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Sample records for dislodged totally implantable

  1. Dislodgement of a cemented exeter femoral stem during closed manipulative reduction of a dislocated total hip replacement

    PubMed Central

    Rajeev, Aysha; Mohamed, Abdalla; Shaikh, Mazharuddin; Banaszkiewicz, Paul

    2016-01-01

    Introduction The incidence of cemented femoral stem migration and dislodgement even though has been described is extremely unusual. There is a high chance of polished femoral stem displacement happening while trying to reduce a dislocated total hip replacement by closed measures. Presentation of the case A 73 year old lady who had an Exeter cemented total hip replacement about two weeks back was admitted from Accident and Emergency with a dislocation. During the closed manipulative reduction under general anaesthesia it was noted that the femoral stem has dislodged from the canal. She underwent revision of the total hip replacement with good outcome. Discussion Femoral stem dislodgement occurs in total hip replacement if polished stem or inadequate cementing of the collar is carried out. Conclusion Gentle manipulative reduction under general anaesthesia of dislocated total hip replacement should be carried out if the polished femoral stem is used. PMID:27060643

  2. The Effect of Inter-Implant Distance on Retention and Resistance to Dislodging Forces for Mandibular Implant-Tissue-Supported Overdentures

    PubMed Central

    Tabatabaian, Farhad; Saboury, Abolfazl; Sobhani, Zahra Sadat; Petropoulos, Vicki C

    2014-01-01

    Objectives: The effect of inter-implant distance on retention and resistance of implant-tissue-supported overdentures is lacking in the literature. An in vitro study was performed to evaluate this effect for mandibular implant-tissue-supported overdentures retained by two ball attachments. Materials and Methods: An acrylic cast of an edentulous mandible was fabricated. Three pairs of implants were symmetrically placed at both sides of the midline. The inter-implant distance was 10, 25, and 35 millimeters in positions A, B and C, respectively. A framework simulating the overdenture was fabricated on the cast. Six attachment housings were placed within the overdenture. For each sample, two ball abutments were screwed onto the implant pairs and two pink nylon inserts were seated in their respective attachment housings. The samples were tested in three groups of 15 (A, B, and C). The testing machine applied tensile dislodging forces and peak loads were measured in three directions: vertical, oblique, and anterior-posterior. A one-way ANOVA followed by Tukey’s HSD was used to determine groups that were significantly different. Tests were carried out at 0.05 level of significance. Results: Peak loads for the anterior-posteriorly directed dislodging forces were significantly the highest for group C (P<0.05); 21.25 N±3.05 N, while there were no statistically significant differences among groups with vertically and obliquely directed forces (P>0.05). Conclusion: Inter-implant distance did not affect the vertical retention and oblique resistance of mandibular implant-tissue-supported overdentures; however, it affected anterior-posterior resistance. PMID:25628676

  3. Traumatic Dislodgement of Tibial Polyethylene Insert after a High-Flex Posterior-Stabilized Total Knee Replacement

    PubMed Central

    Astoul Bonorino, Juan Felix; Slullitel, Pablo Ariel Isidoro; Kido, Gonzalo Rodrigo; Bongiovanni, Santiago; Vestri, Renato; Carbó, Lisandro

    2015-01-01

    Many pathologic entities can produce a painful total knee replacement (TKR) that may lead to potential prosthetic failure. Polyethylene insert dissociation from the tibial baseplate has been described most frequently after mobile-bearing and cruciate-retaining TKRs. However, only 3 tibial insert dislocations in primary fixed-bearing High-Flex posterior-stabilized TKRs have been reported. We present a new case of tibial insert dislocation in a High-Flex model that shares similarities and differences with the cases reported, facilitating the analysis of the potential causes, which still remain undefined. PMID:26457215

  4. Constrained Implants in Total Knee Replacement.

    PubMed

    Touzopoulos, Panagiotis; Drosos, Georgios I; Ververidis, Athanasios; Kazakos, Konstantinos

    2015-05-01

    Total knee replacement (TKR) is a successful procedure for pain relief and functional restoration in patients with advanced osteoarthritis. The number of TKRs is increasing, and this has led to an increase in revision surgeries. The key to long-term success in both primary and revision TKR is stability, as well as adequate and stable fixation between components and underlying bone. In the vast majority of primary TKRs and in some revision cases, a posterior cruciate retaining or a posterior cruciate substituting device can be used. In some primary cases with severe deformity or ligamentous instability and in most of the revision cases, a more constrained implant is required. The purpose of this paper is to review the literature concerning the use of condylar constrained knee (CCK) and rotating hinge (RH) implants in primary and revision cases focusing on the indications and results. According to this review, although excellent and very good results have been reported, there are limitations of the existing literature concerning the indications for the use of constrained implants, the absence of long-term results, and the limited comparative studies. PMID:26055025

  5. Development of a totally implantable total artificial heart controller.

    PubMed

    Lee, S H; Choi, W W; Min, B G

    1991-01-01

    Using a one chip microcontroller, 87C196 (One chip EPROM), and an erasable and programmable logic device (EPLD), an implantable control system to drive a pendulum type electromechanical total artificial heart was developed. This control system consists of four parts: a main management system, a motor driver with power regulator, a state monitoring system, and a communication portion. The main system has a speed detector, proportional and integral (PI) control, pulse width modulation (PWM) generation, serial communication, and an analog data processor. Two kinds of power system are used, separated by eight photocoupler arrays to improve system stability. When the performance of each compartment was compared with that of the previously used Z80 microprocessor based control system, good correspondence was shown. Logic power consumption was reduced to one third that of the previous controller. Using mock circulation tests, the overall performance of the control system was evaluated. PMID:1751254

  6. Development of a totally implantable artificial heart.

    PubMed

    Rowles, J R; Khanwilkar, P S; Diegel, P D; Hansen, A C; Bearnson, G B; Smith, K D; Tatsumi, E; Olsen, D B

    1992-01-01

    The first generation of an integrated, totally implantable electrohydraulic total artificial heart was designed for long-term cardiac replacement. The system consists of an elliptical blood pump with an interatrial shunt, Medtronic-Hall 27 mm and 25 mm inflow and outflow valves, respectively, an energy converter consisting of an axial-flow, hydraulic pump driven by a brushless DC motor, and an electronics system with transcutaneous energy transmission and telemetry. Energy is supplied by internal nickel-cadmium rechargeable batteries that supply power for 20 min and external silver-zinc batteries that are designed to supply energy to run the system for 5 hr. The blood pump consists of a single layer diaphragm cast from Biolon, with joined right and left ventricles sharing a common base. The dynamic stroke volume is 84 ml, and maximum cardiac output is 9.2 L/min at a heart rate of 110 beats/min on the mock circulation. A 4.3 mm diameter interatrial shunt is used to balance the volumetrically coupled ventricles. The energy converter pumps hydraulic fluid alternately between ventricles, with controlled, active filling in one ventricle during the systolic phase of the other ventricle. Internal or external controllers adjust the heart rate and motor speed to maintain normal atrial filling pressures and full stroke. Electromagnetic induction is used to transfer energy through the skin and a bidirectional infrared data link incorporated within the transcutaneous energy transmission coils is used to transmit information. The entire system is being assembled and refined for long-term animal implant studies. PMID:1457955

  7. Determinants of Nephrostomy Tube Dislodgment After Percutaneous Nephrolithotomy

    PubMed Central

    Bayne, David; Hampson, Lindsay; Chi, Thomas; Stoller, Marshall L.

    2015-01-01

    Abstract Background and Purpose: Percutaneous nephrolithotomy (PCNL) traditionally necessitates the placement of a nephrostomy tube at the conclusion of the surgical procedure. Although tubeless PCNL has become more popular, patients with complex problems still need traditional nephrostomy tube drainage. The goal of this study was to investigate whether patient body mass index (BMI) impacted inadvertent nephrostomy tube dislodgement. Furthermore, we hoped to determine whether nephrostomy tube type impacted tube dislodgement rates. Methods: A retrospective review between 2005 and 2012 of 475 consecutive PCNL cases was undertaken. Patients were categorized based on the type of nephrostomy tube placed. BMI was examined as a continuous variable. The primary outcome of nephrostomy tube dislodgment was determined based on imaging obtained at the time of PCNL and postoperative hospitalization. Logistic regression analysis was then used to adjust for nephrostomy tube type and BMI. Results: Overall, 24 (5.5%) total patients experienced nephrostomy tube dislodgment postoperatively. The mean BMI for patients experiencing nephrostomy tube dislodgment was 39.7 vs 30.9 for those without tube dislodgment (P<0.0001; 95% confidence interval [CI] 4.6 to 12.9). Using logistic regression and adjusting for the use tube type, BMI was an independent predictor of tube dislodgement (P<0.001). For each unit of increase in BMI, the likelihood of tube dislodgment increased by 6% (1.06). After adjusting for BMI, however, nephrostomy tube type was not found to be an independent predictor of nephrostomy tube dislodgment. Conclusions: Nephrostomy tube type did not influence nephrostomy tube dislodgment rates. As a patient's BMI increased, the likelihood of tube dislodgment increased in a directly proportionate fashion. This is possibly because of the nephrostomy tube being fixed directly to the mobile skin associated with their fat pannus. Although the nephrostomy tube type itself did not affect

  8. Implantation of the syncardia total artificial heart.

    PubMed

    Tang, Daniel G; Shah, Keyur B; Hess, Micheal L; Kasirajan, Vigneshwar

    2014-01-01

    With advances in technology, the use of mechanical circulatory support devices for end stage heart failure has rapidly increased. The vast majority of such patients are generally well served by left ventricular assist devices (LVADs). However, a subset of patients with late stage biventricular failure or other significant anatomic lesions are not adequately treated by isolated left ventricular mechanical support. Examples of concomitant cardiac pathology that may be better treated by resection and TAH replacement includes: post infarction ventricular septal defect, aortic root aneurysm / dissection, cardiac allograft failure, massive ventricular thrombus, refractory malignant arrhythmias (independent of filling pressures), hypertrophic / restrictive cardiomyopathy, and complex congenital heart disease. Patients often present with cardiogenic shock and multi system organ dysfunction. Excision of both ventricles and orthotopic replacement with a total artificial heart (TAH) is an effective, albeit extreme, therapy for rapid restoration of blood flow and resuscitation. Perioperative management is focused on end organ resuscitation and physical rehabilitation. In addition to the usual concerns of infection, bleeding, and thromboembolism common to all mechanically supported patients, TAH patients face unique risks with regard to renal failure and anemia. Supplementation of the abrupt decrease in brain natriuretic peptide following ventriculectomy appears to have protective renal effects. Anemia following TAH implantation can be profound and persistent. Nonetheless, the anemia is generally well tolerated and transfusion are limited to avoid HLA sensitization. Until recently, TAH patients were confined as inpatients tethered to a 500 lb pneumatic console driver. Recent introduction of a backpack sized portable driver (currently under clinical trial) has enabled patients to be discharged home and even return to work. Despite the profound presentation of these sick

  9. Implantation of the Syncardia Total Artificial Heart

    PubMed Central

    Tang, Daniel G.; Shah, Keyur B.; Hess, Micheal L.; Kasirajan, Vigneshwar

    2014-01-01

    With advances in technology, the use of mechanical circulatory support devices for end stage heart failure has rapidly increased. The vast majority of such patients are generally well served by left ventricular assist devices (LVADs). However, a subset of patients with late stage biventricular failure or other significant anatomic lesions are not adequately treated by isolated left ventricular mechanical support. Examples of concomitant cardiac pathology that may be better treated by resection and TAH replacement includes: post infarction ventricular septal defect, aortic root aneurysm / dissection, cardiac allograft failure, massive ventricular thrombus, refractory malignant arrhythmias (independent of filling pressures), hypertrophic / restrictive cardiomyopathy, and complex congenital heart disease. Patients often present with cardiogenic shock and multi system organ dysfunction. Excision of both ventricles and orthotopic replacement with a total artificial heart (TAH) is an effective, albeit extreme, therapy for rapid restoration of blood flow and resuscitation. Perioperative management is focused on end organ resuscitation and physical rehabilitation. In addition to the usual concerns of infection, bleeding, and thromboembolism common to all mechanically supported patients, TAH patients face unique risks with regard to renal failure and anemia. Supplementation of the abrupt decrease in brain natriuretic peptide following ventriculectomy appears to have protective renal effects. Anemia following TAH implantation can be profound and persistent. Nonetheless, the anemia is generally well tolerated and transfusion are limited to avoid HLA sensitization. Until recently, TAH patients were confined as inpatients tethered to a 500 lb pneumatic console driver. Recent introduction of a backpack sized portable driver (currently under clinical trial) has enabled patients to be discharged home and even return to work. Despite the profound presentation of these sick

  10. Modification of the total first metatarsophalangeal joint implant arthroplasty.

    PubMed

    Corrigan, G; Kanat, I O

    1989-01-01

    The Swanson Silastic HP 100 Flexible Hinge Toe Implant (Dow Corning Wright, Arlington Tennessee) displays superior tensile, elongation and tear propagation strength in comparison to other silicone implant materials. It is, however, subject to many factors which may shorten its life-span. One reason for such failure has been attributed to the irregular contour of bone ends created after metatarsophalangeal joint arthroplasty, resulting in abrasion shards and shearing fractures of the implant stems and hinge. Titanium grommets were developed to alleviate this factor. This case report demonstrates a complication subsequent to total first metatarsophalangeal joint implant arthroplasty and the effectiveness of the Swanson Flexible Hinge Toe Joint Grommet. (Dow Corning Wright, Arlington, Tennessee). PMID:2794361

  11. The Esteem System: a totally implantable hearing device.

    PubMed

    Maurer, J; Savvas, E

    2010-01-01

    The Esteem totally implantable active middle ear implant is a new technology to augment hearing in patients suffering from moderate-to-severe and severe sensorineural hearing loss. In contrast to conventional (acoustic) hearing aids, the system uses two piezoelectric transducers (PZTs). PZTs are used as the sensor and driver to replace the function of the middle ear. Sound is received via a PZT sensor that picks up eardrum vibrations, following the piezoelectric principle, and transforms them into an electric signal. This signal is filtered, modified, amplified and transferred to a PZT driver, which mechanically drives the stapes and thereby the inner ear. The sound processor also contains a power source, which is an implantable lithium iodide battery. All components of the hearing restoration system are totally implantable to offer good sound fidelity and reduce hearing aid stigma caused by the visibility of conventional and semi-implantable hearing systems. Our experience shows that this system can provide considerable benefit to patients with sensorineural hearing loss. PMID:20610915

  12. Sensitivity to implant materials in patients undergoing total hip replacement.

    PubMed

    Granchi, Donatella; Cenni, Elisabetta; Trisolino, Giovanni; Giunti, Armando; Baldini, Nicola

    2006-05-01

    Sensitivity to implant materials is an unpredictable event, which may contribute to the process leading to the failure of the total hip replacement (THR). The aim of the current study was to investigate the informative power of skin testing in detecting the sensitization to the implant components in patients undergoing THR. A consecutive series of 223 patients was enrolled in the study, including 66 candidates to THR, 53 with stable implant, and 104 with THR loosening. The patch testing was performed by using the most relevant components of cobalt-based alloys (CoCrMo), Ti-based alloys (TiAlV), and bone cements. The frequency of positive patch testing in preimplant patients did not differ from that observed after THR. Patients with CoCrMo-failed implant showed a significant low frequency of nickel-positive skin reaction, while patients with TiAlV-THR had a high incidence of vanadium-positive patch testing. The panel of haptens showed a good performance in the identification of patients known to have a contact dermatitis. With regard to the THR outcome, patch testing was not able to discriminate between stable and failed implant. Sensitivity to at least one hapten, namely bone cement, as well as the positive medical history of hypersensitivity, influenced negatively the THR survival. Our results show the reliability of patch testing for investigating the sensitivity to implant components. The cause-effect relationship between sensitization and negative outcome cannot be established, but the shorter lifespan of THR in patients who have a positive patch testing supports the significant role of this event in contributing to the implant failure. PMID:16265661

  13. Innovation in training for totally implanted port insertion.

    PubMed

    Kelly, Linda J; Moss, Jon

    2016-01-27

    This article discusses the use of fresh frozen cadavers as an innovative way to teach the procedure of totally implanted port insertion. In an attempt to increase the number of competent medical and nursing practitioners able to insert these devices, workshops have been devised and delivered at a university clinical anatomy skills centre. This method of teaching has had positive feedback from practitioners. PMID:27282699

  14. Innovation in training for totally implanted port insertion.

    PubMed

    Kelly, Linda J; Moss, Jon

    This article discusses the use of fresh frozen cadavers as an innovative way to teach the procedure of totally implanted port insertion. In an attempt to increase the number of competent medical and nursing practitioners able to insert these devices, workshops have been devised and delivered at a university clinical anatomy skills centre. This method of teaching has had positive feedback from practitioners. PMID:27145548

  15. Saving Implants BMP-2 Application in Revision Total Hip Surgery

    PubMed Central

    Jäger, M.; Emami, R.; Thorey, F.; Krauspe, R.

    2006-01-01

    Objective: Besides others, there are two major problems in total hip replacement surgery which result in implant failure. First there is aseptic loosening due to a lack of implant biocompatibility or micromovements and second periimplant wear debris induced osteolysis which limits the survival rate of an implant. Regarding to recent data there are only limited therapeutic strategies to heal these bony defects without arthroplasty revision surgery. Since the investigation and characterization of adult mesenchymal stem cells (MSCs) from bone marrow, a cell and tissue engineering based therapy might be a promising solution to heal endoprosthesis associated bony defects. Moreover the application of growth factors in bone reconstructive surgery is another treatment concept to promote local bone regeneration. Patient and Methods: We report about a 73-year old patient with a painful weight bearing and a large, wear debris induced pelvic osteolysis after total hip arthroplasty. To prevent from salvage surgical procedures and preserve bone, a healing attempted was performed by filling the critical bony defect zone with a BMP-2/MSC composit. Results: Clinical and radiological follow-ups showed a progressive bony healing of the critical size defect area without any complications. Fifteen months after application the patient is still pain free, has no limitations in daily life or sport activities. Conclusion: The case embarks on a strategy of non-embryonic stem cell and growth factor application to heal bony defects at patients with total hip endoprosthesis. PMID:23674982

  16. Implantation of Total Artificial Heart in Congenital Heart Disease

    PubMed Central

    Adachi, Iki; Morales, David S. L.

    2014-01-01

    In patients with end-stage heart failure (HF), a total artificial heart (TAH) may be implanted as a bridge to cardiac transplant. However, in congenital heart disease (CHD), the malformed heart presents a challenge to TAH implantation. In the case presented here, a 17 year-old patient with congenital transposition of the great arteries (CCTGA) experienced progressively worsening HF due to his congenital condition. He was hospitalized multiple times and received an implantable cardioverter defibrillator (ICD). However, his condition soon deteriorated to end-stage HF with multisystem organ failure. Due to the patient's grave clinical condition and the presence of complex cardiac lesions, the decision was made to proceed with a TAH. The abnormal arrangement of the patient's ventricles and great arteries required modifications to the TAH during implantation. With the TAH in place, the patient was able to return home and regain strength and physical well-being while awaiting a donor heart. He was successfully bridged to heart transplantation 5 months after receiving the device. This report highlights the TAH is feasible even in patients with structurally abnormal hearts, with technical modification. PMID:25078059

  17. Sensitivity to implant materials in patients with total knee arthroplasties.

    PubMed

    Granchi, Donatella; Cenni, Elisabetta; Tigani, Domenico; Trisolino, Giovanni; Baldini, Nicola; Giunti, Armando

    2008-04-01

    Materials used for total knee arthroplasty (TKA), may elicit an immune response whose role in the outcome of the arthroplasty is still unclear. The aim of this study was to evaluate the frequency of sensitization in patients who had undergone TKA, and the clinical impact of this event on the outcome of the implant. Ninety-four subjects were recruited, including 20 patients who had not yet undergone arthroplasty, 27 individuals who had a well-functioning TKA, and 47 patients with loosening of TKA components. Sensitization was detected by using patch testing including haptens representative of cobalt-based alloys (CoCrMo), titanium-based alloys (TiAlV), and bone cements. The frequency of positive skin reactions to metals increased significantly after TKA, either stable or loosened (No Implant 20%; Stable TKA 48.1%, p=0.05; Loosened TKA 59.6%, p=0.001, respectively). We found a higher frequency of positive patch testing to vanadium in patients who had a Stable TKA with at least one TiAlV component (39.1%, p=0.01). The medical history for metal allergy seems to be a risk factor, because the TKA failure was fourfold more likely in patients who had symptoms of metal hypersensitivity before TKA. The prognostic value was supported by survival analysis, because in these individuals the outcome of the implant was negatively influenced (the logrank test Chi square 5.1, p=0.02). This study confirms that in patients with a TKA the frequency of positive patch testing is higher than in the normal population, although no predictive value is attributable to the sensitization because patch testing was not able to discriminate between stable and loose implants. On the contrary, the presence of symptoms of metal allergy before implantation should be taken into account as a potential risk factor for TKA failure. PMID:18155140

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

    PubMed

    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. PMID:27303244

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

    PubMed Central

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

    2016-01-01

    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. PMID:27303244

  20. Complications of Cardiac Perforation and Lead Dislodgement with an MRI-Conditional Pacing Lead: a Korean Multi-Center Experience.

    PubMed

    Kwon, Chang Hee; Choi, Jin Hee; Kim, Jun; Jo, Uk; Lee, Ji Hyun; Lee, Woo Seok; Kim, Yoo Ri; Lee, Soo Yong; Whang, Ki Won; Yang, Jihyun; Kim, Sung Hwan; Oh, Yong Seog; Park, Kyoung Min; Nam, Gi Byoung; Choi, Kee Joon; Kim, You Ho

    2016-09-01

    Medtronic CapSureFix MRI 5086 pacing lead (5086; Medtronic, Inc., Minneapolis, MN, USA) has been reported to be associated with increased cardiac perforation and lead dislodgement. This study aimed to compare the incidence of cardiac perforation and lead dislodgement within 30 days after pacemaker implantation between 5086 MRI lead and previous Medtronic CapSureFix Novus 5076 non-MRI pacing lead. This was a nationwide, multicenter retrospective study in which we compared the incidence of adverse events between 277 patients implanted with 5086 lead and 205 patients implanted with 5076 lead between March 2009 and September 2014. Cardiac perforation within 30 days of pacemaker implantation occurred in 4 patients (1.4%) with the 5086 lead and in no patient with the 5076 lead (P = 0.084). Lead dislodgement occurred in 8 patients (2.9%) with the 5086 lead and in 5 patients (2.4%) with the 5076 lead (P = 0.764). On multivariate logistic regression analysis, age was significantly associated with cardiac perforation. Congestive heart failure and implantation of right atrial (RA) lead at RA free wall or septum were significant factors for the incidence of lead dislodgement and lead revision. The incidence of cardiac perforation and lead dislodgement were not statistically different between the patients with 5086 lead and the patients with 5076 lead. However, careful attention for cardiac perforation may be needed when using the 5086 MRI lead, especially in elderly patients. PMID:27510382

  1. Totally implanted ports: the trapezius approach in practice.

    PubMed

    Hill, Steve

    Implanted ports (IPs) are an essential device for many patients who require long-term vascular access. IPs offer some advantages over other central venous access devices, such as lifestyle, body image benefits and lower infection rates. A typical implantation site for a port is the anterior chest wall. For some patients with breast cancer who have metastatic chest wall disease this site may lead to problems with the function of the device if disease spreads to the port site. One option for this patient group is to place the implanted port over the trapezius muscle. This article discusses six patients, all of whom had metastatic breast cancer with some degree of subcutaneous disease on the anterior chest wall. Three patients had received trapezius port placements and three had anterior chest wall placements. A retrospective review of the patients' medical records was undertaken from the time of insertion until removal or until the patient died. The anterior chest wall group of patients had their devices in for an average of 368 days vs 214 in the trapezius group. The total complications were higher in the anterior chest wall group (7 vs 2 in the trapezius group). Disease spread to two of the devices in the anterior chest wall group meaning the devices could no longer be used. The trapezius approach appears to be a safe and a reliable form of vascular access and may offer fewer complications than the traditional method of anterior chest wall placement when standard anterior chest wall approach is not suitable. PMID:26496871

  2. Totally implantable robot to treat chronic atrial fibrillation.

    PubMed

    Tozzi, Piergiorgio; Hayoz, Daniel; Thévenaz, Pierrick; Roulet, Jean-Yves; Salchli, Francois; von Segesser, Ludwig K

    2008-09-01

    Chronic atrial fibrillation affects millions of people worldwide. Its surgical treatment often fails to restore the transport function of the atrium. This study first introduces the concept of an atrial assist device (AAD) to restore the pump function of the atrium. The AAD is developed to be totally implantable in the human body with a transcutaneous energy transfer system to recharge the implanted battery. The ADD consists of a motorless pump based on artificial muscle technology, positioned on the external surface of the atrium to compress it and restore its muscular activity. A bench model reproduces the function of a fibrillating atrium to assess the circulatory support that this pump can provide. Atripump (Nanopowers SA, Switzerland) is a dome-shaped silicone-coated nitinol actuator 5 mm high, sutured on the external surface of the atrium. A pacemaker-like control unit drives the actuator that compresses the atrium, providing the mechanical support to the blood circulation. Electrical characteristics: the system is composed of one actuator that needs a minimal tension of 15 V and has a maximum current of 1.5 A with a 50% duty cycle. The implantable rechargeable battery is made of a cell having the following specifications: nominal tension of a cell: 4.1 V, tension after 90% of discharge: 3.5 V, nominal capacity of a cell: 163 mA h. The bench model consists of an open circuit made of latex bladder 60 mm in diameter filled with water. The bladder is connected to a vertically positioned tube that is filled to different levels, reproducing changes in cardiac preload. The Atripump is placed on the outer surface of the bladder. Pressure, volume and temperature changes were recorded. The contraction rate was 1 Hz with a power supply of 12 V, 400 mA for 200 ms. Preload ranged from 15 to 21 cm H(2)O. Maximal silicone membrane temperature was 55 degrees C and maximal temperature of the liquid environment was 35 degrees C. The pump produced a maximal work of 16 x 10

  3. Insertion of Totally Implantable Central Venous Access Devices by Surgeons

    PubMed Central

    An, Hyeonjun; Ryu, Chun-Geun; Jung, Eun-Joo; Kang, Hyun Jong; Paik, Jin Hee; Yang, Jung-Hyun

    2015-01-01

    Purpose The aim of this study is to evaluate the results for the insertion of totally implantable central venous access devices (TICVADs) by surgeons. Methods Total 397 patients, in whom TICVADs had been inserted for intravenous chemotherapy between September 2008 and June 2014, were pooled. This procedure was performed under local anesthesia in an operation room. The insertion site for the TICVAD was mainly in the right-side subclavian vein. In the case of breast cancer patients, the subclavian vein opposite the surgical site was used for insertion. Results The 397 patients included 73 males and 324 females. Primary malignant tumors were mainly colorectal and breast cancer. The mean operation time was 54 minutes (18-276 minutes). Operation-related complications occurred in 33 cases (8.3%). Early complications developed in 15 cases with catheter malposition and puncture failure. Late complications, which developed after 24 hours, included inflammation in 6 cases, skin necrosis in 6 cases, hematoma in 3 cases, port malfunction in 1 case, port migration in 1 case, and intractable pain at the port site in 1 case. Conclusion Insertion of a TICVAD under local anesthesia by a surgeon is a relatively safe procedure. Meticulous undermining of the skin and carefully managing the TICVAD could minimize complications. PMID:25960974

  4. Pyoderma gangrenosum after totally implanted central venous access device insertion

    PubMed Central

    Inan, Ihsan; Myers, Patrick O; Braun, Rolf; Hagen, Monica E; Morel, Philippe

    2008-01-01

    Background Pyoderma gangrenosum is an aseptic skin disease. The ulcerative form of pyoderma gangrenosum is characterized by a rapidly progressing painful irregular and undermined bordered necrotic ulcer. The aetiology of pyoderma gangrenosum remains unclear. In about 70% of cases, it is associated with a systemic disorder, most often inflammatory bowel disease, haematological disease or arthritis. In 25–50% of cases, a triggering factor such as recent surgery or trauma is identified. Treatment consists of local and systemic approaches. Systemic steroids are generally used first. If the lesions are refractory, steroids are combined with other immunosuppressive therapy or to antimicrobial agents. Case presentation A 90 years old patient with myelodysplastic syndrome, seeking regular transfusions required totally implanted central venous access device (Port-a-Cath®) insertion. Fever and inflammatory skin reaction at the site of insertion developed on the seventh post-operative day, requiring the device's explanation. A rapid progression of the skin lesions evolved into a circular skin necrosis. Intravenous steroid treatment stopped the necrosis' progression. Conclusion Early diagnosis remains the most important step to the successful treatment of pyoderma gangrenosum. PMID:18325095

  5. Underground storage tanks soft waste dislodging and conveyance

    SciTech Connect

    Wellner, A.F.

    1993-10-01

    Currently 140 million liters (37 million gallons) of waste are stored in the single shell underground storage tanks (SSTs) at Hanford. The wastes contain both hazardous and radioactive constituents. This paper focuses on the Westinghouse Hanford Company`s testing program for soft waste dislodging and conveyance technology. This program was initialized to investigate methods of dislodging and conveying soft waste. The main focus was on using air jets, water jets, and/or mechanical blades to dislodge the waste and air conveyance to convey the dislodged waste. These waste dislodging and conveyance technologies would be used in conjunction with a manipulator based retrieval system.

  6. Dislodgeable copper, chromium and arsenic from CCA-treated wood surfaces.

    PubMed

    Stilwell, David; Toner, Michael; Sawhney, Brij

    2003-08-01

    Chromated copper arsenate (CCA) is commonly used to preserve wood, but its use poses risk of arsenic exposure. In order to evaluate the extent of exposure to As from physical contact with CCA-treated wood, dislodgeable As from treated wood surfaces (as well as Cu and Cr) was determined as a function of weathering time using dampened polyester wipe materials. Six sets of 2.5-m-long CCA-treated boards, three-four boards per set, were purchased from lumber yards and cut into 30- or 60-cm coupons. A total of 44 such coupons were placed outdoors and the dislodgeable CCA components from the surfaces of the wooden coupons were periodically determined over a 1- or 2-year period by a systematic wipe method followed by nitric acid extraction of the CCA components from the cloth. In all 316 samples, appreciable amounts of the three elements, Cu, Cr and As, were detected. The amounts of surface-dislodgeable As, the most potentially hazardous element and the one of major concern in this study, varied from 5 to 122 microg/100 cm(2) with an average value of 37+/-22 microg/100 cm(2). There was considerable variation in As dislodged among coupons, boards, sets and time. Test coupons that tended to release relatively higher (or lower amounts) over time initially, continued to do so over time. However, the amounts of arsenic dislodged over time did not follow a simple pattern. While the As dislodged tended to decrease with time during the first year, it approached the initial value or increased somewhat during the second year, presumably due to surface rejuvenation effects caused by erosion and weathering. When all the data were normalized to the initial values, no trend emerged, as indicated by the average normalized value of 1.0+/-0.4 for As dislodged over time. Apparently, on installations constructed with CCA-treated wood, arsenic may remain available for a number of years. PMID:12873405

  7. Implant alignment in total elbow arthroplasty: conventional vs. navigated techniques

    NASA Astrophysics Data System (ADS)

    McDonald, Colin P.; Johnson, James A.; King, Graham J. W.; Peters, Terry M.

    2009-02-01

    Incorrect selection of the native flexion-extension axis during implant alignment in elbow replacement surgery is likely a significant contributor to failure of the prosthesis. Computer and image-assisted surgery is emerging as a useful surgical tool in terms of improving the accuracy of orthopaedic procedures. This study evaluated the accuracy of implant alignment using an image-based navigation technique compared against a conventional non-navigated approach. Implant alignment error was 0.8 +/- 0.3 mm in translation and 1.1 +/- 0.4° in rotation for the navigated alignment, compared with 3.1 +/- 1.3 mm and 5.0 +/- 3.8° for the non-navigated alignment. Five (5) of the 11 non-navigated alignments were malaligned greater than 5° while none of the navigated alignments were placed with an error of greater than 2.0°. It is likely that improved implant positioning will lead to reduced implant loading and wear, resulting in fewer implantrelated complications and revision surgeries.

  8. The Thoratec system implanted as a modified total artificial heart: the Bad Oeynhausen technique.

    PubMed

    Arusoglu, Latif; Reiss, Nils; Morshuis, Michiel; Schoenbrodt, Michael; Hakim-Meibodi, Kavous; Gummert, Jan

    2010-12-01

    The CardioWest™ total artificial heart (SynCardia Systems, Tuscon, AZ, USA) is the only FDA-approved total artificial heart determined as a bridge to human heart transplantation for patients dying of biventricular heart failure. Implantation provides immediate hemodynamic restoration and clinical stabilization, leading to end-organ recovery and thus eventually allowing cardiac transplantation. Occasionally, implantation of a total artificial heart is not feasible for anatomical reasons. For this patient group, we have developed an alternative technique using the paracorporeal Thoratec biventricular support system (Thoratec, Pleasanton, CA, USA) as a modified total artificial heart. A detailed description of the implantation technique is presented. PMID:21169150

  9. [A totally implantable hearing aid for inner ear deafness: TICA LZ 3001].

    PubMed

    Leysieffer, H; Baumann, J W; Mayer, R; Müller, D; Müller, G; Schön, T; Volz, A; Zenner, H P

    1998-10-01

    Recently, Zenner et al. implanted the first totally implantable electronic hearing devices in patients with SNHL (HNO 46 [1998] 844-852). In the present report, technical and audiological features of the implant TICA are published. The development of the piezoelectric transducer and the microphone for implantation in the posterior wall of the auditory canal as components for the present fully implantable hearing system has already been described (HNO 45, 1997, 792-880). Here we report about our experience with the electronic main module that completes the TICA LZ 3001 system. This module is suited for implantation in the mastoid bone and contains the signal-processing electronics and an integrated battery that can be recharged transcutaneously with a portable charger. The recharging time is around 2 h for an implant operating time of 50 h. The microphone and transducer connectors allow for easy replacement of the main module when the battery lifetime is reached. This lifetime is around 3-5 years. A small wireless remote control allows volume adjustment, contains an on/off switch, and permits selection of four different individual hearing programs. The basic audiological features are provided by a flexible, digitally programmable 3-channel-AGC-system with a peak clipping function. The total bandwidth is around 10 kHz. To our knowledge this is the first fully implantable hearing system that has been in implanted in humans. PMID:9846265

  10. Difficulty in dislodging in vivo fixed radiostrontium.

    PubMed

    Sonawane, V R; Jagtap, V S; Pahuja, D N; Rajan, M G R; Samuel, A M

    2004-07-01

    Many trials based on the basic phenomena of isotopic dilution, adsorption, ion exchange, chelation, etc., have been attempted for the decorporation of radiostrontium, particularly Sr, after its entry in the in vivo system. We have recently demonstrated a non-isotopic carrier effect of some common calcium salts (calcium = 9 mg mL) to reduce the whole body retention of radiostrontium, if administered within 2 h after radiostrontium exposure and furthermore once daily, in rats, supplemented with calcium fortified diet. However, 25-30% of radiostrontium (compared to 50-60% in untreated animals) was still found to be retained in the animal even after 2 wk of treatment. Trial of some simple interventional measures, which would not adversely affect the animal metabolism, like pyrophosphate and magnesium sulfate, sodium citrate, chitin (a bio-absorbent), crown ether (a metal-chelator), and ammonium chloride, was therefore attempted to dislodge this remaining radiostrontium by switching over these animals to normal diet and subjecting them to different lines of treatment with these simple interventions through diet and drinking water separately for a further 4 wk. However, this remaining portion of radiostrontium is fixed in the bone and is difficult to dislodge. PMID:15194921

  11. 21 CFR 876.4680 - Ureteral stone dislodger.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ureteral stone dislodger. 876.4680 Section 876.4680 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4680 Ureteral stone dislodger....

  12. 21 CFR 876.4680 - Ureteral stone dislodger.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ureteral stone dislodger. 876.4680 Section 876.4680 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4680 Ureteral stone dislodger....

  13. A laboratory study on a capacitive displacement sensor as an implant microphone in totally implant cochlear hearing aid systems.

    PubMed

    Huang, Ping; Guo, Jun; Megerian, Cliff A; Young, Darrin J; Ko, Wen H

    2007-01-01

    A totally implant cochlear hearing aids system, integrating an implant microphone, interface electronics, a speech processor, a stimulator, and cochlear electrodes, can overcome the uncomfortable, inconvenient, and stigma problems associated with the conventional and semi-implantable hearing aids. This paper presents a laboratory feasibility study on the use of an electret condenser microphone (ECM) displacement sensor, serving as an implant microphone, and combined with a spring coupler to directly sense the umbo acoustic vibration. The umbo vibration characteristics were extracted from literature to determine the coupler and sensor requirements. A laboratory model was built to simulate the vibration source and experimentally study the transmission coefficient. Experimental data demonstrate that by using a 5 N/m stiffness spring, the umbo vibration amplitude as high as 67% can be transmitted to the sensor. Measurement of the sensor system on the temporal bone was also made. The minimum detectable sound pressure level (SPL) at 1 kHz is 41 and 67 dB for laboratory and 38 and 64 dB for temporal bone measurement for 1 and 388 Hz bandwidth, respectively. Better performance was achieved in a higher frequency. Results and analysis of this study can be used as a guideline for the future design of displacement sensors as implant microphones. PMID:18003304

  14. Successful thermal management of a totally implantable ventricular assist system.

    PubMed

    Tasai, K; Takatani, S; Orime, Y; Damm, G; Ohara, Y; Naito, K; Makinouchi, K; Mizuguchi, K; Matsuda, Y; Shimono, T

    1994-01-01

    Thermal management of the implantable ventricular assist system (VAS) is important not only from the pathophysiological point of view but also from the standpoint of system endurance. The heat distribution within the Baylor VAS was measured using different motor housing materials and environmental conditions. The temperature of the circulating water in the mock loop was set at 37 degrees and 42 degrees C. A polycarbonate motor housing was not a suitable material because of the high temperature development in the actuation system. An anodized aluminum housing demonstrated excellent heat conductivity. The surface temperature of this motor housing was 41.6 degrees C when immersed in circulating water at 42 degrees C. Heat conduction from the motor to the circulating blood revealed an effective thermal path. In the worst case, the heat flux of the motor to the circulating blood revealed an effective thermal path. In the worst case, the heat flux of the motor housing was calculated to be less than 0.062 W/cm2--an acceptable level for the surrounding tissues. PMID:8141658

  15. Hazardous waste dislodging and conveyance: The confined sluicing method

    SciTech Connect

    Summers, D.A.; Fossey, R.D.; Mann, M.D.; Blaine, J.G.; Rinker, M.W.

    1994-09-01

    This report describes an investigation of a means for dislodging and conveying waste currently stored in underground storage tanks. A series of experiments have been carried out to evaluate the potential of a medium pressure, medium flow rate cutting system as a means of dislodging the waste. It has been found that waterjets at a pressure of 10,000 psi can effectively cut the material which has been chosen to simulate the hardened saltcake within the storage tanks. Based on a parameterization test it has thus been calculated that an inlet flow volume of approximately 30 gallons per minute will be sufficient to excavate 30 gallons per minute of waste from a tank. In order to transport the resulting slurry from the tank, a modified jet pump has been developed and has demonstrated its capability of conveying fluid and waste particles, up to one inch in diameter, to a height of more than 60 feet. Experiments were conducted to examine different configurations to achieve the production levels required for waste removal and to clean the walls of residual material. It was found more effective to clean the walls using an inclined angle of impact rather than a perpendicular angle of impact in order to provide a safeguard against driving the water through any cracks in the containment. It was demonstrated that excavation can take place with almost total immediate extraction of the water and debris from the cutting process. The results have qualitatively shown the potential of a medium pressure waterjet system for achieving the required results for underground storage tank waste retrieval.

  16. Use of Bivalirudin for Anticoagulation during Implantation of Total Artificial Heart

    PubMed Central

    Federman, Myke; Dragomer, Douglas; Grant, Stuart; Reemtsen, Brian; Biniwale, Reshma

    2014-01-01

    Abstract: Heparin-induced thrombocytopenia presents a challenge for anticoagulation techniques during cardiac surgery and ventricular assist device implantation. Bivalirudin is currently recommended for use during cardiopulmonary bypass for patients with heparin-induced thrombocytopenia but requires the use of special techniques to avoid blood stagnation. We report the successful use of bivalirudin during cardiopulmonary bypass for implantation of the Total Artificial Heart with late operative bleeding likely resulting from heavy cell saver use. PMID:25208436

  17. Revision arthroplasty utilizing the Biomet Total Toe System for failed silicone elastomer implants.

    PubMed

    Koenig, R D

    1994-01-01

    The author presents a 3-year study of 10 cases of revisional arthroplasty utilizing the Biomet Total Toe System. The procedure is performed to eliminate pain and restore function in cases of metatarsophalangeal joint silicone elastomer implant failure. The surgeon should be familiar with the Total Toe System before attempting revision. PMID:8081327

  18. Durability testing of a completely implantable electric total artificial heart.

    PubMed

    Zapanta, Conrad M; Snyder, Alan J; Weiss, William J; Cleary, Thomas J; Reibson, John D; Rawhouser, Marjorie A; Lewis, Jeffrey P; Pierce, William S; Rosenberg, Gerson

    2005-01-01

    In vitro durability testing was conducted on the Penn State/3M electric total artificial heart (ETAH) to determine device durability and to evaluate device failures. A specialized mock circulatory loop was developed for this testing. Customized software continuously acquired data during the test period, and failures were analyzed using FMEA (failure modes and effects analysis) and FMECA (failure modes, effects, and criticality analysis) principles. Redesigns were implemented when appropriate. Reliability growth principles were then applied to calculate the 1 and 2 year reliability. The 1 and 2 year reliability of the Penn State/3M ETAH was shown to be 96.1% and 59.9%, respectively, at 80% confidence. PMID:15968950

  19. Complications in exodontia--accidental dislodgment to adjacent anatomical areas.

    PubMed

    Grandini, S A; Barros, V M; Salata, L A; Rosa, A L; Soares, U N

    1993-01-01

    The authors report 4 cases of accidental dislodgement of teeth to adjacent anatomical areas during extraction. The causes and their prevention are discussed and solutions for the problem are suggested. PMID:8241759

  20. Dislodgement of coronary stent due to rupture of stent balloon.

    PubMed

    Ayça, Burak; Okuyan, Ertuğrul; Şahin, İrfan; Dinçkal, Mustafa Hakan

    2015-01-01

    Rare stent complications, including dislodgement of stent, unexpanded stent, stent fracture and stent loss etc. can occur during percutaneous coronary interventions (PCI). We present a semi-expanded and dislodged stent due to rupture of stent balloon during primary PCI in this case report. An interventional cardiologist should be aware of the possibility of rare complications, such as in this case, and have enough experience and knowledge to handle them. PMID:25655859

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

    PubMed Central

    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 the mentioned subject from 1986 to 2011. As a searching strategy, we used the following words: implant-supported overdentures, attachment systems, Locator attachment, cantilever, fixed prosthesis. Results and conclusions: Implant-supported overdentures constitute an accurate and predictable treatment option and achieve a higher patients’ satisfaction. This type of treatment constitutes a cheaper treatment than fixed prostheses and in some patients, with loss of lip support or with an interoclusal space larger than 15 mm, the choice of implant-supported overdentures seems to prevent future aesthetic or phonetic problems. Key words:Overdentures, implant occlusion, implant rehabilitation, total edentulous rehabilitation, fixed prosthesis. PMID:24455093

  2. Dislodgement of carbon nanotube bundles under pressure driven flow.

    PubMed

    Baowan, Duangkamon; Cox, Barry J; Hill, James M

    2010-04-16

    Experimental and predicted flow rates through carbon nanotubes vary considerably but generally are reported to be well in excess of that predicted by the conventional Poiseuille flow, and therefore nanotubes embedded in a matrix might provide membranes with exceptional mass transport properties. In this paper, applied mathematical modelling is undertaken to estimate the three forces acting on a nanotube bundle, namely the molecular interaction force, the viscous force, and the static pressure force. In deducing estimates of these forces we introduce a modification of the notion of the effective dead area for a carbon nanotube membrane, and we calculate the total forces necessary to push one or more of the nanotubes out of the bundle, thus creating a channel through which further enhancement of flow may take place. However, careful analysis shows that the nett dislodgement force is entirely independent on the useable flow area, but rather depends only on the total cross-sectional area perpendicular to the flow. This rather surprising result is a consequence of the flow being steady and a balance of the viscous and pressure forces. PMID:20332554

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

    PubMed

    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. PMID:26105105

  4. Removal of trabecular metal osteonecrosis intervention implant and conversion to primary total hip arthroplasty.

    PubMed

    Owens, Joshua B; Ely, Erin E; Guilliani, Nathania M Figueroa; Suarez, Juan C; Patel, Preetesh D

    2012-06-01

    Core decompression and placement of the Trabecular Metal Osteonecrosis Intervention Implant have shown to be initially successful in treating early osteonecrosis. When treatment fails, however, patients often undergo primary total hip arthroplasty (THA) requiring removal of a previously inserted trabecular metal implant. We describe a technical tip for removal of a well-ingrown trabecular metal screw. A metal-cutting trephine placed over the screw allows for removal in an efficient manner while minimizing additional dissection and bone loss during conversion to THA. PMID:22425306

  5. [Total elbow arthroplasty. Indications, operative technique and results after implantation of an Acclaim elbow prosthesis].

    PubMed

    Lerch, K; Tingart, M; Trail, I; Grifka, J

    2003-08-01

    Total elbow arthroplasty has become a reliable treatment option for patients with rheumatoid arthritis as well as primary or posttraumatic arthrosis. The aim of this study is to present the indications, operative technique and results for the implantation of an Acclaim elbow prosthesis. Case reports are given to demonstrate the indications for prosthesis implantation. Furthermore, the follow-up results are reported for 65 patients after implantation of an Acclaim prosthesis. Pre- and postoperative pain were evaluated using the visual analogue scale. The pain level decreased from 8.0 to 2.3 postoperatively. After implantation of an elbow prosthesis, there was a significant improvement in the range of motion. The mean flexion increased from 103 degrees preoperatively to 140 degrees postoperatively. An increase of 10 degrees was found for both supination and pronation. Complications included temporary ulnary nerve irritation in seven patients, intraoperative fractures in four cases and postoperative elbow dislocation in one case. In conclusion, total elbow arthroplasty results in a reduction of pain and an improvement in elbow movement. However, selection of the right patient is important. Patients are advised not to lift heavy objects or to perform hard physical work. If patients' compliance can not be ensured preoperatively, no total elbow arthroplasty should be performed. PMID:12955197

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

    PubMed

    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. PMID:17826276

  7. Two-stage revision of implant-associated infections after total hip and knee arthroplasty

    PubMed Central

    Ellenrieder, Martin; Lenz, Robert; Haenle, Maximilian; Bader, Rainer; Mittelmeier, Wolfram

    2011-01-01

    Septic loosening of total hip and knee endoprostheses gains an increasing proportion of revision arthroplasties. Operative revisions of infected endoprostheses are mentally and physically wearing for the patient, challenging for the surgeon and a significant economic burden for healthcare systems. In cases of early infection within the first three weeks after implantation a one-stage revision with leaving the implant in place is widely accepted. The recommendations for the management of late infections vary by far. One-stage revisions as well as two-stage or multiple revision schedules have been reported to be successful in over 90% of all cases for certain patient collectives. But implant associated infection still remains a severe complication. Moreover, the management of late endoprosthetic infection requires specific logistics, sufficient and standardized treatment protocol, qualified manpower as well as an efficient quality management. With regard to the literature and experience of specialized orthopaedic surgeons from several university and regional hospitals we modified a commonly used treatment protocol for two-stage revision of infected total hip and knee endoprostheses. In addition to the achievement of maximum survival rate of the revision implants an optimisation of the functional outcome of the affected artificial joint is aimed for. PMID:22242098

  8. MEDIUM-TERM ASSESSMENT OF TOTAL KNEE ARTHROPLASTY WITH IMPLANT MADE IN BRAZIL

    PubMed Central

    Barretto, João Maurício; Malta, Márcio; e Albuquerque, Rodrigo Pires; de Assis, Daniel Pinho; Campos, André Siqueira

    2015-01-01

    Objective: This study assessed 47 patients who underwent total knee arthroplasty (TKA) with implants manufactured in Brazil, with a mean follow-up of five years. Methods: This was a retrospective study at Santa Casa de Misericordia Hospital in Rio de Janeiro, from January 1993 to December 2002. The sample comprised 47 patients (44 females and three males) who underwent TKA, totaling 58 knees. The patients’ ages ranged from 46 to 83 years. A diagnosis of osteoarthritis or rheumatic disease was confirmed in all the patients. Results: In this investigation, all the patients underwent cemented TKA with preservation of the posterior cruciate ligament. The length of follow-up ranged from 5 to 17 years. The functional assessment criterion used was the one of the Hospital for Special Surgery (HSS), and this yielded an average of 87 points after the operation. The radiographic criterion used was the Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. We had three cases with a radiolucent line without implant loosening, which were asymptomatic from a clinical standpoint. Conclusion: The total knee arthroplasty procedures using an implant made in Brazil were performed by a trained and experienced team. To date, over the clinical follow-up on these patients with knee osteoarthritis or rheumatoid arthritis, the results have been seen to be satisfactory. PMID:27027051

  9. Catheter fracture and embolization from totally implanted venous access ports--case reports.

    PubMed

    Vadlamani, P; Dawn, B; Perry, M C

    1998-12-01

    Totally implanted venous access ports are excellent devices for delivering chemotherapeutic agents and prolonged intravenous infusions in patients with cancer. Catheter fracture and embolization are rare and potentially serious complications of these widely used devices. Retrieval of the embolized fragment is generally indicated but may not be possible. The authors report three cases of catheter embolization in their center over a period of 9 years. Catheter "pinch-off," fracture, embolization, and retrieval are discussed. PMID:9855376

  10. Endocrine-disrupting compounds in reclaimed water and residential ponds and exposure potential for dislodgeable residues in turf irrigated with reclaimed water.

    PubMed

    Sidhu, Harmanpreet S; Wilson, Patrick C; O'Connor, George A

    2015-07-01

    Endocrine-disrupting chemicals (EDCs) occur in reclaimed water (RW), which may serve as an exposure source for humans. The presence of EDCs in RW used to irrigate turf and in nearby water-retention ponds was determined. In addition, the total dislodgeable mass of each EDC was determined after irrigation (using RW) to simulate exposure of a 3-year-child playing in turf grass recently irrigated with RW. Five EDCs (estrone, 17β-estradiol, 17α-ethynylestradiol, bisphenol A, and 4-n-nonylphenol) were quantified in 28 samples of RWs (wastewater-treatment plant effluents) and 88 samples from residential surface water-retention ponds. St. Augustine variety of turf grass was irrigated with spiked RW to study dislodgement of the five EDCs overtime using a drag-sled method. Grass clippings were analyzed to relate masses of EDC on grass with masses dislodged. EDCs were detected in both RW and ponds at ng/L concentrations. Maximum EDC masses were dislodged immediately after irrigation. Dislodged masses of estrone and 17β-estradiol are two separate EDCs, 17β-estradiol and 17α-ethynylestradiol decreased rapidly and were lower than detection limits 4 h after application. Dislodged bisphenol-A and nonylphenol decreased more slowly but were not detected 6 h after application. Avoiding contact with recently irrigated turf grass should decrease the risks of exposure to these EDCs. PMID:25758534

  11. Outcomes of Varus Valgus Constrained Versus Rotating-Hinge Implants in Total Knee Arthroplasty.

    PubMed

    Malcolm, Tennison L; Bederman, S Samuel; Schwarzkopf, Ran

    2016-01-01

    The stability of a total knee arthroplasty is determined by the ability of the prosthesis components in concert with supportive bone and soft tissue structures to sufficiently resist deforming forces transmitted across the knee joint. Constrained prostheses are used in unstable knees due to their ability to resist varus and valgus transformative forces across the knee. Constraint requires inherent rigidity, which can facilitate early implant failure. The purpose of this study was to describe the comparative indications for surgery and postoperative outcomes of varus valgus constrained knee (VVK) and rotating-hinge knee (RHK) total knee arthroplasty prostheses. Seven retrospective observational studies describing 544 VVK and 254 RHK patients with an average follow-up of 66 months (range, 7-197 months) were evaluated. Patients in both groups experienced similar failure rates (P=.74), ranges of motion (P=.81), and Knee Society function scores (P=.29). Average Knee Society knee scores were 4.2 points higher in VVK patients compared with RHK patients, indicating minimal mid-term clinical differences may exist (P<.0001). Absent collateral ligament support is an almost universal indication for RHK implantation vs VVK. Constrained device implantation is routinely guided by inherent stability of the knee, and, when performed, similar postoperative outcomes can be achieved with VVK and RHK prostheses. PMID:26730689

  12. Clinical and Biomechanical Evaluations of Staged Bilateral Total Knee Arthroplasty Patients with Two Different Implant Designs

    PubMed Central

    Renaud, Alexandre; Fuentes, Alexandre; Hagemeister, Nicola; Lavigne, Martin; Vendittoli, Pascal-André

    2016-01-01

    Background: Various implants of total knee arthroplasty (TKA) are used in clinical practice and each presents specific design characteristics. No implant managed this day to reproduce perfectly the biomechanics of the natural knee during gait. Objectives: We therefore asked whether (1) differences in tridimensional (3D) kinematic data during gait could be observed in two different designs of TKA on the same patients, (2) if those gait kinematic data are comparable with those of asymptomatic knees and (3) if difference in clinical subjective scores can be observed between the two TKA designs on the same patient. Methods: We performed knee kinematic analysis on 15 patients (30 TKAs) with two different TKA implant designs (Nexgen, Zimmer and Triathlon, Stryker) on each knee and on 25 asymptomatic subjects (35 knees). Clinical evaluation included range of motion, weight bearing radiographs, questionnaire of joint perception, KOOS, WOMAC and SF-12. Results: Comparison between TKAs and asymptomatic knees revealed that asymptomatic knees had significantly less knee flexion at initial contact (p < 0.04) and more flexion for most of the swing phase (p between 0.004 and 0.04). Asymptomatic knees also had less varus at loading response, during stance phase and during most of the swing phase (p between 0.001 - 0.05). Transverse plane analysis showed a tendency for asymptomatic knees to be more in internal rotation during stance phase (p 0.02 - 0.04). Comparing both TKA designs, NexgenTM implant had significantly more flexion at the end of swing phase (p = 0.04) compared to knees with the TriathlonTM implant. In frontal plane, from initial contact to maximum mid stance angle and between the mean mid stance angle and initial contact NexgenTM TKA had significantly more adduction (varus, p =0.02 – 0.03). Clinical scores of both TKAs did not have significant difference. Conclusions: TKA with the tested implants did not reproduce natural knee kinematics during gait. In our cohort

  13. Wear and creep behavior of total knee implants undergoing wear testing.

    PubMed

    Teeter, Matthew G; Parikh, Amit; Taylor, Marc; Sprague, Jeff; Naudie, Douglas D

    2015-01-01

    We sought to determine what dimensional changes occurred from wear testing of a total knee implant, as well as any changes within the polyethylene subsurface. Three fixed bearing implants underwent wear simulator testing to 6.1 million cycles. Gravimetric analysis and micro-CT scans were performed pre-test, mid-test, and post-test. Wear volume and surface deviations were greater during 0-3.2 million cycles (91 ± 12mm(3)) than from 3.2 to 6.1 million cycles (52 ± 18mm(3)). Deviations (wear and creep) occurred across all surfaces of the tibial inserts, including the articular surface, backside surface, sides, and locking mechanism. No subsurface changes were found. The micro-CT results were a useful adjunct to gravimetric analysis, defining the dimensional changes that occurred with testing and ruling out subsurface fatigue. PMID:25175057

  14. [Polyethylene in total endoprosthetics--a dead end for permanent implants?].

    PubMed

    Bädorf, D; Willmann, G

    1998-05-01

    Faced with a growing number of younger patients in need of total joint arthroplasty, orthopaedic surgeons are demanding long-term implants for total joint replacement. An assessment of the long-term mechanical behaviour is vivo of all biomaterials in common use in prostheses is in progress. In the present paper, we discuss the long-term reliability of polyethylene (UHMWPE) in joint replacement in terms of tribology and the different biomechanical situation in various human joints. Long-term failure mechanisms for polyethylene in total hip arthoplasty (THA) differ from those seen in total knee arthroplasty (TKA) although the same materials are used. It is thus questionable whether improvements in wear rates of polyethylene in THA would be helpful in TKA. PMID:9616995

  15. Feasibility of a nickel-metal hydride battery for totally implantable artificial hearts.

    PubMed

    Okamoto, E; Yoshida, T; Fujiyoshi, M; Shimanaka, M; Takeuchi, A; Mitamura, Y; Mikami, T

    1996-01-01

    An implantable rechargeable battery is one of the key technologies for totally implantable artificial hearts. The nickel-metal hydride (Ni-MH) battery is promising for its high energy density of 1.5-2.0 times that of a nickel-cadmium battery. In this study, the effects of pulsatile discharge loads on the operating time and cycle life of Ni-MH batteries at 39 degrees C were studied. Two battery cells (TH-3M, 1,200 mAh, phi 14.5 x 49 mm; Toshiba, Tokyo, Japan) in series were charge/discharge cycled at 39 degrees C using a charge current of 1CA (1,200 mA) and then were fully discharged to 1.0 V/cell under either pulsatile discharge loads, which mimicked a systole (1 A for 0.3 sec) and a diastole (0.4 A for 0.3 sec), or a non pulsatile discharge load equivalent to the average of the pulsatile loads (0.7 A). Each cycle life test was interrupted on the 482nd cycle under pulsatile load, and on the 423rd cycle under non pulsatile load, because of malfunction of each battery charger. The tests showed that the pulsatile discharge cells had significantly (p < 0.001) less operating time (74.0 +/- 7.15 min) throughout the test period (up to 482 days) compared to the cells under equivalent non pulsatile discharge loads (93.7 +/- 7.74 min). The pulsatile-discharged Ni-MH cells provide significantly less operating time than the constantly discharged cells; the Ni-MH battery has an operating time of over 78 min and a cycle life of almost 500 cycles at 39 degrees C. In conclusion, the Ni-MH battery is feasible as an implantable back-up battery for a totally implantable artificial heart system. PMID:8944901

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

    SciTech Connect

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

    2012-06-15

    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.

  17. Waste dislodging and conveyance testing summary and conclusions to date

    SciTech Connect

    Rinker, M.W.; Hatchell, B.K.; Mullen, O.D.

    1994-09-01

    This document summarizes recent work performed by the Waste Dislodging and Conveyance technology development program to provide assistance with the retrieval of wastes from the Hanford single-shell tanks (SSTs). This work is sponsored by the Underground Storage Tank-Integrated Demonstration (UST-ID) Office with the U.S. Department of Energy (DOE) Office of Technology Development. A baseline technology of high-pressure water-jet dislodging and pneumatic conveyance integrated as a scarifier is proposed as a means of retrieval. The tests and studies described were performed to demonstrate that at least one robust technology exists that could be effectively used with low water-addition arm-based systems. These results are preliminary and do not represent an optimized baseline. The Waste Dislodging and Conveyance work thus far has demonstrated that waterjet mobilization and air conveyance can mobilize and convey SST waste simulants at the target rates while operating within the space envelope and the dynamic loading constraints of deployment devices. The recommended technologies are well proven in industrial applications and are quite robust, yet lightweight and relatively benign to the retrieval environment. The baseline approach has versatility to continuously dislodge and convey a broad range of waste forms, from hard wastes to soft sludge wastes. The approach also has the major advantage of being noncontact with the waste surface under normal operation.

  18. Successful management of dislodged stents during percutaneous coronary intervention.

    PubMed

    Farman, Muhammad Tariq; Sial, Jawaid Akbar; Saghir, Tahir; Rizvi, Syed Nadeem Hasan; Rasool, Syed Ishtiaq; Jamal, Syed Zahid

    2010-02-01

    Stent dislodgement is a very rare but recognized and potentially serious complication of percutaneous coronary intervention (PCI). This case series describe the incidence and etiology of such cases at National Institute of Cardiovascular Diseases, Karachi during the year 2008 and the method of treatment of this complication. PMID:20209706

  19. Revision total hip and knee arthroplasty implant identification: implications for use of Unique Device Identification 2012 AAHKS member survey results.

    PubMed

    Wilson, Natalia A; Jehn, Megan; York, Sally; Davis, Charles M

    2014-02-01

    FDA's Unique Device Identification (UDI) Rule will mandate manufacturers to assign unique identifiers to their marketed devices. UDI use is expected to improve implant documentation and identification. A 2012 American Association of Hip and Knee Surgeons membership survey explored revision total hip and knee arthroplasty implant identification processes. 87% of surgeons reported regularly using at least 3 methods to identify failed implants pre-operatively. Median surgeon identification time was 20 min; median staff time was 30 min. 10% of implants could not be identified pre-operatively. 2% could not be identified intra-operatively. UDI in TJA registry and UDI in EMR were indicated practices to best support implant identification and save time. FDA's UDI rule sets the foundation for UDI use in patient care settings as standard practice for implant documentation. PMID:23890830

  20. The impact of implantation technique on frontal and sagittal alignment in total lumbar disc replacement: a comparison of anterior versus oblique implantation

    PubMed Central

    Obertacke, U.; Nothwang, J.; Ulrich, C.; Nowicki, J.; Reichel, H.; Cakir, B.

    2010-01-01

    The concept of total lumbar disc replacement (TDR) is gaining acceptance due to good clinical short-term outcome. Standard implantation is strict anterior, which poses especially above the segment L5/S1 sometimes difficulties due to the vessel configuration. Therefore, oblique implantable TDR have been invented. In oblique implantation the anterior longitudinal ligament (ALL) is only partially resected, with additional partial resection of lateral annulus fibers. This could have an impact on biomechanical properties, which has not been evaluated until now. We therefore compared the standing ap and lateral X-rays pre- and postoperative after anterior and oblique implantation of TDR in segment L4/5. Significant differences between the groups were not found. In both the anterior and oblique group, segmental lordosis showed a significant increase, whereas total lordosis as well as ap balance were unchanged. The absolute segmental lordosis increase was nearly double in the anterior group. In conclusion, both anterior and oblique implanted TDR significantly increase segmental lordosis while retaining total lordosis and ap balance. The segmental increase is lower in the oblique implanted group which is probably due to the remaining ALL. Further studies should evaluate whether this finding has any implication for the long-term outcome. PMID:20490873

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

    NASA Astrophysics Data System (ADS)

    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.

  2. Total shoulder arthroplasty outcome for treatment of osteoarthritis: a multicenter study using a contemporary implant.

