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1

Biodegradable Orthopedic Implants  

Microsoft Academic Search

Over the past 30 years, there have been significant advances in the development of biodegradable materials [79]. In particular, these materials have received attention for use as implants to aid regeneration of orthopedic defects [49,91]. Every year more than 3.1 million orthopedic surgeries are performed in the United States alone [1]. However, although current treatments using nondegradable fixation materials have

Johnna S. Temenoff; Antonios G. Mikos

2

Spines, backbones and orthopedic surgery. Spines, backbones and orthopedic surgery.  

E-print Network

1/ 17 Spines, backbones and orthopedic surgery. Spines, backbones and orthopedic surgery. Simon;2/ 17 Spines, backbones and orthopedic surgery. Motivation #12;2/ 17 Spines, backbones and orthopedic surgery. Motivation Recent work (B-boys & Schweinsberg, Aidekon-Harris) considers branching Brownian

3

Lasers in orthopedics  

NASA Astrophysics Data System (ADS)

Orthopedic Surgery is that surgical discipline which deals with the musculoskeletal system. Orthopedists therefore operate on joints, the spine and long bones and engage in such subsecialities as sports medicine, hand surgery, trauma surgery, and joint replacements. Since they must cut and shape bone, cartilage, tendon, and ligament, orthopedists have developed a number of mechanical techniques to achieve these ends and surgical lasers have found few applications in orthopedics because until now they have not been useful for cutting bone. In the past several years, however, there has been considerable interest in several areas within the field of orthopedic surgery that do not entail actual bone surgery and it is expected that as newer and more powerful lasers become available laser osteotomy may become feasible and even routine.

Sherk, Henry H.; Rhodes, Anthony L.; Meller, Menachem M.

1990-06-01

4

Tourniquets in orthopedic surgery  

PubMed Central

Tourniquets are commonly used in limb surgeries, be it orthopedic or plastic surgeries. But the inflation pressures, the duration, and release guidelines are still not clear. According to a survey, majority of orthopedic surgeons inflate the tourniquet to fixed pressures for the upper and the lower limbs without considering the baseline blood pressure of the patient on whom the tourniquets are being applied. This review was designed to recall and review the safe use of tourniquets and the various techniques that can be employed to minimize the complications of tourniquet use. Google, science direct, and pubmed were searched for appropriate literature and relevant articles were identified. PMID:22912509

Sharma, Jai Prakash; Salhotra, Rashmi

2012-01-01

5

Identification of Bone Structure During Automatic Drilling in Orthopedic Surgery  

Microsoft Academic Search

In orthopedic surgery the manipulation “bone drilling” is used very often and it is performed by hand drilling, which causes a lot of problems—getting the big outlets, breaking the tendons or blood vessels, protecting the rear bone wall (which brings one more cutting of the tissue), overheating, and so on. Automatic bone drilling could successfully solve these problems. The drilling

Tony Boiadjiev; Kazimir Zagurski; George Boiadjiev; Kamen Delchev; Vladimir Vitkov; Ivanka Veneva; Rumen Kastelov

2011-01-01

6

Orthopedic Gene Therapy in 2008  

Microsoft Academic Search

Orthopedic disorders, although rarely fatal, are the leading cause of morbidity and impose a huge socioeconomic burden. Their prevalence will increase dramatically as populations age and gain weight. Many orthopedic conditions are difficult to treat by conventional means; however, they are good candidates for gene therapy. Clinical trials have already been initiated for arthritis and the aseptic loosening of prosthetic

Christopher H Evans; Steven C Ghivizzani; Paul D Robbins

2009-01-01

7

Prions and orthopedic surgery.  

PubMed

Prions are a novel class of infectious agents that cause subacute encephalopathy in man and animals as human Creutzfeldt-Jakob disease (CJD), sheep scrapie and bovine spongiform encephalopathy (BSE). Previously, prions were shown to be transmitted by neuro- and ophthalmosurgical measures and by application of brain-derived therapeutic hormones. Recently, prions have been detected in blood specimens of experimentally infected monkeys indicating a principal threat to transfusion medicine, furthermore in human or bovine materials used in reconstructive surgery. In this article the risk of prion transmission from the surgeon to the patient or vice versa during (orthopedic) surgery is reevaluated including the issues of blood transfusion. This is accomplished based on recent epidemiologic findings and biometric calculations on the spread of prions in animals and humans as well as in terms of experimental data on artificially contaminated medical materials and devices. The overall risk of prion transmission in orthopedic surgery is considered very low if adequately prepared and sterilized materials and devices are used. PMID:12789474

Doerr, H W; Cinatl, J; Stürmer, M; Rabenau, H F

2003-06-01

8

Superelastic Orthopedic Implant Coatings  

NASA Astrophysics Data System (ADS)

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.

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

2014-07-01

9

Nanostructured apatites as orthopedic biomaterials  

E-print Network

Historically, using suitable mechanical replacements for bone has been a priority in designing permanent, load-bearing orthopedic implants. As a result, the biomaterials used in these implants have been largely limited to ...

Ahn, Edward Sun, 1972-

2001-01-01

10

Plasma Biomedicine in Orthopedics  

NASA Astrophysics Data System (ADS)

Various effects of plasmas irradiation on cells, tissues, and biomaterials relevant for orthopedic applications have been examined. For direct application of plasmas to living cells or tissues, dielectric barrier discharges (DBDs) with helium flows into ambient air were used. For biomaterial processing, on the other hand, either helium DBDs mentioned above or low-pressure discharges generated in a chamber were used. In this presentation, plasma effects on cell proliferation and plasma treatment for artificial bones will be discussed. First, the conditions for enhanced cell proliferation in vitro by plasma applications have been examined. The discharge conditions for cell proliferation depend sensitively on cell types. Since cell proliferation can be enhanced even when the cells are cultured in a plasma pre-treated medium, long-life reactive species generated in the medium by plasma application or large molecules (such as proteins) in the medium modified by the plasma are likely to be the cause of cell proliferation. It has been found that there is strong correlation between (organic) hydroperoxide generation and cell proliferation. Second, effects of plasma-treated artificial bones made of porous hydroxyapatite (HA) have been examined in vitro and vivo. It has been found that plasma treatment increases hydrophilicity of the surfaces of microscopic inner pores, which directly or indirectly promotes differentiation of mesenchymal stem cells introduced into the pores and therefore causes faster bone growth. The work has been performed in collaboration with Prof. H. Yoshikawa and his group members at the School of Medicine, Osaka University.

Hamaguchi, Satsohi

2012-10-01

11

Medical photography: principles for orthopedics  

PubMed Central

Background Medical photography is used clinically for patient evaluation, treatment decisions, and scientific documentation. Although standards for medical photography exist in many branches of medicine, we have not encountered such criteria in publications in the area of orthopedics. Purpose This study aims to (1) assess the quality of medical images used in an orthopedic publication and (2) to propose standards for medical photography in this area. Methods Clinical photographs were reviewed from all issues of a journal published between the years 2008 and 2012. A quality of clinical images was developed based on the criteria published for the specialties of dermatology and cosmetic surgery. All images were reviewed on the appropriateness of background, patient preparation, and technique. Results In this study, only 44.9% of clinical images in an orthopedic publication adhered to the proposed conventions. Conclusions Standards have not been established for medical photography in orthopedics as in other specialty areas. Our results suggest that photographic clinical information in orthopedic publications may be limited by inadequate presentation. We propose that formal conventions for clinical images should be established. PMID:24708703

2014-01-01

12

Growth factors in orthopedic surgery  

PubMed Central

Growth factors have represented an essential issue of interest for the researchers and clinicians in orthopedics and trauma over the last 40 years. In the last 10 to 15 years, the advances registered in this field have permitted the identification of the most active cellular and humoral factors as well as the improvement of their use in the orthopedic and trauma surgery. Their domain of application has been continuously enlarged and the results have been visible from the beginning. The authors present their appreciation on the actual state of this subject as well as their experience with results and related conclusions. PMID:20302195

Zaharia, C; Despa, N; Simionescu, M; Jinga, V; Fleseriu, I

2010-01-01

13

[Lviv traditions of Polish orthopedics].  

PubMed

The paper presents how orthopedics as a new surgical specialty has emerged in Lviv at the end of the nineteenth century and the first decades of the twentieth century. A medical activity of professors who were in charge of the Surgery Clinic of the Lviv University (Ludwik Rydygier and Hilary Schramm) was described and the eminent orthopedists, Antoni Grabiszewski, who as a first Polish doctor habilitated in surgery and orthopedist, and Tadeusz Ostrowski, who was executed by Gestapo in 1941, as well. Adam Gruca, Józef Kowalski, Marian Garlicki and Marian A. Weiss continued to develop Lviv orthopedics in Warsaw, Wroc?aw and Silesia after the Second World War. PMID:19241889

Magowska, Anita

2008-01-01

14

Porous metal for orthopedics implants  

PubMed Central

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

Matassi, Fabrizio; Botti, Alessandra; Sirleo, Luigi; Carulli, Christian; Innocenti, Massimo

2013-01-01

15

Orthopedic Management of Spina Bifida  

ERIC Educational Resources Information Center

The management of orthopedic problems in spina bifida has seen a dramatic change over the past 10 years. The negative effects of spasticity, poor balance, and the tethered cord syndrome on ambulatory function are better appreciated. There is less emphasis on the hip radiograph and more emphasis on the function of the knee and the prevention of…

Thomson, Jeffrey D.; Segal, Lee S.

2010-01-01

16

Minimally Invasive Orthopedic Surgery: Arthroscopy  

PubMed Central

Arthroscopy, a minimally invasive alternative to standard open surgical techniques and now the most commonly performed orthopedic surgical procedure, was one of the greatest advances in orthopedic surgery of the 20th century. Minimally invasive surgeries result in less postoperative swelling than open techniques and reduce pain, risk of complications, and recovery times. Arthroscopy has evolved from a diagnostic tool to a therapeutic tool capable of treating a wide range of injuries and disorders. Many injuries, particularly those that at one time would have been career ending for athletes, can now be addressed with arthroscopy allowing a quicker return to full function. While arthroscopy has resulted in an overall decrease in morbidity compared with open techniques, it is still an invasive procedure and inherently involves risks. Almost all arthroscopic procedures can be performed in an outpatient setting. In 1999, 211 arthroscopic procedures were performed at Ochsner. PMID:21765685

Treuting, Robert

2000-01-01

17

45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.  

Code of Federal Regulations, 2012 CFR

...PERFORMANCE STANDARDS ON SERVICES FOR CHILDREN WITH DISABILITIES Health Services...Orthopedic impairment. (a) A child is classified as having an orthopedic...severe enough to adversely affect a child's learning. An orthopedic...

2012-10-01

18

45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.  

Code of Federal Regulations, 2014 CFR

...PERFORMANCE STANDARDS ON SERVICES FOR CHILDREN WITH DISABILITIES Health Services...Orthopedic impairment. (a) A child is classified as having an orthopedic...severe enough to adversely affect a child's learning. An orthopedic...

2014-10-01

19

45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.  

Code of Federal Regulations, 2011 CFR

...PERFORMANCE STANDARDS ON SERVICES FOR CHILDREN WITH DISABILITIES Health Services...Orthopedic impairment. (a) A child is classified as having an orthopedic...severe enough to adversely affect a child's learning. An orthopedic...

2011-10-01

20

45 CFR 1308.12 - Eligibility criteria: Orthopedic impairment.  

Code of Federal Regulations, 2013 CFR

...PERFORMANCE STANDARDS ON SERVICES FOR CHILDREN WITH DISABILITIES Health Services...Orthopedic impairment. (a) A child is classified as having an orthopedic...severe enough to adversely affect a child's learning. An orthopedic...

2013-10-01

21

Locking mechanism for orthopedic braces  

NASA Technical Reports Server (NTRS)

A locking mechanism for orthopedic braces is described which automatically prevents or permits the relative pivotable movement between a lower brace member and an upper brace member. The upper and lower brace members are provided with drilled bores within which a slidable pin is disposed, and depending upon the inclination of the brace members with respect to a vertical plane, the slidable pin will be interposed between both brace members. The secondary or auxiliary latching device includes a spring biased, manually operable lever bar arrangement which is manually unlatched and automatically latched under the influence of the spring.

I-Lechao, J.; Epps, C. H., Jr. (inventors)

1976-01-01

22

Locking mechanism for orthopedic braces  

NASA Technical Reports Server (NTRS)

An orthopedic brace locking mechanism is described which under standing or walking conditions cannot be unlocked, however under sitting conditions the mechanism can be simply unlocked so as to permit bending of the patient's knee. Other features of the device include: (1) the mechanism is rendered operable, and inoperable, dependent upon the relative inclination of the brace with respect to the ground; (2) the mechanism is automatically locked under standing or walking conditions and is manually unlocked under sitting conditions; and (3) the mechanism is light in weight and is relatively small in size.

Chao, J. I.; Epps, C. H., Jr.

1981-01-01

23

Orthopedic surgery in ancient Egypt  

PubMed Central

Background — Ancient Egypt might be considered the cradle of medicine. The modern literature is, however, sometimes rather too enthusiastic regarding the procedures that are attributed an Egyptian origin. I briefly present and analyze the claims regarding orthopedic surgery in Egypt, what was actually done by the Egyptians, and what may have been incorrectly ascribed to them. Methods — I reviewed the original sources and also the modern literature regarding surgery in ancient Egypt, concentrating especially on orthopedic surgery. Results — As is well known, both literary sources and the archaeological/osteological material bear witness to treatment of various fractures. The Egyptian painting, often claimed to depict the reduction of a dislocated shoulder according to Kocher’s method, is, however, open to interpretation. Therapeutic amputations are never depicted or mentioned in the literary sources, while the specimens suggested to demonstrate such amputations are not convincing. Interpretation — The ancient Egyptians certainly treated fractures of various kinds, and with varying degrees of success. Concerning the reductions of dislocated joints and therapeutic amputations, there is no clear evidence for the existence of such procedures. It would, however, be surprising if dislocations were not treated, even though they have not left traces in the surviving sources. Concerning amputations, the general level of Egyptian surgery makes it unlikely that limb amputations were done, even if they may possibly have been performed under extraordinary circumstances. PMID:25140982

Blomstedt, Patric

2014-01-01

24

Physical modification of polyetheretherketone for orthopedic implants  

NASA Astrophysics Data System (ADS)

Polyetheretherketone (PEEK) is regarded as one of the most potential candidates for replacing current implant applications. To obtain good bone-implant interfaces, many modification methods have been developed to enable PEEK and PEEK-based composites from bio-inert to bioactive. Among them, physical methods have aroused significant attention and been widely used to modify PEEK for orthopedic implants. This review summarizes current physical modification techniques of PEEK for orthopedic applications, which include composite strategies, surface coating methods and irradiation treatments. The positive consequences of those modification methods will encourage continuing investigations and stimulate the wide range of applications of PEEK-based implants in orthopedics.

