modeling, Gait Data Analysis and Report system

    Directory of Open Access Journals (Sweden)

    Gianluca Mario Izzo

    2012-03-01

    Full Text Available For the treatment of advanced damages of hip joints, Total Hip Arthroplasty is well proven. Due to the different mechanical properties of the prosthesis material and the bone tissue, a partial unloading of the periprosthetic bone occurs. The bone cement causes reduction in bone density as a result of removal of normal stress from the bone, leading to weakening of the bone in that area and the fracture risk increases. Bone loss is identified as one of the main reasons for loosening of the stem. Otherwise, thanks to the press-fit of the non-cemented stem achieved by surgery, the bone layers immediately adjacent to the stem are preloaded, thus encouraged growing, and the bone getting stronger. The non-cemented stem would be the better choice for every patient, but the question remains if the femur can handle the press- fitting surgery. This studies aim to develop a monitoring techniques based on Gait analysis and bone density changes to assess patient recovery after Total Hip Arthroplasty. Furthermore, to validate computational processes based on 3D modeling and Finite Element Methods for optimizing decision making in the operation process and selecting the suited surgical procedure. A vision could be minimizing risk of periprosthetic fracture during and after surgery. Patients: The sample presents 11 patients receiving cemented implant and 13 for the uncemented. Patients are grouped by type of implant. Three checkpoints were considered: before, after operation and one year later. CT scans, gaitrite and kinepro measurements have been realized. Main outcome measures: Fracture risk probability is higher in bone with low bone mineral density; therefore bones are more fragile in elderly people. BMD is indeed one parameter considered among all the observations. Periprosthetic fracture of the femur is a rare but complex complication of THA, and requires demanding surgery. As such, they result in considerable morbidity and dysfunction. Thus, tests of

  13. IMU-based Real-time Pose Measurement system for Anterior Pelvic Plane in Total Hip Replacement Surgeries.

    Science.gov (United States)

    Zhe Cao; Shaojie Su; Hao Tang; Yixin Zhou; Zhihua Wang; Hong Chen

    2017-07-01

    With the aging of population, the number of Total Hip Replacement Surgeries (THR) increased year by year. In THR, inaccurate position of the implanted prosthesis may lead to the failure of the operation. In order to reduce the failure rate and acquire the real-time pose of Anterior Pelvic Plane (APP), we propose a measurement system in this paper. The measurement system includes two parts: Initial Pose Measurement Instrument (IPMI) and Real-time Pose Measurement Instrument (RPMI). IPMI is used to acquire the initial pose of the APP, and RPMI is used to estimate the real-time pose of the APP. Both are composed of an Inertial Measurement Unit (IMU) and magnetometer sensors. To estimate the attitude of the measurement system, the Extended Kalman Filter (EKF) is adopted in this paper. The real-time pose of the APP could be acquired together with the algorithm designed in the paper. The experiment results show that the Root Mean Square Error (RMSE) is within 1.6 degrees, which meets the requirement of THR operations.

  14. Results of the Total Evolutive Shoulder System (TESS): a single-centre study of 56 consecutive patients.

    Science.gov (United States)

    Kadum, Bakir; Mafi, Nader; Norberg, Sigge; Sayed-Noor, Arkan S

    2011-12-01

    Shoulder arthroplasty surgery has undergone remarkable progress. New concepts like reverse and stemless shoulder prostheses have been widely used. The Total Evolutive Shoulder System (TESS) is a new innovative system that provides the surgeon with different prosthetic versions. The purpose of the present study was to evaluate our short-term results and complications of the TESS. 56 consecutive patients were operated with one of the two versions of TESS (anatomical or reverse) between October 2007 and December 2009. Preoperative and postoperative evaluation of the function and life quality was achieved by the Quick Disability of the Arm, Shoulder and Hand (DASH) index and EQ-5D self-report questionnaire, respectively. Radiographic follow-up by anteroposterior, axillary and lateral views was done. The anterosuperior approach was used in all cases. We compared the outcome in fracture patients with other categories. 49 patients were available for 9-24 months (mean 14) clinical and radiographic postoperative follow-up. The mean of quick DASH improved from 56 preoperatively to 34 postoperatively (p TESS prosthesis showed promising short-term results with few complications. The reverse version could be implanted without stem if initial stability was adequate. Long-term follow-up is required to confirm the results of this innovative system in the long run.

  15. Fiscal 1974 Sunshine Project result report. Research on solar energy utilization systems (total system); 1974 nendo taiyo energy riyo system chosa kenkyu seika hokokusho. Total system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1975-03-01

    The current most important solar energy utilization fields are solar energy power generation (solar heat and photovoltaic power generation), and solar heat cooling and heating. A solar heat power system collects or stores solar thermal energy as energy source of power systems, and converts it to electric power through heat exchange systems. To establish such system, not only R and D on a collector, absorption capsule, storage unit and heat transfer unit, but also complete study on an optimum system configuration and environmental impact are necessary. A photovoltaic power system converts solar energy to electric power directly by photoelectric conversion device such solar cell. Except specific local uses, drastic cost reduction and improvement of a conversion efficiency (at present 12-15%) and life (several years) are necessary for solar cells. Although a lot of solar heat cooling and heating systems is in practical use in Japan, for its further diffusion an important research task is development of heat collector excellent in efficiency, cost, life and maintainability. (NEDO)

  16. The Effect of Systemic Steroid on Hearing Preservation After Cochlear Implantation via Round Window Approach: A Guinea Pig Model.

    Science.gov (United States)

    Chang, Mun Young; Rah, Yoon Chan; Choi, Jun Jae; Woo, Shin Wook; Hwang, Yu-Jung; Eastwood, Hayden; O'Leary, Stephen J; Lee, Jun Ho

    2017-08-01

    When administered perioperatively, systemic dexamethasone will reduce the hearing loss associated with cochlear implantation (CI) performed via the round window approach. The benefits of electroacoustic stimulation have led to interest in pharmacological interventions to preserve hearing after CI. Thirty guinea pigs were randomly divided into three experimental groups: a control group; a 3-day infusion group; and a 7-day infusion group. Dexamethasone was delivered via a mini-osmotic pump for either 3 or 7 days after CI via the round window. Pure tone-evoked auditory brainstem response (ABR) thresholds were monitored for a period of 12 weeks after CI. The cochleae were then collected for histology. At 4 and 12 weeks after CI, ABR threshold shifts were significantly reduced in both 7-day and 3-day infusion groups compared with the control group. Furthermore, the 7-day infusion group has significantly reduced ABR threshold shifts compared with the 3-day infusion group. The total tissue response, including fibrosis and ossification, was significantly reduced in the 7-day infusion group compared with the control group. On multiple regression the extent of fibrosis predicted hearing loss across most frequencies, while hair cell counts predicted ABR thresholds at 32 kHz. Hearing protection after systemic administration of steroids is more effective when continued for at least a week after CI. Similarly, this treatment approach was more effective in reducing the fibrosis that encapsulates the CI electrode. Reduced fibrosis seemed to be the most likely explanation for the hearing protection.

  17. The Columbus Knee System: 4-Year Results of a New Deep Flexion Design Compared to the NexGen Full Flex Implant

    Directory of Open Access Journals (Sweden)

    D. Goebel

    2012-01-01

    Full Text Available The Columbus knee system is designed as a standard knee implant to allow high flexion without additional bone resection. Between August, 2004 and March, 2010 we performed 109 total knee arthroplasties of the Columbus knee system in 101 consecutive patients suffering from primary arthrosis of the knee. Mean age was 72.4 years in women and 70.3 years in men. Mean followup was 47.3 months. The 4-year results of a group of patients who received the NexGen Full Flex implant operated by the same surgeon were used for comparison. Mean total knee score was Columbus: 175.6 and NexGen Flex: 183.4; =0.037. Mean operation time was 53 min for Columbus and 66 min for NexGen Flex; 0.05. Radiological assessment showed no signs of loosening for both groups. Therefore, the Columbus knee system can be recommended for flexion angles up to 140∘.

  18. A comparative evaluation of implant supported zirconia framework gap of two CAD/CAM systems

    Directory of Open Access Journals (Sweden)

    Narges Ameri

    2016-11-01

    computer-aided manufacturing (CAM systems (AmannGirrbach and Zirkonzahn. Materials and Methods: The master model of 3-unit FDP was made of two implant abutments (AmannGirrbach and Zirkonzahn from canine to second premolar. Twelve frameworks were manufactured using each fabricating system from semi-sintered zirconia blanks, which had to be sintered for final density after milling. After manufacturing, the absolute marginal discrepancy in each abutment were determined by means of Video Measurement System (VMS. The data were analyzed, using independent and paired t test (P=0.05. Results: For the premolar abutment, the absolute marginal discrepancy of frameworks fabricated by AmannGirrbach system was significantly greater than those of the other system (P=0.005. There was no significant difference between the marginal discrepancy of canine and premolar abutments (P>0.05. Conclusion: Within the limitations of this study, it could be concluded that the marginal fit of zirconia FDPs was significantly dependent on the CAD/CAM system used, but the abutment size was not an effective factor.

  19. Design and optimization of a 3-coil resonance-based wireless power transfer system for biomedical implants

    KAUST Repository

    Yi, Ying

    2014-09-01

    This paper presents a resonance-based wireless power transfer system using a single layer of inductor coil windings, in a pancake configuration, in order to obtain a compact system for implantable electronic applications. We theoretically analyzed the system and characterized it by measuring its inductance, self-resonant frequency, and quality factor Q. In our resonance-based wireless power transfer prototype, we proposed a 3-coil system, using two 15-mm radius implantable coils, with a resonance frequency of 6.76MHz. This system can effectively transfer power for a distance of up to 50mm. Moreover, our proposed 3-coil system can achieve a high Q-factor and has a comparable power transfer efficiency (PTE) to previously reported works about 3-coil and 4-coil systems. The experimental PTE can achieve 82.4% at a separation distance of 20mm and more than 10% PTE at a distance of 40mm.

  20. Design and optimization of a 3-coil resonance-based wireless power transfer system for biomedical implants

    KAUST Repository

    Yi, Ying; Buttner, Ulrich; Fan, Yiqiang; Foulds, Ian G.

    2014-01-01

    This paper presents a resonance-based wireless power transfer system using a single layer of inductor coil windings, in a pancake configuration, in order to obtain a compact system for implantable electronic applications. We theoretically analyzed the system and characterized it by measuring its inductance, self-resonant frequency, and quality factor Q. In our resonance-based wireless power transfer prototype, we proposed a 3-coil system, using two 15-mm radius implantable coils, with a resonance frequency of 6.76MHz. This system can effectively transfer power for a distance of up to 50mm. Moreover, our proposed 3-coil system can achieve a high Q-factor and has a comparable power transfer efficiency (PTE) to previously reported works about 3-coil and 4-coil systems. The experimental PTE can achieve 82.4% at a separation distance of 20mm and more than 10% PTE at a distance of 40mm.

  1. The construction of distant total distributed measuring and controlling system based on RS-232 communication

    International Nuclear Information System (INIS)

    Shi Chengying; Li Tiantuo; Zhu Wenkai; Zhang Quanhu

    1999-01-01

    The author discusses the construction of distant total distributed measuring and controlling system based on RS-232 communication. The merits of this system are simple construction, reliable performance, big communication distance, and wide covering range. The system fits in with application in radiation environment. The author also discusses the system's hardware equipment and communication protocol

  2. Biomechanical rationale and evaluation of an implant system for rib fracture fixation

    OpenAIRE

    Bottlang, M.; Walleser, S.; Noll, M.; Honold, S.; Madey, S. M.; Fitzpatrick, D.; Long, W. B.

    2010-01-01

    Background Biomechanical research directed at developing customized implant solutions for rib fracture fixation is essential to reduce the complexity and to increase the reliability of rib osteosynthesis. Without a simple and reliable implant solution, surgical stabilization of rib fractures will remain underutilized despite proven benefits for select indications. This article summarizes the research, development, and testing of a specialized and comprehensive implant solution for rib fractur...

  3. Precipitation processes in implanted materials

    International Nuclear Information System (INIS)

    Borders, J.A.

    1978-01-01

    Ion implantation is a nonequilibrium process. It is possible to implant materials with impurities to concentration levels which exceed the solid solubilities. The return of the system to thermodynamic equilibrium is often accomplished by precipitation of the implanted species or a compound involving atoms of both the host and the implanted species. This may involve long time scales when taking place at room temperature or it may take place during the implantation

  4. Stent implantation into the tracheo-bronchial system in rabbits: histopathologic sequelae in bare metal vs. drug-eluting stents.

    Science.gov (United States)

    Sigler, Matthias; Klötzer, Julia; Quentin, Thomas; Paul, Thomas; Möller, Oliver

    2015-12-01

    Stent implantation into the tracheo-bronchial system may be life-saving in selected pediatric patients with otherwise intractable stenosis of the upper airways. Following implantation, significant tissue proliferation may occur, requiring re-interventions. We sought to evaluate the effect of immunosuppressive coating of the stents on the extent of tissue proliferation in an animal model. Bare metal and sirolimus-coated stents (Bx Sonic and Cypher Select, Johnson & Johnson, Cordis) were implanted into non-stenotic lower airways of New Zealand white rabbits (weight 3.1 to 4.8 kg). Three stents with sirolimus coating and six bare metal stents could be analyzed by means of histology and immunohistochemistry 12 months after implantation. On a macroscopic evaluation, all stents were partially covered with a considerable amount of whitish tissue. Histologically, these proliferations contained fiber-rich connective tissue and some fibromuscular cells without significant differences between both stent types. The superficial tissue layer was formed by typical respiratory epithelium and polygonal cells. Abundant lymphocyte infiltrations and moderate granulocyte infiltrations were found in both groups correspondingly, whereas foreign-body reaction was more pronounced around sirolimus-eluting stents. After stent implantation in the tracheo-bronchial system of rabbits, we found tissue reactions comparable to those seen after stent implantation into the vascular system. There was no difference between coated and uncoated stents with regard to quality and quantity of tissue proliferation. We found, however, a significantly different inflammatory reaction with a more pronounced foreign-body reaction in sirolimus-coated stents. In our small series, drug-eluting stents did not exhibit any benefit over bare metal stents in an experimental setting.

  5. Development of a DIPG Orthotopic Model in Mice Using an Implantable Guide-Screw System.

    Directory of Open Access Journals (Sweden)

    Miguel Marigil

    Full Text Available In this work we set to develop and to validate a new in vivo frameless orthotopic Diffuse Intrinsic Pontine Glioma (DIPG model based in the implantation of a guide-screw system.It consisted of a guide-screw also called bolt, a Hamilton syringe with a 26-gauge needle and an insulin-like 15-gauge needle. The guide screw is 2.6 mm in length and harbors a 0.5 mm central hole which accepts the needle of the Hamilton syringe avoiding a theoretical displacement during insertion. The guide-screw is fixed on the mouse skull according to the coordinates: 1mm right to and 0.8 mm posterior to lambda. To reach the pons the Hamilton syringe is adjusted to a 6.5 mm depth using a cuff that serves as a stopper. This system allows delivering not only cells but also any kind of intratumoral chemotherapy, antibodies or gene/viral therapies.The guide-screw was successfully implanted in 10 immunodeficient mice and the animals were inoculated with DIPG human cell lines during the same anesthetic period. All the mice developed severe neurologic symptoms and had a median overall survival of 95 days ranging the time of death from 81 to 116 days. Histopathological analysis confirmed tumor into the pons in all animals confirming the validity of this model.Here we presented a reproducible and frameless DIPG model that allows for rapid evaluation of tumorigenicity and efficacy of chemotherapeutic or gene therapy products delivered intratumorally to the pons.