    PubMed

    Wright, Thomas W; Flurin, Pierre-Henri; Crosby, Lynn; Struk, Aimee M; Zuckerman, Joseph D

    2015-11-01

    In this article, we present clinical results of primary total shoulder arthroplasty for osteoarthritis using an implant that provides dual eccentricity and variable neck and version angles for reconstruction of proximal humeral anatomy. Two hundred one patients with symptomatic osteoarthritis underwent 218 total shoulder arthroplasties with a fourth-generation anatomical shoulder and a replicator plate at 4 centers between August 1, 2006, and December 31, 2010. Fourth-generation implants allow for varying humeral neck and version angles and have dual eccentricity so as to be consistently able to cover the humeral head cut. At a mean follow-up of 3 years (minimum, 2 years), there was an 81% follow-up rate. At final follow-up, 3 objective measures were significantly (P < .05) improved over preoperative levels: average active elevation (preoperative, 92°; postoperative, 137°), active external rotation (pre, 15°; post, 42°), and active internal rotation (pre, S3; post, L2). The functional outcome scores that were significantly (P < .05) improved at final follow-up were Constant normalized (pre, 39; post, 79), Shoulder Pain and Disability Index (pre, 86; post, 20), Simple Shoulder Test (pre, 3.3; post, 10), UCLA Shoulder Rating Scale (pre, 13; post, 31), and American Shoulder and Elbow Surgeons Shoulder Assessment (pre, 33; post, 85). Complications were noted in 11% of the shoulders. The most common complications were rotator cuff failure (13, 6%) and infection (5, 2%). PMID:26566554

  3. Differences in articular track area of posterior-stabilized and cruciate-retaining retrieved total knee implants.

    PubMed

    Bradley, Michael P; Mayor, Michael B; Collier, John P

    2004-12-01

    Press-fit condylar total knee arthroplasties removed at revision surgery from 27 knees were examined. Fourteen of the implants were posterior-stabilized press-fit condylar systems and 13 were cruciate-retaining press-fit condylar systems. The articular track areas were examined using a digital camera and manual measurements. Findings revealed the track area in posterior-stabilized implants (93%) was larger than in cruciate-retaining implants (59%). Mean posterior distance ratio of the articular track from the posterior limit of the polyethylene was 2% (.08 cm) for posterior-stabilized implants versus 23% (.97 cm) for cruciate-retaining implants. No differences in wear rating were noted. The pattern of articular contact in cruciate-retaining knees demonstrated little migration of the femoral contact surface across the tibial polyethylene plateau. PMID:15633958

  4. A case report of total breast reconstruction using an inframammary adipofascial flap with an implant

    PubMed Central

    Ogawa, Tomoko; Yamakawa, Tomomi

    2016-01-01

    Introduction Prosthetic-based breast reconstruction can be used in combination with autologous flaps such as a latissimus dorsi (LD) flap or a thoracodorsal artery perforator (TDAP) flap to achieve symmetry. However, the LD and TDAP flaps require a different skin incision from that which is used for the mastectomy. As a new autologous flap for use in combination with prosthetic-based breast reconstruction after nipple-sparing mastectomy (NSM), we used an inframammary adipofascial flap. Presentation of case The patient was a 27-year-old female with moderate ptotic breasts, who had ductal carcinoma in situ in the lower outer quadrant of her left breast. After NSM through the inframammary fold (IMF) incision, the subcutaneous fat of the intended inframammary area was undermined, and the tongue shaped adipofascial flap was pulled up in the intended area. After inserting a tissue expander under the major pectoral muscle, this adipofascial flap was reflected back to the inferior portion of the breast area. After modeling the breast mound with this flap, the inframammary skin incision was sutured. Eleven months later, the patient underwent surgery to replace the expander with a permanent implant. Eight months after the replacement with an implant, the cosmetic result is good. Discussion This procedure can be performed through the same skin incision on the IMF as NSM. Total breast reconstruction using the inframammary adipofascial flap with an implant can be an alternative approach to achieving symmetry in some patients. Conclusion This method is useful for breast reconstruction after NSM for young patients with moderate-ptotic breasts. PMID:27107500

  5. Boulder Dislodgement by Tsunamis and Storms: Version 2.0

    NASA Astrophysics Data System (ADS)

    Weiss, R.; Diplas, P.; Kaihatu, J. M.; Sheremet, A.

    2015-12-01

    In the past, boulder dislodgement by tsunami and storm waves has been approached with a simple threshold approach in which a boulder was moved if the sum of the acting forces on the boulder is larger than zero. The impulse theory taught us, however, that this criterion is not enough to explain particle dislodgement. We employ an adapted version of the Newton's Second Law of Motion (NSLM) in order to consider the essence of the impulse theory which is that the sum of the forces has to exceed a certain threshold for a certain period of time. Furthermore, a classical assumption is to consider linear waves. However, when waves travel toward the shore, they alter due to non-linear processes. We employ the TRIADS model to quantify that change and how it impacts boulder dislodgement. We present our results of the coupled model (adapted NSLM and TRIADS model). The results project a more complex picture of boulder transport by storms and tsunami. The following question arises: What information do we actually invert, and what does it tell us about the causative event?

  6. Boulder Dislodgement by Tsunamis and Storms: Version 2.0

    NASA Astrophysics Data System (ADS)

    Weiss, Robert

    2016-04-01

    In the past, boulder dislodgement by tsunami and storm waves has been approached with a simple threshold approach in which a boulder was moved if the sum of the acting forces on the boulder is larger than zero. The impulse theory taught us, however, that this criterion is not enough to explain particle dislodgement. We employ an adapted version of the Newton's Second Law of Motion (NSLM) in order to consider the essence of the impulse theory which is that the sum of the forces has to exceed a certain threshold for a certain period of time. Furthermore, a classical assumption is to consider linear waves. However, when waves travel toward the shore, they alter due to non-linear processes. We employ the TRIADS model to quantify that change and how it impacts boulder dislodgement. We present our results of the coupled model (adapted NSLM and TRIADS model). The results project a more complex picture of boulder transport by storms and tsunami. The following question arises: What information do we actually invert, and what does it tell us about the causative event?

  7. Femoral Placement of Totally Implantable Venous Access Ports in Patients with Bilateral Breast Cancer

    PubMed Central

    Almasi-Sperling, V.; Hieber, S.; Lermann, J.; Strahl, O.; Beckmann, M. W.; Lang, W.; Sagban, T. A.

    2016-01-01

    Purpose: Aim of this study was to determine the rate of complications following femoral placement of totally implantable venous access ports (f-TIVAP) in women with bilateral breast cancer, with a special focus on long-term function, deep vein thrombosis (DVT), and port infection. Methods: 73 patients with bilateral breast cancer treated between October 2000 and January 2013 with placement of an f-TIVAP using a transfemoral approach were retrospectively reviewed. All patients were followed up, and all complications of f-TIVAP were recorded. Results: The median age was 62.5 years (range: 35–86 years). Four patients received f-TIVAP under local anesthesia, and 69 underwent placement under general anesthesia. Mean follow-up was 33.7 months (SD 25.9; range: 0.2–93.5 months). Complications over the entire period of observation included infections in 21 %, DVT in 19 % and catheter occlusion in 12 %. Patients receiving chemotherapy who developed leukopenia were more likely to experience DVT at the access site (p = 0.037). There was a trend towards a higher infection rate when the device was used more often (p = 0.084). Conclusion: Although the rates of complications in the longer term, especially device infections and DVTs, appeared to be relatively high, TIVAP implantation using femoral vein access is recommended in patients with bilateral breast cancer not suitable for cephalic vein cut-down. PMID:26855441

  8. Surface composition analysis of failed cementless CoCr- and Ti-base-alloy total hip implants.

    PubMed

    Decking, R; Reuter, P; Hüttner, M; Puhl, W; Claes, L E; Scharf, H P

    2003-02-15

    The surfaces of retrieved failed cementless total hip implants made of cobalt-chromium-molybdenum casting alloy and of wrought titanium 6-aluminum 4-vanadium alloy were studied with the use of scanning-electron microscopy (SEM), energy-dispersive X-ray analysis (EDX) and X-ray photoelectron spectroscopy (XPS). New implants of the same make served as controls. The XPS scans revealed a dense carbon layer on the entire analyzed specimen. The relative composition of the titanium alloy implants showed an overall agreement with the international standards for implants for surgery, and the overall surface composition did not change over the period of the implantation. However, an inhomogeneous distribution of the constituents could be demonstrated in the retrieved as well as in the new MEC-screw rings made of TiAl6V4 alloy, an implant that has been linked to a high early failure rate. In the CoCr-alloy components (Lord-screw rings) a high percentage of aluminum, mainly organized in aluminum inclusions, was found in the retrieved as well as in the new implants. PMID:12516084

  9. Provisional Crown Dislodgement during Scuba Diving: A Case of Barotrauma

    PubMed Central

    Gulve, Meenal Nitin; Gulve, Nitin Dilip

    2013-01-01

    Changes in ambient pressure, for example, during flying, diving, or hyperbaric oxygen therapy, can lead to barotrauma. Although it may seem that this issue was neglected in dental education and research in recent decades, familiarity with and understanding of these facts may be of importance for dental practitioners. We report the case of a patient who experienced barotrauma involving dislodgement of a provisional crown during scuba diving. Patients who are exposed to pressure changes as a part of their jobs or hobbies and their dentists should know the causes of barotrauma. In addition, the clinician must be aware of the possible influence of pressure changes on the retention of dental components. PMID:23984113

  10. Provisional Crown Dislodgement during Scuba Diving: A Case of Barotrauma.

    PubMed

    Gulve, Meenal Nitin; Gulve, Nitin Dilip

    2013-01-01

    Changes in ambient pressure, for example, during flying, diving, or hyperbaric oxygen therapy, can lead to barotrauma. Although it may seem that this issue was neglected in dental education and research in recent decades, familiarity with and understanding of these facts may be of importance for dental practitioners. We report the case of a patient who experienced barotrauma involving dislodgement of a provisional crown during scuba diving. Patients who are exposed to pressure changes as a part of their jobs or hobbies and their dentists should know the causes of barotrauma. In addition, the clinician must be aware of the possible influence of pressure changes on the retention of dental components. PMID:23984113

  11. Implant based differences in adverse local tissue reaction in failed total hip arthroplasties: a morphological and immunohistochemical study

    PubMed Central

    2014-01-01

    Background Adverse local tissue reaction (ALTR) is characterized by periprosthetic soft tissue inflammation composed of a mixed inflammatory cell infiltrate, extensive soft tissue necrosis, and vascular changes. Multiple hip implant classes have been reported to result in ALTR, and clinical differences may represent variation in the soft tissue response at the cellular and tissue levels. The purpose of this study was to describe similarities and differences in periprosthetic tissue structure, organization, and cellular composition by conventional histology and immunohistochemistry in ALTR resulting from two common total hip arthroplasty (THA) implant classes. Methods Consecutive patients presenting with ALTR from two major hip implant classes (N = 54 patients with Dual-Modular Neck implant; N = 14 patients with Metal-on-Metal implant) were identified from our prospective Osteolysis Tissue Database and Repository. Clinical characteristics including age, sex, BMI, length of implantation, and serum metal ion levels were recorded. Retrieved synovial tissue morphology was graded using light microscopy and cellular composition was assessed using immunohistochemistry. Results Length of implantation was shorter in the DMN group versus MoM THA group (21.3 [8.4] months versus 43.6 [13.8] months respectively; p < 0.005) suggesting differences in implant performance. Morphologic examination revealed a common spectrum of neo-synovial proliferation and necrosis in both groups. Macrophages were more commonly present in diffuse sheets (Grade 3) in the MoM relative to DMN group (p = 0.016). Perivascular lymphocytes with germinal centers (Grade 4) were more common in the DMN group, which trended towards significance (p = 0.066). Qualitative differences in corrosion product morphology were seen between the two groups. Immunohistochemistry showed features of a CD4 and GATA-3 rich lymphocyte reaction in both implants, with increased ratios of perivascular T

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

    SciTech Connect

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

    2009-09-15

    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.

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

    SciTech Connect

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

    2010-12-15

    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.

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

    PubMed

    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. PMID:26438624

  15. Nasal Foreign Body, Dislodged and Lost - Can the Adenoids Help?

    PubMed

    Jotdar, Arijit; Dutta, Mainak; Mukhopadhyay, Subrataataata

    2015-06-01

    Foreign body in the nasal cavity is one of the most common paediatric otolaryngology emergencies and needs to be promptly addressed. The incidence of nasal foreign body getting dislodged secondary to unsuccessful attempts to take it out is quite high and can be potentially dangerous as it might cause fatal airway compromise. The chances of it getting impacted and retained in the nasopharynx are practical, although such cases are seldom encountered for primarily nasal foreign bodies. Nevertheless, the nasopharynx should always be looked for as a site of impaction of hidden foreign objects. Presence of enlarged adenoids could be of help as it may prevent accidental lodgement of displaced foreign body in the airway, but might also result in difficulty in locating and retrieving the foreign body because it acts as an anchor-pad with its grooves and crevasses. This report presents a rare, interesting case of a child with enlarged adenoids anchoring a metallic ring and describes the clinical presentations and relevant management of a nasal foreign body dislodged and lost in the nasopharynx. PMID:26266143

  16. Management of totally implantable vascular access devices in patients with cystic fibrosis.

    PubMed

    Dal Molin, A; Gatta, C; Festini, F

    2009-10-01

    Cystic fibrosis (CF) is a genetic disease associated with recurrent lung infections, that represent a major cause of mortality and morbidity. Cystic fibrosis requires frequent antibiotic treatments, sometimes by mouth or via aerosol but often via the intravenous route. Totally implanted venous access devices (ports) allow an easy and safe vascular access for unlimited periods of time, and they can be used in CF to administer antibiotics and other i.v. infusions; if compared to external central venous catheters, ports are better tolerated, since they permit almost unlimited physical activity and do not interfere with patient's self-image. Though ports require a minimal level of care, they may be sometimes associated with relevant complications, which can be insertion-related (pneumothorax, arterial puncture, local hematoma), or management-related (infection, occlusion of the lumen, venous thrombosis). This article summarizes some recommendations on the management of ports in CF, considering the existing literature. Still, some issues remain unsolved and will need further research and studies. PMID:19794380

  17. [Experiences with intra-arterial tumor chemotherapy of malignant liver tumors via totally implantable catheter systems].

    PubMed

    Matthias, M; Ridwelski, K; Wolff, H; Preiss, R; Sperling, P; Lüning, M

    1989-01-01

    Locoregional chemotherapy was applied to 30 patients for isolated, surgically not removable liver tumours (13 colorectal carcinomas, 17 carcinomas on different sites). Ten patients were in Stage I, 16 in Stage II, and four in Stage III. Cytostatics were administered through totally implantable catheter systems. The following therapeutic protocol was mainly used: 5-flourouracil 800-1,000 mg/m2/3hr/die X 5 in 22 days, adriamycin 30 mg/m2/3 hr/die X 2 in 22 days. The average time of treatment amounted to ten months. Cytotoxis side effects were of minor importance. Hepatic side effects, such as chemical hepatitis or sclerosing cholangitis, were not recordable. Reduction of tumour size by 50 percent or more was recorded by computed tomography from 14 cases (46.6 percent). The objectivated rate of responsiveness in patients with colorectal carcinoma was 61.5 percent. The average period up to progression amounted to 12.1 months. Premortal spreading of the disease beyond the liver was recorded from six patients. PMID:2750352

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

    PubMed

    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. PMID:26501917

  19. USTID waste dislodging and conveyance FY 1993 technology development summary report

    SciTech Connect

    Powell, M.R.

    1994-07-01

    The purpose of this document is to describe the testing and conclusions that resulted from the FY 1993 waste dislodging and conveyance technology development testing. The final FY 1993 reports from the various waste dislodging and conveyance technology development tasks are attached to this document as appendices.

  20. Dynamic Biomechanical Examination of the Lumbar Spine with Implanted Total Spinal Segment Replacement (TSSR) Utilizing a Pendulum Testing System

    PubMed Central

    Daniels, Alan H.; Paller, David J.; Koruprolu, Sarath; Palumbo, Mark A.; Crisco, Joseph J.

    2013-01-01

    Background Biomechanical investigations of spinal motion preserving implants help in the understanding of their in vivo behavior. In this study, we hypothesized that the lumbar spine with implanted total spinal segment replacement (TSSR) would exhibit decreased dynamic stiffness and more rapid energy absorption compared to native functional spinal units under simulated physiologic motion when tested with the pendulum system. Methods Five unembalmed, frozen human lumbar functional spinal units were tested on the pendulum system with axial compressive loads of 181 N, 282 N, 385 N, and 488 N before and after Flexuspine total spinal segment replacement implantation. Testing in flexion, extension, and lateral bending began by rotating the pendulum to 5°; resulting in unconstrained oscillatory motion. The number of rotations to equilibrium was recorded and bending stiffness (N-m/°) was calculated and compared for each testing mode. Results The total spinal segment replacement reached equilibrium with significantly fewer cycles to equilibrium compared to the intact functional spinal unit at all loads in flexion (p<0.011), and at loads of 385 N and 488 N in lateral bending (p<0.020). Mean bending stiffness in flexion, extension, and lateral bending increased with increasing load for both the intact functional spinal unit and total spinal segment replacement constructs (p<0.001), with no significant differences in stiffness between the intact functional spinal unit and total spinal segment replacement in any of the test modes (p>0.18). Conclusions Lumbar functional spinal units with implanted total spinal segment replacement were found to have similar dynamic bending stiffness, but absorbed energy at a more rapid rate than intact functional spinal units during cyclic loading with an unconstrained pendulum system. Although the effects on clinical performance of motion preserving devices is not fully known, these results provide further insight into the biomechanical

  1. Good short-term outcome of primary total hip arthroplasty with cementless bioactive glass ceramic bottom-coated implants

    PubMed Central

    2012-01-01

    Background and purpose Cementless total hip arthroplasty is currently favored by many orthopedic surgeons. The design of the porous surface is critically important for long-term fixation. We examined the clinical and radiographic outcome of the cementless titanium hip implant with a bottom coating of apatite-wollastonite containing bioactive glass ceramic. Methods We retrospectively reviewed 109 hips (92 patients) that had undergone primary cementless total hip arthroplasty with bioactive glass ceramic bottom-coated implants. The mean follow-up period was 7 (3–9) years. Hip joint function was evaluated with the Merle d’Aubigné and Postel hip score, and radiographic changes were determined from anteroposterior radiographs. Results The mean hip score improved from 9.7 preoperatively to 17 at the final follow-up. The overall survival rate was 100% at 9 years, when radiographic loosening or revision for any reason was used as the endpoint. 3 stems in 2 patients subsided more than 3 mm vertically within 1 year after implantation. Radiographs of the interface of the stem and femur were all classified as bone ingrowth fixation. Conclusions The short-term results of this study show good outcome for cementless implants with a bottom coating of apatite-wollastonite containing bioactive glass ceramic. PMID:23043270

  2. Surgical and Functional Outcomes in Patients Undergoing Total Knee Replacement With Patient-Specific Implants Compared With “Off-the-Shelf” Implants

    PubMed Central

    Schwarzkopf, Ran; Brodsky, Merrick; Garcia, Giancarlo A.; Gomoll, Andreas H.

    2015-01-01

    Background Total knee arthroplasty (TKA) instrumentation and implant designs have been evolving, with one of the current innovations being patient-specific implants (PSIs). Purpose To evaluate whether there is a significant difference in surgical time, intraoperative blood loss, postoperative range of motion, and length of stay between PSI and conventional TKA. Study Design Cohort study; Level of evidence, 3. Methods A consecutive series of 621 TKA patients, 307 with PSIs and 314 with conventional implants, was reviewed. Differences in estimated blood loss, length of stay, range of motion, and surgical time/tourniquet time between the 2 cohorts were analyzed. Results Linear regression analysis demonstrated that PSI decreased estimated blood loss by 44.72 mL (P < .01), decreased length of stay by 0.39 days (P < .01), decreased postoperative range of motion by 3.90° (P < .01), and had a negligible difference on surgical and tourniquet time. Conclusion The use of PSI is associated with decreased estimated blood loss, decreased length of stay, decreased range of motion, and no discernible difference in surgical or tourniquet time, all of which are unlikely to be clinically significant. PMID:26673037

  3. Untangling boulder dislodgement in storms and tsunamis: Is it possible with simple theories?

    NASA Astrophysics Data System (ADS)

    Weiss, R.; Diplas, P.

    2015-03-01

    Boulders can move during storms and tsunamis. It is difficult to find a simple method to distinguish boulders moved by tsunami waves from those moved during storms in the field. In this contribution, we explore boulder dislodgement by storm and tsunami waves by solving an adapted version of Newton's Second Law of Motion in polar coordinates and defining a critical position for boulder dislodgement. We find that the boulder dislodgement is not only a function of the causative wave, but also of the roughness in the vicinity of the boulder and the slope angle. We employ the amplitude of storm and tsunami waves to dislodge boulders of given masses to evaluate if boulder dislodgement in storms can be untangled from boulder transport in tsunamis. As the main result of our numerical experiments, we find a significant difference between storm and tsunami waves to dislodge the same boulder for large masses and large roughness values. This allows us to conclude that simple theories are applicable to answer the questions asked in the title, but we argue only if they contain a critical dislodgement condition like the one presented here.

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

    PubMed Central

    Knebel, P; Fröhlich, B; Knaebel, H-P; Kienle, P; Luntz, S; Buchler, MW; Seiler, CM

    2006-01-01

    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 für Klinische Studien (KKS)

  5. Hydroxyapatite (HA) coating appears to be of benefit for implant durability of tibial components in primary total knee arthroplasty

    PubMed Central

    2011-01-01

    Background It is unclear whether there is a clinical benefit to adding hydroxyapatite (HA) coatings to total knee implants, especially with the tibial component, where failure of the implant more often occurs. A systematic review of the literature was undertaken to identify all prospective randomized trials for determining whether the overall clinical results (as a function of durability, function, and adverse events) favored HA-coated tibial components. Methods A comprehensive literature search was performed for the years 1990 to September 16, 2010. We restricted our search to randomized controlled trials involving participants receiving either an HA-coated tibia or other forms of tibial fixation. The primary outcome measures evaluated were durability, function, and acute adverse events. Results Data from 926 evaluable primary total knee implants in 14 studies were analyzed. Using an RSA definition for durability, HA-coated tibial components (porous or press-fit) without screw fixation were less likely to be unstable at 2 years than porous and cemented metal-backed tibial components (RR = 0.58, 95% CI: 0.34–0.98; p = 0.04, I2 = 39%, M-H random effects model). There was no significant difference in durability, as measured from revision and evaluated at 2 and 8–10 years, between groups. Also, functional status using different validated measures showed no significant difference at 2 and 5 years, no matter what measure was used. Lastly, there was no significant difference in adverse events. Limitations included small numbers of evaluable patients (≤ 50) in 7 of the 14 trials identified, and a lack of “hard” evidence of durability with need for replacement (i.e. frank failure, pain, or loss of functionality). Interpretation In patients > 65 years of age, an HA-coated tibial implant may provide better durability than other forms of tibial fixation. Larger trials should be undertaken comparing the long-term durability, function, and adverse events of HA

  6. Comparative Evaluation of Enhancing Retention of Dislodged Crowns Using Preparation Modifications and Luting Cements: An In-Vitro Study

    PubMed Central

    Amarnath, G S; Pandey, Apurva; Prasad, Hari Ananth; Hilal, Mohammed

    2015-01-01

    Background: Complete cast crowns are good alternatives and have best longevity for the restoration of damaged posterior teeth. Occasionally, a crown with clinically acceptable margins, preparation design, and occlusion becomes loose. Providers often debate whether such a crown can be successfully recemented with any degree of confidence that it will not be dislodged under normal masticatory function. It has been documented that resistance form increases by placing grooves opposing each other in a crown and tooth; cements also have a role to play in retention of crowns. To determine whether the addition of horizontal groove in the internal surface of the crown and/or tooth preparation will increase retention of the crowns, without remaking them and achieving better retention with cements. Materials and Methods: A total of 80 extracted human mandibular molars were taken and standard preparation was done. After the crowns were ready, the groove was made in the internal surface of the crown and on the tooth, which were cemented with glass ionomer cement and resin cement. The tensile force needed to dislodge the crowns and teeth after cementation was found out. Result: The mean tensile force needed to dislodge the crown and tooth combination was highest for the group in which crown had a groove without any groove on the tooth and cemented using resin cement (252.60N). Conclusion: It can be concluded from the study that it is best to recement a crown and tooth combination using resin cement where the crown has a groove, and the tooth has no groove. PMID:26464539

  7. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... dislodge stones from renal calyces (recesses of the pelvis of the kidney) by means of a pressurized stream of water through a conduit. The device is used in the surgical removal of kidney stones....

  8. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... dislodge stones from renal calyces (recesses of the pelvis of the kidney) by means of a pressurized stream of water through a conduit. The device is used in the surgical removal of kidney stones....

  9. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... dislodge stones from renal calyces (recesses of the pelvis of the kidney) by means of a pressurized stream of water through a conduit. The device is used in the surgical removal of kidney stones....

  10. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... dislodge stones from renal calyces (recesses of the pelvis of the kidney) by means of a pressurized stream of water through a conduit. The device is used in the surgical removal of kidney stones....

  11. 21 CFR 876.4650 - Water jet renal stone dislodger system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... dislodge stones from renal calyces (recesses of the pelvis of the kidney) by means of a pressurized stream of water through a conduit. The device is used in the surgical removal of kidney stones....

  12. Flow variation and substrate type affect dislodgement of the freshwater polychaete, Manayunkia speciosa

    USGS Publications Warehouse

    Malakauskas, David M.; Wilson, Sarah J.; Wilzbach, Margaret A.; Som, Nicholas A.

    2013-01-01

    We quantified microscale flow forces and their ability to entrain the freshwater polychaete, Manayunkia speciosa, the intermediate host for 2 myxozoan parasites (Ceratomyxa shasta and Parvicapsula minibicornis) that cause substantial mortalities in salmonid fishes in the Pacific Northwest. In a laboratory flume, we measured the shear stress associated with 2 mean flow velocities and 3 substrates and quantified associated dislodgement of polychaetes, evaluated survivorship of dislodged polychaetes, and observed behavioral responses of the polychaetes in response to increased flow. We used a generalized linear mixed model to estimate the probability of polychaete dislodgement for treatment combinations of velocity (mean flow velocity  =  55 cm/s with a shear velocity  =  3 cm/s, mean flow velocity  =  140 cm/s with a shear velocity  =  5 cm/s) and substrate type (depositional sediments and analogs of rock faces and the filamentous alga, Cladophora). Few polychaetes were dislodged at shear velocities <3 cm/s on any substrate. Above this level of shear, probability of dislodgement was strongly affected by both substrate type and velocity. After accounting for substrate, odds of dislodgement were 8× greater at the higher flow. After accounting for velocity, probability of dislodgement was greatest from fine sediments, intermediate from rock faces, and negligible from Cladophora. Survivorship of dislodged polychaetes was high. Polychaetes exhibited a variety of behaviors for avoiding increases in flow, including extrusion of mucus, burrowing into sediments, and movement to lower-flow microhabitats. Our findings suggest that polychaete populations probably exhibit high resilience to flow-mediated disturbances.

  13. Bisphosphonate Use and Risk of Implant Revision after Total Hip/Knee Arthroplasty: A Meta-Analysis of Observational Studies

    PubMed Central

    Teng, Songsong; Yi, Chengqing; Krettek, Christian; Jagodzinski, Michael

    2015-01-01

    Objective Several studies investigated the association between bisphosphonate use and the risk of implant revision after total hip or knee arthroplasty (THA or TKA); However, the findings were inconsistent. We performed this meta-analysis to evaluate the overall relative risk of such an event. Methods We searched the PubMed, EMBASE and Cochrane library databases to identify relevant publications on April 22, 2015. To calculate the pooled risk ratios (RRs) with 95% confidential intervals (CIs), a fixed- or random-effects model was applied based on the heterogeneity across studies. Results Three cohort studies and one case-control study were included in this meta-analysis. Compared with the bisphosphonate nonusers, the patients who used bisphosphonates for a long period of time had a significantly decreased risk of implant revision after THA/TKA (summary adjusted RR = 0.48, 95% CI: 0.38–0.61), and the summary adjusted RRs for the users who underwent THA and those who underwent TKA were 0.47 (95% CI: 0.36–0.61) and 0.45 (95% CI: 0.21–0.95), respectively. Conclusions Long-term use of bisphosphonates is correlated with a significantly decreased risk of implant revision after THA/TKA. However, due to limited number of the included studies, the findings of the present study should be treated with caution. More well-designed studies are required to further confirm our findings. PMID:26444555

  14. Expertise modeling for automated planning of acetabular cup in total hip arthroplasty using combined bone and implant statistical atlases.

    PubMed

    Otomaru, Itaru; Kobayashi, Kazuto; Okada, Toshiyuki; Nakamoto, Masahiko; Kagiyama, Yoshiyuki; Takao, Masaki; Sugano, Nobuhiko; Tada, Yukio; Sato, Yoshinobu

    2009-01-01

    Intraoperative robotic and computer-guided assistances are now commonly used in total hip arthroplasty (THA) for accurate execution of the preoperative plan. Although the preoperative plan to be accurately executed is critical, it is still interactively prepared in a time-consuming and subjective manner. In this paper, atlas-based approach to automated surgical planning of the acetabular cup in THA is described to stabilize its quality as well as reduce its time-consuming nature. Surgeon's expertise is embedded in two types of statistical atlases, which are constructed from training datasets of CT-based 3D plans prepared by experienced surgeons. One is a statistical shape model which encodes global spatial relationships between the patient anatomy and implant. The other is the statistical map of residual bone thickness on the implant surface, which encodes local spatial constraints of the anatomy and implant. Given the 3D pelvis shape of the patient, we formulate a procedure to determine the best size and position of the acetabular cup which satisfy the constraints derived from the two statistical atlases. We validated the proposed planning method by retrospective study using the datasets which were actually used in the THA surgery. PMID:20426029

  15. Do we need hip-ankle radiographs to assess the coronal alignment and implant position after total knee replacement?

    PubMed Central

    Dargel, Jens; Oppermann, Johannes; Eysel, Peer; Penning, Lenhard

    2016-01-01

    Aims and Objectives: Restoration of the coronal alignment of the knee is known to be one of the major criteria of a successful total knee arthroplasty (TKA). It therefore appears to be mandatory to routinely assess the postoperative limb alignment using hip-ankle radiographs and to identify implants that may be at risk of premature failure. However, there is no clear consensus whether weight-bearing hip-ankle radiographs or rather standardized a-p knee-radiographs should be used to assess implant position and coronal alignment after TKA. It is the aim of the present study to investigate if implant position and the mechanical alignment after TKA can reproducibly be assessed using standardized a-p knee-radiographs or rather if weight-bearing hip-ankle radiographs are needed. Materials and Methods: This study was performed on 100 postoperative weight-bearing hip-ankle radiographs after conventional primary TKA. The true mechanical and anatomical femorotibial angle as well as coronal implant position (MPTA, LDFA) was assessed using the MediCAD software, which served as a control. The hip-ankle radiographs were then digitally cropped to 80%, 60% and 40% of the leg-length. In each cropped radiograph, tibial coronal implant position was assessed by referencing against the visible mid-shaft, whereas femoral implant position was referenced against the visible mid-shaft (anatomical axis) or against a surrogate mechanical axis, which was drawn perpendicular to the distal tangent of the femoral component. Each measurement was performed by three independent observers. The difference between the alignment parameters in the hip-ankle radiographs were statistically compared with the cropped radiographs and the inter-observer correlation coefficient (ICC) was calculated for each parameter. Results: The ICC for inter-observer agreement of measurement of the mechanical femorotibial angle was significantly higher in hip-ankle radiographs (.95) when compared with a radiograph cropped

  16. Can ECAP measures be used for totally objective programming of cochlear implants?

    PubMed

    McKay, Colette M; Chandan, Kirpa; Akhoun, Idrick; Siciliano, Catherine; Kluk, Karolina

    2013-12-01

    An experiment was conducted with eight cochlear implant subjects to investigate the feasibility of using electrically evoked compound action potential (ECAP) measures other than ECAP thresholds to predict the way that behavioral thresholds change with rate of stimulation, and hence, whether they can be used without combination with behavioral measures to determine program stimulus levels for cochlear implants. Loudness models indicate that two peripheral neural response characteristics contribute to the slope of the threshold versus rate function: the way that neural activity to each stimulus pulse decreases as rate increases and the slope of the neural response versus stimulus current function. ECAP measures related to these two characteristics were measured: the way that ECAP amplitude decreases with stimulus rate and the ECAP amplitude growth function, respectively. A loudness model (incorporating temporal integration and the two neural response characteristics) and regression analyses were used to evaluate whether the ECAP measures could predict the average slope of the behavioral threshold versus current function and whether individual variation in the measures could predict individual variation in the slope of the threshold function. The average change of behavioral threshold with increasing rate was well predicted by the model when using the average ECAP data. However, the individual variations in the slope of the thresholds versus rate functions were not well predicted by individual variations in ECAP data. It was concluded that these ECAP measures are not useful for fully objective programming, possibly because they do not accurately reflect the neural response characteristics assumed by the model, or are measured at current levels much higher than threshold currents. PMID:24048907

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

    PubMed Central

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

    2016-01-01

    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. PMID:27345704

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

    NASA Astrophysics Data System (ADS)

    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.

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

    PubMed

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

    2016-01-01

    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. PMID:27345704

  20. Full-field in vitro measurements and in silico predictions of strain shielding in the implanted femur after total hip arthroplasty.

    PubMed

    Chanda, Souptick; Dickinson, Alexander; Gupta, Sanjay; Browne, Martin

    2015-08-01

    Alterations in bone strain as a result of implantation may contribute towards periprosthetic bone density changes after total hip arthroplasty. Computational models provide full-field strain predictions in implant-bone constructs; however, these predictions should be verified using experimental models wherever it is possible. In this work, finite element predictions of surface strains in intact and implanted composite femurs were verified using digital image correlation. Relationships were sought between post-implantation strain states across seven defined Gruen zones and clinically observed longer-term bone density changes. Computational predictions of strain distributions in intact and implanted femurs were compared to digital image correlation measurements in two regions of interest. Regression analyses indicated a strong linear correlation between measurements and predictions (R = 0.927 intact, 0.926 implanted) with low standard error (standard error = 38 µε intact, 26 µε implanted). Pre- to post-operative changes in measured and predicted surface strains were found to relate qualitatively to clinically observed volumetric bone density changes across seven Gruen zones: marked proximal bone density loss corresponded with a 50%-64% drop in surface strain, and slight distal density changes corresponded with 4%-14% strain increase. These results support the use of digital image correlation as a pre-clinical tool for predicting post-implantation strain shielding, indicative of long-term bone adaptations. PMID:26112349

  1. Role of ceramic implants. Design and clinical success with total hip prosthetic ceramic-to-ceramic bearings.

    PubMed

    Clarke, I C

    1992-09-01

    Ceramic implants have become of great interest because of the increased awareness that wear debris from metal-polyethylene components of total hip prostheses can cause osteolysis around implants. Polyethylene wear rates with the Charnley total hip prosthesis were found to be from 0.1 to 0.2 mm/year in the elderly, which corresponded to 30 to 80 mm3 of polyethylene debris being released to the joint tissues. This in turn can be related to 40 million to 40 billion particles being released into the joint every year. This polyethylene particulate is heavily implicated in the osteolytic destruction of periarticular tissues. The ceramic ball, ceramic cup combination of total hip prostheses may have promise of wear rates that could be thousands of times smaller than polyethylene alone. Such alumina ceramic prosthetic concepts were introduced in Europe from 1970 to 1973. Under Food and Drug Administration regulations at that time, the only U.S. introductions allowed circa 1980 were the Autophor and Xenophor types of ceramic prostheses. However, this particular prosthetic design was not successful in the United States because of pain, neck-socket impingement, ceramic fracture, and component loosening. This did not therefore appear to be a successful compromise in the hands of U.S. surgeons. Ceramic innovations from Europe now include cemented ceramic cups of "matching" tolerances with the femoral ball, and press-fit Ti-alloy acetabular shells with modular ceramic inserts. In addition, alumina and zirconia ceramic balls are now in routine clinical use in Europe. The objectives of this Symposium are to highlight these ceramic ball, ceramic cup innovations with their long-term clinical results from Europe. Then one can evaluate which of these innovations in material and design selections offers the best possible alternatives in the 1990s. PMID:1516312

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

    PubMed

    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. PMID:21783150

  3. Total lower eyelid reconstruction with superficial temporal fascia flap and porous polyethylene implant: a case report.

    PubMed

    Sahin, Ismail; Aykan, Andac; Acikel, Cengiz; Alhan, Dogan; Isik, Selcuk

    2012-01-01

    Total reconstruction of the eyelid after serious periorbital injury is a challenging procedure for plastic and reconstructive surgery. Although several methods have been used for reconstructing the eyelids, such as advancement flap with fascia lata sling, island mucochrondrocutaneous flap, prefabricated temporal island flap, porous polyethylene and superficial temporal fascia flap, creating a supportive eyelid for housing an artificial eye without complication is still an ongoing problem. In the case presented, superficial temporal fascia flap with porous polyethylene was used for the reconstruction of total lower eyelid. PMID:21778127

  4. Dynamic Biomechanical Examination of the Lumbar Spine with Implanted Total Disc Replacement (TDR) Utilizing a Pendulum Testing System

    PubMed Central

    Daniels, Alan H; Paller, David J; Koruprolu, Sarath; McDonnell, Matthew; Palumbo, Mark A; Crisco, Joseph J

    2013-01-01

    Study Design Biomechanical cadaver investigation Objective To examine dynamic bending stiffness and energy absorption of the lumbar spine with and without implanted Total Disc Replacement (TDR) under simulated physiologic motion. Summary of background data The pendulum testing system is capable of applying physiologic compressive loads without constraining motion of functional spinal units (FSUs). The number of cycles to equilibrium observed under pendulum testing is a measure of the energy absorbed by the FSU. Methods Five unembalmed, frozen human lumbar FSUs were tested on the pendulum system with axial compressive loads of 181N, 282N, 385N, and 488N before and after Synthes ProDisc-L TDR implantation. Testing in flexion, extension, and lateral bending began by rotating the pendulum to 5° resulting in unconstrained oscillatory motion. The number of rotations to equilibrium was recorded and bending stiffness (N-m/°) was calculated and compared for each testing mode. Results In flexion/extension, the TDR constructs reached equilibrium with significantly (p<0.05) fewer cycles than the intact FSU with compressive loads of 282N, 385N and 488N. Mean dynamic bending stiffness in flexion, extension, and lateral bending increased significantly with increasing load for both the intact FSU and TDR constructs (p<0.001). In flexion, with increasing compressive loading from 181N to 488N, the bending stiffness of the intact FSUs increased from 4.0N-m/° to 5.5N-m/°, compared to 2.1N-m/° to 3.6N-m/° after TDR implantation. At each compressive load, the intact FSU was significantly more stiff than the TDR (p<0.05). Conclusion Lumbar FSUs with implanted TDR were found to be less stiff, but also absorbed more energy during cyclic loading with an unconstrained pendulum system. Although the effects on clinical performance of motion preserving devices are not fully known, these results provide further insight into the biomechanical behavior of this device under approximated

  5. Totally implantable venous access devices: retrospective analysis of different insertion techniques and predictors of complications in 796 devices implanted in a single institution

    PubMed Central

    2014-01-01

    Background The aim of this study was to assess the efficacy and safety of totally implanted vascular devices (TIVAD) using different techniques of insertion. Methods We performed a retrospective study using a prospective collected database of 796 consecutive oncological patients in which TIVADs were inserted. We focused on early and late complications following different insertion techniques (surgical cutdown, blind and ultrasound guided percutaneous) according to different techniques. Results Ultrasound guided technique was used in 646 cases, cephalic vein cutdown in 102 patients and percutaneous blind technique in 48 patients. The overall complication rate on insertion was 7.2% (57 of 796 cases). Early complications were less frequent using the ultrasound guided technique: arterial puncture (p = 0.009), technical failure (p = 0.009), access site change after first attempt (p = 0.002); pneumothorax occurred in 4 cases, all using the blind percutaneus technique. Late complications occurred in 49 cases (6.1%) which required TIVAD removal in 43 cases and included: sepsis (29 cases), thrombosis (3 cases), dislocation (7 cases), skin dehiscence (3 cases), and severe pain (1 case). Conclusion Ultrasound guided technique is the safest option for TIVAD insertion, with the lowest rates of immediate complications. PMID:24886342

  6. Sun's procedure for complex aortic arch repair: total arch replacement using a tetrafurcate graft with stented elephant trunk implantation.

    PubMed

    Ma, Wei-Guo; Zhu, Jun-Ming; Zheng, Jun; Liu, Yong-Min; Ziganshin, Bulat A; Elefteriades, John A; Sun, Li-Zhong

    2013-09-01

    The Sun's procedure is a surgical technique proposed by Dr. Li-Zhong Sun in 2002 that integrates total aortic arch replacement using a tetrafurcated graft with implantation of a specially designed frozen elephant trunk (Cronus(®)) in the descending aorta. It is used as a treatment option for extensive aortic dissections or aneurysms involving the ascending aorta, aortic arch and the descending aorta. The technical essentials of Sun's procedure include implantation of the special open stented graft into the descending aorta, total arch replacement with a 4-branched vascular graft, right axillary artery cannulation, selective antegrade cerebral perfusion for brain protection, moderate hypothermic circulatory arrest at 25 °C, a special anastomotic sequence for aortic reconstruction (i.e., proximal descending aorta → left carotid artery → ascending aorta → left subclavian artery → innominate artery), and early rewarming and reperfusion after distal anastomosis to minimize cerebral and cardiac ischemia. The core advantage of Sun's procedure lies in the use of a unique stented graft, which has superior technical simplicity, flexibility, inherent mechanical durability and an extra centimeter of attached regular vascular graft at both ends. Since its introduction in 2003, the Sun's procedure has produced satisfactory early and long-term results in over 8,000 patients in China and more than 200 patients in South American countries. In a series of 1,092 patients, the authors have achieved an in-hospital mortality rate of 6.27% (7.98% in emergent or urgent vs. 3.98% in elective cases). Given the accumulating clinical experience and the consequent, continual evolution of surgical indications, the Sun's procedure is becoming increasingly applied/used worldwide as an innovative and imaginative enhancement of surgical options for the dissected (or aneurysmal) ascending aorta, aortic arch and proximal descending aorta, and may become the next standard treatment for type

  7. Rupture of totally implantable central venous access devices (Intraports) in patients with cancer: report of four cases

    PubMed Central

    Filippou, Dimitrios K; Tsikkinis, Christoforos; Filippou, Georgios K; Nissiotis, Athanasios; Rizos, Spiros

    2004-01-01

    Background Totally implantable central venous access devices (intraports) are commonly used in cancer patients to administer chemotherapy or parenteral nutrition. Rupture of intraport is a rare complication. Patients and methods During 3 years period, a total of 245 intraports were placed in cancer patients for chemotherapy. Four of these cases (two colon cancer and one each of pancreas and breast cancer) had rupture of the intraport catheter, these forms the basis of present report. Results Mean time insitu for intraports was 164∀35 days. Median follow-up time was 290 days and total port time in situ was 40180 days. The incidence of port rupture was 1 per 10,000 port days. Three of the 4 cases were managed by successful removal of catheters. In two of these the catheter was removed under fluoroscopic control using femoral route, while in the third patient the catheter (partial rupture) was removed surgically. One of the catheters could not be removed and migrated to right ventricle on manipulations. Conclusion Port catheter rupture is a rare but dreaded complication associated with subcutaneous port catheter device placement for chemotherapy. In case of such an event the patient should be managed by an experienced vascular surgeon and interventional radiologist, as in most cases the ruptured catheter can be retrieved by non operative interventional measures. PMID:15494075

  8. Transcutaneous Optical Information Transmission System for a Totally Implantable Artificial Heart

    NASA Astrophysics Data System (ADS)

    Yamamoto, Takahiko; Koshiji, Kohji

    A transcutaneous optical information transmission system (TOITS) offers the most promising method for noninvasively transmitting the information to control a total artificial heart (TAH). We had used light-emitting diode (LED) and photo diode (PD) with different wavelengths for full-duplex bidirectional communication in the TOITS. In this study, reduction of optical crosstalk in full-duplex bidirectional communication was investigated by using a combination of two orthogonal polarizers with the same wavelength. As a result, we confirmed that optical crosstalk could be prevented for communication through a cow's skin (3.5 mm thick) and that the signal waveform could be transmitted satisfactorily.

  9. Near-surface density of ion-implanted Si studied by Rutherford backscattering and total-reflection x-ray fluorescence

    SciTech Connect

    Klockenkaemper, R.; Becker, M.; Bohlen, A. von; Becker, H.W.; Krzyzanowska, H.; Palmetshofer, L.

    2005-08-01

    The implantation of ions in solids is of high technical relevance. The different effects within the solid target caused by the ion bombardment can be investigated by depth profiling of near-surface layers. As and Co ions were implanted in Si wafers: As ions with a fluence of 1x10{sup 17}/cm{sup 2} and an energy of 100 keV and Co ions with 1x10{sup 16}/cm{sup 2} at 25 keV. Subsequently depth profiling was carried out by Rutherford backscattering spectrometry as well as by total-reflection x-ray fluorescence analysis which was combined with differential weighing and interferometry after repeated large-surface sputter etching. Over and above the amorphization of the Si crystal, two other essential effects were observed: (i) a swelling or expansion of the original Si crystal in the near-surface region, in particular in the case of the As implantation, and (ii) a shrinking or compression of the Si crystal for deeper sublayers especially distinct for the Co implantation. On the other hand, a high surface enrichment of implanted ions was found for the As implantation while only a low surface concentration was detected for the Co implantation.

  10. Factors Influencing Dislodgeable 2, 4-D Plant Residues from Hybrid Bermudagrass (Cynodon dactylon L. x C. transvaalensis) Athletic Fields.

    PubMed

    Jeffries, Matthew D; Gannon, Travis W; Brosnan, James T; Ahmed, Khalied A; Breeden, Gregory K

    2016-01-01

    Research to date has confirmed 2,4-D residues may dislodge from turfgrass; however, experiments have not been conducted on hybrid bermudagrass (Cynodon dactylon L. x C. transvaalensis), the most common athletic field turfgrass in subtropical climates. More specifically, previous research has not investigated the effect of post-application irrigation on dislodgeable 2,4-D residues from hybrid bermudagrass and across turfgrass species, research has been nondescript regarding sample time within a d (TWD) or conducted in the afternoon when the turfgrass canopy is dry, possibly underestimating potential for dislodgement. The effect of irrigation and TWD on 2,4-D dislodgeability was investigated. Dislodgeable 2,4-D amine was reduced > 300% following irrigation. From 2 to 7 d after treatment (DAT), ≤ 0.5% of applied 2,4-D was dislodged from irrigated turfgrass, while ≤ 2.3% of applied 2,4-D was dislodged when not irrigated. 2,4-D dislodgeability decreased as TWD increased. Dislodgeable 2,4-D residues declined to < 0.1% of the applied at 1 DAT- 13:00, and increased to 1 to 3% of the applied 2 DAT- 5:00, suggesting 2,4-D re-suspended on treated turfgrass vegetation overnight. In conclusion, irrigating treated turfgrass reduced dislodgeable 2,4-D. 2,4-D dislodgeability increased as TWD decreased, which was attributed to non-precipitation climatic conditions favoring turfgrass canopy wetness. This research will improve turfgrass management practices and research designed to minimize human 2,4-D exposure. PMID:26863005

  11. Factors Influencing Dislodgeable 2, 4-D Plant Residues from Hybrid Bermudagrass (Cynodon dactylon L. x C. transvaalensis) Athletic Fields

    PubMed Central

    Ahmed, Khalied A.; Breeden, Gregory K.

    2016-01-01

    Research to date has confirmed 2,4-D residues may dislodge from turfgrass; however, experiments have not been conducted on hybrid bermudagrass (Cynodon dactylon L. x C. transvaalensis), the most common athletic field turfgrass in subtropical climates. More specifically, previous research has not investigated the effect of post-application irrigation on dislodgeable 2,4-D residues from hybrid bermudagrass and across turfgrass species, research has been nondescript regarding sample time within a d (TWD) or conducted in the afternoon when the turfgrass canopy is dry, possibly underestimating potential for dislodgement. The effect of irrigation and TWD on 2,4-D dislodgeability was investigated. Dislodgeable 2,4-D amine was reduced > 300% following irrigation. From 2 to 7 d after treatment (DAT), ≤ 0.5% of applied 2,4-D was dislodged from irrigated turfgrass, while ≤ 2.3% of applied 2,4-D was dislodged when not irrigated. 2,4-D dislodgeability decreased as TWD increased. Dislodgeable 2,4-D residues declined to < 0.1% of the applied at 1 DAT– 13:00, and increased to 1 to 3% of the applied 2 DAT– 5:00, suggesting 2,4-D re-suspended on treated turfgrass vegetation overnight. In conclusion, irrigating treated turfgrass reduced dislodgeable 2,4-D. 2,4-D dislodgeability increased as TWD decreased, which was attributed to non-precipitation climatic conditions favoring turfgrass canopy wetness. This research will improve turfgrass management practices and research designed to minimize human 2,4-D exposure. PMID:26863005

  12. No association between serum metal ions and implant fixation in large-head metal-on-metal total hip arthroplasty

    PubMed Central

    Søballe, Kjeld; Jakobsen, Stig Storgaard; Lorenzen, Nina Dyrberg; Mechlenburg, Inger; Stilling, Maiken

    2014-01-01

    Background The mechanism of failure of metal-on-metal (MoM) total hip arthroplasty (THA) has been related to a high rate of metal wear debris, which is partly generated from the head-trunnion interface. However, it is not known whether implant fixation is affected by metal wear debris. Patients and methods 49 cases of MoM THA in 41 patients (10 women) with a mean age of 52 (28–68) years were followed with stereoradiographs after surgery and at 1, 2, and 5 years to analyze implant migration by radiostereometric analysis (RSA). Patients also participated in a 5- to 7-year follow-up with measurement of serum metal ions, questionnaires (Oxford hip score (OHS) and Harris hip score (HHS)), and measurement of cup and stem positions and systemic bone mineral density. Results At 1–2 years, mean total translation (TT) was 0.04 mm (95% CI: –0.07 to 0.14; p = 0.5) for the stems; at 2–5 years, mean TT was 0.13 mm (95% CI: –0.25 to –0.01; p = 0.03), but within the precision limit of the method. For the cups, there was no statistically significant TT or total rotation (TR) at 1–2 and 2–5 years. At 2–5 years, we found 4 cups and 5 stems with TT migrations exceeding the precision limit of the method. There was an association between cup migration and total OHS < 40 (4 patients, 4 hips; p = 0.04), but there were no statistically significant associations between cup or stem migration and T-scores < –1 (n = 10), cup and stem positions, or elevated serum metal ion levels (> 7µg/L (4 patients, 6 hips)). Interpretation Most cups and stems were well-fixed at 1–5 years. However, at 2–5 years, 4 cups and 5 stems had TT migrations above the precision limits, but these patients had serum metal ion levels similar to those of patients without measurable migrations, and they were pain-free. Patients with serum metal ion levels > 7 µg/L had migrations similar to those in patients with serum metal ion levels < 7 µg/L. Metal wear debris does not appear to influence the

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

    PubMed

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

    2016-01-01

    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. PMID:27488941

  14. Accuracy of implant positioning for minimally invasive total knee arthroplasty in patients with severe varus deformity.

    PubMed

    Niki, Yasuo; Matsumoto, Hideo; Otani, Toshiro; Enomoto, Hiroyuki; Toyama, Yoshiaki; Suda, Yasunori

    2010-04-01

    Minimally invasive surgery (MIS) in total knee arthroplasty (TKA) reportedly yields decreased patient morbidity and a rapid return of function, but how much deformity can be accepted for MIS-TKA remains unclear. This study investigated 238 knees from 218 consecutive patients who underwent MIS-TKA. Patients were divided into groups with tibiofemoral mechanical axis (TFM) 195 degrees or greater and TFM less than 195 degrees, then clinical and radiographic results were compared. Similar improvements in knee score at 3 months postoperatively were obtained in the both groups, whereas radiographic accuracy of the coronal alignment in the TFM >or=195 degrees group was inferior to that in TFM <195 degrees group. Postoperative TFM was significantly worsened in patients with lateral bowing angle of the femoral shaft (LBFS) 4 degrees or greater, and 53% of patients in the TFM >or=195 degrees group displayed LBFS 4 degrees or greater, explaining the inferior radiographic accuracy in this group compared with the TFM <195 degrees group. These results indicate that use of MIS techniques decreases radiographic accuracy, particularly in patients with severe genu varum and increased LBFS. PMID:20347714

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

    PubMed Central

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

    2016-01-01

    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. PMID:27488941

  16. Stress analysis of mandibular two-implant overdenture with different attachment systems.

    PubMed

    Takeshita, Shin; Kanazawa, Manabu; Minakuchi, Shunsuke

    2011-01-01

    This study aimed to investigate the influence of different overdenture attachment systems on the stress generated in peri-implant bone during overdenture dislodgement and loading. Two implants were placed in the canine regions on an acrylic edentulous mandibular model. Four strain gauges were attached to the resin surface adjacent to the left implant. Bar, ball, and magnetic attachments were examined. Three experimental overdentures were fabricated, and the denture parts of the attachment systems were incorporated into the mucosal surface. Retentive forces and strains generated in peri-implant bone during three types of dislodgement (vertical, anterior and posterior) and loading (left first molar region, right first molar region and mid-anterior region) were measured. The bar attachment showed the highest retentive force and reduced strain on posterior dislodgement. The ball attachment demonstrated the largest strain on loading at molar regions. The magnetic attachment showed the smallest retentive force and little strain. PMID:22123019

  17. EVALUATION OF THE EFFECTIVENESS OF COATINGS IN REDUCING DISLODGEABLE ARSENIC, CHROMIUM, AND COPPER FROM CCA TREATED WOOD; FINAL REPORT

    EPA Science Inventory

    EPA conducted a study to evaluate the effect of coatings on dislodgeable arsenic, chromium, and copper residues on the surfaces of chromated copper arsenate (CAA) treated wood. Dislodgeable CCA, determined by wipe sampling the wood surfaces, was the primary evaluation criterion f...

  18. Continuous-Flow Total Heart Replacement Device Implanted in a 55-Year-Old Man with End-Stage Heart Failure and Severe Amyloidosis

    PubMed Central

    Frazier, O. H.; Cohn, William E.

    2012-01-01

    We implanted a continuous-flow total heart replacement device in a 55-year-old man who had severe end-stage heart failure due to amyloidosis and no other options for treatment. The device was composed of 2 modified HeartMate II ventricular assist pumps. After the implantation, our patient recovered normal neurologic function and was able to converse with his family and work on his computer. He died of multisystem organ failure caused by severe amyloidosis 5 weeks after the implantation. During the past 6 years, we have been developing and testing various technological iterations for total heart replacement in our animal laboratory and have achieved survival periods as long as 90 days in calves. We describe the development, preclinical trials, and adaptation for human use of the modified HeartMate II apparatus, as well as its role in our patient's survival. PMID:22949774

  19. Borehole Miner - Extendible Nozzle Development for Radioactive Waste Dislodging and Retrieval from Underground Storage Tanks

    SciTech Connect

    CW Enderlin; DG Alberts; JA Bamberger; M White

    1998-09-25

    This report summarizes development of borehole-miner extendible-nozzle water-jetting technology for dislodging and retrieving salt cake, sludge} and supernate to remediate underground storage tanks full of radioactive waste. The extendible-nozzle development was based on commercial borehole-miner technology.

  20. Quantification of in vitro wear of a synthetic meniscus implant using gravimetric and micro-CT measurements.

    PubMed

    Elsner, Jonathan J; Shemesh, Maoz; Shefy-Peleg, Adaya; Gabet, Yankel; Zylberberg, Eyal; Linder-Ganz, Eran

    2015-09-01

    A synthetic meniscus implant was recently developed for the treatment of patients with mild to moderate osteoarthritis with knee pain associated with medial joint overload. The implant is distinctively different from most orthopedic implants in its pliable construction, and non-anchored design, which enables implantation through a mini-arthrotomy without disruption to the bone, cartilage, and ligaments. Due to these features, it is important to show that the material and design can withstand knee joint conditions. This study evaluated the long-term performance of this device by simulating loading for a total of 5 million gait cycles (Mc), corresponding to approximately five years of service in-vivo. All five implants remained in good condition and did not dislodge from the joint space during the simulation. Mild abrasion was detected by electron microscopy, but µ-CT scans of the implants confirmed that the damage was confined to the superficial surfaces. The average gravimetric wear rate was 14.5 mg/Mc, whereas volumetric changes in reconstructed µ-CT scans point to an average wear rate of 15.76 mm(3)/Mc (18.8 mg/Mc). Particles isolated from the lubricant had average diameter of 15 µm. The wear performance of this polycarbonate-urethane meniscus implant concept under ISO-14243 loading conditions is encouraging. PMID:26057364

  1. A new approach to implant alignment and ligament balancing in total knee arthroplasty focussing on joint loads.

    PubMed

    Zimmermann, Frauke; Schwenninger, Christoph; Nolten, Ulrich; Firmbach, Franz Peter; Elfring, Robert; Radermacher, Klaus

    2012-08-01

    Preservation and recovery of the mechanical leg axis as well as good rotational alignment of the prosthesis components and well-balanced ligaments are essential for the longevity of total knee arthroplasty (TKA). In the framework of the OrthoMIT project, the genALIGN system, a new navigated implantation approach based on intra-operative force-torque measurements, has been developed. With this system, optical or magnetic position tracking as well as any fixation of invasive rigid bodies are no longer necessary. For the alignment of the femoral component along the mechanical axis, a sensor-integrated instrument measures the torques resulting from the deviation between the instrument's axis and the mechanical axis under manually applied axial compression load. When both axes are coaxial, the resulting torques equal zero, and the tool axis can be fixed with respect to the bone. For ligament balancing and rotational alignment of the femoral component, the genALIGN system comprises a sensor-integrated tibial trial inlay measuring the amplitude and application points of the forces transferred between femur and tibia. Hereby, the impact of ligament tensions on knee joint loads can be determined over the whole range of motion. First studies with the genALIGN system, including a comparison with an imageless navigation system, show the feasibility of the concept. PMID:22868781

  2. Boulder Dislodgment Reloaded: New insights from boulder transport and dislodgement by tsunamis and storms from three-dimensional numerical simulations with GPUSPH

    NASA Astrophysics Data System (ADS)

    Weiss, R.; Zainali, A.

    2014-12-01

    Boulders can be found on many coastlines around the globe. They are generally thought to be moved either during coastal storms or tsunamis because they are too heavy to be moved by more common marine or coastal processes. To understand storm and tsunami risk at given coastline, the event histories of both events need to be separated to produce a robust event statistics for quantitative risk analyses. Because boulders are most likely only moved by coastal storms or tsunamis, they are very suitable to produce the data basis for such event statistics. Boulder transport problem has been approached by comparing the driving with resisting forces acting on a boulder. However, we argue that this approach is not sufficient because the comparison of resisting and driving forces only constitutes boulder motion, but not for boulder dislodgment. Boulder motion means that the boulder starts to move out of its pocket. However, this motion does not guarantee that the boulder will reach the critical dislodgment position. Boulder dislodgment is a necessary condition to identify whether or not a boulder has moved. For boulder dislodgement, an equation of motion is needed, and that equation is Newtons Second Law of Motion (NSL). We perform fully coupled three-dimensional numerical simulation of boulders moved by waves where the boulders move according to NSL. Our numerical simulations are the first of their kind applied to tsunami and storm boulder motion. They show how storm and tsunami waves interact with boulders in a more realistic physical setting, and highlight the importance of submergence. Based on our simulations we perform a dimensional analysis that identifies the Froude number as important parameter, which can be considered large only in the front of tsunami waves, but small in the rest of tsunami wave and also generally small in storm waves. From a general point of view, our results indicate that the boulder transport problem is more complex than recently considered, and

  3. A Case-Control Study to Identify Risk Factors for Totally Implantable Central Venous Port-Related Bloodstream Infection

    PubMed Central

    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

    2014-01-01

    Purpose 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. Materials and Methods 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. Results 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). Conclusion 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. PMID:25038760

  4. An innovative way to reinsert dislodged Arndt blocker using urological glide wire

    PubMed Central

    Pillai, Rahul; Ancheri, Sneha Ann; Dharmalingam, Sathish Kumar; Sahajanandan, Raj

    2016-01-01

    The Arndt blocker is positioned in the desired bronchus using a wire loop which couples the blocker with a fiberoptic bronchoscope (FOB). The wire loop once removed cannot be reinserted in 5F and 7F blockers making repositioning of the blocker difficult. A 34-year-old female was to undergo left thoracotomy followed by laparoscopic cholecystectomy. The left lung was isolated with a 7F Arndt bronchial blocker. During one-lung ventilation, the wire loop was removed for oxygen insufflation. There was loss of lung isolation during the procedure and dislodgement of the blocker was confirmed by FOB. The initial attempts to reintroduce the blocker into the left main bronchus failed. An alternative technique using a glide wire was attempted which resulted in successful reintroduction of the Arndt blocker. The 0.032 inch zebra glide wire may be effectively used to reposition a dislodged Arndt blocker if the wire loop has been removed. PMID:27052085

  5. Preventing "a bridge too far": promoting earlier identification of dislodged dental appliances during the perioperative period.

    PubMed

    Denny, John T; Yeh, Sloane; Mohiuddin, Adil; Denny, Julia E; Fratzola, Christine H

    2015-02-01

    The presence of fixed partial dentures presents a unique threat to the perioperative safety of patients that require orotracheal intubation or placement of instruments into the gastrointestinal (GI) tract. There are many chances for the displacement of a fixed partial denture: instrumentation of the airway for intubation, or introduction of temporary devices, such as gastroscopes or transesophageal echo probes. If dislodged, the fixed partial dentures can enter the hypopharynx, esophagus or lungs and cause perforations with their sharp tines. Oral or esophageal perforation can lead to potentially fatal mediastinitis. We describe a case of a patient with a fixed partial denture who underwent cardiac surgery with intubation and transesophageal echocardiography (TEE). His partial denture was intact after the procedure. After extubation, he reported that his teeth were missing. Multiple procedures were required to remove his dislodged partial dentures. In sign-out reports, verbal descriptions of the patient's partial dentures were not adequate in this case. A picture of the patient's denture and oral pharynx pre-operatively would have provided a more accurate template for the post-operative team to refer to when caring for the patient. This may have avoided the multiple potentially risky procedures the patient had to undergo. We describe a suggested protocol utilizing a pre-operative photo to reduce the incidence of unrecognized partial denture dislodgement in the perioperative period. Because the population is aging, this will become a more frequent issue confronting practitioners. This protocol could mitigate this complication. PMID:25436029

  6. Bone loss during revision of unicompartmental to total knee arthroplasty: an analysis of implanted polyethylene thickness from the National Joint Registry data.

    PubMed

    Sarraf, Khaled M; Konan, Sujith; Pastides, Philip S; Haddad, Fares S; Oussedik, Sam

    2013-10-01

    Using the National Joint Registry (UK) database, we compared the thickness of polyethylene (PE) and the level of constraint used during primary total knee arthroplasty (TKA) versus the revision of unicondylar knee arthroplasty (UKA) to TKA. A total of 251,803 TKA procedures and 374 revision UKA-TKA procedures between 2003 and 2009 were reviewed. The commonest PE size used in TKA was 10mm, compared to 12.79 mm in the revision group. The use of constrained knee implant was required in 2.15% of primary TKA and 4.19% of UKA to TKA revisions. The revision of UKA to TKA is a more complex procedure compared to primary TKA, with a higher incidence of using constrained implants and thicker PE inserts. These findings may be useful for surgeons in their decision making. PMID:23538124

  7. Clinical and Radiographic Mid-Term Outcomes After Total Shoulder Replacement: A Retrospective Study Protocol Including 400 Anatomical and Reverse Prosthetic Implants

    PubMed Central

    Merolla, Giovanni; Tartarone, Antonio; Porcellini, Giuseppe

    2016-01-01

    Objectives: To obtain outcomes data on anatomical and reverse total shoulder arthroplasty by analysis of clinical scores and standard radiographs. Subject selection and enrollment: 400 consecutive series of patients replaced with anatomical and reverse total shoulder arthroplasty (minimum 3 years follow-up). Study Design: retrospective monocenter. Preoperative assessment: Demographics, clinical scores (Constant-Murley) as available, shoulder X-ray (AP, outlet and axillary views) . Last follow-up: Postoperative radiographhs and clinical scores. Adverse events and complications to be reported as occurred since implantation. Statistical analysis: Data collected will be summarized and analyzed for statistical significance. PMID:27326389

  8. Veno-venous extracorporeal membrane oxygenation using a double-lumen bi-caval cannula for severe respiratory failure post total artificial heart implantation.