Du, Ya-Wei; Zhang, Li-Nan; Hou, Zeng-Tao; Ye, Xin; Gu, Hong-Sheng; Yan, Guo-Ping; Shang, Peng

2014-12-01

25

Orthopedic injuries from the Andover, Kansas, tornado.  

PubMed

Devastating tornados struck the state of Kansas on Friday, April 26, 1991. Twenty lives were lost and many people were injured. Property damage was extensive. Overall, the outcome of those admitted to the various hospitals was good, with few orthopedic-related complications. The low complication rate can be attributed to thorough open wound management and suspicion and recognition of other potential orthopedic complications such as compartment syndrome. PMID:8189469

Rosenfield, A L; McQueen, D A; Lucas, G L

1994-05-01

26

Orthopedic issues in vascular anomalies.  

PubMed

Vascular malformations impact the musculoskeletal system depending on the tissue involved (skin, subcutis, muscle, cartilage, or bone), the extent of involvement, and the type of anomalous vessels (arteries, capillaries, veins, or lymphatics). These malformations can cause a multitude of musculoskeletal problems for the patient and their Orthopedic Surgeon to manage. Leg-length discrepancy, intra-articular involvement, muscular lesions, and primary or secondary scoliosis are just to name a few. All of these problems can cause pain, deformity, and a range of functional limitations. Surgical and nonsurgical treatment plans both have a role in the care of these patients. Patients with vascular malformations may also suffer from life-threatening cardiovascular and hematologic abnormalities. For those patients who undergo surgery, thromboembolic risk is elevated, wound breakdown and infection are much more common, and bleeding risk continues well into the postoperative course. Because of the complex nature of these disorders, the clinician must have a full understanding of the types of lesions, their natural history, appropriate diagnostic studies, associated medical problems, indications for treatment, and all the treatment options. For severe malformations, especially syndromes such as CLOVES and Klippel-Trenaunay syndrome, interdisciplinary team management is essential for the best outcomes. PMID:25241103

Spencer, Samantha A; Sorger, Joel

2014-08-01

27

78 FR 17940 - Certain Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof...  

Federal Register 2010, 2011, 2012, 2013, 2014

...Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof...Computerized Orthopedic Surgical Devices, Software, Implants, and Components Thereof...computerized orthopedic surgical devices, software, implants, and components...

2013-03-25

28

76 FR 20690 - International Consortium of Orthopedic Registries; Public Workshop  

Federal Register 2010, 2011, 2012, 2013, 2014

...develop a research consortium...orthopedic medical devices...orthopedic medical devices. III. What are the topics we intend...Regulatory science, clinical...opportunities for medical device outcomes research. IV....

2011-04-13

29

[Psychopathologic reactions in orthopedic patients].  

PubMed

The idea to monitor and research psychopathological responses of physically injured persons in a more systematic manner has come from our observation of huge differences in patient behavior, whose psychological responses were noticeably changed and often inappropriate. The behavior aberrations were all the more striking because we treated war-time injuries in addition to peacetime ones. Our sample had 175 patient subjects, of both sexes, different ages, marital status and professions. A group of 70 patients treated in the Institute for Orthopedic Surgery and Traumatology were divided into two subgroups. The first experimental subgroup (E1) consisted of 26 (37.1%) patients physically injured in combat. The second subgroup (E2) had 44 (62.9%) patients physically injured in peacetime circumstances (car accidents, work accidents, etc). The physical injuries encompassed injuries to spinal column and extremities. The control (K) consisted of 105 subjects without physical injuries. The clinical picture and psychological reactions of the patients were examined by means of 4 instruments--PTSD-10 scale or posttraumatic symptoms scale [1], Family Homogeneity Index/FHI/with 19 variables, applied to measure the relation between the family system homogeneity and accident effects [2], Short Eysenck's Personality Inventory applied to investigate neuroticism and extroversion and introversion traits [3], Late Effects of Accidental Injury Questionnaire [4]. Our observations of psychological responses of patients in our ward (insomnia, sedatives intake) were mostly confirmed by tests conducted with the above instruments. In the group of the wartime injured (E1), as well as in the control (K), Eysenck's scale proved a significantly higher degree of neuroticism in comparison to the peacetime injured. Such results indicated that the wartime injured would most probably develop the picture of Posttraumatic Stress Disorder. Such a conclusion was related not only to the seriousness of injuries but also to the circumstances of their occurrence. The proneness to develop PTSD symptoms was not in correlation with the preparedness for accident, it being much poorer in peace-time injuries, as opposed to wartime patients, who had been prepared to the possibility of injury occurrence. The highest value of family homogeneity (FHI) was established in the wartime injured, which led us to conclude that the injury contributed to the cohesion of the family from which the patient came. By extracting some questions related to psychopathological entities such as insomnia, depression, somatization, anxiety, and cognitive disorders, the following results were obtained. Depression was the most frequent in both groups of injuries. Anxiety was also present in the control group; and insomnia and somatization, that is, conversion symptoms, were present in both groups of the injured. By examining narrower psychological characteristics of the wartime injured revealed dissociation problems--derangement to be the most frequent. Then follow the symptoms of depression, which occur significantly more frequently in the wartime injured in comparison to the peacetime injured. The phenomenological symptoms of derangement and depression proved to be reliable parameters of physical trauma. It is also significant that the three characteristics showed correlation to psychopathological responses: severity of surgery, paralysis, and acute injury. PMID:14692144

Lesi?, Aleksandar; Opali?, Petar

2003-01-01

30

Emotional intelligence in orthopedic surgery residents  

PubMed Central

Background Emotional intelligence (EI) is the ability to understand and manage emotions in oneself and others. It was originally popularized in the business literature as a key attribute for success that was distinct from cognitive intelligence. Increasing focus is being placed on EI in medicine to improve clinical and academic performance. Despite the proposed benefits, to our knowledge, there have been no previous studies on the role of EI in orthopedic surgery. We evaluated baseline data on EI in a cohort of orthopedic surgery residents. Methods We asked all orthopedic surgery residents at a single institution to complete an electronic version of the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT). We used completed questionnaires to calculate total EI scores and 4 branch scores. Data were analyzed according to a priori cutoff values to determine the proportion of residents who were considered competent on the test. Data were also analyzed for possible associations with age, sex, race and level of training. Results Thirty-nine residents (100%) completed the MSCEIT. The mean total EI score was 86 (maximum score 145). Only 4 (10%) respondents demonstrated competence in EI. Junior residents (p = 0.026), Caucasian residents (p = 0.009) and those younger than 30 years (p = 0.008) had significantly higher EI scores. Conclusion Our findings suggest that orthopedic residents score low on EI based on the MSCEIT. Optimizing resident competency in noncognitive skills may be enhanced by dedicated EI education, training and testing. PMID:24666445

Chan, Kevin; Petrisor, Brad; Bhandari, Mohit

2014-01-01

31

Transfusion practices for elective orthopedic surgery  

Microsoft Academic Search

Background: Use of blood conservation techniques in elective surgery reduces the risk of infection and transfusion reactions that result from using allogeneic blood products. We examined the transfusion practice and blood conservation strate- gies for elective orthopedic procedures in 19 Canadian hospitals. Methods: We reviewed the medical records of patients who underwent total hip or knee joint arthroplasty between June

Brian G. Feagan; Cindy J. Wong; William C. Johnston; Ramiro Arellano; Nigel Colterjohn; Keyvan Karkouti; Kim Turner

32

Orthopedically Handicapped Children in Ohio Public Schools.  

ERIC Educational Resources Information Center

The historical development of programs for orthopedically handicapped children, class units and hospital classes approved during 1967-68, and the number of therapy units established are presented. Tables give data on program population: enrollment for years 1962-68, percent of handicaps enrolled, and IQ distributions. Aspects of occupational…

Naples, Victor J.; Todd, Joseph H.

33

Bone Adhesives in Trauma and Orthopedic Surgery  

Microsoft Academic Search

Adhesives, especially bone adhesives, are resorbed and degraded to non-toxic products after fulfilling their function in contact\\u000a with the living organism. The use of such bone adhesives has found growing interest in all fields of medicine in the last\\u000a 50 years. The dream of trauma and orthopedic surgeons for alternatives to osteosynthesis and pins is reflected in the development\\u000a of

Christian Heiss; Ralf Kraus; Dominique Schluckebier; Ann-Christin Stiller; Sabine Wenisch; Reinhard Schnettler

2006-01-01

34

Undergraduate orthopedic education: Is it adequate?  

PubMed Central

Background: Basic musculoskeletal knowledge is essential to the practice of medicine. The purpose of this study was to assess the adequacy of musculoskeletal knowledge of medical students. Materials and Methods: The validated basic competency examination in musculoskeletal medicine devised by Freidman and Bernstein was administered to final year medical students just prior to their final professional examination. Participants were also required to assess their confidence at making a musculoskeletal physical examination and diagnosis as well as comment on the adequacy of time in the curriculum devoted to Orthopedics. Results: The response rate was 83% (40/48). The average cognitive examination score was 48.3%. Two participants (5%) obtained a score of ? 73.1%, the recommended mean passing score. Seventeen students (42.5%) felt orthopedic clinical cases were the most difficult to perform a physical examination and diagnose. Thirteen students (32.5%) felt that the time devoted to orthopedics in the medical curriculum was inadequate. Conclusions: Ninety-five percent of the students failed to show basic musculoskeletal competency. A change in medical curriculum and teaching methods is required to address this problem. PMID:19753186

Menon, Jagdish; Patro, Dilip K

2009-01-01

35

Orthopedic Resident Anatomy Review Course: A Collaboration between Anatomists and Orthopedic Surgeons  

ERIC Educational Resources Information Center

A challenge for new residents and senior residents preparing for board examinations is refreshing their knowledge of basic science disciplines, such as human gross anatomy. The Department of Orthopaedics at the University of Utah School of Medicine has for many years held an annual Orthopedic Resident Anatomy Review Course during the summer months…

DeFriez, Curtis B.; Morton, David A.; Horwitz, Daniel S.; Eckel, Christine M.; Foreman, K. Bo; Albertine, Kurt H.

2011-01-01

36

Prevention of VTE in Orthopedic Surgery Patients  

PubMed Central

Background: VTE is a serious, but decreasing complication following major orthopedic surgery. This guideline focuses on optimal prophylaxis to reduce postoperative pulmonary embolism and DVT. Methods: The methods of this guideline follow those described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement. Results: In patients undergoing major orthopedic surgery, we recommend the use of one of the following rather than no antithrombotic prophylaxis: low-molecular-weight heparin; fondaparinux; dabigatran, apixaban, rivaroxaban (total hip arthroplasty or total knee arthroplasty but not hip fracture surgery); low-dose unfractionated heparin; adjusted-dose vitamin K antagonist; aspirin (all Grade 1B); or an intermittent pneumatic compression device (IPCD) (Grade 1C) for a minimum of 10 to 14 days. We suggest the use of low-molecular-weight heparin in preference to the other agents we have recommended as alternatives (Grade 2C/2B), and in patients receiving pharmacologic prophylaxis, we suggest adding an IPCD during the hospital stay (Grade 2C). We suggest extending thromboprophylaxis for up to 35 days (Grade 2B). In patients at increased bleeding risk, we suggest an IPCD or no prophylaxis (Grade 2C). In patients who decline injections, we recommend using apixaban or dabigatran (all Grade 1B). We suggest against using inferior vena cava filter placement for primary prevention in patients with contraindications to both pharmacologic and mechanical thromboprophylaxis (Grade 2C). We recommend against Doppler (or duplex) ultrasonography screening before hospital discharge (Grade 1B). For patients with isolated lower-extremity injuries requiring leg immobilization, we suggest no thromboprophylaxis (Grade 2B). For patients undergoing knee arthroscopy without a history of VTE, we suggest no thromboprophylaxis (Grade 2B). Conclusions: Optimal strategies for thromboprophylaxis after major orthopedic surgery include pharmacologic and mechanical approaches. PMID:22315265

Francis, Charles W.; Johanson, Norman A.; Curley, Catherine; Dahl, Ola E.; Schulman, Sam; Ortel, Thomas L.; Pauker, Stephen G.; Colwell, Clifford W.

2012-01-01

37

Imaging of orthopedic trauma and surgery  

SciTech Connect

This book presents papers on imaging techniques for diagnosis of trauma of bones. A comparative evaluation is presented for planning of proper diagnosis and treatment. Various techniques discussed are routine radiography; computerized tomography, NMR imaging, angiography, ultrasonography; and use of radioisotopes. The mechanism of injury of bone joints of upper and lower limbs and spine is discussed after discussing the anatomy of each in the beginning of each paper. Topics titled are healing of fractures; fractures of pelvis; knee; shoulder; foot and ankle; fractures of humerus; stress fractures; and orthopedic radiology. Prosthesis use and plastic surgery of joints is also discussed.

Berquist, T.H.

1985-01-01

38

Legal issues affecting ancillaries and orthopedic practice.  

PubMed

The federal and state governments have imposed significant regulations on health care generally and on ancillary services in particular. This article focuses on how state and federal laws shape the ability of an orthopedic physician to offer ancillary services, whether as an individual, through a group practice, or as part of a joint venture. It focuses on how the Stark law, the Medicare anti-kickback statute, state anti-kickback, fee-splitting provisions, certificate of need laws, and various Medicare billing and supervision requirements impact the provision of ancillary services. It also briefly discusses how physicians should prepare for and respond to government investigations. PMID:18061773

Glaser, David M

2008-01-01

39

Hunting stand-related injuries in orthopedics.  

PubMed

Hunting remains an extremely popular recreational activity, with nearly 15 million Americans receiving a hunting license annually. Precautions have helped decrease accidents, but hunting-related injuries remain relatively common. The majority of severe, hunting-related accidents involve either a fall from a hunting platform or an accidental shooting. Both of these mechanisms frequently result in orthopedic injuries, many of which require operative care. Although firearms-associated injury has seemingly decreased, hunting platform falls and their sequelae are increasing. Understanding the mechanisms of these injuries and increasing awareness of them may minimize their morbidity and mortality or help prevent them altogether. PMID:25188622

Lebus, George F; Krueger, Chad A; Stinner, Daniel J; Mir, Hassan R

2014-09-01

40

Computer assisted 3D pre-operative planning tool for femur fracture orthopedic surgery  

NASA Astrophysics Data System (ADS)

Femur shaft fractures are caused by high impact injuries and can affect gait functionality if not treated correctly. Until recently, the pre-operative planning for femur fractures has relied on two-dimensional (2D) radiographs, light boxes, tracing paper, and transparent bone templates. The recent availability of digital radiographic equipment has to some extent improved the workflow for preoperative planning. Nevertheless, imaging is still in 2D X-rays and planning/simulation tools to support fragment manipulation and implant selection are still not available. Direct three-dimensional (3D) imaging modalities such as Computed Tomography (CT) are also still restricted to a minority of complex orthopedic procedures. This paper proposes a software tool which allows orthopedic surgeons to visualize, diagnose, plan and simulate femur shaft fracture reduction procedures in 3D. The tool utilizes frontal and lateral 2D radiographs to model the fracture surface, separate a generic bone into the two fractured fragments, identify the pose of each fragment, and automatically customize the shape of the bone. The use of 3D imaging allows full spatial inspection of the fracture providing different views through the manipulation of the interactively reconstructed 3D model, and ultimately better pre-operative planning.