  6. Dual-modal photoacoustic and ultrasound imaging of dental implants

    Science.gov (United States)

    Lee, Donghyun; Park, Sungjo; Kim, Chulhong

    2018-02-01

    Dental implants are common method to replace decayed or broken tooth. As the implant treatment procedures varies according to the patients' jawbone, bone ridge, and sinus structure, appropriate examinations are necessary for successful treatment. Currently, radiographic examinations including periapical radiology, panoramic X-ray, and computed tomography are commonly used for diagnosing and monitoring. However, these radiographic examinations have limitations in that patients and operators are exposed to radioactivity and multiple examinations are performed during the treatment. In this study, we demonstrated photoacoustic (PA) and ultrasound (US) combined imaging of dental implant that can lower the total amount of absorbed radiation dose in dental implant treatment. An acoustic resolution PA macroscopy and a clinical PA/US system was used for dental implant imaging. The acquired dual modal PA/US imaging results support that the proposed photoacoustic imaging strategy can reduce the radiation dose rate during dental implant treatment.

  7. Control of Insects in Slash Pine Cones with Trunk Implantations of Bidrin® Systemic Insecticide - First-Year Results

    Science.gov (United States)

    Edward P. Merkel

    1969-01-01

    Initial experiments with the implantation of the systemic insecticide Bidrin® into the trunks of slash pines in a seed production area resulted in various degrees of control of coneworms, Dioryctria spp., and the pine seed-worm, Laspeyresia anaronjada Miller, depending on dosage rates and time of application. When applied in early...

  8. Fiscal 1976 Sunshine Project result report. Research on solar energy utilization systems (total system); 1976 nendo taiyo energy riyo system chosa kenkyu seika hokokusho. Total system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1977-03-01

    For every solar energy utilization field, its background, feasibility, impact in practical use, and R and D policy in Japan were studied. Heating and hot water supply by solar energy are already practical because of less technical problems and reasonable profitability, and cooling is also practical as far as a technical viewpoint. At present, the technical level of solar heat power generation is in the stage of basic technology, however, in the future, development of economically reasonable systems will be demanded as well as establishment of its technology. The most difficult problem for realizing practical solar cell power generation systems is cost reduction. It is also another problem that a big demand of Si for solar cells further exceeds the current yield of Si in a semiconductor industry. A small-scale hybrid solar cell power generation system applicable to the roof of general residences is already feasible. Although a solar furnace is still poor in application to industrial fields, it is expected as the leading part for a future solar heat chemical industry. (NEDO)

  9. PREVAIL TRANSAPICAL: multicentre trial of transcatheter aortic valve implantation using the newly designed bioprosthesis (SAPIEN-XT) and delivery system (ASCENDRA-II).

    Science.gov (United States)

    Walther, Thomas; Thielmann, Matthias; Kempfert, Joerg; Schroefel, Holger; Wimmer-Greinecker, Gerhard; Treede, Hendrik; Wahlers, Thorsten; Wendler, Olaf

    2012-08-01

    Transapical (TA) aortic valve implantation (AVI) has evolved as an alternative procedure for high-risk patients. We evaluated the second-generation SAPIEN XT™ prosthesis in a prospective multicentre clinical trial. A total of 150 patients (age: 81.6 ± 5.8 years; 40.7% female) were included. Prosthetic valves (diameter: 23 mm (n = 36), 26 mm (n = 57) and 29 mm (n = 57)) were implanted. The ASCENDRA-II™ modified delivery system was used in the smaller sizes. Mean logistic EuroSCORE was 24.3 ± 7.0%, and mean STS score 7.5 ± 4.4%. All patients gave written informed consent. Off-pump AVI was performed using femoral arterial and venous access wires as a safety net. All but two patients received TA-AVI, as planned. The 29-mm valve showed similar function as the values of two other diameters did. Three patients (2%) required temporary cardiopulmonary bypass support. Postoperative complications included renal failure requiring long-term dialysis in four, bleeding requiring rethoracotomy in four, respiratory complication requiring reintubation in eight and sepsis in four patients, respectively. Thirty-day mortality was 13 (8.7%) for the total cohort and 2/57 (3.5%) for patients receiving the 29-mm valve, respectively. Echocardiography at discharge showed none or trivial aortic incompetence (AI) in 71% and mild-AI in 22% of the patients. Post-implantation AI was predominantly paravalvular and ≥ 2+ in 7% of patients. One patient required reoperation for AI within 30 days. The PREVAIL TA multicentre trial demonstrates good functionality and good outcomes for TA-AVI, using the SAPIEN XT™ prosthesis and its second-generation ASCENDRA-II™ delivery system, as well successful introduction of the 29-mm SAPIEN XT™ valve for the benefit of high-risk elderly patients.

  10. Optical system optimization of the microprobe beamline of the Ion Implantation Laboratory (IF-UFRGS), Brazil

    International Nuclear Information System (INIS)

    Bauer, Deiverti de Vila

    2015-01-01

    The aim of the present work is to optimize the microprobe beamline of the Ion Implantation Laboratory (IF-UFRGS). In short, an ion microprobe consists of charged particles focused to the dimensions of a few micrometers. The focusing system is made of two slits for demagnification, a set of magnetic lenses with scanning capability and a reaction chamber. By changing the parameters related to this system, one can optimize the features of the beam. To that end, samples of poly(tereftalate etylene) were irradiated with 2.2 MeV H+ ions and etched, yielding 2D microstructures with high aspect ratio. The analysis of the structures with Scanning Electron Microscopy proved to be an important tool in order to establish a correlation between the size of the microstructures and the parameters of the focusing system. In this work, the causes leading to a beam enlargement are discussed, as well as the aberrations which affect the system. Finally, the advantages of using ions for lithography purposes is pointed out. (author)

  11. Optimization of stand-alone photovoltaic systems with hydrogen storage for total energy self-sufficiency

    Energy Technology Data Exchange (ETDEWEB)

    Lund, P D [Helsinki Univ. of Technology, Espoo (Finland). Dept. of Technical Physics

    1991-01-01

    A new method for optimization of stand-alone photovoltaic-hydrogen energy systems is presented. The methodology gives the optimum values for the solar array and hydrogen storage size for any given system configuration and geographical site. Sensitivity analyses have been performed to study the effect of subsystem efficiencies on the total system performance and sizing, and also to identify possibilities for further improvements. Optimum system configurations have also been derived. The results indicate that a solar-hydrogen energy system is a very promising potential alternative for low power applications requiring a total electricity self-sufficiency. (Author).

  12. Novel cemented cup-holding technique while performing total hip arthroplasty with navigation system.

    Science.gov (United States)

    Takai, Hirokazu; Takahashi, Tomoki

    2017-09-01

    Recently, navigation systems have been more widely utilized in total hip arthroplasty. However, almost all of these systems have been developed for cementless cups. In the case of cemented total hip arthroplasty using a navigation system, a special-ordered cemented holder is needed. We propose a novel cemented cup-holding technique for navigation systems using readily available articles. We combine a cementless cup holder with an inverted cementless trial cup. The resulting apparatus is used as a cemented cup holder. The upside-down cup-holding technique is useful and permits cemented cup users to utilize a navigation system for placement of the acetabular component.

  13. Novel cemented cup-holding technique while performing total hip arthroplasty with navigation system

    Directory of Open Access Journals (Sweden)

    Hirokazu Takai, MD

    2017-09-01

    Full Text Available Recently, navigation systems have been more widely utilized in total hip arthroplasty. However, almost all of these systems have been developed for cementless cups. In the case of cemented total hip arthroplasty using a navigation system, a special-ordered cemented holder is needed. We propose a novel cemented cup-holding technique for navigation systems using readily available articles. We combine a cementless cup holder with an inverted cementless trial cup. The resulting apparatus is used as a cemented cup holder. The upside-down cup-holding technique is useful and permits cemented cup users to utilize a navigation system for placement of the acetabular component.

  14. Direct tumor in vivo dosimetry in highly-conformal radiotherapy: A feasibility study of implantable MOSFETs for hypofractionated extracranial treatments using the Cyberknife system

    International Nuclear Information System (INIS)

    Scalchi, Paolo; Righetto, Roberto; Cavedon, Carlo; Francescon, Paolo; Colombo, Federico

    2010-01-01

    Purpose: In highly-conformal radiotherapy, due to the complexity of both beam configurations and dose distributions, traditional in vivo dosimetry is unpractical or even impossible. The ideal dosimeter would be implanted inside the planning treatment volume so that it can directly measure the total delivered dose during each fraction with no additional uncertainty due to calculation models. The aim of this work is to verify if implantable metal oxide semiconductors field effect transistors (MOSFETs) can achieve a sufficient degree of dosimetric accuracy when used inside extracranial targets undergoing radiotherapy treatments using the Cyberknife system. Methods: Based on the preliminary findings of this study, new prototypes for high dose fractionations were developed to reduce the time dependence for long treatment delivery times. These dosimeters were recently cleared and are marketed as DVS-HFT. Multiple measurements were performed using both Virtual Water and water phantoms to characterize implantable MOSFETs under the Cyberknife beams, and included the reference-dosimetry consistency, the dependence of the response on the collimator size, on the daily delivered dose, and the time irradiation modality. Finally a Cyberknife prostate treatment simulation using a body phantom was conducted, and both MOSFET and ionization readings were compared to Monte Carlo calculations. The feasibility analysis was conducted based on the ratios of the absorbed dose divided by the dose reading, named as ''further calibration factor'' (FCF). Results: The average FCFs resulted to be 0.98 for the collimator dependence test, and about 1.00 for the reference-dosimetry test, the dose-dependence test, and the time-dependence test. The average FCF of the prostate treatment simulation test was 0.99. Conclusions: The obtained results are well within DVS specifications, that is, the factory calibration is still valid for such kind of treatments using the Cyberknife system, with no need of

  15. Predicting the Failure of Dental Implants Using Supervised Learning Techniques

    Directory of Open Access Journals (Sweden)

    Chia-Hui Liu

    2018-05-01

    Full Text Available Prosthodontic treatment has been a crucial part of dental treatment for patients with full mouth rehabilitation. Dental implant surgeries that replace conventional dentures using titanium fixtures have become the top choice. However, because of the wide-ranging scope of implant surgeries, patients’ body conditions, surgeons’ experience, and the choice of implant system should be considered during treatment. The higher price charged by dental implant treatments compared to conventional dentures has led to a rush among medical staff; therefore, the future impact of surgeries has not been analyzed in detail, resulting in medial disputes. Previous literature on the success factors of dental implants is mainly focused on single factors such as patients’ systemic diseases, operation methods, or prosthesis types for statistical correlation significance analysis. This study developed a prediction model for providing an early warning mechanism to reduce the chances of dental implant failure. We collected the clinical data of patients who received artificial dental implants at the case hospital for a total of 8 categories and 20 variables. Supervised learning techniques such as decision tree (DT, support vector machines, logistic regressions, and classifier ensembles (i.e., Bagging and AdaBoost were used to analyze the prediction of the failure of dental implants. The results show that DT with both Bagging and Adaboost techniques possesses the highest prediction performance for the failure of dental implant (area under the receiver operating characteristic curve, AUC: 0.741; the analysis also revealed that the implant systems affect dental implant failure. The model can help clinical surgeons to reduce medical failures by choosing the optimal implant system and prosthodontics treatments for their patients.

  16. Systemic Assessment of Calcium and Phosphorus Level after Implantation of Porous Iron in Rats

    Science.gov (United States)

    Siallagan, S. F.; Amelia, F.; Utami, N. D.; Ulum, M. F.; Boediono, A.; Estuningsih, S.; Hermawan, H.; Noviana, D.

    2017-07-01

    One of important aspects in bone healing process is physiological level of calcium (Ca), and phosphorus (P) that can be altered by implantation of biodegradable porous iron. Therefore, this study aims to investigate the concentration of Ca, P and Ca/P ratio in the peripheral blood during the implantation period up to 4 months. Forty adult male Sprague Dawley rats were used and divided into 3 groups receiving different pore size of iron implants (pore size 450, 580, 800μm) and one group of sham. The implants (5x2x0.5mm) were inserted into flat bone defects at latero-medial of femoral bone. Blood sample was taken from ventral tail artery before and after 4 month of implantation. Calcium and P concentrations in the blood were determined by BA-88A Semi-Auto Chemistry Analyzer. Results showed that concentration of Ca and P are slightly higher after implantation than before implantation, except for the 450μm group. The Ca/P ratio before and after implantation was increased in the sham group, and decreased in the 450 and 800μm groups. Concentration of Ca, P and Ca/P ratio insignificantly change between before and 4 months after surgery in some groups.

  17. Comparative cost analyses: total flow vs other power conversion systems for the Salton Sea Geothermal Resource

    Energy Technology Data Exchange (ETDEWEB)

    Wright, G.W.

    1978-09-18

    Cost studies were done for Total Flow, double flash, and multistage flash binary systems for electric Energy production from the Salton Sea Geothermal Resource. The purpose was to provide the Department of energy's Division of Geothermal Energy with information by which to judge whether to continue development of the Total Flow system. Results indicate that the Total Flow and double flash systems have capital costs of $1,135 and $1,026 /kW with energy costs of 40.9 and 39.7 mills/kW h respectively. The Total Flow and double flash systems are not distinguishable on a cost basis alone; the multistage flash binary system, with capital cost of $1,343 /kW and energy cost of 46.9 mills/kW h, is significantly more expensive. If oil savings are considered in the total analysis, the Total Flow system could save 30% more oil than the double flash system, $3.5 billion at 1978 oil prices.

  18. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  19. Do illness rating systems predict discharge location, length of stay, and cost after total hip arthroplasty?

    Directory of Open Access Journals (Sweden)

    Sarah E. Rudasill, BA

    2018-06-01

    Conclusions: These findings suggest that although ASA classifications predict discharge location and SOI scores predict length of stay and total costs, other factors beyond illness rating systems remain stronger predictors of discharge for THA patients.

  20. Implantable and transdermal polymeric drug delivery technologies for the treatment of central nervous system disorders.

    Science.gov (United States)

    Govender, Thiresen; Choonara, Yahya E; Kumar, Pradeep; Bijukumar, Divya; du Toit, Lisa C; Modi, Girish; Naidoo, Dinesh; Pillay, Viness

    2017-06-01

    The complexity of the brain and the membranous blood-brain barrier (BBB) has proved to be a significant limitation to the systemic delivery of pharmaceuticals to the brain rendering them sub-therapeutic and ineffective in the treatment of neurological diseases. Apart from this, lack of innovation in product development to counteract the problem is also a major contributing factor to a poor therapeutic outcome. Various innovative strategies show potential in treating some of the neurological disorders; however, drug delivery remains the most popular. To attain therapeutic drug levels in the central nervous system, large, intolerable systemic doses are generally administered. The major factors responsible for the success maintenance therapy of neurological diseases included controlled and sustained release of neurotherapeutics, reduced frequency of administration, higher bioavailability, and patient compliances. Conventional oral or injectable formulations cannot satisfy all the requirements in many circumstances. This article reviews the therapeutic implantable polymeric and transdermal devices employed in an attempt to effectively achieve therapeutic quantities of drug across the BBB over a prolonged period, to improve patient disease prognosis.