    PubMed

    Miessau, J; Yang, Q; Unai, S; Entwistle, J W C; Cavarocchi, N C; Hirose, H

    2015-07-01

    We report a unique utilization of a double-lumen, bi-caval Avalon cannula for veno-venous (VV) extracorporeal membrane oxygenation (ECMO) during placement of a total artificial heart (TAH, SynCardia, Tucson, AZ). A 22-year-old female with post-partum cardiomyopathy was rescued on veno-arterial (VA) ECMO because of cardiogenic shock. The inability to wean ECMO necessitated implantation of the TAH as a bridge to transplant. In addition, the patient continued to have respiratory failure and concomitant VV ECMO was planned with the implant. During TAH implantation, the Avalon cannula was placed percutaneously from the right internal jugular vein into the inferior vena cava (IVC) under direct vision while the right atrium was open. During VV ECMO support, adequate flows on both ECMO and TAH were maintained without adverse events. VV ECMO was discontinued, without reopening the chest, once the patient's respiratory failure improved. However, the patient subsequently developed a profound respiratory acidosis and required VV ECMO for CO2 removal. The Avalon cannula was placed in the femoral vein to avoid accessing the internal jugular vein and risking damage to the TAH. The patient's oxygenation eventually improved and the cannula was removed at the bedside. The patient was supported for 22 days on VV ECMO and successfully weaned from the ventilator prior to her orthotropic heart transplantation. PMID:25239275

  9. Dynamics and dislodgment from pore constrictions of a trapped nonwetting droplet stimulated by seismic waves

    NASA Astrophysics Data System (ADS)

    Deng, Wen; Cardenas, M. Bayani

    2013-07-01

    Seismic waves affect fluid flow and transport processes in porous media. Therefore, quantitative understanding of the role of seismic waves in subsurface hydrodynamics is important for the development of practical applications and prediction of natural phenomena. We present a theoretical fluid dynamics model to describe how low-frequency elastic waves mobilize isolated droplets trapped in pores by capillary resistance. The ability of the theoretical model to predict the critical mobilization amplitudes (Ac) and the displacement dynamics of the nonwetting droplet are validated against computational fluid dynamics (CFD) simulations. Our theory has the advantage of rapid calculation of Ac for various scenarios. Both theory and CFD simulations show that the Ac increases with increasing wave frequency. The theoretical and computational models agree well in the low-frequency range both in terms of predicting the displacement history of the droplet and its eventual dislodgment, but their results begin to diverge with increasing wave frequency since the Hagen-Poiseuille flow approximation in the model becomes invalid. Relative to a previous "viscous seismic model," our model compares more favorably to experimental observations. The model is thus appropriate for predicting trapped nonwetting droplet dynamics in and dislodgement from pore constrictions by low-frequency elastic waves.

  10. Dislodging a sessile drop by a high-Reynolds-number shear flow at subfreezing temperatures

    NASA Astrophysics Data System (ADS)

    Roisman, Ilia V.; Criscione, Antonio; Tropea, Cameron; Mandal, Deepak Kumar; Amirfazli, Alidad

    2015-08-01

    The drop, exposed to an air flow parallel to the substrate, starts to dislodge when the air velocity reaches some threshold value, which depends on the substrate wetting properties and drop volume. In this study the critical air velocity is measured for different drop volumes, on substrates of various wettabilities. The substrate initial temperatures varied between the normal room temperature (24 .5∘C ) and subfreezing temperatures (-5∘C and -1∘C ). The physics of the drop did not change at the subfreezing temperatures of the substrates, which clearly indicates that the drop does not freeze and remains liquid for a relatively long time. During this time solidification is not initiated, neither by the air flow nor by mechanical disturbances. An approximate theoretical model is proposed that allows estimation of the aerodynamic forces acting on the sessile drop. The model is valid for the case when the drop height is of the same order as the thickness of the viscous boundary in the airflow, but the inertial effects are still dominant. Such a situation, relevant to many practical applications, was never modeled before. The theoretical predictions for the critical velocity of drop dislodging agree well with the experimental data for both room temperature and lower temperatures of the substrates.

  11. Performance Assessment of the Waste Dislodging Conveyance System During the Gunite And Associated Tanks Remediation Project

    SciTech Connect

    Lloyd, P.D.

    2001-02-21

    The Waste Dislodging and Conveyance System (WD and CS) and other components of the Tank Waste Retrieval System (TWRS) were developed to address the need for removal of hazardous wastes from underground storage tanks (USTs) in which radiation levels and access limitations make traditional waste retrieval methods impractical. Specifically, these systems were developed for cleanup of the Gunite and Associated Tanks (GAAT) Operable Unit (OU) at the Oak Ridge National Laboratory (ORNL). The WD and CS is comprised of a number of different components. The three primary hardware subsystems are the Hose Management System (HMS), the Confined Sluicing End-Effector (CSEE), and the Flow Control Equipment and Containment Box (FCE/CB). In addition, a Decontamination Spray Ring (DSR) and a control system were developed for the system. The WD and CS is not a stand-alone system; rather, it is designed for deployment with either a long-reach manipulator like the Modified Light Duty Utility Arm (MLDUA) or a remotely operated vehicle system such as the Houdini{trademark}. The HMS was designed to act as a pipeline for the transfer of dislodged waste; as a hose-positioning and tether-management system; and as a housing for process equipment such as the water-powered jet pump that provides the necessary suction to vacuum slurried waste from the UST. The HMS was designed to facilitate positioning of an end-effector at any point within the 25-ft- or 50-ft-diameter USTs in the GAAT OU.

  12. Dislodging a sessile drop by a high-Reynolds-number shear flow at subfreezing temperatures.

    PubMed

    Roisman, Ilia V; Criscione, Antonio; Tropea, Cameron; Mandal, Deepak Kumar; Amirfazli, Alidad

    2015-08-01

    The drop, exposed to an air flow parallel to the substrate, starts to dislodge when the air velocity reaches some threshold value, which depends on the substrate wetting properties and drop volume. In this study the critical air velocity is measured for different drop volumes, on substrates of various wettabilities. The substrate initial temperatures varied between the normal room temperature (24.5∘C) and subfreezing temperatures (-5∘C and -1∘C). The physics of the drop did not change at the subfreezing temperatures of the substrates, which clearly indicates that the drop does not freeze and remains liquid for a relatively long time. During this time solidification is not initiated, neither by the air flow nor by mechanical disturbances. An approximate theoretical model is proposed that allows estimation of the aerodynamic forces acting on the sessile drop. The model is valid for the case when the drop height is of the same order as the thickness of the viscous boundary in the airflow, but the inertial effects are still dominant. Such a situation, relevant to many practical applications, was never modeled before. The theoretical predictions for the critical velocity of drop dislodging agree well with the experimental data for both room temperature and lower temperatures of the substrates. PMID:26382503

  13. Totally implantable venous access port systems and associated complications: A single-institution retrospective analysis of 2,996 breast cancer patients

    PubMed Central

    MA, LI; LIU, YUEPING; WANG, JIANXIN; CHANG, YUAN; YU, LONG; GENG, CUIZHI

    2016-01-01

    Totally implantable venous access port systems (TIVAPS) are widely used in breast cancer patients. However, complications are frequent and may necessitate device replacement or removal, resulting in additional patient stress and treatment delays. The aim of this study was to investigate possible risk factors for complications. A total of 2,996 consecutive female breast cancer patients, with a median age of 50.2 years (range, 21.2–85.5 years) were enrolled in this observational, single-centre study between December, 2008 and April, 2014. TIVAPS implantation was principally performed using local anaesthesia and the blind puncture or Seldinger technique through internal jugular or subclavian vein access. A retrospective chart review was conducted to obtain information associated with TIVAPS and patient data. Insertion performed by blind puncture and Seldinger technique had a success ratio of 96.34 and 99.80%, respectively (χ2=29.905, P<0.001). However, the success ratio of the puncture technique group was 99.76% when the TIVAPS was implanted in the right internal jugular vein. The most common complications were late complications, with an overall incidence rate of 5.41% (162/2,996) during the entire device duration. The most common late complications included fibrin formation (1.84%, 55/2,996), port-related bacteraemia (1.44%, 43/2,996) and deep vein thrombosis (0.63%, 19/2,996). No patient died during the study. Our results demonstrated that insertion of TIVAPS by blind puncture or the Seldinger technique through internal jugular or subclavian vein access is convenient, and insertion by the Seldinger technique through the right internal jugular vein is the preferred method. Therefore, TIVAPS is safe for continuous infusional chemotherapy regimens for breast cancer patients. PMID:26998304

  14. Development of a multi-functional scarifier dislodger with an integral pneumatic conveyance retrieval system for single-shell tank remediation. FY93 summary report

    SciTech Connect

    Bamberger, J.A.; McKinnon, M.A.; Alberts, D.A.; Steele, D.E.; Crowe, C.T.

    1994-10-01

    The Underground Storage Tank Integrated Demonstration (UST-ID) is evaluating several hydraulic dislodger concepts and retrieval technologies to develop specifications for system that can retrieve wastes from single-shell tanks. Each of the dislodgers will be evaluated sequentially to determine its ability to fracture and dislodge various waste simulants such as salt cake, sludge, and viscous liquid. The retrieval methods will be evaluated to determine their ability to convey this dislodged material from the tank. This report describes on-going research that commenced in FY93 to develop specifications for a scarifier dislodger coupled with a pneumatic conveyance retrieval system. The scarifier development is described in Section 3; pneumatic conveyance development is described in Section 4. Preliminary system specifications are listed in Section 5. FY94 plans are summarized in Section 6.

  15. EVALUATION OF THE EFFECTIVENESS OF COATINGS IN REDUCING DISLODGEABLE ARSENIC, CHROMIUM, AND COPPER FROM CCA TREATED WOOD, INTERIM DATA REPORT

    EPA Science Inventory

    EPA is approximately 20 months into a project to evaluate the performance of wood coatings as a way to prevent arsenic, chromium and copper exposure from the surfaces of CCA treated wood. Potential dermal exposure, as measured by wipe sampling dislodgeable CCA chemical from wood ...

  16. Final test report: demonsration testing in support of the Track 3system waste dislodging, retrieval and conveyance concepts

    SciTech Connect

    Berglin, E.J.

    1997-07-24

    This report contains the quantitative and qualitative data and information collected during performance of the Track 3 System testing protocol. Information contained herein focuses on the data collected during performance ofthe following Tests Procedures. *Test Procedure-1, Position Management Test Procedure-2, Waste Dislodging, Retrieval, and Conveyance and Decontamination *Test Procedure-3, Dynamic Response Test procedures, Safety Demonstration

  17. Improving patient reported outcome measures (PROMs) in total knee replacement by changing implant and preserving the infrapatella fatpad: a quality improvement project

    PubMed Central

    Partridge, Thomas; Carluke, Ian; Emmerson, Kevin; Partington, Paul; Reed, Mike

    2016-01-01

    Patient reported outcome measures (PROMs) were introduced in 2009 to allow patient perspectives to potentially influence change and improvement. In collaboration with the national joint registry (NJR), PROMs data has been examined on a national basis to compare surgical factors in total knee replacement (TKR). Initial results demonstrated there were statistically significant differences in Oxford Knee Score (OKS) when using different brands of implant. Preservation of the infrapatella fatpad (IFP) has also been shown improve outcomes. This led Northumbria Healthcare NHS Foundation Trust to make a mass move to the Zimmer Nexgen TKR and later change surgeons' routine practice to preserving the IFP. The PROMs were recorded pre and six months post operation to obtain improvement scores. The baseline improvement in OKS was 14.0. After changing implant to the Zimmer Nexgen in Plan-Do-Study-Act (PDSA) cycle 1 the average improvement score was 16.7. After implementing default preservation of the IFP in PDSA cycle 2 the average OKS improvement score was 17.3. The results from this project demonstrate a significant improvement in local services after implementing changes based on national and local evaluations. This initiative is an excellent example of improvement by evidence based practice and success of the English National Health Service PROMs scheme. PMID:27239301

  18. Postoperative osteomyelitis following implant arthroplasty of the foot: diagnosis with indium-111 white blood cell scintigraphy

    SciTech Connect

    Bakst, R.H.; Kanat, I.O.

    1987-11-01

    Many complications can occur following insertion of silicone elastomer implants into the foot. Postoperative infection may be difficult to distinguish from other conditions such as dislodgment, fracture, ectopic and heterotopic new bone formation, synovitis, and bursitis. White blood cell scintigraphy, in conjunction with the clinical scenario, may prove to be an invaluable tool in the diagnosis of postoperative osteomyelitis, subsequent to implant arthroplasties. 32 references.

  19. 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

    PubMed Central

    2013-01-01

    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 93.1% after 8

  20. [Total aortic arch replacement in Stanford type A aortic dissection using a new method of implanting the stented graft].

    PubMed

    Kiyama, Hiroshi; Kaki, Nobuaki; Shiomi, Daisuke; Shimada, Naohiro

    2012-07-01

    In surgery for Stanford type A aortic dissection (SAAD) with intimal tear in the arch or proximal descending aorta, we performed total arch replacement with frozen elephant trunk technique for the purpose of achieving complete exclusion of the entry. To reduce the circulatory arrest time, we developed a quick stent graft placement method in the proximal descending aorta. We reported the early results and assessed the efficacy of our new method. Between March 2006 and February 2010, 52 consecutive patients with SAAD were divided into 2 groups:group A consisted of 17 patients who received total arch replacement with our new method;group B consisted of 35 patients who received ascending aorta or partial arch replacement. The duration of operation and cardiopulmonary bypass were significantly longer in group A. However, the duration of circulatory arrest time and postoperative factors including hospital mortality did not differ in both groups. In group A, thrombus obliteration of the residual false lumen in the descending aorta was observed in 75% at 19.2±13.1 months postoperatively. Shrinkage of false lumen in the aortic arch occurred in 15 patients( 93.8%). There was no reoperation for the residual false lumen and late death. Total aortic arch replacement with our new method for SAAD is technically feasible without increasing the operative risk and might reduce the necessity for further operations. PMID:22750824

  1. Innate immune response and implant loosening: Interferon gamma is inversely associated with early migration of total knee prostheses.

    PubMed

    Schoeman, Monique A E; Pijls, Bart G; Oostlander, Angela E; Keurentjes, Johan C; Valstar, Edward R; Nelissen, Rob G H H; Meulenbelt, Ingrid

    2016-01-01

    To allow prediction of the risk of loosening prior to surgery, we investigated the relationship between innate immune cytokine response via TLR2 stimulation and early migration of six different knee prostheses using RSA (radiostereometry). This study included 114 patients of a prospective RSA-cohort who received a total knee arthroplasty. Whole blood cytokine responses were obtained by ex vivo stimulation with tripalmitoyl-S-glycerylcysteine (Pam3Cys-SK4) for assessment of the TLR2 immune response. Early migration was calculated using the maximum total point motion (MTPM) 1 year post surgery. Principal component analysis (PCA) was applied to the cytokine data to reduce the correlated data of individual cytokines and identified two components. Subsequently, linear mixed model analyses were applied with adjustments for gender, age, BMI, time-to-blood sampling, and prosthesis type. Component 1, consisting of IFNγ, IL-12p40, IL-10, IL-1β, TNFα, and IL-6, showed a significant inverse association (β = -0.128; p = 0.041) with MTPM. Further analysis showed that IFNγ (β = -0.161, p = 0.008) had the highest contribution to this association and is particularly found in patients receiving another prosthesis than Nexgen (β = -0.239; p < 0.001). In conclusion, patients with high levels of IFNγ upon stimulation of TLR2 are at lower risk of early migration of their knee prosthesis. PMID:26212694

  2. Thoracoscopy-assisted removal of a thoracoamniotic shunt double-basket catheter dislodged into the fetal thoracic cavity: report of three cases.

    PubMed

    Inoue, Seiichiro; Odaka, Akio; Baba, Kazunori; Kunikata, Tetsuya; Sobajima, Hisanori; Tamura, Masanori

    2014-04-01

    The indications for and timing of surgical removal of a dislodged thoracoamniotic shunt double-basket catheter are not established, and the side effects of the dislodged into the thoracic cavity remain controversial. The double-basket catheter was designed to reduce the incidence of catheter dislodgement; however, we have encountered four cases of thoracoamniotic shunt double-basket catheter dislodgement into the fetal thorax. The dislodged shunt catheters were removed safely with thoracoscopic assistance within several days of birth, when additional treatments for pleural effusion were needed, such as thoracic drainage tube insertion and adhesion treatment of the thorax. We report the clinical courses of three of these cases of thoracoamniotic shunt tube dislocation. By waiting several days postnatally for stabilization of respiratory and circulatory status and the effective use of thoracoscopic assistance, the dislodged catheter was safely removed from the neonatal thorax. The accumulation of case reports will help establish suitable treatments, and their indication, for a dislodged thoracoamniotic shunt catheter within the fetal thoracic cavity. PMID:23536145

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

    SciTech Connect

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

    2011-12-15

    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.

  4. Ultrasound-Guided Retrieval and Position Replacement of a Dislodged Fetal Pleuro-Amniotic Shunt: A Novel Approach for a Known Complication of Feto-Amniotic Shunting.

    PubMed

    Adams, Tracy M; Kunzier, Nadia B; Chavez, Martin R; Vintzileos, Anthony M

    2016-01-01

    Untreated fetal pleural effusion can cause significant perinatal morbidity and mortality. Treatment of pleural effusions with pleuro-amniotic shunting has been shown to improve outcomes. Pleuro-amniotic shunting is associated with complications including ruptured membranes, preterm labor and shunt dislodgement into either the amniotic cavity or the fetal thorax. Shunt dislodgement into the thoracic cavity can cause prenatal complications from the shunt itself or may necessitate neonatal surgery for removal. We present a case where a novel ultrasound-guided technique was used to replace the dislodged pleural shunt in utero, thereby effectively draining the effusion while simultaneously obviating the need for neonatal surgery and decreasing possible perinatal complications. PMID:25660293

  5. Which total knee replacement implant should I pick? Correcting the pathology: the role of knee bearing designs.

    PubMed

    Berend, K R; Lombardi, A V; Adams, J B

    2013-11-01

    Debate has raged over whether a cruciate retaining (CR) or a posterior stabilised (PS) total knee replacement (TKR) provides a better range of movement (ROM) for patients. Various sub-sets of CR design are frequently lumped together when comparing outcomes. Additionally, multiple factors have been proven to influence the rate of manipulation under anaesthetic (MUA) following TKR. The purpose of this study was to determine whether different CR bearing insert designs provide better ROM or different MUA rates. All primary TKRs performed by two surgeons between March 2006 and March 2009 were reviewed and 2449 CR-TKRs were identified. The same CR femoral component, instrumentation, and tibial base plate were consistently used. In 1334 TKRs a CR tibial insert with 3° posterior slope and no posterior lip was used (CR-S). In 803 there was an insert with no slope and a small posterior lip (CR-L) and in 312 knees the posterior cruciate ligament (PCL) was either resected or lax and a deep-dish, anterior stabilised insert was used (CR-AS). More CR-AS inserts were used in patients with less pre-operative ROM and greater pre-operative tibiofemoral deformity and flexion contracture (p < 0.05). The mean improvement in ROM was highest for the CR-AS inserts (5.9° (-40° to 55°) vs CR-S 3.1° (-45° to 70°) vs CR-L 3.0° (-45° to 65°); p = 0.004). There was a significantly higher MUA rate with the CR-S and CR-L inserts than CR-AS (Pearson rank 6.51; p = 0.04). Despite sacrificing or not substituting for the PCL, ROM improvement was highest, and the MUA rate was lowest in TKRs with a deep-dish, anterior-stabilised insert. Substitution for the posterior cruciate ligament (PCL) in the form of a PS design may not be necessary even when the PCL is deficient. PMID:24187370

  6. Development of a waste dislodging and retrieval system for use in the Oak Ridge National Laboratory gunite tank

    SciTech Connect

    Randolph, J.D.; Lloyd, P.D.; Burks, B.L.

    1997-03-01

    As part of the Gunite And Associated Tanks (GAAT) Treatability Study the Oak Ridge National Laboratory (ORNL) has developed a tank waste retrieval system capable of removing wastes varying from liquids to thick sludges. This system is also capable of scarifying concrete walls and floors. The GAAT Treatability Study is being conducted by the Department of Energy Oak Ridge Environmental Restoration Program. Much of the technology developed for this project was cosponsored by the DOE Office of Science and Technology through the Tanks Focus Area (TFA) and the Robotics Technology Development Program. The waste dislodging and conveyance (WD&C) system was developed jointly by ORNL and participants from the TFA. The WD&C system is comprised of a four degree-of-freedom arm with back driveable motorized joints. a cutting and dislodging tool, a jet pump and hose management system for conveyance of wastes, confined sluicing end-effector, and a control system, and must be used in conjunction with a robotic arm or vehicle. Other papers have been submitted to this conference describing the development and operation of the arm and vehicle positioning systems. This paper will describe the development of the WD&C system and its application for dislodging and conveyance of ORNL sludges from the GAAT tanks. The confined sluicing end-effector relies on medium pressure water jets to dislodge waste that is then pumped by the jet pump through the conveyance system out of the tank. This paper will describe the results of cold testing of the integrated system. At the conference presentation there will also be results from the field deployment. ORNL has completed fabrication of the WD&C system for waste removal and is full-scale testing, including testing of the confined sluicing end-effector.

  7. Comparison of Whole-Blood Metal Ion Levels Among Four Types of Large-Head, Metal-on-Metal Total Hip Arthroplasty Implants: A Concise Follow-up, at Five Years, of a Previous Report.

    PubMed

    Hutt, Jonathan; Lavigne, Martin; Lungu, Eugen; Belzile, Etienne; Morin, François; Vendittoli, Pascal-André

    2016-02-17

    Few studies of total hip arthroplasty (THA) implants with a large-diameter femoral head and metal-on-metal design have directly compared the progression of metal ion levels over time and the relationship to complications. As we previously reported, 144 patients received one of four types of large-diameter-head, metal-on-metal THA designs (Durom, Birmingham, ASR XL, or Magnum implants). Cobalt, chromium, and titanium ion levels were measured over five years. We compared ion levels and clinical results over time. The Durom group showed the highest levels of cobalt (p ≤ 0.002) and titanium ions (p ≤ 0.03). Both the Durom and Birmingham groups demonstrated significant ongoing cobalt increases up to five years. Eight patients (seven with a Durom implant and one with a Birmingham implant) developed adverse local tissue reaction. Six Durom implants and one Birmingham implant required revision, with one pseudotumor under surveillance at the time of the most recent follow-up. We found that ion generation and related complications varied among designs. More concerning was that, for some designs, ion levels continued to increase. Coupling a cobalt-chromium adapter sleeve to an unmodified titanium femoral trunnion along with a large metal-on-metal bearing may explain the poor performances of two of the designs in the current study. PMID:26888673

  8. Functions and requirements for a waste dislodging and conveyance system for the Gunite and Associated Tanks Treatability Study at Oak Ridge National Laboratory

    SciTech Connect

    Potter, J.D.; Mullen, O.D.

    1995-09-01

    Functions and requirements for the Waste Dislodging and Conveyance System to be deployed in Gunite and Associated Tanks (GAAT) and tested and evaluated as a candidate tank waste retrieval technology by the GAAT Treatability Study (GAAT TS).

  9. Clinical and radiologic comparison of dynamic cervical implant arthroplasty and cervical total disc replacement for single-level cervical degenerative disc disease.

    PubMed

    Shichang, Liu; Yueming, Song; Limin, Liu; Lei, Wang; Zhongjie, Zhou; Chunguang, Zhou; Xi, Yang

    2016-05-01

    Anterior cervical discectomy and fusion, to date the most successful spine procedure for the surgical treatment of cervical radiculopathy, has limitations that have led to the development of non-fusion cervical procedures, such as cervical total disc replacement (TDR) and dynamic cervical implant (DCI) arthroplasty. We compared the clinical and radiological results of DCI and cervical TDR for the treatment of single-level cervical degenerative disc disease in Chinese patients. A retrospective review of 179 patients with cervical spondylotic myelopathy who underwent DCI or TDR between April 2010 and October 2012 was conducted, and 152 consecutive patients (67 patients single-level DCI and 85 single-level TDR) who completed at least 2years of follow-up were included. Clinical and radiological assessments were performed preoperatively and at 1week and 3, 6, 12, and 24months postoperatively. The most common operative level was C5/C6 (49.3%). The differences in blood loss, duration of surgery, and duration of hospitalization were not statistically significant. The Japanese Orthopaedic Association scale, Visual Analog Scale, Neck Disability Index, and Short Form-36 scores improved significantly after surgery in both the DCI and TDR groups (P<0.05), but the differences were not statistically significant at the final follow-up. The rate of occurrence of heterotopic ossification was 22.4% and 28.2% in the DCI and TDR groups, respectively. As an effective non-fusion technique, DCI is a more economical procedure. Further prospective, randomized studies with long-term follow-up periods are needed to determine the long-term effects. PMID:26928156

  10. Trends in Cochlear Implants

    PubMed Central

    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. PMID:15247993

  11. Unusual Presentation of Infected Vertebroplasty with Delayed Cement Dislodgment in an Immunocompromised Patient: Case Report and Review of Literature

    SciTech Connect

    Lin Weiche; Lee Chenhsiang; Chen Shihhao; Lui Chunchung

    2008-07-15

    Percutaneous vertebroplasty has been established as a safe and effective treatment for compression fractures of osteoporotic vertebrae. Complications of vertebroplasty, such as infection or anterior cement extrusion, are rare. Herein, we report an unusual presentation in an immunocompromised patient with an insidious infection of the disk. This infection resulted in dislodgment of the cement inferiorly and a compression fracture of the adjacent vertebra 6 months after vertebroplasty. We discuss the significance of this case and compare it with 7 others found in the literature.

  12. A Dislodged Tectonic Block Wedged Beneath Tokyo, and Implications for the Enigmatic 1855 Ansei-Edo Earthquake

    NASA Astrophysics Data System (ADS)

    Toda, S.; Stein, R. S.; Bozkurt, S. B.; Nakamura, R.

    2005-12-01

    On the basis of microearthquake distributions, seismic tomography, and seismic stress inversion, we argue that a dislodged block of the Pacific plate is jammed between the Pacific (PAC), Philippine Sea (PHS) and Eurasian (EUR) plates beneath Tokyo at a depth of at depths of 40-100 km. We argue that the block controls much of Tokyos seismic behavior, including recent M~6 class earthquakes, and the 1855 M~7.2 Ansei-Edo shock as well. To illuminate the plate configuration and possible large earthquake sources, we examined 320,000 earthquakes recorded by NIED during 1979-2004 in a 3D GIS, from which we identify several new features of the Kanto triple junction. First, a 25-km-thick, 90 x 120-km-wide enclosed volume of seismicity with high seismic velocity lies between the PAC and the EUR beneath the Kanto Plain, which we interpret to be a lithospheric block dislodged from the descending PAC. Second, we find that the leading edge of the PHS lies at 35 km depth and abuts the southern margin of the block. Third, there is a pronounced bend to the double seismic zone defining the descending PAC slab, which closely parallels the sharp curvature of the volcanic front. Because of the bend, the PAC/EUR contact at shallow depth is nearly flat-lying, and undergoes episodic aseismic slip unaccompanied by large subduction earthquakes. We associate the corridor of active seismicity extending from upper Tokyo Bay for 100 km northward with the eastern edge of the dislodged block. Within this Kanto seismic corridor, eight M≥5.7 shocks have been recorded since 1985, and four M≥7 shocks have struck since 1603. We speculate the Ansei-Edo earthquake was an intermediate-depth (30-60 km) or deep (70-100 km) thrust interplate event on the upper or lower surface of the dislodged block, rather than being an intraplate or shallow crustal shock. The 1855 event, which devastated Edo (now Tokyo) and killed more than seven thousand people, is the only well-documented inland historical earthquake

  13. Cochlear Implants.

    ERIC Educational Resources Information Center

    Clark, Catherine; Scott, Larry

    This brochure explains what a cochlear implant is, lists the types of individuals with deafness who may be helped by a cochlear implant, describes the process of evaluating people for cochlear implants, discusses the surgical process for implanting the aid, traces the path of sound through the cochlear implant to the brain, notes the costs of…

  14. Potential of solid phase extraction disks to aid determination of dislodgeable foliar residues of chlorpyriphos, malathion, diazinon, and acephate.

    PubMed

    Snyder, J C; Thacker, R R; Boeniger, M; Antonious, G F

    2003-11-01

    The utility of solid phase extraction (SPE) for concentrating four organophosphate insecticides from solutions of water and sodium dioctyl sulfosuccinate, a surfactant, was evaluated. Reverse phase (C18, octadecyl bonded silica) sorbent in the form of a disk was the SPE medium evaluated. Chlorpyriphos, malathion, and diazinon, but not acephate, were retained on and eluted from the SPE disks. For pesticides that were retained on SPE disks, recoveries from the disks were equal to or higher than recoveries achieved by solvent partitioning. Dislodgeable foliar residues of acephate were successfully concentrated for analysis by lyophilization of water-surfactant solutions. Recoveries of pesticides from SPE disks stored at -15 degrees C for one week were equal to or higher than those of pesticides stored in water-surfactant for one week at -15 degrees C. Malathion- and diazinon-fortified samples in watersurfactant and on SPE disks were prepared in one state and shipped for analysis in another state. Pesticides in the water-surfactant samples were concentrated by solvent partitioning and were underestimated by 41% (diazinon) and 16% (malathion). Conversely, diazinon samples on the SPE disks were on average underestimated by 3% and malathion was overestimated by an average of 55%. The overestimation of malathion was attributed to a matrix effect during analysis associated with the presence of surfactant, which was retained on and subsequently eluted from the SPE disks. The retention of surfactant by the SPE disks and its subsequent elution may considerably limit their usefulness in determination of dislodgeable foliar residues. PMID:14708658

  15. PIXE microbeam analysis of the metallic debris release around endosseous implants

    NASA Astrophysics Data System (ADS)

    Buso, G. P.; Galassini, S.; Moschini, G.; Passi, P.; Zadro, A.; Uzunov, N. M.; Doyle, B. L.; Rossi, P.; Provencio, P.

    2005-10-01

    The mechanical friction that occurs during the surgical insertion of endosseous implants, both in dentistry and orthopaedics, may cause the detachment of metal debris which are dislodged into the peri-implant tissues and can lead to adverse clinical effects. This phenomenon more likely happens with coated or roughened implants that are the most widely employed. In the present study were studied dental implants screws made of commercially pure titanium and coated using titanium plasma-spray (TPS) technique. The implants were inserted in the tibia of rabbits, and removed "en bloc" with the surrounding bone after one month. After proper processing and mounting on plastic holders, samples from bones were analysed by EDXRF setup at of National Laboratories of Legnaro, INFN, Italy, and consequently at 3 MeV proton microbeam setup at Sandia National Laboratories. Elemental maps were drawn, showing some occasional presence of metal particles in the peri-implant bone.

  16. Study rationale and protocol: prospective randomized comparison of metal ion concentrations in the patient's plasma after implantation of coated and uncoated total knee prostheses

    PubMed Central

    Lützner, Jörg; Dinnebier, Gerd; Hartmann, Albrecht; Günther, Klaus-Peter; Kirschner, Stephan

    2009-01-01

    Background Any metal placed in a biological environment undergoes corrosion. Thus, with their large metallic surfaces, TKA implants are particularly prone to corrosion with subsequent release of metal ions into the human body which may cause local and systemic toxic effects and hypersensitivity reactions, and increase cancer risk. To address this problem, a new 7-layer zirconium coating developed especially for cobalt-chrome orthopaedic implants was tested biomechanically and found to lower metal ion release. The purpose of the proposed clinical trial is to compare the metal ion concentration in patients' plasma before and after implantation of a coated or uncoated TKA implant. Methods/Design In this randomised controlled trial, 120 patients undergoing primary TKA will be recruited at the Department of Orthopaedic Surgery of the University Hospital in Dresden, Germany, and randomised to either the coated or uncoated prosthesis. Outcome assessments will be conducted preoperatively and at 3 months, 12 months and 5 years postoperatively. The primary clinical endpoint will be the chromium ion concentration in the patient's plasma after 1 and 5 years. Secondary outcomes include cobalt, molybdenum and nickel ion concentrations after 1 and 5 years, allergy testing for hypersensitivity against one of these metals, the Knee Society Score to assess clinical and physical function of the knee joint, the self-assessment Oxford Score and the Short Form 36 quality of live questionnaire. Discussion The metal ion concentration in the patient's plasma has been shown to increase after TKA, its eventual adverse effects being widely debated. In the light of this discussion, ways to reduce metal ion release from orthopaedic implants should be studied in detail. The results of this investigation may lead to a new method to achieve this goal. Trials register Clinicaltrials registry NCT00862511 PMID:19828019

  17. The Development of a Wireless Implantable Blood Flow Monitor.

    PubMed

    Unadkat, Jignesh V; Rothfuss, Michael; Mickle, Marlin H; Sejdic, Ervin; Gimbel, Michael L

    2015-07-01

    Microvascular anastomotic failure remains an uncommon but devastating problem. Although the implantable Doppler probe is helpful in flap monitoring, the devices are cumbersome, easily dislodged, and plagued by false-positive results. The authors have developed an implantable wireless Doppler monitor prototype from off-the-shelf components and tested it in a swine model. The wireless probe successfully distinguished between femoral vein flow, occlusion, and reflow, and wirelessly reported the different signals reliably. This is the first description of a wireless implantable blood flow sensor for flap monitoring. Future iterations will incorporate an integrated microchip-based Doppler system that will decrease the size to 1 mm, small enough to fit onto an anastomotic coupler. PMID:26111323

  18. Left Main Coronary Artery Obstruction by Dislodged Native-Valve Calculus after Transcatheter Aortic Valve Replacement

    PubMed Central

    Durmaz, Tahir; Keles, Telat; Aslan, Abdullah Nabi; Erdogan, Kemal Esref; Sari, Cenk; Bilen, Emine; Akcay, Murat; Bozkurt, Engin

    2014-01-01

    Transcatheter aortic valve replacement can be an effective, reliable treatment for severe aortic stenosis in surgically high-risk or ineligible patients. However, various sequelae like coronary artery obstruction can occur, not only in the long term, but also immediately after the procedure. We present the case of a 78-year-old woman whose left main coronary artery became obstructed with calculus 2 hours after the transfemoral implantation of an Edwards Sapien XT aortic valve. Despite percutaneous coronary intervention in that artery, the patient died. This case reminds us that early recognition of acute coronary obstruction and prompt intervention are crucial in patients with aortic stenosis who have undergone transcatheter aortic valve replacement. PMID:25120396

  19. [Implantable medical devices].

    PubMed

    Crickx, B; Arrault, X

    2008-01-01

    Medical devices have been individualized to include a category of implantable medical devices, "designed to be totally implanted in the human body or to replace an epithelial surface or a surface of the eye, through surgery, and remain in place after the intervention" (directive 93/42/CEE and decree of 20 April 206). Each implantable medical device has a common name and a commercial name for precise identification of the model (type/references). The users' service and the implanting physician should be clearly identified. There are a number of rules concerning health traceability to rapidly identify patients exposed to risks in which the implantable medical devices of a particular batch or series were used and to monitor the consequences. The traceability data should be preserved 10 years and the patient's medical file for 20 years. PMID:18442666

  20. Cochlear Implants

    MedlinePlus

    ... electrodes are inserted. The electronic device at the base of the electrode array is then placed under ... FDA approval for implants The Food and Drug Administration (FDA) regulates cochlear implant devices for both adults ...

  1. Goserelin Implant

    MedlinePlus

    Goserelin implant is used in combination with radiation therapy and other medications to treat localized prostate cancer and is ... treatment of abnormal bleeding of the uterus. Goserelin implant is in a class of medications called gonadotropin- ...

  2. Cochlear Implants

    MedlinePlus

    A cochlear implant is a small, complex electronic device that can help to provide a sense of sound. People who are ... of-hearing can get help from them. The implant consists of two parts. One part sits on ...

  3. Carmustine Implant

    MedlinePlus

    Carmustine implant is used along with surgery and sometimes radiation therapy to treat malignant glioma (a certain type of ... Carmustine implant comes as a small wafer that is placed in the brain by a doctor during surgery to ...

  4. Cochlear implant

    MedlinePlus

    ... antenna. This part of the implant receives the sound, converts the sound into an electrical signal, and sends it to ... implants allow deaf people to receive and process sounds and speech. However, these devices do not restore ...

  5. Breast Implants

    MedlinePlus

    ... Updated Safety Information (Consumer Article) FDA Provides Updated Safety Data on Silicone Gel-Filled Breast Implants (Press Announcement) [ARCHIVED] Breast Implant Guidance for Industry (2006) Post Approval Studies Webpage Freedom of Information ...

  6. Why are mini-implants lost: The value of the implantation technique!

    PubMed Central

    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. PMID:25741821

  7. Patients with Intolerance Reactions to Total Knee Replacement: Combined Assessment of Allergy Diagnostics, Periprosthetic Histology, and Peri-implant Cytokine Expression Pattern

    PubMed Central

    Thomas, Peter; von der Helm, Christine; Schopf, Christoph; Mazoochian, Farhad; Frommelt, Lars; Gollwitzer, Hans; Schneider, Josef; Flaig, Michael; Krenn, Veit; Thomas, Benjamin

    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. PMID:25866822

  8. Detection of venous needle dislodgement during haemodialysis using fractional order shape index ratio and fuzzy colour relation analysis.

    PubMed

    Lin, Chia-Hung; Chen, Wei-Ling; Kan, Chung-Dann; Wu, Ming-Jui; Mai, Yi-Chen

    2015-12-01

    Venous needle dislodgement (VND) is a life-threatening complication during haemodialysis (HD) treatment. When VND occurs, it only takes a few minutes for blood loss in an adult patient. According to the ANNA (American Nephrology Nurses' Association) VND survey reports, VND is a concerning issue for the nephrology nurses/staff and patients. To ensure HD care and an effective treatment environment, this Letter proposes a combination of fractional order shape index ratio (SIR) and fuzzy colour relation analysis (CRA) to detect VND. If the venous needle drops out, clinical examinations show that both heart pulses and pressure wave variations have a low correlation at the venous anatomic site. Therefore, fractional order SIR is used to quantify the differences in transverse vibration pressures (TVPs) between the normal condition and meter reading. Linear regression shows that the fractional order SIR has a high correlation with the TVP variation. Fuzzy CRA is designed in a simple and visual message manner to identify the risk levels. A worst-case study demonstrated that the proposed model can be used for VND detection in clinical applications. PMID:26713159

  9. Dislodgement and removal of dust-particles from a surface by a technique combining acoustic standing wave and airflow.

    PubMed

    Chen, Di; Wu, Junru

    2010-01-01

    It is known that there are many fine particles on the moon and Mars. Their existence may cause risk for the success of a long-term project for NASA, i.e., exploration and habitation of the moon and Mars. These dust-particles might cover the solar panels, making them fail to generate electricity, and they might also penetrate through seals on space suits, hatches, and vehicle wheels causing many incidents. The fine particles would be hazardous to human health if they were inhaled. Development of robust dust mitigation technology is urgently needed for the viable long-term exploration and habilitation of either the moon or Mars. A feasibility study to develop a dust removal technique, which may be used in space-stations or other enclosures for habitation, is reported. It is shown experimentally that the acoustic radiation force produced by a 13.8 kHz 128 dB sound-level standing wave between a 3 cm-aperture tweeter and a reflector separated by 9 cm is strong enough to overcome the van der Waals adhesive force between the dust-particles and the reflector-surface. Thus the majority of fine particles (>2 microm diameter) on a reflector-surface can be dislodged and removed by a technique combining acoustic levitation and airflow methods. The removal efficiency deteriorates for particles of less than 2 microm in size. PMID:20058949

  10. Design and Testing of a Percutaneously Implantable Fetal Pacemaker

    PubMed Central

    Loeb, Gerald E.; Zhou, Li; Zheng, Kaihui; Nicholson, Adriana; Peck, Raymond A.; Krishnan, Anjana; Silka, Michael; Pruetz, Jay; Chmait, Ramen; Bar-Cohen, Yaniv

    2012-01-01

    We are developing a cardiac pacemaker with a small, cylindrical shape that permits percutaneous implantation into a fetus to treat complete heart block and consequent hydrops fetalis, which can otherwise be fatal. The device uses off-the-shelf components including a rechargeable lithium cell and a highly efficient relaxation oscillator encapsulated in epoxy and glass. A corkscrew electrode made from activated iridium can be screwed into the myocardium, followed by release of the pacemaker and a short, flexible lead entirely within the chest of the fetus to avoid dislodgement from fetal movement. Acute tests in adult rabbits demonstrated the range of electrical parameters required for successful pacing and the feasibility of successfully implanting the device percutaneously under ultrasonic imaging guidance. The lithium cell can be recharged inductively as needed, as indicated by a small decline in the pulsing rate. PMID:22855119

  11. Percutaneously Inject able Fetal Pacemaker: Electrodes, Mechanical Design and Implantation*

    PubMed Central

    Zhou, Li; Chmait, Ramen; Bar-Cohen, Yaniv; Peck, Raymond A.; Loeb, Gerald E.

    2015-01-01

    We are developing a self-contained cardiac pacemaker with a small, cylindrical shape (~3×20mm) that permits it to be implanted percutaneously into a fetus to treat complete heart block and consequent hydrops fetalis, which is otherwise fatal. The device uses off-the-shelf components including a rechargeable lithium cell and a highly efficient relaxation oscillator encapsulated in epoxy and glass. A corkscrew electrode made from activated iridium can be screwed into the myocardium, followed by release of the pacemaker and a short, flexible lead entirely within the chest of the fetus to avoid dislodgement from fetal movement. The feasibility of implanting the device percutaneously under ultrasonic imaging guidance was demonstrated in acute adult rabbit experiments. PMID:23367442

  12. Total Hip Arthroplasty Dislocations Are More Complex Than They Appear: A Case Report of Intraprosthetic Dislocation of an Anatomic Dual-Mobility Implant After Closed Reduction

    PubMed Central

    Waddell, Bradford S.; De Martino, Ivan; Sculco, Thomas; Sculco, Peter

    2016-01-01

    Background: Total hip arthroplasty is a successful operation for the treatment of hip pain. One of the common complications of hip arthroplasty is dislocation. While reduction of standard prosthetic dislocations is highly successful, new prostheses add the potential for new complications. Case Report: We present the case of a patient who experienced intraprosthetic dislocation of an anatomic dual-mobility total hip prosthesis after a closed hip reduction and include the prereduction and postreduction radiographic findings. Conclusion: Emergency department physicians should be aware of intraprosthetic dislocation. This complication can be easily missed because the metal/ceramic femoral head appears to be reduced in the acetabulum. PMID:27303232

  13. 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

    PubMed Central

    Datt, Vishnu; Tempe, D. K.; Lalwani, Parin; Aggarwal, Saket; Kumar, Pradeep; Diwakar, Anitha; Tomar, A. S.

    2015-01-01

    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. PMID:26139758

  14. Cochlear implantation: a biomechanical prosthesis for hearing loss

    PubMed Central

    Yawn, Robert; Hunter, Jacob B.; Sweeney, Alex D.

    2015-01-01

    Cochlear implants are a medical prosthesis used to treat sensorineural deafness, and one of the greatest advances in modern medicine. The following article is an overview of cochlear implant technology. The history of cochlear implantation and the development of modern implant technology will be discussed, as well as current surgical techniques. Research regarding expansion of candidacy, hearing preservation cochlear implantation, and implantation for unilateral deafness are described. Lastly, innovative technology is discussed, including the hybrid cochlear implant and the totally implantable cochlear implant. PMID:26097718

  15. Implantable Microimagers

    PubMed Central

    Ng, David C.; Tokuda, Takashi; Shiosaka, Sadao; Tano, Yasuo; Ohta, Jun

    2008-01-01

    Implantable devices such as cardiac pacemakers, drug-delivery systems, and defibrillators have had a tremendous impact on the quality of live for many disabled people. To date, many devices have been developed for implantation into various parts of the human body. In this paper, we focus on devices implanted in the head. In particular, we describe the technologies necessary to create implantable microimagers. Design, fabrication, and implementation issues are discussed vis-à-vis two examples of implantable microimagers; the retinal prosthesis and in vivo neuro-microimager. Testing of these devices in animals verify the use of the microimagers in the implanted state. We believe that further advancement of these devices will lead to the development of a new method for medical and scientific applications.

  16. High Productivity Implantation ''PARTIAL IMPLANT''

    SciTech Connect

    Hino, Masayoshi; Miyamoto, Naoki; Sakai, Shigeki; Matsumoto, Takao

    2008-11-03

    The patterned ion implantation 'PARTIAL IMPLANT' has been developed as a productivity improvement tool. The Partial Implant can form several different ion dose areas on the wafer surface by controlling the speed of wafer moving and the stepwise rotation of twist axis. The Partial Implant system contains two implant methods. One method is 'DIVIDE PARTIAL IMPLANT', that is aimed at reducing the consumption of the wafer. The Divide Partial Implant evenly divides dose area on one wafer surface into two or three different dose part. Any dose can be selected in each area. So the consumption of the wafer for experimental implantation can be reduced. The second method is 'RING PARTIAL IMPLANT' that is aimed at improving yield by correcting electrical characteristic of devices. The Ring Partial Implant can form concentric ion dose areas. The dose of wafer external area can be selected to be within plus or minus 30% of dose of wafer central area. So the electrical characteristic of devices can be corrected by controlling dose at edge side on the wafer.

  17. Immediate total tooth replacement.

    PubMed

    Garber, D A; Salama, M A; Salama, H

    2001-03-01

    Successful implant placement at the time of extraction has been documented. Implant placement at the time of extraction was initially performed as a two-stage procedure often with barrier membranes and sophisticated second-stage surgical uncoverings. The authors describe the next generation of this technique, including atraumatic tooth removal with simultaneous root form, implant placement, and temporization at one appointment. This technique of "Immediate Total Tooth Replacement" allows for the maintenance of the bony housing and soft-tissue form that existed before extraction, while at the same time establishing a root form anchor in the bone for an esthetic restoration. PMID:11913258

  18. [Implant allergies].

    PubMed

    Thomas, P; Thomsen, M

    2010-03-01

    An increasing number of patients receive and benefit from osteosynthesis materials or artificial joint replacement. The most common complications are mechanical problems or infection. Metals like nickel, chromium and cobalt as well as bone cement components like acrylates and gentamicin are potential contact allergens which can cause intolerance reactions to implants. Eczema, delayed wound/bone healing, recurrent effusions, pain and implant loosening all have been described as manifestation of implant allergy. In contrast to the high incidence of cutaneous metal allergy, allergies associated with implants are rare. Diagnosis of metal implant allergy is still difficult. Thus differential diagnoses--in particular infection--have to be excluded and a combined approach of allergologic diagnostics by patch test and histopathology of peri-implant tissue is recommended. It is still unknown which conditions induce allergic sensitization to implants or trigger peri-implant allergic reactions in the case of preexisting cutaneous metal allergy. Despite the risk of developing complications being unclear, titanium based osteosynthesis materials are recommended for metal allergic patients and the use of metal-metal couplings in arthroplasty is not recommended for such patients. If the regular CoCr-polyethylene articulation is employed, the patient should give informed written consent. PMID:20204719

  19. ANTIARRHYTHMICS VERSUS IMPLANTABLE DEFIBRILLATORS (AVID)

    EPA Science Inventory

    Evaluates whether use of an implantable cardiac defibrillator (ICD) results in reduction in total mortality, when compared with conventional pharmacological therapy, in patients resuscitated from sudden cardiac death who are otherwise at very high risk of mortality from arrhythmi...

  20. Is the use of computer navigation in total knee arthroplasty improving implant positioning and function? A comparative study of 198 knees operated at a Norwegian district hospital

    PubMed Central

    2013-01-01

    Background There are few Scandinavian studies on the effect of computer assisted orthopedic surgery (CAOS) in total knee arthroplasty (TKA), compared to conventional technique (CON), and there is little information on effects in pain and function scores. This retrospective study has evaluated the effects of CAOS on radiological parameters and pain, function and quality of life after primary TKA. Methods 198 primary TKAs were operated by one surgeon in two district hospitals; 103 CAOS and 95 CON. The groups were evaluated based on 3 months post-operative radiographs and a questionnaire containing the knee osteoarthritis outcome score (KOOS), the EQ-5D index score and a visual analogue scale (VAS) two years after surgery. Multiple linear regression method was used to investigate possible impact from exposure (CON or CAOS). Results On hip-knee-ankle radiographs, 20% of measurements were > ±3° of neutral in the CAOS group and 25% in the CON group (p = 0.37). For the femoral component, the number was 5% for CAOS and 18% for CON (p < 0.01). For the tibial component, the difference was not statistically significant (p = 0.58). In the sagittal plane, the surgeon tended to apply more femoral flexion and more posterior tibial slope with CAOS. We observed no statistically or clinically significant difference in KOOS score, VAS or ∆EQ-5D (all p values >0.05), but there was a trend towards better scores for CAOS. Operation time was 3 minutes longer for CON (p = 0.37). Conclusions CAOS can improve radiological measurements in primary TKA, and makes it possible to adjust component placement to the patient’s anatomy. Over-all, the two methods are equal in pain, function and quality-of-life scores. PMID:24228727

  1. Comparison of Three Attachments in Implant-Tissue Supported Overdentures: An In Vitro Study

    PubMed Central

    Tabatabaian, F.; Alaie, F.; Seyedan, K.

    2010-01-01

    Objective: Retention and resistance of the implant-tissue supported overdenture may be affected by the type of attachment. The aim of this research was to compare the retention and resistance of Nobel Biocare Ball (NBB), Nobel Biocare Bar and Clip (NBBC) and Sterngold ERA Red (ERAR) attachments on an implant-tissue supported overdenture model. Materials and Methods: The attachment samples were divided into 3 groups of NBB, NBBC, and ERAR (5 samples in each group). Two parallel Nobel Biocare Branemark implants were placed symmetrically at the symphysis region of a mandibular test model. A metallic overdenture was fabricated precisely adapted to the model and attached to a Zwick testing machine (crosshead speed of 51 mm/min). Dislodging tensile forces were applied in three vertical, oblique, anterior-posterior directions and two situations, at the beginning and after 100 times of insertion/removal of the overdenture, for each sample. The maximum dislodging force was measured. A One-way ANOVA test was employed followed by Tukey’s test. Results: ERAR was the most retentive and resistant in both situations. NBB and NBBC showed the same anterior-posterior resistance at the beginning. All test groups represented a large amount of retention and resistance loss after the insertion/removal of the overdenture, while NBBC showed a higher loss of anterior-posterior resistance than NB. Conclusion: A highest level of retention and resistance was seen in ERAR. The retention and resistance were affected by the wear of attachments. PMID:21998784

  2. Pediatric Cochlear Implantation: Why Do Children Receive Implants Late?

    PubMed Central

    Ham, Julia; Whittingham, JoAnne

    2015-01-01

    Objectives: Early cochlear implantation has been widely promoted for children who derive inadequate benefit from conventional acoustic amplification. Universal newborn hearing screening has led to earlier identification and intervention, including cochlear implantation in much of the world. The purpose of this study was to examine age and time to cochlear implantation and to understand the factors that affected late cochlear implantation in children who received cochlear implants. Design: In this population-based study, data were examined for all children who underwent cochlear implant surgery in one region of Canada from 2002 to 2013. Clinical characteristics were collected prospectively as part of a larger project examining outcomes from newborn hearing screening. For this study, audiologic details including age and severity of hearing loss at diagnosis, age at cochlear implant candidacy, and age at cochlear implantation were documented. Additional detailed medical chart information was extracted to identify the factors associated with late implantation for children who received cochlear implants more than 12 months after confirmation of hearing loss. Results: The median age of diagnosis of permanent hearing loss for 187 children was 12.6 (interquartile range: 5.5, 21.7) months, and the age of cochlear implantation over the 12-year period was highly variable with a median age of 36.2 (interquartile range: 21.4, 71.3) months. A total of 118 (63.1%) received their first implant more than 12 months after confirmation of hearing loss. Detailed analysis of clinical profiles for these 118 children revealed that late implantation could be accounted for primarily by progressive hearing loss (52.5%), complex medical conditions (16.9%), family indecision (9.3%), geographical location (5.9%), and other miscellaneous known (6.8%) and unknown factors (8.5%). Conclusions: This study confirms that despite the trend toward earlier implantation, a substantial number of children

  3. Cochlear Implants

    MedlinePlus

    ... additional visits are needed for activating, adjusting, and programming the various electrodes that have been implanted. Also, ... to the center for checkups once the final programming is made to the speech processor. Both children ...

  4. Histrelin Implant

    MedlinePlus

    ... bone growth and development of sexual characteristics) in girls usually between 2 and 8 years of age ... MRI scans (radiology techniques designed to show the images of body structures) to find the implant when ...

  5. Goserelin Implant

    MedlinePlus

    ... which the type of tissue that lines the uterus [womb] grows in other areas of the body ... with the treatment of abnormal bleeding of the uterus. Goserelin implant is in a class of medications ...

  6. Ion Implantation

    NASA Astrophysics Data System (ADS)

    Langouche, G.; Yoshida, Y.

    In this tutorial we describe the basic principles of the ion implantation technique and we demonstrate that emission Mössbauer spectroscopy is an extremely powerful technique to investigate the atomic and electronic configuration around implanted atoms. The physics of dilute atoms in materials, the final lattice sites and their chemical state as well as diffusion phenomena can be studied. We focus on the latest developments of implantation Mössbauer spectroscopy, where three accelerator facilities, i.e., Hahn-Meitner Institute Berlin, ISOLDE-CERN and RIKEN, have intensively been used for materials research in in-beam and on-line Mössbauer experiments immediately after implantation of the nuclear probes.

  7. Dental Implants

    MedlinePlus Videos and Cool Tools

    ... facts so you can make an informed decision as to whether dental implants are right for your ... the jaw bone. It’s obviously not the same as the original connection , but functions just the same. ...

  8. Does the number of implants have any relation with peri-implant disease?

    PubMed Central

    PASSONI, Bernardo Born; DALAGO, Haline Renata; SCHULDT FILHO, Guenther; OLIVEIRA DE SOUZA, João Gustavo; BENFATTI, César Augusto Magalhães; MAGINI, Ricardo de Souza; BIANCHINI, Marco Aurélio

    2014-01-01

    Objective The aim of this study was to evaluate the relationship between the number of pillar implants of implant-supported fixed prostheses and the prevalence of periimplant disease. Material and Methods Clinical and radiographic data were obtained for the evaluation. The sample consisted of 32 patients with implant-supported fixed prostheses in function for at least one year. A total of 161 implants were evaluated. Two groups were formed according to the number of implants: G1) ≤5 implants and G2) >5 implants. Data collection included modified plaque index (MPi), bleeding on probing (BOP), probing depth (PD), width of keratinized mucosa (KM) and radiographic bone loss (BL). Clinical and radiographic data were grouped for each implant in order to conduct the diagnosis of mucositis or peri-implantitis. Results Clinical parameters were compared between groups using Student's t test for numeric variables (KM, PD and BL) and Mann-Whitney test for categorical variables (MPi and BOP). KM and BL showed statistically significant differences between both groups (p<0.001). Implants from G1 – 19 (20.43%) – compared with G2 – 26 (38.24%) – showed statistically significant differences regarding the prevalence of peri-implantitis (p=0.0210). Conclusion It seems that more than 5 implants in total fixed rehabilitations increase bone loss and consequently the prevalence of implants with periimplantitis. Notwithstanding, the number of implants does not have any influence on the prevalence of mucositis. PMID:25466474

  9. Anatomic consideration for preventive implantation.

    PubMed

    Denissen, H W; Kalk, W; Veldhuis, H A; van Waas, M A

    1993-01-01

    The aim of preventive implant therapy is to prevent or delay loss of alveolar ridge bone mass. For use in an anatomic study of 60 mandibles, resorption of the alveolar ridge was classified into four preventive stages: (1) after extraction of teeth; (2) after initial resorption; (3) when the ridge has atrophied to a knife-edge shape; and (4) when only basal bone remains. Implantation in stage 3 necessitates removal of the knife-edge ridge to create space for cylindrical implants. Therefore, implantation in stage 2 is advocated to prevent the development of stage 3. The aim of implantation in stage 4 is to prevent total loss of function of the atrophic mandible. PMID:8359876

  10. Functions and requirements for a waste dislodging and conveyance system for the gunite and associated tanks treatability study at Oak Ridge National Laboratory

    SciTech Connect

    Potter, J.D.; Mullen, O.D.

    1997-02-01

    Since the mid 1940s, the Department of Defense (DOD) and the Department of Energy (DOE) have conducted research and development activities at the Oak Ridge National Laboratory (ORNL) in support of urgent national interests in the fields of nuclear weaponry and nuclear energy. Some of these activities resulted in radiologically hazardous waste being temporarily deposited at ORNL, Waste Area Grouping 1. At this location, waste is stored in several underground storage tanks, awaiting ultimate final disposal. There are tanks of two basic categories. One category is referred to as the gunite tanks, the other category is associated tanks. The ORNL Gunite and Associated Tanks Treatability Study (GAAT TS) project was initiated in FY 1994 to support a record of decision in selecting from seven different options of technologies for retrieval and remediation of these tanks. As part of this decision process, new waste retrieval technologies will be evaluated at the 25-foot diameter gunite tanks in the North tank farm. Work is currently being conducted at Hanford and the University of Missouri-Rolla to evaluate and develop some technologies having high probability of being most practical and effective for the dislodging and conveying of waste from underground storage tanks. The findings of these efforts indicate that a system comprised of a dislodging end effector employing jets of high-pressure fluids, coupled to a water-jet conveyance system, all carried above the waste by a mechanical arm or other mechanism, is a viable retrieval technology for the GAAT TS tasks.

  11. Method for the analysis of triadimefon and ethofumesate from dislodgeable foliar residues on turfgrass by solid-phase extraction and in-vial elution.

    PubMed

    Runes, H B; Jenkins, J J; Field, J A

    1999-08-01

    Triadimefon, a fungicide, and ethofumesate, an herbicide, are commonly applied to turfgrass in the Pacific Northwest, resulting in foliar residues. A simple and rapid method was developed to determine triadimefon and ethofumesate concentrations from dislodgeable foliar residues on turfgrass. Turfgrass samples were washed, and wash water containing surfactant (a 0.126% solution) was collected for residue analysis. This analytical method utilizes a 25 mm C(8) Empore disk and in-vial elution to quantitatively determine triadimefon and ethofumesate in 170 mL aqueous samples. The analytes were eluted by placing the disk in a 2 mL autosampler vial with 980 microL of ethyl acetate and 20 microL of 2-chlorolepidine, the internal standard, for analysis by GC/MS. The method quantitation limits are 0.29 microg/L for ethofumesate and 0.59 microg/L for triadimefon. The method detection limits are 0.047 microg/L and 0.29 microg/L for ethofumesate and triadimefon, respectively. Concentrations of triadimefon and ethofumesate from dislodgeable foliar residues from a field study are reported. PMID:10552640

  12. Mathematical simulation of boulder dislodgement by high-energy marine flows in the western coast of Portugal

    NASA Astrophysics Data System (ADS)

    Canelas, Ricardo; Oliveira, Maria; Crespo, Alejandro; Neves, Ramiro; Costa, Pedro; Freitas, Conceição; Andrade, César; Ferreira, Rui

    2014-05-01

    The study of coastal boulder deposits related with marine abrupt inundation events has been addressed by several authors using conventional numerical solutions that simulate particle transport by storm and tsunami, sometimes with contradictory results (Nandasena et al. 2011, Kain et al. 2012). The biggest challenge has been the differentiation of the events (storm or tsunami), and the reconstruction of wave parameters (e.g. wave height, length, direction) responsible for the entrainment and transport of these megaclasts. In this study we employ an inverse-problem strategy to determine the cause of dislodgement of megaclasts and to explain the pattern of deposition found in some locations of the Portuguese western coast, well above maximum records of sea level. It is envisaged that the causes are either flows originated by wave breaking, typically associated to storms, which would impart large momentum in a short time interval (herein impulsive motion), or long waves such as a tsunamis, that would transport the clasts in a mode analogous to bedload (herein sustained motion). The geometry of the problem is idealized but represents the key features of overhanging layers related with fractures, bedding and differential erosion of sub-horizontal layers. In plan view, concave and convex coastline shapes are testes to assess the influence of flow concentration. These geometrical features are representative of the western Portuguese coast. The fluid-solid model solves numerically the Navier-Stokes equations for the liquid phase and Newton's motion equations for solid bodies. The discretization of both fluid and solids is performed with Smooth Particle Hydrodynamics (SPH). The model is based DualSPHyics code (www.dual.sphysics.org) and represents an effort to avoid different discretization techniques for different phases in motion. This approach to boulder transport demonstrates that the ability of high-energy flow events to entrain and transport large particles largely

  13. Implant Maintenance: A Clinical Update

    PubMed Central

    Gulati, Minkle; Govila, Vivek; Anand, Vishal; Anand, Bhargavi

    2014-01-01

    Introduction. The differences in the supporting structure of the implant make them more susceptible to inflammation and bone loss when plaque accumulates as compared to the teeth. Therefore, a comprehensive maintenance protocol should be followed to ensure the longevity of the implant. Material and Method. A research to provide scientific evidence supporting the feasibility of various implant care methods was carried out using various online resources to retrieve relevant studies published since 1985. Results. The electronic search yielded 708 titles, out of which a total of 42 articles were considered appropriate and finally included for the preparation of this review article. Discussion. A typical maintenance visit for patients with dental implants should last 1 hour and should be scheduled every 3 months to evaluate any changes in their oral and general history. It is essential to have a proper instrument selection to prevent damage to the implant surface and trauma to the peri-implant tissues. Conclusion. As the number of patients opting for dental implants is increasing, it becomes increasingly essential to know the differences between natural teeth and implant care and accept the challenges of maintaining these restorations. PMID:27437506

  14. Testing the retention of attachments for implant overdentures - validation of an original force measurement system.

    PubMed

    Fromentin, O; Lassauzay, C; Abi Nader, S; Feine, J; de Albuquerque Junior, R F

    2010-01-01

    The aim of this study was to validate an original portable device to measure attachment retention of implant overdentures both in the lab and in clinical settings. The device was built with a digital force measurement gauge (Imada) secured to a vertical wheel stand associated with a customized support to hold and position the denture in adjustable angulations. Sixteen matrix and patrix cylindrical stud attachments (Locator) were randomly assigned as in vitro test specimens. Attachment abutments were secured in an implant analogue hung to the digital force gauge or to the load cell of a traction machine used as the gold standard (Instron Universal Testing Machine). Matrices were secured in a denture duplicate attached to the customized support, permitting reproducibility of their position on both pulling devices. Attachment retention in the axial direction was evaluated by measuring maximum dislodging force or peak load during five consecutive linear dislodgments of each attachment on both devices. After a wear simulation, retention was measured again at several time periods. The peak load measurements with the customized Imada device were similar to those obtained with the gold standard Instron machine. These findings suggest that the proposed portable device can provide accurate information on the retentive properties of attachment systems for removable dental prostheses. PMID:19912482

  15. Effectiveness of Implant Therapy Analyzed in a Swedish Population

    PubMed Central

    Derks, J.; Håkansson, J.; Wennström, J.L.; Tomasi, C.; Larsson, M.; Berglundh, T.

    2015-01-01

    Treatment outcomes in implant dentistry have been mainly assessed as implant survival rates in small, selected patient groups of specialist or university clinical settings. This study reports on loss of dental implants assessed in a large and randomly selected patient sample. The results were aimed at representing evaluation of effectiveness of implant dentistry. Using the national data register of the Swedish Social Insurance Agency, 4,716 patients were randomly selected. All had been provided with implant-supported restorative therapy in 2003. Patient files of 2,765 patients (11,311 implants) were collected from more than 800 clinicians. Information on patients, treatment procedures, and outcomes related to the implant-supported restorative therapy was extracted from the files. In total, 596 of the 2,765 subjects, provided with 2,367 implants, attended a clinical examination 9 y after therapy. Implant loss that occurred prior to connection of the supraconstruction was scored as an early implant loss, while later occurring loss was considered late implant loss. Early implant loss occurred in 4.4% of patients (1.4% of implants), while 4.2% of the patients who were examined 9 y after therapy presented with late implant loss (2.0% of implants). Overall, 7.6% of the patients had lost at least 1 implant. Multilevel analysis revealed higher odds ratios for early implant loss among smokers and patients with an initial diagnosis of periodontitis. Implants shorter than 10 mm and representing certain brands also showed higher odds ratios for early implant loss. Implant brand also influenced late implant loss. Implant loss is not an uncommon event, and patient and implant characteristics influence outcomes (ClinicalTrials.gov NCT01825772). PMID:25503901

  16. Cochlear Implants

    MedlinePlus

    ... outside of the body, behind the ear. A second part is surgically placed under the skin. An implant does not restore normal hearing. It can help a person understand speech. Children and adults can benefit from them. National Institute on Deafness and Other Communication Disorders

  17. Cochlear implant

    MedlinePlus

    ... are sent along the auditory nerve to the brain. A deaf person does not have a functioning inner ear. A cochlear implant tries to replace the function of the inner ear by ... signals to the brain. Sound is picked up by a microphone worn ...