Gamage, Pavan; Xie, Sheng Quan; Delmas, Patrice; Xu, Wei Liang

2010-02-01

41

Preoperative evaluation and preparation of patients for orthopedic surgery.  

PubMed

Orthopedic patients frequently have multiple comorbidities when they present for surgery. This article discusses risk stratification of this population and the preoperative work-up for patients with specific underlying conditions who often require orthopedic procedures. Preoperative strategies to decrease exposure to allogeneic blood and advantages of the Perioperative Surgical Home model in this unique population are discussed. PMID:25453668

Abel, Richard B; Rosenblatt, Meg A

2014-12-01

42

Novel anti-cancer orthopedic materials: Nanostructured selenium  

Microsoft Academic Search

Metallic bone implants possess numerous problems limiting their efficacy, such as poor osseointegration, stress shielding, and corrosion in in vivo environments. In addition, these materials were not originally developed to simultaneously serve as an orthopedic implant and treat bone cancer (for which some patients require an orthopedic implant). This study is to investigate the potential use of selenium in bone

Phong Tran; Thomas J. Webster

2007-01-01

43

Piriformis Fossa – An Anatomical and Orthopedics Consideration  

PubMed Central

Introduction: Piriformis fossa is an important anatomical landmark having significant clinical value in orthopedic surgery; but its location and anatomical relationship with surrounding structures are not clearly defined. Hence it is necessary to clearly describe it in respect to anatomical and orthopedic aspect. Materials and Methods: Fifty Cadaveric dry femoral bones and Dissection of the four hip specimens were used to study the Piriformis fossa in respect to location and its relationship with surrounding structures. Clinical importance of piriformis fossa was determined in reference to antegrade femoral nail insertion. Observations: Piriformis muscle and so called piriformis fossa are unrelated entities. Piriformis fossa is anatomical site of insertion of obturator externus. In dry cadaveric femora; fossa was not always located in the direction of femoral shaft. It was located in the direction of femoral shaft in 24% cases only. In 68% cases femoral canal was aligned lateral and in 8% cases, it lies medial to the fossa. Conclusion: Piriformis fossa should be named as Trorchanteric fossa or Obturator fossa for better anatomical description. So called Piriformis fossa does not found to be universally corresponding to femoral shaft hence selection of entry site should be based on variable proximal femur and area on femur which corresponds to femoral shaft. PMID:24783092

Lakhwani, O.P.; Mittal, P.S.; Naik, D.C.

2014-01-01

44

The use of orthopedic surgical devices for forensic identification.  

PubMed

Surgically implanted devices have become increasingly common in modern skeletal material. Therefore, having the knowledge of the variety of implanted orthopedic devices, their manufacturer, and where to find and how to use identifying numbers in such implants can assist in the identification process when traditional methods are not applicable. Orthopedic device manufacturers are required by the Safe Medical Devices Act of 1990 and the FDA Modernization Act of 1997 to track permanently implanted devices. Manufacturer information on orthopedic devices associates the orthopedic surgeon who implanted the device with the patient. By providing a current list of the most common orthopedic device manufacturers in the U.S.A. and the associated contact information, investigators will have updated tools for the individuation process. Despite numerous complicating factors regarding how device data are tracked, the information presented here can assist forensic professionals with obtaining presumptive and/or positive identifications. PMID:21342187

Wilson, Rebecca J; Bethard, Jonathan D; DiGangi, Elizabeth A

2011-03-01

45

Orthopedic applications of silicon nitride ceramics.  

PubMed

Silicon nitride (Si(3)N(4)) is a ceramic material developed for industrial applications that demand high strength and fracture resistance under extreme operating conditions. Recently, Si(3)N(4) has been used as an orthopedic biomaterial, to promote bone fusion in spinal surgery and to develop bearings that can improve the wear and longevity of prosthetic hip and knee joints. Si(3)N(4) has been implanted in human patients for over 3 years now, and clinical trials with Si(3)N(4) femoral heads in prosthetic hip replacement are contemplated. This review will provide background information and data relating to Si(3)N(4) ceramics that will be of interest to engineering and medical professionals. PMID:22542731

Bal, B S; Rahaman, M N

2012-08-01

46

[The use of regional anesthesia in orthopedics].  

PubMed

Regional anesthesia has its place in the perioperative pain management of orthopedic patients. A reduction in postoperative mortality and morbidity with regional anesthesia is acknowledged for subsets of patient populations. Single shot and continuous applications are techniques for providing regional analgesia. Continuous infusion of local anesthetics with catheter techniques provides for uninterrupted postoperative analgesia. The combination of regional and general anesthesia reduces the consumption of systemic anesthetics. The side effects of opioid therapy are thereby reduced. The inhibition of intraoperative stress reaction, especially with epidural anesthesia, helps to prevent or lower unwanted metabolic changes. Patient contentment with analgesic quality differs with the technique with which the regional anesthesia is applied (PDA, PCEA, IVRA, peripheral block, i.a. injection), and the medication (LA, opioid) used. PMID:15150685

Zimmermann, M; Jansen, V; Rittmeister, M

2004-07-01

47

Application of Stem Cells in Orthopedics  

PubMed Central

Stem cell research plays an important role in orthopedic regenerative medicine today. Current literature provides us with promising results from animal research in the fields of bone, tendon, and cartilage repair. While early clinical results are already published for bone and cartilage repair, the data about tendon repair is limited to animal studies. The success of these techniques remains inconsistent in all three mentioned areas. This may be due to different application techniques varying from simple mesenchymal stem cell injection up to complex tissue engineering. However, the ideal carrier for the stem cells still remains controversial. This paper aims to provide a better understanding of current basic research and clinical data concerning stem cell research in bone, tendon, and cartilage repair. Furthermore, a focus is set on different stem cell application techniques in tendon reconstruction, cartilage repair, and filling of bone defects. PMID:22550505

Schmitt, Andreas; van Griensven, Martijn; Imhoff, Andreas B.; Buchmann, Stefan

2012-01-01

48

Orthopedic surgical analyzer for percutaneous vertebroplasty  

NASA Astrophysics Data System (ADS)

Since the spine is one of the most complex joint structures in the human body, its surgical treatment requires careful planning and high degree of precision to avoid any unwanted neurological compromises. In addition, comprehensive biomechanical analysis can be very helpful because the spine is subject to a variety of load. In case for the osteoporotic spine in which the structural integrity has been compromised, it brings out the double challenges for a surgeon both clinically and biomechanically. Thus, we have been developing an integrated medical image system that is capable of doing the both. This system is called orthopedic surgical analyzer and it combines the clinical results from image-guided examination and the biomechanical data from finite element analysis. In order to demonstrate its feasibility, this system was applied to percutaneous vertebroplasty. Percutaneous vertebroplasty is a surgical procedure that has been recently introduced for the treatment of compression fracture of the osteoporotic vertebrae. It involves puncturing vertebrae and filling with polymethylmethacrylate (PMMA). Recent studies have shown that the procedure could provide structural reinforcement for the osteoporotic vertebrae while being minimally invasive and safe with immediate pain relief. However, treatment failures due to excessive PMMA volume injection have been reported as one of complications. It is believed that control of PMMA volume is one of the most critical factors that can reduce the incidence of complications. Since the degree of the osteoporosis can influence the porosity of the cancellous bone in the vertebral body, the injection volume can be different from patient to patient. In this study, the optimal volume of PMMA injection for vertebroplasty was predicted based on the image analysis of a given patient. In addition, biomechanical effects due to the changes in PMMA volume and bone mineral density (BMD) level were investigated by constructing clinically relevant finite element models. In conclusion, we were able to demonstrate the feasibility of our orthopedic surgical analyzer in a case for percutaneous vertebroplasty.

Tack, Gye Rae; Choi, Hyung Guen; Lim, Do H.; Lee, Sung J.

2001-05-01

49

Robot Manipulators  

NASA Technical Reports Server (NTRS)

Space Shuttle's Remote Manipulator System (Canadarm) is a 50 foot robot arm used to deploy, retrieve or repair satellites in orbit. Initial spinoff version is designed to remove, inspect and replace large components of Ontario Hydro's CANDU nuclear reactors, which supply 50 percent of Ontario Hydro's total power reduction. CANDU robot is the first of SPAR's Remote Manipulator Systems intended for remote materials handling operations in nuclear servicing, chemical processing, smelting and manufacturing. Inco Limited used remote manipulator for remote control mining equipment to enhance safety and productivity of Inco's hardrock mining operations. System not only improves safety in a hazardous operation that costs more than a score of lives annually, it also increases productivity fourfold. Remote Manipulator System Division is also manufacturing a line of industrial robots and developing additional system for nuclear servicing, mining, defense and space operations.

1988-01-01

50

Orthopedic Health: Osteoarthritis— What You Should Know (quiz)  

MedlinePLUS

... Bar Home Current Issue Past Issues Orthopedic Health Osteoarthritis— What You Should Know Past Issues / Spring 2009 ... Javascript on. How much do you know about osteoarthritis, its causes, and its therapies? Take this quiz ...

51

Orthopedic surgery and its complication in systemic lupus erythematosus  

PubMed Central

Systemic lupus erythematosus (SLE) is a multi-systemic immune-complex mediated autoimmune condition which chiefly affects women during their prime year. While the management of the condition falls into the specialty of internal medicine, patients with SLE often present with signs and symptoms pertaining to the territory of orthopedic surgery such as tendon rupture, carpal tunnel syndrome, osteonecrosis, osteoporotic fracture and infection including septic arthritis, osteomyelitis and spondylodiscitis. While these orthopedic-related conditions are often debilitating in patients with SLE which necessitate management by orthopedic specialists, a high index of suspicion is necessary in diagnosing these conditions early because lupus patients with potentially severe orthopedic conditions such as osteomyelitis frequently present with mild symptoms and subtle signs such as low grade fever, mild hip pain and back tenderness. Additionally, even if these orthopedic conditions can be recognized, complications as a result of surgical procedures are indeed not uncommon. SLE per se and its various associated pharmacological treatments may pose lupus patients to certain surgical risks if they are not properly attended to and managed prior to, during and after surgery. Concerted effort of management and effective communication among orthopedic specialists and rheumatologists play an integral part in enhancing favorable outcome and reduction in postoperative complications for patients with SLE through thorough pre-operative evaluation, careful peri-operative monitoring and treatment, as well as judicious postoperative care. PMID:24653977

Mak, Anselm

2014-01-01

52

Are academic orthopedic surgeons interested in global health?  

PubMed

Two thirds of the world's population lack orthopedic services. Natural disasters such as the 2010 Haiti earthquake temporarily increased volunteering, but the decision to volunteer regularly is likely multifactorial. In the study reported here, we investigated whether academic orthopedic surgeons are interested in volunteering abroad and identified factors that influence participation. Academic orthopedic surgeons were identified through the faculty listings of all 154 orthopedic residency programs listed by the Association of American Medical Colleges (AAMC) Electronic Residency Application Service and were sent surveys by e-mail. Of the 3,697 eligible academic orthopedic surgeons, 600 were randomly selected, and 109 completed the survey. Of the 109 respondents, 52% had volunteered abroad previously, and 62% said they were highly likely to volunteer abroad in the future. The most common barriers were scheduling, and family and social commitments (65% and 66%, respectively), followed by lack of specialty-specific opportunities (40%). In a multivariate model, the only barrier significantly decreasing likelihood to volunteer abroad was concern for medical safety (P = .015). Altruistic motivations (P = .005), religious sentiments (P = .006), international networking (P = .004), and fulfilling the true medical creed (P = .015) significantly increased likelihood. Academic orthopedic surgeons are interested in volunteering abroad. Addressing common motivations and barriers may help improve care in the developing world. PMID:24660182

Makhni, Melvin C; Miao, Diana; Zurakowski, David; Day, Charles S

2014-03-01

53

Underwater manipulator  

SciTech Connect

Self-contained, waterproof, water-submersible, remote-controlled apparatus is provided for manipulating a device, such as an ultrasonic transducer for measuring crack propagation on an underwater specimen undergoing shock testing. The subject manipulator includes metal bellows for transmittal of angular motions without the use of rotating shaft seals or O-rings. Inside the manipulator, a first stepper motor controls angular movement. In the preferred embodiment, the bellows permit the first stepper motor to move an ultrasonic transducer .+-.45 degrees in a first plane and a second bellows permit a second stepper motor to move the transducer .+-.10 degrees in a second plane orthogonal to the first. In addition, an XY motor-driven table provides XY motion.

Schrum, Phillip B. (Clairton, PA); Cohen, George H. (Pittsburgh, PA)

1993-01-01

54

Underwater manipulator  

DOEpatents

Self-contained, waterproof, water-submersible, remote-controlled apparatus is described for manipulating a device, such as an ultrasonic transducer for measuring crack propagation on an underwater specimen undergoing shock testing. The subject manipulator includes metal bellows for transmittal of angular motions without the use of rotating shaft seals or O-rings. Inside the manipulator, a first stepper motor controls angular movement. In the preferred embodiment, the bellows permit the first stepper motor to move an ultrasonic transducer [plus minus]45 degrees in a first plane and a second bellows permit a second stepper motor to move the transducer [plus minus]10 degrees in a second plane orthogonal to the first. In addition, an XY motor-driven table provides XY motion.

Schrum, P.B.; Cohen, G.H.