  1. Wear at the Implant-Abutment Interface of Zirconia Abutments Manufactured by Three CAD/CAM Systems.

    Science.gov (United States)

    Pinheiro Tannure, Ana Luiza; Cunha, Alfredo Gonçalves; Borges Junior, Luiz Antônio; da Silva Concílio, Laís Regiane; Claro Neves, Ana Christina

    To evaluate the changes in the external-hexagon surface of the titanium (Ti) implant before and after mechanical cycling, when coupled with zirconia (Zr) abutments (A) manufactured by three computer-aided design/computer-aided manufacturing (CAD/CAM) systems (Neodent Digital, Zirkonzahn, and AmannGirrbach) and the ZrTi abutment manufactured by Neodent. Four groups were formed (n = 6): titanium implant with Zr AmannGirrbach abutment (AZrAG), with Zr Zirkonzahn abutment (AZrZ), with Zr Neodent abutment (AZrN), and with Zr abutment with infrastructure in Ti Neodent (AZrTiN). Standardized abutments were made from three identical abutments milled in wax. Images of the surface of each side of the hexagons of the implant were obtained by scanning electron microscopy, before and after mechanical cycling, to evaluate the parameters: (1) scratches in the hexagon face; (2) hexagon superior shoulder kneading; (3) hexagon shoulder wear; (4) alterations on the hexagon base; and (5) scratches on the hexagon top. The abutments were coupled with the implants, and Cr-Co crowns were cemented. The implant/abutment/crown assemblies were submitted to mechanical cycling (400 N, 8.0 Hz) for 1 million cycles. The observed changes were classified as follows: absence (0), mild (1), moderate (2), and severe (3). The results were analyzed using the Mann-Whitney, Kruskal-Wallis, and Dunn tests (P abutments, the AZrN group had shown more surface alterations. Among the Zr groups, AZrZ samples had shown the most altered surfaces, suggesting that alterations on the implant/Zr abutment hexagon surfaces are related to the abutment milled hexagon shape.

  2. Impact of Intentional Overload on Joint Stability of Internal Implant-Abutment Connection System with Different Diameter.

    Science.gov (United States)

    Lee, Ji-Hye; Lee, Won; Huh, Yoon-Hyuk; Park, Chan-Jin; Cho, Lee-Ra

    2017-09-05

    To evaluate the axial displacement of the implant-abutment assembly of different implant diameter after static and cyclic loading of overload condition. An internal conical connection system with three diameters (Ø 4.0, 4.5, and 5.0) applying identical abutment dimension and the same abutment screw was evaluated. Axial displacement of abutment and reverse torque loss of abutment screw were evaluated under static and cyclic loading conditions. Static loading test groups were subjected to vertical static loading of 250, 400, 500, 600, 700, and 800 N consecutively. Cyclic loading test groups were subjected to 500 N cyclic loading to evaluate the effect of excessive masticatory loading. After abutment screw tightening for 30 Ncm, axial displacement was measured upon 1, 3, 10, and 1,000,000 cyclic loadings of 500 N. Repeated-measure ANOVA and 2-way ANOVA were used for statistical analysis (α = 0.05). The increasing magnitude of vertical load and thinner wall thickness of implant increased axial displacement of abutment and reverse torque loss of abutment screw (p < 0.05). Implants in the Ø 5.0 diameter group demonstrated significantly low axial displacement, and reverse torque loss after static loading than Ø 4.0 and Ø 4.5 diameter groups (p < 0.05). In the cyclic loading test, all diameter groups of implant showed significant axial displacement after 1 cycle of loading of 500 N (p < 0.05). There was no significant axial displacement after 3, 10, or 1,000,000 cycles of loading (p = 0.603). Implants with Ø 5.0 diameter demonstrated significantly low axial displacement and reverse torque loss after the cyclic and static loading of overload condition. © 2017 by the American College of Prosthodontists.

  3. Evaluation of stabilization techniques for ion implant processing

    Science.gov (United States)

    Ross, Matthew F.; Wong, Selmer S.; Minter, Jason P.; Marlowe, Trey; Narcy, Mark E.; Livesay, William R.

    1999-06-01

    With the integration of high current ion implant processing into volume CMOS manufacturing, the need for photoresist stabilization to achieve a stable ion implant process is critical. This study compares electron beam stabilization, a non-thermal process, with more traditional thermal stabilization techniques such as hot plate baking and vacuum oven processing. The electron beam processing is carried out in a flood exposure system with no active heating of the wafer. These stabilization techniques are applied to typical ion implant processes that might be found in a CMOS production process flow. The stabilization processes are applied to a 1.1 micrometers thick PFI-38A i-line photoresist film prior to ion implant processing. Post stabilization CD variation is detailed with respect to wall slope and feature integrity. SEM photographs detail the effects of the stabilization technique on photoresist features. The thermal stability of the photoresist is shown for different levels of stabilization and post stabilization thermal cycling. Thermal flow stability of the photoresist is detailed via SEM photographs. A significant improvement in thermal stability is achieved with the electron beam process, such that photoresist features are stable to temperatures in excess of 200 degrees C. Ion implant processing parameters are evaluated and compared for the different stabilization methods. Ion implant system end-station chamber pressure is detailed as a function of ion implant process and stabilization condition. The ion implant process conditions are detailed for varying factors such as ion current, energy, and total dose. A reduction in the ion implant systems end-station chamber pressure is achieved with the electron beam stabilization process over the other techniques considered. This reduction in end-station chamber pressure is shown to provide a reduction in total process time for a given ion implant dose. Improvements in the ion implant process are detailed across

  4. Irradiation influence on Mylar and Makrofol induced by argon ions in a plasma immersion ion implantation system

    Energy Technology Data Exchange (ETDEWEB)

    Hassan, A. [Accelerators & Ion Sources Department, Nuclear Research Center, Atomic Energy Authority, P.O. 13759, Cairo (Egypt); El-Saftawy, A.A., E-mail: aama1978@yahoo.com [Accelerators & Ion Sources Department, Nuclear Research Center, Atomic Energy Authority, P.O. 13759, Cairo (Egypt); Aal, S.A. Abd El [Central Lab. for Elemental & Isotopic Analysis, Nuclear Research Center, Atomic Energy Authority, P.O. 13759, Cairo (Egypt); Ghazaly, M. El [Physiology Department, College of Medicine, Taif University, P.O. 888, Taif (Saudi Arabia); Physics Department, Faculty of Science, Zagazig University, P.O. 44519, Zagazig (Egypt)

    2015-08-30

    Highlights: • A home-built plasma immersion ion implantation system was tested in modifying surfaces. • Wettability modifications within the energy range 10 keV implantation are not investigated elsewhere, up to our knowledge. • The wettability of Mylar and Makrofol surface was enhanced by the dual effect of ion implantation and plasma treatment. • The improved wettability was found to depend on both surface roughness and chemistry. • The adhesive bonding and surface energy of the polymers are improved. - Abstract: Mylar and Makrofol polycarbonate polymers were irradiated by Ar ions in a plasma immersion ion implantation (PIII) system. The surface wettability of both polymers was investigated by employing the contact angle method. The measured contact angles were found to depend on the surface layer properties. Good wetting surfaces were found to depend not only on surface roughness but also on its chemistry that analyzed by Fourier transform infrared (FTIR) spectroscopy. Surfaces topography and roughness was investigated and correlated to their surface energy which studied with the aid of acid-base model for evaluating the improvement of surface wettability after irradiation. PIII improves polymers surface properties efficiently in a controllable way.

  5. Chewing efficiency and maximum bite force with different attachment systems of implant overdentures: a crossover study.

    Science.gov (United States)

    Elsyad, Moustafa Abdou; Khairallah, Ahmed Samir

    2017-06-01

    This crossover study aimed to evaluate and compare chewing efficiency and maximum bite force (MBF) with resilient telescopic and bar attachment systems of implant overdentures in patients with atrophied mandibles. Ten participants with severely resorbed mandibles and persistent denture problems received new maxillary and mandibular conventional dentures (control, CD). After 3 months of adaptation, two implants were inserted in canine region of the mandible. In a quasi-random method, overdentures were connected to the implants with either bar overdentures (BOD) or resilient telescopic overdentures (TOD) attachment systems. Chewing efficiency in terms of unmixed fraction (UF) was measured using chewing gum (after 5, 10, 20, 30 and 50 strokes), and MBF was measured using a bite force transducer. Measurements were performed 3 months after using each of the following prostheses: CD, BOD and TOD. Chewing efficiency and MBF increased significantly with BOD and TOD compared to CD. As the number of chewing cycles increased, the UF decreased. TOD recorded significant higher chewing efficiency and MBF than BOD. Resilient telescopic attachments are associated with increased chewing efficiency and MBF compared bar attachments when used to retain overdentures to the implants in patients with atrophied mandibles. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. Comparison of two systems for rigidly connecting 2.0-mm bone screws to an implantable device : in vitro stability testing

    NARCIS (Netherlands)

    van Loon, JP; de Bont, LGM; Verkerke, GJ

    The stability of a screw-fixed implantable device can be improved by eliminating the freedom of movement between the screws and the device. Two systems have been developed for rigidly connecting 2.0-mm bone screws to an implantable device, and the aim of this study was to test and compare the

  7. Speech Understanding with a New Implant Technology: A Comparative Study with a New Nonskin Penetrating Baha System

    OpenAIRE

    Kurz, Anja; Flynn, Mark; Caversaccio, Marco; Kompis, Martin

    2014-01-01

    Objective. To compare hearing and speech understanding between a new, nonskin penetrating Baha system (Baha Attract) to the current Baha system using a skin-penetrating abutment. Methods. Hearing and speech understanding were measured in 16 experienced Baha users. The transmission path via the abutment was compared to a simulated Baha Attract transmission path by attaching the implantable magnet to the abutment and then by adding a sample of artificial skin and the external parts of the Baha...

  8. Development of data communication system with ultra high frequency radio wave for implantable artificial hearts.

    Science.gov (United States)

    Tsujimura, Shinichi; Yamagishi, Hiroto; Sankai, Yoshiyuki

    2009-01-01

    In order to minimize infection risks of patients with artificial hearts, wireless data transmission methods with electromagnetic induction or light have been developed. However, these methods tend to become difficult to transmit data if the external data transmission unit moves from its proper position. To resolve this serious problem, the purpose of this study is to develop a prototype wireless data communication system with ultra high frequency radio wave and confirm its performance. Due to its high-speed communication rate, low power consumption, high tolerance to electromagnetic disturbances, and secure wireless communication, we adopted Bluetooth radio wave technology for our system. The system consists of an internal data transmission unit and an external data transmission unit (53 by 64 by 16 mm, each), and each has a Bluetooth module (radio field intensity: 4 dBm, receiver sensitivity: -80 dBm). The internal unit also has a micro controller with an 8-channel 10-bit A/D converter, and the external unit also has a RS-232C converter. We experimented with the internal unit implanted into pig meat, and carried out data transmission tests to evaluate the performance of this system in tissue thickness of up to 3 mm. As a result, data transfer speeds of about 20 kbps were achieved within the communication distance of 10 m. In conclusion, we confirmed that the system can wirelessly transmit the data from the inside of the body to the outside, and it promises to resolve unstable data transmission due to accidental movements of an external data transmission unit.

  9. Transcatheter embolization of renal neoplasms. A comparison of the merits of the radio-active infarct implant versus total embolization with inert material

    International Nuclear Information System (INIS)

    Lang, E.K.; Pisco, J.M.

    1980-01-01

    Transcatheter embolization with radio-active infarct particles and inert embolic material has been proposed for adjuvant therapy in the management of renal cell carcinoma. Transcatheter embolization with inert embolic material has been advocated in preparation for surgical resection of renal tumours. Embolization with radio-active infarct particles is undertaken to deliver a tumouricidal dose to the primary neoplasm. The resultant interstitial implant offers the advantage of a high dose to the primary tumour, choice of time of delivery of the radiant energy by selection of a radio-isotope with appropriate half-life, and limitation of the integral dose to the patient by selection of appropriate physical characteristics of the radio-isotope utilized. Transcatheter embolization with radio-active infarct particles is advocated either as definitive therapy for clearly inoperable neoplasms, or in hope to make an initially inoperable neoplasm operable. (Auth.)

  10. Influence of the ion implantation on the nanoscale intermetallic phases formation in Ni-Ti system

    International Nuclear Information System (INIS)

    Kalashnikov, M.P.; Kurzina, I.A.; Bozhko, I.A.; Kozlov, E.V.; Fortuna, S.V.; Sivin, D.O.; Stepanov, I.B.; Sharkeev, Yu.P.

    2005-01-01

    Full text: The ion implantation at a high intensity mode is an effective method for modification of the surface properties of metals and alloys. Improvement of mechanical and tribological properties of irradiated materials using the high intensity implantation is connected with an element composition and microstructure modification of the surface and subsurface layers. One shows a great interest in intermetallic phase's synthesis by ion implantation, because of unique physical-mechanical properties of the intermetallic compounds. The influence of the irradiation conditions on the structural state and surface properties of implanted materials is not clear enough. The study of the factors influencing on the formation of the surface ion - alloyed layers of metal targets having the high tribological and mechanical properties by high intensity ion implantation is actual. The aim of the present work is a study of the microstructure, phase composition, physical and mechanical properties of the ion-alloyed Ni surfaces formed at high intensity implantation of Ti ions. The implantation Ti ions into Ni samples at high intensity mode was realized using ion source 'Raduga - 5'. The implantation Ti ions into Ni was carried out at accelerating voltage 20 kV for 2 h. The regimes were differed in the samples temperature (580 - 700 K), the distance from the ion implanted samples to the ion source (0.43-0.93 m) and the dose of irradiated ions (0.3·10 18 -2.9·10 18 ion/cm -2 ). The element composition of the implanted samples was analyzed by the electron spectroscopy. The structural-phase state of the Ni ion-modified layers was investigated by the transmission electron microscopy and X-ray diffraction methods. Additionally, the investigation of mechanical and tribological properties of the implanted Ni samples was carried out. It was established that the maximum thickness of the ion-alloyed nickel layers at high intensity mode allows forming the nanoscale intermetallic phases (Ni

  11. Spinal shape modulation in a porcine model by a highly flexible and extendable non-fusion implant system

    NARCIS (Netherlands)

    Wessels, Martijn; Hekman, Edsko E G; Kruyt, Moyo C.; Castelein, RM; Homminga, Jasper J.; Verkerke, Gijsbertus J.

    2016-01-01

    Purpose: In vivo evaluation of scoliosis treatment using a novel approach in which two posterior implants are implanted: XSLAT (eXtendable implant correcting Scoliosis in LAT bending) and XSTOR (eXtendable implant correcting Scoliosis in TORsion). The highly flexible and extendable implants use only

  12. Grain-A Java data analysis system for Total Data Readout

    International Nuclear Information System (INIS)

    Rahkila, P.