  18. Implant failure: regional versus cumulative evaluation.

    PubMed

    Lauc, T; Krnić, D; Katanec, D

    2000-07-01

    In this paper the success rate of implant therapy in various bone regions is discussed. The objective is to determine whether differences existed in success rates of cylinder implants placed in different areas in the both maxilla and mandible. Forty four patients have been treated and reviewed five years after the placement of the fixed prosthetic restoration. The patients were provided with a total of 92 implants. Results from this study show very low survival rate for implants placed in anterior region of maxilla (55.6%) after five years. It is concluded that simple cumulative follow up studies do not entirely correspond to actual situations, positioning the implants has an important role in the planning of the implant therapy and that important factor for force compensation is not only the surrounding bone density, but also the region of the jaw where the implants are placed. PMID:10946471

  19. [Implant fracture: a complication of treatment with dental implants--review of the literature].

    PubMed

    Tagger-Green, N; Horwitz, J; Machtei, E E; Peled, M

    2002-10-01

    Dental implants are a functional and esthetic solution to partial and total edentulism. The initial success rate of this treatment modality is 90-95%. But, that treatment modality is not free of complications. One of the rare complications yet, with severe clinical results is fracture of dental implants. The current literature review presents the various causative factors that may lead to implant fracture. Implant failures may be sorted into groups by the timing of their appearance, or by the origin of failure. Fractures belong to the group of late complications, caused by a biomechanical overload. Overload may be caused by inappropriate seat of the superstructure, in-line arrangement of the implants, leverage, heavy occlusal forces (bruxing, clenching), location of the implant and the size of the implant or metal fatigue. Good clinical examinations and correct treatment plans may reduce the risk of implant fracture. PMID:12510252

  20. Microbiological aspects of human mandibular subperiosteal dental implants.

    PubMed

    Rams, Thomas E; Balkin, Burton E; Roberts, Thomas W; Molzan, Arthur K

    2013-12-01

    Clinical, microbiological, and biochemical features of human mandibular subperiosteal dental implants exhibiting peri-implantitis were compared with those experiencing long-term peri-implant health. After evaluation of clinical parameters, submucosal plaque samples were obtained from permucosal implant abutment posts exhibiting probing depths ≥5 mm and bleeding on probing in subjects with peri-implantitis (n = 3) and from posts with peri-implant health in subjects with long-term subperiosteal implant health (n = 8). The microbial specimens were transported in VMGA III and plated onto enriched Brucella blood agar and Hammond's selective medium with anaerobic incubation, and onto selective TSBV with 5% CO2 incubation. Total anaerobic viable counts and selected bacterial species were identified using established phenotypic methods and criteria. In vitro resistance to doxycycline (2 μg/mL), amoxicillin (2 μg/mL), or metronidazole (4 μg/mL) was recorded per subject when bacterial pathogen growth was noted on antibiotic-supplemented isolation plates. Interleukin (IL)-1β levels were measured with an enzyme-linked immunosorbent assay in peri-implant crevicular fluid samples from 5 study subjects. Significantly higher Plaque Index scores, higher total anaerobic viable counts, more red complex species, and lower proportions of gram-positive facultative viridans streptococci and Actinomyces species were detected on peri-implantitis-affected subperiosteal implants as compared with subperiosteal implants with long-term peri-implant health. No in vitro resistance to the 3 test antibiotic breakpoint concentrations studied was found, except a Fusobacterium nucleatum strain resistant to doxycycline at 2 μg/mL from 1 peri-implantitis subject. Subperiosteal implants with peri-implantitis tended to yield higher peri-implant crevicular fluid IL-1β levels. The level of peri-implant supramucosal plaque control and the composition of the peri-implant submucosal microbiome may be

  1. High-field-strength MR imaging and metallic biomedical implants: an ex vivo evaluation of deflection forces.

    PubMed

    Shellock, F G; Crues, J V

    1988-08-01

    Ferromagnetic biomedical implants are considered a contraindication for MR imaging primarily because of the potential hazards associated with their movement or dislodgment. Many metallic biomedical implants are composed of nonferromagnetic materials and do not present a danger to patients during MR imaging. Therefore, to evaluate the ferromagnetic qualities of 36 different metallic biomedical implants (four aneurysm clips, six hemostatic clips, four dental implants, seven prosthetic heart valves, eight orthopedic prostheses, one artificial urinary sphincter, three contraceptive diaphragms, and three cerebral ventricular shunt tube connectors) not previously evaluated with a high-field-strength MR system, we measured deflection forces at the portal of the magnet of a 1.5-T MR system. Fourteen of the 36 metallic biomedical implants were determined to be ferromagnetic as indicated by their deflection in the static magnetic field. However, only the four aneurysm clips (Drake, Mayfield, McFadden, and Sundt-Kees) had sufficient ferromagnetism to warrant exclusion of patients with these implants from imaging with a 1.5-T MR system because of the possibility of movement or displacement. The calculated deflection forces for these aneurysm clips were comparable with previously reported values of certain aneurysm clips that have been designated to present a risk for patients undergoing MR imaging. Patients with 32 of 36 metallic biomedical implants tested can be safely imaged with high-field-strength MR systems. PMID:3260731

  2. Dental Implants Installed in Irradiated Jaws

    PubMed Central

    Chambrone, L.; Mandia, J.; Shibli, J.A.; Romito, G.A.; Abrahao, M.

    2013-01-01

    The aim of this study was to assess the survival rate of titanium implants placed in irradiated jaws. MEDLINE, EMBASE, and CENTRAL were searched for studies assessing implants that had been placed in nongrafted sites of irradiated patients. Random effects meta-analyses assessed implant loss in irradiated versus nonirradiated patients and in irradiated patients treated with hyperbaric oxygen (HBO) therapy. Of 1,051 potentially eligible publications, 15 were included. A total of 10,150 implants were assessed in the included studies, and of these, 1,689 (14.3%) had been placed in irradiated jaws. The mean survival rate in the studies ranged from 46.3% to 98.0%. The pooled estimates indicated a significant increase in the risk of implant failure in irradiated patients (risk ratio: 2.74; 95% confidence interval: 1.86, 4.05; p < .00001) and in maxillary sites (risk ratio: 5.96; 95% confidence interval: 2.71, 13.12; p < .00001). Conversely, HBO therapy did not reduce the risk of implant failure (risk ratio: 1.28; 95% confidence interval: 0.19, 8.82; p = .80). Radiotherapy was linked to higher implant failure in the maxilla, and HBO therapy did not improve implant survival. Most included publications reported data on machined implants, and only 3 studies on HBO therapy were included. Overall, implant therapy appears to be a viable treatment option for reestablishing adequate occlusion and masticatory conditions in irradiated patients. PMID:24158336

  3. Short dental implants: a systematic review.

    PubMed

    Annibali, S; Cristalli, M P; Dell'Aquila, D; Bignozzi, I; La Monaca, G; Pilloni, A

    2012-01-01

    Growing evidence has suggested the utility of short dental implants for oral reconstructive procedures in clinical situations of limited vertical bone height. The aim of this review was to systematically evaluate clinical studies of implants < 10 mm in length, to determine short implant-supported prosthesis success in the atrophic jaw. Implant survival, incidence of biological and biomechanical complications, and radiographic peri-implant marginal bone loss were evaluated. Screening of eligible studies, quality assessment, and data extraction were conducted by two reviewers independently. Meta-analyses were performed by the pooling of survival data by implant surface, surgical technique, implant location, type of edentulism, and prosthetic restoration. Two randomized controlled trials and 14 observational studies were selected and analyzed for data extraction. In total, 6193 short-implants were investigated from 3848 participants. The observational period was 3.2 ± 1.7 yrs (mean ± SD). The cumulative survival rate (CSR) was 99.1% (95%CI: 98.8-99.4). The biological success rate was 98.8% (95%CI: 97.8-99.8), and the biomechanical success rate was 99.9% (95%CI: 99.4-100.0). A higher CSR was reported for rough-surfaced implants. The provision of short implant-supported prostheses in patients with atrophic alveolar ridges appears to be a successful treatment option in the short term; however, more scientific evidence is needed for the long term. PMID:22034499

  4. Evaluation of safety and efficacy of pacemaker and defibrillator implantation by axillary incision in pediatric patients.

    PubMed

    Lee, Joselyn C R; Shannon, Kevin; Boyle, Noel G; Klitzner, Thomas S; Bersohn, Malcolm M

    2004-03-01

    We successfully implanted 11 pacemakers, 6 defibrillators, and 1 biventricular pacemaker in 18 pediatric patients (15 female; 4 to 15 years, average age: 9) using the retropectoral transvenous approach with a hidden axillary incision. The average follow-up period was 24 months (range 49 months). Eight patients had congenital structural heart conditions (d-transposition of great arteries S/P Mustard operation, d-transposition of great arteries S/P arterial switch operation, truncus arteriosus, right ventricular diverticula, ventricular septal defect, hypertrophic cardiomyopathy). Four patients had acquired heart conditions (dilated cardiomyopathy, myocarditis). Excellent sensing and pacing thresholds were achieved in all attempted implantations. There was no pneumothorax. There was one lead dislodgement. One lead fracture distant from the subclavian vein occurred 4 months after implantation. Implantation of pacemakers and defibrillators via axillary incisions can be safe and effective in pediatric patients. This approach avoids skin erosion when implanting large devices such as defibrillators or biventricular devices in small patients with limited muscle mass while achieving superior aesthetic results. The axillary or extrathoracic venous entry site avoids subclavian crush syndrome. PMID:15009854

  5. Array of Biodegradable Microraftsfor Isolation and Implantation of Living, Adherent Cells

    PubMed Central

    Wang, Yuli; Phillips, Colleen N.; Herrera, Gabriela S.; Sims, Christopher E.; Yeh, Jen Jen; Allbritton, Nancy L.

    2013-01-01

    A new strategy for efficient sorting and implantation of viable adherent cells into animals is described. An array of biodegradable micro-structures (microrafts) was fabricated using a polydimethylsiloxane substrate for micromolding poly(lactic-co-glycolic acid) (PLGA). Screening various forms of PLGA determined that the suitability of PLGA for microraft manufacture, biocompatibility and in vitro degradation was dependent on molecular weight and lactic/glycolic ratio. Cells plated on the array selectively attached to the microrafts and could be identified by their fluorescence, morphology or other criteria. The cells were efficiently dislodged and collected from the array using a microneedle device. The platform was used to isolate specific cells from a mixed population establishing the ability to sort target cells for direct implantation. As a proof of concept, fluorescently conjugated microrafts carrying tumor cells stably expressing luciferase were isolated from an array and implanted subcutaneously into mice. In vivo bio-luminescence imaging confirmed the growth of a tumor in the recipient animals. Imaging of tissue sections from the tumors demonstrated in vivo degradation of the implanted microrafts. The process is a new strategy for isolating and delivering a small number of adherent cells for animal implantation with potential applications in tissue repair, tumor induction, in vivo differentiation of stem cells and other biomedical research. PMID:23930219

  6. Hip Resurfacing Implants.

    PubMed

    Cadossi, Matteo; Tedesco, Giuseppe; Sambri, Andrea; Mazzotti, Antonio; Giannini, Sandro

    2015-08-01

    EDUCATIONAL OBJECTIVES As a result of reading this article, physicians should be able to: 1. Describe the advantages of hip resurfacing. 2. Describe the disadvantages of hip resurfacing. 3. Identify the population in which hip resurfacing is most often indicated. 4. Demonstrate how to properly postoperatively manage patients with metal-on-metal prostheses. Hip resurfacing offers a suitable solution for young patients affected by hip disease who have high function demands and good bone quality. Bone stock preservation, restoration of the normal proximal femur anatomy, the lack of stress shielding, and the possibility of resuming sporting activity are proven advantages of hip resurfacing. However, there are some disadvantages, such as fracture of the femoral neck, onset of neck narrowing, and possible complications due to the metal-on-metal bearings, including pseudotumors, peri-implant osteolysis, and chronic elevation of metal ions in serum levels. Recent data suggest that the ideal candidate for hip resurfacing is an active male, younger than 65 years, with primary or posttraumatic osteoarthritis, and with a femoral head diameter larger than 50 to 54 mm. Based on these selection criteria, the literature reports implant survival to be similar to that of total hip arthroplasty. The current authors' experience confirms a low failure rate and excellent functional outcomes, with metal ion serum levels becoming stable over time in well-functioning implants. Proper surgical technique, correct patient selection, and the right choice of a well-established prosthetic model are essential elements for the long-term success of these implants. PMID:26270748

  7. Comparison of retention and release periods for implant overdenture attachments.

    PubMed

    Petropoulos, V C; Smith, W; Kousvelari, E

    1997-01-01

    The aim of this study was to compare the retention and release periods of the Nobel Biocare bar and clip (NBC), Nobel Biocare ball (NB), Zest anchor (ZA), Zest magnet (ZM), and Sterngold ERA (SE) attachments on an implant-retained overdenture model. The attachments were tested using two permanently placed Brånemark implants on a test model that was attached to an Instron machine (cross-head speed 50.8 mm/minute). Each attachment had one part embedded in a denture-like housing, and the other part screwed into the implants. Dislodging tensile forces were applied to the housings in two directions simulating function: vertical and oblique. Eight tests were done in two directions with three samples of each attachment. The dislodging forces generated measurements of the peak load, break load, and displacement at peak load and break load. Release periods were calculated using displacements between the peak load and break load and the cross-head speed. Results showed the NBC to be significantly most retentive for the break load when subjected to vertical and oblique forces with mean values and standard deviations of 2104.5 +/- 506.7 g and 1958.1 +/- 165.4 g, respectively. Next most retentive was the SE, followed by the ZA and NB. The ZM was significantly least retentive (127.8 +/- 7.0 g and 143.5 +/- 19.7 g). For the release period, results showed the NBC to have significantly the fastest release period for vertical and oblique forces (1.86 x 10(-3) and 7.35 x 10(-4) minutes). The ZM significantly had the slowest release period for those forces (3.02 x 10(-2) and 2.35 x 10(-2) minutes). The data suggested that the NBC could be selected when a higher degree of retention and fast release period are desired. The next most retentive was the SE; ZM was the least retentive and had the slowest release period. PMID:9109267

  8. A retrospective report on three implant devices used to restore posterior partial edentulism: overall performance and changes in crestal bone levels.

    PubMed

    Kermalli, Jaffer Y; Deporter, Douglas A; Atenafu, Eshetu G; Lam, Ernest W

    2014-01-01

    Three implant designs were used to treat posterior partial edentulism. A total of 799 implants (563 Osseotite, 65 Straumann SLA,171 Endopore SPS) were placed in 345 patients. SPS implants were used in sites with less bone, had shorter lengths, and functioned longer than the threaded implant designs. Comparing implant losses, SPS implants had a higher failure rate (9.3%) compared with Osseotite (4.0%) or SLA (0%) implants. SPS implant losses generally occurred as late failures, while Osseotite losses were early failures. However, among surviving implants, SPS implants had less crestal bone loss at all time intervals compared with both of the threaded implant designs. PMID:24600658

  9. Retrograde peri-implantitis.

    PubMed

    Mohamed, Jumshad B; Shivakumar, B; Sudarsan, Sabitha; Arun, K V; Kumar, T S S

    2010-01-01

    Retrograde peri-implantitis constitutes an important cause for implant failure. Retrograde peri-implantitis may sometimes prove difficult to identify and hence institution of early treatment may not be possible. This paper presents a report of four cases of (the implant placed developing to) retrograde peri-implantitis. Three of these implants were successfully restored to their fully functional state while one was lost due to extensive damage. The paper highlights the importance of recognizing the etiopathogenic mechanisms, preoperative assessment, and a strong postoperative maintenance protocol to avoid retrograde peri-implant inflammation. PMID:20922082

  10. Effects of pore size, implantation time, and nano-surface properties on rat skin ingrowth into percutaneous porous titanium implants.

    PubMed

    Farrell, Brad J; Prilutsky, Boris I; Ritter, Jana M; Kelley, Sean; Popat, Ketul; Pitkin, Mark

    2014-05-01

    The main problem of percutaneous osseointegrated implants is poor skin-implant integration, which may cause infection. This study investigated the effects of pore size (Small, 40-100 μm and Large, 100-160 μm), nanotubular surface treatment (Nano), and duration of implantation (3 and 6 weeks) on skin ingrowth into porous titanium. Each implant type was percutaneously inserted in the back of 35 rats randomly assigned to seven groups. Implant extrusion rate was measured weekly and skin ingrowth into implants was determined histologically after harvesting implants. It was found that all three types of implants demonstrated skin tissue ingrowth of over 30% (at week 3) and 50% (at weeks 4-6) of total implant porous area under the skin; longer implantation resulted in greater skin ingrowth (p < 0.05). Only one case of infection was observed (infection rate 2.9%). Small and Nano groups showed the same implant extrusion rate which was lower than the Large group rate (0.06 ± 0.01 vs. 0.16 ± 0.02 cm/week; p < 0.05). Ingrowth area was comparable in the Small, Large, and Nano implants. However, qualitatively, the Nano implants showed greatest cellular inhabitation within first 3 weeks. We concluded that percutaneous porous titanium implants allow for skin integration with the potential for a safe seal. PMID:23703928

  11. Effects of pore size, implantation time and nano-surface properties on rat skin ingrowth into percutaneous porous titanium implants

    PubMed Central

    Farrell, Brad J.; Prilutsky, Boris I.; Ritter, Jana M.; Kelley, Sean; Popat, Ketul; Pitkin, Mark

    2013-01-01

    The main problem of percutaneous osseointegrated implants is poor skin-implant integration, which may cause infection. This study investigated the effects of pore size (Small, 40–100 microns and Large, 100–160 microns), nanotubular surface treatment (Nano), and duration of implantation (3 and 6 weeks) on skin ingrowth into porous titanium. Each implant type was percutaneously inserted in the back of 35 rats randomly assigned to 7 groups. Implant extrusion rate was measured weekly and skin ingrowth into implants was determined histologically after harvesting implants. It was found that all 3 types of implants demonstrated skin tissue ingrowth of over 30% (at week 3) and 50% (at weeks 4–6) of total implant porous area under the skin; longer implantation resulted in greater skin ingrowth (p<0.05). Only one case of infection was observed (infection rate 2.9%). Small and Nano groups showed the same implant extrusion rate which was lower than the Large group rate (0.06±0.01 vs. 0.16 ± 0.02 cm/week; p<0.05). Ingrowth area was comparable in the Small, Large and Nano implants. However, qualitatively, the Nano implants showed greatest cellular inhabitation within first three weeks. We concluded that percutaneous porous titanium implants allow for skin integration with the potential for a safe seal. PMID:23703928

  12. Total protein

    MedlinePlus

    The total protein test measures the total amount of two classes of proteins found in the fluid portion of your ... nutritional problems, kidney disease or liver disease . If total protein is abnormal, you will need to have more ...

  13. Total protein

    MedlinePlus

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  14. The feasibility of immediately loading dental implants in edentulous jaws

    PubMed Central

    2016-01-01

    Purpose Immediate loading of dental implants has been proved to be feasible in partially edentulous jaws. The purpose of this retrospective investigation was to assess the feasibility of immediately loading dental implants in fully edentulous jaws. Methods A total of 24 patients aged between 53 and 89 years received a total of 154 implants in their edentulous maxillae or mandibles. Among the implants, 45 were set in fresh extracted sockets and 109 in consolidated alveolar bones. The implants were provisionally managed with chair-side made provisional resin bridges and exposed to immediate loading. Implants were followed up for 1–8 years, including radiographic imaging. Marginal bone levels were evaluated based on radiographic imaging. Results A total of 148 out of the 154 implants survived over the follow-up period of 1 to 8 years, giving a survival rate of 96%. The time or region of the implantation, the pre-implant augmentation, and the length and diameter of the implants had no statistically significant influence on the survival or the success rate. The marginal bone level remained stable with only minimal loss of 0.3 mm after 60 months of loading. Conclusions Within the limitations of this study, immediate loading is feasible for dental implants in edentulous jaws. PMID:27588213

  15. Accuracy of computer-assisted implant placement with insertion templates

    PubMed Central

    Naziri, Eleni; Schramm, Alexander; Wilde, Frank

    2016-01-01

    Objectives: The purpose of this study was to assess the accuracy of computer-assisted implant insertion based on computed tomography and template-guided implant placement. Material and methods: A total of 246 implants were placed with the aid of 3D-based transfer templates in 181 consecutive partially edentulous patients. Five groups were formed on the basis of different implant systems, surgical protocols and guide sleeves. After virtual implant planning with the CoDiagnostiX Software, surgical guides were fabricated in a dental laboratory. After implant insertion, the actual implant position was registered intraoperatively and transferred to a model cast. Deviations between the preoperative plan and postoperative implant position were measured in a follow-up computed tomography of the patient’s model casts and image fusion with the preoperative computed tomography. Results: The median deviation between preoperative plan and postoperative implant position was 1.0 mm at the implant shoulder and 1.4 mm at the implant apex. The median angular deviation was 3.6º. There were significantly smaller angular deviations (P=0.000) and significantly lower deviations at the apex (P=0.008) in implants placed for a single-tooth restoration than in those placed at a free-end dental arch. The location of the implant, whether in the upper or lower jaw, did not significantly affect deviations. Increasing implant length had a significant negative influence on deviations from the planned implant position. There was only one significant difference between two out of the five implant systems used. Conclusion: The data of this clinical study demonstrate the accuracy and predictable implant placement when using laboratory-fabricated surgical guides based on computed tomography. PMID:27274440

  16. Total Shoulder Arthroplasty

    PubMed Central

    Sanchez-Sotelo, Joaquin

    2011-01-01

    Shoulder arthroplasty has been the subject of marked advances over the last few years. Modern implants provide a wide range of options, including resurfacing of the humeral head, anatomic hemiarthroplasty, total shoulder arthroplasty, reverse shoulder arthroplasty and trauma-specific implants for fractures and nonunions. Most humeral components achieve successful long-term fixation without bone cement. Cemented all-polyethylene glenoid components remain the standard for anatomic total shoulder arthroplasty. The results of shoulder arthroplasty vary depending on the underlying diagnosis, the condition of the soft-tissues, and the type of reconstruction. Total shoulder arthroplasty seems to provide the best outcome for patients with osteoarthritis and inflammatory arthropathy. The outcome of hemiarthroplasty for proximal humerus fractures is somewhat unpredictable, though it seems to have improved with the use of fracture-specific designs, more attention to tuberosity repair, and the selective use of reverse arthroplasty, as well as a shift in indications towards internal fixation. Reverse shoulder arthroplasty has become extremely popular for patients with cuff-tear arthropathy, and its indications have been expanded to the field of revision surgery. Overall, shoulder arthroplasty is a very successful procedure with predictable pain relief and substantial improvements in motion and function. PMID:21584206

  17. Survival of Implants in Immediate Extraction Sockets of Anterior Teeth: Early Clinical Results

    PubMed Central

    Sabir, Mohammad

    2015-01-01

    Background The aims and objectives of this study were placement of implants in freshly extracted sockets of anterior teeth and to evaluate the implant stability, peri-implant radiolucency and gingival inflammation around implant over a short period of 30 months. Materials and Methods A total of 12 patients (8 male and 4 female), ranging in the age from 20 to 50 years, from March 2007 to June 2007, were evaluated for immediate implant placement into 22 fresh extraction sockets. Only maxillary and mandibular anterior teeth/roots (central incisors, lateral incisors and canines) were considered for replacement with implants. One piece implant with integrated abutment and integrated surface, non-submerged, threaded and tapered at apical 5 mm, sand-blasted and acid etched surfaced implants (HI-TEC TRX-OP Implants of Life Care Company) were used. Results The mobility was not present in any of the implants at all the follow up visits. There were 2 implants at 6 month, 1 implant at 12 month, 1 implant at 18 month visits, showing peri-implant radiolucency at some sites at bone to implant contact site. Severe gingival inflammation was not observed in any of the implant site. At every follow-up visit, every implant met the criteria of success and none was found to be failed over a 30 months duration i.e. 100% success rate was achieved by implants in immediate extraction socket. Conclusion The success rate of implant survival in this study was found 100%. These implants have fulfilled all the criteria of implant success and based on the defined criteria, the success rate of implants placed in immediate extraction sockets of anterior teeth compared favorably with the conventional implants. The early results of the present study showed that high survival rates with the implants in immediate extraction sockets can be achieved. PMID:26266220

  18. The effect of implant angulation and splinting on stress distribution in implant body and supporting bone: A finite element analysis

    PubMed Central

    Behnaz, Ebadian; Ramin, Mosharraf; Abbasi, Samaneh; Pouya, Memar Ardestani; Mahmood, Farzin

    2015-01-01

    Objective: The aim of this study was to investigate the influence of implant crown splinting and the use of angulated abutment on stress distribution in implant body and surrounding bone by three-dimensional finite element analysis. Materials and Methods: For this study, three models with two implants at the site of mandibular right second premolar and first molar were designed (1): Both implants, parallel to adjacent teeth, with straight abutments (2): Anterior implant with 15 mesial angulations and posterior implant were placed parallel to adjacent tooth, (3): Both implants with 15 mesial angulations and parallel to each other with 15° angulated abutments. Restorations were modeled in two shapes (splinted and nonsplinted). Loading in tripod manner as each point 50 N and totally 300 N was applied. Stress distribution in relation to splinting or nonsplinting restorations and angulations was done with ABAQUS6.13. Results: Splinting the restorations in all situations, led to lower stresses in all implant bodies, cortical bone and spongy bone except for the spongy bone around angulated first molar. Angulated implant in nonsplinted restoration cause lower stresses in implant body and bone but in splinted models more stresses were seen in implant body in comparison with straight abutment (model 2). Stresses in nonsplinted and splinted restorations in cortical bone of angulated molar region were more than what was observed in straight molar implant (model 3). Conclusion: Implant restorations splinting lead to a better distribution of stresses in implant bodies and bone in comparison with nonsplinted restorations, especially when the load is applied off center to implant body. Angulations of implant can reduce stresses when the application of the load is in the same direction as the implant angulation. PMID:26430356

  19. On the Horizon: Cochlear Implant Technology.

    PubMed

    Roche, Joseph P; Hansen, Marlan R

    2015-12-01

    Cochlear implantation and cochlear implants (CIs) have a long history filled with innovations that have resulted in the high-performing device's currently available. Several promising technologies have been reviewed in this article, which hold the promise to drive performance even higher. Remote CI programming, totally implanted devices, improved neural health and survival through targeted drug therapy and delivery, intraneural electrode placement, electroacoustical stimulation and hybrid CIs, and methods to enhance the neural-prosthesis interface are evolving areas of innovation reviewed in this article. PMID:26443490

  20. Poster — Thur Eve — 41: Considerations for Patients with Permanently Implant Radioactive Sources Requiring Unrelated Surgery

    SciTech Connect

    Basran, P. S; Beckham, WA; Baxter, P

    2014-08-15

    Permanent implant of sealed radioactive sources is an effective technique for treating cancer. Typically, the radioactive sources are implanted in and near the disease, depositing dose locally over several months. There may be instances where these patients must undergo unrelated surgical procedures when the radioactive material remains active enough to pose risks. This work explores these risks, discusses strategies to mitigate those risks, and describes a case study for a permanent I-125 prostate brachytherapy implant patient who developed colo-rectal cancer and required surgery 6 months after brachytherapy. The first consideration is identifying the risk from unwarranted radiation to the patient and staff before, during, and after the surgical procedure. The second is identifying the risk the surgical procedure may have on the efficacy of the brachytherapy implant. Finally, there are considerations for controlling for radioactive substances from a regulatory perspective. After these risks are defined, strategies to mitigate those risks are considered. These strategies may include applying the concepts of ALARA, the use of protective equipment and developing a best practice strategy with the operating room team. We summarize this experience with some guidelines: If the surgical procedure is near (ex: 5 cm) of the implant; and, the surgical intervention may dislodge radioisotopes enough to compromise treatment or introduces radiation safety risks; and, the radioisotope has not sufficiently decayed to background levels; and, the surgery cannot be postponed, then a detailed analysis of risk is advised.

  1. Urinary incontinence - injectable implant

    MedlinePlus

    Injectable implants are injections of material into the urethra to help control urine leakage ( urinary incontinence ) caused by a ... into the tissue next to the sphincter. The implant procedure is usually done in the hospital. Or ...

  2. Hair implant complications.

    PubMed

    Hanke, C W; Norins, A L; Pantzer, J G; Bennett, J E

    1981-04-01

    Four men who underwent hair implantation for pattern baldness were treated for complications such as infection, foreign-body reaction, pruritus, and scarring. The complications were similar to those reported with synthetic modacrylic fiber implants that have been used for the same purpose. Although we believe this is the first article to report complications from hair implants, the illogical basis of the procedure suggests that complications will occur in many unsuspecting patients who undergo hair implantation. PMID:7009899

  3. Implantable telemetry for small animals

    NASA Technical Reports Server (NTRS)

    1982-01-01

    A series of totally implantable telemetry devices for use in measuring deep body parameters in small animals were developed. Under a collaborative agreement with NASA, several of these systems; the continuous wave Doppler ultrasonic flowmeter, the multichannel telemetry system, and the inductively-powered dual channel cardiac pacer were evaluated in a series of ten mongrel dogs (15 to 20 kg.). These systems were used to measure ascending aortic and coronary blood flow, aortic pressure, and subcutaneous EKG.

  4. Implantable telemetry for small animals

    NASA Astrophysics Data System (ADS)

    1982-03-01

    A series of totally implantable telemetry devices for use in measuring deep body parameters in small animals were developed. Under a collaborative agreement with NASA, several of these systems; the continuous wave Doppler ultrasonic flowmeter, the multichannel telemetry system, and the inductively-powered dual channel cardiac pacer were evaluated in a series of ten mongrel dogs (15 to 20 kg.). These systems were used to measure ascending aortic and coronary blood flow, aortic pressure, and subcutaneous EKG.

  5. Effects of gold coating on experimental implant fixation

    PubMed Central

    Zainali, Kasra; Danscher, Gorm; Jakobsen, Thomas; Jakobsen, Stig S.; Baas, Jørgen; Møller, Per; Bechtold, Joan E.; Soballe, Kjeld

    2013-01-01

    Insertions of orthopedic implants are traumatic procedures that trigger an inflammatory response. Macrophages have been shown to liberate gold ions from metallic gold. Gold ions are known to act in an antiinflammatory manner by inhibiting cellular NF-κB–DNA binding and suppressing I-κ B-kinase activation. The present study investigated whether gilding implant surfaces augmented early implant osseointegration and implant fixation by its modulatory effect on the local inflammatory response. Ion release was traced by autometallographic silver enhancement. Gold-coated cylindrical porous coated Ti6Al4V implants were inserted press-fit in the proximal part of tibiae in nine canines and control implants without gold inserted contralateral. Observation time was 4 weeks. Biomechanical push-out tests showed that implants with gold coating had ~50% decrease in mechanical strength and stiffness. Histomorphometrical analyses showed gold-coated implants had a decrease in overall total bone-to-implant contact of 35%. Autometallographic analysis revealed few cells loaded with gold close to the gilded implant surface. The findings demonstrate that gilding of implants negatively affects mechanical strength and osseointegration because of a significant effect of the released gold ions on the local inflammatory process around the implant. The possibility that a partial metallic gold coating could prolong the period of satisfactory mechanical strength, however, cannot be excluded. PMID:18335533

  6. Nitrogen and aluminum implantation in high resistivity silicon carbide

    SciTech Connect

    Dwight, D.; Rao, M.V.; Holland, O.W.; Kelner, G.; Chi, P.H.; Kretchmer, J.; Ghezzo, M.

    1997-12-01

    In this article, the results on N and Al implantations into undoped high-resistance and vanadium doped semi-insulating bulk 6H-SiC are reported for the first time. The N implants were performed at 700{degree}C and the Al implants at 800{degree}C to create n- and p-type layers, respectively. For comparison, implants were performed into epitaxial layers at the above temperatures and, for N, also at room temperature. The implanted/annealed material was characterized by van der Pauw Hall, secondary ion mass spectrometry, and Rutherford backscattering (RBS) measurements. After annealing, the room temperature N implantation gave similar electrical and RBS results as the 700{degree}C implantation for a total implant dose of 8{times}10{sup 14}cm{sup {minus}2} which corresponds to a volume concentration of 2{times}10{sup 19}cm{sup {minus}3}. The Al implant redistributed in the bulk crystals during annealing, resulting in a shoulder formation at the tail of the implant profile. Lower implant activation was obtained in V-doped material compared to the undoped bulk and epitaxial layers, but the results were promising enough to use implantation technology for making planar high frequency devices in the bulk V-doped substrates, especially as the quality of the substrates continue to improve. {copyright} {ital 1997 American Institute of Physics.}

  7. Implantable Heart Aid

    NASA Technical Reports Server (NTRS)

    1984-01-01

    CPI's human-implantable automatic implantable defibrillator (AID) is a heart assist system, derived from NASA's space circuitry technology, that can prevent erratic heart action known as arrhythmias. Implanted AID, consisting of microcomputer power source and two electrodes for sensing heart activity, recognizes onset of ventricular fibrillation (VF) and delivers corrective electrical countershock to restore rhythmic heartbeat.

  8. Dependence of implantation sequence on surface blistering characteristics due to H and He ions co-implanted in silicon

    NASA Astrophysics Data System (ADS)

    Liang, J. H.; Hsieh, H. Y.; Wu, C. W.; Lin, C. M.

    2015-12-01

    This study investigated surface blistering characteristics due to H and He ions co-implanted in silicon at room temperature. The H and He ion energies were 40 and 50 keV, respectively, so that their depth profiles were similar. The total implantation fluence for the H and He ions was 5 × 1016 cm-2 under various fluence fractions in the H ions. The implantation sequences under investigation were He + H and H + He. Dynamic optical microscopy (DOM) was employed in order to dynamically analyze surface blistering characteristics. This study used DOM data to construct so-called time-temperature-transformation (T-T-T) curves to easily predict blistering and crater transformation at specific annealing times and temperatures. The results revealed that the curves of blister initialization, crater initialization, and crater completion in the He + H implant occurred at a lower annealing temperature but with a longer annealing time compared to those in the H + He implant. Furthermore, the threshold annealing temperatures for blister and crater formation in the He + H implant were lower than they were in the H + He implant. The size distributions of the blisters and craters in the He + H implant extended wider than those in the H + He implant. In addition, the He + H implant exhibited larger blisters and craters compared to the ones in the H + He implant. Since the former has a higher percentage of exfoliation area than the latter, it is regarded as the more optimal implantation sequence.

  9. Hip and knee arthroplasty implants contraindicated in obesity.

    PubMed

    Craik, J D; Bircher, M D; Rickman, M

    2016-05-01

    Introduction High patient weight is a risk factor for mechanical implant failure and some manufacturers list obesity as a contraindication for implant use. We reviewed data from the 2012-2013 UK National Joint Registry to determine whether surgical practice reflects these manufacturer recommendations. Methods The product literature for the most commonly used hip and knee implants was reviewed for recommendations against use in obese patients (body mass index [BMI] ≥ 30kg/m(2)). The total number of obese patients undergoing hip and knee arthroplasty was calculated, as was the proportion receiving implants against manufacturer recommendations. Results Out of 200,054 patient records, 147,691 (74%) had a recorded BMI. The mean BMI for patients undergoing primary total hip arthroplasty was 29kg/m(2), compared with 31kg/m(2) for total knee arthroplasty. Of the 25 components reviewed, 5 listed obesity as a contraindication or recommended against implant use in obese patients. A total of 10,745 patients (16% of all obese patients) received implants against manufacturer recommendations. Conclusions A high proportion of patients are receiving implants against manufacturer recommendations. However, there are limitations to using BMI for stratifying risk of implant fatigue failure and manufacturers should therefore provide more detailed guidelines on size specific implant load limits to facilitate surgical decisions. PMID:27023636

  10. Biomaterials in total joint replacement.

    PubMed

    Katti, Kalpana S

    2004-12-10

    The current state of materials systems used in total hip replacement is presented in this paper. An overview of the various material systems used in total hip replacement reported in literature is presented in this paper. Metals, polymers, ceramics and composites are used in the design of the different components of hip replacement implants. The merits and demerits of these material systems are evaluated in the context of mechanical properties most suitable for total joint replacement such as a hip implant. Current research on advanced polymeric nanocomposites and biomimetic composites as novel materials systems for bone replacement is also discussed. This paper examines the current research in the materials science and the critical issues and challenges in these materials systems that require further research before application in biomedical industry. PMID:15556342

  11. Medium-term outcome of Astra Tech implants in head and neck oncology patients.

    PubMed

    Gander, T; Studer, S; Studer, G; Grätz, K W; Bredell, M

    2014-11-01

    Rehabilitation with implant-retained prostheses is a key step in the rehabilitation of patients after ablative head and neck surgery. Data of patients who underwent mandibular restoration with Astra Tech implants were gathered consecutively and analyzed retrospectively. Implant survival was calculated by Kaplan-Meier analysis, and Cox models were used to identify any association between implant failure and contributing factors. In total, 136 implants were placed in 33 patients. The main reason for ablative surgery was squamous cell carcinoma. Twenty-one patients received adjuvant radiotherapy with a cumulative radiation dose of 56-76Gy prior to implantation. Failure occurred in six patients, resulting in the loss of 17 implants. The cumulative implant survival rate was 92.7% after 1 year and 87.5% after 20 months. Smoking and alcohol consumption were associated with a significantly higher implant failure rate. Most patients had a stable implant status after 20 months. PMID:24907130

  12. The effect of implant splinting on the load distribution in bone bed around implant-supported fixed prosthesis with different framework materials: A finite element study.

    PubMed

    Hasan, I; Bourauel, C; Keilig, L; Stark, H; Lückerath, W

    2015-05-01

    Analysing the influence of implant splinting and its relation to different framework materials is a complex issue. The stiffness of framework materials and the overload of the implant system directly affect the final transferred load of the bone around implants. A finite element model of a long-span cementable implant-supported fixed prosthesis was created. Three materials were analysed for the framework: Titanium, gold alloy, and zirconia. The connection screws were first preloaded with 200 N. Two loading conditions were studied: The implant at the molar region was first loaded without splinting to the framework, and in the second condition, the implant was splinted to the framework. A total force of 500 N and 1000 N in 30° from the long axis of the framework were applied in buccal or distal direction on the implant system. The stresses and strains within the framework materials, implant system, and bone bed around the supporting implants were analysed. Loading the implant distally was associated with high stresses within the implant system in comparison to buccal loading. By splinting the implant, the stress in the implant system was reduced from 5393 MPa to 2942 MPa. Buccal loading of the implant was more critical than the distal loading. In the splinted condition of the implant, the stresses in the cortical bone were reduced from 570 MPa to 275 MPa. PMID:25640904

  13. Implant success rates in full-arch rehabilitations supported by upright and tilted implants: a retrospective investigation with up to five years of follow-up

    PubMed Central

    2015-01-01

    Purpose The aim of this retrospective study was to investigate the cumulative success rate, the implant survival rate, and the occurrence of biological complications in implants supporting full-arch immediately loaded rehabilitations supported by upright and tilted implants. Methods The clinical records and periapical radiographs of patients who attended follow-up visits were collected, and information was recorded regarding marginal bone loss resorption, the occurrence of peri-implant infectious diseases, and the implant survival rate. Implants were classified as successful or not successful according to two distinct classifications for implant success. Results A total of 53 maxillary and mandibular restorations including 212 implants were analysed, of which 56 implants were studied over the full five-year follow-up period. After five years, the cumulative success rate was 76.04% according to the Misch classification and 56.34% according to the Albrektsson classification. The cumulative implant survival rate was 100%, although one implant was found to be affected by peri-implantitis at the second follow-up visit. Conclusions The cumulative success rate of the implants dropped over time, corresponding to the progression of marginal bone resorption. The prevalence of peri-implantitis was very low, and the implant survival rate was not found to be related to the cumulative success rate. PMID:26734491

  14. Clinical outcomes of implant therapy in ectodermal dysplasia patients: a systematic review.

    PubMed

    Wang, Y; He, J; Decker, A M; Hu, J C; Zou, D

    2016-08-01

    The purpose of this review was to determine the outcome of oral function reconstruction in ectodermal dysplasia (ED) patients who have received dental implant therapy. A search was made of the PubMed and Web of Science databases; key words used were "(ectodermal dysplasia) AND (implant OR implants)", with supplementary retrieval key words "dental implant", "zygomatic implant", "anodontia", and "edentulous". Patient age, use of bone graft, implant site, type of implant, and survival rate of the implants were included in the subsequent data analysis. Forty-five articles published between 1988 and October 2015 were included in this analysis. The cases of a total of 96 patients were retrieved (22 children and 74 adults); these patients received a total of 701 implants. Fourteen implants were removed during a median follow-up time of 24 months. The 24-month implant survival rate was 97.9% in adult subjects and 98.6% in children. Sixty-eight percent of adult patients underwent bone augmentation prior to implant placement. Based on this review, dental implants are commonly used in the oral reconstruction of ED patients. However, long-term data on bone augmentation and implant success are needed, as well as additional clinical evidence on bone resorption, the esthetic outcomes of implant therapy, and physiological considerations in ED patients. PMID:27052318

  15. Fibronectin-Grafted Titanium Dental Implants: An In Vivo Study.

    PubMed

    Chang, Yu-Chi; Ho, Kuo-Ning; Feng, Sheng-Wei; Huang, Haw-Ming; Chang, Chia-Hsun; Lin, Che-Tong; Teng, Nai-Chia; Pan, Yu Hwa; Chang, Wei-Jen

    2016-01-01

    Modification of the physiochemical properties of titanium surfaces using glow discharge plasma (GDP) and fibronectin coating has been shown to enhance the surface hydrophilicity, surface roughness, cell adhesion, migration, and proliferation. This in vivo study aimed to evaluate the bone integration efficacy of a biologically modified implant surface. Two different surface-modified implants (Ar-GDP and GDP-fib) were placed in the mandibular premolar area of six beagle dogs for 2-8 weeks. Three techniques [histologic evaluation, resonance frequency analysis (RFA), and microcomputed tomography (micro-CT) evaluation] were used to detect the implant stability and bone-implant contact. The implant stability quotient values of GDP-fib implants were significantly greater than the Ar-GDP implants at 2 and 4 weeks (P < 0.01). The bone volume/total volume ratio of GDP-fib implants was greater than the Ar-GDP implants in micro-CT evaluation. A high positive correlation was observed between RFA and micro-CT measurements. At 2 weeks, osteoblasts were seen to line the implant surface, and multinuclear osteoclasts could be seen on the surface of old parent bone. After 8 weeks, a majority of the space in the wound chamber appeared to be replaced by bone. Enhancement of the stability of biologically modified implants was proved by the results of RFA, micro-CT, and histological analysis. This enhanced stability may help fasten treatment and be clinically beneficial. PMID:27366739

  16. Fibronectin-Grafted Titanium Dental Implants: An In Vivo Study

    PubMed Central

    Chang, Yu-Chi; Ho, Kuo-Ning; Feng, Sheng-Wei; Huang, Haw-Ming; Chang, Chia-Hsun; Lin, Che-Tong; Teng, Nai-Chia; Pan, Yu Hwa; Chang, Wei-Jen

    2016-01-01

    Modification of the physiochemical properties of titanium surfaces using glow discharge plasma (GDP) and fibronectin coating has been shown to enhance the surface hydrophilicity, surface roughness, cell adhesion, migration, and proliferation. This in vivo study aimed to evaluate the bone integration efficacy of a biologically modified implant surface. Two different surface-modified implants (Ar-GDP and GDP-fib) were placed in the mandibular premolar area of six beagle dogs for 2–8 weeks. Three techniques [histologic evaluation, resonance frequency analysis (RFA), and microcomputed tomography (micro-CT) evaluation] were used to detect the implant stability and bone-implant contact. The implant stability quotient values of GDP-fib implants were significantly greater than the Ar-GDP implants at 2 and 4 weeks (P < 0.01). The bone volume/total volume ratio of GDP-fib implants was greater than the Ar-GDP implants in micro-CT evaluation. A high positive correlation was observed between RFA and micro-CT measurements. At 2 weeks, osteoblasts were seen to line the implant surface, and multinuclear osteoclasts could be seen on the surface of old parent bone. After 8 weeks, a majority of the space in the wound chamber appeared to be replaced by bone. Enhancement of the stability of biologically modified implants was proved by the results of RFA, micro-CT, and histological analysis. This enhanced stability may help fasten treatment and be clinically beneficial. PMID:27366739

  17. An implantable blood pressure and flow transmitter.

    NASA Technical Reports Server (NTRS)

    Rader, R. D.; Meehan, J. P.; Henriksen, J. K. C.

    1973-01-01

    A miniature totally implantable FM/FM telemetry system has been developed to simultaneously measure blood pressure and blood flow, thus providing an appreciation of the hemodynamics of the circulation to the entire body or to a particular organ. Developed for work with animal subjects, the telemetry system's transmission time is controlled by an RF signal that permits an operating life of several months. Pressure is detected by a miniature intravascular transducer and flow is detected by an extravascular interferometric ultrasonic technique. Both pressure and flow are calibrated prior to implanting. The pressure calibration can be checked after the implanting by cannulation; flow calibration can be verified only at the end of the experiment by determining the voltage output from the implanted sensing system as a function of several measured flow rates. The utility of this device has been established by its use in investigating canine renal circulation during exercise, emotional encounters, administration of drugs, and application of accelerative forces.

  18. Silicone breast implant materials.

    PubMed

    Daniels, A U

    2012-01-01

    This opinion article has been written on request because of the recent public controversy over silicone breast implants produced by a now-defunct company, Poly Implant Prosthese (PIP) in France. More than 300,000 PIP devices have been implanted. The purposes of my article are to (1.) provide a general overview of silicone breast implant materials, (2.) to describe the general safety of these materials as reported to date, and (3.) to summarise current publicly available information about these aspects of the PIP prostheses. The materials covered are the silicone rubber from which the implant shells are made and the silicone gel used to fill the shell. The materials safety issues are biocompatibility (especially of the gel) and biodurability of the shell. The literature reviewed indicates that biocompatibility is not an issue with other current generation implants. However, biodurability is. A rough estimate of implant shell rupture rate is ~10+% at 10 years. Information is still emerging about the PIP implants. Initial regulatory disclosures suggest the PIP implants may have both biocompatibility and biodurability problems. They also suggest that PIP implants may have been produced using silicone materials not certified as medical grade. Governmental health and regulatory agencies are just now in the process of deciding what actions should be taken to protect patients. PMID:22826101

  19. The total artificial heart.

    PubMed

    Meyer, A; Slaughter, M

    2011-09-01

    In the 1960s, cardiac surgeons and biomedical engineers pioneered the development of total artificial hearts (TAH) for the treatment of left and right heart failure. As we mark the 10th anniversary of the first implantation of the AbioCor device, the use of TAH has been limited, having failed to reach its envisioned potential and promise as an alternative therapy to heart transplantation. The Syncardia/CardioWest device, originally developed 30 years ago as the Jarvik TAH and later renamed the CardioWest TAH, continues to be used clinically in over 50 centers within the US and Europe having supported over 900 patients worldwide. Syncardia continues to develop TAH technology as evidenced by their recent introduction of a new portable pneumatic driver that enables patients to be discharged from the hospital. In contrast to TAH devices, continuous flow ventricular assist devices (VAD) have made tremendous technological strides and are rapidly gaining widespread clinical acceptance. The VAD technology has demonstrated extraordinary safety and reliability records through evolving technologies, advanced biocompatible materials, and improved patient management. Subsequently, the number of TAH implantations remains low compared to the growth in LVAD implants. Nonetheless, the Syncardia/CardioWest TAH remains an important and viable option for patients with severe biventricular failure and end organ dysfunction. Overall, a 79% survival rate has been achieved in patients supported with a Syncardia/CardioWest TAH as bridge-to-transplantation. In this review article, a brief history on the evolution of TAH devices, their current use and emerging use of evolving continuous flow VAD technology as chronic biventricular and TAH device systems are presented. PMID:21775941

  20. Total Elbow Arthroplasty for Distal Humerus Fractures.

    PubMed

    Harmer, Luke S; Sanchez-Sotelo, Joaquin

    2015-11-01

    Total elbow arthroplasty is a good treatment alternative for selected patients with distal humerus fractures. Its attractiveness is related to several factors, including the possibility of performing the procedure; leaving the extensor mechanism intact; faster, easier rehabilitation compared with internal fixation; and overall good outcomes reported in terms of both pain relief and function. Implant failure leading to revision surgery does happen, and patients must comply with certain limitations to extend the longevity of their implant. Development of high-performance implants may allow expanding the indications of elbow arthroplasty for fractures. PMID:26498549

  1. Strontium in the bone-implant interface.

    PubMed

    Vestermark, Marianne Toft

    2011-05-01

    Total hip replacement surgery is being performed on an increasingly large part of the population and at increasingly younger age. Because we live and stay physically active longer, and since hip replacement surgery has become quite successful, the treatment is being offered to progressively more patients. Unfortunately, about 17% of hip replacement surgeries currently involve revisions. Consequently, the longevity of both the primary and revision implant is an issue and warrants further investigation. Implants undergoing early instability or even subsidence correlate with an increased risk of aseptic loosening, subsequently requiring revision. Thus, the goal is early fixation by osseointegration of the implant. For revision implants, this is an even greater challenge since an allograft is often needed during surgery to obtain immediate stability of the implant. Bone grafts are rapidly resorbed. Thus, instability of the prosthesis may develop before new bone formation is well established and can mechanically secure the prosthesis. Strontium is a dual action drug; being both bone anabolic and anti-catabolic. In the form of strontiumranelate, it is used in the treatment of osteoporosis. Strontium may potentially improve the early osseointegration and fixation of implants. This dissertation consists of three studies investigating the effect of strontium at the bone-implant interface. The questions were firstly, what is the optimal delivery method for strontium to the interface, and secondly, can strontium exercise its dual action at the interface? The studies were performed in a cementless, experimental gap model in canine. The effects of strontium were evaluated by histomorphometrical analysis of the osseointegration and mechanical push-out test of implant fixation. Different stereological methods were used for the histomorphometrical analysis of each study. The methods used were reviewed critically and found valid. Study I compared a 5% strontium

  2. Active Robotics for Total Hip Arthroplasty.

    PubMed

    Dungy, Danton S; Netravali, Nathan A

    2016-01-01

    Robotics and computer-assisted navigation have been developed to increase the accuracy of hip implant placement and improve long-term outcomes of total hip arthroplasty (THA). These technologies have shown significant improvements in implant positioning when compared to conventional techniques. Currently, 3 robotic systems are cleared for use for THA in the US. The lead author (DSD) describes his preferred technique for using one of these systems, the TSolution One® (Think Surgical, Inc.). PMID:27327918

  3. Early radiographic diagnosis of peri-implantitis enhances the outcome of peri-implantitis treatment: a 5-year retrospective study after non-surgical treatment

    PubMed Central

    Chang, Hee-Yung; Park, Shin-Young; Kim, Jin-Ah; Kim, Young-Kyun

    2015-01-01

    Purpose This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. Results Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. Conclusions Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant. Graphical Abstract PMID:26131368

  4. Health Characteristics of Postmenopausal Women with Breast Implants

    PubMed Central

    Rubin, J. Peter; Landfair, Angela Song; Shestak, Kenneth; Lane, Dorothy; Valoski, Alice; Chang, Yuefang; Tindle, Hilary A.; Kuller, Lewis H.

    2009-01-01

    Background Implant breast augmentation has long been a subject of controversy in both the plastic surgery and mainstream media. Methods We evaluated characteristics of women who had breast implant surgery in the Women's Health Initiative observational study (WHI OS) between 1993 and 1998. Most women in this study cohort had breast implant surgery 20 or more years prior to recruitment into the WHI OS. The women who were in the WHI OS who had not undergone breast implant surgery served as the comparison group. There were 86,686 women in the WHI OS who did not have breast implant surgery and an absent history of breast cancer, and 1,257 women who had breast implant surgery and no prior breast cancer. Results Total mortality rates were substantially lower among women with breast implant as was incidence of coronary heart disease. Women with breast implants in this study had a lower BMI throughout adult life and were more physically active than control subjects. After adjustment for these variables, differences in total mortality were no longer statistically significant. Women who had breast implants reported overall poorer quality of life and emotional well-being. Among women with breast implant surgery, 7% of deaths were due to suicide (n=3) versus 0.4% (n=20) in controls. Conclusion Significant differences in health characteristics and quality of life measures are seen in a cohort of women with breast implants decades following implant surgery. Further longitudinal studies need to focus on both physical and psychological health among women undergoing breast implant surgery. PMID:20195108

  5. Implants in adolescents

    PubMed Central

    Shah, Rohit A.; Mitra, Dipika K.; Rodrigues, Silvia V.; Pathare, Pragalbha N.; Podar, Rajesh S.; Vijayakar, Harshad N.

    2013-01-01

    Implants have gained tremendous popularity as a treatment modality for replacement of missing teeth in adults. There is extensive research present on the use of implants in adults, but there is a dearth of data available on the same in adolescents. The treatment planning and execution of implant placement in adolescents is still in its infancy. This review article is an attempt to bring together available literature. PMID:24174743

  6. Larynx: implants and stents

    PubMed Central

    Sittel, Christian

    2011-01-01

    In the human larynx, implants a primarily used for the correction of glottis insufficiency. In a broader sense laryngeal stents may be considered as implants as well. Laryngeal implants can be differentiated into injectable and solid. The most important representatives of both groups are discussed in detail along with the respective technique of application. Laryngeal stents are primarily used perioperatively. Different types and their use are presented. PMID:22073097

  7. Minimally-Invasive, Image-Guided Cochlear Implantation Surgery: First report of clinical implementation

    PubMed Central

    Labadie, Robert F; Balachandran, Ramya; Noble, Jack H; Blachon, Grégoire S; Mitchell, Jason E; Reda, Fitsum A; Dawant, Benoit M; Fitzpatrick, J Michael

    2015-01-01

    OBJECTIVE Minimally-invasive image-guided approach to cochlear implantation (CI) involves drilling a narrow, linear tunnel to the cochlea. Reported herein is the first clinical implementation of this approach. STUDY DESIGN Prospective, cohort study. METHODS On preoperative CT, a safe linear trajectory through the facial recess targeting the scala tympani was planned. Intraoperatively, fiducial markers were bone-implanted, a second CT was acquired, and the trajectory was transferred from preoperative to intraoperative CT. A customized microstereotactic frame was rapidly designed and constructed to constrain a surgical drill along the desired trajectory. Following sterilization, the frame was employed to drill the tunnel to the middle ear. After lifting a tympanomeatal flap and performing a cochleostomy, the electrode array was threaded through the drilled tunnel and into the cochlea. RESULTS Eight of nine patients were successfully implanted using the proposed approach with six insertions completely within scala tympani. Traditional mastoidectomy was performed on one patient following difficulty threading the electrode array via the narrow tunnel. Other difficulties encountered included use of the back-up implant when an electrode was dislodged during threading via the tunnel, tip fold-over, and facial nerve paresis (House-Brackmann II/VII at 12 months) secondary to heat during drilling. Average time of intervention was 182±36 minutes. CONCLUSION Minimally-invasive, image-guided CI is clinically achievable. Further clinical study is necessary to address technological difficulties during drilling and insertion and to assess potential benefits including decreased time of intervention, standardization of surgical intervention, and decreased tissue dissection potentially leading to shorter recovery and earlier implant activation. PMID:24272427

  8. Music perception with cochlear implants: a review.

    PubMed

    McDermott, Hugh J

    2004-01-01

    The acceptance of cochlear implantation as an effective and safe treatment for deafness has increased steadily over the past quarter century. The earliest devices were the first implanted prostheses found to be successful in compensating partially for lost sensory function by direct electrical stimulation of nerves. Initially, the main intention was to provide limited auditory sensations to people with profound or total sensorineural hearing impairment in both ears. Although the first cochlear implants aimed to provide patients with little more than awareness of environmental sounds and some cues to assist visual speech-reading, the technology has advanced rapidly. Currently, most people with modern cochlear implant systems can understand speech using the device alone, at least in favorable listening conditions. In recent years, an increasing research effort has been directed towards implant users' perception of nonspeech sounds, especially music. This paper reviews that research, discusses the published experimental results in terms of both psychophysical observations and device function, and concludes with some practical suggestions about how perception of music might be enhanced for implant recipients in the future. The most significant findings of past research are: (1) On average, implant users perceive rhythm about as well as listeners with normal hearing; (2) Even with technically sophisticated multiple-channel sound processors, recognition of melodies, especially without rhythmic or verbal cues, is poor, with performance at little better than chance levels for many implant users; (3) Perception of timbre, which is usually evaluated by experimental procedures that require subjects to identify musical instrument sounds, is generally unsatisfactory; (4) Implant users tend to rate the quality of musical sounds as less pleasant than listeners with normal hearing; (5) Auditory training programs that have been devised specifically to provide implant users with

  9. Music Perception with Cochlear Implants: A Review

    PubMed Central

    McDermott, Hugh J.

    2004-01-01

    The acceptance of cochlear implantation as an effective and safe treatment for deafness has increased steadily over the past quarter century. The earliest devices were the first implanted prostheses found to be successful in compensating partially for lost sensory function by direct electrical stimulation of nerves. Initially, the main intention was to provide limited auditory sensations to people with profound or total sensorineural hearing impairment in both ears. Although the first cochlear implants aimed to provide patients with little more than awareness of environmental sounds and some cues to assist visual speech-reading, the technology has advanced rapidly. Currently, most people with modern cochlear implant systems can understand speech using the device alone, at least in favorable listening conditions. In recent years, an increasing research effort has been directed towards implant users’ perception of nonspeech sounds, especially music. This paper reviews that research, discusses the published experimental results in terms of both psychophysical observations and device function, and concludes with some practical suggestions about how perception of music might be enhanced for implant recipients in the future. The most significant findings of past research are: (1) On average, implant users perceive rhythm about as well as listeners with normal hearing; (2) Even with technically sophisticated multiple-channel sound processors, recognition of melodies, especially without rhythmic or verbal cues, is poor, with performance at little better than chance levels for many implant users; (3) Perception of timbre, which is usually evaluated by experimental procedures that require subjects to identify musical instrument sounds, is generally unsatisfactory; (4) Implant users tend to rate the quality of musical sounds as less pleasant than listeners with normal hearing; (5) Auditory training programs that have been devised specifically to provide implant users with

  10. 2D FEA of evaluation of micromovements and stresses at bone-implant interface in immediately loaded tapered implants in the posterior maxilla

    PubMed Central

    Desai, Shrikar R.; Singh, Rika; Karthikeyan, I.

    2013-01-01

    Aim: The aim of the study is to evaluate the influence implant length on stress distribution at bone implant interface in single immediately loaded implants when placed in D4 bone quality. Materials and Methods: A 2-dimensional finite element models were developed to simulate two types of implant designs, standard 3.75 mm–diameter tapered body implants of 6 and 10 mm lengths. The implants were placed in D4 bone quality with a cortical bone thickness of 0.5 mm. The implant design incorporated microthreads at the crestal part and the rest of the implant body incorporated Acme threads. The Acme thread form has a 29° thread angle with a thread height half of the pitch; the apex and valley are flat. A 100 N of force was applied vertically and in the oblique direction (at an angle of 45°) to the long axis of the implants. The respective material properties were assigned. Micro-movements and stresses at the bone implant interface were evaluated. Results: The results of total deformation (micro-movement) and Von mises stress were found to be lower for tapered long implant (10 mm) than short implant (6 mm) while using both vertical as well as oblique loading. Conclusion: Short implants can be successfully placed in poor bone quality under immediate loading protocol. The novel approach of the combination of microthreads at the crestal portion and acme threads for body portion of implant fixture gave promising results. PMID:24174759

  11. Dental implants installed in irradiated jaws: a systematic review.

    PubMed

    Chambrone, L; Mandia, J; Shibli, J A; Romito, G A; Abrahao, M

    2013-12-01

    The aim of this study was to assess the survival rate of titanium implants placed in irradiated jaws. MEDLINE, EMBASE, and CENTRAL were searched for studies assessing implants that had been placed in nongrafted sites of irradiated patients. Random effects meta-analyses assessed implant loss in irradiated versus nonirradiated patients and in irradiated patients treated with hyperbaric oxygen (HBO) therapy. Of 1,051 potentially eligible publications, 15 were included. A total of 10,150 implants were assessed in the included studies, and of these, 1,689 (14.3%) had been placed in irradiated jaws. The mean survival rate in the studies ranged from 46.3% to 98.0%. The pooled estimates indicated a significant increase in the risk of implant failure in irradiated patients (risk ratio: 2.74; 95% confidence interval: 1.86, 4.05; p < .00001) and in maxillary sites (risk ratio: 5.96; 95% confidence interval: 2.71, 13.12; p < .00001). Conversely, HBO therapy did not reduce the risk of implant failure (risk ratio: 1.28; 95% confidence interval: 0.19, 8.82; p = .80). Radiotherapy was linked to higher implant failure in the maxilla, and HBO therapy did not improve implant survival. Most included publications reported data on machined implants, and only 3 studies on HBO therapy were included. Overall, implant therapy appears to be a viable treatment option for reestablishing adequate occlusion and masticatory conditions in irradiated patients. PMID:24158336

  12. Dielectric behavior of Ar{sup +} implanted CR-39 polymer

    SciTech Connect

    Shekhawat, Nidhi; Sharma, Annu; Aggarwal, Sanjeev; Deshpande, S. K.; Nair, K. G. M.

    2012-06-05

    The frequency dependent dielectric response of Ar{sup +} implanted CR-39 specimens has been studied. Samples were implanted with 130 keV Ar{sup +} ions to various doses ranging from 5x10{sup 14} to 1x10{sup 16} cm{sup -2}. The frequency response of dielectric constant (e) and dielectric loss has been studied both in the pristine and argon ion implanted samples of CR-39 polymer in the frequency range 10{sup 4} to 10{sup 8} Hz. Structural changes produced in CR-39 specimens due to implantation have been studied using Attenuated total reflectance (ATR) Fourier transform infrared spectroscopic technique. Results of dielectric analysis indicate the lowering in dielectric constant ({epsilon}') and similar behavior of dielectric loss with increase in ion fluence. An attempt has been made to correlate these changes produced in the dielectric properties of implanted specimens with the structural changes produced due to implantation.

  13. The Future of Biologic Coatings for Orthopaedic Implants

    PubMed Central

    Goodman, Stuart B.; Yao, Zhenyu; Keeney, Michael; Yang, Fan

    2013-01-01

    Implants are widely used for othopaedic applications such as fixing fractures, repairing nonunions, obtaining a joint arthrodesis, total joint arthroplasty, spinal reconstruction, and soft tissue anchorage. Previously, orthopaedic implants were designed simply as mechanical devices; the biological aspects of the implant were a byproduct of stable internal/external fixation of the device to the surrounding bone or soft tissue. More recently, biologic coatings have been incorporated into orthopaedic implants in order to modulate the surrounding biological environment. This opinion article reviews current and potential future use of biologic coatings for orthopaedic implants to facilitate osseointegration and mitigate possible adverse tissue responses including the foreign body reaction and implant infection. While many of these coatings are still in the preclinical testing stage, bioengineers, material scientists and surgeons continue to explore surface coatings as a means of improving clinical outcome of patients undergoing orthopaedic surgery. PMID:23391496

  14. Emergence of a Vowel System in a Young Cochlear Implant Recipient.

    ERIC Educational Resources Information Center

    Ertmer, David J.