1993-04-20

55

Orthopedic Injuries Following the East Azerbaijan Earthquake  

PubMed Central

Background Evaluating demographic characteristics, distribution and types of orthopedic injuries following major earthquakes may be helpful in future planning for disasters. Objectives This study aimed to analyze data from trauma patients with extremity injury resulting from the earthquakes of East Azerbaijan, Iran. Patients and Methods Medical records of 686 patients admitted to Shohada hospital, Trauma Center of Tabriz University of Medical Sciences were reviewed. There were 200 patients with extremity injury assessed. Demographic characteristics and patterns of injuries in these patients were evaluated. Results In this study, there were 105 females (52.5%) and 95 males (47.5%), out of which, 6 (3%) patients with associated severe head injuries died. The most common sites of injury were lower extremities (81 patients, 41.5% of total victims) while 32 patients (16%) suffered from both upper and lower extremity injuries. Open Fractures were seen in lower extremities of 26 (13%) patients. Compartment syndrome was observed in 3 (1.5%) patients with lower limb fractures. Also, 42 (21%) patients living in Tabriz were injured while they were running away (falling down the stairs and jumping out of windows). Conclusions Extremity injuries especially open fractures of lower limbs account for the majority of hospitalized victims. Compartment syndrome is one of the main problems that should be addressed. Our study demonstrates that people still need more education regarding earthquakes and the government should direct more attention to this issue. PMID:24350141

Elmi, Asghar; Ganjpour Sales, Jafar; Tabrizi, Ali; Soleimanpour, Jafar; Mohseni, Mohammad Ali

2013-01-01

56

Computer-assisted surgery in orthopedic oncology  

PubMed Central

Background and purpose — In orthopedic oncology, computer-assisted surgery (CAS) can be considered an alternative to fluoroscopy and direct measurement for orientation, planning, and margin control. However, only small case series reporting specific applications have been published. We therefore describe possible applications of CAS and report preliminary results in 130 procedures. Patients and methods — We conducted a retrospective cohort study of all oncological CAS procedures in a single institution from November 2006 to March 2013. Mean follow-up time was 32 months. We categorized and analyzed 130 procedures for clinical parameters. The categories were image-based intralesional treatment, image-based resection, image-based resection and reconstruction, and imageless resection and reconstruction. Results — Application to intralesional treatment showed 1 inadequate curettage and 1 (other) recurrence in 63 cases. Image-based resections in 42 cases showed 40 R0 margins; 16 in 17 pelvic resections. Image-based reconstruction facilitated graft creation with a mean reconstruction accuracy of 0.9 mm in one case. Imageless CAS was helpful in resection planning and length- and joint line reconstruction for tumor prostheses. Interpretation — CAS is a promising new development. Preliminary results show a high number of R0 resections and low short-term recurrence rates for curettage. PMID:25140984

Gerbers, Jasper G; Stevens, Martin; Ploegmakers, Joris JW; Bulstra, Sjoerd K; Jutte, Paul C

2014-01-01

57

Feeling manipulated: cytomegalovirus immune manipulation  

PubMed Central

No one likes to feel like they have been manipulated, but in the case of cytomegalovirus (CMV) immune manipulation, we do not really have much choice. Whether you call it CMV immune modulation, manipulation, or evasion, the bottom line is that CMV alters the immune response in such a way to allow the establishment of latency with lifelong shedding. With millions of years of coevolution within their hosts, CMVs, like other herpesviruses, encode numerous proteins that can broadly influence the magnitude and quality of both innate and adaptive immune responses. These viral proteins include both homologues of host proteins, such as MHC class I or chemokine homologues, and proteins with little similarity to any other known proteins, such as the chemokine binding protein. Although a strong immune response is launched against CMV, these virally encoded proteins can interfere with the host's ability to efficiently recognize and clear virus, while others induce or alter specific immune responses to benefit viral replication or spread within the host. Modulation of host immunity allows survival of both the virus and the host. One way of describing it would be a kind of "mutually assured survival" (as opposed to MAD, Mutually Assured Destruction). Evaluation of this relationship provides important insights into the life cycle of CMV as well as a greater understanding of the complexity of the immune response to pathogens in general. PMID:19134204

Miller-Kittrell, Mindy; Sparer, Tim E

2009-01-01

58

Novel applications of osseointegration in orthopedic limb salvage surgery.  

PubMed

Osseointegration is a biologic process vital to modern endoprosthetic fixation in orthopedic surgery. Numerous engineering advancements have improved the utilization of this technology in orthopedics; however, issues such as stress shielding, aseptic loosening, and bone loss remain an ongoing challenge. These host responses are especially problematic in limb salvage surgery. Novel applications of osseointegration have been developed to address some of these fixation issues with massive tumor endoprostheses. This articles reviews osseointegration and emerging novel applications of this technology in limb salvage surgery and future prosthetics for amputees. PMID:25435037

Monument, Michael J; Lerman, Daniel M; Randall, R Lor

2015-01-01

59

Applications of Metal Additive Manufacturing in Veterinary Orthopedic Surgery  

NASA Astrophysics Data System (ADS)

Veterinary medicine has undergone a rapid increase in specialization over the last three decades. Veterinarians now routinely perform joint replacement, neurosurgery, limb-sparing surgery, interventional radiology, radiation therapy, and other complex medical procedures. Many procedures involve advanced imaging and surgical planning. Evidence-based medicine has also become part of the modus operandi of veterinary clinicians. Modeling and additive manufacturing can provide individualized or customized therapeutic solutions to support the management of companion animals with complex medical problems. The use of metal additive manufacturing is increasing in veterinary orthopedic surgery. This review describes and discusses current and potential applications of metal additive manufacturing in veterinary orthopedic surgery.

Harrysson, Ola L. A.; Marcellin-Little, Denis J.; Horn, Timothy J.

2015-03-01

60

Applications of Metal Additive Manufacturing in Veterinary Orthopedic Surgery  

NASA Astrophysics Data System (ADS)

Veterinary medicine has undergone a rapid increase in specialization over the last three decades. Veterinarians now routinely perform joint replacement, neurosurgery, limb-sparing surgery, interventional radiology, radiation therapy, and other complex medical procedures. Many procedures involve advanced imaging and surgical planning. Evidence-based medicine has also become part of the modus operandi of veterinary clinicians. Modeling and additive manufacturing can provide individualized or customized therapeutic solutions to support the management of companion animals with complex medical problems. The use of metal additive manufacturing is increasing in veterinary orthopedic surgery. This review describes and discusses current and potential applications of metal additive manufacturing in veterinary orthopedic surgery.

Harrysson, Ola L. A.; Marcellin-Little, Denis J.; Horn, Timothy J.

2015-02-01

61

Manipulating Perception  

E-print Network

Maurice Merleau-Ponty observed that consciousness exists in the world and experience of things in the world exist in consciousness. We similarly believe that the physiological foundations of perception exist in the world and can be acted upon. As way of argument, we describe the experience of several devices that manipulate the precepts. Such devices act on consciousness but also the set of things that can be experienced. The manipulation of perception allows variations of individual experience. Human experience can be mapped to analogs of animal experience. Dennett has looked to neuroscience as a source of grounding for accounts of the mind. However, the brain is just one element of experience. When my knee is hit suddenly, my spinal cord acts before I become cognisant of the blow. Physiologists have mapped a somatic nervous system which encompasses the perceptual circuits from the nerve endings, to receptors, toward nerve bundles, onward to the brain, and back toward muscles. The underlying physiological objects (in the somatic system) are the physical corollaries to perception. By building devices which act upon the

62

The Special Orthopedic Hospital—Past and Present  

PubMed Central

Pioneer orthopedic institutions established in Europe in the late 18th and early 19th centuries, and in the U.S.A. in the second half of the 19th and the first decade of the 20th century, can trace their ancestry in ideas back to the practice and teachings of Hippocrates. Experience in treatment of great numbers of injured soldiers in the First World War opened a new era in reconstructive surgery of the locomotor system. After the Second World War, in advanced nations the pattern of crippling diseases showed a spectacular change. Problems that justify the existence of large special orthopedic hospitals are, in children, the more complex congenital deformities, cerebral palsies, and the increasing number of injuries due to hazards of modern life; in the adult, the reconstructive surgery of trauma and of arthritis. In modern orthopedic hospitals physicians have joined orthopedic surgeons in the study of the natural history of the various forms of arthritis. These centres provide facilities for biomechanical research and postgraduate training which acute general hospitals cannot offer. PMID:14228224

Platt, Harry

1964-01-01

63

Orthopedic pitfalls in the ED: Achilles tendon rupture  

Microsoft Academic Search

Achilles tendon rupture is a relatively uncommon occurrence in a general ED population. The history can be subtle, and physical findings may not be clear-cut. Prompt diagnosis and treatment of these injuries, however, is important to improved clinical outcome. The emergency physician needs to remain vigilant for this diagnosis to avoid this orthopedic pitfall. This review article examines the clinical

Jacob Ufberg; Richard A. Harrigan; Thomas Cruz; Andrew D. Perron

2004-01-01

64

Survey of 2582 Cases of Acute Orthopedic Trauma  

PubMed Central

Background: Orthopedic injuries are among the most common causes of mortality, morbidity, hospitalization, and economic burden in societies. Objectives: In this research, we study the prevalence of different types of trauma requiring orthopedic surgery. Patients and Methods: We conducted a cross-sectional study on 2582 patients with acute orthopedic injuries admitted to the orthopedic emergency ward at the Poursina Hospital (a referral center in Guilan province (northern Iran), during December 2010 through September 2011. Patients were examined and the data collection form was filled for each patient. Data were analyzed by SPSS software version 19 and were listed in tables. Results: Of 2582 included cases, 1940 were male and 642 were female, with a mean age of 34.5 years. Most injuries were seen in the 25 to 44 year age group from rural areas. The highest frequency of trauma related to falls. On the other hand, bicycling and shooting had the lowest frequencies. There were 18 cases with limb amputation. Overall, 66.5% of patients had fractures, 5% had soft tissue lacerations, and 10% had dislocations. Conclusions: Identification of risk factors and methods of prevention is one of the most important duties of healthcare systems. Devising plans to minimize these risk factors and familiarizing people with them is prudent. PMID:25717444

Soleymanha, Mehran; Mobayen, Mohammadreza; Asadi, Kamran; Adeli, Alborz; Haghparast-Ghadim-Limudahi, Zahra

2014-01-01

65

Hydroxyapatite-nanotube composites and coatings for orthopedic applications  

Microsoft Academic Search

Hydroxyapatite (HA) has received wide attention in orthopedics, due to its biocompatibility and osseointegration ability. Despite these advantages, the brittle nature and low fracture toughness of HA often results in rapid wear and premature fracture of implant. Hence, there is a need to improve the fracture toughness and wear resistance of HA without compromising its biocompatibility. ^ The aim of

Debrupa Lahiri

2011-01-01

66

Mainstreaming Preschoolers: Children with Orthopedic Handicaps. A Guide for Teachers, Parents, and Others Who Work with Orthopedically Handicapped Preschoolers.  

ERIC Educational Resources Information Center

This guide to mainstreaming preschoolers with orthopedic handicaps is one of a series of eight manuals on mainstreaming preschoolers developed by Project Head Start. The guide is addressed to parents, teachers, and other professionals and paraprofessionals. Chapter I presents information on the meaning, benefits and implementation of…

Kieran, Shari Stokes; And Others

67

Learning blood management in orthopedic surgery through gameplay.  

PubMed

Orthopedic surgery treats the musculoskeletal system, in which bleeding is common and can be fatal. To help train future surgeons in this complex practice, researchers designed and implemented a serious game for learning orthopedic surgery. The game focuses on teaching trainees blood management skills, which are critical for safe operations. Using state-of-the-art graphics technologies, the game provides an interactive and realistic virtual environment. It also integrates game elements, including task-oriented and time-attack scenarios, bonuses, game levels, and performance evaluation tools. To study the system's effect, the researchers conducted experiments on player completion time and off-target contacts to test their learning of psychomotor skills in blood management. PMID:20650710

Qin, Jing; Chui, Yim-Pan; Pang, Wai-Man; Choi, Kup-Sze; Heng, Pheng-Ann

2010-01-01

68

Potential utility of liposome bupivacaine in orthopedic surgery.  

PubMed

Management of postsurgical analgesia is an important consideration in orthopedic procedures, including joint arthroplasty. Inadequate postsurgical analgesia is associated with increased hospital length of stay, delayed ambulation, and reduced exercise capacity. In this article, we review the potential contribution of a prolonged-release liposomal formulation of bupivacaine as part of a multimodal analgesic regimen after orthopedic surgery. Controlled studies across multiple surgical settings have demonstrated that, compared with placebo and bupivacaine HCl, liposome bupivacaine in a single administration provides postsurgical analgesia for up to 72 hours, delays use of rescue medication, and reduces postsurgical opioid consumption. Liposome bupivacaine has been well tolerated in clinical studies and has had a low rate of treatment-related adverse events. To date, there has been no signal of cardiac toxicity, chondrolysis, or delayed wound healing associated with liposome bupivacaine. PMID:25750943

Lonner, Jess H; Scuderi, Giles R; Lieberman, Jay R

2015-03-01

69

Blood conservation strategies in orthopedic surgeries: A review  

PubMed Central

In orthopedics management of surgical blood loss is an important aspect which has evolved along with modern surgeries. Replacement of lost blood by transfusion alone is not the answer as was considered earlier. Complications like infection and immune reaction due to blood transfusion are a major concern. Today numerous techniques are available in place of allogenic blood transfusion which can be employed safely and effectively. In this article we have reviewed these techniques, their merits and demerits.

Sambandam, Balaji; Batra, Sahil; Gupta, Rajat; Agrawal, Nidhi

2013-01-01

70

Hydroxyapatite-Nanotube Composites and Coatings for Orthopedic Applications  

Microsoft Academic Search

Hydroxyapatite (HA) has received wide attention in orthopedics, due to its biocompatibility and osseointegration ability. Despite these advantages, the brittle nature and low fracture toughness of HA often results in rapid wear and premature fracture of implant. Hence, there is a need to improve the fracture toughness and wear resistance of HA without compromising its biocompatibility.\\u000aThe aim of the

Debrupa Lahiri

2011-01-01

71

[Orthopedic activators for growth and treatment of Class II malocclusion].  

PubMed

Activators are functional jaw orthopedic appliances which provide various mandibular position, but always different from habitual positions. Mechanisms and modus operandi of activators explain therapeutic objectives of clinicians. When we analyse different determinants of modus operandi of activators (skeletal, muscular and articular), it is possible to classify these appliances in rigid monobloc appliances, composite or elastic activators and thrusting activators. Many prospective or retrospective clinical studies analyse dentoalveolar or skeletal effects of the activators. PMID:16708662

Simon, Y; Chabre, C; Lautrou, A

2006-03-01

72

Student opinions on orthopedic residency selection, education, and work hours.  