    2008-01-01

    Grain is a data analysis system developed to be used with the novel Total Data Readout data acquisition system. In Total Data Readout all the electronics channels are read out asynchronously in singles mode and each data item is timestamped. Event building and analysis has to be done entirely in the software post-processing the data stream. A flexible and efficient event parser and the accompanying software system have been written entirely in Java. The design and implementation of the software are discussed along with experiences gained in running real-life experiments

  13. In vitro culture of pre-implanted mouse embryos. A model system for studying combined effects

    International Nuclear Information System (INIS)

    Streffer, C.; Beuningen, D. van; Molls, M.; Pon, A.; Schulz, S.; Zamboglou, N.

    1978-01-01

    Studies on combined effects, e.g. interaction between chemical toxicants and ionizing radiation, are difficult to perform, as they are dependent on many factors (substance concentration, radiation dose, sequence of treatments, etc.). In order to obtain data from such studies it is necessary to establish a comparatively simple experimental model system. We have established such a model system by studying combined effects on pre-implanted mouse embryos cultured in vitro. This system has the following advantages: (1) The embryos can be cultivated for several days in vitro; (2) Their physiological intactness can be tested; and (3) Cell proliferation, cell killing and chromosomal damage can be investigated comparatively easily. The embryos are isolated at the 2-cell stage and incubated in a culture medium in vitro. The development of the embryos is followed under the microscope until the development of blastocysts or the hatching of blastocysts is observed. These blastocysts can be transplanted to fostered mice and the development of normal animals determined. The proliferation kinetics can be studied easily, and the methods are described. A method has also been developed to measure the DNA content of individual cells by microscope fluorometry. After treatment of the embryos with ionizing radiation or drugs the release of micronuclei has been observed from the cell nuclei, which is an expression for chromosomal damage. Substances or radionuclides can be added to the culture medium or external irradiation can be performed during the culture period. Also the combined effects of radiation and heating can be studied. The effects of X-rays and tritiated compounds have also been investigated. The combined effects of radiation with antibiotics such as actinomycin D, and environmental toxicants such as lead, have been determined. The system described has been useful to evaluate cytological, teratogenic and cytogenetic effects

  14. From Fertilisation to Implantation in Mammalian Pregnancy—Modulation of Early Human Reproduction by the Endocannabinoid System

    Directory of Open Access Journals (Sweden)

    Justin C. Konje

    2010-09-01

    Full Text Available There is an increasing recognition that the endocannabinoid system is the crucial cytokine-hormone system regulating early human pregnancy. The synchronous development of the fertilized embryo and the endometrium to ensure timely implantation has been shown to be one of the pivotal steps to successful implantation. This development is thought to be regulated by a finely balanced relationship between various components of the endocannabinoid system in the endometrium, the embryo and the Fallopian tube. In addition, this system has also been shown to be involved in the regulation of the development and maturation of the gametes prior to fertilization. In this review, we will examine the evidence from animal and human studies to support the role of the endocannabinoid system in gametogenesis, fertilization, implantation, early pregnancy maintenance, and in immunomodulation of pregnancy. We will discuss the role of the cannabinoid receptors and the enzymes involved in the synthesis and degradation of the key endocannabinoid ligands (e.g., anandamide and 2-arachinoylglycerol in early reproduction.

  15. Pacemaker dependency after transcatheter aortic valve implantation with the self-expanding Medtronic CoreValve System.

    Science.gov (United States)

    van der Boon, Robert M A; Van Mieghem, Nicolas M; Theuns, Dominic A; Nuis, Rutger-Jan; Nauta, Sjoerd T; Serruys, Patrick W; Jordaens, Luc; van Domburg, Ron T; de Jaegere, Peter P T

    2013-09-30

    To determine pacemaker (PM) dependency at follow-up visit in patients who underwent new permanent pacemaker implantation (PPI) following transcatheter aortic valve implantation (TAVI). Single center prospective observational study including 167 patients without previous PM implantation who underwent TAVI with the self-expanding Medtronic CoreValve System (MCS) between November 2005 and February 2011. PM dependency was defined by the presence of a high degree atrioventricular block (HDAVB; second [AV2] and third degree [AV3B]), or a slow (atrial fibrilation with slow response (n=1, 2.8%) and left bundle branch block (n=1, 2.8%). Long term follow-up was complete for all patients and ranged from 1 to 40 months (median (IQR): 11.5 (5.0-18.0 months). Of those patients with a HDAVB, 16 out of the 30 patients (53.3%) were PM independent at follow-up visit (complete or partial resolution of the AV conduction abnormality). Overall, 20 out of the 36 patients (55.6%) who received a new PM following TAVI were PM independent at follow-up. Partial and even complete resolution of peri-operative AV conduction abnormalities after MCS valve implantation occurred in more than half of the patients. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  16. Biocompatibility and Systemic Safety of a Novel Implantable Annuloplasty Ring for the Treatment of Mitral Regurgitation in a Minipig Model.

    Science.gov (United States)

    Ramot, Yuval; Rousselle, Serge D; Yellin, Nadav; Willenz, Udi; Sabag, Itai; Avner, Avi; Nyska, Abraham

    2016-07-01

    Prosthetic annuloplasty rings are a common treatment modality for mitral regurgitation, and recently, percutaneous implantation techniques have gained popularity due to their favorable safety profile. Although in common use, biocompatibility of annuloplasty rings has been reported only sparsely in the literature, and none of these reports used the percutaneous technique of implantation. We report on the biocompatibility and the systemic safety of a novel transcatheter mitral valve annuloplasty ring (AMEND™) in 6 minipigs. This device is composed of a nitinol tube surrounded by a braided polyethylene terephthalate fabric tube. The device produced no adverse inflammatory response, showing gradual integration between the metal ring and the fabric by normal host fibrocellular response, leading to complete neoendocardium coverage. There was no evidence for adverse reactions, rejection, or intolerance in the valvular structure. In 2 animals, hemopericardium resulted from the implantation procedure, leading to right-sided cardiac insufficiency with pulmonary edema and liver congestion. The findings reported herein can serve as a case study for the expected healing pathology reactions after implantation of transcatheter mitral valve annuloplasty rings. © The Author(s) 2016.

  17. Clinical Parameters and Crestal Bone Loss in Internal Versus External Hex Implants at One Year after Loading

    Directory of Open Access Journals (Sweden)

    HamidReza Arab

    2015-09-01

    Full Text Available Introduction: The survival of an implant system is affected by the choice of antirotational design, which can include an external or internal hex. Implant success also is affected by the maintenance of the crestal bone around implants. The aim of present study was to evaluate the crestal bone loss and clinical parameters related to bone loss in patients loaded with an external or internal hex 3i implant (3i Implant Innovation, Palm Beach Gardens, FL, USA. The evaluations were performed one year after loading. Materials and Methods: A total of 39 implants (23 external hex, 16 internal hex were placed randomly in 23 patients (10 male, 13 female by a submerged approach. None of patients had compromised conditions or parafunctional habits. At placement and at one year after loading, periapical radiographs were taken via the parallel method from the implant sites. Results: Crestal bone loss was -0.712±0.831 mm in implants with an internal hex connection and -0.139±0.505 mm in implants with an external hex connection (P≤0.05. No correlation was found between crestal bone loss and parameters such as age, gender, jaw, implant location (anterior, premolar, or molar, implant diameter, or implant length. Conclusions: Crestal bone loss was greater in patients with internal hex 3i implants than in those with external implants. Similar results in other clinical factors were found between the groups.

  18. Design and simulation of a totally digital image system for medical image applications

    International Nuclear Information System (INIS)

    Archwamety, C.

    1987-01-01

    The Totally Digital Imaging System (TDIS) is based on system requirements information from the Radiology Department, University of Arizona Health Science Center. This dissertation presents the design of this complex system, the TDIS specification, the system performance requirements, and the evaluation of the system using the computer-simulation programs. Discrete-event simulation models were developed for the TDIS subsystems, including an image network, imaging equipment, storage migration algorithm, data base archive system, and a control and management network. The simulation system uses empirical data generation and retrieval rates measured at the University Medical Center hospital. The entire TDIS system was simulated in Simscript II.5 using a VAX 8600 computer system. Simulation results show the fiber-optical-image network to be suitable; however, the optical-disk-storage system represents a performance bottleneck

  19. Degradation products of irradiated haloperidol: implications for the development of an implantible delivery system

    Energy Technology Data Exchange (ETDEWEB)

    Booker, J

    1988-01-01

    Haloperidol was chosen as a model compound to determine whether the degradation products created by sterilizing dose of gamma radiation would contaminate an implantible delivery device and be hazardous to the health of the person using it. Acrolein, chlorobenzene, and several other products were identified among the degradation products. They were quantitated and evaluated as being potentially dangerous. It is recommended that the development protocol for a radiation-sterilized, implantible drug include the identification and evaluation of the degradation products.

  20. Degradation products of irradiated haloperidol: implications for the development of an implantible delivery system

    International Nuclear Information System (INIS)

    Booker, J.

    1988-01-01

    Haloperidol was chosen as a model compound to determine whether the degradation products created by sterilizing dose of gamma radiation would contaminate an implantible delivery device and be hazardous to the health of the person using it. Acrolein, chlorobenzene, and several other products were identified among the degradation products. They were quantitated and evaluated as being potentially dangerous. It is recommended that the development protocol for a radiation-sterilized, implantible drug include the identification and evaluation of the degradation products. (author)

  1. Systemic levels of metallic ions released from orthodontic mini-implants.

    Science.gov (United States)

    de Morais, Liliane Siqueira; Serra, Glaucio Guimarães; Albuquerque Palermo, Elisabete Fernandes; Andrade, Leonardo Rodrigues; Müller, Carlos Alberto; Meyers, Marc André; Elias, Carlos Nelson

    2009-04-01

    Orthodontic mini-implants are a potential source of metallic ions to the human body because of the corrosion of titanium (Ti) alloy in body fluids. The purpose of this study was to gauge the concentration of Ti, aluminum (Al), and vanadium (V), as a function of time, in the kidneys, livers, and lungs of rabbits that had Ti-6Al-4V alloy orthodontic mini-implants placed in their tibia. Twenty-three New Zealand rabbits were randomly divided into 4 groups: control, 1 week, 4 weeks, and 12 weeks. Four orthodontic mini-implants were placed in the left proximal tibia of 18 rabbits. Five control rabbits had no orthodontic mini-implants. After 1, 4, and 12 weeks, the rabbits were killed, and the selected tissues were extracted and prepared for analysis by graphite furnace atomic absorption spectrophotometry. Low amounts of Ti, Al, and V were detectable in the 1-week, 4-weeks, and 12-weeks groups, confirming that release of these metals from the mini-implants occurs, with diffusion and accumulation in remote organs. Despite the tendency of ion release when using the Ti alloy as orthodontic mini-implants, the amounts of metals detected were significantly below the average intake of these elements through food and drink and did not reach toxic concentrations.

  2. Radiologic total lung capacity measurement. Development and evaluation of a computer-based system

    Energy Technology Data Exchange (ETDEWEB)

    Seeley, G.W.; Mazzeo, J.; Borgstrom, M.; Hunter, T.B.; Newell, J.D.; Bjelland, J.C.

    1986-11-01

    The development of a computer-based radiologic total lung capacity (TLC) measurement system designed to be used by non-physician personnel is detailed. Four operators tested the reliability and validity of the system by measuring inspiratory PA and lateral pediatric chest radiographs with a Graf spark pen interfaced to a DEC VAX 11/780 computer. First results suggest that the ultimate goal of developing an accurate and easy to use TLC measurement system for non-physician personnel is attainable.

  3. A low power cyclic ADC design for a wireless monitoring system for orthopedic implants

    Energy Technology Data Exchange (ETDEWEB)

    Chen Yi; Li Fule; Chen Hong; Zhang Chun; Wang Zhihua, E-mail: chenyi02@mails.tsinghua.edu.c [Tsinghua National Laboratory for Information Science and Technology, Institute of Microelectronics, Tsinghua University, Beijing 100084 (China)

    2009-08-15

    This paper presents a low power cyclic analog-to-digital convertor (ADC) design for a wireless monitoring system for orthopedic implants. A two-stage cyclic structure including a single to differential converter, two multiplying DAC functional blocks (MDACs) and some comparators is adopted, which brings moderate speed and moderate resolution with low power consumption. The MDAC is implemented with the common switched capacitor method. The 1.5-bit stage greatly simplifies the design of the comparator. The operational amplifier is carefully optimized both in schematic and layout for low power and offset. The prototype chip has been fabricated in a United Microelectronics Corporation (UMC) 0.18-{mu}m 1P6M CMOS process. The core of the ADC occupies only 0.12 mm{sup 2}. With a 304.7-Hz input and 4-kHz sampling rate, the measured peak SNDR and SFDR are 47.1 dB and 57.8 dBc respectively and its DNL and INL are 0.27 LSB and 0.3 LSB, respectively. The power consumption of the ADC is only 12.5 {mu}W in normal working mode and less than 150 nW in sleep mode. (semiconductor integrated circuits)

  4. Hollow Abutment Screw Design for Easy Retrieval in Case of Screw Fracture in Dental Implant System.

    Science.gov (United States)

    Sim, Bo Kyun; Kim, Bongju; Kim, Min Jeong; Jeong, Guk Hyun; Ju, Kyung Won; Shin, Yoo Jin; Kim, Man Yong; Lee, Jong-Ho

    2017-01-01

    The prosthetic component of dental implant is attached on the abutment which is connected to the fixture with an abutment screw. The abutment screw fracture is not frequent; however, the retrieval of the fractured screw is not easy, and it poses complications. A retrieval kit was developed which utilizes screw removal drills to make a hole on the fractured screw that provides an engaging drill to unscrew it. To minimize this process, the abutment screw is modified with a prefabricated access hole for easy retrieval. This study aimed to introduce this modified design of the abutment screw, the concept of easy retrieval, and to compare the mechanical strengths of the conventional and hollow abutment screws by finite element analysis (FEA) and mechanical test. In the FEA results, both types of abutment screws showed similar stress distribution in the single artificial tooth system. A maximum load difference of about 2% occurred in the vertical load by a mechanical test. This study showed that the hollow abutment screw may be an alternative to the conventional abutment screws because this is designed for easy retrieval and that both abutment screws showed no significant difference in the mechanical tests and in the FEA.

  5. Hollow Abutment Screw Design for Easy Retrieval in Case of Screw Fracture in Dental Implant System

    Directory of Open Access Journals (Sweden)

    Bo Kyun Sim

    2017-01-01

    Full Text Available The prosthetic component of dental implant is attached on the abutment which is connected to the fixture with an abutment screw. The abutment screw fracture is not frequent; however, the retrieval of the fractured screw is not easy, and it poses complications. A retrieval kit was developed which utilizes screw removal drills to make a hole on the fractured screw that provides an engaging drill to unscrew it. To minimize this process, the abutment screw is modified with a prefabricated access hole for easy retrieval. This study aimed to introduce this modified design of the abutment screw, the concept of easy retrieval, and to compare the mechanical strengths of the conventional and hollow abutment screws by finite element analysis (FEA and mechanical test. In the FEA results, both types of abutment screws showed similar stress distribution in the single artificial tooth system. A maximum load difference of about 2% occurred in the vertical load by a mechanical test. This study showed that the hollow abutment screw may be an alternative to the conventional abutment screws because this is designed for easy retrieval and that both abutment screws showed no significant difference in the mechanical tests and in the FEA.