    2001-01-01

    This article chronicles changes in vowel production by a child with congenital deafness who received a multichannel cochlear implant at 19 months. The child exhibited three vowel types before implantation, however, a total of nine different vowel types were observed during her first year of implant experience. (Contains references.) (Author/CR)

  15. 10 CFR 35.75 - Release of individuals containing unsealed byproduct material or implants containing byproduct...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... material or implants containing byproduct material. 35.75 Section 35.75 Energy NUCLEAR REGULATORY... containing unsealed byproduct material or implants containing byproduct material. (a) A licensee may... material or implants containing byproduct material if the total effective dose equivalent to any...

  16. 10 CFR 35.75 - Release of individuals containing unsealed byproduct material or implants containing byproduct...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... material or implants containing byproduct material. 35.75 Section 35.75 Energy NUCLEAR REGULATORY... containing unsealed byproduct material or implants containing byproduct material. (a) A licensee may... material or implants containing byproduct material if the total effective dose equivalent to any...

  17. 10 CFR 35.75 - Release of individuals containing unsealed byproduct material or implants containing byproduct...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... material or implants containing byproduct material. 35.75 Section 35.75 Energy NUCLEAR REGULATORY... containing unsealed byproduct material or implants containing byproduct material. (a) A licensee may... material or implants containing byproduct material if the total effective dose equivalent to any...

  18. 10 CFR 35.75 - Release of individuals containing unsealed byproduct material or implants containing byproduct...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... material or implants containing byproduct material. 35.75 Section 35.75 Energy NUCLEAR REGULATORY... containing unsealed byproduct material or implants containing byproduct material. (a) A licensee may... material or implants containing byproduct material if the total effective dose equivalent to any...

  19. Smoking and dental implants

    PubMed Central

    Kasat, V.; Ladda, R.

    2012-01-01

    Smoking is a prevalent behaviour in the population. The aim of this review is to bring to light the effects of smoking on dental implants. These facts will assist dental professionals when implants are planned in tobacco users. A search of “PubMed” was made with the key words “dental implant,” “nicotine,” “smoking,” “tobacco,” and “osseointegration.” Also, publications on tobacco control by the Government of India were considered. For review, only those articles published from 1988 onward in English language were selected. Smoking has its influence on general as well as oral health of an individual. Tobacco negatively affects the outcome of almost all therapeutic procedures performed in the oral cavity. The failure rate of implant osseointegration is considerably higher among smokers, and maintenance of oral hygiene around the implants and the risk of peri-implantitis are adversely affected by smoking. To increase implant survival in smokers, various protocols have been recommended. Although osseointegrated dental implants have become the state of the art for tooth replacement, they are not without limitations or complications. In this litigious era, it is extremely important that the practitioner clearly understands and is able and willing to convey the spectrum of possible complications and their frequency to the patients. PMID:24478965

  20. Implantable, Ingestible Electronic Thermometer

    NASA Technical Reports Server (NTRS)

    Kleinberg, Leonard

    1987-01-01

    Small quartz-crystal-controlled oscillator swallowed or surgically implanted provides continuous monitoring of patient's internal temperature. Receiver placed near patient measures oscillator frequency, and temperature inferred from previously determined variation of frequency with temperature. Frequency of crystal-controlled oscillator varies with temperature. Circuit made very small and implanted or ingested to measure internal body temperature.

  1. Synthetic facial implants.

    PubMed

    Quatela, Vito C; Chow, Jen

    2008-02-01

    This article presents a range of synthetic implant materials for use in facial plastic surgery. The authors discuss alternatives to autogenous tissue transfer in terms of biocompatibility, technique, complications, controversies, and cautions. The reader is presented information about a range of synthetic implant materials such as silicone, polyester fiber, polyamide mesh, metal, polyethylene, polyacrylamide gel, hydroxyapatite, polylactic acid, collagen, and others. PMID:18063244

  2. Implantable CMOS Biomedical Devices

    PubMed Central

    Ohta, Jun; Tokuda, Takashi; Sasagawa, Kiyotaka; Noda, Toshihiko

    2009-01-01

    The results of recent research on our implantable CMOS biomedical devices are reviewed. Topics include retinal prosthesis devices and deep-brain implantation devices for small animals. Fundamental device structures and characteristics as well as in vivo experiments are presented. PMID:22291554

  3. Batteryless implanted echosonometer

    NASA Technical Reports Server (NTRS)

    Kojima, G. K.

    1977-01-01

    Miniature ultrasonic echosonometer implanted within laboratory animals obtains energy from RF power oscillator that is electronically transduced via induction loop to power receiving loop located just under animal's skin. Method of powering device offers significant advantages over those in which battery is part of implanted package.

  4. Gold bead implants.

    PubMed

    Durkes, T E

    1992-03-01

    Gold bead implantation is an experimental area of study in the acupuncture field dealing with chronic diseases. Special acupuncture techniques are required to implant the gold beads successfully in the proper location. Gold beads are used to treat degenerative joint disease, osteochondritis, osteochondritis dessicans, ventral spondylosis, and seizures. PMID:1581658

  5. Percutaneous and skeletal biocarbon implants

    NASA Technical Reports Server (NTRS)

    Mooney, V.

    1977-01-01

    Review of carbon implants developed by NASA discussed four different types of implants and subsequent improvements. Improvements could be of specific interest to rehabilitation centers and similar organizations.

  6. Number of implants for mandibular implant overdentures: a systematic review

    PubMed Central

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

    2012-01-01

    PURPOSE The aim of this systematic review is to address treatment outcomes of Mandibular implant overdentures relative to implant survival rate, maintenance and complications, and patient satisfaction. MATERIALS AND METHODS A systematic literature search was conducted by a PubMed search strategy and hand-searching of relevant journals from included studies. Randomized Clinical Trials (RCT) and comparative clinical trial studies on mandibular implant overdentures until August, 2010 were selected. Eleven studies from 1098 studies were finally selected and data were analyzed relative to number of implants. RESULTS Six studies presented the data of the implant survival rate which ranged from 95% to 100% for 2 and 4 implant group and from 81.8% to 96.1% for 1 and 2 implant group. One study, which statistically compared implant survival rate showed no significant differences relative to the number of implants. The most common type of prosthetic maintenance and complications were replacement or reattaching of loose clips for 2 and 4 implant group, and denture repair due to the fracture around an implant for 1 and 2 implant groups. Most studies showed no significant differences in the rate of prosthetic maintenance and complication, and patient satisfaction regardless the number of implants. CONCLUSION The implant survival rate of mandibular overdentures is high regardless of the number of implants. Denture maintenance is likely not inflenced substantially by the number of implants and patient satisfaction is typically high again regardless os the number of implants. PMID:23236572

  7. Graphene for Biomedical Implants

    NASA Astrophysics Data System (ADS)

    Moore, Thomas; Podila, Ramakrishna; Alexis, Frank; Rao, Apparao; Clemson Bioengineering Team; Clemson Physics Team

    2013-03-01

    In this study, we used graphene, a one-atom thick sheet of carbon atoms, to modify the surfaces of existing implant materials to enhance both bio- and hemo-compatibility. This novel effort meets all functional criteria for a biomedical implant coating as it is chemically inert, atomically smooth and highly durable, with the potential for greatly enhancing the effectiveness of such implants. Specifically, graphene coatings on nitinol, a widely used implant and stent material, showed that graphene coated nitinol (Gr-NiTi) supports excellent smooth muscle and endothelial cell growth leading to better cell proliferation. We further determined that the serum albumin adsorption on Gr-NiTi is greater than that of fibrinogen, an important and well understood criterion for promoting a lower thrombosis rate. These hemo-and biocompatible properties and associated charge transfer mechanisms, along with high strength, chemical inertness and durability give graphene an edge over most antithrombogenic coatings for biomedical implants and devices.

  8. Cochlear implants in children.

    PubMed

    Young, N M

    1994-04-01

    Children with such profound deafness that they are not helped by hearing aids are now candidates for cochlear implantation. This technology permits us to provide these children with a significant degree of useful hearing. The degree of improvement in speech perception and spoken language in pediatric cochlear implant recipients varies. However, the younger the children and the less time they have been completely deprived of auditory stimuli, the more likely they are to make significant progress. The evaluation of the deaf child for implantation is best done by a multidisciplinary team who understands the needs of hearing-impaired children and who can work with the family, the child, and classroom teachers, as well as other school professionals. The decision to proceed with cochlear implantation in a child is one that requires long-term commitment on the part of the family and the cochlear implant team. PMID:8039409

  9. [Spinal column: implants and revisions].

    PubMed

    Krieg, S M; Meyer, H S; Meyer, B

    2016-03-01

    Non-fusion spinal implants are designed to reduce the commonly occurring risks and complications of spinal fusion surgery, e.g. long duration of surgery, high blood loss, screw loosening and adjacent segment disease, by dynamic or movement preserving approaches. This principle could be shown for interspinous spacers, cervical and lumbar total disc replacement and dynamic stabilization; however, due to the continuing high rate of revision surgery, the indications for surgery require as much attention and evidence as comparative data on the surgical technique itself. PMID:26779646

  10. Electrospun vancomycin-loaded coating on titanium implants for the prevention of implant-associated infections

    PubMed Central

    Zhang, Li; Yan, Junwei; Yin, Zhaowei; Tang, Cheng; Guo, Yang; Li, Dong; Wei, Bo; Xu, Yan; Gu, Qiangrong; Wang, Liming

    2014-01-01

    The objectives of this work were to develop an antibiotic coating on the surface of a titanium plate to determine its antibacterial properties in vitro and in vivo. To prepare vancomycin-coated titanium implants, we adopted the electrospinning nanotechnique. The surface structure of the coating implants was observed using a scanning electron microscope. An elution method and a high-pressure liquid chromatography assay were used to characterize the release behavior of vancomycin from the coating. The antibacterial efficacy and the cytotoxicity of the coated titanium implants on osteoblasts were investigated in vitro. In addition, X-ray, white blood cell count, C-reactive protein, erythrocyte sedimentation rate, and pathological examination were performed to validate its antimicrobial efficacy in vivo. The antibiotic coating released 82.7% (approximately 528.2 μg) of total vancomycin loading in the coating in vitro. The release behavior of vancomycin from nanofiber coatings exhibited a biphasic release pattern with an initial burst on day 1, followed by a slow and controlled release over 28 days. There was no cytotoxicity observed in vitro for the vancomycin-loaded coating. The vancomycin-coated titanium implants were active in treating implant-associated infection in vivo. Thus, vancomycin-coated titanium implants may be a promising approach to prevent and treat implant-associated infections. PMID:25028544

  11. Metallographic evaluation of hip joint implants wear and electrochemical implants potential.

    PubMed

    Kmieć, Krzysztof; Sibinski, Marcin; Synder, Marek; Drobniewski, Marek; Kozłowski, Piotr

    2014-12-01

    We performed metallographic evaluations of implants, removed during revision hip arthroplasty. The implants were evaluated for electrochemical potentials and the presence of wear products on the implants surface. A total of 50 patients (50 hips) underwent revision hip arthroplasty during the years 2007-2009 for aseptic loosening. The mean follow-up from primary hip replacement to revision was 10.1 years (from six months to 17 years). All hip joint implants removed during the revision arthroplasty were submitted to metallographic analysis and all heads were submitted to analysis under a scanning microscope. All polyethylene (PE) cups and inserts showed numerous features of wear (friction wear, plastic deformation and creeping, fatigue wear and degradation), six PE cups were broken. In six ceramic cups, only friction wear features were found; one of them was mechanically broken. In all heads articulating on PE not one had any mechanical damage. Heads of ceramic implants in ceramic-ceramic articulation undergo abrasive wear. None of the studied stems (cemented or uncemented) revealed any features of wear. Areas of titanium crystals (formed by electrolytic sedimentation of metals) were macroscopically identified on the sliding surface of six heads that was confirmed by chemical composition and scanning microscope.In the course of prosthesis use, wear products are produced and transferred onto the sliding surfaces of implant heads and cups via ways other than purely mechanical contact. It has been confirmed that metals used for implant construction, make galvanic cells with different electrochemical potentials. PMID:25362874

  12. Melodic Contour Identification by Cochlear Implant Listeners

    PubMed Central

    Galvin, John J.; Fu, Qian-Jie; Nogaki, Geraldine

    2013-01-01

    Objective While the cochlear implant provides many deaf patients with good speech understanding in quiet, music perception and appreciation with the cochlear implant remains a major challenge for most cochlear implant users. The present study investigated whether a closed-set melodic contour identification (MCI) task could be used to quantify cochlear implant users’ ability to recognize musical melodies and whether MCI performance could be improved with moderate auditory training. The present study also compared MCI performance with familiar melody identification (FMI) performance, with and without MCI training. Methods For the MCI task, test stimuli were melodic contours composed of 5 notes of equal duration whose frequencies corresponded to musical intervals. The interval between successive notes in each contour was varied between 1 and 5 semitones; the “root note” of the contours was also varied (A3, A4, and A5). Nine distinct musical patterns were generated for each interval and root note condition, resulting in a total of 135 musical contours. The identification of these melodic contours was measured in 11 cochlear implant users. FMI was also evaluated in the same subjects; recognition of 12 familiar melodies was tested with and without rhythm cues. MCI was also trained in 6 subjects, using custom software and melodic contours presented in a different frequency range from that used for testing. Results Results showed that MCI recognition performance was highly variable among cochlear implant users, ranging from 14% to 91% correct. For most subjects, MCI performance improved as the number of semitones between successive notes was increased; performance was slightly lower for the A3 root note condition. Mean FMI performance was 58% correct when rhythm cues were preserved and 29% correct when rhythm cues were removed. Statistical analyses revealed no significant correlation between MCI performance and FMI performance (with or without rhythmic cues). However

  13. TOPICAL REVIEW: Microsystem technologies for implantable applications

    NASA Astrophysics Data System (ADS)

    Receveur, Rogier A. M.; Lindemans, Fred W.; de Rooij, Nicolaas F.

    2007-05-01

    Microsystem technologies (MST) have become the basis of a large industry. The advantages of MST compared to other technologies provide opportunities for application in implantable biomedical devices. This paper presents a general and broad literature review of MST for implantable applications focused on the technical domain. A classification scheme is introduced to order the examples, basic technological building blocks relevant for implantable applications are described and finally a case study on the role of microsystems for one clinical condition is presented. We observe that the microfabricated parts span a wide range for implantable applications in various clinical areas. There are 94 active and 67 commercial 'end items' out of a total of 142. End item refers to the total concept, of which the microsystem may only be a part. From the 105 active end items 18 (13% of total number of end items) are classified as products. From these 18 products, there are only two for chronic use. The number of active end items in clinical, animal and proto phase for chronic use is 17, 13 and 20, respectively. The average year of first publication of chronic end items that are still in the animal or clinical phase is 1994 (n = 7) and 1993 (n = 11), respectively. The major technology market combinations are sensors for cardiovascular, drug delivery for drug delivery and electrodes for neurology and ophthalmology. Together these form 51% of all end items. Pressure sensors form the majority of sensors and there is just one product (considered to be an implantable microsystem) in the neurological area. Micro-machined ceramic packages, glass sealed packages and polymer encapsulations are used. Glass to metal seals are used for feedthroughs. Interconnection techniques such as flip chip, wirebonding or conductive epoxy as used in the semiconductor packaging and assembly industry are also used for manufacturing of implantable devices. Coatings are polymers or metal. As an alternative to

  14. Peri-implant bone changes following tooth extraction, immediate placement and loading of implants in the edentulous maxilla.

    PubMed

    Barbier, Lieven; Abeloos, Johan; De Clercq, Calix; Jacobs, Reinhilde

    2012-08-01

    The aim of this study was to clinically and radiographically evaluate peri-implant bone level changes after rehabilitation of a fully edentulous maxilla by placement of six implants in either fresh extraction sites or healed edentulous ridges up till 18 months after implant placement. Twenty patients with a terminal dentition in the maxillae (11 men, 9 women) received a total of 120 OsseoSpeed implants; 118 implants could be loaded immediately of which 59 were placed in extraction sockets and 59 were placed in healed sites. Within 24 h after surgery, all patients received a chairside-assembled, fibre-reinforced temporary fixed prosthetic reconstruction in occlusion. Six months post-surgery, final screw-retained CoCr (15) or Ti (5) computer numerical control-milled and acrylic-veneered frameworks were placed directly at implant level without interposing abutments. Intraoral radiographs were taken 6 and 18 months after implant placement. Implant survival rate was 100%. Mean marginal bone level was located on average -0.35 mm below the reference point (standard deviation 0.29, range -1.20 to +0.02 mm) 18 months after loading. Whether implants were placed in healed bone sites or fresh extraction sockets did not significantly affect the bone level changes. Furthermore, the use of either CoCr or Ti at the implant level did not significantly affect marginal bone loss. Within the limits of this prospective clinical trial, results seem to indicate that immediate placement and occlusal loading of five to six implants in the edentulous maxilla can be carried out successfully. Whether or not those implants are placed in fresh extraction sockets does not seem to alter the outcome. The present data show a successful 1-year outcome of a treatment protocol involving tooth extraction immediately combined with implant placement and loading. PMID:21932023

  15. Relationship between the surface chemical composition of implants and contact with the substrate.

    PubMed

    Lima da Costa Valente, Mariana; Shimano, Antonio Carlos; Marcantonio Junior, Elcio; Reis, Andréa Candido Dos

    2015-02-01

    The purpose of the study was to use scanning electron microscopy and energy dispersive x-ray spectrometry to assess possible morphologic and chemical changes after performing double-insertion and pullout tests of implants of different shapes and surface treatments. Four different types of implants were used-cylindrical machined-surface implants, cylindrical double-surface-treated porous implants, cylindrical surface-treated porous implants, and tapered surface-treated porous implants-representing a total of 32 screws. The implants were inserted into synthetic bone femurs, totaling 8 samples, before performing each insertion with standardized torque. After each pullout the implants were analyzed by scanning electron microscopy and energy dispersive x-ray spectrometry using a universal testing machine and magnified 35 times. No structural changes were detected on morphological surface characterization, only substrate accumulation. As for composition, there were concentration differences in the titanium, oxygen, and carbon elements. Implants with surface acid treatment undergo greater superficial changes in chemical composition than machined implants, that is, the greater the contact area of the implant with the substrate, the greater the oxide layer change. In addition, prior manipulation can alter the chemical composition of implants, typically to a greater degree in surface-treated implants. PMID:23339297

  16. Dental Implant Systems

    PubMed Central

    Oshida, Yoshiki; Tuna, Elif B.; Aktören, Oya; Gençay, Koray

    2010-01-01

    Among various dental materials and their successful applications, a dental implant is a good example of the integrated system of science and technology involved in multiple disciplines including surface chemistry and physics, biomechanics, from macro-scale to nano-scale manufacturing technologies and surface engineering. As many other dental materials and devices, there are crucial requirements taken upon on dental implants systems, since surface of dental implants is directly in contact with vital hard/soft tissue and is subjected to chemical as well as mechanical bio-environments. Such requirements should, at least, include biological compatibility, mechanical compatibility, and morphological compatibility to surrounding vital tissues. In this review, based on carefully selected about 500 published articles, these requirements plus MRI compatibility are firstly reviewed, followed by surface texturing methods in details. Normally dental implants are placed to lost tooth/teeth location(s) in adult patients whose skeleton and bony growth have already completed. However, there are some controversial issues for placing dental implants in growing patients. This point has been, in most of dental articles, overlooked. This review, therefore, throws a deliberate sight on this point. Concluding this review, we are proposing a novel implant system that integrates materials science and up-dated surface technology to improve dental implant systems exhibiting bio- and mechano-functionalities. PMID:20480036

  17. PIP breast implant removal: a study of 828 cases.

    PubMed

    Oulharj, S; Pauchot, J; Tropet, Y

    2014-03-01

    In March, 2010, the French Health Products Safety Agency suspended the sale of prefilled silicone breast implants manufactured by Poly Implants Prosthèse Prothese (PIP) because of a high failure rate and the use of an inappropriate silicone gel that did not comply with CE marking. These findings led to an international medical crisis. In France, 30,000 female patients had PIP implants. In our Department, 1150 PIP breast implants had been implanted in 630 patients since 2001. A retrospective study was conducted to define the rupture rate of these implants and the complications that arise. The women included in the study underwent implant removal from May 2010 to September 2012 for preventive or curative reasons. Data were collected from medical records that included: results of clinical examination, breast ultrasound before removal, rates of implant rupture, results of biopsy of periprosthetic capsule and pericapsule tissue and postoperative complications. A total of 828 PIP breast implants were removed in 455 patients. The rate of ruptured implants was 7.73% (64/828), corresponding to 11.6% of patients. A periprosthetic effusion was associated with rupture in 44% of cases. Breast ultrasound indicated a rupture for 87 implants; 32% were true positives and 3% were false negatives. Periprosthetic capsule biopsy demonstrated the presence of a foreign body, which seemed to be silicone, in 26% of cases and the presence of inflammation in 13% of cases. No siliconoma-type lesion was identified in the pericapsular tissue at biopsy. A total of 14 implants presented perspiration at removal. A statistically significant difference was found between the rates of rupture for texturised implants as compared to the smooth-surfaced implants. There were eight post-revisional-surgery complications (1%) and three cases of breast adenocarcinoma. The preventive explantation of PIP breast implants is justified given the high failure rate (7.73%) and given patients' exposure to silicone

  18. Reflections on Rodent Implantation.

    PubMed

    Cha, Jeeyeon M; Dey, Sudhansu K

    2015-01-01

    Embryo implantation is a complex process involving endocrine, paracrine, autocrine, and juxtacrine modulators that span cell-cell and cell-matrix interactions. The quality of implantation is predictive for pregnancy success. Earlier observational studies formed the basis for genetic and molecular approaches that ensued with emerging technological advances. However, the precise sequence and details of the molecular interactions involved have yet to be defined. This review reflects briefly on aspects of our current understanding of rodent implantation as a tribute to Roger Short's lifelong contributions to the field of reproductive physiology. PMID:26450495

  19. [Implantable hearing aids].

    PubMed

    Luers, J C; Beutner, D; Hüttenbrink, K-B

    2011-10-01

    Strictly speaking, implantable hearing aids are technical systems that process audiological signals and convey these by direct mechanical stimulation of the ossicular chain or cochlea. They have certain benefits over conventional hearing aids in terms of wearing comfort and general acceptance. As current studies lack convincing audiological results, the indications for implantable hearing aids are primarily of medical or cosmetic nature. To date, three systems are available in Germany: Vibrant Soundbridge®, Carina®, and Esteem®. Because the performance of the different implantable and nonimplantable hearing systems together with various surgical procedures are currently undergoing major changes, audiological indications may also develop in the future. PMID:21956678

  20. Transcatheter aortic valve implantation

    PubMed Central

    Oliemy, Ahmed

    2014-01-01

    Transcatheter aortic valve implantation was developed to offer a therapeutic solution to patients with severe symptomatic aortic stenosis who are not candidates for conventional aortic valve replacement. The improvement in transcatheter aortic valve implantation outcomes is still of concern in the areas of stroke, vascular injury, heart block, paravalvular regurgitation and valve durability. Concomitantly, the progress, both technical and in terms of material advances of transcatheter valve systems, as well as in patient selection, renders transcatheter aortic valve implantation an increasingly viable treatment for more and more patients with structural heart disease. PMID:25374670

  1. The evolution of embryo implantation.

    PubMed

    McGowen, Michael R; Erez, Offer; Romero, Roberto; Wildman, Derek E

    2014-01-01

    Embryo implantation varies widely in placental mammals. We review this variation in mammals with a special focus on two features: the depth of implantation and embryonic diapause. We discuss the two major types of implantation depth, superficial and interstitial, and map this character on a well-resolved molecular phylogenetic tree of placental mammals. We infer that relatively deep interstitial implantation has independently evolved at least eight times within placental mammals. Moreover, the superficial type of implantation represents the ancestral state for placental mammals. In addition, we review the genes involved in various phases of implantation, and suggest a future direction in investigating the molecular evolution of implantation-related genes. PMID:25023681

  2. Dental implants inserted in native bone: Cases series analyses

    PubMed Central

    Guidi, Riccardo; Viscioni, Alessandro; Dattola, Frencesco; Carinci, Francesco

    2012-01-01

    Background: The concept of osseointegration, i.e., the direct anchorage of endosseous implants made of commercially pure or titanium alloy to the bone caused a breakthrough in oral rehabilitation. The identification of factors for long-term survival and success rate are the main goal of the recent literature. Several variables can influence the final result, and in general they are grouped in surgery-, host-, implant-, and occlusion-related factors. Materials and Methods: A retrospective analysis on a large series of dental implants was performed to detect those variables influencing the clinical outcome. In the period between January 2007 and December 2009, 157 patients were operated. A total of 429 implants were inserted. Dental implants are reliable devices to be used in oral rehabilitation. Results: Globally, very few implants were lost at the end of the follow-up period. Slight but significant differences existed among different implants types with regard to peri-implant bone resorption. Conclusion: A better clinical outcome was revealed for Sweden and Martina global implant. PMID:23814579

  3. Regaining venous access for implantation of a new lead

    PubMed Central

    Syska, Paweł; Maciąg, Aleksander; Oręziak, Artur; Kuśmierczyk, Mariusz; Przybylski, Andrzej

    2013-01-01

    Introduction Venous occlusion is a relatively common complication of endocardial lead implantation. It may cause a critical problem when implantation of a new lead is needed. Traditional methods result in leaving abandoned leads. The optimal approach seems to be the extraction of the damaged or abandoned lead, regaining venous access and implantation of a new lead. Aim To assess the efficacy and safety of new lead implantation by the method of lead extraction. Material and methods All transvenous lead extraction procedures (203 patients) between 1 August 2008 and 15 October 2012 were assessed. The analysis included cases with leads implanted for at least 6 months prior to extraction. Results Regaining venous access was the main indication for lead extraction in 5 patients (4.9%). The reason for new lead implantation was lead damage (n = 7) and system up-grade to cardiac resynchronization therapy (CRT) (n = 3). In total, 23 leads were extracted (9 defibrillation leads, 12 pacing leads and 2 left ventricular leads). The mean time from the implantation was 92.2 ±43.2 (48-152) months. In all cases Cook mechanical sheaths were applied. The use of the Evolution system was necessary to extract 3 leads. In all cases the new leads were successfully implanted as planned. No serious complications occurred. Conclusions Diagnosis of venous occlusion should not be a contraindication for ipsilateral implantation of the new lead, because the techniques of transvenous lead extraction enable successful regaining of venous access. PMID:24570688

  4. Implant-supported overdentures: a longitudinal prospective study.

    PubMed

    Bergendal, T; Engquist, B

    1998-01-01

    The aim of this study was to evaluate the clinical function and long-term prognosis of overdentures retained by a small number of implants in the maxilla and mandible using one of two different attachment systems. Included in the study were all patients referred to specialty clinics in Jönköping and Linköping, Sweden, during the treatment period who needed an overdenture and could be provided with a minimum number of two bilaterally-placed implants. Excluded were patients with bone-grafted jaws, irradiated cancer patients, heavy bruxers, and patients who had lost a fixed prosthesis because of implant losses. The patients were randomly assigned to receive one retentive system, either a round 2-mm-diameter bar with clips or ball attachments (Nobel Biocare). Eighteen overdentures were placed in maxillae and 32 in mandibles, supported by a total of 115 Brånemark implants. Of the implants placed, 86.1% were continuously osseointegrated. The cumulative implant survival rates after 7 years of loading were 75.4% in the maxillae and 100% in the mandibles. There was no difference in implant survival rate between the attachment systems. Patients with implant losses were characterized by severely resorbed maxillary ridges and inferior bone quality, together with unfavorable loading circumstances such as short implants combined with long leverages. Complications and prosthetic adjustments were mostly resolved early and easily. PMID:9581412

  5. Effect of Implant Height Differences on Different Attachment Types and Peri-Implant Bone in Mandibular Two-Implant Overdentures: 3D Finite Element Study.

    PubMed

    Ozan, Oguz; Ramoglu, Serhat

    2015-06-01

    Implant-supported overdentures with self-aligning attachment systems are preferred to improve the stability and retention of complete dentures. The positioning of the implant attachments is a very important aspect of two-implant overdentures in obtaining better stress distribution. Therefore, the objective of this study was to compare two different attachment systems in a two-implant overdenture by evaluating the stress distributions in peri-implant bone and stresses on the attachments with positioning at different height levels using the 3D FEA method. Six models with ball attachments and 6 models with locator attachments-totaling 12 models (including 2 controls)-with the left implant positioned unilaterally at different height levels were subjected to 3 loading conditions (anterior, right posterior, and left posterior). Data for Von Misses stresses were produced numerically, color coded, and compared among the models for attachments and peri-implant cortical bone. The configurations in which implants presented 3 mm height differences in the bone level showed the most successful results in the peri-implant bone. When stresses on the attachments were compared, greater stress values were obtained from the ball attachments. As a conclusion, the configurations with a considerable (3 mm) height difference between quadrants of the mandible in the anterior segment showed the most successful results in the peri-implant bone. On the contrary, peak stress values around the implant observed from the models with less (1 mm) bone height difference may require leveling of the bone during surgery. However, these findings should be corroborated with clinical studies. PMID:24471769

  6. [Silicone breast implants].

    PubMed

    Nielsen, M; Brandt, B; Breiting, V B; Christensen, L H; Thomsen, J L

    1989-12-18

    A brief review of the use of silicone breast implants, their structure, methods of implantation and complications is presented. Acute complications are rare, being mainly infection and hematoma. Long-term complications, on the contrary, are common, consisting mainly of capsular contracture around the prosthesis with subsequent pain and deformation of the breast. More rarely silicone granulomas form, and prosthesis rupture or herniation occurs. The importance of silicone leakage for these complications is discussed separately as well as the treatment of and prevention of capsular contracture and demonstration of silicone in tissue. A critical attitude towards the use of silicone breast implants, when these are used for purely cosmetic purposes, is recommended at present. New improved types of silicone breast implants are currently being tested clinically. PMID:2692262

  7. Peri-Implant Diseases

    MedlinePlus

    ... and flossing and regular check-ups from a dental professional. Other risks factors for developing peri-implant disease include previous periodontal disease diagnosis, poor plaque control, smoking , and diabetes . It is essential to routinely ...

  8. Biocompatibility of surgical implants

    NASA Technical Reports Server (NTRS)

    Kaelble, D. H.

    1979-01-01

    Method of selecting biocompatible materials for surgical implants uses fracture mechanic relationships and surface energies of candidate materials in presence of blood plasma. Technique has been used to characterize 190 materials by parameters that reflect their biocompatibility.

  9. Risks of Breast Implants

    MedlinePlus

    ... larger and longer than these conducted so far. Breastfeeding Some women who undergo breast augmentation can successfully ... breast implant silicone shell into breast milk during breastfeeding. Although there are currently no established methods for ...

  10. Clinically based implant selection.

    PubMed

    Fugazzotto, P A

    1999-01-01

    A hierarchy of implant selection is presented, based on overcoming specific clinical challenges in a variety of situations, including maximization of the esthetic, comfort, and functional potentials of therapy. PMID:10709488

  11. Breast reconstruction - implants

    MedlinePlus

    ... stages, or surgeries. During the first stage, a tissue expander is used. An implant is placed during the ... a pouch under your chest muscle. A small tissue expander is placed in the pouch. The expander is ...

  12. Superelastic Orthopedic Implant Coatings

    NASA Astrophysics Data System (ADS)

    Fournier, Eric; Devaney, Robert; Palmer, Matthew; Kramer, Joshua; El Khaja, Ragheb; Fonte, Matthew

    2014-07-01

    The demand for hip and knee replacement surgery is substantial and growing. Unfortunately, most joint replacement surgeries will fail within 10-25 years, thereby requiring an arduous, painful, and expensive revision surgery. To address this issue, a novel orthopedic implant coating material ("eXalt") has been developed. eXalt is comprised of super elastic nitinol wire that is knit into a three-dimensional spacer fabric structure. eXalt expands in vivo to conform to the implantation site and is porous to allow for bone ingrowth. The safety and efficacy of eXalt were evaluated through structural analysis, mechanical testing, and a rabbit implantation model. The results demonstrate that eXalt meets or exceeds the performance of current coating technologies with reduced micromotion, improved osseointegration, and stronger implant fixation in vivo.

  13. Implantable microscale neural interfaces.

    PubMed

    Cheung, Karen C

    2007-12-01

    Implantable neural microsystems provide an interface to the nervous system, giving cellular resolution to physiological processes unattainable today with non-invasive methods. Such implantable microelectrode arrays are being developed to simultaneously sample signals at many points in the tissue, providing insight into processes such as movement control, memory formation, and perception. These electrode arrays have been microfabricated on a variety of substrates, including silicon, using both surface and bulk micromachining techniques, and more recently, polymers. Current approaches to achieving a stable long-term tissue interface focus on engineering the surface properties of the implant, including coatings that discourage protein adsorption or release bioactive molecules. The implementation of a wireless interface requires consideration of the necessary data flow, amplification, signal processing, and packaging. In future, the realization of a fully implantable neural microsystem will contribute to both diagnostic and therapeutic applications, such as a neuroprosthetic interface to restore motor functions in paralyzed patients. PMID:17252207

  14. Ion sources for ion implantation technology (invited)

    SciTech Connect

    Sakai, Shigeki Hamamoto, Nariaki; Inouchi, Yutaka; Umisedo, Sei; Miyamoto, Naoki

    2014-02-15

    Ion sources for ion implantation are introduced. The technique is applied not only to large scale integration (LSI) devices but also to flat panel display. For LSI fabrication, ion source scheduled maintenance cycle is most important. For CMOS image sensor devices, metal contamination at implanted wafer is most important. On the other hand, to fabricate miniaturized devices, cluster ion implantation has been proposed to make shallow PN junction. While for power devices such as silicon carbide, aluminum ion is required. For doping processes of LCD fabrication, a large ion source is required. The extraction area is about 150 cm × 10 cm, and the beam uniformity is important as well as the total target beam current.

  15. Implant treatment planning: endodontic considerations.

    PubMed

    Simonian, Krikor; Frydman, Alon; Verdugo, Fernando; Roges, Rafael; Kar, Kian

    2014-12-01

    Implants are a predictable and effective method for replacing missing teeth. Some clinicians have advocated extraction and replacement of compromised but treatable teeth on the assumption that implants will outperform endodontically and/or periodontally treated teeth. However, evidence shows that conventional therapy is as effective as implant treatment. With data on implants developing complications long term and a lack of predictable treatment for peri-implantitis, retaining and restoring the natural dentition should be the first choice when possible. PMID:25928961

  16. Ion implantation at elevated temperatures

    SciTech Connect

    Lam, N.Q.; Leaf, G.K.

    1985-11-01

    A kinetic model has been developed to investigate the synergistic effects of radiation-enhanced diffusion, radiation-induced segregation and preferential sputtering on the spatial redistribution of implanted solutes during implantation at elevated temperatures. Sample calculations were performed for Al and Si ions implanted into Ni. With the present model, the influence of various implantation parameters on the evolution of implant concentration profiles could be examined in detail.

  17. Short Term Evaluation of an Anatomically Shaped Polycarbonate Urethane Total Meniscus Replacement in a Goat Model

    PubMed Central

    Vrancken, A. C. T.; Madej, W.; Hannink, G.; Verdonschot, N.; van Tienen, T. G.; Buma, P.

    2015-01-01

    Purpose Since the treatment options for symptomatic total meniscectomy patients are still limited, an anatomically shaped, polycarbonate urethane (PCU), total meniscus replacement was developed. This study evaluates the in vivo performance of the implant in a goat model, with a specific focus on the implant location in the joint, geometrical integrity of the implant and the effect of the implant on synovial membrane and articular cartilage histopathological condition. Methods The right medial meniscus of seven Saanen goats was replaced by the implant. Sham surgery (transection of the MCL, arthrotomy and MCL suturing) was performed in six animals. The contralateral knee joints of both groups served as control groups. After three months follow-up the following aspects of implant performance were evaluated: implant position, implant deformation and the histopathological condition of the synovium and cartilage. Results Implant geometry was well maintained during the three month implantation period. No signs of PCU wear were found and the implant did not induce an inflammatory response in the knee joint. In all animals, implant fixation was compromised due to suture breakage, wear or elongation, likely causing the increase in extrusion observed in the implant group. Both the femoral cartilage and tibial cartilage in direct contact with the implant showed increased damage compared to the sham and sham-control groups. Conclusion This study demonstrates that the novel, anatomically shaped PCU total meniscal replacement is biocompatible and resistant to three months of physiological loading. Failure of the fixation sutures may have increased implant mobility, which probably induced implant extrusion and potentially stimulated cartilage degeneration. Evidently, redesigning the fixation method is necessary. Future animal studies should evaluate the improved fixation method and compare implant performance to current treatment standards, such as allografts. PMID:26192414

  18. Biomaterials in cochlear implants

    PubMed Central

    Stöver, Timo; Lenarz, Thomas

    2011-01-01

    The cochlear implant (CI) represents, for almost 25 years now, the gold standard in the treatment of children born deaf and for postlingually deafened adults. These devices thus constitute the greatest success story in the field of ‘neurobionic’ prostheses. Their (now routine) fitting in adults, and especially in young children and even babies, places exacting demands on these implants, particularly with regard to the biocompatibility of a CI’s surface components. Furthermore, certain parts of the implant face considerable mechanical challenges, such as the need for the electrode array to be flexible and resistant to breakage, and for the implant casing to be able to withstand external forces. As these implants are in the immediate vicinity of the middle-ear mucosa and of the junction to the perilymph of the cochlea, the risk exists – at least in principle – that bacteria may spread along the electrode array into the cochlea. The wide-ranging requirements made of the CI in terms of biocompatibility and the electrode mechanism mean that there is still further scope – despite the fact that CIs are already technically highly sophisticated – for ongoing improvements to the properties of these implants and their constituent materials, thus enhancing the effectiveness of these devices. This paper will therefore discuss fundamental material aspects of CIs as well as the potential for their future development. PMID:22073103

  19. [Implantable materials (author's transl)].

    PubMed

    Schaldach, M

    1975-11-01

    There is a steadily increasing importance of implants used as substitutions for body functions which have been impaired due to disease, natural abrasion or accident. With the present state of the art, the limitations for the application of surgical substitutions are due to insufficient properties of biomaterials with regard to specific applications as well as to deficiencies in design and function of the implants used. The basis for the improvement and new development of implants is therefore a functionally adequate design in which the specific properties of the material are taken into account with regard to the individual requirements of the implantation site. For orthopedic implants, materials have to be developed which are to a large extent corrosion and degradation resistant, and withstand high mechanical stress. For implants in the cardiovascular system, compatibility with blood is most significant. Present research in this field is concentrated on efforts to improve the thromboresistivity of conventional polymers by different kinds of surface treatments. One possibility is to influence actively the electrochemical interactions between material and blood components, e.g. by the use of redox catalysts. PMID:1107653

  20. Passive and active middle ear implants

    PubMed Central

    Beutner, Dirk; Hüttenbrink, Karl-Bernd

    2011-01-01

    Besides eradication of chronic middle ear disease, the reconstruction of the sound conduction apparatus is a major goal of modern ear microsurgery. The material of choice in cases of partial ossicular replacement prosthesis is the autogenous ossicle. In the event of more extensive destruction of the ossicular chain diverse alloplastic materials, e.g. metals, ceramics, plastics or composits are used for total reconstruction. Their specialised role in conducting sound energy within a half-open implant bed sets high demands on the biocompatibility as well as the acoustic-mechanic properties of the prosthesis. Recently, sophisticated titanium middle ear implants allowing individual adaptation to anatomical variations are widely used for this procedure. However, despite modern developments, hearing restoration with passive implants often faces its limitations due to tubal-middle-ear dysfunction. Here, implantable hearing aids, successfully used in cases of sensorineural hearing loss, offer a promising alternative. This article reviews the actual state of affairs of passive and active middle ear implants. PMID:22073102

  1. Utilization of implantable defibrillators in Africa.

    PubMed

    Millar, R N Scott; Mayosi, B M

    2003-01-01

    Sub-Saharan Africa is dominated by diseases of poverty. HIV/AIDS affects 28.5 out of a total of 600 million in the region. South Africa is the only country in sub-Saharan Africa in which implantable cardiovertor defibrillators (ICDs) are implanted (0.8/million in 2001). Only 3 of the 35 new ICDs were implanted in state-funded public hospitals. The pacemaker implantation rate for South Africa was 41/million in 2001. Approximately 20% of the population consume 56% of the health care expenditure, mainly funded by Medical Insurance. A tax-funded state health care system serves the rest of the population, but is concentrated on improving sanitation and primary health care. Diversion of funds from academic tertiary hospitals has reduced specialised services, particularly cardiology and cardiac surgery, and has resulted in an exodus of skilled personnel to the private sector. In the rest of sub-Saharan Africa, tertiary health care is mainly privately funded. Cardiology and cardiac surgery is not widely available. Many countries are crippled by debt and chronic local conflicts. Only one state hospital (Groote Schuur, Cape Town) provides an electrophysiology (EP) service including catheter ablation and ICD implantation, and training in EP, by two electrophysiologists. EP services are available privately in 3 centres. No EP service exists in the rest of sub-Saharan Africa. PMID:12766510

  2. Peri-implantation Intercourse Lowers Fecundability

    PubMed Central

    Steiner, Anne Z.; Pritchard, David A.; Young, Steven L.; Herring, Amy H.

    2014-01-01

    Objective To determine the impact of sexual intercourse around the time of implantation on the probability of achieving a pregnancy. Design Time-to-pregnancy cohort using day-specific probability of pregnancy modeling to account for intercourse during the fertile window. Setting Community cohort. Patient(s) Women trying to conceive naturally, ages 30-44 without known infertility. Intervention(s) None. Main Outcome Measure(s) Positive pregnancy test Result(s) A total of 564 women provided 1,332 complete cycles for analysis. Intercourse frequency during the fertile window and during the peri-implantation window was significantly correlated. Cycles in which couples had 2 or more days with intercourse during the implantation window were significantly less likely to result in a positive pregnancy test compared to cycles in which couples didn’t have intercourse in this window, after adjusting for age, race, history of regular menstrual cycles, previous pregnancy, and body mass index (Fecundability Ratio=0.62, 95% Confidence Interval: 0.42-0.91). Conclusions Intercourse during the peri-implantation window may be detrimental to natural fertility. Methods that allow couples to time intercourse to the fertile window may decrease time to pregnancy by not only increasing the probability of fertilization but also decreasing the probability of failed implantation. PMID:24746744

  3. Effects of surgical implantation of temperature dataloggers on reproduction of captive striped skunks (Mephitis mephitis).

    PubMed

    Hwang, Yeen Ten; Gentes, Marie-Line; Parker, Dennilyn L; Larivière, Serge; Messier, François

    2004-12-01

    A total of 20 (14 females, six males) captive striped skunks (Mephitis mephitis) with miniature temperature dataloggers implanted free in the abdominal cavity were examined for reproductive performance and pathology because of implants. Eleven of 12 female skunks reproduced successfully 45.9+/-3.7 days after surgery to remove implanted dataloggers. The pregnancy rate of 91.7% (11/12) was much higher than other captive studies and was comparable with that of wild skunks. Eight striped skunks (six males, two females) that were euthanatized and necropsied after having implants in the abdominal cavity for 5 mo showed no apparent pathology associated with the implant. Implantation of the intraperitoneal devices did not lead to complications in abdominal tissues. Neither implant nor surgery affected reproduction. We conclude that implanted dataloggers can safely be used in physiologic studies of striped skunks or possibly other small carnivores in captive or field studies. PMID:15732593

  4. Dental Implants – Perceiving Patients’ Satisfaction in Relation to Clinical and Electromyography Study on Implant Patients

    PubMed Central

    Saha, Soumendra

    2015-01-01

    The aim of this study is to evaluate the satisfaction of patients with posterior implants in relation to the clinical success criteria and surface electromyography (sEMG) findings of the masseter and temporalis muscles. Total 42 subjects were investigated. Twenty one subjects with posterior dental implants were interviewed using a questionnaire and the clinical success criteria were determined based on The International Congress of Oral Implantologists. The myofunction of the masticatory muscles were assessed using sEMG (21 subjects) and compared to the control group of subjects without implants (21 subjects). Out of 21 subjects, all were satisfied with the aesthetics of their implant. Twenty of them (95.2%) were satisfied with its function and stability. As for clinical criteria, 100% (50) of the implants were successful with no pain, mobility or exudates. sEMG findings showed that patients have significantly lower (p<0.01) basal or resting median power frequency but with muscle burst. During chewing, control subjects showed faster chewing action. There was no difference in reaction and recovery time of clenching for both groups. In conclusion, the satisfaction of implant patients was high, and which was in relation to the successful clinical success criteria and sEMG findings. PMID:26465146

  5. Effect of Osteotomy Preparation on Osseointegration of Immediately Loaded, Tapered Dental Implants.

    PubMed

    Stavropoulos, A; Cochran, D; Obrecht, M; Pippenger, B E; Dard, M

    2016-03-01

    The aim of the present preclinical in vivo study was to evaluate whether a modified "drill-only" protocol, involving slight underpreparation of the implant site, may have an effect on aspects of osseointegration of a novel bone-level tapered implant, compared with the "standard drilling" protocol involving taping and profiling of the marginal aspect of the implant socket. In each side of the edentulated and completely healed mandible of 11 minipigs, 2 tapered implants (8 mm long × 4.1 mm Ø, BLT; Institut Straumann AG, Basel, Switzerland) were installed either with the drill-only or the standard drilling protocol. Significantly lower average insertion torque values were recorded for the standard drilling protocol group (52 ± 29 Ncm) compared with the drill-only group (70 ± 27 Ncm) (t test, P ≤ 0.05); no significant difference was observed between the 2 groups regarding implant stability, by means of resonance frequency analysis (75 ± 8 vs. 75 ± 6, respectively). Half of the implants were immediately loaded and the rest were submerged, providing observation times of 8 or 4 wk, respectively. Non-decalcified histological and histomorphometric analysis of the implants with surrounding tissues showed no significant differences between the 2 drilling protocols regarding the distance from the implant platform to the first coronal bone-to-implant contact (f-BIC), the total bone-to-implant contact (BIC) as a percentage of the total implant perimeter, and the bone density in an area extending 1 mm laterally from the implant (BATA) within 2 rectangular regions of interest (ROIs) 4 mm in height, representing the coronal (parallel-walled) and apical (tapered) aspect of the implant (ROI 1 and ROI 2, respectively) in non-submerged implants. In general, marginal peri-implant bone levels were at or slightly apical to the implant platform, and large amounts of bone-to-implant contact were observed. In contrast, immediately loaded implants placed with the drill-only protocol

  6. Thoracoscopic left ventricular lead implantation in cardiac resynchronization therapy.

    PubMed

    Jeong, Dong Seop; Park, Pyo Won; Lee, Young Tak; Park, Seung-Jung; Kim, June Soo; On, Young Keun

    2012-12-01

    Cardiac resynchronization therapy is known to reduce morbidity and mortality in patients with advanced heart failure as a result of dyssynchrony and systolic dysfunction of the left ventricle. Placement of the left ventricular (LV) lead via the coronary sinus can be difficult. When LV lead implantation is difficult, a video-assisted epicardial approach can be a good alternative. Although there are several reports of video-assisted epicardial LV lead implantation, mini-thoracotomy and lead implantation under direct vision have been used in most series. A 49-yr-old woman with dilated cardiomyopathy underwent the video-assisted epicardial LV lead implantation because percutaneous transvenous approach was difficult due to small cardiac veins. The patient was discharged without problems and showed improved cardiac function at the 3 follow-up months. We report the first successful total thoracoscopic LV lead implantation (without mini-thoracotomy) in Korea. PMID:23255865

  7. Antimicrobial dental implant functionalization strategies -A systematic review.

    PubMed

    Grischke, Jasmin; Eberhard, Jörg; Stiesch, Meike

    2016-01-01

    Biofilm formation on dental implant surfaces is a serious threat. Up to 50% of all implants show signs of irreversible tissue destruction. The aim of the present systematic review was to summarize the state of the art of strategies to functionalize antimicrobial dental implant surfaces. We searched the following electronic database: SCOPUS, MEDLINE and GOOGLE SCHOLAR and identified relevant controlled trials that evaluated the efficiency of new biomaterial strategies to modify dental implant surfaces, in such a way that biofilm formation was inhibited. The search yielded 2,990 potentially relevant publications. A total of 142 publications met the inclusion criteria. Analysis found that it may be concluded that silver-implanted surfaces, drug-loaded surfaces, surfaces with antimicrobial peptides, bioactive and biopassive polymer coatings as well as nanoscale or UV-activatable surfaces enhance antimicrobial activity compared to commercial pure titanium. PMID:27477219

  8. Update on immediate implant loading: a review of the literature.

    PubMed

    Herrera Briones, Francisco J; Romero Olid, M N; Vallecillo Capilla, Manuel

    2004-01-01

    The treatment of totally or partially edentulous patients with osseointegrated implants is an increasing part of daily dental practice. The greater aesthetic and functional demands made by these patients have created a constant pressure to reduce the waiting time before implants are loaded. In some cases, however, a shortening of the waiting period may compromise the osseointegration of the fixtures. The present review aims to inform the clinician about the continuing controversy on this issue. Data from the reviewed studies allow comparisons to be made between the different success rates obtained after immediate implant loading, offering a more objective basis for our advice to patients on this type of treatment. According to our review, the type and quality of the bone and the surface of the implant are the factors that determine the selection of patients who can undergo the premature loading of implants. PMID:14704621

  9. Palatal positioned implants in severely atrophic maxillae versus conventional implants to support fixed full-arch prostheses: Controlled retrospective study with 5 years of follow-up

    PubMed Central

    Candel-Marti, Eugenia; Peñarrocha-Oltra, David; Bagán, Leticia; Peñarrocha-Diago, Maria

    2015-01-01

    Background To evaluate soft tissue conditions and bone loss around palatal positioned implants supporting fixed full-arch prostheses to rehabilitate edentulous maxillae with horizontal atrophy and compare them with conventional well-centered implants placed in non-atrophic maxillae after a minimum follow-up of 5 years. Material and Methods A clinical retrospective study was performed of patients that were rehabilitated with full-arch fixed implant-supported maxillary prostheses and had a minimum follow-up of 5 years after implant loading. Patients were divided into 2 groups: patients with class IV maxilla according to Cawood and Howell and treated with palatal positioned implants (test) and with class III maxilla and treated with implants well-centered in the alveolar ridge and completely surrounded by bone (control). The following variables were assessed: age, sex, frequency of tooth brushing, smoking, type of prosthesis, type of implant, implant success, amount of buccal keratinized mucosa, buccal retraction, probing depth, plaque index, modified bleeding index, presence of mucositis or peri-implantitis and peri-implant bone loss. Statistical analysis was performed applying Chi2 Test and Student’s t-test using alpha set at 0.05. Results A total of 57 patients were included: 32 patients with 161 palatal positioned implants (test) and 25 patients with 132 well centered implants (control). No statistically significant differences were found regarding age, sex and smoking, but test group patients reported a significantly higher frequency of daily tooth brushing. Implant success rates were 96.9% for test group implants and 96.0% for control group implants. Peri-implant mucosa retraction was significantly higher in the control group than in the test group (p=0,017). No significant differences were observed either for all the other assessed clinical parameters or for peri-implant bone loss. Conclusions Despite its limitations the outcomes of the present study suggest

  10. Implant interactions with orthodontics.

    PubMed

    Celenza, Frank

    2012-09-01

    Many situations arise in which orthodontic therapy in conjunction with implant modalities is beneficial, relevant or necessary. These situations might entail orthodontic treatment preparatory to the placement of an implant, such as in the site preparation for implant placement. Traditionally, this has been somewhat well understood, but there are certain guidelines that must be adhered to as well as diagnostic steps that must be followed. Provision of adequate space for implant placement is of paramount importance, but there is also the consideration of tissue manipulation and remodeling which orthodontic therapy can achieve very predictably and orthodontists should be well versed in harnessing and employing this modality of site preparation. In this way, hopeless teeth that are slated for extraction can still be utilized by orthodontic extraction to augment tissues, both hard and soft, thereby facilitating site development. On the corollary, and representing a significant shift in treatment sequencing, there are many situations in which orthodontic mechanotherapy can be simplified, expedited, and facilitated by the placement of an implant and utilization as an integral part of the mechanotherapy. Implants have proven to provide excellent anchorage, and have resulted in a new class of anchorage known as "absolute anchorage". Implants can be harnessed as anchors both in a direct and indirect sense, depending upon the dictates of the case. Further, this has led to the development of orthodontic miniscrew systems and techniques, which can have added features such as flexibility in location and placement, as well as ease of use and removal. As orthodontic appliances evolve, the advent of aligner therapy has become mainstream and well accepted, and many of the aforementioned combined treatment modalities can and should be incorporated into this relatively new treatment modality as well. PMID:23040348

  11. Hearing Preservation after Cochlear Implantation: UNICAMP Outcomes

    PubMed Central

    de Carvalho, Guilherme Machado; Guimaraes, Alexandre C.; Duarte, Alexandre S. M.; Muranaka, Eder B.; Soki, Marcelo N.; Martins, Renata S. Zanotello; Bianchini, Walter A.; Paschoal, Jorge R.; Castilho, Arthur M.

    2013-01-01

    Background. Electric-acoustic stimulation (EAS) is an excellent choice for people with residual hearing in low frequencies but not high frequencies and who derive insufficient benefit from hearing aids. For EAS to be effective, subjects' residual hearing must be preserved during cochlear implant (CI) surgery. Methods. We implanted 6 subjects with a CI. We used a special surgical technique and an electrode designed to be atraumatic. Subjects' rates of residual hearing preservation were measured 3 times postoperatively, lastly after at least a year of implant experience. Subjects' aided speech perception was tested pre- and postoperatively with a sentence test in quiet. Subjects' subjective responses assessed after a year of EAS or CI experience. Results. 4 subjects had total or partial residual hearing preservation; 2 subjects had total residual hearing loss. All subjects' hearing and speech perception benefited from cochlear implantation. CI diminished or eliminated tinnitus in all 4 subjects who had it preoperatively. 5 subjects reported great satisfaction with their new device. Conclusions. When we have more experience with our surgical technique we are confident we will be able to report increased rates of residual hearing preservation. Hopefully, our study will raise the profile of EAS in Brazil and Latin/South America. PMID:23573094

  12. Bio-activated titanium surface utilizable for mimetic bone implantation in dentistry—Part III: Surface characteristics and bone implant contact formation

    NASA Astrophysics Data System (ADS)

    Strnad, Jakub; Strnad, Zdeněk; Šesták, Jaroslav; Urban, Karel; Povýšil, Ctibor

    2007-05-01

    This study was carried out to quantify the effect of an alkali-modified surface on the bone implant interface formation during healing using an animal model. A total of 24 screw-shaped, self-tapping, (c.p.) titanium dental implants, divided into test group B—implants with alkali-modified surface (Bio surface) and control group M—implants with turned, machined surface, were inserted without pre-tapping in the tibiae of three beagle dogs. The animals were sacrificed after 2, 5 and 12 weeks and the bone implant contact (BIC%) was evaluated histometrically. The surface characteristics that differed between the implant surfaces, i.e. specific surface area, contact angle, may represent factors that influence the rate of osseointegration and the secondary implant stability. The alkali-treated surface enhances the BIC formation during the first 2 5 weeks of healing compared to the turned, machined surface.

  13. Multiaxis cyclic biomechanical testing of Harrington, Luque, and Drummond implants.

    PubMed

    Nasca, R J; Lemons, J E; Walker, J; Batson, S

    1990-01-01

    The performance characteristics of Harrington-Moe distraction rods, paired wired Luque rods and Drummond's system were evaluated and compared when subjected to nondestructive cyclic, multidirectional biomechanical testing. Twelve fresh, frozen swine spines with intact facet joints and anterior and posterior ligamentous complexes were instrumented and tested in a specially designed pneumatic testing machine. The instrumented spines were subjected to 207 kN/m2 compression and 49 N-m torsion. Each spine was cycled 28,000 times at 1 cycle per second. Linear and angular displacements were determined by digitizing photographs and video tapes made during testing. A computer program developed and refined for the project was used to complete the data analysis. Approximately 540 items of angular and linear displacement data were collected for each spine. Inspection of the spines after cyclic, multidirectional testing revealed no change in their osteoligamentous integrity compared with pre-testing. Pre- and post-testing radiographs showed no evidence of osseous failure, hook dislodgement or wire breakage. Erosion of laminal bone at the Harrington hook attachment sites was observed. Displacement of the Harrington hooks was seen during off-axis compression-torsion testing. Fretting and deposit of metal wear debris occurred between the sublaminal wires and "L" rods. There was no evidence of loosening of either the Drummond or Luque implants or fatigue failure of any component. Analysis of the linear and angular displacement data showed that the Luque and Drummond instrumented spines displaced less in axial compression, off-axis compression and off-axis compression-torsion than the single Harrington-Moe distraction rod.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2326694

  14. Penile Implants among Prisoners—A Cause for Concern?

    PubMed Central

    Yap, Lorraine; Butler, Tony; Richters, Juliet; Malacova, Eva; Wand, Handan; Smith, Anthony M. A.; Grant, Luke; Richards, Alun; Donovan, Basil

    2013-01-01

    Background We report the prevalence of penile implants among prisoners and determine the independent predictors for having penile implants. Questions on penile implants were included in the Sexual Health and Attitudes of Australian Prisoners (SHAAP) survey following concerns raised by prison health staff that increasing numbers of prisoners reported having penile implants while in prison. Methods Computer-Assisted Telephone Interviewing (CATI) of a random sample of prisoners was carried out in 41 prisons in New South Wales and Queensland (Australia). Men were asked, “Have you ever inserted or implanted an object under the skin of your penis?” If they responded Yes: “Have you ever done so while you were in prison?” Univariate logistic regression and logistic regression were used to determine the factors associated with penile implants. Results A total of 2,018 male prisoners were surveyed, aged between 18 and 65 years, and 118 (5.8%) reported that they had inserted or implanted an object under the skin of their penis. Of these men, 87 (73%) had this done while they were in prison. In the multivariate analysis, a younger age, birth in an Asian country, and prior incarceration were all significantly associated with penile implants (p<0.001). Men with penile implants were also more likely to report being paid for sex (p<0.001), to have had body piercings (p<0.001) or tattoos in prison (p<0.001), and to have taken non-prescription drugs while in prison (p<0.05). Conclusions Penile implants appear to be fairly common among prisoners and are associated with risky sexual and drug use practices. As most of these penile implants are inserted in prison, these men are at risk of blood borne viruses and wound infection. Harm reduction and infection control strategies need to be developed to address this potential risk. PMID:23326383

  15. Positron implantation in solids

    SciTech Connect

    Ghosh, V.J.; Lynn, K.G.; Welch, D.O.

    1993-12-31

    The Monte Carlo technique for modeling positron prior to annihilation and electron implantation in semi-infinite metals is described. Particle implantation is modelled as a multistep process, a series of collisions with the atoms of the host material. In elastic collisions with neutral atoms there is no transfer of energy. The particle loses energy by several different channels, excitation of the electron gas, ionization of the ion cores, or, at low energies, by phonon excitation. These competing scattering mechanisms have been incorporated into the Monte Carlo framework and several different models are being used. Brief descriptions of these Monte Carlo schemes, as well as an analytic model for positron implantation are included. Results of the Monte Carlo simulations are presented and compared with expermental data. Problems associated with modeling positron implantation are discuss and the need for more expermental data on energy-loss in different materials is stressed. Positron implantation in multilayers of different metals is briefly described and extensions of this work to include a study of multilayers and heterostructures is suggested.

  16. Imaging for cochlear implants.

    PubMed

    Phelps, P D; Annis, J A; Robinson, P J

    1990-07-01

    Insertion of a sound amplification device into the round window niche (extracochlear implant) or into the coils of the cochlea (intracochlear implant) can give significant benefits to some carefully selected, severely deaf patients. Imaging has an essential role in selective and pre-operative assessment. Severe otosclerosis and post-meningitic labyrinthitis ossificans are common causes of deafness in these patients and can be demonstrated by computed tomography (CT). The most suitable side for operation can be assessed. We describe our experiences with 165 patients, 69 of whom were found suitable for implants. Thin (1 mm) section CT in axial and coronal planes is the best imaging investigation of the petrous temporal bones but the place of magnetic resonance scanning to confirm that the inner ear is fluid-filled and polytomography to show a multichannel implant in the cochlea is discussed. No implants were used for congenital deformities, but some observations are made of this type of structural deformity of the inner ear. PMID:2390686

  17. The total artificial heart

    PubMed Central

    Cook, Jason A.; Shah, Keyur B.; Quader, Mohammed A.; Cooke, Richard H.; Kasirajan, Vigneshwar; Rao, Kris K.; Smallfield, Melissa C.; Tchoukina, Inna

    2015-01-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient’s native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review. PMID:26793338

  18. Total disc replacement.

    PubMed

    Vital, J-M; Boissière, L

    2014-02-01

    Total disc replacement (TDR) (partial disc replacement will not be described) has been used in the lumbar spine since the 1980s, and more recently in the cervical spine. Although the biomechanical concepts are the same and both are inserted through an anterior approach, lumbar TDR is conventionally indicated for chronic low back pain, whereas cervical TDR is used for soft discal hernia resulting in cervicobrachial neuralgia. The insertion technique must be rigorous, with precise centering in the disc space, taking account of vascular anatomy, which is more complex in the lumbar region, particularly proximally to L5-S1. All of the numerous studies, including prospective randomized comparative trials, have demonstrated non-inferiority to fusion, or even short-term superiority regarding speed of improvement. The main implant-related complication is bridging heterotopic ossification with resulting loss of range of motion and increased rates of adjacent segment degeneration, although with an incidence lower than after arthrodesis. A sufficiently long follow-up, which has not yet been reached, will be necessary to establish definitively an advantage for TDR, particularly in the cervical spine. PMID:24412045

  19. NEW BEARING SURFACES IN TOTAL HIP REPLACEMENT

    PubMed Central

    Schwartsmann, Carlos Roberto; Boschin, Leonardo Carbonera; Gonçalves, Ramiro Zilles; Yépez, Anthony Kerbes; de Freitas Spinelli, Leandro

    2015-01-01

    Total hip arthroplasty is being increasingly indicated for younger and more active patients, in addition to a naturally growing demand for the procedure because of increasing life expectancy among patients. The high costs of this surgery and the controversies regarding implant performance have made this topic the subject of constant research, seeking new materials with better resistance to wear and better biocompatibility. The present article provides a review of new surfaces in total hip arthroplasty. PMID:27042614

  20. Assessment of modified gold surfaced titanium implants on skeletal fixation.

    PubMed

    Zainali, Kasra; Danscher, Gorm; Jakobsen, Thomas; Baas, Jorgen; Møller, Per; Bechtold, Joan E; Soballe, Kjeld

    2013-01-01

    Noncemented implants are the primary choice for younger patients undergoing total hip replacements. However, the major concern in this group of patients regarding revision is the concern from wear particles, periimplant inflammation, and subsequently aseptic implant loosening. Macrophages have been shown to liberate gold ions through the process termed dissolucytosis. Furthermore, gold ions are known to act in an anti-inflammatory manner by inhibiting cellular NF-κB-DNA binding. The present study investigated whether partial coating of titanium implants could augment early osseointegration and increase mechanical fixation. Cylindrical porous coated Ti-6Al-4V implants partially coated with metallic gold were inserted in the proximal region of the humerus in ten canines and control implants without gold were inserted in contralateral humerus. Observation time was 4 weeks. Biomechanical push out tests and stereological histomorphometrical analyses showed no statistically significant differences in the two groups. The unchanged parameters are considered an improvement of the coating properties, as a previous complete gold-coated implant showed inferior mechanical fixation and reduced osseointegration compared to control titanium implants in a similar model. Since sufficient early mechanical fixation is achieved with this new coating, it is reasonable to investigate the implant further in long-term studies. PMID:22847873

  1. Assessment of modified gold surfaced titanium implants on skeletal fixation

    PubMed Central

    Zainali, Kasra; Danscher, Gorm; Jakobsen, Thomas; Baas, Jorgen; Møller, Per; Bechtold, Joan E.; Soballe, Kjeld

    2013-01-01

    Noncemented implants are the primary choice for younger patients undergoing total hip replacements. However, the major concern in this group of patients regarding revision is the concern from wear particles, periimplant inflammation, and subsequently aseptic implant loosening. Macrophages have been shown to liberate gold ions through the process termed dissolucytosis. Furthermore, gold ions are known to act in an anti-inflammatory manner by inhibiting cellular NF-κB-DNA binding. The present study investigated whether partial coating of titanium implants could augment early osseointegration and increase mechanical fixation. Cylindrical porous coated Ti-6Al-4V implants partially coated with metallic gold were inserted in the proximal region of the humerus in ten canines and control implants without gold were inserted in contralateral humerus. Observation time was 4 weeks. Biomechanical push out tests and stereological histomorphometrical analyses showed no statistically significant differences in the two groups. The unchanged parameters are considered an improvement of the coating properties, as a previous complete gold-coated implant showed inferior mechanical fixation and reduced osseointegration compared to control titanium implants in a similar model. Since sufficient early mechanical fixation is achieved with this new coating, it is reasonable to investigate the implant further in long-term studies. PMID:22847873

  2. Soft tissue balancing in total knee arthroplasty

    PubMed Central

    MELONI, MARIA CHIARA; HOEDEMAEKER, RUSSALKA W.; VIOLANTE, BRUNO; MAZZOLA, CLAUDIO

    2014-01-01

    A good outcome in total knee arthroplasty depends on many factors: joint alignment, range of motion, patellar tracking and ligament stability. A correct soft tissue balance keeps the joint aligned in flexion and extension, and therefore constitutes the most important factor for durability of the implant. Indeed, incorrect soft tissue balancing is the primary cause of early implant failure necessitating revision surgery. Soft tissue releases, serving to correct imbalances, are performed until the flexion and extension gaps appear symmetrical and balanced. A knee is considered perfectly balanced when the flexion and extension gaps are perfectly rectangular and all the measurements are absolutely equal. PMID:25606540

  3. [The implant denture in the laboratory].