PubMed

Other articles have been written about resident selection, musculoskeletal education, work hours, and call coverage, but none has described orthopedic applicants' opinions on these issues. We conducted a study to gain insight into applicants' attitudes about issues relevant to the specialty. We distributed a survey to 53 applicants interviewing for an orthopedic residency. The survey used both a multiple-choice format and a Likert scale ranging from 1 (strongly disagree or least important) to 5 (strongly agree or most important). Respondents rated the adequacy of musculoskeletal education in medical school a mean standard deviation (SD) of 2.00 (0.8) on the Likert scale. Ranking the factors most valuable to an orthopedic surgery application, they rated United States Medical Licensing Examination (USMLE) Step 1 board examination scores a mean (SD) of 4.26 (0.9). In addition, of the 53 respondents, 46 (87%) anticipated working as a resident more than 80 hours per week, and 36 (68%) anticipated working as an attending 60 to 70 hours per week or less. Respondents also agreed that they should receive compensation for call coverage. Therefore, students agreed that medical school education is insufficient, rated USMLE scores the most important application factor, anticipated working more than 80 hours per week, and agreed that call coverage should be compensated. PMID:24078953

Hussain, Waqas; Hussain, Haroon; Manning, David W

2013-08-01

73

Clinical conundrums and challenges during geriatric orthopedic emergency surgeries  

PubMed Central

Despite so many advancements and innovations in anesthetic techniques, expectations and challenges have also grown in plenty. Cardiac, pediatric, obstetric and neuro-anesthesia have perfectly developed to fulfill the desired needs of respective patient population. However, geriatric anesthesia has been shown a lesser interest in teaching and clinical practices over the years as compared with other anesthetic sub-specialties. The large growing geriatric population globally is also associated with an increase number of elderly patients presenting for orthopedic emergency surgeries. Orthopedic emergency surgery in geriatric population is not only a daunting clinical challenge but also has numerous socio-behavioral and economic ramifications. Decision making in anesthesia is largely influenced by the presence of co-morbidities, neuro-cognitive functions and the current socio-behavioral status. Pre-anesthetic evaluation and optimization are extremely important for a better surgical outcome but is limited by time constraints during emergency surgery. The current review aims to highlight comprehensively the various clinical, social, behavioral and psychological aspects during pre-anesthetic evaluation associated with emergency orthopedic surgery in geriatric population.

Bajwa, Sukhminder Jit Singh

2015-01-01

74

Manipulator mounted transfer platform  

SciTech Connect

The patent describes in a manipulator system for use in hazardous environments including a manipulator adapted for reciprocal movement upon a guide device, a transfer platform. It comprises: a bed frame defining a generally horizontal bed projecting outwardly from the manipulator; and frame mounting means securing the bed frame to the manipulator in a generally cantilevered fashion, thereby essentially minimizing the structure necessary to support the platform outwardly of the manipulator while enhancing operator visibility of the platform and the manipulator during use of the manipulator system.

Dobbins, J.C.; Hoover, M.A.; May, K.W.; Ross, M.J.

1990-01-23

75

A History of Orthopedics in San Francisco and the West  

PubMed Central

The unique development of early medical specialization in the West can be traced to California's geography and economic development. Such early specialization produced men with orthopedic inclinations. Early orthopedists founded the first medical school and the first modern teaching hospital, helped to found Stanford's Lane Medical Library and made the first use of x-rays in the West. In addition many of these orthopedists were prominent in the political and social activities of the time. ImagesFigure 1.Figure 2.Figure 3.Figure 4. PMID:795165

Mandell, Peter; Raih, Thomas; Taylor, Lloyd W.

1976-01-01

76

The Early Years of Organized Chiropractic Orthopedics, 1954–1973: A Social History  

PubMed Central

Objective: This paper presents the origins and development of the organized chiropractic orthopedics movement in the United States from 1954–1973. Methods: Hand searches of early periodicals were performed and information was organized chronologically to create a timeline. Context for the timeline was provided by extracting pertinent information from audio recordings of interviews. Relevant background information was located using the cumulative index of the journal Chiropractic History and searching the MANTIS database. Historical Features: After World War I, The advent of third party reimbursement for health care created a new environment for health care practitioners. For doctors of chiropractic, this event provided the impetus to begin the postgraduate chiropractic orthopedics program over 50 years ago. In 1954, Alvin A. Hancock, DC and F. Maynard Lipe, DC successfully launched an active orthopedics movement after several earlier attempts failed during the 1940s and early 1950s. The movement generated from the desire to train and certify chiropractors to manage personal injury and workers’ compensation low back injuries. In addition to developing interdisciplinary educational programs, the chiropractic orthopedics group was responsible for producing a research agenda, some of the profession’s early orthopedic-focused research, and for starting the National Council on Chiropractic Orthopedics of the National Chiropractic Association, which later became the American Chiropractic Association Council on Orthopedics. These organizations produced thousands of specialists in chiropractic orthopedics, later known as Diplomates of the American Board of Chiropractic Orthopedists. Conclusion: Several orthopedics interest groups were formed and credentialing processes were created to qualify doctors as recognized chiropractic orthopedics specialists. The popularity of this movement resulted in the inclusion of orthopedics into core chiropractic college curricula and the production of various research studies before the development of the modern science of chiropractic. PMID:19488411

Green, Bart N.; Johnson, Claire D.

2009-01-01

77

Improving A Remote Manipulator  

NASA Technical Reports Server (NTRS)

Set of three reports describes work on Protoflight Manipulator Assembly (PFMA). "Performance Characteristics of Protoflight Manipulator Assembly" presents parameters of PFMA after refurbishment of operating components. "End Effector and Task Board Development for the Protoflight Manipulator Assembly" describes special tools and adaptations allowing PFMA to be used for servicing equipment. "Modular Software Development for the Protoflight Manipulator Assembly" documents interface and control software for PFMA.

Haslam, John W., Jr.; Shields, Nicholas, Jr.; Fagg, Mary F.; Rodriguez, Ricardo C.

1989-01-01

78

Complementary and alternative medicine interventions for the orthopedic patient: a review of the literature  

Microsoft Academic Search

New branches of established disciplines are continually being developed to help patients with chronic orthopedic ailments. What is thought to be conventional treatment varies between countries and changes over time. Therefore the boundary between complementary and conventional medicine remains blurred and constantly shifting. This article reviews the most frequently used CAM interventions for the orthopedic population and will include the

Mary Lou Galantino; Christina Boothroyd; Sandra Lucci

2003-01-01

79

Oral Factor Xa Inhibitors for Venous Thromboembolism Prevention in Major Orthopedic Surgery: A Review  

Microsoft Academic Search

Venous thromboembolism (VTE), which includes deep vein thrombosis and pulmonary embolism, is a major cause of morbidity and mortality in patients undergoing major orthopedic surgery, and routine thromboprophylaxis has been the standard of care over the last 20 years. Currently available options for the prevention of VTE in major orthopedic surgery include low-molecular-weight heparins, vitamin K antagonists and, more recently,

Davide Imberti; Domenico Prisco

2009-01-01

80

Military Curricula for Vocational & Technical Education. Orthopedic Specialist, Classroom Course 10-13.  

ERIC Educational Resources Information Center

These military-developed curriculum materials for a course for orthopedic specialists are targeted for students from grades 11 through the adult level. The course is designed to provide a working knowledge of the application of casts, traction, and splints to orthopedic patients and the removal of these devices; a working knowledge of assisting in…

Brooke Army Medical Center, Fort Sam Houston, TX. Health Care Research Div.

81

Laser-deposited Ti-Nb-Zr-Ta orthopedic alloys.  

PubMed

The complex quaternary Ti-35Nb-7Zr-5Ta orthopedic alloy has been successfully deposited from a powder feedstock consisting of a blend of elemental titanium, niobium, zirconium, and tantalum powders, using the laser engineered net-shaping (LENStrade mark) process. In the as laser-deposited form, these alloys exhibit a substantially higher tensile strength as compared with more conventionally processed counterparts of similar composition, while maintaining excellent ductility and a low modulus. Furthermore, the as-deposited alloys appear to exhibit a <001> texture, with a substantially large number of grains of the beta phase aligning one of their <001> axes nearly normal to the substrate or parallel to the growth direction. The microstructure of the as-deposited as well as tensile-tested alloys have been characterized in detail using scanning electron microscopy (SEM), orientation microscopy (OM), and transmission electron microscopy (TEM). Formation of a high density of shear bands, possibly arising from slip localization due to precipitates of the omega phase in the beta matrix, is clearly evident in the tensile-tested sample. The enhanced tensile strength and low modulus in these laser-deposited alloys coupled with the ability to form near-net shape components makes LENS an attractive processing technology for orthopedic implants. PMID:16637044

Banerjee, R; Nag, S; Samuel, S; Fraser, H L

2006-08-01

82

Adherence to perioperative antibiotic prophylaxis among orthopedic trauma patients  

PubMed Central

Background The goal of this study was to assess whether patients receive their antibiotic prophylaxis as prescribed. We also investigated what doses and durations of antibiotics are typically ordered, which patients actually receive antibiotics and factors causing the ordered antibiotic regimen to be altered. Methods We performed a retrospective review of 205 patient charts and sent a national survey to all surgeon members of the Canadian Orthopaedic Trauma Society (COTS) about antibiotic prophylaxis in the setting of surgical treatment for closed fractures. Results In all, 93% (179 of 193) of patients received an appropriate preoperative dose of antibiotics, whereas less than 32% (58 of 181) of patients received their postoperative antibiotics as ordered. The most commonly stated reason for patients not receiving their postoperative antibiotics as ordered was patients being discharged before completing 3 postoperative doses. There was a 70% (39 of 56) response rate to the survey sent to COTS surgeons. A single dose of a first-generation cephalosporin preoperatively followed by 3 doses postoperatively is the most common practice among orthopedic trauma surgeons across Canada, but several surgeons give only preoperative prophylaxis. Conclusion Adherence to multidose postoperative antibiotic regimens is poor. Meta-analyses have failed to demonstrate the superiority of multidose regimens over single-dose prophylaxis. Single-dose preoperative antibiotic prophylaxis may be a reasonable choice for most orthopedic trauma patients with closed fractures. PMID:21092428

Lundine, Kristopher M.; Nelson, Susan; Buckley, Richard; Putnis, Sven; Duffy, Paul J.

2010-01-01

83

Publication rates of papers presented at the Brazilian Orthopedic Meeting  

PubMed Central

OBJECTIVE: To quantify the publication rates of the papers presented at the 2007 Brazilian Orthopedics Meeting (Congresso Brasileiro de Ortopedia - CBOT). METHODS: Evaluation of the proportion of abstracts submitted by the various orthopedic subspecialties and according to the Brazilian states. Then, a Lilacs and PubMed search was performed in order to determine which presentations generated national or international published papers. RESULTS: São Paulo and the Southeast region were responsible for the greatest number of presentations at the congress (54.1% and 68.3% respectively). Shoulder and Elbow were the subspecialty responsible for more presentations (13.8%). Among the 653 studies presented at the congress, 174 (26.6%) were published. Oral presentations obtained a publication rate 3.58 times higher than posters. CONCLUSION: The CBOT publication rate is lower than 30%. Many of the papers presented at the CBOT does not pass the scrutiny of scientific journals and therefore should not be the only source of scientific update of the participants: Descriptive Epidemiologic. PMID:24453684

Ejnisman, Leandro; Gomes, Guilherme Sevá; de Oliveira, Rafael Garcia; Malavolta, Eduardo Angeli; Gobbi, Riccardo Gomes; de Camargo, Olavo Pires

2013-01-01

84

Angiogenesis and osteogenesis in an orthopedically expanded suture  

NASA Technical Reports Server (NTRS)

The purpose of this study was to examine the angiogenic and the subsequent osteogenic responses during a 96-hour time-course after sutural expansion. Fifty rats were divided into: (1) a control group that received only angiogenic induction through injection of 5 ng/gm recombinant human endothelial cell growth factor (rhECGF); (2) an experimental group that received orthopedic expansion and rhECGF; (3) a sham group that received expansion and sodium chloride (NaCl) injection; and (4) a baseline group that received no expansion or injection. All rats were injected with 3H-thymidine (1.0 microCi/gm) 1 hour before death to label the DNA of S-phase cells. Demineralized sections (4 microm thick) were stained with hematoxylin and eosin. Angiogenesis and cell migration were analyzed with a previously established cell kinetics model. Analysis of variance was used to test the hypothesis that enhancement of angiogenesis stimulates reestablishment of osteogenic capability. Blood vessel number, area, and endothelial cell-labeled index significantly increased in experimental groups, but no difference was found between control and baseline groups. Labeled-pericyte index and activated pericyte numbers in the experimental group were also higher than in the sham groups. These results show that supplemental rhECGF enhances angiogenesis in expanded sutures but not in nonexpanded sutures. Data also suggest that pericytes are the source of osteoblasts in an orthopedically expanded suture.

Chang, H. N.; Garetto, L. P.; Potter, R. H.; Katona, T. R.; Lee, C. H.; Roberts, W. E.

1997-01-01

85

Parathyroid hormone--possible future drug for orthopedic surgery.  

PubMed

Parathyroid hormone naturally secreted by the parathyroid glands is a potent anabolic agent for bone. Parathyroid hormone is primarily thought of as a catabolic protein involved in the physiologic release of calcium from bone. Whereas during recent years, a number of animal studies and clinical trials have demonstrated that intermittent parathyroid hormone administration induces anabolic effects on both cancellous and cortical bone, enhances bone mass and increases mechanical strength of the bones. Most of the studies, both animal and human, have addressed the treatment of osteoporosis and parathyroid hormone represents an important new advance in the therapy of osteoporosis. Few studies have investigated the effect of intermittent parathyroid hormone treatment in the field of orthopedics on fracture healing and fixation of orthopedic implants. The results of those studies indicated an enhancement of fracture healing, faster bone repair and better fixation of the implant. Recently there were few animal studies started to investigate the effects of parathyroid hormone treatment on bone formation in regenerated and surrounding bone of distracted callus during limb lengthening. Distraction osteogenesis is a technique for bone lengthening that is widely used clinically and experimentally. Newly forming bone during distraction osteogenesis is expected to be an appropriate pattern for parathyroid hormone anabolic effect. Preclinical studies as well as clinical trials suggest that parathyroid hormone might be useful as a stimulator of bone formation whereas a lot of questions regarding parathyroid hormone therapy remain unanswered and require further experimental studies and investigations. PMID:15456969

Aleksyniene, Ramune; Hvid, Ivan

2004-01-01

86

The Insignificance of Manipulation  

E-print Network

The Insignificance of Manipulation David Papineau Summary I want to show that Jim Woodward's account of causation is not a manipulability theory, whatever its other virtues. (Of course,we can all agree that causation is needed for manipulation--ie an action producing a desired result. But so

Fitelson, Branden

87

Presurgical orthopedic treatment ameliorates postoperative nasal deformity after cheiloplasty.  