  6. Hollow Abutment Screw Design for Easy Retrieval in Case of Screw Fracture in Dental Implant System

    Science.gov (United States)

    Kim, Bongju; Shin, Yoo Jin

    2017-01-01

    The prosthetic component of dental implant is attached on the abutment which is connected to the fixture with an abutment screw. The abutment screw fracture is not frequent; however, the retrieval of the fractured screw is not easy, and it poses complications. A retrieval kit was developed which utilizes screw removal drills to make a hole on the fractured screw that provides an engaging drill to unscrew it. To minimize this process, the abutment screw is modified with a prefabricated access hole for easy retrieval. This study aimed to introduce this modified design of the abutment screw, the concept of easy retrieval, and to compare the mechanical strengths of the conventional and hollow abutment screws by finite element analysis (FEA) and mechanical test. In the FEA results, both types of abutment screws showed similar stress distribution in the single artificial tooth system. A maximum load difference of about 2% occurred in the vertical load by a mechanical test. This study showed that the hollow abutment screw may be an alternative to the conventional abutment screws because this is designed for easy retrieval and that both abutment screws showed no significant difference in the mechanical tests and in the FEA. PMID:29065610

  7. Total robotic radical rectal resection with da Vinci Xi system: single docking, single phase technique.

    Science.gov (United States)

    Tamhankar, Anup Sunil; Jatal, Sudhir; Saklani, Avanish

    2016-12-01

    This study aims to assess the advantages of Da Vinci Xi system in rectal cancer surgery. It also assesses the initial oncological outcomes after rectal resection with this system from a tertiary cancer center in India. Robotic rectal surgery has distinct advantages over laparoscopy. Total robotic resection is increasing following the evolution of hybrid technology. The latest Da Vinci Xi system (Intuitive Surgical, Sunnyvale, USA) is enabled with newer features to make total robotic resection possible with single docking and single phase. Thirty-six patients underwent total robotic resection in a single phase and single docking. We used newer port positions in a straight line. Median distance from the anal verge was 4.5 cm. Median robotic docking time and robotic procedure time were 9 and 280 min, respectively. Median blood loss was 100 mL. One patient needed conversion to an open approach due to advanced disease. Circumferential resection margin and longitudinal resection margins were uninvolved in all other patients. Median lymph node yield was 10. Median post-operative stay was 7 days. There were no intra-operative adverse events. The latest Da Vinci Xi system has made total robotic rectal surgery feasible in single docking and single phase. With the new system, four arm total robotic rectal surgery may replace the hybrid technique of laparoscopic and robotic surgery for rectal malignancies. The learning curve for the new system appears to be shorter than anticipated. Early perioperative and oncological outcomes of total robotic rectal surgery with the new system are promising. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  8. Small-displacement sensing system based on multiple total internal reflections in heterodyne interferometry.

    Science.gov (United States)

    Wang, Shinn-Fwu; Chiu, Ming-Hung; Chen, Wei-Wu; Kao, Fu-Hsi; Chang, Rong-Seng

    2009-05-01

    A small-displacement sensing system based on multiple total internal reflections in heterodyne interferometry is proposed. In this paper, a small displacement can be obtained only by measuring the variation in phase difference between s- and p-polarization states for the total internal reflection effect. In order to improve the sensitivity, we increase the number of total internal reflections by using a parallelogram prism. The theoretical resolution of the method is better than 0.417 nm. The method has some merits, e.g., high resolution, high sensitivity, and real-time measurement. Also, its feasibility is demonstrated.

  9. [Electromagnetic fields of mobile telephone systems--thresholds, effects and risks for cochlear implant patients and healthy people].

    Science.gov (United States)

    Bischof, F; Langer, J; Begall, K

    2008-11-01

    Every day life is detectably affected by manifold natural sources of electromagnetic fields (EMF), e. g. infrared radiation, light and the terrestrial magnetic field. However, there is still uncertainty about the consequences or hazards of artificial EMF, which emerge from mobile phone or wireless network (wireless local area network [WLAN]) services, for instance. Following recommendations of the International Commission on Non-Ionizing Radiation Protection (ICNIRP) the German Commission on Radiation Protection (SSK) defined corresponding thresholds for high frequency electromagnetic fields (HF-EMF) in 2003. By observing those thresholds HF-EMF is thought to be innocent so far. However, there is still controversial discussion about induction of cancer or neurovegetative symptoms due to inconsistent study results. Patients with cochlea implants are of particular interest within the speciality of otorhinolaryngology due to specific hazards, which arise during mobile telephone use from the distance between brain and inductive metal implants (electrode) on the one hand and the electronic system of the cochlear implant and the source of HF-EMF on the other hand. Besides many studies about the impact of HF-EMF on common welfare, there are only very few surveys (n = 6) covering the effects on patients with cochlear implants. The purpose of this paper is to overview sources, thresholds and subsequently harmful or harmless effects of HFEMF. Due to the current state of knowledge about the impact of mobile phone use on health, we assume, that HF-EMF are harmless both for healthy people and patients with cochlea implants, provided that legal thresholds are observed.

  10. Employee Engagement Is Vital for the Successful Selection of a Total Laboratory Automation System.

    Science.gov (United States)

    Yu, Hoi-Ying E; Wilkerson, Myra L

    2017-11-08

    To concretely outline a process for selecting a total laboratory automation system that connects clinical chemistry, hematology, and coagulation analyzers and to serve as a reference for other laboratories. In Phase I, a committee including the laboratory's directors and technologists conducted a review of 5 systems based on formal request for information process, site visits, and vendor presentations. We developed evaluation criteria and selected the 2 highest performing systems. In Phase II, we executed a detailed comparison of the 2 vendors based on cost, instrument layout, workflow design, and future potential. In addition to selecting a laboratory automation system, we used the process to ensure employee engagement in preparation for implementation. Selecting a total laboratory automation system is a complicated process. This paper provides practical guide in how a thorough selection process can be done with participation of key stakeholders. © American Society for Clinical Pathology, 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  11. Institutional applications of solar total-energy systems. Draft final report. Volume 2. Appendixes

    Energy Technology Data Exchange (ETDEWEB)

    None

    1978-07-01

    The appendices present the analytical basis for the analysis of solar total energy (STE) systems. A regional-climate model and a building-load requirements model are developed, along with fuel-price scenarios. Life-cycle costs are compared for conventional-utility, total energy, and STE systems. Thermal STE system design trade-offs are performed and thermal STE system performance is determined. The sensitivity of STE competitiveness to fuel prices is examined. The selection of the photovoltaic array is briefly discussed. The institutional-sector decision processes are analyzed. Hypothetical regional back-up rates and electrical-energy costs are calculated. The algorithms and equations used in operating the market model are given, and a general methodology is developed for projecting the size of the market for STE systems and applied to each of 8 institutional subsectors. (LEW)

  12. Patients with intolerance reactions to total knee replacement: combined assessment of allergy diagnostics, periprosthetic histology, and peri-implant cytokine expression pattern.

    Science.gov (United States)

    Thomas, Peter; von der Helm, Christine; Schopf, Christoph; Mazoochian, Farhad; Frommelt, Lars; Gollwitzer, Hans; Schneider, Josef; Flaig, Michael; Krenn, Veit; Thomas, Benjamin; Summer, Burkhard

    2015-01-01

    We performed a combined approach to identify suspected allergy to knee arthroplasty (TKR): patch test (PT), lymphocyte transformation test (LTT), histopathology (overall grading; T- and B-lymphocytes, macrophages, and neutrophils), and semiquantitative Real-time-PCR-based periprosthetic inflammatory mediator analysis (IFNγ, TNFα, IL1-β, IL-2, IL-6, IL-8, IL-10, IL17, and TGFβ). We analyzed 25 TKR patients with yet unexplained complications like pain, effusion, and reduced range of motion. They consisted of 20 patients with proven metal sensitization (11 with PT reactions; 9 with only LTT reactivity). Control specimens were from 5 complicated TKR patients without metal sensitization, 12 OA patients before arthroplasty, and 8 PT patients without arthroplasty. Lymphocytic infiltrates were seen and fibrotic (Type IV membrane) tissue response was most frequent in the metal sensitive patients, for example, in 81% of the PT positive patients. The latter also had marked periprosthetic IFNγ expression. 8/9 patients with revision surgery using Ti-coated/oxinium based implants reported symptom relief. Our findings demonstrate that combining allergy diagnostics with histopathology and periprosthetic cytokine assessment could allow us to design better diagnostic strategies.

  13. Patients with Intolerance Reactions to Total Knee Replacement: Combined Assessment of Allergy Diagnostics, Periprosthetic Histology, and Peri-implant Cytokine Expression Pattern

    Directory of Open Access Journals (Sweden)

    Peter Thomas

    2015-01-01

    Full Text Available We performed a combined approach to identify suspected allergy to knee arthroplasty (TKR: patch test (PT, lymphocyte transformation test (LTT, histopathology (overall grading; T- and B-lymphocytes, macrophages, and neutrophils, and semiquantitative Real-time-PCR-based periprosthetic inflammatory mediator analysis (IFNγ, TNFα, IL1-β, IL-2, IL-6, IL-8, IL-10, IL17, and TGFβ. We analyzed 25 TKR patients with yet unexplained complications like pain, effusion, and reduced range of motion. They consisted of 20 patients with proven metal sensitization (11 with PT reactions; 9 with only LTT reactivity. Control specimens were from 5 complicated TKR patients without metal sensitization, 12 OA patients before arthroplasty, and 8 PT patients without arthroplasty. Lymphocytic infiltrates were seen and fibrotic (Type IV membrane tissue response was most frequent in the metal sensitive patients, for example, in 81% of the PT positive patients. The latter also had marked periprosthetic IFNγ expression. 8/9 patients with revision surgery using Ti-coated/oxinium based implants reported symptom relief. Our findings demonstrate that combining allergy diagnostics with histopathology and periprosthetic cytokine assessment could allow us to design better diagnostic strategies.

  14. Cochlear Implant

    Directory of Open Access Journals (Sweden)

    Mehrnaz Karimi

    1992-04-01

    Full Text Available People with profound hearing loss are not able to use some kinds of conventional amplifiers due to the nature of their loss . In these people, hearing sense is stimulated only when the auditory nerve is activated via electrical stimulation. This stimulation is possible through cochlear implant. In fact, for the deaf people who have good mental health and can not use surgical and medical treatment and also can not benefit from air and bone conduction hearing aids, this device is used if they have normal central auditory system. The basic parts of the device included: Microphone, speech processor, transmitter, stimulator and receiver, and electrode array.

  15. Repair of segmental bone defect using Totally Vitalized tissue engineered bone graft by a combined perfusion seeding and culture system.

    Directory of Open Access Journals (Sweden)

    Lin Wang

    Full Text Available BACKGROUND: The basic strategy to construct tissue engineered bone graft (TEBG is to combine osteoblastic cells with three dimensional (3D scaffold. Based on this strategy, we proposed the "Totally Vitalized TEBG" (TV-TEBG which was characterized by abundant and homogenously distributed cells with enhanced cell proliferation and differentiation and further investigated its biological performance in repairing segmental bone defect. METHODS: In this study, we constructed the TV-TEBG with the combination of customized flow perfusion seeding/culture system and β-tricalcium phosphate (β-TCP scaffold fabricated by Rapid Prototyping (RP technique. We systemically compared three kinds of TEBG constructed by perfusion seeding and perfusion culture (PSPC method, static seeding and perfusion culture (SSPC method, and static seeding and static culture (SSSC method for their in vitro performance and bone defect healing efficacy with a rabbit model. RESULTS: Our study has demonstrated that TEBG constructed by PSPC method exhibited better biological properties with higher daily D-glucose consumption, increased cell proliferation and differentiation, and better cell distribution, indicating the successful construction of TV-TEBG. After implanted into rabbit radius defects for 12 weeks, PSPC group exerted higher X-ray score close to autograft, much greater mechanical property evidenced by the biomechanical testing and significantly higher new bone formation as shown by histological analysis compared with the other two groups, and eventually obtained favorable healing efficacy of the segmental bone defect that was the closest to autograft transplantation. CONCLUSION: This study demonstrated the feasibility of TV-TEBG construction with combination of perfusion seeding, perfusion culture and RP technique which exerted excellent biological properties. The application of TV-TEBG may become a preferred candidate for segmental bone defect repair in orthopedic and

  16. Short-term results of the reverse Total Evolutive Shoulder System (TESS) in cuff tear arthropathy and revision arthroplasty cases.

    Science.gov (United States)

    von Engelhardt, Lars Victor; Manzke, Michael; Filler, Timm J; Jerosch, Joerg

    2015-07-01

    The aim of this study was to evaluate the clinical and radiological outcome of the Total Evolutive Shoulder System (TESS) in patients with cuff tear arthropathy and patients in need of a revision arthroplasty. In this sequential study, 67 patients (56 non-stemmed, 11 stemmed) were evaluated after a mean follow-up of 17.5 months. The relative Constant and DASH scores, radiological joint geometry changes, complications and postoperative problems, which are not likely to affect the outcome, were evaluated. A significant increase was noticed for the relative Constant (11.3 vs. 78.8 %) and DASH scores (73.7 vs. 31.8) without significant differences between both etiology groups. Complication rates were similar to previous studies. An aseptic loosening of the non-stemmed humeral component was not noticed in the cuff tear arthropathy group, whereas one case with a loosening was noticed in the revision arthroplasty group. With nine cases (13.4 %), scapular notching rates were very low. On average, the acromiohumeral distance increased by 17 mm and the humeral offset by 13.9 mm; the height of the center of rotation decreased by 4.6 mm and the lateral glenohumeral offset by 6.1 mm, p TESS system provided adequate distalization and medialization of the humerus and the center of rotation. This corresponds to a good clinical outcome. The use of the surgical opportunity to implant the prosthesis with a relatively low neck-shaft angle might explain the low rates of scapular notching in our series. Regarding the case with a loosening of the humeral component, the surgeon should carefully indicate a stemless version for metaphyseal press-fit fixation in patients with revision arthroplasty.

  17. Total system performance assessment - 1995: An evaluation of the potential Yucca Mountain repository

    Energy Technology Data Exchange (ETDEWEB)

    Atkins, J.E.; Lee, J.H.; Lingineni, S.; Mishra, S; McNeish, J.A.; Sassani, D.C.; Sevougian, S.D.

    1995-11-01

    The U.S. Department of Energy (DOE) is currently investigating the feasibility of permanently disposing the nation`s commercial high-level radioactive wastes (in the form of spent fuel from the over 100 electric power-generating nuclear reactors across the U.S.) and a portion of the defense high-level radioactive wastes (currently stored at federal facilities around the country) in the unsaturated tuffaceous rocks at Yucca Mountain, Nevada. Quantitative predictions based on the most current understanding of the processes and parameters potentially affecting the long-term behavior of the disposal system are used to assess the ability of the site and its associated engineered designs to meet regulatory objectives of the US NRC and the US EPA. The evaluation of the ability of the overall system to meet the performance objectives specified in the applicable regulatory standards has been termed total system performance assessment (TSPA). Total system performance assessments require the explicit quantification of the relevant processes and process interactions. In addition assessments are useful to help define the most significant processes, the information gaps and uncertainties and therefore the additional information required for more robust and defensible assessment of the overall performance. The aim of any total system performance assessment is to be as complete and reasonably conservative as possible and to assure that the descriptions of the predictive models and parameters are sufficient to ascertain their accuracy. Total system performance assessments evolve with time. Previous iterations of total system performance assessment of the Yucca Mountain site and associated engineered barriers have been conducted in 1991 and 1993.