    PubMed

    Scortecci, G M; Crousillat, J; Foesser, P; Bourbon, B

    1989-09-01

    The authors analyzed the numerous devices and prosthetic kits currently available for implant prosthodontics. Existing systems can be classified into two fundamentally different categories: the gold ring cylinder (or its equivalent in resin for casting) and the prosthetic abutment core or post concept. The former is based on connection of two nearly flat, horizontal surfaces by means of a screw, which avoids problems of parallelism; the latter can be likened to insertion of one part into another, like a crown that slides along the vertical axis of an abutment, with connection being obtained by cementation and/or screwing. Prosthetic abutment core or post: Whether monoblock or multiblock, the implant core or post is very similar to a conventional metallic abutment. Construction of the implant prosthesis is generally no problem when parallelism has been respected during surgery; if problems are encountered with parallelism, options include: 1. Adjustment of the abutment core by grinding, 2. Use of a telescope to achieve parallelism, 3. Use of a bendable prosthetic abutment core, 4. Use of a prosthetic abutment core preangulated 10 degrees-20 degrees, 5. A combination of the above solutions. The implant prostheses may be screwed, cemented or clipped in position. Gold ring cylinder concept The gold ring cylinder (or its equivalent in resin for casting) theoretically eliminates problems of parallelism, but at the same time restricts the implant prosthesis to screw techniques. A special protocol is required for the impression and construction of the prosthesis. Impression with plaster is often the best method for total edentulism whereas "open" impression trays are advisable for partial prostheses. In the laboratory, use of a machined gold ring cylinder provides optimum precision, but intra-oral verification remains necessary. Implant prosthodontics unquestionably represent a new type of "know how": both the dentist and the dental lab technician must acquire the

  4. First Implantation of Silicon Nanopore Membrane Hemofilters.

    PubMed

    Kensinger, Clark; Karp, Seth; Kant, Rishi; Chui, Benjamin W; Goldman, Kenneth; Yeager, Torin; Gould, Edward R; Buck, Amanda; Laneve, David C; Groszek, Joseph J; Roy, Shuvo; Fissell, William H

    2016-01-01

    An implantable hemofilter for the treatment of kidney failure depends critically on the transport characteristics of the membrane and the biocompatibility of the membrane, cartridge, and blood conduits. A novel membrane with slit-shaped pores optimizes the trade-off between permeability and selectivity, enabling implanted therapy. Sustained (3-8) day function of an implanted parallel-plate hemofilter with minimal anticoagulation was achieved by considering biocompatibility at the subnanometer scale of chemical interactions and the millimeter scale of blood fluid dynamics. A total of 400 nm-thick polysilicon flat sheet membranes with 5-8 nm × 2 micron slit-shaped pores were surface-modified with polyethylene glycol. Hemofilter cartridge geometries were refined based on computational fluid dynamics models of blood flow. In an uncontrolled pilot study, silicon filters were implanted in six class A dogs. Cartridges were connected to the cardiovascular system by anastamoses to the aorta and inferior vena cava and filtrate was drained to collection pouches positioned in the peritoneum. Pain medicine and acetylsalicylic acid were administered twice daily until the hemofilters were harvested on postoperative days 3 (n = 2), 4 (n = 2), 5 (n = 1), and 8 (n = 1). No hemofilters were thrombosed. Animals treated for 5 and 8 days had microscopic fractures in the silicon nanopore membranes and 20-50 ml of transudative (albumin sieving coefficient θalb ~ 0.5 - 0.7) fluid in the collection pouches at the time of explant. Shorter experimental durations (3-4 days) resulted in filtration volumes similar to predictions based on mean arterial pressures and membrane hydraulic permeability and (θalb ~ 0.2 - 0.3), similar to preimplantation measurements. In conclusion, a detailed mechanistic and materials science attention to blood-material interactions allows implanted hemofilters to resist thrombosis. Additional testing is needed to determine optimal membrane characteristics and

  5. Local delivery of zoledronate from a poly (D,L-lactide)-Coating increases fixation of press-fit implants.

    PubMed

    Jakobsen, Thomas; Bechtold, Joan E; Søballe, Kjeld; Jensen, Thomas; Greiner, Stefan; Vestermark, Marianne T; Baas, Jørgen

    2016-01-01

    Early secure fixation of total joint replacements is crucial for long-term survival. Antiresorptive agents such as bisphosphonates have been shown to increase implant fixation. We investigated whether local delivery of zoledronate from poly-D, L-lactide (PDLLA)-coated implants could improve implant fixation and osseointegration. Experimental titanium implants were bilaterally inserted press-fit into the proximal tibiae of 10 dogs. On one side the implant was coated with PDLLA containing zoledronate. The contralateral implant was uncoated and used as control. Observation period was 12 weeks. Implant fixation was evaluated with histomorphometry and biomechanical push-out test. We found an approximately twofold increase in all biomechanical parameters when comparing data from the zoledronate group with their respective controls. Histomorphometry showed increased amount of preserved bone and increased bone formation around the zoledronate implants. This study indicates that local delivery of zoledronate from a PDDLA coating has the potential to increase implant fixation. PMID:26177742

  6. Implantable Heart Aid

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Medrad utilized NASA's Apollo technology to develop a new device called the AID implantable automatic pulse generator which monitors the heart continuously, recognizes the onset of ventricular fibrillation and delivers a corrective electrical shock. AID pulse generator is, in effect, a miniaturized version of the defibrillator used by emergency squads and hospitals to restore rhythmic heartbeat after fibrillation, but has the unique advantage of being permanently available to the patient at risk. Once implanted, it needs no specially trained personnel or additional equipment. AID system consists of a microcomputer, a power source and two electrodes which sense heart activity.

  7. Hydroxylapatite Otologic Implants

    SciTech Connect

    McMillan, A.D.; Lauf, R.J.; Beale, B.; Johnson, R.

    2000-01-01

    A Cooperative Research and Development Agreement (CRADA) between Lockheed Martin Energy Research Corporation (LMER) and Smith and Nephew Richards Inc. of Bartlett, TN, was initiated in March 1997. The original completion date for the Agreement was March 25, 1998. The purpose of this work is to develop and commercialize net shape forming methods for directly creating dense hydroxylapatite (HA) ceramic otologic implants. The project includes three tasks: (1) modification of existing gelcasting formulations to accommodate HA slurries; (2) demonstration of gelcasting to fabricate green HA ceramic components of a size and shape appropriate to otologic implants: and (3) sintering and evaluation of the HA components.

  8. Ion implantation in silicate glasses

    SciTech Connect

    Arnold, G.W.

    1993-12-01

    This review examines the effects of ion implantation on the physical properties of silicate glasses, the compositional modifications that can be brought about, and the use of metal implants to form colloidal nanosize particles for increasing the nonlinear refractive index.

  9. Current trends in dental implants

    PubMed Central

    Gaviria, Laura; Salcido, John Paul; Guda, Teja

    2014-01-01

    Tooth loss is very a very common problem; therefore, the use of dental implants is also a common practice. Although research on dental implant designs, materials and techniques has increased in the past few years and is expected to expand in the future, there is still a lot of work involved in the use of better biomaterials, implant design, surface modification and functionalization of surfaces to improve the long-term outcomes of the treatment. This paper provides a brief history and evolution of dental implants. It also describes the types of implants that have been developed, and the parameters that are presently used in the design of dental implants. Finally, it describes the trends that are employed to improve dental implant surfaces, and current technologies used for the analysis and design of the implants. PMID:24868501

  10. Tungsten contamination in ion implantation

    NASA Astrophysics Data System (ADS)

    Polignano, M. L.; Barbarossa, F.; Galbiati, A.; Magni, D.; Mica, I.

    2016-06-01

    In this paper the tungsten contamination in ion implantation processes is studied by DLTS analysis both in typical operating conditions and after contamination of the implanter by implantation of wafers with an exposed tungsten layer. Of course the contaminant concentration is orders of magnitude higher after contamination of the implanter, but in addition our data show that different mechanisms are active in a not contaminated and in a contaminated implanter. A moderate tungsten contamination is observed also in a not contaminated implanter, however in that case contamination is completely not energetic and can be effectively screened by a very thin oxide. On the contrary, the contamination due to an implantation in a previously contaminated implanter is reduced but not suppressed even by a relatively thick screen oxide. The comparison with SRIM calculations confirms that the observed deep penetration of the contaminant cannot be explained by a plain sputtering mechanism.

  11. The roles of different scale ranges of surface implant topography on the stability of the bone/implant interface.

    PubMed

    Davies, John E; Ajami, Elnaz; Moineddin, Rahim; Mendes, Vanessa C

    2013-05-01

    We sought to deconvolute the effects of sub-micron topography and microtopography on the phenomena of bone bonding and interfacial stability of endosseous implants. To address this experimentally, we implanted custom-made titanium alloy implants of varying surface topographical complexity in rat femora, for 6, 9 or 12 days. The five surfaces were polished, machined, dual acid etched, and two forms of grit blasted and acid etched; each surface type was further modified with the deposition of nanocrystals of calcium phosphate to make a total of 10 materials groups (n = 10 for each time point; total 300 implants). At sacrifice, we subjected the bone-implant interface to a mechanical disruption test. We found that even the smoothest surfaces, when modified with sub-micron scale crystals, could be bone-bonding. However, as locomotor loading through bone to the implant increased with time of healing, such interfaces failed while others, with sub-micron features superimposed on surfaces of increasing microtopographical complexity remained intact under loading. We demonstrate here that higher order, micron or coarse-micron, topography is a requirement for longer-term interfacial stability. We show that each of these topographical scale-ranges represents a scale-range seen in natural bone tissue. Thus, what emerges from an analysis of our findings is a new means by which biologically-relevant criteria can be employed to assess the importance of implant surface topography at different scale-ranges. PMID:23415644

  12. The ruptured PIP breast implant.

    PubMed

    Helyar, V; Burke, C; McWilliams, S

    2013-08-01

    Public concern erupted about the safety of Poly Implant Prothèse (PIP) breast implants when it was revealed in 2011 that they contained an inferior, unlicensed industrial-grade silicone associated with a high rate of rupture. There followed national guidance for UK clinicians, which led to a considerable increase in referrals of asymptomatic women for breast implant assessment. In this review we discuss possible approaches to screening the PIP cohort and the salient characteristics of a ruptured implant. PMID:23622796

  13. Rehabilitation using single stage implants

    PubMed Central

    Mohamed, Jumshad B.; Sudarsan, Sabitha; Arun, K. V.; Shivakumar, B.

    2009-01-01

    Implant related prosthesis has become an integral part of rehabilitation of edentulous areas. Single stage implant placement has become popular because of its ease of use and fairly predictable results. In this paper, we present a series of cases of single stage implants being used to rehabilitate different clinical situations. All the implants placed have been successfully restored and followed up for up to one year. PMID:20376239

  14. Material Science in Cervical Total Disc Replacement

    PubMed Central

    Pham, Martin H.; Mehta, Vivek A.; Tuchman, Alexander; Hsieh, Patrick C.

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation. PMID:26523281

  15. Material Science in Cervical Total Disc Replacement.

    PubMed

    Pham, Martin H; Mehta, Vivek A; Tuchman, Alexander; Hsieh, Patrick C

    2015-01-01

    Current cervical total disc replacement (TDR) designs incorporate a variety of different biomaterials including polyethylene, stainless steel, titanium (Ti), and cobalt-chrome (CoCr). These materials are most important in their utilization as bearing surfaces which allow for articular motion at the disc space. Long-term biological effects of implanted materials include wear debris, host inflammatory immune reactions, and osteolysis resulting in implant failure. We review here the most common materials used in cervical TDR prosthetic devices, examine their bearing surfaces, describe the construction of the seven current cervical TDR devices that are approved for use in the United States, and discuss known adverse biological effects associated with long-term implantation of these materials. It is important to appreciate and understand the variety of biomaterials available in the design and construction of these prosthetics and the considerations which guide their implementation. PMID:26523281

  16. Survival of batch numbers within dental implants following incineration as an aid to identification.

    PubMed

    Berketa, J; James, H; Marino, V

    2010-12-01

    Dental implants have become a popular choice of treatment in replacing individual lost teeth or entire dentitions. The physical properties of high corrosion resistance, high structural strength and high melting point, suggest the retention of intact implants following most physical assaults. As the implants are machine made, they lack the individualisation required for their use as identifiers of the deceased, however the Straumann™ Company (Waldenburg, Switzerland) has recently released information that within the chamber of their implants they have laser etched batch numbers. The number of implants with the same batch number varies from 24 to 2400. The purpose of this study was to ascertain if the batch number was still identifiable following intense heat exposure in a furnace. A Straumann™ Standard Plus 3.3 x 8 mm implant, with no healing cap nor abutment attached was incinerated to 1125 degrees Celsius. Another Straumann™ Standard Plus 3.3 x 8 mm implant was also incinerated in the same way as the first implant but with an abutment attached. The results indicated that the first implant had totally oxidised within the internal chamber whilst the second implant following the removal of the abutment revealed an intact identifiable batch number. If the companies constructing implants were to place individual serial numbers rather than batch numbers on these implants then the potential exists for a new approach to be established for the identification of the deceased. PMID:21239857

  17. Prosthetic failure in implant dentistry.

    PubMed

    Sadid-Zadeh, Ramtin; Kutkut, Ahmad; Kim, Hyeongil

    2015-01-01

    Although osseointegrated dental implants have become a predictable and effective modality for the treatment of single or multiple missing teeth, their use is associated with clinical complications. Such complications can be biologic, technical, mechanical, or esthetic and may compromise implant outcomes to various degrees. This article presents prosthetic complications accompanied with implant-supported single and partial fixed dental prostheses. PMID:25434566

  18. Differences between buccal and lingual bone quality and quantity of peri-implant regions.

    PubMed

    Kim, Do-Gyoon; Elias, Kathy L; Jeong, Yong-Hoon; Kwon, Hyun-Jung; Clements, Matthew; Brantley, William A; Lee, Damian J; Han, Jung-Suk

    2016-07-01

    The objective of the current study was to examine whether peri-implant bone tissue properties are different between the buccal and lingual regions treated by growth factors. Four dental implant groups were used: titanium (Ti) implants, alumina-blasted zirconia implants (ATZ-N), alumina-blasted zirconia implants with demineralized bone matrix (DBM) (ATZ-D), and alumina-blasted zirconia implants with rhBMP-2 (ATZ-B). These implants were placed in mandibles of six male dogs. Nanoindentation elastic modulus (E) and plastic hardness (H) were measured for the buccal and lingual bone tissues adjacent and away from the implants at 3 and 6 weeks post-implantation. A total of 2281 indentations were conducted for 48 placed implants. The peri-implant buccal region had less bone quantity resulting from lower height and narrower width of bone tissue than the lingual region. Buccal bone tissues had significant greater mean values of E and H than lingual bone tissues at each distance and healing period (p<0.007). Nearly all implant treatment groups displayed lower mean values of the E at the lingual bone tissues than at the buccal bone tissues (p<0.046) although the difference was not significant for the Ti implant group (p=0.758). The DBM and rhBMP-2 treatments stimulated more peri-implant bone remodeling at the lingual region, producing more immature new bone tissues with lower E than at the buccal region. This finding suggests that the growth factor treatments to the zirconia implant system may help balance the quantity and quality differences between the peri-implant bone tissues. PMID:26773652

  19. Robot-assisted total hip arthroplasty.

    PubMed

    Banerjee, Samik; Cherian, Jeffery J; Elmallah, Randa K; Pierce, Todd P; Jauregui, Julio J; Mont, Michael A

    2016-01-01

    Precise and accurate biomechanical reconstruction during total hip arthroplasty (THA) is essential for durable long-term survivorship. Accurate fit of cementless hip implants is also crucial to reduce micromotion between the bone-implant interfaces to allow for stable osseointegration. Robotic technology aims to minimize potential human errors and improve implant alignment and fit, and address persisting concerns with modern-day cementless THA. Although robotic THA dates back to the early 1990s, concerns with increased operating times, costs, and complications led to its withdrawal. However, semi-active systems have renewed interest in robot-assisted joint arthroplasty. We reviewed the current technology, its potential benefits, and the reported clinical and radiographic outcomes. Early evidence suggests that robotic use may lead to more accurate reconstruction of radiographic parameters, such as implant positioning, fit, center-of-rotation, and leg-length discrepancy. Further research is needed to determine if these will translate into better outcomes and improved implant longevity to justify increased costs. PMID:26592900

  20. Remote actuated valve implant

    DOEpatents

    McKnight, Timothy E; Johnson, Anthony; Moise, Jr., Kenneth J; Ericson, Milton Nance; Baba, Justin S; Wilgen, John B; Evans, III, Boyd McCutchen

    2014-02-25

    Valve implant systems positionable within a flow passage, the systems having an inlet, an outlet, and a remotely activatable valve between the inlet and outlet, with the valves being operable to provide intermittent occlusion of the flow path. A remote field is applied to provide thermal or magnetic activation of the valves.

  1. Cochlear Implantation in Neurobrucellosis

    PubMed Central

    Bajin, Münir Demir; Savaş, Özden; Aslan, Filiz; Sennaroğlu, Levent

    2016-01-01

    Background: Neurobrucellosis is a disease consisting of a wide spectrum of complications such as peripheral neuropathy, cranial nerve involvement, ataxia, meningeal irritation, paraplegia, seizures, coma, and even death. The vestibulocochlear nerve seems to be the most commonly affected cranial nerve (10%). We present a patient with neurobrucellosis whose auditory perception and speech intelligibility skill performances improved after cochlear implantation. Case Report: A 35 year-old woman was admitted to another hospital 2 years ago with the symptoms of headache, nausea, and altered consciousness, who was finally diagnosed with neurobrucellosis. She developed bilateral profound sensorineural hearing loss during the following 6 months. There was no benefit of using hearing aids. After successful treatment of her illness, she was found to be suitable for cochlear implantation. After the operation, her auditory perception skills improved significantly with a Categories of Auditory Performance (CAP) score of 5. According to clinical observations and her family members’ statements, her Speech Intelligibility Rating (SIR) score was 3. Her speech intelligibility skills are still improving. Conclusion: Our case report represents the second case of hearing rehabilitation with cochlear implantation after neurobrucellosis. Cochlear implantation is a cost-effective and time-proven successful intervention in post-lingual adult patients with sensorineural hearing loss. Early timing of the surgery after appropriate treatment of meningitis helps the patient to achieve better postoperative results. PMID:26966626

  2. Implantable electrical device

    NASA Technical Reports Server (NTRS)

    Jhabvala, M. D. (Inventor)

    1982-01-01

    A fully implantable and self contained device is disclosed composed of a flexible electrode array for surrounding damaged nerves and a signal generator for driving the electrode array with periodic electrical impulses of nanoampere magnitude to induce regeneration of the damaged nerves.

  3. Remote actuated valve implant

    DOEpatents

    McKnight, Timothy E.; Johnson, Anthony; Moise, Kenneth J.; Ericson, Milton Nance; Baba, Justin S.; Wilgen, John B.; Evans, Boyd Mccutchen

    2016-05-10

    Valve implant systems positionable within a flow passage, the systems having an inlet, an outlet, and a remotely activatable valve between the inlet and outlet, with the valves being operable to provide intermittent occlusion of the flow path. A remote field is applied to provide thermal or magnetic activation of the valves.

  4. Implantable Drug Dispenser

    NASA Technical Reports Server (NTRS)

    Collins, E. R. J.

    1983-01-01

    Drugs such as insulin are injected as needed directly into bloodstream by compact implantable dispensing unit. Two vapor cavities produce opposing forces on drug-chamber diaphragm. Heaters in cavities allow control of direction and rate of motion of bellows. Dispensing capsule fitted with coil so batteries can be recharged by induction.

  5. Allergy to Surgical Implants.

    PubMed

    Pacheco, Karin A

    2015-01-01

    Surgical implants have a wide array of therapeutic uses, most commonly in joint replacements, but also in repair of pes excavatum and spinal disorders, in cardiac devices (stents, patches, pacers, valves), in gynecological implants, and in dentistry. Many of the metals used are immunologically active, as are the methacrylates and epoxies used in conjunction with several of these devices. Allergic responses to surgical components can present atypically as failure of the device, with nonspecific symptoms of localized pain, swelling, warmth, loosening, instability, itching, or burning; localized rash is infrequent. Identification of the specific metal and cement components used in a particular implant can be difficult, but is crucial to guide testing and interpretation of results. Nickel, cobalt, and chromium remain the most common metals implicated in implant failure due to metal sensitization; methacrylate-based cements are also important contributors. This review will provide a guide on how to assess and interpret the clinical history, identify the components used in surgery, test for sensitization, and provide advice on possible solutions. Data on the pathways of metal-induced immune stimulation are included. In this setting, the allergist, the dermatologist, or both have the potential to significantly improve surgical outcomes and patient care. PMID:26362550

  6. Semiconductor Ion Implanters

    SciTech Connect

    MacKinnon, Barry A.; Ruffell, John P.

    2011-06-01

    In 1953 the Raytheon CK722 transistor was priced at $7.60. Based upon this, an Intel Xeon Quad Core processor containing 820,000,000 transistors should list at $6.2 billion. Particle accelerator technology plays an important part in the remarkable story of why that Intel product can be purchased today for a few hundred dollars. Most people of the mid twentieth century would be astonished at the ubiquity of semiconductors in the products we now buy and use every day. Though relatively expensive in the nineteen fifties they now exist in a wide range of items from high-end multicore microprocessors like the Intel product to disposable items containing 'only' hundreds or thousands like RFID chips and talking greeting cards. This historical development has been fueled by continuous advancement of the several individual technologies involved in the production of semiconductor devices including Ion Implantation and the charged particle beamlines at the heart of implant machines. In the course of its 40 year development, the worldwide implanter industry has reached annual sales levels around $2B, installed thousands of dedicated machines and directly employs thousands of workers. It represents in all these measures, as much and possibly more than any other industrial application of particle accelerator technology. This presentation discusses the history of implanter development. It touches on some of the people involved and on some of the developmental changes and challenges imposed as the requirements of the semiconductor industry evolved.

  7. Semiconductor Ion Implanters

    NASA Astrophysics Data System (ADS)

    MacKinnon, Barry A.; Ruffell, John P.

    2011-06-01

    In 1953 the Raytheon CK722 transistor was priced at 7.60. Based upon this, an Intel Xeon Quad Core processor containing 820,000,000 transistors should list at 6.2 billion! Particle accelerator technology plays an important part in the remarkable story of why that Intel product can be purchased today for a few hundred dollars. Most people of the mid twentieth century would be astonished at the ubiquity of semiconductors in the products we now buy and use every day. Though relatively expensive in the nineteen fifties they now exist in a wide range of items from high-end multicore microprocessors like the Intel product to disposable items containing `only' hundreds or thousands like RFID chips and talking greeting cards. This historical development has been fueled by continuous advancement of the several individual technologies involved in the production of semiconductor devices including Ion Implantation and the charged particle beamlines at the heart of implant machines. In the course of its 40 year development, the worldwide implanter industry has reached annual sales levels around 2B, installed thousands of dedicated machines and directly employs thousands of workers. It represents in all these measures, as much and possibly more than any other industrial application of particle accelerator technology. This presentation discusses the history of implanter development. It touches on some of the people involved and on some of the developmental changes and challenges imposed as the requirements of the semiconductor industry evolved.

  8. The reverse zygomatic implant: a new implant for maxillofacial reconstruction.

    PubMed

    Dawood, Andrew; Collier, Jonathan; Darwood, Alastair; Tanner, Susan

    2015-01-01

    This case report describes the rehabilitation of a patient who had been treated with a hemimaxillectomy, reconstruction with a latissimus dorsi vascularized free flap, and radiotherapy for carcinoma of the sinus some years previously. Limited jaw opening, difficult access through the flap to the bony site, and the very small amount of bone available in which to anchor the implant inspired the development and use of a new "reverse zygomatic" implant. For this treatment, site preparation and implant insertion were accomplished using an extraoral approach. The implant was used along with two other conventional zygomatic implants to provide support for a milled titanium bar and overdenture to rehabilitate the maxilla. Two years later, the patient continues to enjoy a healthy reconstruction. The reverse zygomatic implant appears to show promise as a useful addition to the implant armamentarium for the treatment of the patient undergoing maxillectomy. PMID:26574864

  9. Short-term improvement of masticatory function after implant restoration

    PubMed Central

    2015-01-01

    Purpose Dental implants present several advantages over other tooth replacement options. However, there has been little research on masticatory function in relation to implant treatment. Therefore, the aim of the present study was to evaluate the improvement of masticatory function two weeks after implant restoration. Methods Masticatory ability was evaluated with the subjective food intake ability (FIA) and objective mixing ability index (MAI) methods. Fifty-four subjects with first and second missing molars completed the study. The subjects were asked to complete a self-reported questionnaire about 30 different food items, and to chew wax samples 10 times both before and two weeks after implant restoration. A total of 108 waxes were analyzed with an image analysis program. Results Dental implant restoration for lost molar teeth on one side increased the FIA score by 9.0% (P<0.0001). The MAI score also increased, by 14.3% after implant restoration (P<0.0001). Comparison between the good and poor mastication groups, which were subdivided based on the median MAI score before implant restoration, showed that the FIA score of the poor group was enhanced 1.1-fold while its MAI score was enhanced 2.0-fold two weeks after an implant surgery. Conclusions Using the FIA and MAI assessment methods, this study showed that masticatory function was improved two weeks after implant restoration. In particular, the enhancement of masticatory function by implant restoration was greater in patients with relatively poor initial mastication than in those with good initial mastication. PMID:26734490

  10. Surgical evaluation of candidates for cochlear implants

    NASA Technical Reports Server (NTRS)

    Black, F. O.; Lilly, D. J.; Fowler, L. P.; Stypulkowski, P. H.

    1987-01-01

    The customary presentation of surgical procedures to patients in the United States consists of discussions on alternative treatment methods, risks of the procedure(s) under consideration, and potential benefits for the patient. Because the contents of the normal speech signal have not been defined in a way that permits a surgeon systematically to provide alternative auditory signals to a deaf patient, the burden is placed on the surgeon to make an arbitrary selection of candidates and available devices for cochlear prosthetic implantation. In an attempt to obtain some information regarding the ability of a deaf patient to use electrical signals to detect and understand speech, the Good Samaritan Hospital and Neurological Sciences Institute cochlear implant team has routinely performed tympanotomies using local anesthesia and has positioned temporary electrodes onto the round windows of implant candidates. The purpose of this paper is to review our experience with this procedure and to provide some observations that may be useful in a comprehensive preoperative evaluation for totally deaf patients who are being considered for cochlear implantation.

  11. Total Toe Replacement in the United States: What Is Known and What Is on the Horizon.

    PubMed

    Johnson, Michael D; Brage, Michael E

    2016-06-01

    Arthritis of the first metatarsophalangeal is a common problem of the forefoot. The gold standard surgical treatment has been fusion of the first metatarsophalangeal joint. Many patients are unwilling to accept pain relief at the expense of loss of motion and the corresponding loss of shoe wear choices and activities requiring dorsiflexion of the hallux. Early implants were plagued with loosening and continued pain but implants have evolved. Current implants use modern bearing surfaces with press-fit fixation. These implants have renewed optimism for total toe arthroplasty. This article reviews the literature for implants currently available and describes the surgical techniques. PMID:27261805

  12. Biotelemetry implant volume and weight in rats: A pilot study report

    NASA Technical Reports Server (NTRS)

    Somps, Chris J.

    1994-01-01

    This paper reports the results of a pilot study in which a 240-gram rat was implanted for 41 days with biotelemetry devices weighing a total of 36 gm (18 cc). The implanted animal showed no differences in weight gain, food and water consumption, and postnecropsy organ weights when compared to both an unoperated control animal and an animal that underwent surgery but did not receive an implant. The implanted animal also had temperature and activity rhythms similar to those reported using much smaller implants. Thus, this pilot study showed that a 240-gm rat could be implanted with biotelemetry devices weighing nearly 15 percent of body weight without significant changes in health or behavior. A larger study involving more animals and similar implant sizes is recommended.

  13. Prosthodontic management of implant therapy.

    PubMed

    Thalji, Ghadeer; Bryington, Matthew; De Kok, Ingeborg J; Cooper, Lyndon F

    2014-01-01

    Implant-supported dental restorations can be screw-retained, cement-retained, or a combination of both, whereby a metal superstructure is screwed to the implants and crowns are individually cemented to the metal frame. Each treatment modality has advantages and disadvantages. The use of computer-aided design/computer-assisted manufacture technologies for the manufacture of implant superstructures has proved to be advantageous in the quality of materials, precision of the milled superstructures, and passive fit. Maintenance and recall evaluations are an essential component of implant therapy. The longevity of implant restorations is limited by their biological and prosthetic maintenance requirements. PMID:24286654

  14. Surgeons' knowledge about the costs of orthopaedic implants.

    PubMed

    Rohman, Lebur; Hadi, Saifullah; Whitwell, George

    2014-08-01

    PURPOSE. To investigate consultant surgeons' knowledge about the costs of implants for various joint surgeries. METHODS. Questionnaires were distributed to consultant orthopaedic surgeons at 2 hospitals. Respondents were asked to estimate the implant costs of any brand for low-demand and high-demand total hip replacement (THR), total knee replacement (TKR), uni-compartmental knee replacement, arthroscopy shaver blade, total anterior cruciate ligament (ACL) fixation, and meniscal repair. The actual cost of each implant was obtained from the manufacturer. RESULTS. 16 consultant surgeons completed the questionnaires. The respective mean estimated and actual costs for a low-demand THR implant were £1714 (range, £600-3000) and £1448 (range, £985- 2335), with an overestimation of 18.4%. The respective costs for a high-demand THR implant were £2172 (range, £600-6000) and £1737 (range, £1192-2335), with an overestimation of 25%. The respective costs for a TKR implant were £1550 (range, £600-6000) and £1316 (range, £995-1535), with an overestimation of 17.8%. The respective costs for a uni-compartmental knee replacement implant were £1040 (range, £600-2000) and £1296 (range, £698-1470), with an underestimation of 19.7%. The respective costs for an arthroscopy shaver blade were £110 (range, £75-150) and £94 (range, £80-100), with an overestimation of 16.6%. The respective costs for a total ACL fixation implant were £246 (range, £80-500) and £306 (range, £272-335), with an underestimation of 19.4%. The respective costs for a meniscal repair implant were £153 (range, £50-250) and £242 (range, £170-260), with an underestimation of 37%. CONCLUSION. The knowledge among consultant orthopaedic surgeons about implant costs was poor. To reduce implant costs, cooperation between surgeons and hospital managers and measures to increase surgeons' awareness about cost-reduction programmes are needed. PMID:25163960

  15. Predictability of short implants (< 10 mm) as a treatment option for the rehabilitation of atrophic maxillae. A systematic review

    PubMed Central

    García-Sala-Bonmatí, Fernando; Martínez-González, Amparo; García-Dalmau, Carlos; Mañes-Ferrer, José-Félix; Brotons-Oliver, Alejandro

    2016-01-01

    Background Short implants (< 10 mm) are one of the treatment options available in cases of limited vertical bone. A purpose of this paper is to evaluate the predictability of short implants as an alternative to technically molthough such implants are now widely used, there is controversy regarding their clinical reliability. There complex treatments in patients with atrophic maxillae, based on a systematic review of the literature and the analysis of the implant survival rates, changes in peri-implant bone level, and associated complications. It is postulated that short implants offer clinical results similar to those of longer implants. Material and Methods A Medline-PubMed search was made covering the period between January 2004 and December 2014 (both included). Studies in English published in indexed journals, involving at least 20 implants and with a follow-up period of at least 12 months were considered. A manual search in four high impact journals was also conducted. Results A total of 37 studies meeting the inclusion criteria were included in this review. 9792 implants placed in over 5000 patients were analyzed. Conclusions Based on the results of this review, short implants are seen to offer clinical results in terms of survival, bone loss and complications similar to those of longer implants. Key words:Survival rate, clinical results, dental implants, oral implants, short implants, short lengt PMID:26946199

  16. Wear study of Total Ankle Replacement explants by microstructural analysis.

    PubMed

    Cottrino, S; Fabrègue, D; Cowie, A P; Besse, J-L; Tadier, S; Gremillard, L; Hartmann, D J

    2016-08-01

    The implantation of Total Ankle Replacement (TAR) prostheses generally gives satisfactory results. However, a high revision rate is associated with the Ankle Evolutive System (AES) implant, due to periprosthetic osteolysis that generates significant cortical lesions and bone cysts in the periprosthetic region. Radioclinical and histological analyses of peri-implant tissues show the presence of numerous foreign particles that may come from the implant. It is known that a precocious wear of materials may lead to an important rate of foreign body in tissues and may generate osteolysis lesions and inflammatory reactions. Thus the objectives of this retrospective study of 10 AES TAR implants (recovered after revision surgeries) are to understand how the prostheses wear out, which part is the most stressed and to determine the nature and size of foreign body particles. A better understanding of friction mechanisms between the three parts of the implant and of the nature and morphology of foreign particles generated was needed to explain the in vivo behavior of the implant. This was achieved using microstuctural and tomographic analysis of both implants parts and periprosthetic tissues. PMID:26807869

  17. Method For Silicon Surface Texturing Using Ion Implantation

    SciTech Connect

    Kadakia, Nirag; Naczas, Sebastian; Bakhru, Hassaram; Huang Mengbing

    2011-06-01

    As the semiconductor industry continues to show more interest in the photovoltaic market, cheaper and readily integrable methods of silicon solar cell production are desired. One of these methods - ion implantation - is well-developed and optimized in all commercial semiconductor fabrication facilities. Here we have developed a silicon surface texturing technique predicated upon the phenomenon of surface blistering of H-implanted silicon, using only ion implantation and thermal annealing. We find that following the H implant with a second, heavier implant markedly enhances the surface blistering, causing large trenches that act as a surface texturing of c-Si. We have found that this method reduces total broadband Si reflectance from 35% to below 5percent;. In addition, we have used Rutherford backscattering/channeling measurements investigate the effect of ion implantation on the crystallinity of the sample. The data suggests that implantation-induced lattice damage is recovered upon annealing, reproducing the original monocrystalline structure in the previously amorphized region, while at the same time retaining the textured surface.

  18. Implant-retained auricular prostheses: a clinical challenge.

    PubMed

    Arora, V; Sahoo, N K; Gopi, A; Saini, D K

    2016-05-01

    Microtia, malformation, deformity, and partial or complete loss of the pinna may be due to various congenital or acquired factors. In adult patients, surgical reconstruction of the missing pinna is difficult and the results are often far from satisfactory. An implant-retained auricular prosthesis is a suitable alternative. A retrospective study of eight patients treated with implant-retained auricular prostheses was performed. For each missing pinna, three titanium implants were placed in the temporal bone. After 6 months of osseointegration, the implants were loaded. Four cases were rehabilitated with a magnet-retained prosthesis and the remaining four with a bar and clip retained prosthesis. There were six male and two female patients with an average age of 30.62 years. Seven patients had unilateral absence of the pinna and one had bilateral absence. The loss was due to trauma in four patients and to burn in one patient, and three had congenital absence. A total 27 implants were placed, 12 on the right side and 15 on the left. The average post-rehabilitation follow-up was 21 months. Peri-implant tissue reactions were observed at two sites. The implant-retained auricular prosthesis is an alternative treatment approach with good retention and patient satisfaction. Long-term follow-up is required to assess delayed complications. PMID:26792146

  19. Retrospective study of sintered porous-surfaced dental implants placed in the augmented sinus.

    PubMed

    Sohn, Dong-Seok; Lee, Jae-Mok; Park, In-Sook; Jung, Heui-Seung; Park, Do-Young; Shin, Im-Hee

    2014-01-01

    The purpose of this study was to analyze clinical and radiographic outcomes of sintered porous-surfaced dental implants placed in partially edentulous posterior maxillae. The study group consisted of 42 partially edentulous patients who received sinus augmentation using the lateral window technique or crestal approach at Catholic University Hospital of Daegu and one private clinic. The 42 patients received a total of 92 sintered porous-surfaced dental implants in the edentulous posterior maxillae. All implants were restored with fixed prostheses. Of the 92 implants, 17 implants were restored with individual (nonsplinted) crowns, while 75 implants were splinted to other implants. Panoramic views and periapical radiographs using the standardized long-cone paralleling technique were taken at the first visit, postoperatively, at the time of prosthesis seating, and at a follow-up visit. Survival rates of implants in relation to location, length, diameter, crown-to-implant (C/I) ratio, and type of prosthesis were investigated. Statistical data were analyzed using software with the chi-square test. Of the 92 implants, 8 (8.7%) were removed, and the cumulative survival rate was 91.3% after a maximum 9-year functional period (mean: 72.8 months; range: 11 to 107 months). There were no statistical differences in relation to the location of implants, C/I ratio, or type of prosthesis. However, there were statistical differences in relation to the length and diameter of implants. Average crestal bone loss was 0.68 mm at 1-year follow-up and 1.13 mm at final examination. All implants were inserted in the augmented maxillary sites. The cumulative survival rate of sintered porous-surfaced implants in posterior maxillae was 91.3%. Sintered porous-surfaced implants showed satisfactory results in the edentulous posterior maxillae. PMID:25006774

  20. The self-tapping and ICE 3i implants: a prospective 3-year multicenter evaluation.

    PubMed

    Davarpanah, M; Martinez, H; Tecucianu, J F; Alcoforado, G; Etienne, D; Celletti, R

    2001-01-01

    This multicenter prospective clinical evaluation was undertaken to determine the therapeutic success and marginal bone level stability of 3i's self-tapping and ICE implants after 3 years of prosthetic loading. Between July 1995 and June 1996, 189 completely or partially edentulous patients were treated with 614 machined-surface screw-type commercially pure titanium implants (self-tapping or ICE). Two hundred seventy-seven self-tapping implants were placed in 85 patients (average age of 56 years), and 337 ICE implants were placed in 104 patients (average age of 61 years). A total of 360 implants (58.6%) were placed in posterior segments. Easier placement was reported with the ICE implant in normal or dense bone. For the self-tapping implants, survival rates of 92.9% and 91.6% were noted after 1 and 3 years of prosthetic loading, respectively. Survival rates of 95.4% and 93.8% were obtained with the ICE implant for the same periods. Late failures (after loading) were more common than early failures (before loading) for both types of implants. The marginal bone level of 238 self-tapping implants (85.9%) and of 307 ICE implants (91%) was radiographically evaluated at 3 years. Marginal bone level was at the first thread for 95.1% of implants. A loss of marginal bone level of 2 to 4 threads was noted for 4.9% of the evaluated implants. No implant showed bone loss greater than the fourth thread. Overall survival rates of 94.3% and 92.9% were obtained after 1 and 3 years of prosthetic loading, respectively, for 596 and 588 implants. PMID:11280362

  1. Effect of implant macro-design on primary stability: A prospective clinical study

    PubMed Central

    Lozano-Carrascal, Naroa; Salomó-Coll, Oscar; Gilabert-Cerdà, Marta; Farré-Pagés, Nuria; Hernández-Alfaro, Federico

    2016-01-01

    Background Implant restorations have become a high predictable treatment option. Several caracteristics such as surgical technique and implant design can influence the treatment outcomes. The aim of the present study was to evaluate the influence of implant macro-design on primary stability measured with resonance frequency analysis (RFA) and insertion torque (IT). Material and Methods A total of 47 implants divided in two groups: Test group (TI): 22 Tapered MIS® Seven implants; Control group (CI): 25 cylindrical Astra® Osseospeed implants. All implants were inserted following the manufacturers’ standard protocols. Implant primary stability was measured at the moment of implant placement by registering insertion torque values (ITv) and ISQ values by means of Osstell™ Mentor (ISQv) (Integration Diagnostic Ltd., Goteborg, Sweden). Results In the mandible, mean ISQv for tapered implants (TI) was 71.67±5.16 and for cylindrical implants (CI) 57.15±4.83 (p=0.01). Mean insertion torque was 46.67±6.85 Ncm for TI and 35.77±6.72 Ncm for CI (p=0.01). In the maxilla, mean ISQ was 67.2±4.42 for tapered implants and 49.17±15.30 for cylindrical implants (p=0.01). Mean insertion torque for TI was 41.5±6.26 Ncm and for CI 39.17±6.34 Ncm (p>0.05). For tapered implants, no correlation could be found between implant diameter and primary stability. But for cylindrical implants there was a statistically significant correlation between implant diameter and primary stability: ITv (p=0.03); ISQv (p=0.04). Conclusions Within the limits of the present study, tapered shaped implants achieve higher primary stability measured through ISQ and insertion torque values. Moreover, for cylindrical implants positive correlation has been established between implant diameter and primary stability. Key words:Primary stability, tapered, cylindrical, conical, implant macro-design. PMID:26827067

  2. A Regenerative Approach to the Successful Treatment of Peri-implantitis: A Consecutive Series of 170 Implants in 100 Patients with 2- to 10-Year Follow-up.

    PubMed

    Froum, Stuart J; Froum, Scott H; Rosen, Paul S

    2015-01-01

    This article presents the results of a consecutive case series of 170 treated peri-implantitis-affected implants in 100 patients with follow-up measurements from 2 to 10 years. A total of 51 implants in 38 patients previously reported on were followed for an additional 2.5 years, and 119 additional implants in 62 additional patients were treated with the same protocol and monitored for at least 2 years posttreatment. The treatment consisted of flap reflection, surface decontamination, use of enamel matrix derivative (EMD) or platelet-derived growth factor (PDGF), and guided bone regeneration with mineralized freezedried bone and/or anorganic bovine bone combined with PDGF or EMD and covered with an absorbable membrane and/or subepithelial connective tissue graft. Maintenance and monitoring followed every 2 to 3 months. Two implants were lost 6 months posttreatment, for a 98.8% survival rate. Bleeding on probing was eliminated in 91% of the treated implants. Probing depth reduction averaged 5.10 mm, bone level gain averaged 1.77 mm, and soft tissue marginal gain averaged 0.52 mm. These outcomes were obtained with one surgical procedure on 140 implants, with two procedures on 18 implants, and with three procedures on 10 implants. The results to date with this layered/combined regenerative approach for the treatment of peri-implantitis appear to be encouraging. PMID:26509990

  3. Hydrogenation of Zr-2.5Nb alloy after plasma-immersion titanium implantation

    NASA Astrophysics Data System (ADS)

    Sutygina, A. N.; Kashkarov, E. B.; Nikitenkov, N. N.; Tyurin, Yu I.; Syrtanov, M. S.

    2016-02-01

    The study results of the influence of plasma-immersion ion implantation of titanium in Zr-2.5Nb on hydrogenation are presented. The titanium implantation was carried out in two modes: with active plasma filtering (APF) and passive plasma filtering (PPF). The results of total hydrogen concentration, absorption rate, XRD analyses and depth distribution of elements revealed that modified surface layer after titanium ion implantation is formed hydrogen diffusion barrier reduces hydrogen absorption by Zr-2.5Nb.

  4. Bioactive macroporous titanium implants highly interconnected.

    PubMed

    Caparrós, Cristina; Ortiz-Hernandez, Mónica; Molmeneu, Meritxell; Punset, Miguel; Calero, José Antonio; Aparicio, Conrado; Fernández-Fairén, Mariano; Perez, Román; Gil, Francisco Javier

    2016-10-01

    Intervertebral implants should be designed with low load requirements, high friction coefficient and low elastic modulus in order to avoid the stress shielding effect on bone. Furthermore, the presence of a highly interconnected porous structure allows stimulating bone in-growth and enhancing implant-bone fixation. The aim of this study was to obtain bioactive porous titanium implants with highly interconnected pores with a total porosity of approximately 57 %. Porous Titanium implants were produced by powder sintering route using the space holder technique with a binder phase and were then evaluated in an in vivo study. The size of the interconnection diameter between the macropores was about 210 μm in order to guarantee bone in-growth through osteblastic cell penetration. Surface roughness and mechanical properties were analyzed. Stiffness was reduced as a result of the powder sintering technique which allowed the formation of a porous network. Compression and fatigue tests exhibited suitable properties in order to guarantee a proper compromise between mechanical properties and pore interconnectivity. Bioactivity treatment effect in novel sintered porous titanium materials was studied by thermo-chemical treatments and were compared with the same material that had undergone different bioactive treatments. Bioactive thermo-chemical treatment was confirmed by the presence of sodium titanates on the surface of the implants as well as inside the porous network. Raman spectroscopy results suggested that the identified titanate structures would enhance in vivo apatite formation by promoting ion exchange for the apatite formation process. In vivo results demonstrated that the bioactive titanium achieved over 75 % tissue colonization compared to the 40 % value for the untreated titanium. PMID:27582071

  5. Compensating for poor primary implant stability in different bone densities by varying implant geometry: a laboratory study.

    PubMed

    Möhlhenrich, S C; Heussen, N; Elvers, D; Steiner, T; Hölzle, F; Modabber, A

    2015-12-01

    The aim of this study was to determine the influence of implant diameter and length on primary stability in artificial bone blocks. In total, 240 implants of various diameters (Ø 3.3, 4.1, and 4.8mm) and lengths (8 and 12 mm) were inserted in four artificial bone blocks of different densities (D1-D4). The primary stability for each bone block density was measured and compared with the primary stability of a narrow and short implant (Ø 3.3mm, length 8mm) in the next higher density block. Analysis was done by three-way ANOVA, and mean differences were determined with the 95% confidence interval. Levels of primary stability achieved by choosing the next higher diameter or length were not comparable to those of the next level of block density. However, equivalent values could be achieved by selecting the largest diameter for short and long implants in the lowest block density D4, as well as for long implants in bone type D2. The diameter of an implant has greater influence on primary stability than length. In particular, in the case of poor bone quality, a variation of implant geometry can lead to significant improvement in primary stability. PMID:26362488

  6. Implant-connected versus tooth-connected implant-supported partial dentures: 2-year clinical and radiographic comparative evaluation.

    PubMed

    Mostafa, Tamer Mohamed; El-Sheikh, Mohamed M; Abd El-Fattah, Fadel

    2015-01-01

    The purpose of this study was to clinically and radiographically compare implant-connected and tooth-connected implant-supported fixed-detachable mandibular partial dentures. Twenty partially edentulous patients (age range: 25 to 50 years) with mandibular Kennedy Class II configurations were equally divided into two groups receiving a three-unit, fixed-detachable, screw-retained partial denture. Group 1 comprised patients with unilateral missing mandibular molars and premolars. Two implants were placed at the mandibular first premolar and first molar areas. Group 2 comprised patients with missing mandibular molars and second premolars. An implant was placed at the mandibular first molar area, the first premolar was prepared, and a coping was cemented to the tooth with permanent cement. Each case was evaluated clinically and radiographically at baseline (partial denture insertion) and after 6, 12, and 24 months. Data were collected and statistically analyzed using repeated-measures one-way and two-way analysis of variance tests. There was no statistically significant difference between the two groups (P > .05). The implant-tooth-supported prosthesis provided an equally predictable treatment option compared to the totally implant-supported prosthesis in terms of implant survival and loss of marginal bone. PMID:25909533

  7. Novel metallic implantation technique for osteochondral defects of the medial talar dome

    PubMed Central

    van Bergen, Christiaan J A

    2010-01-01

    Background and purpose A metallic inlay implant (HemiCAP) with 15 offset sizes has been developed for the treatment of localized osteochondral defects of the medial talar dome. The aim of this study was to test the following hypotheses: (1) a matching offset size is available for each talus, (2) the prosthetic device can be reproducibly implanted slightly recessed in relation to the talar cartilage level, and (3) with this implantation level, excessive contact pressures on the opposite tibial cartilage are avoided. Methods The prosthetic device was implanted in 11 intact fresh-frozen human cadaver ankles, aiming its surface 0.5 mm below cartilage level. The implantation level was measured at 4 margins of each implant. Intraarticular contact pressures were measured before and after implantation, with compressive forces of 1,000–2,000 N and the ankle joint in plantigrade position, 10° dorsiflexion, and 14° plantar flexion. Results There was a matching offset size available for each specimen. The mean implantation level was 0.45 (SD 0.18) mm below the cartilage surface. The defect area accounted for a median of 3% (0.02–18) of the total ankle contact pressure before implantation. This was reduced to 0.1% (0.02–13) after prosthetic implantation. Interpretation These results suggest that the implant can be applied clinically in a safe way, with appropriate offset sizes for various talar domes and without excessive pressure on the opposite cartilage. PMID:20515434

  8. A technique to prevent dural adhesions to chronically implanted microelectrode arrays.

    PubMed

    Maynard, E M; Fernandez, E; Normann, R A

    2000-04-15

    Minimizing relative movements between neural tissues and arrays of microelectrodes chronically implanted into them is expected to greatly enhance the capacity of the microelectrodes to record from single cortical neurons on a long-term basis. We describe a new surgical technique to minimize the formation of adhesions between the dura and an implanted electrode array using a 12 microm (0.5 mil) thick sheet of Teflon film positioned between the array and the dura. A total of 15 cats were implanted using this technique. Gross examination of 12 implant sites at the time of sacrifice failed to find evidence of adhesions between the arrays and the dura when the Teflon(R) film remained in its initial position. In six implants from which recordings were made, an average of nine of the 11 (81%) connected electrodes in each array recorded evoked neural activity after 180 days post implantation. Further, on average, two separable units were identified on each of the implanted electrodes in these arrays. No significant change was found in the density of cell bodies around implanted electrodes of four of the implanted electrode arrays. However, histological evaluation of the implant sites revealed evidence of meningeal proliferation beneath the arrays. The technique described is shown to be effective at preventing adhesions between implanted electrode arrays and improve the characteristics of chronic recordings obtained with these structures. PMID:10788663

  9. Bone sialoprotein-coated femoral implants are osteoinductive but mechanically compromised.

    PubMed

    O'Toole, Gary C; Salih, E; Gallagher, C; FitzPatrick, D; O'Higgins, N; O'Rourke, S K

    2004-05-01

    Aseptic loosening of femoral implants in total hip replacement remains an unsolved orthopaedic problem. This paper investigates the potential role of bone sialoprotein (BSP) in enhancing bone-implant adherence. As BSP is osteoinductive in rat calvarial models, we investigated whether BSP is similarly osteoinductive when coated onto intramedullary femoral implants. BSP-coated titanium implants were implanted into the femur of female 'Wistar' rats (average weight 215 g) that were sacrificed at days 10, 20 and 30. Harvested femoral implants were subjected to pullout testing and then examined histologically. BSP-coated implants demonstrate osteoinduction when examined histologically. Plugging the femoral canal with BSP prior to inserting the implant neither increased implant pullout strengths nor further increased osteoblastic activity. This study has demonstrated for the first time that BSP is osteoinductive when coated onto femoral implants and inserted into bones subjected to mechanical loading. However, we found that pullout strengths are a function of implant surface topographical characteristics and are not affected by BSP coating or histological osteoinduction. PMID:15099646

  10. Piezosurgery in implant dentistry

    PubMed Central

    Stübinger, Stefan; Stricker, Andres; Berg, Britt-Isabelle

    2015-01-01

    Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible. This clinical overview gives a short summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in implant dentistry. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies. PMID:26635486

  11. Implants as absolute anchorage.

    PubMed

    Rungcharassaeng, Kitichai; Kan, Joseph Y K; Caruso, Joseph M

    2005-11-01

    Anchorage control is essential for successful orthodontic treatment. Each tooth has its own anchorage potential as well as propensity to move when force is applied. When teeth are used as anchorage, the untoward movements of the anchoring units may result in the prolonged treatment time, and unpredictable or less-than-ideal outcome. To maximize tooth-related anchorage, techniques such as differential torque, placing roots into the cortex of the bone, the use of various intraoral devices and/or extraoral appliances have been implemented. Implants, as they are in direct contact with bone, do not possess a periodontal ligament. As a result, they do not move when orthodontic/orthopedic force is applied, and therefore can be used as "absolute anchorage." This article describes different types of implants that have been used as orthodontic anchorage. Their clinical applications and limitations are also discussed. PMID:16463910

  12. Hormonal control of implantation.

    PubMed

    Sandra, Olivier

    2016-06-01

    In mammals, implantation represents a key step of pregnancy and its progression conditions not only the success of pregnancy but health of the offspring. Implantation requires a complex and specific uterine tissue, the endometrium, whose biological functions are tightly regulated by numerous signals, including steroids and polypeptide hormones. Endometrial tissue is endowed with dynamic properties that associate its ability to control the developmental trajectory of the embryo (driver property) and its ability to react to embryos displaying distinct capacities to develop to term (sensor property). Since dynamical properties of the endometrium can be affected by pre- and post-conceptional environment, determining how maternal hormonal signals and their biological actions are affected by environmental factors (e.g. nutrition, stress, infections) is mandatory to reduce or even to prevent their detrimental effects on endometrial physiology in order to preserve the optimal functionality of this tissue. PMID:27172870

  13. Sterilisation of implantable devices.

    PubMed

    Matthews, I P; Gibson, C; Samuel, A H

    1994-01-01

    The pathogenesis and rates of infection associated with the use of a wide variety of implantable devices are described. The multi-factorial nature of post-operative periprosthetic infection is outlined and the role of sterilisation of devices is explained. The resistance of bacterial spores is highlighted as a problem and a full description is given of the processes of sterilisation by heat, steam, ethylene oxide, low temperature steam and formaldehyde, ionising radiation and liquid glutaraldehyde. Sterility assurance and validation are discussed in the context of biological indicators and physical/chemical indicators. Adverse effects upon the material composition of devices and problems of process control are listed. Finally, possible optimisations of the ethylene oxide process and their potential significance to the field of sterilisation of implants is explored. PMID:10172076

  14. Diabetes and Oral Implant Failure

    PubMed Central

    Chrcanovic, B.R.; Albrektsson, T.; Wennerberg, A.

    2014-01-01

    The aim of this systematic review and meta-analysis was to investigate whether there are any effects of diabetes mellitus on implant failure rates, postoperative infections, and marginal bone loss. An electronic search without time or language restrictions was undertaken in March 2014. The present review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligibility criteria included clinical human studies. The search strategy resulted in 14 publications. The I2 statistic was used to express the percentage of total variation across studies due to heterogeneity. The inverse variance method was used for the random effects model when heterogeneity was detected or for the fixed effects model when heterogeneity was not detected. The estimates of an intervention for dichotomous outcomes were expressed in risk ratio and in mean difference in millimeters for continuous outcomes, both with a 95% confidence interval. There was a statistically significant difference (p = .001; mean difference = 0.20, 95% confidence interval = 0.08, 0.31) between diabetic and non-diabetic patients concerning marginal bone loss, favoring non-diabetic patients. A meta-analysis was not possible for postoperative infections. The difference between the patients (diabetic vs. non-diabetic) did not significantly affect implant failure rates (p = .65), with a risk ratio of 1.07 (95% confidence interval = 0.80, 1.44). Studies are lacking that include both patient types, with larger sample sizes, and that report the outcome data separately for each group. The results of the present meta-analysis should be interpreted with caution because of the presence of uncontrolled confounding factors in the included studies. PMID:24928096

  15. Sputtering studies during lanthanum implantation in stainless steels

    NASA Astrophysics Data System (ADS)

    Ager, F. J.; Respaldiza, M. A.; Soares, J. C.; da Silva, M. F.; Odriozola, J. A.

    1997-05-01

    Lanthanum ions of 100 keV have been implanted in AISI304 specimens at different doses. The erosion or sputtering of the surface atoms, either from the steel matrix or already implanted, during the implantation process imposes a limitation on the maximum implantable dose. Hoping to increase this dose, we deposited thin layers of aluminium and alumina (Al 2O 3) on top of steel samples of similar composition and sputtering behaviour (AISI302), as the sputtering effect is much weaker on such species and this layer could also prevent the steel atoms from being removed from the surface. The experimental determination of the sputtering coefficients, total or partial, and its comparison with theoretical values, when possible, is another aim of this work.

  16. Miniature implantable ultrasonic echosonometer

    NASA Technical Reports Server (NTRS)

    Kojima, G. K. (Inventor)

    1978-01-01

    A miniature echosonometer adapted for implantation in the interior of an animal for imaging the internal structure of a organ, tissue or vessel is presented. The echosonometer includes a receiver/transmitter circuit which is coupled to an ultrasonic transducer. Power is coupled to the echosonometer by electromagnetic induction through the animal's skin. Imaging signals from the echosonometer are electromagnetically transmitted through the animal's skin to an external readout apparatus.

  17. [Neurotology and cochlear implants].

    PubMed

    Merchán, Miguel A

    2015-05-01

    In this review we analyse cochlear implantation in terms of the fundamental aspects of the functioning of the auditory system. Concepts concerning neuronal plasticity applied to electrical stimulation in perinatal and adult deep hypoacusis are reviewed, and the latest scientific bases that justify early implantation following screening for congenital deafness are discussed. Finally, this review aims to serve as an example of the importance of fostering the sub-specialty of neurotology in our milieu, with the aim of bridging some of the gaps between specialties and thus improving both the knowledge in the field of research on auditory pathologies and in the screening of patients. The objectives of this review, targeted above all towards specialists in the field of otorhinolaryngology, are to analyse some significant neurological foundations in order to reach a better understanding of the clinical events that condition the indications and the rehabilitation of patients with cochlear implants, as well as to use this means to foster the growth of the sub-specialty of neurotology. PMID:25912703

  18. [Permanent pacemaker implantation. Indications and results].

    PubMed

    Gutiérrez, A; Iturralde, P; Gutiérrez Fuster, E; Martínez Ríos, N; Martínez Ríos, M A; Romero, L; Hernández, D; González Hermosillo, J A

    1990-01-01

    Clinical, laboratory and electrocardiographic data from 608 patients with permanent pacemakers implanted over a period of 8 years, were evaluated retrospectively. The number of implants was greater in males (56.5%) and in patients over 60 years of age (77.5%). Atherosclerosis was the most common disease found in this group (50%). Syncope occurred in 96.2% of the cases; and complete AV block was the most common electrocardiographic alteration (50.5%). Electrode displacement occurred in 32 patients (5.2%) and was the most commonly found early complication. Among the late complications, 10.3% of the patients had infections in the area of the generator. The total mortality was 7.7% due to the heart disease rather than pacemaker-related complication. PMID:2344227

  19. Surface characteristics of a novel hydroxyapatite-coated dental implant

    PubMed Central

    Jung, Ui-Won; Hwang, Ji-Wan; Choi, Da-Yae; Hu, Kyung-Seok; Kwon, Mi-Kyung; Choi, Seong-Ho

    2012-01-01

    Purpose This study evaluated the surface characteristics and bond strength produced using a novel technique for coating hydroxyapatite (HA) onto titanium implants. Methods HA was coated on the titanium implant surface using a super-high-speed (SHS) blasting method with highly purified HA. The coating was performed at a low temperature, unlike conventional HA coating methods. Coating thickness was measured. The novel HA-coated disc was fabricated. X-ray diffraction analysis was performed directly on the disc to evaluate crystallinity. Four novel HA-coated discs and four resorbable blast medium (RBM) discs were prepared. Their surface roughnesses and areas were measured. Five puretitanium, RBM-treated, and novel HA-coated discs were prepared. Contact angle was measured. Two-way analysis of variance and the post-hoc Scheffe's test were used to analyze differences between the groups, with those with a probability of P<0.05 considered to be statistically significant. To evaluate exfoliation of the coating layer, 7 sites on the mandibles from 7 mongrel dogs were used. Other sites were used for another research project. In total, seven novel HA-coated implants were placed 2 months after extraction of premolars according to the manufacturer's instructions. The dogs were sacrificed 8 weeks after implant surgery. Implants were removed using a ratchet driver. The surface of the retrieved implants was evaluated microscopically. Results A uniform HA coating layer was formed on the titanium implants with no deformation of the RBM titanium surface microtexture when an SHS blasting method was used. Conclusions These HA-coated implants exhibited increased roughness, crystallinity, and wettability when compared with RBM implants. PMID:22586524

  20. Bisphosphonate treatment and dental implants: A systematic review

    PubMed Central

    de-Freitas, Nayara-Ribeiro; de-Moura, Marcos-Boaventura; Veloso-Guedes, Cizelene-do-Carmo-Faleiros; Simamoto-Júnior, Paulo-César; de-Magalhães, Denildo

    2016-01-01

    Background To analyze articles that studied patients submitted to diphosphonates therapy and who received dental implants before, during or after bisphosphonate (BP) treatment, compared to healthy patients, analyzing the increase of failure and loss of implants or bisphosphonate related osteonecrosis of the jaw (BRONJ) incidence. Material and Methods The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was used in this study. The clinical question in “PICO” format was: In patients under bisphosphonate therapy, do dental implants placement, compared to healthy patients, increase the failure and loss of implants or bisphosphonate related osteonecrosis of the jaw incidence? PubMed/MEDLINE was searched for articles published up until April 15, 2015 using a combination of MeSH terms and their Entry terms. Results The search resulted in 375 articles. After selection according to the eligibility criteria, 15 studies fulfilled were included (eight retrospective, one prospective and six case series), with a total of 1339 patients analyzed, 3748 implants placed, 152 loss of implants and 78 cases of BRONJ. Conclusions Due to the lack of randomized clinical trials looking at this theme, further studies with longer follow-up are needed to elucidate the remaining questions. Thus, it is wise to be careful when planning dental implant surgery in patients undergoing bisphosphonate therapy because of the risk of developing BRONJ as well as occurring failure of implant. Moreover, complete systemic condition of the patient must be also taking into considering when such procedures are performed. Key words:Bisphosphonates, diphosphonates, dental implants, osteonecrosis. PMID:27475681

  1. Factors associated with implant recommendation for single-tooth replacement.

    PubMed

    Al-Shammari, Khalaf F; Al-Ansari, Jassem M; Al-Khabbaz, Areej K; Nociti, Francisco H; Wang, Hom-Lay

    2005-06-01

    The use of dental implants for single-tooth replacement has been established as a predictable treatment option; yet, limited data are available as to how frequently this option is recommended to patients. The aim of the present study was to examine the frequency of implant recommendation by general dental practitioners after single-tooth extraction and factors influencing their decision to recommend an implant. All single-tooth extractions performed in 26 general dental practice clinics in Kuwait over a 30-day period were examined. Dentists in these centers used the study form to record demographic data, the type of tooth extracted, reason for extraction, and replacement options presented to the patients. Univariate and logistic regression analyses were used to examine associations between background factors and decisions to recommend implant therapy. A total of 1367 patients (mean age, 37.9 +/- 11.8 years) had an extraction of one tooth during the study period. Forty-three patients were offered implants as a replacement option (3.3% of the total sample; 8.6% of patients who were offered tooth replacement options). Factors associated significantly with the recommendation of an implant by Kuwaiti dentists to their patients included younger age, regular dental maintenance visits, and adequate oral hygiene practices (P < 0.05; binary logistic regression). Dental implant recommendation for single-tooth replacement in the present sample of dentists was low. Factors associated significantly with dentist recommendation of an implant for single-tooth replacement included age, history of dental maintenance, and oral hygiene practices. PMID:15968193

  2. Short implants: are they a viable option in implant dentistry?

    PubMed

    Schwartz, Steven Richard

    2015-04-01

    Short-length implants (<10 mm) can be used effectively in atrophic maxillae or mandibles even with crown/implant ratios that previously would have been considered excessive. Short implants can support either single or multiple units and can be used for fixed prostheses or overdentures. The use of short-length implants may avoid the need for complicated bone augmentation procedures, thus allowing patients who were either unwilling or unable for financial or medical reasons to undergo these advanced grafting techniques to be adequately treated. PMID:25835796

  3. Risk Factors Associated With Complication Rates of Becker-Type Expander Implants in Relation to Implant Survival: Review of 314 Implants in 237 Patients.