PubMed

We assessed the postoperative nasal form and symmetry after presurgical use of a Hotz plate (HP) in patients with unilateral complete cleft lip and palate (UCLP). The subjects were 28 infants with UCLP who underwent cheiloplasty. Of these subjects, 14 underwent presurgical orthopedic treatment using the HP (HP group) and 14 underwent the same treatment without the HP (non-HP group). Photographic records were obtained 1 and 6 months after cheiloplasty, and the results of anthropometric analysis were compared between the 2 groups. The nasal inclination and the ratio of the width of the nasal base to the total width of the nose were significantly improved in the HP group compared with the non-HP group at both postoperative time points. Thus, presurgical use of the HP significantly improved the nasal asymmetry and deformity in UCLP patients after primary cheiloplasty and nasal repair. PMID:23123612

Adachi, Koji; Togashi, Shinji; Yanagawa, Toru; Ishibashi, Naomi; Goto, Takuya; Yamagata, Kenji; Onizawa, Kojiro; Sasaki, Hiroyoshi; Sasaki, Kaoru; Bukawa, Hiroki; Sekido, Mitsuru

2013-08-01

88

Antibiotic-Loaded Cement in Orthopedic Surgery: A Review  

PubMed Central

Infections in orthopaedic surgery are a serious issue. Antibiotic-loaded bone cement was developed for the treatment of infected joint arthroplasties and for prophylaxes in total joint replacement in selected cases. Despite the widespread use of the antibiotic-loaded bone cement in orthopedics, many issues are still unclear or controversial: bacterial adhesion and antibiotic resistance, modification of mechanical properties which follows the addition of the antibiotic, factors influencing the release of the antibiotic from the cement and the role of the surface, the method for mixing the cement and the antibiotic, the choice and the effectiveness of the antibiotic, the combination of two or more antibiotics, and the toxicity. This review discusses all these topics, focusing on properties, merits, and defects of the antibiotic loaded cement. The final objective is to provide the orthopaedic surgeons clear and concise information for the correct choice of cement in their clinical practice. PMID:24977058

Bistolfi, Alessandro; Massazza, Giuseppe; Verné, Enrica; Massè, Alessandro; Deledda, Davide; Ferraris, Sara; Miola, Marta; Galetto, Fabrizio; Crova, Maurizio

2011-01-01

89

SPECT/CT imaging in general orthopedic practice.  

PubMed

The availability of hybrid devices that combine the latest single-photon emission computed tomography (SPECT) imaging technology with multislice computed tomography (CT) scanning has allowed us to detect subtle, nonspecific abnormalities on bone scans and interpret them as specific focal areas of pathology. Abnormalities in the spine can be separated into those caused by pars fractures, facet joint arthritis, or osteophyte formation on vertebral bodies. Compression fractures can be distinguished from severe degenerative disease, both of which can cause intense activity across the spine on either planar or SPECT imaging. Localizing activity in patients who have had spinal fusion can provide tremendous insight into the causes of therapeutic failures. Infections of the spine now can be diagnosed with gallium SPECT/CT, despite the fact that gallium has long been abandoned because of its failure to detect spine infection on either planar or SPECT imaging. Small focal abnormalities in the feet and ankles can be localized well enough to make specific orthopedic diagnoses on the basis of their location. Moreover, when radiographic imaging provides equivocal or inadequate information, SPECT/CT can provide a road map for further diagnostic studies and has been invaluable in planning surgery. Our ability to localize activity within a bone or at an articular surface has allowed us to distinguish between fractures and joint disease. Increased activity associated with congenital anomalies, such as tarsal coalition and Bertolotti's syndrome have allowed us to understand the pathophysiology of these conditions, to confirm them as the cause of the patient's symptoms, and to provide information that is useful in determining appropriate clinical management. As our experience broadens, SPECT/CT will undoubtedly become an important tool in the evaluation and management of a wider variety of orthopedic patients. PMID:19646556

Scharf, Stephen

2009-09-01

90

Hydroxyapatite-nanotube composites and coatings for orthopedic applications  

NASA Astrophysics Data System (ADS)

Hydroxyapatite (HA) has received wide attention in orthopedics, due to its biocompatibility and osseointegration ability. Despite these advantages, the brittle nature and low fracture toughness of HA often results in rapid wear and premature fracture of implant. Hence, there is a need to improve the fracture toughness and wear resistance of HA without compromising its biocompatibility. The aim of the current research is to explore the potential of nanotubes as reinforcement to HA for orthopedic implants. HA- 4 wt.% carbon nanotube (CNT) composites and coatings are synthesized by spark plasma sintering and plasma spraying respectively, and investigated for their mechanical, tribological and biological behavior. CNT reinforcement improves the fracture toughness (>90%) and wear resistance (>66%) of HA for coating and free standing composites. CNTs have demonstrated a positive influence on the proliferation, differentiation and matrix mineralization activities of osteoblasts, during in-vitro biocompatibility studies. In-vivo exposure of HA-CNT coated titanium implant in animal model (rat) shows excellent histocompatibility and neobone integration on the implant surface. The improved osseointegration due to presence of CNTs in HA is quantified by the adhesion strength measurement of single osteoblast using nano-scratch technique. Considering the ongoing debate about cytotoxicity of CNTs in the literature, the present study also suggests boron nitride nanotube (BNNT) as an alternative reinforcement. BNNT with the similar elastic modulus and strength as CNT, were added to HA. The resulting composite having 4 wt.% BNNTs improved the fracture toughness (˜85%) and wear resistance (˜75%) of HA in the similar range as HA-CNT composites. BNNTs were found to be non-cytotoxic for osteoblasts and macrophages. In-vitro evaluation shows positive role of BNNT in osteoblast proliferation and viability. Apatite formability of BNNT surface in ˜4 days establishes its osseointegration ability.

Lahiri, Debrupa

91

Prevalence of Internet and Social Media Usage in Orthopedic Surgery  

PubMed Central

Prior studies in other specialties have shown that social networking and Internet usage has become an increasingly important means of patient communication and referral. The purpose of this study is to evaluate the prevalence of Internet or social media usage in new patients referred to a major academic orthopedics center and to identify new avenues to optimize patient recruitment and communication. New patients were surveyed (n=752) between December 2012 to January 2013 in a major academic orthopaedic center to complete a 15-item questionnaire including social media and Internet usage information. Data was collected for all orthopaedic sub-specialties and statistical analysis was performed. Fifty percent of patients use social networking sites, such as Facebook. Sports medicine patients tend to be higher social networking users (35.9%) relative to other services (9.8-17.9%) and was statistically higher when compared to the joints/tumor service (P<0.0001). Younger age was the biggest indicator predicting the use of social media. Patients that travelled between 120 to 180 miles from the hospital for their visits were significantly more likely to be social media users, as were patients that did research on their condition prior to their new patient appointment. We conclude that orthopedic patients who use social media/Internet are more likely to be younger, researched their condition prior to their appointment and undergo a longer average day’s travel (120-180 miles) to see a physician. In an increasingly competitive market, surgeons with younger patient populations will need to utilize social networking and the Internet to capture new patient referrals. PMID:25317312

Curry, Emily; Nguyen, Joseph; Matzkin, Elizabeth

2014-01-01

92

Prevalence of internet and social media usage in orthopedic surgery.  

PubMed

Prior studies in other specialties have shown that social networking and Internet usage has become an increasingly important means of patient communication and referral. The purpose of this study is to evaluate the prevalence of Internet or social media usage in new patients referred to a major academic orthopedics center and to identify new avenues to optimize patient recruitment and communication. New patients were surveyed (n=752) between December 2012 to January 2013 in a major academic orthopaedic center to complete a 15-item questionnaire including social media and Internet usage information. Data was collected for all orthopaedic sub-specialties and statistical analysis was performed. Fifty percent of patients use social networking sites, such as Facebook. Sports medicine patients tend to be higher social networking users (35.9%) relative to other services (9.8-17.9%) and was statistically higher when compared to the joints/tumor service (P<0.0001). Younger age was the biggest indicator predicting the use of social media. Patients that travelled between 120 to 180 miles from the hospital for their visits were significantly more likely to be social media users, as were patients that did research on their condition prior to their new patient appointment. We conclude that orthopedic patients who use social media/Internet are more likely to be younger, researched their condition prior to their appointment and undergo a longer average day's travel (120-180 miles) to see a physician. In an increasingly competitive market, surgeons with younger patient populations will need to utilize social networking and the Internet to capture new patient referrals. PMID:25317312

Curry, Emily; Li, Xinning; Nguyen, Joseph; Matzkin, Elizabeth

2014-08-01

93

Manipulability of Robotic Mechanisms  

Microsoft Academic Search

This paper discusses the manipulating ability of robotic mechanisms in positioning and orienting end-effectors and proposes a measure of manipulability. Some properties of this measure are obtained, the best postures of various types of manipulators are given, and a four-degree-of-freedom finger is considered from the viewpoint of the measure. The pos tures somewhat resemble those of human arms and fingers.

Tsuneo Yoshikawa

1985-01-01

94

Rethinking Concrete Manipulatives  

NSDL National Science Digital Library

This article provides information from research on the benefits and cautions associated with using manipulatives to teach children. The authors urge that much care be used in assessing whether the learner regards the activity with concrete objects in the same context as was intended by the instructor. The article looks at the comparative advantages of computer manipulatives and gives advice on the selection and use of both physical and computer manipulatives. An extensive reference list is included.

Douglas Clements

1996-01-01

95

Manipulator system performance measurement  

NASA Technical Reports Server (NTRS)

Free-flying teleoperator technology for satellite servicing is reported. The rationale for a series of manipulator system tests is presented. Data are reported on movement time in a fine positioning task using two different manipulator systems. The movement time data showed reliable effects of movement direction and index of difficulty. These data were considered to be baseline performance measures for the manipulator system used and modifications to the control and visual systems were suggested for future testing.

Kirkpatrick, M., III; Shields, N. L., Jr.; Malone, T. B.

1975-01-01

96

[Evolution on rotation manipulation].  

PubMed

Through review of ancient literature, the developing history of rotation manipulation is traced, various rotation manipulation techniques in different historical periods are analyzed, and evolution process of rotation manipulation is also summarized. It is found that uni-direction rotation was mainly adopted before the establishment of the Republic of China (1911). Influenced by Japanese technique, back and fro rotation took place of the uni-direction rotation, and became the mainstay of the rotation manipulations. However, it is held that the uni-direction rotation has stronger stimulative effects as well as soft tissue relaxation effect, which can be applied for treatment of various diseases. PMID:24032195

Zhang, Yi

2013-07-01

97

Manipulators in teleoperation  

SciTech Connect

Teleoperated manipulators represent a mature technology which has evolved over nearly 40 years of applications experience. The wide range of manipulator concepts developed thus far reflect differing applications, priorities, and philosophies. The technology of teleoperated manipulators is in a rapid state of change (just as are industrial robotics) fueled by microelectronics and materials advances. Large strides in performance and dexterity are now practical and advantageous. Even though improved controls and sensory feedback will increase functionality, overall costs should be reduced as manipulator fabrication and assembly labor costs are reduced through improved manufacturing technology. As these advances begin to materialize, broader applications in nonnuclear areas should occur.

Hamel, W.R.

1985-01-01

98

Manipulator mounted transfer platform  

DOEpatents

A transfer platform for the conveyance of objects by a manipulator includes a bed frame and saddle clamp secured along an edge of the bed frame and adapted so as to secure the bed frame to a horizontal crosspiece of the manipulator. The platform may thus move with the manipulator in a reciprocal linear path defined by a guide rail. A bed insert may be provided for the support of conveyed objects and a lifting bail may be provided to permit the manipulator arm to install the bed frame upon the crosspiece under remote control.

Dobbins, James C. (Idaho Falls, ID); Hoover, Mark A. (Idaho Falls, ID); May, Kay W. (Idaho Falls, ID); Ross, Maurice J. (Pocatello, ID)

1990-01-01

99

Manipulator mounted transfer platform  

SciTech Connect

This invention is comprised of a transfer platform for the conveyance of objects by a manipulator includes a bed frame and saddle clamp secured along an edge of the bed fame and adapted so as to secure the bed frame to a horizontal crosspiece of the manipulator. The platform may thus move with the manipulator in a reciprocal linear path defined by a guide rail. A bed insert may be provided for the support of conveyed objects and a lifting bail may be provided to permit the manipulator arm to install the bed frame upon the crosspiece under remote control. 5 figs.

Dobbins, J.C.; Hoover, M.A.; May, K.W.; Ross, M.J.

1988-10-12

100

Usefulness of a metal artifact reduction algorithm for orthopedic implants in abdominal CT: phantom and clinical study results.  

PubMed

OBJECTIVE. The purpose of this study was to evaluate the usefulness of a metal artifact reduction (MAR) algorithm for orthopedic prostheses in phantom and clinical CT. MATERIALS AND METHODS. An agar phantom with two sets of spinal screws was scanned at various tube voltage (80-140 kVp) and tube current-time (34-1032 mAs) settings. The orthopedic MAR algorithm was combined with filtered back projection (FBP) or iterative reconstruction. The mean SDs in three ROIs were compared among four datasets (FBP, iterative reconstruction, FBP with orthopedic MAR, and iterative reconstruction with orthopedic MAR). For the clinical study, the mean SDs of three ROIs and 4-point scaled image quality in 52 patients with metallic orthopedic prostheses were compared between CT images acquired with and without orthopedic MAR. The presence and type of image quality improvement with orthopedic MAR and the presence of orthopedic MAR-related new artifacts were also analyzed. RESULTS. In the phantom study, the mean SD with orthopedic MAR was significantly lower than that without orthopedic MAR regardless of dose settings and reconstruction algorithms (FBP versus iterative reconstruction). The mean SD near the metallic prosthesis in 52 patients was significantly lower on CT images with orthopedic MAR (28.04 HU) than those without it (49.21 HU). Image quality regarding metallic artifact was significantly improved with orthopedic MAR (rating of 2.60 versus 1.04). Notable reduction of metallic artifacts and better depiction of abdominal organs were observed in 45 patients. Diagnostic benefit was achieved in six patients, but orthopedic MAR-related new artifacts were seen in 30 patients. CONCLUSION. Use of the orthopedic MAR algorithm significantly reduces metal artifacts in CT of both phantoms and patients and has potential for improving diagnostic performance in patients with severe metallic artifacts. PMID:25615752

Jeong, Seonji; Kim, Se Hyung; Hwang, Eui Jin; Shin, Cheong-Il; Han, Joon Koo; Choi, Byung Ihn

2015-02-01

101

Coordinating locomotion and manipulation of a mobile manipulator  

Microsoft Academic Search

A mobile manipulator in this study is a manipulator mounted on a mobile platform. Assuming the end point of the manipulator is guided, e.g., by a human operator to follow an arbitrary trajectory, it is desirable that the mobile platform is able to move as to position the manipulator in certain preferred configurations. Since the motion of the manipulator is

Y. Yamamoto; Xiaoping Yun

1994-01-01

102

[Skin and soft tissue complications after orthopedic interventions on tumors : Interdisciplinary management].  