  18. Total system performance assessment - 1995: An evaluation of the potential Yucca Mountain repository

    International Nuclear Information System (INIS)

    Atkins, J.E.; Lee, J.H.; Lingineni, S.; Mishra, S.; McNeish, J.A.; Sassani, D.C.; Sevougian, S.D.

    1995-11-01

    The U.S. Department of Energy (DOE) is currently investigating the feasibility of permanently disposing the nation's commercial high-level radioactive wastes (in the form of spent fuel from the over 100 electric power-generating nuclear reactors across the U.S.) and a portion of the defense high-level radioactive wastes (currently stored at federal facilities around the country) in the unsaturated tuffaceous rocks at Yucca Mountain, Nevada. Quantitative predictions based on the most current understanding of the processes and parameters potentially affecting the long-term behavior of the disposal system are used to assess the ability of the site and its associated engineered designs to meet regulatory objectives of the US NRC and the US EPA. The evaluation of the ability of the overall system to meet the performance objectives specified in the applicable regulatory standards has been termed total system performance assessment (TSPA). Total system performance assessments require the explicit quantification of the relevant processes and process interactions. In addition assessments are useful to help define the most significant processes, the information gaps and uncertainties and therefore the additional information required for more robust and defensible assessment of the overall performance. The aim of any total system performance assessment is to be as complete and reasonably conservative as possible and to assure that the descriptions of the predictive models and parameters are sufficient to ascertain their accuracy. Total system performance assessments evolve with time. Previous iterations of total system performance assessment of the Yucca Mountain site and associated engineered barriers have been conducted in 1991 and 1993

  19. Total System Performance Assessment, 1993: An evaluation of the potential Yucca Mountain repository

    International Nuclear Information System (INIS)

    Andrews, R.W.; Dale, T.F.; McNeish, J.A.

    1994-03-01

    Total System Performance Assessments are an important component in the evaluation of the suitability of Yucca Mountain, Nevada as a potential site for a mined geologic repository for the permanent disposal of high-level radioactive wastes in the United States. The Total System Performance Assessments are conducted iteratively during site characterization to identify issues which should be addressed by the characterization and design activities as well as providing input to regulatory/licensing and programmatic decisions. During fiscal years 1991 and 1992, the first iteration of Total System Performance Assessment (hereafter referred to as TSPA 1991) was completed by Sandia National Laboratories and Pacific Northwest Laboratory. Beginning in fiscal year 1993, the Civilian Radioactive Waste Management System Management and Operating Contractor was assigned the responsibility to plan, coordinate, and contribute to the second iteration of Total System Performance Assessment (hereafter referred to as TSPA 1993). This document presents the objectives, approach, assumptions, input, results, conclusions, and recommendations associated with the Management and Operating Contractor contribution to TSPA 1993. The new information incorporated in TSPA 1993 includes (1) revised estimates of radionuclide solubilities (and their thermal and geochemical dependency), (2) thermal and geochemical dependency of spent fuel waste alteration and glass dissolution rates, (3) new distribution coefficient (k d ) estimates, (4) revised estimates of gas-phase velocities and travel times, and (5) revised hydrologic modeling of the saturated zone which provides updated estimates of the advective flux through the saturated zone

  20. Total System Performance Assessment, 1993: An evaluation of the potential Yucca Mountain repository

    Energy Technology Data Exchange (ETDEWEB)

    Andrews, R.W.; Dale, T.F.; McNeish, J.A.

    1994-03-01

    Total System Performance Assessments are an important component in the evaluation of the suitability of Yucca Mountain, Nevada as a potential site for a mined geologic repository for the permanent disposal of high-level radioactive wastes in the United States. The Total System Performance Assessments are conducted iteratively during site characterization to identify issues which should be addressed by the characterization and design activities as well as providing input to regulatory/licensing and programmatic decisions. During fiscal years 1991 and 1992, the first iteration of Total System Performance Assessment (hereafter referred to as TSPA 1991) was completed by Sandia National Laboratories and Pacific Northwest Laboratory. Beginning in fiscal year 1993, the Civilian Radioactive Waste Management System Management and Operating Contractor was assigned the responsibility to plan, coordinate, and contribute to the second iteration of Total System Performance Assessment (hereafter referred to as TSPA 1993). This document presents the objectives, approach, assumptions, input, results, conclusions, and recommendations associated with the Management and Operating Contractor contribution to TSPA 1993. The new information incorporated in TSPA 1993 includes (1) revised estimates of radionuclide solubilities (and their thermal and geochemical dependency), (2) thermal and geochemical dependency of spent fuel waste alteration and glass dissolution rates, (3) new distribution coefficient (k{sub d}) estimates, (4) revised estimates of gas-phase velocities and travel times, and (5) revised hydrologic modeling of the saturated zone which provides updated estimates of the advective flux through the saturated zone.

  1. Analysis of the total system life cycle cost for the Civilian Radioactive Waste Management Program

    International Nuclear Information System (INIS)

    1989-05-01

    The total-system life-cycle cost (TSLCC) analysis for the Department of Energy's (DOE) Civilian Radioactive Waste Management Program is an ongoing activity that helps determine whether the revenue-producing mechanism established by the Nuclear Waste Policy Act of 1982 -- a fee levied on electricity generated in commercial nuclear power plants -- is sufficient to cover the cost of the program. This report provides cost estimates for the sixth annual evaluation of the adequacy of the fee and is consistent with the program strategy and plans contained in the DOE's Draft 1988 Mission Plan Amendment. The total-system cost for the system with a repository at Yucca Mountain, Nevada, a facility for monitored retrievable storage (MRS), and a transportation system is estimated at $24 billion (expressed in constant 1988 dollars). In the event that a second repository is required and is authorized by the Congress, the total-system cost is estimated at $31 to $33 billion, depending on the quantity of spent fuel to be disposed of. The $7 billion cost savings for the single-repository system in comparison with the two-repository system is due to the elimination of $3 billion for second-repository development and $7 billion for the second-repository facility. These savings are offset by $2 billion in additional costs at the first repository and $1 billion in combined higher costs for the MRS facility and transportation. 55 refs., 2 figs., 24 tabs

  2. A decision-making framework for total ownership cost management of complex systems: A Delphi study

    Science.gov (United States)

    King, Russel J.

    This qualitative study, using a modified Delphi method, was conducted to develop a decision-making framework for the total ownership cost management of complex systems in the aerospace industry. The primary focus of total ownership cost is to look beyond the purchase price when evaluating complex system life cycle alternatives. A thorough literature review and the opinions of a group of qualified experts resulted in a compilation of total ownership cost best practices, cost drivers, key performance factors, applicable assessment methods, practitioner credentials and potential barriers to effective implementation. The expert panel provided responses to the study questions using a 5-point Likert-type scale. Data were analyzed and provided to the panel members for review and discussion with the intent to achieve group consensus. As a result of the study, the experts agreed that a total ownership cost analysis should (a) be as simple as possible using historical data; (b) establish cost targets, metrics, and penalties early in the program; (c) monitor the targets throughout the product lifecycle and revise them as applicable historical data becomes available; and (d) directly link total ownership cost elements with other success factors during program development. The resultant study framework provides the business leader with incentives and methods to develop and implement strategies for controlling and reducing total ownership cost over the entire product life cycle when balancing cost, schedule, and performance decisions.

  3. Integration of project management and systems engineering: Tools for a total-cycle environmental management system

    International Nuclear Information System (INIS)

    Blacker, P.B.; Winston, R.

    1997-01-01

    An expedited environmental management process has been developed at the Idaho National Engineering and Environmental Laboratory (INEEL). This process is one result of the Lockheed Martin commitment to the US Department of Energy to incorporate proven systems engineering practices with project management and program controls practices at the INEEL. Lockheed Martin uses a graded approach of its management, operations, and systems activities to tailor the level of control to the needs of the individual projects. The Lockheed Martin definition of systems engineering is: ''''Systems Engineering is a proven discipline that defines and manages program requirements, controls risk, ensures program efficiency, supports informed decision making, and verifies that products and services meet customer needs.'''' This paper discusses: the need for an expedited environmental management process; how the system was developed; what the system is; what the system does; and an overview of key components of the process

  4. Reliable and energy-efficient communications for wireless biomedical implant systems.

    Science.gov (United States)

    Ntouni, Georgia D; Lioumpas, Athanasios S; Nikita, Konstantina S

    2014-11-01

    Implant devices are used to measure biological parameters and transmit their results to remote off-body devices. As implants are characterized by strict requirements on size, reliability, and power consumption, applying the concept of cooperative communications to wireless body area networks offers several benefits. In this paper, we aim to minimize the power consumption of the implant device by utilizing on-body wearable devices, while providing the necessary reliability in terms of outage probability and bit error rate. Taking into account realistic power considerations and wireless propagation environments based on the IEEE P802.l5 channel model, an exact theoretical analysis is conducted for evaluating several communication scenarios with respect to the position of the wearable device and the motion of the human body. The derived closed-form expressions are employed toward minimizing the required transmission power, subject to a minimum quality-of-service requirement. In this way, the complexity and power consumption are transferred from the implant device to the on-body relay, which is an efficient approach since they can be easily replaced, in contrast to the in-body implants.

  5. Effects of ion implantation on charges in the silicon--silicon dioxide system

    International Nuclear Information System (INIS)

    Learn, A.J.; Hess, D.W.

    1977-01-01

    Structures consisting of thermally grown oxide on silicon were implanted with boron, arsenic, or argon ions. For argon implantation through oxides, an increased fixed oxide charge (Q/sub ss/) was observed with the increase being greater for than for silicon. This effect is attributed to oxygen recoil which produces additional excess ionized silicon in the oxide of a type similar to that arising in thermal oxidation. Fast surface state (N/sub st/) generation was also noted which in most cases obscured the Q/sub ss/ increase. Of various heat treatments tested, only a 900 degreeC anneal in hydrogen annihilated N/sub st/ and allowed Q/sub ss/ measurement. Such N/sub st/ apparently arises as a consequence of implantation damage at the silicon--silicon dioxide interface. With the exception of boron implantations into thick oxides or through aluminum electrodes, reduction of the mobile ionic charge (Q/sub o/) was achieved by implantation. The reduction again is presumably damage related and is not negated by high-temperature annealing but may be counterbalanced by aluminum incorporation in the oxide

  6. Percutaneous implantation of intra-arterial port system for regional drug infusion: results and complications in 110 cases

    International Nuclear Information System (INIS)

    Won, Je Hwan; Lee, Jong Hyuk; Ko, Kyung Hee; Won, Jong Yoon; Park, Sung Il; Lee, Do Yun; Kang, Byung Chul

    2000-01-01

    To investigate the feasibility and complications of a percutaneously implantable port system for regional drug infusion. For intra-arterial drug infusion, a 5.8 or 5-F pediatric venous port system was implanted in 110 patients with hepatocellular carcinoma (n=79), liver metastasis (n=16), gallbladder cancer (n=4), stomach cancer (n=3), pancreatic cancer (n=3), Burger's diseases mellitus (n=2), or lymphoma (n=1). All intra-arterial port implantations were performed percutaneously in an angiographic ward through the common femoral artery (n=98), left subclavian artery (n=10), or left superficial femoral artery (n=2). Complications were evaluated during the follow-up period, which ranged from 21 to 530 (mean, 163) days. The technical success rate for percutaneous implantation of the system was 97.3% (107 of 110 patients). The tips of the port catheter were located in the common hepatic artery (n=34), proper hepatic artery (n=49), right hepatic artery quick resulthepatic artery (n=1), descending aorta at T9 level (n=10), left popliteal artery (n=2), right external iliac artery (n=1), left external iliac artery (n=1), or left deep femoral artery (n=1). Complications were encountered in 24 patients (22.4%), namely chamber site infection (n=7), catheter dislodgement (n=7), catheter occlusion (n=3), migration of coil (n=2), disconnection between chamber and catheter (n=1), kinking of catheter (n=1), arterial occlusion (n=1), necrosis of overlying skin (n=1), and leakage around port chamber (n=1). Outcomes of complications included removal of port systems or cessation of therapy in 12 cases (11.2%), correction of catheter location using a guide wire in five (4.7%), thrombolysis with urokinase in three (2.8%), and straightening using a snare in one (0.9%). In three patients, the port system was used without reintervention. Percutaneous implantation of an intra-arterial port system showed a high technical success rate and a low rate of serious complications. The method may be

  7. Total Measurement Uncertainty for the Plutonium Finishing Plant (PFP) Segmented Gamma Scan Assay System

    CERN Document Server

    Fazzari, D M

    2001-01-01

    This report presents the results of an evaluation of the Total Measurement Uncertainty (TMU) for the Canberra manufactured Segmented Gamma Scanner Assay System (SGSAS) as employed at the Hanford Plutonium Finishing Plant (PFP). In this document, TMU embodies the combined uncertainties due to all of the individual random and systematic sources of measurement uncertainty. It includes uncertainties arising from corrections and factors applied to the analysis of transuranic waste to compensate for inhomogeneities and interferences from the waste matrix and radioactive components. These include uncertainty components for any assumptions contained in the calibration of the system or computation of the data. Uncertainties are propagated at 1 sigma. The final total measurement uncertainty value is reported at the 95% confidence level. The SGSAS is a gamma assay system that is used to assay plutonium and uranium waste. The SGSAS system can be used in a stand-alone mode to perform the NDA characterization of a containe...

  8. Personnel protective equipment total-encapsulating suit decontamination study using shower systems

    International Nuclear Information System (INIS)

    Menkhaus, D.E.

    1991-01-01

    This report documents an experimental evaluation, conducted at the Idaho National Engineering Laboratory, of a shower-based decontamination station for personnel wearing a Level A, total- encapsulating, chemical-protective suit. The decontamination station is used by personnel when egressing a dry, dusty environment contaminated with transuranic radionuclides. This system has the potential to minimize the risk of spreading the contaminants to clean areas. Two types of shower systems were evaluated, a drench shower and a multi-nozzle shower. A total-encapsulating suit, worn by personnel. was contaminated with soil containing 239 Pu. Pre- shower and post-shower contamination samples were collected and visual observations were made to evaluate the ability of the shower system to remove the contaminated dust and to obtain baseline data useful in designing a shower-based personnel decontamination system. 12 figs., 7 tabs

  9. An inexpensive optical sensor system for monitoring total suspended solids in water

    International Nuclear Information System (INIS)

    Sami Gumaan Daraigan; Mohd Zubir Matjafri; Khiruddin Abdullah; Azlan Abdul Aziz; Abdul Aziz Tajuddin; Mohd Firdaus Othman

    2005-01-01

    The objectives of this work are to design and develop an optical transsmissometer sensor for measuring total suspended solids TSS concentrations in water samples. The proposed optical sensor has the advantages of being relatively inexpensive, and easy to make and operate. An optical algorithm has been developed and used for the measurement of total suspended solids concentrations. The developed optical sensor components include light emitting diodes LEDs that are used for measuring transmitted light. The concentrations of total suspended solids TSS are determined from transmitted light through the water samples. The transmitted light is measured in terms of the output voltage of the photodetector of the sensor system. The readings are measured using a digital multimeter. The results indicate that the level of the photocurrent is linearly proportional to the total suspended solids concentration. The proposed algorithm produces a high correlation coefficient and low root mean square error. (Author)

  10. Implantable Self-Powered Low-Level Laser Cure System for Mouse Embryonic Osteoblasts' Proliferation and Differentiation.