    PubMed

    Taboada-Suarez, Antonio; Brea-García, Beatriz; Magán-Muñoz, Fernando; Couto-González, Iván; González-Álvarez, Eduardo

    2015-12-01

    Although autologous tissue reconstruction is the best option for breast reconstruction, using implants is still a reliable and simple method, offering acceptable aesthetic results. Becker-type implants are permanent implants that offer a 1-stage reconstructive option. A retrospective study was carried out in our center reviewing the clinical reports of 237 patients, in whom a total of 314 Becker-type prostheses were implanted. Overall survival was calculated using a Kaplan-Meier estimate. Cox proportional hazard models were used to calculate adjusted hazard ratios. At the end of the study, 214 expanders (68.15%) presented no complications, 40 (12.47%) developed significant capsular contracture, in 27 (8.60%) infection occurred, 24 (7.64%) suffered minor complications, and 9 (2.87%) ruptured. The mean survival time of the expanders was 120.41 months (95% CI: 109.62, 131.19). Radiotherapy, chemotherapy, high Molecular Immunology Borstel, age, mastectomy performed previously to the implant, ductal carcinoma, advanced tumoral stage, experience of the surgeon, and Becker 35-type implants were significantly related to a high number of complications in relation to the survival of the implants. Cox regression analysis revealed that the main risk factors for the survival of expander implants included radiotherapy and surgeon experience. The complication hazard ratio or relative risk caused by these 2 factors was 1.976 and 1.680, respectively. One-stage reconstruction using Becker-type expanders is an appropriate, simple, and reliable option in delayed breast reconstruction in patients who have not received radiotherapy and as long as the procedure is carried out by surgeons skilled in the technique. PMID:25003425

  4. Total ankle arthroplasty with severe preoperative varus deformity.

    PubMed

    Hanselman, Andrew E; Powell, Brian D; Santrock, Robert D

    2015-04-01

    Advancements in total ankle arthroplasty (TAA) over the past several decades have led to improved patient outcomes and implant survivorship. Despite these innovations, many implant manufacturers still consider a preoperative coronal plane deformity greater than 10° a relative contraindication to TAA. Without proper intraoperative alignment, these implants may experience abnormal wear and hardware failure. Correcting these deformities, often through the use of soft tissue procedures and/or osteotomies, not only increases the difficulty of a case, but also the intraoperative time and radiation exposure. The authors report a case in which a 54-year-old man with a severe right ankle varus deformity of 29° underwent successful TAA using the INBONE II Prophecy total ankle system (Wright Medical Technology, Inc, Memphis, Tennessee) and additional soft tissue reconstruction. Intraoperatively, the patient's coronal deformity was corrected to 1.8°. At 8 months postoperatively, the patient ambulated without restriction and had substantial improvement in validated patient outcome scores, specifically the Academy of Orthopaedic Surgeons Foot and Ankle Module and the Short Form Health Survey-12 This unique report documents the first time that this particular implant, with an exclusive preoperative computed tomography-derived patient-specific guide, has been used effectively for a severe preoperative varus deformity greater than 20° without the need for an osteotomy. Future studies should be directed toward the prospective evaluation of different total ankle implant systems and their outcomes with severe coronal plane deformity, specifically computed tomography-derived patient-specific guided implants. PMID:25901630

  5. 21 CFR 874.3495 - Total ossicular replacement prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Total ossicular replacement prosthesis. 874.3495 Section 874.3495 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... be implanted for the total functional reconstruction of the ossicular chain and facilitates...

  6. 21 CFR 874.3495 - Total ossicular replacement prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Total ossicular replacement prosthesis. 874.3495 Section 874.3495 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... be implanted for the total functional reconstruction of the ossicular chain and facilitates...

  7. 21 CFR 874.3495 - Total ossicular replacement prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Total ossicular replacement prosthesis. 874.3495 Section 874.3495 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... be implanted for the total functional reconstruction of the ossicular chain and facilitates...

  8. 21 CFR 874.3495 - Total ossicular replacement prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Total ossicular replacement prosthesis. 874.3495 Section 874.3495 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... be implanted for the total functional reconstruction of the ossicular chain and facilitates...

  9. 21 CFR 874.3495 - Total ossicular replacement prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Total ossicular replacement prosthesis. 874.3495 Section 874.3495 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... be implanted for the total functional reconstruction of the ossicular chain and facilitates...

  10. [Actuality with the breast implants].

    PubMed

    Duchateau, J

    2013-09-01

    The author presents the history of breast implants, and the modern evolution where breast implants are largely used in both cosmetic and reconstructive surgery. Breast augmentation is one of the most performed cosmetic procedures, with a high satisfaction rate. However, one needs to remind that breast implants have a limited duration of life. The estimated rate of breast implant rupture after 10 years is of 10% in the current literature, This rate will probably become lower with the new more cohesive implants recently available on the market. It is therefore essential to propose a regular follow-up to all patients having breast implants. This follow-up is performed using a combination of physical examination, mammograms, ultrasound and MRI. The more specific therapeutic approach for patients having a PIP prosthesis will also be discussed. PMID:24195240

  11. The learning curve associated with the introduction of the subcutaneous implantable defibrillator

    PubMed Central

    Knops, Reinoud E.; Brouwer, Tom F.; Barr, Craig S.; Theuns, Dominic A.; Boersma, Lucas; Weiss, Raul; Neuzil, Petr; Scholten, Marcoen; Lambiase, Pier D.; Leon, Angel R.; Hood, Margaret; Jones, Paul W.; Wold, Nicholas; Grace, Andrew A.; Olde Nordkamp, Louise R.A.; Burke, Martin C.

    2016-01-01

    Aims The subcutaneous implantable cardioverter defibrillator (S-ICD) was introduced to overcome complications related to transvenous leads. Adoption of the S-ICD requires implanters to learn a new implantation technique. The aim of this study was to assess the learning curve for S-ICD implanters with respect to implant-related complications, procedure time, and inappropriate shocks (IASs). Methods and results In a pooled cohort from two clinical S-ICD databases, the IDE Trial and the EFFORTLESS Registry, complications, IASs at 180 days follow-up and implant procedure duration were assessed. Patients were grouped in quartiles based on experience of the implanter and Kaplan–Meier estimates of complication and IAS rates were calculated. A total of 882 patients implanted in 61 centres by 107 implanters with a median of 4 implants (IQR 1,8) were analysed. There were a total of 59 patients with complications and 48 patients with IAS. The complication rate decreased significantly from 9.8% in Quartile 1 (least experience) to 5.4% in Quartile 4 (most experience) (P = 0.02) and non-significantly for IAS from 7.9 to 4.8% (P = 0.10). Multivariable analysis demonstrated a hazard ratio of 0.78 (P = 0.045) for complications and 1.01 (P = 0.958) for IAS. Dual-zone programming increased with experience of the individual implanter (P < 0.001), which reduced IAS significantly in the multivariable model (HR 0.44, P = 0.01). Procedure time decreased from 75 to 65 min (P < 0.001). The complication rate and procedure time stabilized after Quartile 2 (>13 implants). Conclusion There is a short and significant learning curve associated with physicians adopting the S-ICD. Performance stabilizes after 13 implants. PMID:26324840

  12. Total Hip Joint Replacement Biotelemetry System

    NASA Technical Reports Server (NTRS)

    Boreham, J. F.; Postal, R. B.; Luntz, R. A.

    1981-01-01

    The development of a biotelemetry system that is hermetically sealed within a total hip replacement implant is reported. The telemetry system transmits six channels of stress data to reconstruct the major forces acting on the neck of the prosthesis and uses an induction power coupling technique to eliminate the need for internal batteries. The activities associated with the telemetry microminiaturization, data recovery console, hardware fabrications, power induction systems, electrical and mechanical testing and hermetic sealing test results are discussed.

  13. TOTAL CLIPLESS CHOLECYSTECTOMY BY MEANS OF HARMONIC SEALING

    PubMed Central

    RAMOS, Almino Cardoso; RAMOS, Manoela Galvão; GALVÃO-NETO, Manoel dos Passos; MARINS, Josemberg; BASTOS, Eduardo Lemos de Souza; ZUNDEL, Natan

    2015-01-01

    Background In traditional laparoscopic cholecistectomy, the cystic duct and artery are commonly closed by metallic clips just before their division. Although the placement of these clips for occluding cystic artery and duct can be considered safe, biliary leaks and bleeding may occur especially by its dislodgement. Aim To report a prospective case-series in total clipless cholecystectomy by means of harmonic shears for closure and division of the artery and cystic duct as well removal of the gallbladder from the liver. Methods Was evaluate a series of 125 patients who underwent laparoscopic cholecystectomy where the sealing and division of cystic artery and duct was carried out only by harmonic shears. The intact extracted gallbladder was submitted to a reverse pressure test for assessment of the technique safety by means of CO2 insuflation. Results The most common indication for surgery was gallstones. The mean operative time was 26 min and all gallbladders were dissected intact from the liver bed. There was no mortality and the overall morbidity rate was 0.8% with no hemorrhage or leaks. The reverse pressure test showed that all specimens support at least 36-mmHg of pressure without leaking. Conclusions The harmonic shears is effective and safe in laparoscopic cholecystectomy as a sole instrument for sealing and division of the artery and cystic duct. The main advantages could be related to the safety and decreased operative time. PMID:25861071

  14. Positron Implantation Profile in Kapton

    NASA Astrophysics Data System (ADS)

    Dryzek, J.; Dryzek, E.

    2006-11-01

    The discussion presented in the paper focuses on processes accompanying positron implantation in condensed matter. They finally constitute the positron implantation profile which generally does not exhibit the exponential behavior as it is concluded from the Monte Carlo simulation made using the EGSnrc 4.0 code. The simulation was performed for the kapton and two commonly used positron sources 22Na and 68Ge\\68Ga. New formula for the implantation profile was proposed.

  15. [Pre-implant esthetic study].

    PubMed

    Missika, P; Khayat, P

    1990-09-01

    The first dental prostheses used on Branemark implants were aesthetically disappointing both for the dentists and their patients. Therefore the authors will consider the various aesthetic problems encountered when treating loss of teeth with implant systems. The problems related to resorption are numerous: large bone losses are resolved by adapting removable acrylic, carrying out bone transplants immediately fixed by the implants, using filling materials, or complete dentures fixed with attachments supported by the implants. Periodontal surgery often provides a solution to the problem of gum visibility at the level of the maxillary anterior teeth. The problems related to the site where implants emerge can often be avoided by consultation between the surgeon and the prosthodontist and by flexing a surgical guide compiled from a pre-prosthetic analysis of the clinical situation. The aesthetic problems related to the actual implant systems are dependent on three factors: When the prosthesis is directly screwed onto the implant, the axis of the implant determines the axis of the dental prosthesis and can lead to the emergence of the screw on the buccal surface; With angulated cores, orientated screws provide the required solution. The implant material, when metallic leads to an unsightly border at the gingival level. Ceramic implants, or the "ceraming" of titanium, provide a solution to this problem. In case of diastema the use of an implant system gives the best choice in comparison to the more conventional treatments. In conclusion, the authors point out the importance of pre-implant analysis which must give an evaluation of the aesthetic result. The fragility of the aesthetic evaluation should encourage dentists to obtain the "clear and written consent" of their patients, accepting the risks run by treatment of this kind. PMID:2268774

  16. Bone regeneration over a poorly-positioned implant to correct an esthetic deformity: a case report.

    PubMed

    Fugazzotto, P A

    1993-11-01

    Guided tissue regeneration was employed to effect regeneration of a disfigured edentulous ridge, with a poorly positioned implant in place. Demineralized freeze dried bone and an expanded polytetrafluoroethylene membrane were utilized and resulted in growth of new, bone-like material in both a bucco-lingual and apico-occlusal dimension, totally submerging the unusable implant. PMID:8295097

  17. International Classification of Reliability for Implanted Cochlear Implant Receiver Stimulators

    PubMed Central

    Battmer, Rolf-Dieter; Backous, Douglas D.; Balkany, Thomas J.; Briggs, Robert J. S.; Gantz, Bruce J.; van Hasselt, Andrew; Kim, Chong Sun; Kubo, Takeshi; Lenarz, Thomas; Pillsbury, Harold C.; O’Donoghue, Gerard M.

    2016-01-01

    Objective To design an international standard to be used when reporting reliability of the implanted components of cochlear implant systems to appropriate governmental authorities, cochlear implant (CI) centers, and for journal editors in evaluating manuscripts involving cochlear implant reliability. Study Design The International Consensus Group for Cochlear Implant Reliability Reporting was assembled to unify ongoing efforts in the United States, Europe, Asia, and Australia to create a consistent and comprehensive classification system for the implanted components of CI systems across manufacturers. Setting All members of the consensus group are from tertiary referral cochlear implant centers. Interventions None. Main Outcome Measure A clinically relevant classification scheme adapted from principles of ISO standard 5841-2:2000 (1) originally designed for reporting reliability of cardiac pacemakers, pulse generators, or leads. Results Standard definitions for device failure, survival time, clinical benefit, reduced clinical benefit, and specification were generated. Time intervals for reporting back to implant centers for devices tested to be “out of specification,” categorization of explanted devices, the method of cumulative survival reporting, and content of reliability reports to be issued by manufacturers was agreed upon by all members. The methodology for calculating Cumulative survival was adapted from ISO standard 5841-2:2000 (1). Conclusion The International Consensus Group on Cochlear Implant Device Reliability Reporting recommends compliance to this new standard in reporting reliability of implanted CI components by all manufacturers of CIs and the adoption of this standard as a minimal reporting guideline for editors of journals publishing cochlear implant research results. PMID:20864879

  18. Implant biomaterials: A comprehensive review

    PubMed Central

    Saini, Monika; Singh, Yashpal; Arora, Pooja; Arora, Vipin; Jain, Krati

    2015-01-01

    Appropriate selection of the implant biomaterial is a key factor for long term success of implants. The biologic environment does not accept completely any material so to optimize biologic performance, implants should be selected to reduce the negative biologic response while maintaining adequate function. Every clinician should always gain a thorough knowledge about the different biomaterials used for the dental implants. This article makes an effort to summarize various dental bio-materials which were used in the past and as well as the latest material used now. PMID:25610850

  19. Graphene synthesis by ion implantation

    NASA Astrophysics Data System (ADS)

    Garaj, Slaven; Hubbard, William; Golovchenko, J. A.

    2010-11-01

    We demonstrate an ion implantation method for large-scale synthesis of high quality graphene films with controllable thickness. Thermally annealing polycrystalline nickel substrates that have been ion implanted with carbon atoms results in the surface growth of graphene films whose average thickness is controlled by implantation dose. The graphene film quality, as probed with Raman and electrical measurements, is comparable to previously reported synthesis methods. The implantation synthesis method can be generalized to a variety of metallic substrates and growth temperatures, since it does not require a decomposition of chemical precursors or a solvation of carbon into the substrate.

  20. Graphene synthesis by ion implantation.

    PubMed

    Garaj, Slaven; Hubbard, William; Golovchenko, J A

    2010-11-01

    We demonstrate an ion implantation method for large-scale synthesis of high quality graphene films with controllable thickness. Thermally annealing polycrystalline nickel substrates that have been ion implanted with carbon atoms results in the surface growth of graphene films whose average thickness is controlled by implantation dose. The graphene film quality, as probed with Raman and electrical measurements, is comparable to previously reported synthesis methods. The implantation synthesis method can be generalized to a variety of metallic substrates and growth temperatures, since it does not require a decomposition of chemical precursors or a solvation of carbon into the substrate. PMID:21124725

  1. Implantable medical devices MRI safe.

    PubMed

    Dal Molin, Renzo; Hecker, Bertrand

    2013-01-01

    Pacemakers, ICDs, neurostimulators like deep brain stimulator electrodes, spiral cord stimulators, insulin pumps, cochlear implants, retinal implants, hearing aids, electro cardio gram (ECG) leads, or devices in interventional MRI such as vascular guide wires or catheters are affected by MRI magnetic and electromagnetic fields. Design of MRI Safe medical devices requires computer modeling, bench testing, phantom testing, and animal studies. Implanted medical devices can be MRI unsafe, MRI conditional or MRI safe (see glossary). In the following paragraphs we will investigate how to design implanted medical devices MRI safe. PMID:23739365

  2. Graphene synthesis by ion implantation

    PubMed Central

    Garaj, Slaven; Hubbard, William; Golovchenko, J. A.

    2010-01-01

    We demonstrate an ion implantation method for large-scale synthesis of high quality graphene films with controllable thickness. Thermally annealing polycrystalline nickel substrates that have been ion implanted with carbon atoms results in the surface growth of graphene films whose average thickness is controlled by implantation dose. The graphene film quality, as probed with Raman and electrical measurements, is comparable to previously reported synthesis methods. The implantation synthesis method can be generalized to a variety of metallic substrates and growth temperatures, since it does not require a decomposition of chemical precursors or a solvation of carbon into the substrate. PMID:21124725

  3. Limitation of motion and shoulder disabilities in patients with cardiac implantable electronic devices.

    PubMed

    Findikoglu, Gulin; Yildiz, Bekir S; Sanlialp, Musa; Alihanoglu, Yusuf I; Kilic, Ismail D; Evregul, Harun; Senol, Hande

    2015-12-01

    The aim of this study is to investigate the presence of limitations in the shoulder range of motion (ROM) or the loss of upper extremity function on the affected side in patients with cardiac implantable electronic devices (CIEDs) with respect to the implantation time. Forty-nine patients (30 men and 19 women), mean age 64.84±11.18 years, who had been living with a CIED for less than 3 months were included in the short-term recipient (STR) group and 127 patients (85 men and 42 women), mean age 64.91±14.70 years, and with the device for longer than 3 months were included in the long-term recipients group. Shoulder ROMs were measured using a digital goniometer. The other arm was used as the control. The Constant-Murler Score, Shoulder Pain Disability Index, and Shoulder Disability Questionnaire were used to assess the functional status. Limitations of ROM for flexion, abduction, and internal rotation were found to be significantly lower in the arm on the side of CIED compared with the control arm. Significant differences in shoulder flexion, abduction, and external rotation in STRs were found compared with long-term recipient (P<0.05). However, the functional comparison of groups by the Constant-Murler Score was not significant. A low to moderate amount of shoulder disability measured by Shoulder Pain Disability Index and Shoulder Disability Questionnaire was found in patients with CIEDs, which was more prominent in STRs (P<0.05). Pain, association of CIED with pectoral muscles, a possible subtle ongoing capsular pathology, and avoidance behaviors of patients to minimize the risk of lead dislodgement might be related to restriction of motion and function in the shoulder joint in patients with CIEDs. PMID:26164799

  4. The use of IMZ osseointegrated implants in partially and completely edentulous patients: success and failure rates of 2,023 implant cylinders up to 60+ months in function.

    PubMed

    Fugazzotto, P A; Gulbransen, H J; Wheeler, S L; Lindsay, J A

    1993-01-01

    A total of 974 patients were treated with 2,023 IMZ implants. A variety of prosthodontic designs were utilized. These included replacement of single teeth, use as pier abutments, and for totally implant-supported prostheses. The implants were followed in function for 6 to 60+ months. Absolute success rates were 96.4% and 98.4% in the maxilla and mandible, respectively. Cumulative success rates at the end of the study were 92.9% and 95.8% in the maxilla and mandible, respectively. The use of an intramobile element is also discussed. PMID:8181823

  5. Cementless total hip arthroplasty.

    PubMed

    Morscher, E W

    1983-12-01

    The differences between prostheses fixed with and without cement are mainly in the design and nature of the surface implant. The shapes of the sockets to be implanted without cement show a wide variety: cylinder, square, conus, and ellipsoid with and without threads. The hemispheric shape, however, which was chosen for the acetabular component of the isoelastic hip joint, does not disturb the natural form and function of the hip joint since the outer surface is closely adapted to the original subchondral bone layer. The noncemented cup is secured by threads, pegs, screws, etc., and by ingrowth of bony tissue in the grooves of the surfaces. Most femoral stems are based on the self-locking principle. All prosthetic models incorporate attempts to increase the surface of the stem (ribs, wings, corrugations, rims, etc.). There is a tendency to use less rigid elastic implants instead of the well known rigid metallic prostheses. The aim is to overcome the problems of stress protection and stress concentration observed with rigid implants. For the biomechanical integration of an implant, the properties of the surface, especially macroporosity and microporosity, are important. Most European models of noncemented endoprostheses are based on macroporosity (porometal, madreporic, etc.). The increase in implant surface area achieved with macroscopic perforations and recesses is relatively minor compared with the possibilities offered by microporosity ("alumine fritée," Proplast, fiber-metal, etc.). The best indication for use of a cementless hip endoprosthesis is in revision arthroplasty. The lost bone stock is replaced by bone grafts, thereby creating a situation comparable with that of a primary arthroplasty. Clinical experience with noncemented hip endoprostheses is, to date, promising, although the observation time for most models is short. PMID:6357588

  6. Implantable medical sensor system

    DOEpatents

    Darrow, Christopher B.; Satcher, Jr., Joe H.; Lane, Stephen M.; Lee, Abraham P.; Wang, Amy W.

    2001-01-01

    An implantable chemical sensor system for medical applications is described which permits selective recognition of an analyte using an expandable biocompatible sensor, such as a polymer, that undergoes a dimensional change in the presence of the analyte. The expandable polymer is incorporated into an electronic circuit component that changes its properties (e.g., frequency) when the polymer changes dimension. As the circuit changes its characteristics, an external interrogator transmits a signal transdermally to the transducer, and the concentration of the analyte is determined from the measured changes in the circuit. This invention may be used for minimally invasive monitoring of blood glucose levels in diabetic patients.

  7. Broad beam ion implanter

    DOEpatents

    Leung, Ka-Ngo

    1996-01-01

    An ion implantation device for creating a large diameter, homogeneous, ion beam is described, as well as a method for creating same, wherein the device is characterized by extraction of a diverging ion beam and its conversion by ion beam optics to an essentially parallel ion beam. The device comprises a plasma or ion source, an anode and exit aperture, an extraction electrode, a divergence-limiting electrode and an acceleration electrode, as well as the means for connecting a voltage supply to the electrodes.

  8. Broad beam ion implanter

    DOEpatents

    Leung, K.N.

    1996-10-08

    An ion implantation device for creating a large diameter, homogeneous, ion beam is described, as well as a method for creating same, wherein the device is characterized by extraction of a diverging ion beam and its conversion by ion beam optics to an essentially parallel ion beam. The device comprises a plasma or ion source, an anode and exit aperture, an extraction electrode, a divergence-limiting electrode and an acceleration electrode, as well as the means for connecting a voltage supply to the electrodes. 6 figs.

  9. [Implantation of the zygote].

    PubMed

    Hicks Gómez, J J

    1990-01-01

    In order for implantation to occur, the endometrium must be adequately differentiated, a estate which results from the sequential interaction of progesterone and estrogens, and the local effects of prostaglandins and histamine. Nevertheless, the exact mechanism through which these hormones affect the uterus is not clearly understood. Recently it has been proposed the role of second messengers (cAMP.cGMP, inositol triphosphate and diacylglycerol) in this process. All these messengers are related with the intracellular mechanisms of proteic and steroid hormones action. PMID:2177440

  10. Suture materials affect peri-implant bone healing and implant osseointegration.

    PubMed

    Villa, Oscar; Lyngstadaas, Staale P; Monjo, Marta; Satué, Maria; Rønold, Hans J; Petzold, Christiane; Wohlfahrt, Johan C

    2015-09-01

    The aim of this study was to evaluate the effects of the remnants of two suture materials on osseointegration of titanium implants in a rabbit tibial model. Calibrated defects were prepared in the tibia of five Chinchilla rabbits. Filaments of nonresorbable (NR) nylon or resorbable (R) chitosan were placed at the bone to implant interface, whereas control sites had no suture material. After a healing period of 4 weeks, a pull-out test procedure was performed followed by enzymatic analyses of the wound fluid and relative quantification of mRNA levels for bone-related and cytokine markers from the peri-implant bone. A trend toward a reduced pull-out force was observed in the NR group (NR: 23.0 ± 12.8 N; R: 33.9 ± 11.3 N; control: 33.6 ± 24.0 N). Similarly, the bone resorption marker vacuolar type H+-ATPase was increased in the NR group compared with that in the control group (P = 0.041). The R group showed trends for lower alkaline phosphatase activity and osteocalcin expression and higher total protein content and RNA compared with the control group. In this submerged healing model, peri-implant bone healing was marginally affected by the two suture materials tested. However, there was a tendency toward better osseointegration and lower expression of bone resorption markers in the R group compared with the control group. PMID:26369486

  11. Screw vs cement-implant-retained restorations: an experimental study in the beagle. Part 2. Immunohistochemical evaluation of the peri-implant tissues.

    PubMed

    Assenza, Bartolomeo; Artese, Luciano; Scarano, Antonio; Rubini, Corrado; Perrotti, Vittoria; Piattelli, Maurizio; Thams, Ulf; San Roman, Fidel; Piccirilli, Marcello; Piattelli, Adriano

    2006-01-01

    Crestal bone loss has been reported to occur around dental implants. Even if the causes of this bone loss are not completely understood, the presence of a microgap between implant and abutment with a possible contamination of the internal portion of the implants has been suggested. The aim of this study was to see if there were differences in the vascular endothelial growth factor (VEGF) expression, microvessel density (MVD), proliferative activity (MIB-1), and inflammatory infiltrate in the soft tissues around implants with screwed and cemented abutments. Sandblasted and acid-etched implants were inserted in the mandibles of 6 Beagle dogs. Ten 3.5- x 10-mm root-form implants were inserted in each mandible. A total of 60 implants (30 with screwed abutments and 30 with cemented abutments) were used. After 12 months, all the bridges were removed and all abutments were checked for mobility. A total of 8 loosened screws (27%) were found in the screwed abutments, whereas no loosening was observed in cemented abutments. A gingival biopsy was performed in 8 implants with cemented abutments, in 8 implants with screwed abutments, and in 8 implants with unscrewed abutments. No statistically significant differences were found in the inflammatory infiltrate and in the MIB-1 among the different groups. No statistically significant difference was found in the MVD between screwed and cemented abutments (P = .2111), whereas there was a statistically significant difference in MVD between screwed and unscrewed abutments (P = .0277) and between cemented and unscrewed abutments (P = .0431). A low intensity of VEGF was prevalent in screwed and in cemented abutments, whereas a high intensity of VEGF was prevalent in unscrewed abutments. These facts could be explained by the effects induced, in the abutments that underwent a screw loosening, by the presence of bacteria inside the hollow portion of the implants or by enhanced reparative processes. PMID:16526575

  12. Peri-implant crevicular fluid levels of cathepsin-K, RANKL, and OPG around standard, short, and mini dental implants after prosthodontic loading

    PubMed Central

    Marakoğlu, İsmail; Haliloğlu, Seyfullah

    2015-01-01

    Purpose Despite the high success rates of endosseous dental implants, their placement is restricted according to the height and volume of bone available. The use of short or mini dental implants could be one way to overcome this limitation. Thus, this study aimed to compare standard, short, and mini dental implants with regard to associated clinical parameters and peri-implant crevicular fluid (PICF) levels of cathepsin -K (CTSK), RANK ligand (RANKL), and osteoprotegerin (OPG), after prosthodontic loading. Methods A total of 78 non-submerged implants (Euroteknika, Aesthetica+2, Sallanches, France) were installed in 30 subjects (13 male, 17 female; range, 26-62 years) who visited the clinic of the Periodontology Department, Faculty of Dentistry, Selcuk University. Sampling and measurements were performed on the loading date (baseline) and 2, 14, and 90 days after loading. Assessment of the peri-implant status for the implant sites was performed using the pocket probing depth (PPD), modified plaque index, modified gingival index, modified sulcular bleeding index, and radiographic signs of bone loss. PICF samples collected from each implant were evaluated for CTSK, RANKL, and OPG levels using the ELISA method. Keratinized tissue and marginal bone loss (MBL) were also noted. Results Clinical parameters statistically significantly increased in each group but did not show statistical differences between groups without PPD. Although implant groups showed a higher MBL in the upper jaw, only the standard dental group demonstrated a statistically significant difference. At 90 days, the OPG: sRANKL ratio and total amounts of CTSK for each group did not differ from baseline. Conclusions Within the limitations of this study, both short and mini dental implants were achieving the same outcomes as the standard dental implants in the early period after loading. PMID:26550525

  13. Two-Year Success Rate of Implant-Retained Mandibular Overdentures by Novice General Dentistry Residents.

    PubMed

    Malmstrom, Hans; Xiao, Jin; Romanos, Georgios; Ren, Yan-Fang

    2015-06-01

    The purpose of the present study was to evaluate the clinical success and patient satisfaction when dental implant-retained mandibular overdentures are placed and restored by novice general dentistry residents. A total of 50 subjects who were dissatisfied with their mandibular complete dentures were enrolled in the study. Two dental implants were placed in the anterior mandible between the mental foramina by novice general dentistry residents under the direct supervision of the principal investigator. The resident attached the denture to the implants 3 to 4 months later using locator attachments. The implant success rate was determined by measuring bone loss, mobility, pocket probing depth, and gingival and plaque indices. Subjects were asked to complete a satisfaction questionnaire with the prosthesis at 3 months, 1 year, and 2 years after overdenture delivery. A total of 100 implants were placed in the 50 study subjects. Of these, 2 implants were lost in 1 subject, and 1 subject died due to unrelated causes. Of the 48 remaining subjects, 45 have had their implants restored with overdentures. The subjects' overall satisfaction with fit and ability to chew hard foods with their mandibular overdentures improved significantly (P < .05) following the denture attachment to the dental implants. We conclude that novice general dentistry residents can successfully place mandibular implants and restore them with overdentures under direct supervision, subsequently enhancing the subjects' satisfaction with their mandibular dentures. PMID:24188137

  14. Protocol for Bone Augmentation with Simultaneous Early Implant Placement: A Retrospective Multicenter Clinical Study

    PubMed Central

    2015-01-01

    Purpose. To present a novel protocol for alveolar bone regeneration in parallel to early implant placement. Methods. 497 patients in need of extraction and early implant placement with simultaneous bone augmentation were treated in a period of 10 years. In all patients the same specific method was followed and grafting was performed utilizing in situ hardening fully resorbable alloplastic grafting materials consisting of β-tricalcium phosphate and calcium sulfate. The protocol involved atraumatic extraction, implant placement after 4 weeks with simultaneous bone augmentation, and loading of the implant 12 weeks after placement and grafting. Follow-up periods ranged from 6 months to 10 years (mean of 4 years). Results. A total of 601 postextraction sites were rehabilitated in 497 patients utilizing the novel protocol. Three implants failed before loading and three implants failed one year after loading, leaving an overall survival rate of 99.0%. Conclusions. This standardized protocol allows successful long-term functional results regarding alveolar bone regeneration and implant rehabilitation. The concept of placing the implant 4 weeks after extraction, augmenting the bone around the implant utilizing fully resorbable, biomechanically stable, alloplastic materials, and loading the implant at 12 weeks seems to offer advantages when compared with traditional treatment modalities. PMID:26858757

  15. Protocol for Bone Augmentation with Simultaneous Early Implant Placement: A Retrospective Multicenter Clinical Study.

    PubMed

    Fairbairn, Peter; Leventis, Minas

    2015-01-01

    Purpose. To present a novel protocol for alveolar bone regeneration in parallel to early implant placement. Methods. 497 patients in need of extraction and early implant placement with simultaneous bone augmentation were treated in a period of 10 years. In all patients the same specific method was followed and grafting was performed utilizing in situ hardening fully resorbable alloplastic grafting materials consisting of β-tricalcium phosphate and calcium sulfate. The protocol involved atraumatic extraction, implant placement after 4 weeks with simultaneous bone augmentation, and loading of the implant 12 weeks after placement and grafting. Follow-up periods ranged from 6 months to 10 years (mean of 4 years). Results. A total of 601 postextraction sites were rehabilitated in 497 patients utilizing the novel protocol. Three implants failed before loading and three implants failed one year after loading, leaving an overall survival rate of 99.0%. Conclusions. This standardized protocol allows successful long-term functional results regarding alveolar bone regeneration and implant rehabilitation. The concept of placing the implant 4 weeks after extraction, augmenting the bone around the implant utilizing fully resorbable, biomechanically stable, alloplastic materials, and loading the implant at 12 weeks seems to offer advantages when compared with traditional treatment modalities. PMID:26858757

  16. Contamination by slow diffusers in ion implantation processes: The examples of molybdenum and tungsten

    NASA Astrophysics Data System (ADS)

    Polignano, M. L.; Mica, I.; Barbarossa, F.; Galbiati, A.; Grasso, S.; Soncini, V.

    2015-08-01

    A procedure to measure molybdenum and tungsten contamination in implantation processes by DLTS (Deep Level Transient Spectroscopy) is defined and calibrated for the evaluation of molybdenum and tungsten contaminant dose. The obtained calibrations are used to study molybdenum contamination in BF2 implantations and tungsten contamination by sputtering from a previously contaminated wafer holder. In molybdenum-implanted samples, the molybdenum level located 0.3 eV above valence band is revealed only. In tungsten-implanted samples, two levels are revealed. One of these levels is the tungsten-related hole trap located 0.4 eV above valence band. The other level does not correspond to any tungsten-related level, however it is related to the presence of tungsten and to the sample preparation process. The SPV (Surface Photovoltage) measurement sensitivity to tungsten contamination was also tested, and it was found much lower than the DLTS sensitivity, due to the low tungsten diffusivity. This procedure was used to evaluate contamination in implantation processes. In BF2 implantations, in addition to molybdenum, tungsten contamination is found. Molybdenum and tungsten contamination is found in boron implantation too. The tungsten contamination induced by implantation in a previously contaminated implanter was quantified, and the efficiency of arsenic implantation as a decontamination process was tested. Finally, it was shown that TXRF (Total reflection X-ray Fluorescence) is much less sensitive than DLTS for monitoring tungsten contamination.

  17. The effects of high-fat diet on implant osseointegration: an experimental study

    PubMed Central

    2016-01-01

    Objectives In this study, we investigated whether a high-fat diet (HFD) affected the bone implant connection (BIC) in peri-implant bone. Materials and Methods Four male rabbits were used in this study. Dental implant surgery was introduced into each tibia, and four implants were integrated into each animal. In both the normal diet (ND) group (n=2) and HFD group (n=2), 8 implants were integrated, for a total of 16 integrated implants. The animals continued with their respective diets for 12 weeks post-surgery. Afterward, the rabbits were sacrificed, and the BIC was assessed histomorphometrically. Results Histologic and histomorphometric analyses demonstrated that BIC was not impaired in the HFD group compared to the ND group. Conclusion Within the limitations of this study, we found that HFD did not decrease the BIC in rabbit tibias. PMID:27595085

  18. Influence of Thickness and Contact Surface Geometry of Condylar Stem of TMJ Implant on Its Stability

    NASA Astrophysics Data System (ADS)

    Arabshahi, Zohreh; Kashani, Jamal; Kadir, Mohammed Rafiq Abdul; Azari, Abbas

    The aim of this study is to examine the effect thickness and contact surface geometry of condylar stem of TMJ implant on its stability in total reconstruction system and evaluate the micro strain resulted in bone at fixation screw holes in jaw bone embedded with eight different designs of temporomandibular joint implants. A three dimensional model of a lower mandible of an adult were developed from a Computed Tomography scan images. Eight different TMJ implant designs and fixation screws were modeled. Three dimensional finite element models of eight implanted mandibles were analyzed. The forces assigned to the masticatory muscles for incisal clenching were applied consisting of nine important muscular loads. In chosen loading condition, The results indicated that the anatomical curvature contact surface design of TMJ implant can moderately improve the stability and the strain resulted in fixation screw holes in thinner TMJ implant was diminished in comparison with other thicknesses.

  19. EFFECT OF MECHANICAL STIMULI ON SKELETAL REGENERATION AROUND IMPLANTS

    PubMed Central

    Leucht, Philipp; Kim, Jae-Beom; Wazen, Rima; Currey, Jennifer A.; Nanci, Antonio; Brunski, John B.; Helms, Jill A.

    2007-01-01

    Due to the aging population and the increasing need for total joint replacements, osseointegration is of a great interest for various clinical disciplines. Our objective was to investigate the molecular and cellular foundation that underlies this process. Here, we used an in vivo mouse model to study the cellular and molecular response in three distinct areas of unloaded implants: the periosteum, the gap between implant and cortical bone, and the marrow space. Our analyses began with the early phases of healing, and continued until the implants were completely osseointegrated. We investigated aspects of osseointegration ranging from vascularization, cell proliferation, differentiation, and bone remodeling. In doing so, we gained an understanding of the healing mechanisms of different skeletal tissues during unloaded implant osseointegration. To continue our analysis, we used a micromotion device to apply a defined physical stimulus to the implants, and in doing so, we dramatically enhanced bone formation in the peri-implant tissue. By comparing strain measurements with cellular and molecular analyses, we developed an understanding of the correlation between strain magnitudes and fate decisions of cells shaping the skeletal regenerate. PMID:17175211

  20. Automatic Model Generation Framework for Computational Simulation of Cochlear Implantation.

    PubMed

    Mangado, Nerea; Ceresa, Mario; Duchateau, Nicolas; Kjer, Hans Martin; Vera, Sergio; Dejea Velardo, Hector; Mistrik, Pavel; Paulsen, Rasmus R; Fagertun, Jens; Noailly, Jérôme; Piella, Gemma; González Ballester, Miguel Ángel

    2016-08-01

    Recent developments in computational modeling of cochlear implantation are promising to study in silico the performance of the implant before surgery. However, creating a complete computational model of the patient's anatomy while including an external device geometry remains challenging. To address such a challenge, we propose an automatic framework for the generation of patient-specific meshes for finite element modeling of the implanted cochlea. First, a statistical shape model is constructed from high-resolution anatomical μCT images. Then, by fitting the statistical model to a patient's CT image, an accurate model of the patient-specific cochlea anatomy is obtained. An algorithm based on the parallel transport frame is employed to perform the virtual insertion of the cochlear implant. Our automatic framework also incorporates the surrounding bone and nerve fibers and assigns constitutive parameters to all components of the finite element model. This model can then be used to study in silico the effects of the electrical stimulation of the cochlear implant. Results are shown on a total of 25 models of patients. In all cases, a final mesh suitable for finite element simulations was obtained, in an average time of 94 s. The framework has proven to be fast and robust, and is promising for a detailed prognosis of the cochlear implantation surgery. PMID:26715210

  1. Porous polyethylene implants in facial reconstruction: Outcome and complications.

    PubMed

    Ridwan-Pramana, Angela; Wolff, Jan; Raziei, Ashkan; Ashton-James, Claire E; Forouzanfar, Tymour

    2015-10-01

    The aim of the present study was to assess the indications, results and complications of patients treated with porous polyethylene (Medpor(®)) implants in the Department of Oral and Maxillofacial Surgery of VU Medical Centre, Amsterdam over 17 years. A total of 69 high-density porous polyethylene implants (Medpor(®) Biomaterial; Porex Surgical, Newman, GA) were used in forty patients (22 males, 18 females). All patients were analysed for gender, age, diagnosis, indications for surgery, follow-up period and postoperative complications. A mean age of 34.1 years was observed. The main reason for implant surgery was post-traumatic functional impairment (27.5%). Most implants were placed at the mandibular angel and the orbital floor. Unsatisfactory appearance scored the highest in postoperative complications (10.1%) followed by infection rate (7.2%). Comparing the number of implants placed over the years and the incidence of complications, makes the overall complications rate of porous polyethylene very low. A consensus about antibiotic prophylaxis is needed. The objective measurements in patient satisfaction and proper implant design would be of great use. PMID:26276064

  2. Method For Silicon Surface Texturing Using Ion Implantation

    NASA Astrophysics Data System (ADS)

    Kadakia, Nirag; Naczas, Sebastian; Bakhru, Hassaram; Huang, Mengbing

    2011-06-01

    As the semiconductor industry continues to show more interest in the photovoltaic market, cheaper and readily integrable methods of silicon solar cell production are desired. One of these methods—ion implantation—is well-developed and optimized in all commercial semiconductor fabrication facilities. Here we have developed a silicon surface texturing technique predicated upon the phenomenon of surface blistering of H-implanted silicon, using only ion implantation and thermal annealing. We find that following the H implant with a second, heavier implant markedly enhances the surface blistering, causing large trenches that act as a surface texturing of c-Si. We have found that this method reduces total broadband Si reflectance from 35% to below 5percent;. In addition, we have used Rutherford backscattering/channeling measurements investigate the effect of ion implantation on the crystallinity of the sample. The data suggests that implantation-induced lattice damage is recovered upon annealing, reproducing the original monocrystalline structure in the previously amorphized region, while at the same time retaining the textured surface.

  3. Permanent Breast Seed Implant Dosimetry Quality Assurance

    SciTech Connect

    Keller, Brian M.; Ravi, Ananth; Sankreacha, Raxa; Pignol, Jean-Philippe

    2012-05-01

    Purpose: A permanent breast seed implant is a novel method of accelerated partial breast irradiation for women with early-stage breast cancer. This article presents pre- and post-implant dosimetric data, relates these data to clinical outcomes, and makes recommendations for those interested in starting a program. Methods and Materials: A total of 95 consecutive patients were accrued into one of three clinical trials after breast-conserving surgery: a Phase I/II trial (67 patients with infiltrating ductal carcinoma); a Phase II registry trial (25 patients with infiltrating ductal carcinoma); or a multi-center Phase II trial for patients with ductal carcinoma in situ (3 patients). Contouring of the planning target volume (PTV) was done on a Pinnacle workstation and dosimetry calculations, including dose-volume histograms, were done using a Variseed planning computer. Results: The mean pre-implant PTV coverage for the V{sub 90}, V{sub 100}, V{sub 150}, and V{sub 200} were as follows: 98.8% {+-} 1.2% (range, 94.5-100%); 97.3% {+-} 2.1% (range, 90.3-99.9%), 68.8% {+-} 14.3% (range, 32.7-91.5%); and 27.8% {+-} 8.6% (range, 15.1-62.3%). The effect of seed motion was characterized by post-implant dosimetry performed immediately after the implantation (same day) and at 2 months after the implantation. The mean V{sub 100} changed from 85.6% to 88.4% (p = 0.004) and the mean V{sub 200} changed from 36.2% to 48.3% (p < 0.001). Skin toxicity was associated with maximum skin dose (p = 0.014). Conclusions: Preplanning dosimetry should aim for a V{sub 90} of approximately 100%, a V{sub 100} between 95% and 100%, and a V{sub 200} between 20% and 30%, as these numbers are associated with no local recurrences to date and good patient tolerance. In general, the target volume coverage improved over the duration of the seed therapy. The maximum skin dose, defined as the average dose over the hottest 1 Multiplication-Sign 1-cm{sup 2} surface area, should be limited to 90% of the

  4. Influence of cementless cup surface on stability and bone fixation 2 years after total hip arthroplasty.

    PubMed

    Urbański, Wiktor; Krawczyk, Artur; Dragan, Szymon Ł; Kulej, Mirosław; Dragan, Szymon F

    2012-01-01

    Loss of fixation between bone and implant surface is one of the main treatment problems in total hip arthroplasty. It might lead to implant instability, bone loss and treatment failure resulting in revision surgery. Surface modification is a method for improving bone response to implant and increasing implant osseointegration. However, the currently applied modifications such as hydroxyapatite coatings do not meet expectation and do not provide good clinical result. The object of the study was to evaluate the influence of acetabular cup surface modification on fixation and bone remodelling in total hip arthroplasty. Clinical and radiological outcomes were evaluated in patients two years after cementless total hip replacement. Two groups were compared: patients with acetabular component with uncoated titanium surface and patients with hydroxyapatite-coated acetabular surface. Hips X-rays were analysed for early signs of losing stability of acetabular cups. Two years after surgery the analysis of X-rays did not reveal any statistical differences in stability, migration of acetabular components of endoprosthesis between both groups. No differences were also observed in bone remodelling around implants. Particularly high percentage of cups, i.e. 17.64%, were classified into the group with high risk of early implant loosening, i.e., the group with HA coatings. Hydroxyapatite coatings on titanium cementless acetabular cups implanted by press-fit technique have no influence on their stability, bone-implant fixation and the remodelling of bone surrounding an implant two years after surgery. PMID:22793261

  5. Biomechanics of reverse total shoulder arthroplasty.

    PubMed

    Berliner, Jonathan L; Regalado-Magdos, Ashton; Ma, C Benjamin; Feeley, Brian T

    2015-01-01

    Reverse total shoulder arthroplasty is an effective procedure for treatment of glenohumeral joint disease among patients with severe rotator cuff deficiency. Improvements in prosthetic design are the result of an evolved understanding of both shoulder and joint replacement biomechanics. Although modern generations of the reverse shoulder prosthesis vary in specific design details, they continue to adhere to Grammont's core principles demonstrated by his original Delta III prosthesis. This review article discusses the biomechanics of reverse total shoulder arthroplasty with a focus on elements of implant design and surgical technique that may affect stability, postoperative complications, and functional outcomes. PMID:25441574

  6. An Implanted, Stimulated Muscle Powered Piezoelectric Generator

    NASA Technical Reports Server (NTRS)

    Lewandowski, Beth; Gustafson, Kenneth; Kilgore, Kevin

    2007-01-01

    A totally implantable piezoelectric generator system able to harness power from electrically activated muscle could be used to augment the power systems of implanted medical devices, such as neural prostheses, by reducing the number of battery replacement surgeries or by allowing periods of untethered functionality. The features of our generator design are no moving parts and the use of a portion of the generated power for system operation and regulation. A software model of the system has been developed and simulations have been performed to predict the output power as the system parameters were varied within their constraints. Mechanical forces that mimic muscle forces have been experimentally applied to a piezoelectric generator to verify the accuracy of the simulations and to explore losses due to mechanical coupling. Depending on the selection of system parameters, software simulations predict that this generator concept can generate up to approximately 700 W of power, which is greater than the power necessary to drive the generator, conservatively estimated to be 50 W. These results suggest that this concept has the potential to be an implantable, self-replenishing power source and further investigation is underway.

  7. Sequential provisional implant prosthodontics therapy.

    PubMed

    Zinner, Ira D; Markovits, Stanley; Jansen, Curtis E; Reid, Patrick E; Schnader, Yale E; Shapiro, Herbert J

    2012-01-01

    The fabrication and long-term use of first- and second-stage provisional implant prostheses is critical to create a favorable prognosis for function and esthetics of a fixed-implant supported prosthesis. The fixed metal and acrylic resin cemented first-stage prosthesis, as reviewed in Part I, is needed for prevention of adjacent and opposing tooth movement, pressure on the implant site as well as protection to avoid micromovement of the freshly placed implant body. The second-stage prosthesis, reviewed in Part II, should be used following implant uncovering and abutment installation. The patient wears this provisional prosthesis until maturation of the bone and healing of soft tissues. The second-stage provisional prosthesis is also a fail-safe mechanism for possible early implant failures and also can be used with late failures and/or for the necessity to repair the definitive prosthesis. In addition, the screw-retained provisional prosthesis is used if and when an implant requires removal or other implants are to be placed as in a sequential approach. The creation and use of both first- and second-stage provisional prostheses involve a restorative dentist, dental technician, surgeon, and patient to work as a team. If the dentist alone cannot do diagnosis and treatment planning, surgery, and laboratory techniques, he or she needs help by employing the expertise of a surgeon and a laboratory technician. This team approach is essential for optimum results. PMID:23220306

  8. [Allergy diagnostics in implant intolerance].

    PubMed

    Thomas, P; Thomsen, M

    2008-02-01

    To clarify a suspected implant allergy, a patch test with implant metals and bone cement components can be used. The (immuno)histology of periimplant tissue may also indicate T-lymphocyte-dominant inflammation. Identification of histological allergy characteristics and evaluation of the lymphocyte transformation test beyond indications of sensitization will be possible only when larger studies are available. PMID:18227997

  9. Porous metal for orthopedics implants

    PubMed Central

    Matassi, Fabrizio; Botti, Alessandra; Sirleo, Luigi; Carulli, Christian; Innocenti, Massimo

    2013-01-01

    Summary Porous metal has been introduced to obtain biological fixation and improve longevity of orthopedic implants. The new generation of porous metal has intriguing characteristics that allows bone healing and high osteointegration of the metallic implants. This article gives an overview about biomaterials properties of the contemporary class of highly porous metals and about the clinical use in orthopaedic surgery. PMID:24133527

  10. Regenerative Surgical Treatment of Peri-implantitis

    ClinicalTrials.gov

    2016-08-31

    Failure of Dental Implant Due to Infection; Infection; Inflammation; Peri-implantitis; Bacterial Infections; Bleeding of Subgingival Space; Molecular Sequence Variation; Periodontal Diseases; Mouth Diseases

  11. On total disc replacement.

    PubMed

    Berg, Svante

    2011-02-01

    Low back pain consumes a large part of the community's resources dedicated to health care and sick leave. Back disorders also negatively affect the individual leading to pain suffering, decreased quality-of-life and disability. Chronic low back pain (CLBP) due to degenerative disc disease (DDD) is today often treated with fusion when conservative treatment has failed and symptoms are severe. This treatment is as successful as arthroplasty is for hip arthritis in restoring the patient's quality of life and reducing disability. Even so, there are some problems with this treatment, one of these being recurrent CLBP from an adjacent segment (ASD) after primarily successful surgery. This has led to the development of alternative surgical treatments and devices that maintain or restore mobility, in order to reduce the risk for ASD. Of these new devices, the most frequently used are the disc prostheses used in Total Disc Replacement (TDR). This thesis is based on four studies comparing total disc replacement with posterior fusion. The studies are all based on a material of 152 patients with DDD in one or two segments, aged 20-55 years that were randomly treated with either posterior fusion or TDR. The first study concerned clinical outcome and complications. Follow-up was 100% at both one and two years. It revealed that both treatment groups had a clear benefit from treatment and that patients with TDR were better in almost all outcome scores at one-year follow-up. Fusion patients continued to improve during the second year. At two-year follow-up there was a remaining difference in favour of TDR for back pain. 73% in the TDR group and 63% in the fusion group were much better or totally pain-free (n.s.), while twice as many patients in the TDR group were totally pain free (30%) compared to the fusion group (15%). Time of surgery and total time in hospital were shorter in the TDR group. There was no difference in complications and reoperations, except that seventeen of the

  12. Impingement in Total Hip Replacement: Mechanisms and Consequences

    PubMed Central

    Brown, Thomas D.; Callaghan, John J.

    2009-01-01

    The occurrence of total hip impingement, whether or not accompanied by frank dislocation, holds substantial untoward clinical consequences, especially as less-forgiving advanced bearing implant designs come into ever more widespread use. Biomechanical aspects of impingement and dislocation have historically received relatively little scientific attention, although that situation is now rapidly changing. The present article reviews contemporary laboratory and clinical research on the impingement/dislocation phenomena, focusing particularly on how implant design variables, surgical implantation factors and patient activity each act individually and in concert to pose impingement and dislocation challenges. In recent years, several powerful new research methodologies have emerged that have greatly expanded the scope for clinical translation of systematic laboratory study. Transferring the findings from such research into yet better implant designs, and even better surgical procedures, offers encouragement that the clinical impact of this troublesome complication can be further reduced. PMID:19956356

  13. Implant survivorship analysis after minimally invasive sacroiliac joint fusion using the iFuse Implant System®

    PubMed Central

    Cher, Daniel J; Reckling, W Carlton; Capobianco, Robyn A

    2015-01-01

    Introduction Surgical revision rate is a key outcome with all permanent implants. The iFuse Implant System® is a permanent implant used to perform minimally invasive sacroiliac joint fusion. The purpose of this study is to determine the surgical revision rate after sacroiliac joint fusion surgery with this system. Methods Using two internal sources of information, revision surgeries were identified and linked to index surgeries. The likelihood of revision surgery was calculated using the Kaplan–Meier life table approach. Predictors of revision were explored. Results Four-year survivorship free from implant revision was 96.46%. Revision rate did not differ by sex and was lower for age >65. In all, 24% of revisions occurred within the first 30 days after surgery; 63.5% occurred within year 1. Implant survivorship has improved annually since the device was introduced in 2009. Conclusion The survivorship rate with this implant is high and improving; the rate is somewhat higher than total hip replacement but lower than that of lumbar spine procedures. PMID:26648762

  14. Prosody and Voice Characteristics of Children with Cochlear Implants

    ERIC Educational Resources Information Center

    Lenden, Jessica M.; Flipsen, Peter, Jr.

    2007-01-01

    This descriptive, longitudinal study involved the analysis of the prosody and voice characteristics of conversational speech produced by six young children with severe to profound hearing impairments who had been fitted with cochlear implants. A total of 40 samples were analyzed using the Prosody-Voice Screening Profile (PVSP; Shriberg, L. D.,…

  15. Silicon solar cells by ion implantation and pulsed energy processing

    NASA Technical Reports Server (NTRS)

    Kirkpatrick, A. R.; Minnucci, J. A.; Shaughnessy, T. S.; Greenwald, A. C.

    1976-01-01

    A new method for fabrication of silicon solar cells is being developed around ion implantation in conjunction with pulsed electron beam techniques to replace conventional furnace processing. Solar cells can be fabricated totally in a vacuum environment at room temperature. Cells with 10% AM0 efficiency have been demonstrated. High efficiency cells and effective automated processing capabilities are anticipated.

  16. Less Invasive Surgical Procedures Using Narrow-Diameter Implants: A Prospective Study in 20 Consecutive Patients.

    PubMed

    Lambert, France Emmanuelle; Lecloux, Geoffrey; Grenade, Charlotte; Bouhy, Alice; Lamy, Marc; Rompen, Eric Henri

    2015-12-01

    Narrow-diameter implants (NDIs) are increasingly produced and used in implant dentistry, especially since the introduction of new, more resistant materials. The objective of the present study was to evaluate the clinical performance of NDIs (3.3 mm) placed in thin alveolar crests. Twenty consecutive patients needing implant-supported fixed partial dentures and presenting an alveolar thickness ≤6 mm were treated with 1 or several NDIs. The surgical protocol was chosen according to the clinical situation: (1) flapless, (2) mini-cervical flap, (3) wide flap, (4) wide flap + guided bone regeneration (GBR). Implants were immediately loaded if the primary stability was higher than 20 Ncm. Implant survival and success, prosthodontic success rates, and patient-centered outcomes were evaluated after a follow-up period of 1 year. A total of 39 implants were placed in 20 patients, 12 and 27 implants in the anterior regions and in the posterior mandible, respectively. All but 1 implant reached an insertion torque higher than 20 Ncm and were loaded within 48 hours. The implant survival and success rates both reached 94.7%. The need for GBR was avoided in 60% of the implant sites. The mean peri-implant bone remodeling after a follow-up period of 1 year was -0.35 mm at the implant level. Peri-implant bone remodeling was higher in the posterior region, when the alveolar crest was thinner than 4 mm and GBR was required in addition. In conclusion, use of NDIs to restore partial edentation in sites with limited horizontal thickness seems to be an effective treatment option that prevented GBR in the majority of the present cases. Immediate provisionalization of NDIs does not seem to impair the results. PMID:24766161

  17. Evidence-based considerations for removable prosthodontic and dental implant occlusion: a literature review.

    PubMed

    Taylor, Thomas D; Wiens, Jonathan; Carr, Alan

    2005-12-01

    The dental literature is filled with discussions of dental occlusion, occlusal schemes, philosophies, and methods to correct and restore the diseased, worn, or damaged occlusion. Traditionally, these discussions have been empirical in nature and not based on scientific evidence. Due to the empirical nature of the literature, the study of occlusion has been extremely complex and troublesome to both pre- and post-doctoral students. The introduction of osseointegrated implants has further complicated the situation. Dentists may apply the principles of occlusion for the natural dentition directly to implant-supported and retained restorations. Although this may be successful, this rationale may result in overly complex or simplified treatment protocols and outcomes. There is an emerging body of scientific literature related to dental implant therapy that may be useful in formulating treatment protocols and prosthesis designs for implant-supported restorations. This review focuses on some of the "classic" removable prosthodontic literature and the currently available scientific literature involving removable prosthodontic occlusion and dental implant occlusion. The authors reviewed the English peer-reviewed literature prior to 1996 in as comprehensive manner as possible, and material after 1996 was reviewed electronically using MEDLINE. Electronic searches of the literature were performed in MEDLINE using key words-animal studies, case series, clinical trials, cohort studies, complete denture occlusion, dental implant function, dental implant occlusion, dental implant occlusion research, dental implant functional loading, dental implants, dental occlusion, dental occlusion research, denture function, denture occlusion, dentures, implant function, implant functional loading, implant occlusion, occlusion, and removable partial denture occlusion-in various combinations to obtain potential references for review. A total of 5447 English language titles were obtained, many of

  18. Periprosthetic Fractures Following Total Knee Arthroplasty

    PubMed Central

    Kim, Nam Ki

    2015-01-01

    Periprosthetic fractures after total knee arthroplasty may occur in any part of the femur, tibia and patella, and the most common pattern involves the supracondylar area of the distal femur. Supracondylar periprosthetic fractures frequently occur above a well-fixed prosthesis, and risk factors include anterior femoral cortical notching and use of the rotational constrained implant. Periprosthetic tibial fractures are frequently associated with loose components and malalignment or malposition of implants. Fractures of the patella are much less common and associated with rheumatoid arthritis, use of steroid, osteonecrosis and malalignment of implants. Most patients with periprosthetic fractures around the knee are the elderly with poor bone quality. There are many difficulties and increased risk of nonunion after treatment because reduction and internal fixation is interfered with by preexisting prosthesis and bone cement. Additionally, previous soft tissue injury is another disadvantageous condition for bone healing. Many authors reported good clinical outcomes after non-operative treatment of undisplaced or minimally displaced periprosthetic fractures; however, open reduction or revision arthroplasty was required in displaced fractures or fractures with unstable prosthesis. Periprosthetic fractures around the knee should be prevented by appropriate technique during total knee arthroplasty. Nevertheless, if a periprosthetic fracture occurs, an appropriate treatment method should be selected considering the stability of the prosthesis, displacement of fracture and bone quality. PMID:25750888

  19. Adverse sequelae following revision of a total hip replacement for a fractured ceramic component: case report

    PubMed Central

    Lee, Ling Hong; Langton, David; Green, Stephen

    2015-01-01

    Revision total hip replacement following a fractured ceramic bearing component presents a challenge in the choice of the new bearing implant. A femoral head made of equal or harder material should be implanted to prevent catastrophic wear. Despite this, patients and surgeons must be wary of potential complications. PMID:27163083

  20. Adverse sequelae following revision of a total hip replacement for a fractured ceramic component: case report.

    PubMed

    Lee, Ling Hong; Langton, David; Green, Stephen

    2015-01-01

    Revision total hip replacement following a fractured ceramic bearing component presents a challenge in the choice of the new bearing implant. A femoral head made of equal or harder material should be implanted to prevent catastrophic wear. Despite this, patients and surgeons must be wary of potential complications. PMID:27163083

  1. Safety and Cost-Effectiveness of Same-Day Cardiac Resynchronization Therapy and Implantable Cardioverter Defibrillator Implantation.

    PubMed

    Atherton, Gavin; McAloon, Christopher James; Chohan, Bhaveek; Heining, Dominic; Anderson, Benjamin; Barker, Jethro; Randeva, Harpal; Osman, Faizel

    2016-05-01

    Cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillator (ICD) implantation improve morbidity and mortality in selected patients. Many centers still admit patients overnight. We evaluated the safety, feasibility, and cost savings of same-day CRT/ICD device implantation by performing a retrospective study of all consecutive elective CRT/ICD implants at a tertiary center from January 2009 to April 2013. All emergency and/or inpatient cases were excluded. Data were collected on baseline demographics, implantation indication, procedure details, complications (categorized as immediate [≤24 hours], short term [24 hours to 6 weeks], medium term [6 weeks to 4 months], and long term [>4 months]), and mortality (30 day and 1 year). Comparisons were made between those having planned same-day versus overnight stay procedures. A cost analysis was performed to evaluate cost savings of the same-day policy. A total of 491 devices were implanted during this period: 267 were elective (54 planned overnight, 213 planned same-day) of which 229 were CRT pacemakers or CRT defibrillators and 38 ICDs. There were 26 total overall complications (9.7%) with no significant differences between planned same-day versus planned overnight stay cohorts (9.4% vs 11.1%, p = 0.8) and specifically no differences in immediate, short-, medium-, and long-term complications at follow-up. The 30-day and 1-year mortality rates did not differ between the two groups. An overnight stay at our hospital costs $450 (£300); our cost saving during this period was $91,800 (£61,200). Same-day CRT/ICD implantation is safe, feasible, and associated with significant cost savings. It provides significant advantages for patients and health care providers, especially given the current financial climate. PMID:26993428

  2. Transcatheter aortic valve implantation.

    PubMed

    Nielsen, Hans Henrik Møller

    2012-12-01

    Transcatheter aortic valve implantation (TAVI) was introduced experimentally in 1989, based on a newly developed heart valve prosthesis - the stentvalve. The valve was invented by a Danish cardiologist named Henning Rud Andersen. The new valve was revolutionary. It was foldable and could be inserted via a catheter through an artery in the groin, without the need for heart lung machine. This allowed for a new valve implantation technique, much less invasive than conventional surgical aortic valve replacement (SAVR). Surgical aortic valve replacement is safe and improves symptoms along with survival. However, up to 1/3 of patients with aortic valve stenosis cannot complete the procedure due to frailty. The catheter technique was hoped to provide a new treatment option for these patients. The first human case was in 2002, but more widespread clinical use did not begin until 2006-2010. Today, in 2011, more than 40,000 valves have been implanted worldwide. Initially, because of the experimental character of the procedure, TAVI was reserved for patients who could not undergo SAVR due to high risk. The results in this group of patients were promising. The procedural safety was acceptable, and the patients experienced significant improvements in their symptoms. Three of the papers in this PhD-thesis are based on the outcome of TAVI at Skejby Hospital, in this high-risk population [I, II and IV]. Along with other international publications, they support TAVI as being superior to standard medical treatment, despite a high risk of prosthetic regurgitation. These results only apply to high-risk patients, who cannot undergo SAVR. The main purpose of this PhD study has been to investigate the quality of TAVI compared to SAVR, in order to define the indications for this new procedure. The article attached [V] describes a prospective clinical randomised controlled trial, between TAVI to SAVR in surgically amenable patients over 75 years of age with isolated aortic valve stenosis

  3. A Retrospective Analysis of Ruptured Breast Implants

    PubMed Central

    Baek, Woo Yeol; Lew, Dae Hyun

    2014-01-01

    Background Rupture is an important complication of breast implants. Before cohesive gel silicone implants, rupture rates of both saline and silicone breast implants were over 10%. Through an analysis of ruptured implants, we can determine the various factors related to ruptured implants. Methods We performed a retrospective review of 72 implants that were removed for implant rupture between 2005 and 2014 at a single institution. The following data were collected: type of implants (saline or silicone), duration of implantation, type of implant shell, degree of capsular contracture, associated symptoms, cause of rupture, diagnostic tools, and management. Results Forty-five Saline implants and 27 silicone implants were used. Rupture was diagnosed at a mean of 5.6 and 12 years after insertion of saline and silicone implants, respectively. There was no association between shell type and risk of rupture. Spontaneous was the most common reason for the rupture. Rupture management was implant change (39 case), microfat graft (2 case), removal only (14 case), and follow-up loss (17 case). Conclusions Saline implants have a shorter average duration of rupture, but diagnosis is easier and safer, leading to fewer complications. Previous-generation silicone implants required frequent follow-up observation, and it is recommended that they be changed to a cohesive gel implant before hidden rupture occurs. PMID:25396188

  4. [Maintenance care for dental implant].