PubMed

Interdisciplinary collaboration between orthopedic and plastic surgeons is indicated in reconstructive surgery of the extremities for both traumatic orthopedic fractures with extensive soft tissue damage and musculoskeletal tumor resection. We want to emphasize the need for close cooperation starting in the preoperative planning for reconstruction after tumor resection in order to discuss and establish a unified approach. This is particularly important to establish a joint approach with special consideration of possibly necessary adjuvant therapies. One collaborative approach is for the orthopedic surgeon to resect the tumor and the plastic surgeon to carry out the defect reconstruction for exclusive soft tissue coverage including flap surgery as well as for functional reconstruction depending on the location and extent of tumor resection. Thus, careful preoperative and postoperative communication on the precise location, extent of tumor resection and the therapy timing between the orthopedic surgeon and the plastic surgeon will allow the most effective subsequent repair of the resection site. PMID:25801687

Radtke, C; Calliess, T; Windhagen, H; Vogt, P

2015-03-01

103

Global research coaching in orthopedic surgery: seeding for an international network  

PubMed Central

Despite the importance of delivering evidence-based health care, orthopedic surgeons have directed fewer efforts towards the generation of such evidence. Even when present, published evidence lacks methodological rigor and is known to be inaccurate. One of the main reasons for the lack of generation of quality evidence, and the low involvement in research among orthopedic surgeons, is the lack of structured research coaching environments where they can learn concepts and hone their research skills. There is a palpable need for a pragmatic and outcome-oriented approach that can equip orthopedic surgeons with effective ways of communicating their research in writing. We describe a pragmatic research coaching program, designed and developed by the Research on Research group, which aims to build a global network of orthopedic researchers trained in streamlined and standardized research methods. We also provide a brief overview of the course principles and tools, and the platforms used in this program. PMID:24453591

Ferreira, Ana Paula Bonilauri; Rajgor, Dimple; Shah, Jatin; Shah, Anand; Pietrobon, Ricardo

2012-01-01

104

Improved performance of ultra-high molecular weight polyethylene for orthopedic applications  

E-print Network

A considerable number of total-joint replacement devices used in orthopedic medicine involve articulation between a metallic alloy and ultra-high molecular weight polyethylene (UHMWPE). Though this polymer has excellent wear resistance, the wear...

Plumlee, Kevin Grant

2009-05-15

105

Biomaterials 27 (2006) 58455854 A citric acid-based hydroxyapatite composite for orthopedic implants  

E-print Network

Biomaterials 27 (2006) 5845­5854 A citric acid-based hydroxyapatite composite for orthopedic with hydroxyapatite (HA), a bioceramic that can be found in natural bone. Although HA is very brittle and hard

Yang, Jian

106

The Effectiveness of Active and Traditional Teaching Techniques in the Orthopedic Assessment Laboratory  

NSDL National Science Digital Library

Active learning is a teaching methodology with a focus on student-centered learning that engages students in the educational process. This study implemented active learning techniques in an orthopedic assessment laboratory, and the effects of these teachi

Sara Nottingham

2010-05-01

107

Rational design of nanofiber scaffolds for orthopedic tissue repair and regeneration  

PubMed Central

This article reviews recent significant advances in the design of nanofiber scaffolds for orthopedic tissue repair and regeneration. It begins with a brief introduction on the limitations of current approaches for orthopedic tissue repair and regeneration. It then illustrates that rationally designed scaffolds made up of electrospun nanofibers could be a promising solution to overcome the problems that current approaches encounter. The article also discusses the intriguing properties of electrospun nanofibers, including control of composition, structures, orders, alignments and mechanical properties, use as carriers for topical drug and/or gene sustained delivery, and serving as substrates for the regulation of cell behaviors, which could benefit musculoskeletal tissue repair and regeneration. It further highlights a few of the many recent applications of electrospun nanofiber scaffolds in repairing and regenerating various orthopedic tissues. Finally, the article concludes with perspectives on the challenges and future directions for better design, fabrication and utilization of nanofiber scaffolds for orthopedic tissue engineering. PMID:23987110

Ma, Bing; Xie, Jingwei; Jiang, Jiang; Shuler, Franklin D; Bartlett, David E

2013-01-01

108

Clothing Manipulation Takeo Igarashi  

E-print Network

various cloth configurations quickly during the design process , both in 3D character design and realClothing Manipulation Takeo Igarashi Computer Science Department, University of Tokyo 7-3-1 Hongo techniques (and the underlying implementations) for putting clothes on a 3D character and manipulating them

Igarashi, Takeo

109

Linearization of Robot Manipulators  

NASA Technical Reports Server (NTRS)

Four nonlinear control schemes equivalent. Report discusses theory of nonlinear feedback control of robot manipulator, emphasis on control schemes making manipulator input and output behave like decoupled linear system. Approach, called "exact external linearization," contributes efforts to control end-effector trajectories, positions, and orientations.

Kreutz, Kenneth

1987-01-01

110

An Overview of Dexterous Manipulation  

Microsoft Academic Search

Presents an overview of research in dexterous manipulation. We first define robotic dexterous manipulation in comparison to traditional robotics and human manipulation. Next, kinematics, contact types and forces are used to formulate the dexterous manipulation problem. Dexterous motion planning is described, which includes grasp planning and quality measures. We look at mid- and low-level control frameworks, and then compare manipulation

Allison M. Okamura; Niels Smaby; Mark R. Cutkosky

2000-01-01

111

Manipulator comparative testing program  

SciTech Connect

The Manipulator Comparative Testing Program examined differences among manipulator systems from the United States and Japan. The manipulator systems included the Meidensha BILARM 83A, the Model M-2 of Central Research Laboratories Division of Sargent Industries (CRL), and the GCA Corporation PaR Systems Model 6000. The site of testing was the Remote Operations Maintenance Demonstration (ROMD) facility, operated by the Fuel Recycle Division in the Consolidated Fuel Reprocessing Program at the Oak Ridge National Laboratory (ORNL). In all stages of testing, operators using the CRL Model M-2 manipulator had consistently lower times to completion and error rates than they did using other machines. Performance was second best with the Meidensha BILARM 83A in master-slave mode. Performance with the BILARM in switchbox mode and the PaR 6000 manipulator was approximately equivalent in terms of criteria recorded in testing. These data show no impact of force reflection on task performance.

Draper, J.V.; Handel, S.J.; Sundstrom, E.; Herndon, J.N.; Fujita, Y.; Maeda, M.

1986-01-01

112

Osteopathic Manipulative Treatment  

PubMed Central

Dermatological diseases, such as dysesthesia syndromes, stasis dermatoses, and hyperhidrosis are difficult to treat due to their complex etiologies. Current theories suggest these diseases are caused by physiological imbalances, such as nerve impingement, localized tissue congestion, and impaired autonomic regulation. Osteopathic manipulative therapy targets these physiological dysfunctions and may serve as a beneficial therapeutic option. Osteopathic manipulative therapy techniques include high velocity low amplitude, muscle energy, counterstrain, myofascial release, craniosacral, and lymphatic drainage. An osteopathic manipulative therapy technique is chosen based on its physiological target for a particular disease. Osteopathic manipulative therapy may be useful alone or in combination with standard therapeutic options. However, due to the lack of standardized trials supporting the efficacy of osteopathic manipulative therapy treatment for dermatological disease, randomized, well-controlled studies are necessary to confirm its therapeutic value. PMID:23125887

Campbell, Shannon M.; Walkowski, Stevan

2012-01-01

113

A qualitative and quantitative needs assessment of pain management for hospitalized orthopedic patients.  

PubMed

Despite advances in pain management, little formal teaching is given to practitioners and nurses in its use for postoperative orthopedic patients. The goal of our study was to determine the educational needs for orthopedic pain management of our residents, nurses, and physical therapists using a quantitative and qualitative assessment. The needs analysis was conducted in a 10-bed orthopedic unit at a teaching hospital and included a survey given to 20 orthopedic residents, 9 nurses, and 6 physical therapists, followed by focus groups addressing barriers to pain control and knowledge of pain management. Key challenges for nurses included not always having breakthrough pain medication orders and the gap in pain management between cessation of patient-controlled analgesia and ordering and administering oral medications. Key challenges for orthopedic residents included treating pain in patients with a history of substance abuse, assessing pain, and determining when to use long-acting vs short-acting opioids. Focus group assessments revealed a lack of training in pain management and the need for better coordination of care between nurses and practitioners and improved education about special needs groups (the elderly and those with substance abuse issues). This needs assessment showed that orthopedic residents and nurses receive little formal education on pain management, despite having to address pain on a daily basis. This information will be used to develop an educational program to improve pain management for postoperative orthopedic patients. An integrated educational program with orthopedic residents, nurses, and physical therapists would promote understanding of issues for each discipline. PMID:21815578

Cordts, Grace A; Grant, Marian S; Brandt, Lynsey E; Mears, Simon C

2011-08-01

114

Randomized prospective study on prophylactic antibiotics in clean orthopedic surgery in one ward for 1 year  

Microsoft Academic Search

Background  At present in Japan, there are neither reports on antibiotic prophylaxis regardless of underlying diseases nor precise guidelines\\u000a on prophylactic antibiotics in orthopedic surgery. Therefore, the preventive effect of antimicrobial agents on surgical site\\u000a infection (SSI) after clean orthopedic surgery was studied to control the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in our ward and to reduce SSI caused by

Daisuke Kato; Katsuhiko Maezawa; Ikuho Yonezawa; Yoshiyuki Iwase; Hiroshi Ikeda; Masahiko Nozawa; Hisashi Kurosawa

2006-01-01

115

Alternative Procedures for Reducing Allogeneic Blood Transfusion in Elective Orthopedic Surgery  

Microsoft Academic Search

Perioperative blood loss is a major problem in elective orthopedic surgery. Allogeneic transfusion is the standard treatment\\u000a for perioperative blood loss resulting in low postoperative hemoglobin, but it has a number of well-recognized risks, complications,\\u000a and costs. Alternatives to allogeneic blood transfusion include preoperative autologous donation and intraoperative salvage\\u000a with postoperative autotransfusion. Orthopedic surgeons are often unaware of the different

Kathrin Kleinert; Oliver M. Theusinger; Johannes Nuernberg; Clément M. L. Werner

2010-01-01

116

Biofilm Disrupting Technology for Orthopedic Implants: What’s on the Horizon?  

PubMed Central

The use of orthopedic implants in joints has revolutionized the treatment of patients with many debilitating chronic musculoskeletal diseases such as osteoarthritis. However, the introduction of foreign material into the human body predisposes the body to infection. The treatment of these infections has become very complicated since the orthopedic implants serve as a surface for multiple species of bacteria to grow at a time into a resistant biofilm layer. This biofilm layer serves as a protectant for the bacterial colonies on the implant making them more resistant and difficult to eradicate when using standard antibiotic treatment. In some cases, the use of antibiotics alone has even made the bacteria more resistant to treatment. Thus, there has been surge in the creation of non-antibiotic anti-biofilm agents to help disrupt the biofilms on the orthopedic implants to help eliminate the infections. In this study, we discuss infections of orthopedic implants in the shoulder then we review the main categories of anti-biofilm agents that have been used for the treatment of infections on orthopedic implants. Then, we introduce some of the newer biofilm disrupting technology that has been studied in the past few years that may advance the treatment options for orthopedic implants in the future. PMID:25705632

Connaughton, Alexander; Childs, Abby; Dylewski, Stefan; Sabesan, Vani J.

2014-01-01

117

PEEK biomaterials in trauma, orthopedic, and spinal implants.  

PubMed

Since the 1980s, polyaryletherketones (PAEKs) have been increasingly employed as biomaterials for trauma, orthopedic, and spinal implants. We have synthesized the extensive polymer science literature as it relates to structure, mechanical properties, and chemical resistance of PAEK biomaterials. With this foundation, one can more readily appreciate why this family of polymers will be inherently strong, inert, and biocompatible. Due to its relative inertness, PEEK biomaterials are an attractive platform upon which to develop novel bioactive materials, and some steps have already been taken in that direction, with the blending of HA and TCP into sintered PEEK. However, to date, blended HA-PEEK composites have involved a trade-off in mechanical properties in exchange for their increased bioactivity. PEEK has had the greatest clinical impact in the field of spine implant design, and PEEK is now broadly accepted as a radiolucent alternative to metallic biomaterials in the spine community. For mature fields, such as total joint replacements and fracture fixation implants, radiolucency is an attractive but not necessarily critical material feature. PMID:17686513

Kurtz, Steven M; Devine, John N

2007-11-01

118

Advances in musculoskeletal oncology: experience of the Lublin Orthopedic Clinic.  

PubMed

Major milestones in the diagnosis and treatment of musculoskeletal tumors and tumor-like lesions are presented on the basis of the authors' 40 years of experience in the Lublin Orthopedic Clinic. A prompt, adequate and complex diagnosis should be established using clinical, radiological and laboratory data. The biopsy (usually trepano-biopsy) that is performed routinely can be omitted in some patients. lmmunohistochemistry tests enable adequate differential diagnosis in many cases. Great progress has also been observed in treatment methods. Burring of sclerotic bony walls in benign osteolytic lesions is a major improvement over traditional but ineffective curettage. A multidisciplinary approach using neoadjuvant chemotherapy has radically improved outcomes in the treatment of ostegenic sarcoma and Ewing's sarcoma. Progress in surgical methods is enabling limb salvage by reconstructing large bone defects with modular endoprostheses. Patients with bone metastases are routinely operated for pathological fractures, large bone destruction or spinal cord compression. The authors call for the establishment of several Musculoskeletal Oncology centers in Poland. PMID:17618220

Warda, Edward; Mazurkiewicz, Tomasz; Kopacz, Jacek; Gronowska, Stanis?awa

2004-10-30

119

Bioactive, mechanically favorable, and biodegradable copolymer nanocomposites for orthopedic applications.  