    Science.gov (United States)

    Tang, Wei; Tian, Jingjing; Zheng, Qiang; Yan, Lin; Wang, Jiangxue; Li, Zhou; Wang, Zhong Lin

    2015-08-25

    Bone remodeling or orthodontic treatment is usually a long-term process. It is highly desirable to speed up the process for effective medical treatment. In this work, a self-powered low-level laser cure system for osteogenesis is developed using the power generated by the triboelectric nanogenerator. It is found that the system significantly accelerated the mouse embryonic osteoblasts' proliferation and differentiation, which is essential for bone and tooth healing. The system is further demonstrated to be driven by a living creature's motions, such as human walking or a mouse's breathing, suggesting its practical use as a portable or implantable clinical cure for bone remodeling or orthodontic treatment.

  11. Cochlear Implants

    Science.gov (United States)

    ... implant, including: • How long a person has been deaf, •The number of surviving auditory nerve fibers, and • ... Implant, Severe Sensoryneurial Hearing Loss Get Involved Professional Development Practice Management ENT Careers Marketplace Privacy Policy Terms ...

  12. Monitoring failure rates of commercial implant brands; substantial equivalence in question?

    Science.gov (United States)

    Hujoel, Philippe; Becker, William; Becker, Burton

    2013-07-01

    The aim of this study was to report on the failure rates of two distinct dental implant systems in a clinical practice setting. Date of implant placement and loss were entered prospectively in a data registry system. Failure rates of two commercially pure titanium implants, one with a porous oxydized surface (POS) and the other with a chemically altered surface (CAS), were assessed using a quality control chart and survival analyses. A total of 860 POS and 759 CAS implants were placed. A warning of an increased failure rate of the CAS implant was identified by means of the quality control chart. Survival analyses indicated that the CAS implant failure rate was twice that of the POS implant (Hazard Ratio: 2.08; 95% CI: 1.33-3.28, P-value POS implant was associated with a non-significant 64% drop in the implant failure rate within less than a year (HR: 0.36; 95% CI: 0.12-1.14; P-value POS implant and an 8% failure with the CAS implant appears inconsistent with the assumption of substantial equivalence. © 2012 John Wiley & Sons A/S.

  13. Three-tiered integration of PACS and HIS toward next generation total hospital information system.

    Science.gov (United States)

    Kim, J H; Lee, D H; Choi, J W; Cho, H I; Kang, H S; Yeon, K M; Han, M C

    1998-01-01

    The Seoul National University Hospital (SNUH) started a project to innovate the hospital information facilities. This project includes installation of high speed hospital network, development of new HIS, OCS (order communication system), RIS and PACS. This project aims at the implementation of the first total hospital information system by seamlessly integrating these systems together. To achieve this goal, we took three-tiered systems integration approach: network level, database level, and workstation level integration. There are 3 loops of networks in SNUH: proprietary star network for host computer based HIS, Ethernet based hospital LAN for OCS and RIS, and ATM based network for PACS. They are linked together at the backbone level to allow high speed communication between these systems. We have developed special communication modules for each system that allow data interchange between different databases and computer platforms. We have also developed an integrated workstation in which both the OCS and PACS application programs run on a single computer in an integrated manner allowing the clinical users to access and display radiological images as well as textual clinical information within a single user environment. A study is in progress toward a total hospital information system in SNUH by seamlessly integrating the main hospital information resources such as HIS, OCS, and PACS. With the three-tiered systems integration approach, we could successfully integrate the systems from the network level to the user application level.

  14. Toward a System of Total Quality Management: Applying the Deming Approach to the Education Setting.

    Science.gov (United States)

    McLeod, Willis B.; And Others

    1992-01-01

    Recently, the Petersburg (Virginia) Public Schools have moved away from a highly centralized organizational structure to a Total Quality Management system featuring shared decision making and school-based management practices. The district was guided by Deming's philosophy that all stakeholders should be involved in defining the level of products…

  15. Dental Implants in an Aged Population: Evaluation of Periodontal Health, Bone Loss, Implant Survival, and Quality of Life.

    Science.gov (United States)

    Becker, William; Hujoel, Philippe; Becker, Burton E; Wohrle, Peter

    2016-06-01

    To evaluate aged partially and fully edentulous patients who received dental implants and were maintained over time. Further, to determine how the partially and edentulous ageing populations (65 and above) with dental implants maintain bone levels, proper oral hygiene, and perceive benefits of dental implants. Since 1995, patients receiving dental implants have been prospectively entered into an Access-based computerized program (Triton Tacking System). Patient demographics (age, sex), bone quality, quantity, implant location, and type of surgery have been continuously entered into the database. The database was queried for patients receiving implants (first stage) between 66 and 93 years of age. Thirty-one patients were within this age group. Twenty-five patients returned to the clinic for periodontal and dental implant evaluation. The Periodontal Index was used to evaluate selected teeth in terms of probing depth, bleeding on probing, plaque accumulation, and mobility. Using NIH Image J, radiographs taken at second stage and last examination were measured for changes in interproximal bone levels. Once identified, each patient anomalously filled out an abbreviated quality of health life form. Due to small sample size, descriptive statistics were used to compare clinical findings. Fifteen males ranging from 78 to 84 (mean age 84 years) years and 16 females from 66 to 93 (mean age 83 years) (age range 66-93) were contacted by phone or mail and asked to return to our office for a re-examination. For this group, the first dental implants were placed in 1996 (n = initial two implants) and continuously recorded through 2013 (n = last seven implants). Thirty-one patients received a total of 84 implants. Two patients were edentulous, and the remaining were partially edentulous. Four implants were lost. Between implant placement and 6- to 7-year interval, 13 patients with 40 implants had a cumulative survival rate of 94.6%. Of the original group (n = 33), three

  16. Controlled Systemic Delivery by Polymeric Implants Enhances Tissue and Plasma Curcumin Levels Compared with Oral Administration

    Science.gov (United States)

    Bansal, Shyam S.; Kausar, Hina; Vadhanam, Manicka V.; Ravoori, Srivani; Gupta, Ramesh C.

    2012-01-01

    Curcumin possess potent anti-inflammatory and anti-proliferative activities but with poor biopharmaceutical attributes. To overcome these limitations, curcumin implants were developed and tissue (plasma, brain and liver) curcumin concentrations were measured in female ACI rats for 3 months. Biological efficacy of tissue levels achieved was analyzed by modulation of hepatic cytochromes. Curcumin implants exhibited diffusion-mediated biphasic release pattern with ~2-fold higher in vivo release as compared to in vitro. Plasma curcumin concentration from implants was ~3.3 ng/ml on day 1 which dropped to ~0.2 ng/ml after 3 months whereas only 0.2–0.3 ng/ml concentration was observed from 4–12 days with diet and was undetected subsequently. Almost 10 fold higher curcumin levels were observed in brain on day 1 from implants compared with diet (30.1±7.3 vs 2.7±0.8 ng/g) and were higher even after 90 days (7.7±3.8 vs 2.2±0.8 ng/g). Although, curcumin levels were similar in liver from both the routes (~25–30 ng/g from day 1–4 and ~10–15 ng/g at 90 days), implants were more efficacious in altering hepatic CYP1A1 levels and CYP3A4 activity at ~28 fold lower doses. Curcumin implants provided much higher plasma and tissue concentrations and are a viable alternative for delivery of curcumin to various organs like brain. PMID:22227368

  17. Renin-angiotensin system blockade therapy after transcatheter aortic valve implantation.

    Science.gov (United States)

    Ochiai, Tomoki; Saito, Shigeru; Yamanaka, Futoshi; Shishido, Koki; Tanaka, Yutaka; Yamabe, Tsuyoshi; Shirai, Shinichi; Tada, Norio; Araki, Motoharu; Naganuma, Toru; Watanabe, Yusuke; Yamamoto, Masanori; Hayashida, Kentaro

    2018-04-01

    The persistence of left ventricular (LV) hypertrophy is associated with poor clinical outcomes after transcatheter aortic valve implantation (TAVI) for aortic stenosis. However, the optimal medical therapy after TAVI remains unknown. We investigated the effect of renin-angiotensin system (RAS) blockade therapy on LV hypertrophy and mortality in patients undergoing TAVI. Between October 2013 and April 2016, 1215 patients undergoing TAVI were prospectively enrolled in the Optimized CathEter vAlvular iNtervention (OCEAN)-TAVI registry. This cohort was stratified according to the postoperative usage of RAS blockade therapy with angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs). Patients with at least two prescriptions dispensed 180 days apart after TAVI and at least a 6-month follow-up constituted the RAS blockade group (n=371), while those not prescribed any ACE inhibitors or ARBs after TAVI were included in the no RAS blockade group (n=189). At 6 months postoperatively, the RAS blockade group had significantly greater LV mass index regression than the no RAS blockade group (-9±24% vs -2±25%, p=0.024). Kaplan-Meier analysis revealed a significantly lower cumulative 2-year mortality in the RAS blockade than that in the no RAS blockade group (7.5% vs 12.5%; log-rank test, p=0.031). After adjusting for confounding factors, RAS blockade therapy was associated with significantly lower all-cause mortality (HR, 0.45; 95% CI 0.22 to 0.91; p=0.025). Postoperative RAS blockade therapy is associated with greater LV mass index regression and reduced all-cause mortality. These data need to be confirmed by a prospective randomised controlled outcome trial. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Accuracy of linear drilling in temporal bone using drill press system for minimally invasive cochlear implantation.

    Science.gov (United States)

    Dillon, Neal P; Balachandran, Ramya; Labadie, Robert F

    2016-03-01

    A minimally invasive approach for cochlear implantation involves drilling a narrow linear path through the temporal bone from the skull surface directly to the cochlea for insertion of the electrode array without the need for an invasive mastoidectomy. Potential drill positioning errors must be accounted for to predict the effectiveness and safety of the procedure. The drilling accuracy of a system used for this procedure was evaluated in bone surrogate material under a range of clinically relevant parameters. Additional experiments were performed to isolate the error at various points along the path to better understand why deflections occur. An experimental setup to precisely position the drill press over a target was used. Custom bone surrogate test blocks were manufactured to resemble the mastoid region of the temporal bone. The drilling error was measured by creating divots in plastic sheets before and after drilling and using a microscope to localize the divots. The drilling error was within the tolerance needed to avoid vital structures and ensure accurate placement of the electrode; however, some parameter sets yielded errors that may impact the effectiveness of the procedure when combined with other error sources. The error increases when the lateral stage of the path terminates in an air cell and when the guide bushings are positioned further from the skull surface. At contact points due to air cells along the trajectory, higher errors were found for impact angles of [Formula: see text] and higher as well as longer cantilevered drill lengths. The results of these experiments can be used to define more accurate and safe drill trajectories for this minimally invasive surgical procedure.

  19. Why are mini-implants lost: the value of the implantation technique!

    Science.gov (United States)

    Romano, Fabio Lourenço; Consolaro, Alberto

    2015-01-01

    The use of mini-implants have made a major contribution to orthodontic treatment. Demand has aroused scientific curiosity about implant placement procedures and techniques. However, the reasons for instability have not yet been made totally clear. The aim of this article is to establish a relationship between implant placement technique and mini-implant success rates by means of examining the following hypotheses: 1) Sites of poor alveolar bone and little space between roots lead to inadequate implant placement; 2) Different sites require mini-implants of different sizes! Implant size should respect alveolar bone diameter; 3) Properly determining mini-implant placement site provides ease for implant placement and contributes to stability; 4) The more precise the lancing procedures, the better the implant placement technique; 5) Self-drilling does not mean higher pressures; 6) Knowing where implant placement should end decreases the risk of complications and mini-implant loss.

  20. Why are mini-implants lost: The value of the implantation technique!

    Directory of Open Access Journals (Sweden)

    Fabio Lourenço Romano

    2015-02-01

    Full Text Available The use of mini-implants have made a major contribution to orthodontic treatment. Demand has aroused scientific curiosity about implant placement procedures and techniques. However, the reasons for instability have not yet been made totally clear. The aim of this article is to establish a relationship between implant placement technique and mini-implant success rates by means of examining the following hypotheses: 1 Sites of poor alveolar bone and little space between roots lead to inadequate implant placement; 2 Different sites require mini-implants of different sizes! Implant size should respect alveolar bone diameter; 3 Properly determining mini-implant placement site provides ease for implant placement and contributes to stability; 4 The more precise the lancing procedures, the better the implant placement technique; 5 Self-drilling does not mean higher pressures; 6 Knowing where implant placement should end decreases the risk of complications and mini-implant loss.

  1. Long-term outcomes of dental implants placed in elderly patients: a retrospective clinical and radiographic analysis.

    Science.gov (United States)

    Park, Jung-Chul; Baek, Won-Sun; Choi, Seong-Ho; Cho, Kyoo-Sung; Jung, Ui-Won

    2017-02-01

    The aim of this retrospective study was to determine the clinical and the radiographic outcomes of dental implants placed in elderly people older than 65 years. In total, 902 implants in 346 patients (age: 65-89 years) were followed up for 2-17 years following the implant surgery. The survival rate of these implants was recorded and analyzed. Changes in marginal bone levels were also analyzed in serial radiographs, and Cox regression analysis for implant loss was performed. The survival rates were 95.39% and 99.98% in the implant- and patient-based analyses, respectively (involving a total of 29 implant failures), and the marginal bone loss at the implants was 0.17 ± 0.71 mm (mean ± SD). The number of failures was greatest in patients aged 65-69 years. The Cox regression with shared frailty analysis showed that implant loss was significantly greater in those aged 65-69 years than in those aged 70-74 years (P implant systems. Within the limitations of this retrospective study, it was concluded that implant therapy can be successfully provided to elderly patients and that age alone does not seem to affect the implant survival rate. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. FY 1987 report on the result of the R and D of an automatic sewing system. Total system; 1987 nendo jido hosei system no kenkyu kaihatsu seika hokokusho. Total system

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1988-03-01

    The paper summarized the R and D of a total system which is an element technology of an automatic sewing system by the Automatic Sewing System Technology Research Association. As to the research on the apparel side, the following were studied: A. To clarify the effective field of element technology by dress type. B. To clarify the method of applying the system to small-/medium-size plants. C. To make study for automation so that it can be the basic data for experimental plants. To proceed with the study concretely, they asked 6 companies developing element technology to have the field study meeting. To study conditions for experimental plants from viewpoints of FA and FMS, the following studies were conducted concretely using a system model, based on the plant design law: A. Layout plan of the system model. B. Handling plan of the system model. C. Communication plan of the system model. D. Utility plan of the system model. E. Building plan. F. Study of the medium-term evaluation method. G. Study on the model plant. The above-mentioned study of the total system was proceeded with under the consideration of supporting the smooth progress of the developmental schedule of the automatic sewing system. (NEDO)

  3. Cubic systems with invariant affine straight lines of total parallel multiplicity seven

    Directory of Open Access Journals (Sweden)

    Alexandru Suba

    2013-12-01

    Full Text Available In this article, we study the planar cubic differential systems with invariant affine straight lines of total parallel multiplicity seven. We classify these system according to their geometric properties encoded in the configurations of invariant straight lines. We show that there are only 17 different topological phase portraits in the Poincar\\'e disc associated to this family of cubic systems up to a reversal of the sense of their orbits, and we provide representatives of every class modulo an affine change of variables and rescaling of the time variable.