    PubMed

    Kamoi, K

    1989-10-01

    Dental implant has tried at the early stage in 19th century recovering an oral function and esthetics. Technological revolutions in biochemical and new materials have developed on the remarkable change in the dental implants, nowadays we call the three generation therapy for dental implantology. There are many kinds of methods and techniques in dental implants, however a lot of troublesome complication on the process of surgical phase, construction of prothodontics and prognosis of maintenance care. In the proceedings of this symposium, I would like to propose you how to manage the maintenance care for various kind of dental implants through the methodology and case presentations. Tendenay and future for dental implants The current outlook of dental implant has increasing supply and demand not only dentists but also patients. According to Japanese Welfare Ministry's report in 1987, average missing teeth over sixty years old generations are approximately 42% in accordance with NIDR (U.S.A.) research. They are missed on ten over teeth in full 28th teeth dentitions owing to dental caries and periodontal diseases. Generally speaking, latent implant patients are occupied on the same possibility of needs for dental implants both Japan and U.S.A. Management of maintenance care The patients hardly recognized the importance of plaque control for the maintenance care in the intraoral condition after implantation. Dentists and dental staffs must be instruct patients for importance of plaque removal and control, because they already had forgotten the habit of teeth cleaning, especially in the edenturous conditions. 1) Concept of establishment in oral hygiene. Motivation and instruction for patients include very important factors in dental implants as well as in periodontal diseases. Patients who could not achieve on good oral hygiene levels obtained no good results in the long term observations. To establish good oral hygiene are how to control supra plaque surrounding tissues

  5. Patellar meniscus in total knee arthroplasty.

    PubMed

    Lavernia, Carlos J; Sheldon, Daniel A; Hernández, Victor H; D'Apuzzo, Michele R; Lee, David J; Krackow, Kenneth A; Hungerford, David S

    2007-04-01

    Twenty-four clinically successful, autopsy retrieved porous-coated anatomic total knee arthroplasty (TKA) specimens were evaluated to determine the structure and function of the patellar meniscus. Mean implant duration was 76 months (range: 11-135 months). Histological examination showed the patellar meniscus to be composed of dense fibrous tissue with scattered regions of chronic granulomatous response to polyethylene debris. Patellar wear and polyethylene exposed patellar surface area were correlated with implant duration (r = 0.47, P = .03; r = 0.52, P = .06). Postoperative patellar tilt was also associated with patellar component wear (r = 0.64, P = .03). No other clinical measures were significantly associated with patellar wear or exposed surface area. Additional research is needed to determine what role, if any, the patellar meniscus plays in TKA outcomes. PMID:17486906

  6. Percutaneous Pulmonary Valve Implantation

    PubMed Central

    Lee, Hyoung-Doo

    2012-01-01

    Pulmonary regurgitation (PR) is a frequent sequelae after repair of tetralogy of Fallot, pulmonary atresia, truncus arteriosus, Rastelli and Ross operation. Due to patient growth and conduit degeneration, these conduits have to be changed frequently due to regurgitation or stenosis. However, morbidity is significant in these repeated operations. To prolong conduit longevity, bare-metal stenting in the right ventricular outflow tract (RVOT) obstruction has been performed. Stenting the RVOT can reduce the right ventricular pressure and symptomatic improvement, but it causes PR with detrimental effects on the right ventricle function and risks of arrhythmia. Percutaneous pulmonary valve implantation has been shown to be a safe and effective treatment for patients with pulmonary valve insufficiency, or stenotic RVOTs. PMID:23170091

  7. Nitinol Surfaces for Implantation

    NASA Astrophysics Data System (ADS)

    Shabalovskaya, Svetlana; Rondelli, Gianni; Rettenmayr, Markus

    2009-08-01

    Nitinol, a group of nearly equiatomic Ni-Ti alloys, steadily conquers new areas of application. Because of the need to keep a low profile of miniature implant devices, and considering the lack of compatibility between Nitinol superelasticity and the mechanical properties of traditional coatings, bare surfaces are of interest. In this article, an overview of our studies of bare Nitinol surfaces is presented, and the performance of coated surfaces is outlined. Together dense and porous Nitinol offer a wide array of surface topographies, suitable for attachment and migration of biological cells and tissue ingrowth. Native Nitinol surface oxides vary from amorphous to crystalline and exhibit semiconducting properties associated with better blood compatibility. Nitinol surfaces are analyzed with regard to high and lasting nickel release in vitro. Surface oxide thickness and Nitinol intermetallic particulates are discussed in relation to corrosion resistance and mechanical performance of the material.

  8. Transcatheter Aortic Valve Implantation.

    PubMed

    Malaisrie, S Chris; Iddriss, Adam; Flaherty, James D; Churyla, Andrei

    2016-05-01

    Severe aortic stenosis (AS) is a life-threatening condition when left untreated. Aortic valve replacement (AVR) is the gold standard treatment for the majority of patients; however, transcatheter aortic valve implantation/replacement (TAVI/TAVR) has emerged as the preferred treatment for high-risk or inoperable patients. The concept of transcatheter heart valves originated in the 1960s and has evolved into the current Edwards Sapien and Medtronic CoreValve platforms available for clinical use. Complications following TAVI, including cerebrovascular events, perivalvular regurgitation, vascular injury, and heart block have decreased with experience and evolving technology, such that ongoing trials studying TAVI in lower risk patients have become tenable. The multidisciplinary team involving the cardiac surgeon and cardiologist plays an essential role in patient selection, procedural conduct, and perioperative care. PMID:27021619

  9. Implantable, multifunctional, bioresorbable optics

    PubMed Central

    Tao, Hu; Kainerstorfer, Jana M.; Siebert, Sean M.; Pritchard, Eleanor M.; Sassaroli, Angelo; Panilaitis, Bruce J. B.; Brenckle, Mark A.; Amsden, Jason J.; Levitt, Jonathan; Fantini, Sergio; Kaplan, David L.; Omenetto, Fiorenzo G.

    2012-01-01

    Advances in personalized medicine are symbiotic with the development of novel technologies for biomedical devices. We present an approach that combines enhanced imaging of malignancies, therapeutics, and feedback about therapeutics in a single implantable, biocompatible, and resorbable device. This confluence of form and function is accomplished by capitalizing on the unique properties of silk proteins as a mechanically robust, biocompatible, optically clear biomaterial matrix that can house, stabilize, and retain the function of therapeutic components. By developing a form of high-quality microstructured optical elements, improved imaging of malignancies and of treatment monitoring can be achieved. The results demonstrate a unique family of devices for in vitro and in vivo use that provide functional biomaterials with built-in optical signal and contrast enhancement, demonstrated here with simultaneous drug delivery and feedback about drug delivery with no adverse biological effects, all while slowly degrading to regenerate native tissue. PMID:23150544

  10. Mobile- vs. fixed-bearing total knee replacement

    PubMed Central

    Tjørnild, Michael; Søballe, Kjeld; Hansen, Per Møller; Holm, Carsten; Stilling, Maiken

    2015-01-01

    Background and purpose It is unclear whether mobile-bearing (MB) total knee arthroplasties reduce the risk of tibial component loosening compared to fixed-bearing (FB) designs. This randomized study investigated implant migration, periprosthetic bone mineral density (BMD), and patient-reported outcomes (Oxford knee score)—all at 2 years—for the P.F.C. Sigma Cruciate Retaining total knee arthroplasty. Patients and methods 50 osteoarthritis patients were allocated to either FB or MB tibial articulation. Resultsand interpretation At 2 years, the mean total translation (implant migration) was higher for the FB implant (0.30 mm, SD 0.22) than for the MB implant (0.17 mm, SD 0.09) (p = 0.04). BMD decreased between baseline and 1-year follow-up. At 2-year follow-up, BMD was close to the baseline level. The knee scores of both groups improved equally well. The FB tibial implant migrated more than the MB, but this was not clinically significant. The mobile polyethylene presumably partly absorbs the force transmitted to the metal tibial tray, thereby reducing micromotion. PMID:25280132

  11. Microsystems Technology for Retinal Implants

    NASA Astrophysics Data System (ADS)

    Weiland, James

    2005-03-01

    The retinal prosthesis is targeted to treat age-related macular degeneration, retinitis pigmentosa, and other outer retinal degenerations. Simulations of artificial vision have predicted that 600-1000 individual pixels will be needed if a retinal prosthesis is to restore function such as reading large print and face recognition. An implantable device with this many electrode contacts will require microsystems technology as part of its design. An implantable retinal prosthesis will consist of several subsystems including an electrode array and hermetic packaging. Microsystems and microtechnology approaches are being investigated as possible solutions for these design problems. Flexible polydimethylsiloxane (PDMS) substrate electrode arrays and silicon micromachined electrode arrays are under development. Inactive PDMS electrodes have been implanted in 3 dogs to assess mechanical biocompatibility. 3 dogs were followed for 6 months. The implanted was securely fastened to the retina with a single retinal tack. No post-operative complications were evident. The array remained within 100 microns of the retinal surface. Histological evaluation showed a well preserved retina underneath the electrode array. A silicon device with electrodes suspended on micromachined springs has been implanted in 4 dogs (2 acute implants, 2 chronic implants). The device, though large, could be inserted into the eye and positioned on the retina. Histological analysis of the retina from the spring electrode implants showed that spring mounted posts penetrated the retina, thus the device will be redesigned to reduce the strength of the springs. These initial implants will provide information for the designers to make the next generation silicon device. We conclude that microsystems technology has the potential to make possible a retinal prosthesis with 1000 individual contacts in close proximity to the retina.

  12. TETE: Total Education in the Total Environment.

    ERIC Educational Resources Information Center

    Eblen, William R.

    The Hudson River Museum's Environmental Arts and Science Division has published this booklet describing their model educational program, "TETE: Total Education in the Total Environment," a multidisciplinary approach to environmental education utilizing existing curricula. For conducting the program model communities strategically located along the…

  13. Male chest enhancement: pectoral implants.

    PubMed

    Benito-Ruiz, J; Raigosa, J M; Manzano-Surroca, M; Salvador, L

    2008-01-01

    The authors present their experience with the pectoral muscle implant for male chest enhancement in 21 patients. The markings and technique are thoroughly described. The implants used were manufactured and custom made. The candidates for implants comprised three groups: group 1 (18 patients seeking chest enhancement), group 2 (1 patient with muscular atrophy), and group 3 (2 patients with muscular injuries). Because of the satisfying results obtained, including significant enhancement of the chest contour and no major complications, this technique is used for an increasing number of male cosmetic surgeries. PMID:17676376

  14. Pediatric cochlear implantation: an update.

    PubMed

    Vincenti, Vincenzo; Bacciu, Andrea; Guida, Maurizio; Marra, Francesca; Bertoldi, Barbara; Bacciu, Salvatore; Pasanisi, Enrico

    2014-01-01

    Deafness in pediatric age can adversely impact language acquisition as well as educational and social-emotional development. Once diagnosed, hearing loss should be rehabilitated early; the goal is to provide the child with maximum access to the acoustic features of speech within a listening range that is safe and comfortable. In presence of severe to profound deafness, benefit from auditory amplification cannot be enough to allow a proper language development. Cochlear implants are partially implantable electronic devices designed to provide profoundly deafened patients with hearing sensitivity within the speech range. Since their introduction more than 30 years ago, cochlear implants have improved their performance to the extent that are now considered to be standard of care in the treatment of children with severe to profound deafness. Over the years patient candidacy has been expanded and the criteria for implantation continue to evolve within the paediatric population. The minimum age for implantation has progressively reduced; it has been recognized that implantation at a very early age (12-18 months) provides children with the best outcomes, taking advantage of sensitive periods of auditory development. Bilateral implantation offers a better sound localization, as well as a superior ability to understand speech in noisy environments than unilateral cochlear implant. Deafened children with special clinical situations, including inner ear malformation, cochlear nerve deficiency, cochlear ossification, and additional disabilities can be successfully treated, even thogh they require an individualized candidacy evaluation and a complex post-implantation rehabilitation. Benefits from cochlear implantation include not only better abilities to hear and to develop speech and language skills, but also improved academic attainment, improved quality of life, and better employment status. Cochlear implants permit deaf people to hear, but they have a long way to go before

  15. Silicone breast implants and platinum.

    PubMed

    Wixtrom, Roger N

    2007-12-01

    Platinum, in a specific form, is used as a catalyst in the cross-linking reactions of the silicone gel and elastomer in breast implants. After manufacture, it remains in the devices at low-parts-per-million levels. Potential concerns have been raised as to whether this platinum might diffuse from silicone breast implants into the body and result in adverse health effects. The weight of evidence indicates that the platinum present is in its most biocompatible (zero valence) form, and the very minute levels (<0.1 percent) that might diffuse from the implants do not represent a significant health risk to patients. PMID:18090821

  16. 21 CFR 522.1350 - Melatonin implant.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Melatonin implant. 522.1350 Section 522.1350 Food... Melatonin implant. (a) Specifications. The drug is a silicone rubber elastomer implant containing 2.7...—(1) Amount. One implant per mink. (2) Indications for use. For use in healthy male and female kit...

  17. 21 CFR 522.1350 - Melatonin implant.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Melatonin implant. 522.1350 Section 522.1350 Food... Melatonin implant. (a) Specifications. The drug is a silicone rubber elastomer implant containing 2.7...—(1) Amount. One implant per mink. (2) Indications for use. For use in healthy male and female kit...

  18. 21 CFR 522.1350 - Melatonin implant.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Melatonin implant. 522.1350 Section 522.1350 Food... Melatonin implant. (a) Specifications. The drug is a silicone rubber elastomer implant containing 2.7...—(1) Amount. One implant per mink. (2) Indications for use. For use in healthy male and female kit...

  19. 21 CFR 522.1350 - Melatonin implant.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Melatonin implant. 522.1350 Section 522.1350 Food... Melatonin implant. (a) Specifications. The drug is a silicone rubber elastomer implant containing 2.7...—(1) Amount. One implant per mink. (2) Indications for use. For use in healthy male and female kit...

  20. Occlusion on oral implants: current clinical guidelines.

    PubMed

    Koyano, K; Esaki, D

    2015-02-01

    Proper implant occlusion is essential for adequate oral function and the prevention of adverse consequences, such as implant overloading. Dental implants are thought to be more prone to occlusal overloading than natural teeth because of the loss of the periodontal ligament, which provides shock absorption and periodontal mechanoreceptors, which provide tactile sensitivity and proprioceptive motion feedback. Although many guidelines and theories on implant occlusion have been proposed, few have provided strong supportive evidence. Thus, we performed a narrative literature review to ascertain the influence of implant occlusion on the occurrence of complications of implant treatment and discuss the clinical considerations focused on the overloading factors at present. The search terms were 'dental implant', 'dental implantation', 'dental occlusion' and 'dental prosthesis'. The inclusion criteria were literature published in English up to September 2013. Randomised controlled trials (RCTs), prospective cohort studies and case-control studies with at least 20 cases and 12 months follow-up interval were included. Based on the selected literature, this review explores factors related to the implant prosthesis (cantilever, crown/implant ratio, premature contact, occlusal scheme, implant-abutment connection, splinting implants and tooth-implant connection) and other considerations, such as the number, diameter, length and angulation of implants. Over 700 abstracts were reviewed, from which more than 30 manuscripts were included. We found insufficient evidence to establish firm clinical guidelines for implant occlusion. To discuss the ideal occlusion for implants, further well-designed RCTs are required in the future. PMID:25284468

  1. Results of immediate loading for implant restoration in partially edentulous patients: a 6-month preliminary prospective study using SinusQuick™ EB implant system

    PubMed Central

    Kim, Jong-Hwa; Kim, Young-Kyun; Yi, Yang-Jin; Yun, Pil-Young; Lee, Hyo-Jung; Kim, Myung-Jin

    2009-01-01

    STATEMENT OF PROBLEM Many dental clinicians are concerned about immediate loading of inserted implants. However, there have been few clinical studies surveying the success rates of immediate loading, based on Korean implant systems. PURPOSE The aim of this study was to evaluate the outcome of immediate functional loading of the implant (SinusQuick™ EB, Neobiotech Co., Seoul, Korea) in partially edentulous maxilla or mandible. MATERIAL AND METHODS Total 15 implants were placed. Within 2 weeks after implant insertion, provisional implant-supported fixed partial dentures were delivered to the patients. Quantitatively, marginal bone loss was measured at the time of immediate loading, after 3-months of continued loading and at the last follow-up. The mean follow-up period was 4.8 months. RESULTS Mean marginal bone loss from implant surgery to early loading, 3-months follow-up and last follow-up was 0.03 ± 0.07 mm, 0.16 ± 0.17 mm and 0.29 ± 0.19 mm. No implant failed up to 6 months after insertion, resulting in a 100% survival rate. CONCLUSION Immediate loading exhibited high success rate in partial edentulism for up to 6 months. Well-controlled long term clinical studies with large sample size are necessary to confirm this finding. PMID:21165269

  2. A contact mechanics model for ankle implants with inclusion of surface roughness effects

    NASA Astrophysics Data System (ADS)

    Hodaei, M.; Farhang, K.; Maani, N.

    2014-02-01

    Total ankle replacement is recognized as one of the best procedures to treat painful arthritic ankles. Even though this method can relieve patients from pain and reproduce the physiological functions of the ankle, an improper design can cause an excessive amount of metal debris due to wear, causing toxicity in implant recipient. This paper develops a contact model to treat the interaction of tibia and talus implants in an ankle joint. The contact model describes the interaction of implant rough surfaces including both elastic and plastic deformations. In the model, the tibia and the talus surfaces are viewed as macroscopically conforming cylinders or conforming multi-cylinders containing micrometre-scale roughness. The derived equations relate contact force on the implant and the minimum mean surface separation of the rough surfaces. The force is expressed as a statistical integral function of asperity heights over the possible region of interaction of the roughness of the tibia and the talus implant surfaces. A closed-form approximate equation relating contact force and minimum separation is used to obtain energy loss per cycle in a load-unload sequence applied to the implant. In this way implant surface statistics are related to energy loss in the implant that is responsible for internal void formation and subsequent wear and its harmful toxicity to the implant recipient.

  3. Strontium coating by electrochemical deposition improves implant osseointegration in osteopenic models

    PubMed Central

    LIANG, YONGQIANG; LI, HAOYAN; XU, JIANG; LI, XIN; LI, XINCHANG; YAN, YUTING; QI, MENGCHUN; HU, MIN

    2015-01-01

    Osteopenia, a preclinical state of osteoporosis, restricts the application of adult orthodontic implant anchorage and tooth implantation. Strontium (Sr) is able to promote bone formation and inhibit bone absorption. The aim of the present study was to evaluate a new method for improving the success rate of dental implantation. In this study, an electrochemical deposition (ECD) method was used to prepare a Sr coating on a titanium implant. The coating composition was investigated by energy dispersive X-ray spectroscopy and X-ray diffraction, and the surface morphology of the coating was studied using scanning electron microscopy. A total of 24 Sprague-Dawley rats received bilateral ovariectomy (OVX) and an additional 12 rats underwent a sham surgery. All rats were then implanted in the bilateral tibiae with titanium mini-implants with or without a Sr coating. The results of histological examination and a fluorescence double labeling assay showed strong new bone formation with a wider zone between the double labels, a higher rate of bone mineralization and better osseointegration in the OVX rats that received Sr-coated implants compared with the OVX rats that received uncoated implants. The study indicates that Sr coatings are easily applied by an ECD method, and that Sr coatings have a promoting effect on implant osseointegration in animals with osteopenia. PMID:25452797

  4. Strontium coating by electrochemical deposition improves implant osseointegration in osteopenic models.

    PubMed

    Liang, Yongqiang; Li, Haoyan; Xu, Jiang; Li, Xin; Li, Xinchang; Yan, Yuting; Qi, Mengchun; Hu, Min

    2015-01-01

    Osteopenia, a preclinical state of osteoporosis, restricts the application of adult orthodontic implant anchorage and tooth implantation. Strontium (Sr) is able to promote bone formation and inhibit bone absorption. The aim of the present study was to evaluate a new method for improving the success rate of dental implantation. In this study, an electrochemical deposition (ECD) method was used to prepare a Sr coating on a titanium implant. The coating composition was investigated by energy dispersive X-ray spectroscopy and X-ray diffraction, and the surface morphology of the coating was studied using scanning electron microscopy. A total of 24 Sprague-Dawley rats received bilateral ovariectomy (OVX) and an additional 12 rats underwent a sham surgery. All rats were then implanted in the bilateral tibiae with titanium mini-implants with or without a Sr coating. The results of histological examination and a fluorescence double labeling assay showed strong new bone formation with a wider zone between the double labels, a higher rate of bone mineralization and better osseointegration in the OVX rats that received Sr-coated implants compared with the OVX rats that received uncoated implants. The study indicates that Sr coatings are easily applied by an ECD method, and that Sr coatings have a promoting effect on implant osseointegration in animals with osteopenia. PMID:25452797

  5. Knowledge and attitudes of dental interns in Karnataka state, India, regarding implants.

    PubMed

    Chaudhary, Sohini; Gowda, Triveni M; Kumar, Tarun A B; Mehta, Dhoom S

    2013-10-01

    Implant treatment today is highly reliable as a valid restorative option for missing teeth. As more patients worldwide opt for implant treatment, it is now imperative for dental practitioners to have sound information about dental implants so they can help patients make informed decisions. This study sought to define the knowledge and attitudes regarding dental implants of dental interns in the state of Karnataka, India, and to evaluate the dental implant curriculum structure at the undergraduate level. A survey was conducted of dental interns (students in their fifth, clinical year of undergraduate study) in seven of the forty-five academic dental institutions in this state. The questionnaire consisted of fifteen questions that assessed the respondents' level of knowledge and source of information regarding implants. A total of 500 questionnaires were distributed, and 417 interns responded for a response rate of 83.4 percent. In the results, 73.3 percent reported they were not provided sufficient information about implants in their undergraduate curriculum, and 95.7 percent of them wanted more. Also, 63.5 percent of the respondents believed that high costs could limit the use of dental implants as a tooth replacement modality in India. This study concludes that revision in the undergraduate dental curricula at these schools is needed to better prepare students for practicing implant dentistry. PMID:24098041

  6. A genetic algorithm based multi-objective shape optimization scheme for cementless femoral implant.

    PubMed

    Chanda, Souptick; Gupta, Sanjay; Kumar Pratihar, Dilip

    2015-03-01

    The shape and geometry of femoral implant influence implant-induced periprosthetic bone resorption and implant-bone interface stresses, which are potential causes of aseptic loosening in cementless total hip arthroplasty (THA). Development of a shape optimization scheme is necessary to achieve a trade-off between these two conflicting objectives. The objective of this study was to develop a novel multi-objective custom-based shape optimization scheme for cementless femoral implant by integrating finite element (FE) analysis and a multi-objective genetic algorithm (GA). The FE model of a proximal femur was based on a subject-specific CT-scan dataset. Eighteen parameters describing the nature of four key sections of the implant were identified as design variables. Two objective functions, one based on implant-bone interface failure criterion, and the other based on resorbed proximal bone mass fraction (BMF), were formulated. The results predicted by the two objective functions were found to be contradictory; a reduction in the proximal bone resorption was accompanied by a greater chance of interface failure. The resorbed proximal BMF was found to be between 23% and 27% for the trade-off geometries as compared to ∼39% for a generic implant. Moreover, the overall chances of interface failure have been minimized for the optimal designs, compared to the generic implant. The adaptive bone remodeling was also found to be minimal for the optimally designed implants and, further with remodeling, the chances of interface debonding increased only marginally. PMID:25392855

  7. Erythritol-Enriched Air-Polishing Powder for the Surgical Treatment of Peri-Implantitis.

    PubMed

    Taschieri, Silvio; Weinstein, Roberto; Del Fabbro, Massimo; Corbella, Stefano

    2015-01-01

    Peri-implantitis represents a major complication that can compromise the success and survival of implant-supported rehabilitations. Both surgical and nonsurgical treatment protocols were proposed to improve clinical parameters and to treat implants affected by peri-implantitis. A systematic review of the literature was performed on electronic databases. The use of air-polishing powder in surgical treatment of peri-implantitis was investigated. A total of five articles, of different study designs, were included in the review. A meta-analysis could not be performed. The data from included studies reported a substantial benefit of the use of air-polishing powders for the decontamination of implant surface in surgical protocols. A case report of guided bone regeneration in sites with implants affected by peri-implantitis was presented. Surgical treatment of peri-implantitis, though demanding and not supported by a wide scientific literature, could be considered a viable treatment option if an adequate decontamination of infected surfaces could be obtained. PMID:26065025

  8. Erythritol-Enriched Air-Polishing Powder for the Surgical Treatment of Peri-Implantitis

    PubMed Central

    Taschieri, Silvio; Weinstein, Roberto

    2015-01-01

    Peri-implantitis represents a major complication that can compromise the success and survival of implant-supported rehabilitations. Both surgical and nonsurgical treatment protocols were proposed to improve clinical parameters and to treat implants affected by peri-implantitis. A systematic review of the literature was performed on electronic databases. The use of air-polishing powder in surgical treatment of peri-implantitis was investigated. A total of five articles, of different study designs, were included in the review. A meta-analysis could not be performed. The data from included studies reported a substantial benefit of the use of air-polishing powders for the decontamination of implant surface in surgical protocols. A case report of guided bone regeneration in sites with implants affected by peri-implantitis was presented. Surgical treatment of peri-implantitis, though demanding and not supported by a wide scientific literature, could be considered a viable treatment option if an adequate decontamination of infected surfaces could be obtained. PMID:26065025

  9. Implant design and its effects on osseointegration over time within cortical and trabecular bone.

    PubMed

    Beutel, Bryan G; Danna, Natalie R; Granato, Rodrigo; Bonfante, Estevam A; Marin, Charles; Tovar, Nick; Suzuki, Marcelo; Coelho, Paulo G

    2016-08-01

    Healing chambers present at the interface between implant and bone have become a target for improving osseointegration. The objective of the present study was to compare osseointegration of several implant healing chamber configurations at early time points and regions of interest within bone using an in vivo animal femur model. Six implants, each with a different healing chamber configuration, were surgically implanted into each femur of six skeletally mature beagle dogs (n = 12 implants per dog, total n = 72). The implants were harvested at 3 and 5 weeks post-implantation, non-decalcified processed to slides, and underwent histomorphometry with measurement of bone-to-implant contact (BIC) and bone area fraction occupied (BAFO) within healing chambers at both cortical and trabecular bone sites. Microscopy demonstrated predominantly woven bone at 3 weeks and initial replacement of woven bone by lamellar bone by 5 weeks. BIC and BAFO were both significantly increased by 5 weeks (p < 0.001), and significantly higher in cortical than trabecular bone (p < 0.001). The trapezoidal healing chamber design demonstrated a higher BIC than other configurations. Overall, a strong temporal and region-specific dependence of implant osseointegration in femurs was noted. Moreover, the findings suggest that a trapezoidal healing chamber configuration may facilitate the best osseointegration. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1091-1097, 2016. PMID:26034012

  10. In vivo determination of total knee arthroplasty kinematics

    SciTech Connect

    Komistek, Richard D; Mahfouz, Mohamed R; Bertin, Kim; Rosenberg, Aaron; Kennedy, William

    2008-01-01

    The objective of this study was to determine if consistent posterior femoral rollback of an asymmetrical posterior cruciate retaining (PCR) total knee arthroplasty was mostly influenced by the implant design, surgical technique, or presence of a well-functioning posterior cruciate ligament (PCL). Three-dimensional femorotibial kinematics was determined for 80 subjects implanted by 3 surgeons, and each subject was evaluated under fluoroscopic surveillance during a deep knee bend. All subjects in this present study having an intact PCL had a well-functioning PCR knee and experienced normal kinematic patterns, although less in magnitude than the normal knee. In addition, a surprising finding was that, on average, subjects without a PCL still achieved posterior femoral rollback from full extension to maximum knee flexion. The findings in this study revealed that implant design did contribute to the normal kinematics demonstrated by subjects having this asymmetrical PCR total knee arthroplasty.

  11. Poly Implant Prothèse™ (PIP) experience in the United Kingdom: A prospective cohort study into the accuracy of diagnostic imaging findings in comparison to operative findings of 1029 implants.

    PubMed

    Leckenby, Jonathan; Chana, Jagdeep; Harrison, Douglas; Grobbelaar, Adriaan

    2016-04-01

    The Poly Implant Prosthèse™ (PIP) implants were withdrawn from market use in the United Kingdom on 31st March 2010 following Government issued advice. In June 2012 a final Government report was issued and during this period the majority of patients elected to have their prostheses removed. This study presents the operative findings of three surgeons. 517 patients were identified retrospectively from the implant database as having received PIP implants with a total of 1029 implants. 62 patients (124 implants) declined explantation after consultation and imaging. The data was recorded prospectively for all patients and included the clinical, imaging and operative findings. A total of 905 implants were removed of which 129 were ruptured at the time of explantation (14.25%). 27 implants were intact but the presence of liquid surrounding the prosthesis was noted. 93 implants were reported as being ruptured after diagnostic imaging but were intact operatively resulting in a test sensitivity of 0.82 and a specificity of 0.92 yielding a positive predictive value of 0.59 and a negative predictive value of 0.97 overall. Capsule formation was noted in 27 breasts (3%). Our study showed that the prevalence of PIP ruptures is comparable to other manufacturers. The prevalence of implant rupture predictably increased over time and the prevalence of abnormal capsule formation was similar to other manufacturers. PMID:26936318

  12. Investigation of anodized titanium implants coated with triterpenoids extracted from black cohosh: an animal study

    PubMed Central

    Park, In-Phill; Kang, Tae-Joo; Heo, Seong-Joo; Koak, Jai-Young; Kim, Ju-Han; Lee, Joo-Hee; Lee, Shin-Jae

    2014-01-01

    PURPOSE The purpose of this study was to evaluate bone response to anodized titanium implants coated with the extract of black cohosh, Asarum Sieboldii, and pharbitis semen. MATERIALS AND METHODS Forty anodized titanium implants were prepared as follows: group 1 was for control; group 2 were implants soaked in a solution containing triterpenoids extracted from black cohosh for 24 hours; group 3 were implants soaked in a solution containing extracts of black cohosh and Asarum Sieboldii for 24 hours; group 4 were implants soaked in a solution containing extracts of pharbitis semen for 24 hours. The implants from these groups were randomly and surgically implanted into the tibiae of ten rabbits. After 1, 2, and 4 weeks of healing, the nondecalcified ground sections were subjected to histological observation, and the percentage of bone-to-implant contact (BIC%) was calculated. RESULTS All groups exhibited good bone healing with the bone tissue in direct contact with the surface of the implant. Group 2 (52.44 ± 10.98, 25.54 ± 5.56) showed a significantly greater BIC% compared to that of group 3 (45.34 ± 5.00, 22.24 ± 2.20) with respect to the four consecutive threads and total length, respectively. The BIC% of group 1 (25.22 ± 6.00) was significantly greater than that of group 3 (22.24 ± 2.20) only for total length. CONCLUSION This study did not show any remarkable effects of the extract of black coshosh and the other natural products on osseointegration of anodized titanium implants as coating agents. Further studies about the application method of the natural products on to the surface of implants are required. PMID:24605201

  13. [Future of implantable electrical cardiac devices].

    PubMed

    Daubert, Jean-Claude; Behaghel, Albin; Leclercq, Christophe; Mabo, Philippe

    2014-03-01

    Major improvements in implantable electrical cardiac devices have been made during the last two decades, notably with the advent of automatic internal defibrillation (ICD) to prevent sudden arrhythmic death, and cardiac resynchronisation (CRT) to treat the discoordinated failing heart. They now constitute a major therapeutic option and may eventually supersede drug therapy. The coming era will be marked by a technological revolution, with improvements in treatment delivery, safety and efficacy, and an expansion of clinical indications. Leadless technologyfor cardiac pacemakers and defibrillators is already in the pipeline, endovascular leads currently being responsible for most long-term complications (lead failure, infection, vein thrombosis, etc.). Miniaturized pacemakers based on nanotechnology can now be totally implanted inside the right ventricle through the transvenous route, thus eliminating leads, pockets and scarring In the same way, totally subcutaneous ICD systems are now available, although they are currently only capable of delivering shocks, without pacing (including antitachycardia pacing). In CRT optimised delivery is important to improve clinical responses and to reduce the non-response rate (around 30 % with current technology). Endocardial left ventricular pacing could be a solution if it can be achieved at an acceptable risk. Multisite ventricular pacing is an alternative. Besides CRT neuromodulation, especially by vagal stimulation, is another important field of device researchfor heart failure. Preliminary clinical results are encouraging. PMID:26427291

  14. Use of HTR synthetic bone grafts in conjunction with immediate dental implants.

    PubMed

    Yukna, Raymond A; Sayed-Suleyman, Amer; Finley, James M; Hochstedler, J; Mayer, Elizabeth T

    2003-09-01

    Immediate placement of dental implants in fresh extraction sockets is associated with remaining voids around the implants and often a partial dehiscence or thinning of the facial alveolar plate. Nine patients had Bioplant HTR synthetic bone used as a ridge preservation/augmentation material in conjunction with immediate placement of 10 implants. Hard tissue replacement (HTR) was used to fill the remaining socket void and enhance the facial ridge width, and the wound closed as completely as possible. Dental implants were uncovered at approximately 6 months. Measurements taken of the internal socket width and total ridge width at the implant placement and uncovering showed the mean internal socket width was maintained (7.2 mm vs 6.9 mm), and the total ridge width exhibited a mean change from 9.6 mm to 8.8 mm. Of the 10 implant sites, 7 showed a net increase, 2 no change, and 1 a decrease in overall ridge width. All 10 implants were restored for at least 6 months. These clinical results suggest that HTR is a useful adjunct in the placement of immediate dental implants for the preservation of ridge width and provides a good base for functional and esthetic prosthetic reconstruction. PMID:14596206

  15. Programmatic assessment of a university-based implant training program using patient-reported outcomes.

    PubMed

    Al-Sabbagh, Mohanad; Jenkins, Diane W; de Leeuw, Reny; Nihill, Patricia; Robinson, Fonda G; Thomas, Mark V

    2014-11-01

    The University of Kentucky College of Dentistry (UKCD) established an implant training program that provides training in the use of a single implant system, evidence-based diagnostic and treatment protocols (standardized work practices), and a total quality management system (Implant Quality Assurance Program). The aim of this study was to assess the programmatic effectiveness of the UKCD implant training program by reporting the success and survival of implants placed, using patient-reported outcomes and comparing them to previously established benchmarks. A total of 415 patients (963 implants) were interviewed, approximately 50 percent of all qualified patients. The implant survival rate was 97 percent, and 88 percent of the implants were considered successful (as determined by patient-centric criteria). These outcomes were consistent with the program's previously established benchmarks of 90 percent. These results suggest that work standardization (in the form of specific treatment protocols) and the use of a formal, incremental learning system can result in positive patient outcomes. Clinical outcomes should be monitored in academic dental settings as part of clinical process improvement, and these outcomes can provide a means of assessing the effectiveness of the training program. PMID:25362695

  16. Masticatory efficiency and oral health-related quality of life with implant-retained mandibular overdentures

    PubMed Central

    Sun, Xu; Zhai, Jun-Jiang; Liao, Jian; Teng, Min-Hua; Tian, Ai; Liang, Xing

    2014-01-01

    Objectives: To evaluate masticatory efficiency (ME) and oral health-related quality of life (OHRQoL) in patients rehabilitated with implant-retained mandibular overdentures. Methods: In this randomized controlled clinical trial, 50 edentulous patients visiting the Implant Center and Department of Prosthodontics, West China College of Stomatology, Sichuan University, Chengdu, China between June 2010 and June 2012 were selected and received 2 implant-retained mandibular overdenture treatments. All patients were rehabilitated with maxillary complete dentures. The ME and OHRQoL were determined both one month before the mandibular complete denture was anchored to the osseointegrated implants, and 6 months after anchoring. Paired t-tests were used to compare means of ME, and oral health impact profile-49 (OHIP-49) domains scores between pre- and post-implant. Linear regression models were utilized to seek correlations between ME and OHIP domains scores. Results: The ME increased from pre- to post-implant retained mandibular overdentures significantly (p<0.001). The total OHIP score and 4 subscales scores were changed significantly from pre- to post-implant; namely, functional limitation, psychological discomfort, physical disability, and physical pain. The total OHIP score, functional limitation, physical disability, and physical pain subscale scores were related to ME. Conclusion: Implant-retained mandibular over dentures can significantly improve patients’ ME and OHRQoL. The improvement in OHRQoL is mainly because of the improved ME. An improved chewing experience, and pain relief also contributes to improvement of OHRQoL. PMID:25316463

  17. Delayed loss of hearing after hearing preservation cochlear implantation: Human temporal bone pathology and implications for etiology.

    PubMed

    Quesnel, Alicia M; Nakajima, Hideko Heidi; Rosowski, John J; Hansen, Marlan R; Gantz, Bruce J; Nadol, Joseph B

    2016-03-01

    After initially successful preservation of residual hearing with cochlear implantation, some patients experience subsequent delayed hearing loss. The etiology of such delayed hearing loss is unknown. Human temporal bone pathology is critically important in investigating the etiology, and directing future efforts to maximize long term hearing preservation in cochlear implant patients. Here we present the temporal bone pathology from a patient implanted during life with an Iowa/Nucleus Hybrid S8 implant, with initially preserved residual hearing and subsequent hearing loss. Both temporal bones were removed for histologic processing and evaluated. Complete clinical and audiologic records were available. He had bilateral symmetric high frequency severe to profound hearing loss prior to implantation. Since he was implanted unilaterally, the unimplanted ear was presumed to be representative of the pre-implantation pathology related to his hearing loss. The implanted and contralateral unimplanted temporal bones both showed complete degeneration of inner hair cells and outer hair cells in the basal half of the cochleae, and only mild patchy loss of inner hair cells and outer hair cells in the apical half. The total spiral ganglion neuron counts were similar in both ears: 15,138 (56% of normal for age) in the unimplanted right ear and 13,722 (51% of normal for age) in the implanted left ear. In the basal turn of the implanted left cochlea, loose fibrous tissue and new bone formation filled the scala tympani, and part of the scala vestibuli. Delayed loss of initially preserved hearing after cochlear implantation was not explained by additional post-implantation degeneration of hair cells or spiral ganglion neurons in this patient. Decreased compliance at the round window and increased damping in the scala tympani due to intracochlear fibrosis and new bone formation might explain part of the post-implantation hearing loss. Reduction of the inflammatory and immune response to

  18. PIP breast implants: rupture rate and correlation with breast cancer

    PubMed Central

    MOSCHETTA, M.; TELEGRAFO, M.; CORNACCHIA, I.; VINCENTI, L.; RANIERI, V.; CIRILLI, A.; RELLA, L.; IANORA, A.A. STABILE; ANGELELLI, G.

    2014-01-01

    Aim To evaluate the incidence of Poly Implant Prosthése (PIP) rupture as assessed by magnetic resonance imaging (MRI), the prevalence of the detected signs and the potential correlation with breast carcinoma. Patients and methods 67 patients with silicone breast implants and clinical indications for breast MRI were evaluated for a total of 125 implants: 40 (32%) PIP in 21 patients and 85 non-PIP in 46 patients (68%), the latest considered as control group. A 1.5-T MR imaging device was used in order to assess implant integrity with dedicated sequences and in 6 cases a dynamic study was performed for characterizing breast lesions. Two radiologists with more than 5 years’ experience in the field of MRI evaluated in consensus all MR images searching for the presence of clear signs of intra or extra-capsular implant rupture. Results 20/40 (50%) PIP implants presented signs of intra-capsular rupture: linguine sign in 20 cases (100%), tear-drop sign in 6 (30%). In 12/20 cases (60%), MRI signs of extra-capsular rupture were detected. In the control group, an intra-capsular rupture was diagnosed in 12/85 cases (14%) associated with extra-capsular one in 5/12 cases (42%). Among the six cases with suspected breast lesions, in 2/21 patients with PIP implants (10%) a breast carcinoma was diagnosed (mucinous carcinoma, n=1; invasive ductal carcinoma, n=1). In 4/46 patients (9%) with non-PIP implants, an invasive ductal carcinoma was diagnosed. Conclusion The rupture rate of PIP breast implants is significantly higher than non-PIP (50% vs 14%). MRI represents the most accurate imaging tool for evaluating breast prostheses and the linguine sign is the most common MRI sign to be searched. The incidence of breast carcinoma does not significantly differ between the PIP and non-PIP implants and a direct correlation with breast cancer can not been demonstrated. PMID:25644728

  19. Metal-on-metal total hip arthroplasty: the concerns.

    PubMed

    MacDonald, S J

    2004-12-01

    The metal-on-metal bearing couple is having a resurgence in clinical applications seen in total hip and hip resurfacing technologies. The most noteworthy advantage of a metal-on-metal implant is the improved wear characteristics seen in vitro on wear simulators and in vivo with retrieved implants. All bearings have disadvantages, and a metal-on-metal bearing is no exception. Concerns exist regarding the generation of metal ions seen in the blood and urine of patients with metal-on-metal implants. These elevated metal ions have theoretical, although not proven, risks related to carcinogenic and biologic concerns. Additionally, concerns exist regarding hypersensitivity, increased incidence of instability and increased costs. Specific patient selection issues arise with metal-on-metal implants. The current generation of implants has only early and mid-term results available, with no long-term series yet published. Therefore, although a metal-on-metal bearing may be considered a viable alternative to either polyethylene or ceramic implants, outstanding and unresolved issues continue to exist with this bearing, as they do with the alternatives. PMID:15577471

  20. [Imaging in silicone breast implantation].

    PubMed

    Gielens, Maaike P M; Koolen, Pieter G L; Hermens, Roland A E C; Rutten, Matthieu J C M

    2013-01-01

    Recently, there have been concerns regarding the use of breast implants from Poly Implant Prothèse (PIP, Seyne sur Mer, France) for breast augmentation due to their tendency to rupture and the possibility of having toxic contents. MRI using a specific silicone-sensitive sequence has proven to be the most sensitive and specific technique in the detection of intra- and extracapsular implant rupture. However, given its high costs, it is important that this technique is used sparingly. In this clinical lesson, we compare the sensitivity and specificity of mammography, ultrasound, CT and MRI for the detection of breast implant rupture. Based on two cases, a diagnostic approach is given in order to reduce health care costs. PMID:24252405

  1. Advances in lens implant technology

    PubMed Central

    Kampik, Anselm; Dexl, Alois K.; Zimmermann, Nicole; Glasser, Adrian; Baumeister, Martin; Kohnen, Thomas

    2013-01-01

    Cataract surgery is one of the oldest and the most frequent outpatient clinic operations in medicine performed worldwide. The clouded human crystalline lens is replaced by an artificial intraocular lens implanted into the capsular bag. During the last six decades, cataract surgery has undergone rapid development from a traumatic, manual surgical procedure with implantation of a simple lens to a minimally invasive intervention increasingly assisted by high technology and a broad variety of implants customized for each patient’s individual requirements. This review discusses the major advances in this field and focuses on the main challenge remaining – the treatment of presbyopia. The demand for correction of presbyopia is increasing, reflecting the global growth of the ageing population. Pearls and pitfalls of currently applied methods to correct presbyopia and different approaches under investigation, both in lens implant technology and in surgical technology, are discussed. PMID:23413369

  2. Implants for draining neovascular glaucoma.

    PubMed Central

    Molteno, A C; Van Rooyen, M M; Bartholomew, R S

    1977-01-01

    The implant design, surgical technique, and pharmacological methods of controlling bleb fibrosis, used to treat neovascular glaucoma, are described, together with the results of 14 operations performed on 12 eyes. Images PMID:843508

  3. A 5-year retrospective clinical study of the Dentium implants

    PubMed Central

    Lee, Jeong-Yol; Park, Hyo-Jin; Kim, Jong-Eun; Choi, Yong-Geun; Kim, Young-Soo; Huh, Jung-Bo

    2011-01-01

    PURPOSE The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION The 5-year CSR of Implantium implants was 97.37%. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated

  4. The acceptability of cochlear implants and vibrotactile aids.

    PubMed

    Thornton, A R

    1988-05-01

    To obtain data on the likely acceptability of cochlear implants (and of vibrotactile aids), a questionnaire was sent to profoundly/totally hearing-impaired patients. The patients were asked how they felt about their current communication problems and possible benefits to be obtained from such devices. Of the 153 replies obtained, the combined 'yes' or 'maybe' responses indicated that 58% would accept an implant. The corresponding figure for vibrotactile aids was 73%. The statistically significant factors correlating with cochlear implant acceptance were the patient's expectation of the benefit it would give, the time needed for rehabilitation and the degree of communication difficulty that they suffer. The only significant factor in acceptance of a vibrotactile aid was whether the patient had attended the IHR clinic. This implies that the underlying factor is the patient's knowledge about these devices. PMID:2968826

  5. Power harvesting using PZT ceramics embedded in orthopedic implants.

    PubMed

    Chen, Hong; Liu, Ming; Jia, Chen; Wang, Zihua

    2009-09-01

    Battery lifetime has been the stumbling block for many power-critical or maintenance-free real-time embedded applications, such as wireless sensors and orthopedic implants. Thus a piezoelectric material that could convert human motion into electrical energy provides a very attractive solution for clinical implants. In this work, we analyze the power generation characteristics of stiff lead zirconate titanate (PZT) ceramics and the equivalent circuit through extensive experiments. Our experimental framework allows us to explore many important design considerations of such a PZT-based power generator. Overall we can achieve a PZT element volume of 0.5 x 0.5 x 1.8 cm, which is considerably smaller than the results reported so far. Finally, we outline the application of our PZT elements in a total knee replacement (TKR) implant. PMID:19812004

  6. Transcatheter aortic valve implantation in a patient with bicuspid aortic stenosis and a borderline-sized annulus.

    PubMed

    Colkesen, Yucel; Baykan, Oytun; Dagdelen, Sinan; Cayli, Murat

    2015-11-01

    Bicuspid aortic valve (BAV) is currently considered an exclusion criterion for transcatheter aortic valve implantation (TAVI). The risk of adverse aortic events such as incomplete sealing, severe paravalvular regurgitation or dislocation due to elliptic shape and asymmetric calcifications in annulus are higher in TAVI. In this case report, we detailed a case of successful trans-femoral TAVI in a 51-year old male with BAV and its management without in-hospital and 30-day complications. The challenge in this case was the patient's anatomy with a 27-mm annulus for balloon expandable device. The applied strategy was balloon sizing and overdilating the 29-mm stented valve with additional volume that obviated re-ballooning. Trans-femoral TAVI was performed uneventfully under fluoroscopic and transoesophageal echocardiography guidance. A multidetector computed tomography (MDCT) evaluation at 1 month did not show device dislodgement or any other complications. Evidence for evaluation post-TAVI is not sufficient in BAV. We believe patients with BAV should undergo a comprehensive assessment after TAVI including MDCT evaluation. PMID:26265070

  7. Fiber implantation for pattern baldness.

    PubMed

    Hanke, C W; Bergfeld, W F

    1979-01-12

    Examination of 20 patients who had fiber implantation for the treatment of pattern baldness showed that nearly all the fibers had fallen out by ten weeks. Complications observed were facial swelling, infection, foreign-body granulomas, scarring, and permanent hair loss. Scanning electron microscopy identified the fibers as modacrylic fibers. The complications, high monetary cost, and ultimate futility of fiber implantation make it an unacceptable procedure. PMID:364078

  8. Nanostructured Surfaces of Dental Implants

    PubMed Central

    Bressan, Eriberto; Sbricoli, Luca; Guazzo, Riccardo; Tocco, Ilaria; Roman, Marco; Vindigni, Vincenzo; Stellini, Edoardo; Gardin, Chiara; Ferroni, Letizia; Sivolella, Stefano; Zavan, Barbara

    2013-01-01

    The structural and functional fusion of the surface of the dental implant with the surrounding bone (osseointegration) is crucial for the short and long term outcome of the device. In recent years, the enhancement of bone formation at the bone-implant interface has been achieved through the modulation of osteoblasts adhesion and spreading, induced by structural modifications of the implant surface, particularly at the nanoscale level. In this context, traditional chemical and physical processes find new applications to achieve the best dental implant technology. This review provides an overview of the most common manufacture techniques and the related cells-surface interactions and modulation. A Medline and a hand search were conducted to identify studies concerning nanostructuration of implant surface and their related biological interaction. In this paper, we stressed the importance of the modifications on dental implant surfaces at the nanometric level. Nowadays, there is still little evidence of the long-term benefits of nanofeatures, as the promising results achieved in vitro and in animals have still to be confirmed in humans. However, the increasing interest in nanotechnology is undoubted and more research is going to be published in the coming years. PMID:23344062

  9. Ion implanted dielectric elastomer circuits

    NASA Astrophysics Data System (ADS)

    O'Brien, Benjamin M.; Rosset, Samuel; Anderson, Iain A.; Shea, Herbert R.

    2013-06-01

    Starfish and octopuses control their infinite degree-of-freedom arms with panache—capabilities typical of nature where the distribution of reflex-like intelligence throughout soft muscular networks greatly outperforms anything hard, heavy, and man-made. Dielectric elastomer actuators show great promise for soft artificial muscle networks. One way to make them smart is with piezo-resistive Dielectric Elastomer Switches (DES) that can be combined with artificial muscles to create arbitrary digital logic circuits. Unfortunately there are currently no reliable materials or fabrication process. Thus devices typically fail within a few thousand cycles. As a first step in the search for better materials we present a preliminary exploration of piezo-resistors made with filtered cathodic vacuum arc metal ion implantation. DES were formed on polydimethylsiloxane silicone membranes out of ion implanted gold nano-clusters. We propose that there are four distinct regimes (high dose, above percolation, on percolation, low dose) in which gold ion implanted piezo-resistors can operate and present experimental results on implanted piezo-resistors switching high voltages as well as a simple artificial muscle inverter. While gold ion implanted DES are limited by high hysteresis and low sensitivity, they already show promise for a range of applications including hysteretic oscillators and soft generators. With improvements to implanter process control the promise of artificial muscle circuitry for soft smart actuator networks could become a reality.

  10. Auditory midbrain implant: a review.

    PubMed

    Lim, Hubert H; Lenarz, Minoo; Lenarz, Thomas

    2009-09-01

    The auditory midbrain implant (AMI) is a new hearing prosthesis designed for stimulation of the inferior colliculus in deaf patients who cannot sufficiently benefit from cochlear implants. The authors have begun clinical trials in which five patients have been implanted with a single shank AMI array (20 electrodes). The goal of this review is to summarize the development and research that has led to the translation of the AMI from a concept into the first patients. This study presents the rationale and design concept for the AMI as well a summary of the animal safety and feasibility studies that were required for clinical approval. The authors also present the initial surgical, psychophysical, and speech results from the first three implanted patients. Overall, the results have been encouraging in terms of the safety and functionality of the implant. All patients obtain improvements in hearing capabilities on a daily basis. However, performance varies dramatically across patients depending on the implant location within the midbrain with the best performer still not able to achieve open set speech perception without lip-reading cues. Stimulation of the auditory midbrain provides a wide range of level, spectral, and temporal cues, all of which are important for speech understanding, but they do not appear to sufficiently fuse together to enable open set speech perception with the currently used stimulation strategies. Finally, several issues and hypotheses for why current patients obtain limited speech perception along with several feasible solutions for improving AMI implementation are presented. PMID:19762428

  11. Therapy using implanted organic bioelectronics

    PubMed Central

    Jonsson, Amanda; Song, Zhiyang; Nilsson, David; Meyerson, Björn A.; Simon, Daniel T.; Linderoth, Bengt; Berggren, Magnus

    2015-01-01

    Many drugs provide their therapeutic action only at specific sites in the body, but are administered in ways that cause the drug’s spread throughout the organism. This can lead to serious side effects. Local delivery from an implanted device may avoid these issues, especially if the delivery rate can be tuned according to the need of the patient. We turned to electronically and ionically conducting polymers to design a device that could be implanted and used for local electrically controlled delivery of therapeutics. The conducting polymers in our device allow electronic pulses to be transduced into biological signals, in the form of ionic and molecular fluxes, which provide a way of interfacing biology with electronics. Devices based on conducting polymers and polyelectrolytes have been demonstrated in controlled substance delivery to neural tissue, biosensing, and neural recording and stimulation. While providing proof of principle of bioelectronic integration, such demonstrations have been performed in vitro or in anesthetized animals. Here, we demonstrate the efficacy of an implantable organic electronic delivery device for the treatment of neuropathic pain in an animal model. Devices were implanted onto the spinal cord of rats, and 2 days after implantation, local delivery of the inhibitory neurotransmitter γ-aminobutyric acid (GABA) was initiated. Highly localized delivery resulted in a significant decrease in pain response with low dosage and no observable side effects. This demonstration of organic bioelectronics-based therapy in awake animals illustrates a viable alternative to existing pain treatments, paving the way for future implantable bioelectronic therapeutics. PMID:26601181

  12. Auditory Midbrain Implant: A Review

    PubMed Central

    Lim, Hubert H.; Lenarz, Minoo; Lenarz, Thomas

    2009-01-01

    The auditory midbrain implant (AMI) is a new hearing prosthesis designed for stimulation of the inferior colliculus in deaf patients who cannot sufficiently benefit from cochlear implants. The authors have begun clinical trials in which five patients have been implanted with a single shank AMI array (20 electrodes). The goal of this review is to summarize the development and research that has led to the translation of the AMI from a concept into the first patients. This study presents the rationale and design concept for the AMI as well a summary of the animal safety and feasibility studies that were required for clinical approval. The authors also present the initial surgical, psychophysical, and speech results from the first three implanted patients. Overall, the results have been encouraging in terms of the safety and functionality of the implant. All patients obtain improvements in hearing capabilities on a daily basis. However, performance varies dramatically across patients depending on the implant location within the midbrain with the best performer still not able to achieve open set speech perception without lip-reading cues. Stimulation of the auditory midbrain provides a wide range of level, spectral, and temporal cues, all of which are important for speech understanding, but they do not appear to sufficiently fuse together to enable open set speech perception with the currently used stimulation strategies. Finally, several issues and hypotheses for why current patients obtain limited speech perception along with several feasible solutions for improving AMI implementation are presented. PMID:19762428

  13. IMMEDIATE VERSUS DELAYED LOADING IMPLANTS: RATIONALE AND CONTROVERSIES.

    PubMed

    Corradini, G; Delle Donne, U; Boni, W; Tettamanti, L; Tagliabue, A

    2015-01-01

    Loading implants immediately after their position in alveolar bone crest is a procedure that has become popular in the last decade. The aim of this study is to evaluate the survival rate of 811 immediate loaded implants (ILIs). In the period between January 2008 and December 2013, 877 patients (498 females and 379 males) were operated at the BDD private Practice Clinic (Milan, Italy). The mean post-surgical follow-up was 30±17 months (max – min, 84 – 1). One thousasnd three hundred and eighty-six fixtures (EDIERRE Implant System SpA, Genoa, Italy) were evaluated in the present study, 811 immediately loaded and 575 loaded after 3 months. All patients underwent the same surgical protocol and agreed to participate in a post-operative check-up program. SPSS program was used for statistical analysis. Survival rate (SVR) was 97.3% since only 38 fixtures were lost from a total of 1,348 implants. Cross-tabulation between failures demonstrated slight but significant worse results for ILIs (p= 0.037). There were 28 failures out of 811 ILIs whereas only 10 fixtures were lost out of 565 implants loaded after 3 months. Immediate loading performed in selected cases is a reliable tool for oral rehabilitation. PMID:26511174

  14. Imaging of common breast implants and implant-related complications: A pictorial essay

    PubMed Central

    Shah, Amisha T; Jankharia, Bijal B

    2016-01-01

    The number of women undergoing breast implant procedures is increasing exponentially. It is, therefore, imperative for a radiologist to be familiar with the normal and abnormal imaging appearances of common breast implants. Diagnostic imaging studies such as mammography, ultrasonography, and magnetic resonance imaging are used to evaluate implant integrity, detect abnormalities of the implant and its surrounding capsule, and detect breast conditions unrelated to implants. Magnetic resonance imaging of silicone breast implants, with its high sensitivity and specificity for detecting implant rupture, is the most reliable modality to asses implant integrity. Whichever imaging modality is used, the overall aim of imaging breast implants is to provide the pertinent information about implant integrity, detect implant failures, and to detect breast conditions unrelated to the implants, such as cancer. PMID:27413269

  15. SynCardia: the total artificial heart

    PubMed Central

    Anyanwu, Anelechi; Zucchetta, Fabio; Gerosa, Gino

    2014-01-01

    The SynCardia total artificial heart (TAH) currently provides the most definitive option for patients with biventricular failure who are not candidates for isolated left ventricular (LV) assist device placement. The techniques for implantation are adaptable to almost all patients with advanced heart failure, including those with severe biventricular cardiomyopathy, complex congenital heart disease, failed LV assist devices, failed transplantations, and acquired structural heart defects that have failed or are not amenable to conventional surgical treatment. Over the years, the implantation technique has evolved in order to minimize the surgical invasiveness of the procedure, in anticipation of additional future surgery. Meticulous hemostasis with double layer sutures, use of Gore-Tex sheets around the TAH and the pericardial cavity, and use of tissue expanders to avoid contraction of pericardial cavity around the device are discussed in detail in the following report. Additionally, we will provide our experience with implantation of TAH in various challenging scenarios, such as patients with a small chest cavity, congenital heart defects, and simultaneous use of extracorporeal membrane oxygenation (ECMO). PMID:25512904

  16. SynCardia: the total artificial heart.

    PubMed

    Torregrossa, Gianluca; Anyanwu, Anelechi; Zucchetta, Fabio; Gerosa, Gino

    2014-11-01

    The SynCardia total artificial heart (TAH) currently provides the most definitive option for patients with biventricular failure who are not candidates for isolated left ventricular (LV) assist device placement. The techniques for implantation are adaptable to almost all patients with advanced heart failure, including those with severe biventricular cardiomyopathy, complex congenital heart disease, failed LV assist devices, failed transplantations, and acquired structural heart defects that have failed or are not amenable to conventional surgical treatment. Over the years, the implantation technique has evolved in order to minimize the surgical invasiveness of the procedure, in anticipation of additional future surgery. Meticulous hemostasis with double layer sutures, use of Gore-Tex sheets around the TAH and the pericardial cavity, and use of tissue expanders to avoid contraction of pericardial cavity around the device are discussed in detail in the following report. Additionally, we will provide our experience with implantation of TAH in various challenging scenarios, such as patients with a small chest cavity, congenital heart defects, and simultaneous use of extracorporeal membrane oxygenation (ECMO). PMID:25512904

  17. Periprosthetic Osteolysis after Total Wrist Arthroplasty

    PubMed Central

    Boeckstyns, Michel E. H.; Herzberg, Guillaume

    2014-01-01

    Background and Literature Review Periprosthetic osteolysis (PPO) after second- or third-generation total wrist arthroplasty (TWA), with or without evident loosening of the implant components, has previously been reported in the literature, but rarely in a systematic way. Purpose The purpose of this study was to analyze the prevalence, location, and natural history of PPO following a TWA and to determine whether this was associated with prosthetic loosening. Patients and Methods We analyzed 44 consecutive cases in which a RE-MOTION TWA (Small Bone Innovations Inc., Morrisville, PA, USA) had been done. Results We found significant periprosthetic radiolucency (more than 2 mm in width) at the radial component side in 16 of the cases and at the carpal component side in 7. It developed gradually juxta-articularly around the prosthetic components regardless of the primary diagnosis, and seemed to stabilize in most patients after 1–3 years. In a small percentage of the patients, the periprosthetic area of bone resorption was markedly larger. In general, radiolucency was not related to evident loosening of the implant components, and only five carpal components and one radial had subsided or tilted. Conclusion Periprosthetic loosening is frequent following a TWA. In our series it was not necessarily associated with implant loosening and seemed to stabilize within 3 years. Close and continued observation is, however, recommended. Level of Evidence Therapeutic IV PMID:25032076

  18. Cochlear Implants (For Parents)

    MedlinePlus

    ... t be totally "natural." After the first few programming sessions, the user begins to pick up sounds ... hear sounds. This is an extended process with programming and intensive therapy that often lasts for several ...

  19. Total Artificial Heart, Augmented by Venovenous Extracorporeal Membrane Oxygenation.

    PubMed

    Lick, Scott D; Tran, Phat L; Kazui, Toshinobu; Smith, Richard G; Khalpey, Zain I

    2016-01-01

    Shortly after SynCardia total artificial heart (TAH) implant, venovenous extracorporeal membrane oxygenation (ECMO) via a 31 Fr Avalon cannula was used for profound hypoxic lung dysfunction. Immediately after starting ECMO, TAH flow increased by 1.5-2.0 L/min, presumably because of augmented TAH filling by the ECMO jet. PMID:26771394

  20. Correlation between clinical parameters characterising peri-implant and periodontal health: A practice-based research in Spain in a series of patients with implants installed 4-5 years ago

    PubMed Central

    Lopez-Piriz, Roberto; Giménez, Maria J.; Bowen, Antonio; Carroquino, Rafael; Aguilar, Lorenzo; Corral, Ignacio; del Val, Cora; González, Inmaculada; Ilzarbe, Luis M.; Maestre, Juan R.; Padullés, Esteban; Torres-Lear, Francisco; Granizo, Juan J.; San-Román, Fide; Hernández, Sofía; Prieto, José

    2012-01-01

    Objectives: To explore periimplant health (and relation with periodontal status) 4-5 years after implant insertion. Study Design: A practice-based dental research network multicentre study was performed in 11 Spanish centres. The first patient/month with implant insertion in 2004 was considered. Per patient four teeth (one per quadrant) showing the highest bone loss in the 2004 panoramic X-ray were selected for periodontal status assessment. Bone losses in implants were calculated as the differences between 2004 and 2009 bone levels in radiographs. Results: A total of 117 patients were included. Of the 408 teeth considered, 73 (17.9%) were lost in 2009 (losing risk: >50% for bone losses ≥7mm). A total of 295 implants were reviewed. Eight of 117 (6.8%) patients had lost implants (13 of 295 implants installed; 4.4%). Implant loss rate (quadrant status) was 1.4% (edentulous), 3.6% (preserved teeth), and 11.1% (lost teeth) (p=0.037). The percentage of implant loss significantly (p<0.001) increased when the medial/distal bone loss was ≥3 mm. The highest (p≤0.001) pocket depths were found in teeth with ≥5mm and implants with ≥3mm bone losses, with similar mean values (≥4mm), associated with higher rates of plaque index and bleeding by probing. Conclusions: The significant bi-directional relation between plaque and bone loss, and between each of these two parameters/signs and pocket depths or bleeding (both in teeth and implants, and between them) together with the higher percentage of implants lost when the bone loss of the associated teeth was ≥3 mm suggest that the patient’s periodontal status is a critical issue in predicting implant health/lesion. Key words:Implants, periimplantitis, periodontitis, oral health, practice-based research PMID:22549681