  4. Total Isolation Status Monitoring and Management System by CAD Assisted Technology

    International Nuclear Information System (INIS)

    Nakamura, Masaaki

    1995-01-01

    Isolation tasks in a nuclear power station require high confidence and quick response particularly during the annual inspection when the equipment must be checked in a safe and planned manner. To realize these advanced isolation works, JAPC has developed TOtal Isolation Status Monitoring and Management System using CAD Assisted Technology. This system, TOMM-CAT, developed under the concept of 'User friendly advanced man-machine interface', allows planning and management to be performed on a CRT display. TOMM-CAT allows isolation tasks to be performed accurately and efficiently in conjunction with equipment information from the existing Job Order Management System, which runs on the station host computer. (author)

  5. Hybrid procedure for total laryngectomy with a flexible robot-assisted surgical system.

    Science.gov (United States)

    Schuler, Patrick J; Hoffmann, Thomas K; Veit, Johannes A; Rotter, Nicole; Friedrich, Daniel T; Greve, Jens; Scheithauer, Marc O

    2017-06-01

    Total laryngectomy is a standard procedure in head-and-neck surgery for the treatment of cancer patients. Recent clinical experiences have indicated a clinical benefit for patients undergoing transoral robot-assisted total laryngectomy (TORS-TL) with commercially available systems. Here, a new hybrid procedure for total laryngectomy is presented. TORS-TL was performed in human cadavers (n = 3) using a transoral-transcervical hybrid procedure. The transoral approach was performed with a robotic flexible robot-assisted surgical system (Flex®) and compatible flexible instruments. Transoral access and visualization of anatomical landmarks were studied in detail. Total laryngectomy is feasible with a combined transoral-transcervical approach using the flexible robot-assisted surgical system. Transoral visualization of all anatomical structures is sufficient. The flexible design of the robot is advantageous for transoral surgery of the laryngeal structures. Transoral robot assisted surgery has the potential to reduce morbidity, hospital time and fistula rates in a selected group of patients. Initial clinical studies and further development of supplemental tools are in progress. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Total system performance assessment - 1995: An evaluation of the potential Yucca Mountain Repository

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-11-01

    The U.S. Department of Energy (DOE) is currently investigating the feasibility of permanently disposing the nation`s commercial high-level radioactive wastes (in the form of spent fuel from the over 100 electric power-generating nuclear reactors across the U.S.) and a portion of the defense high-level radioactive wastes (currently stored at federal facilities around the country) in the unsaturated tuffaceous rocks at Yucca Mountain, Nevada. Quantitative predictions based on the most current understanding of the processes and parameters potentially affecting the long-term behavior of the disposal system are used to assess the ability of the site and its associated engineered designs to meet regulatory objectives set forward by the U.S. Nuclear Regulatory Commission (NRC) and the U.S. Environmental Protection Agency (EPA). The evaluation of the ability of the overall system to meet the performance objectives specified in the applicable regulatory standards has been termed total system performance assessment (TSPA). The aim of any total system performance assessment is to be as complete and reasonably conservative as possible and to assure that the descriptions of the predictive models and parameters are sufficient to ascertain their accuracy. Total system performance assessments evolve with time. As additional site and design information is generated, performance assessment analyses can be revised to become more representative of the expected conditions and remove some of the conservative assumptions necessitated by the incompleteness of site and design data. Previous iterations of total system performance assessment of the Yucca Mountain site and associated engineered barriers have been conducted in 1991 and 1993. These analyses have been documented in Barnard, Eslinger, Wilson and Andrews.

  7. Total system performance assessment - 1995: An evaluation of the potential Yucca Mountain Repository

    International Nuclear Information System (INIS)

    1995-11-01

    The U.S. Department of Energy (DOE) is currently investigating the feasibility of permanently disposing the nation's commercial high-level radioactive wastes (in the form of spent fuel from the over 100 electric power-generating nuclear reactors across the U.S.) and a portion of the defense high-level radioactive wastes (currently stored at federal facilities around the country) in the unsaturated tuffaceous rocks at Yucca Mountain, Nevada. Quantitative predictions based on the most current understanding of the processes and parameters potentially affecting the long-term behavior of the disposal system are used to assess the ability of the site and its associated engineered designs to meet regulatory objectives set forward by the U.S. Nuclear Regulatory Commission (NRC) and the U.S. Environmental Protection Agency (EPA). The evaluation of the ability of the overall system to meet the performance objectives specified in the applicable regulatory standards has been termed total system performance assessment (TSPA). The aim of any total system performance assessment is to be as complete and reasonably conservative as possible and to assure that the descriptions of the predictive models and parameters are sufficient to ascertain their accuracy. Total system performance assessments evolve with time. As additional site and design information is generated, performance assessment analyses can be revised to become more representative of the expected conditions and remove some of the conservative assumptions necessitated by the incompleteness of site and design data. Previous iterations of total system performance assessment of the Yucca Mountain site and associated engineered barriers have been conducted in 1991 and 1993. These analyses have been documented in Barnard, Eslinger, Wilson and Andrews

  8. Quality control of system of imaging for rectal ultrasound for implants seed prostate low rate; Control de calidad del sistem de imagen por ecografia rectal para implantes de semillas de prostata de baja tasa

    Energy Technology Data Exchange (ETDEWEB)

    Luquero Llopis, N.; Ferrer Gracia, C.; Huertas Martinez, C.; Huerga Cabrerizo, C.; Corredoira Silva, E.; Serrada Hierro, A.

    2013-07-01

    In this work, the objective is the evaluation of the image system used in implants of prostate of low rate held at our hospital, for maximum control on the placement of the seeds in the patient and therefore carried out dosimetry. (Author)

  9. Analog Integrated Circuit and System Design for a Compact, Low-Power Cochlear Implant

    NARCIS (Netherlands)

    Ngamkham, W.

    2015-01-01

    Cochlear Implants (CIs) are prosthetic devices that restore hearing in profoundly deaf patients by bypassing the damaged parts of the inner ear and directly stimulating the remaining auditory nerve fibers in the cochlea with electrical pulses. This thesis describs the electronic circuit design of

  10. A Cortically Implantable Multielectrode Array for Investigating the Mammalian Visual System.

    Science.gov (United States)

    1981-12-01

    AFIT Multielectrode Array from the harsh cerebro - spinal environment encountered inside the cranium. Secondary emphasis is placed on analyzing the...experience before a primate implant). This is a particularly exciting period for neurocortical research because we are at the brink of significant

  11. Perioperative management of a patient with Dandy Walker malformation with tetralogy of Fallot undergoing total correction and fresh homologous pericardial pulmonary valve conduit implantation: Report of a rare case

    Directory of Open Access Journals (Sweden)

    Vishnu Datt

    2015-01-01

    Full Text Available Perioperative management of a patient with Dandy-Walker malformation (DWM with tetralogy of Fallot (TOF, patent ductus arteriosus, and pulmonary artery stenosis is a great challenge to the anesthesiologist. Anesthetic management in such patients can trigger tet spells that might rapidly increase intracranial pressure (ICP, conning and even death. The increase in ICP can precipitate tet spells and further brain hypoxia. To avoid an increase in ICP during TOF corrective surgery ventriculo-peritoneal (VP shunt should be performed before cardiac surgery. We present the first case report of a 11-month-old male baby afflicted with DWM and TOF who underwent successful TOF total corrective surgery and fresh autologous pericardial pulmonary valve conduit implantation under cardiopulmonary bypass after 1 week of VP shunt insertion.

  12. Dosimetric evaluation of total marrow irradiation using 2 different planning systems

    International Nuclear Information System (INIS)

    Nalichowski, Adrian; Eagle, Don G.; Burmeister, Jay

    2016-01-01

    This study compared 2 different treatment planning systems (TPSs) for quality and efficiency of total marrow irradiation (TMI) plans. The TPSs used in this study were VOxel-Less Optimization (VoLO) (Accuray Inc, Sunnyvale, CA) using helical dose delivery on a Tomotherapy Hi-Art treatment unit and Eclipse (Varian Medical Systems Inc, Palo Alto, CA) using volumetric modulated arc therapy (VMAT) dose delivery on a Varian iX treatment unit. A total dose of 1200 cGy was prescribed to cover 95% of the planning target volume (PTV). The plans were optimized and calculated based on a single CT data and structure set using the Alderson Rando phantom (The Phantom Laboratory, Salem, NY) and physician contoured target and organ at risk (OAR) volumes. The OARs were lungs, heart, liver, kidneys, brain, and small bowel. The plans were evaluated based on plan quality, time to optimize the plan and calculate the dose, and beam on time. The resulting mean and maximum doses to the PTV were 1268 and 1465 cGy for VoLO and 1284 and 1541 cGy for Eclipse, respectively. For 5 of 6 OAR structures the VoLO system achieved lower mean and D10 doses ranging from 22% to 52% and 3% to 44%, respectively. Total computational time including only optimization and dose calculation were 0.9 hours for VoLO and 3.8 hours for Eclipse. These times do not include user-dependent target delineation and field setup. Both planning systems are capable of creating high-quality plans for total marrow irradiation. The VoLO planning system was able to achieve more uniform dose distribution throughout the target volume and steeper dose fall off, resulting in superior OAR sparing. VoLO's graphics processing unit (GPU)–based optimization and dose calculation algorithm also allowed much faster creation of TMI plans.

  13. Dosimetric evaluation of total marrow irradiation using 2 different planning systems

    Energy Technology Data Exchange (ETDEWEB)

    Nalichowski, Adrian, E-mail: nalichoa@karmanos.org [Karmanos Cancer Center, Detroit, MI (United States); Eagle, Don G. [Wayne State University School of Medicine, Detroit, MI (United States); Burmeister, Jay [Karmanos Cancer Center, Detroit, MI (United States); Wayne State University School of Medicine, Detroit, MI (United States)

    2016-10-01

    This study compared 2 different treatment planning systems (TPSs) for quality and efficiency of total marrow irradiation (TMI) plans. The TPSs used in this study were VOxel-Less Optimization (VoLO) (Accuray Inc, Sunnyvale, CA) using helical dose delivery on a Tomotherapy Hi-Art treatment unit and Eclipse (Varian Medical Systems Inc, Palo Alto, CA) using volumetric modulated arc therapy (VMAT) dose delivery on a Varian iX treatment unit. A total dose of 1200 cGy was prescribed to cover 95% of the planning target volume (PTV). The plans were optimized and calculated based on a single CT data and structure set using the Alderson Rando phantom (The Phantom Laboratory, Salem, NY) and physician contoured target and organ at risk (OAR) volumes. The OARs were lungs, heart, liver, kidneys, brain, and small bowel. The plans were evaluated based on plan quality, time to optimize the plan and calculate the dose, and beam on time. The resulting mean and maximum doses to the PTV were 1268 and 1465 cGy for VoLO and 1284 and 1541 cGy for Eclipse, respectively. For 5 of 6 OAR structures the VoLO system achieved lower mean and D10 doses ranging from 22% to 52% and 3% to 44%, respectively. Total computational time including only optimization and dose calculation were 0.9 hours for VoLO and 3.8 hours for Eclipse. These times do not include user-dependent target delineation and field setup. Both planning systems are capable of creating high-quality plans for total marrow irradiation. The VoLO planning system was able to achieve more uniform dose distribution throughout the target volume and steeper dose fall off, resulting in superior OAR sparing. VoLO's graphics processing unit (GPU)–based optimization and dose calculation algorithm also allowed much faster creation of TMI plans.

  14. Design and Implementation of Remotely Monitoring System for Total Dissolved Solid in Baghdad Drinking Water Networks

    Directory of Open Access Journals (Sweden)

    Hussein Abdul-Ridha Mohammed

    2018-01-01

    Full Text Available he pollution of drinking water is a dangerous problem for the whole world, it can threaten the health of people and as people in developed society attaches more importance to environmental protection, it is of great research significance to intelligently and remotely monitoring the environment. Therefore in this paper, a remote water monitoring system for Baghdad drinking water system is suggested. The proposed system consists of data sensing and monitoring nodes at different locations in Baghdad to sensing and analyzes the data. These nodes are periodically measured Total Dissolved Solids (TDS. In case of measured value above TDS threshold which is 500 ppm, then an automated warning message will be sent to authorize persons in the maintenance center via Global Position System to take the correct action. This suggested structure has several advantages over traditional monitoring systems in terms of price, portability, reliability, applicability and takes a sample from a water tap in easy and real-time approach.

  15. Comprehensive evaluation index system of total supply capability in distribution network

    Science.gov (United States)

    Zhang, Linyao; Wu, Guilian; Yang, Jingyuan; Jia, Shuangrui; Zhang, Wei; Sun, Weiqing

    2018-01-01

    Aiming at the lack of a comprehensive evaluation of the distribution network, based on the existing distribution network evaluation index system, combined with the basic principles of constructing the evaluation index, put forward a new evaluation index system of distribution network capacity. This paper is mainly based on the total supply capability of the distribution network, combining single index and various factors, into a multi-evaluation index of the distribution network, thus forming a reasonable index system, and various indicators of rational quantification make the evaluation results more intuitive. In order to have a comprehensive judgment of distribution network, this paper uses weights to analyse the importance of each index, verify the rationality of the index system through the example, it is proved that the rationality of the index system, so as to guide the direction of distribution network planning.

  16. Emergency and elective implantation of covered stent systems in iatrogenic arterial injuries

    International Nuclear Information System (INIS)

    Goltz, J.P.; Kickuth, R.; Bastuerk, P.; Hoppe, H.; Triller, J.

    2011-01-01

    Purpose: To evaluate the effectiveness and safety of covered stents for the management of iatrogenic arterial injury. Materials and Methods: Between 03/1998 and 12/2009, 31 patients underwent selective covered stent implantation after iatrogenic arterial injury. 12/31 of these patients (38.7 %) were hemodynamically unstable. Six different endovascular covered stent types were utilized. The primary endpoints of this study were technical and clinical success and rates of minor and major complications. Results: Initial angiograms demonstrated active extravasation in 19 (61.3 %) patients and pseudoaneurysms in 12 (38.7 %) patients. The following sites of bleeding origin were detected: axillary artery, subclavian artery, common iliac artery, external iliac artery, internal iliac artery, common femoral artery, superficial femoral artery, popliteal and fibular artery, femoro-popliteal and popliteo-crural bypasses, common hepatic artery, aberrant hepatic artery, cystic and gastroduodenal artery. In all patients bleeding was effectively controlled by covered stent implantation resulting in an immediate technical success of 100 %. Clinical success attributed to covered stent implantation was documented in 30 of the 31 patients (96.8 %). Major complications included death in four patients (11.1 %), acute thrombosis with arm ischemia in one patient (2.8 %) and stent fracture with associated pseudoaneurysm in another patient (2.8 %). In 2/31 patients (6.5 %) covered stent failure was detected and successfully treated by implantation of a second covered stent. Conclusion: Emergency and elective implantation of covered stents may be used for minimally invasive and effective management of iatrogenic arterial injury. (orig.)

  17. Dual-Functionalized Graphene Oxide Based siRNA Delivery System for Implant