PubMed

We report the synthesis of mechanically favorable, bioactive, and biodegradable copolymer nanocomposites for potential bone applications. The nanocomposites consist of in situ polymerized biodegradable copolyester with hydroxyapatite (HA). Biodegradable copolyesters comprise carboxy terminated poly(propylene fumarate) (CT-PPF) and poly(trimethylol propane fumarate co mannitol sebacate) (TF-Co-MS). Raman spectral imaging clearly reveals a uniform homogenous distribution of HA in the copolymer matrix. The mechanical studies reveal that improved mechanical properties formed when crosslinked with methyl methacrylate (MMA) when compared to N-vinyl pyrrolidone (NVP). The SEM micrographs of the copolymer nanocomposites reveal a serrated structure reflecting higher mechanical strength, good dispersion, and good interfacial bonding of HA in the polymer matrix. In vitro degradation of the copolymer crosslinked with MMA is relatively more than that of NVP and the degradation decreases with an increase in the amount of the HA filler. The mechanically favorable and degradable MMA based nanocomposites also have favorable bioactivity, blood compatibility, cytocompatibility and cell adhesion. The present nanocomposite is a more promising material for orthopedic applications. PMID:24863211

Victor, Sunita Prem; Muthu, Jayabalan

2014-06-01

120

Development of an orthopedic surgery trauma patient handover checklist  

PubMed Central

Background In surgery, preoperative handover of surgical trauma patients is a process that must be made as safe as possible. We sought to determine vital clinical information to be transferred between patient care teams and to develop a standardized handover checklist. Methods We conducted standardized small-group interviews about trauma patient handover. Based on this information, we created a questionnaire to gather perspectives from all Canadian Orthopaedic Association (COA) members about which topics they felt would be most important on a handover checklist. We analyzed the responses to develop a standardized handover checklist. Results Of the 1106 COA members, 247 responded to the questionnaire. The top 7 topics felt to be most important for achieving patient safety in the handover were comorbidities, diagnosis, readiness for the operating room, stability, associated injuries, history/mechanism of injury and outstanding issues. The expert recommendations were to have handover completed the same way every day, all appropriate radiographs available, adequate time, all appropriate laboratory work and more time to spend with patients with more severe illness. Conclusion Our main recommendations for safe handover are to use standardized checklists specific to the patient and site needs. We provide an example of a standardized checklist that should be used for preoperative handovers. To our knowledge, this is the first checklist for handover developed by a group of experts in orthopedic surgery, which is both manageable in length and simple to use. PMID:24461220

LeBlanc, Justin; Donnon, Tyrone; Hutchison, Carol; Duffy, Paul

2014-01-01

121

Outcome errors are not necessary for learning orthopedic bone drilling  

PubMed Central

Background When learning orthopedic bone drilling, a surgical trainee relies on internally generated and externally provided feedback. The quality and type of feedback often varies in the clinical environment, thus affecting skill acquisition. We investigated the effect of feedback on technical error (plunging) when novice surgical trainees learned bone drilling. Methods Medical students (n = 22) and experienced postgraduate surgical residents (n = 4) drilled bicortical holes in a lamb femur under 1 of 3 feedback conditions: no feedback, self-generated feedback and externally generated feedback. Novices performed a retention test (10 bicortical holes) 1 week after the initial training. We measured plunge depth, the clinically relevant outcome, using computer-assisted methods. Results During the initial experiment, the plunges of novices who were exposed to external feedback were similar to those of residents in the experienced group. Novices in the self-generated feedback group plunged more than those in the external feedback group or those in the experienced group (p = 0.002). All novices plunged similarly on the retention test, a measure of true skill learning. Conclusion When learning bicortical bone drilling, feedback related to plunging is not necessary to achieve a competent level of performance. In addition, although external feedback facilitates the achievement of better outcomes, it does not improve learning. It is suggested that to minimize plunging, trainees should learn how to optimize their drilling through the bone rather than how to prevent the plunge. PMID:19399203

Khokhotva, Mykola; Backstein, David; Dubrowski, Adam

2009-01-01

122

PEEK Biomaterials in Trauma, Orthopedic, and Spinal Implants  

PubMed Central

Since the 1980s, polyaryletherketones (PAEKs) have been increasingly employed as biomaterials for trauma, orthopedic, and spinal implants. We have synthesized the extensive polymer science literature as it relates to structure, mechanical properties, and chemical resistance of PAEK biomaterials. With this foundation, one can more readily appreciate why this family of polymers will be inherently strong, inert, and biocompatible. Due to its relative inertness, PEEK biomaterials are an attractive platform upon which to develop novel bioactive materials, and some steps have already been taken in that direction, with the blending of HA and TCP into sintered PEEK. However, to date, blended HA-PEEK composites have involved a trade-off in mechanical properties in exchange for their increased bioactivity. PEEK has had the greatest clinical impact in the field of spine implant design, and PEEK is now broadly accepted as a radiolucent alternative to metallic biomaterials in the spine community. For mature fields, such as total joint replacements and fracture fixation implants, radiolucency is an attractive but not necessarily critical material feature. PMID:17686513

Kurtz, S. M.; Devine, J. N.

2007-01-01

123

Hydroxyapatite electrodeposition on anodized titanium nanotubes for orthopedic applications  

NASA Astrophysics Data System (ADS)

Nanotubes modification for orthopedic implants has shown interesting biological performances (such as improving cell adhesion, cell differentiation, and enhancing osseointegration). The purpose of this study is to investigate effect of titanium dioxide (TiO2) nanotube feature on performance of hydroxyapatite-coated titanium (Ti) bone implants. TiO2 nanotubes were prepared by anodization using ammonium fluoride electrolyte (NH4F) with and without modifiers (PEG400 and Glycerol) at various potential forms, and times. After anodization, the nanotubes were subsequently annealed. TiO2 nanotubes were characterized by scanning electron microscope and X-ray diffractometer. The amorphous to anatase transformation due to annealing was observed. Smooth and highly organized TiO2 nanotubes were found when high viscous electrolyte, NH4F in glycerol, was used. Negative voltage (-4 V) during anodization was confirmed to increase nanotube thickness. Length of the TiO2 nanotubes was significantly increased by times. The TiO2 nanotube was electrodeposited with hydroxyapatite (HA) and its adhesion was estimated by adhesive tape test. The result showed that nanotubes with the tube length of 560 nm showed excellent adhesion. The coated HA were tested for biological test by live/dead cell straining. HA coated on TiO2 nanotubes showed higher cells density, higher live cells, and more spreading of MC3T3-E1 cells than that growing on titanium plate surface.

Parcharoen, Yardnapar; Kajitvichyanukul, Puangrat; Sirivisoot, Sirinrath; Termsuksawad, Preecha

2014-08-01

124

Dielectrophoresis for Bioparticle Manipulation  

PubMed Central

As an ideal method to manipulate biological particles, the dielectrophoresis (DEP) technique has been widely used in clinical diagnosis, disease treatment, drug development, immunoassays, cell sorting, etc. This review summarizes the research in the field of bioparticle manipulation based on DEP techniques. Firstly, the basic principle of DEP and its classical theories are introduced in brief; Secondly, a detailed introduction on the DEP technique used for bioparticle manipulation is presented, in which the applications are classified into five fields: capturing bioparticles to specific regions, focusing bioparticles in the sample, characterizing biomolecular interaction and detecting microorganism, pairing cells for electrofusion and separating different kinds of bioparticles; Thirdly, the effect of DEP on bioparticle viability is analyzed; Finally, the DEP techniques are summarized and future trends in bioparticle manipulation are suggested. PMID:25310652

Qian, Cheng; Huang, Haibo; Chen, Liguo; Li, Xiangpeng; Ge, Zunbiao; Chen, Tao; Yang, Zhan; Sun, Lining

2014-01-01

125

Data Manipulation and Display  

NASA Technical Reports Server (NTRS)

BDMADS, BASIC Data Manipulation and Display System, is software package that runs on Apple II Plus or lle personal computer to provide user-friendly environment in which to perform many complex operations on array of numbers.

Szuch, J. R.

1986-01-01

126

Manipulation of Thermal Phonons  

E-print Network

in silicon nanofabrication techniques, this makes tungsten/silicon phononic crystal a particularly attractive platform for manipulating thermal phonons. Phononic crystal makes use of the fundamental properties of waves to create band gap over which there can...

Hsu, Chung-Hao

2013-03-28

127

Base Blocks Virtual Manipulative  

NSDL National Science Digital Library

This virtual manipulative provides base blocks that consist of individual "units," "longs," "flats," and "blocks" (ten of each set for base 10). They can be used to show place value for numbers and to increase understanding of addition and subtraction.

National Library of Virtual Manipulatives

2008-12-10

128

Classifying human manipulation behavior  

Microsoft Academic Search

This paper presents a taxonomy for detailed classification of human and anthropomorphic manipulation behavior. This hand-centric, motion-centric taxonomy differentiates tasks based on criteria such as object contact, prehension, and the nature of object motion relative to a hand frame. A sub-classification of the most dexterous categories, within-hand manipulation, is also presented, based on the principal axis of object rotation or

Ian M. Bullock; Aaron M. Dollar

2011-01-01

129

Remote manipulator dynamic simulation  

NASA Technical Reports Server (NTRS)

A simulator to generate the real time visual scenes required to perform man in the loop investigations of remote manipulator application and design concepts for the space shuttle is described. The simulated remote manipulator consists of a computed display system that uses a digital computer, the electronic scene generator, an operator's station, and associated interface hardware. A description of the capabilities of the implemented simulation is presented. The mathematical models and programs developed for the simulation are included.

Wild, E. C.; Donges, P. K.; Garand, W. A.

1972-01-01

130

Manipulators and Manipulation: Public Opinion in a Representative Democracy  

Microsoft Academic Search

Politicians and special interests have attempted to capture and manipulate citizens for as long as recorded history. The question is not whether elites attempt to manipulate citizens but whether and to what degree they succeed. Is public opinion relatively autonomous from the willful strategies of politicians and private interests to manipulate it in specific directions? Or, are citizens willfully manipulated

Lawrence R. Jacobs

2001-01-01

131

Micro manipulator motion control to counteract macro manipulator structural vibrations  

SciTech Connect

Inertial force damping control by micro manipulator modulation is proposed to suppress the vibrations of a micro/macro manipulator system. The proposed controller, developed using classical control theory, is added to the existing control system. The proposed controller uses real-time measurements of macro manipulator flexibility to adjust the motion of the micro manipulator to counteract structural vibrations. Experimental studies using an existing micro/macro flexible link manipulator testbed demonstrate the effectiveness of the proposed approach to suppression of vibrations in the macro/micro manipulator system using micro-manipulator-based inertial active damping control.

Lew, J.Y.; Trudnowski, D.J.; Evans, M.S.; Bennett, D.W.

1995-02-01

132

A simple strategy to reduce stereotype threat for orthopedic residents  

PubMed Central

Background Stereotype threat, defined as the predicament felt by people in either positive or negative learning experiences where they could conform to negative stereotypes associated with their own group membership, can interfere with learning. The purpose of this study was to determine if a simple orientation session could reduce stereotype threat for orthopedic residents. Methods The intervention group received an orientation on 2 occasions focusing on their possible responses to perceived poor performance in teaching rounds and the operating room (OR). Participants completed a survey with 7 questions typical for stereotype threat evaluating responses to their experiences. The questions had 7 response options with a maximum total score of 49, where higher scores indicated greater degree of experiences typical of stereotype threat. Results Of the 84 eligible residents, 49 participated: 22 in the nonintervention and 27 in the intervention group. The overall scores were 29 and 29.4, and 26.2 and 25.8 in the nonintervention and intervention groups for their survey responses to perceived poor performance in teaching rounds (p = 0.85) and the OR (p = 0.84), respectively. Overall, responses typical of stereotype threat were greater for perceived poor performance at teaching rounds than in the OR (p = 0.001). Conclusion Residents experience low self-esteem following perceived poor performance, particularly at rounds. A simple orientation designed to reduce stereotype threat was unsuccessful in reducing this threat overall. Future research will need to consider longer-term intervention as possible strategies to reduce perceived poor performance at teaching rounds and in the OR. PMID:24666454

Gomez, Everlyne; Wright, James G.

2014-01-01

133

Chitosan for gene delivery and orthopedic tissue engineering applications.  

PubMed

Gene therapy involves the introduction of foreign genetic material into cells in order exert a therapeutic effect. The application of gene therapy to the field of orthopaedic tissue engineering is extremely promising as the controlled release of therapeutic proteins such as bone morphogenetic proteins have been shown to stimulate bone repair. However, there are a number of drawbacks associated with viral and synthetic non-viral gene delivery approaches. One natural polymer which has generated interest as a gene delivery vector is chitosan. Chitosan is biodegradable, biocompatible and non-toxic. Much of the appeal of chitosan is due to the presence of primary amine groups in its repeating units which become protonated in acidic conditions. This property makes it a promising candidate for non-viral gene delivery. Chitosan-based vectors have been shown to transfect a number of cell types including human embryonic kidney cells (HEK293) and human cervical cancer cells (HeLa). Aside from its use in gene delivery, chitosan possesses a range of properties that show promise in tissue engineering applications; it is biodegradable, biocompatible, has anti-bacterial activity, and, its cationic nature allows for electrostatic interaction with glycosaminoglycans and other proteoglycans. It can be used to make nano- and microparticles, sponges, gels, membranes and porous scaffolds. Chitosan has also been shown to enhance mineral deposition during osteogenic differentiation of MSCs in vitro. The purpose of this review is to critically discuss the use of chitosan as a gene delivery vector with emphasis on its application in orthopedic tissue engineering. PMID:23676471

Raftery, Rosanne; O'Brien, Fergal J; Cryan, Sally-Ann

2013-01-01

134

Biocompatibility evaluation of porous ceria foams for orthopedic tissue engineering.  

PubMed

Ceria ceramics have the unique ability to protect cells from free radical-induced damage, making them materials of interest for biomedical applications. To expand upon the understanding of the potential of ceria as a biomaterial, porous ceria, fabricated via direct foaming, was investigated to assess its biocompatibility and its ability to scavenge free radicals. A mouse osteoblast (7F2) cell line was cultured with the ceria foams to determine the extent of the foams' toxicity. Toxicity assessments indicate that mouse osteoblasts cultured directly on the ceria scaffold for 72 h did not show a significant (p?>?0.05) increase in toxicity, but rather show comparable toxicity to cells cultured on porous 45S5 Bioglass. The in vitro inflammatory response elicited from porous ceria foams was measured as a function of tumor necrosis factor alpha (TNF-?) secreted from a human monocytic leukemia cell line. Results indicate that the ceria foams do not cause a significant inflammatory response, eliciting a response of 27.1?±?7.1 pg mL(-1) of TNF-? compared to 36.3?±?5.8 pg mL(-1) from cells on Bioglass, and 20.1?±?2.9 pg mL(-1) from untreated cells. Finally, we report cellular toxicity in response to free radicals from tert-butyl hydroperoxide with and without foamed ceria. Our preliminary results show that the foamed ceria is able to decrease the toxic effect of induced oxidative stress. Collectively, this study demonstrates that foamed ceria scaffolds do not activate an inflammatory response, and show potential free radical scavenging ability, thus they have promise as an orthopedic biomaterial. PMID:24677427

Ball, Jordan P; Mound, Brittnee A; Monsalve, Adam G; Nino, Juan C; Allen, Josephine B

2015-01-01

135

ROBOTICS -INTRODUCTION t Manipulator Arms  

E-print Network

ROBOTICS - INTRODUCTION t Manipulator Arms The common industrial manipulator is often referred to as a robot arm, with links and joints described in similar terms. Manipulators which emulate). A representative articulated manipulators is the ASEA robot. ASEA robot performing a mechanical assembly task

Petriu, Emil M.

136

Orthopedic Management of Patients with Pompe Disease: A Retrospective Case Series of 8 Patients  

PubMed Central

Introduction. Pompe disease (PD), a lysosomal storage disease as well as a neuromuscular disorder, is a rare disease marked by progressive muscle weakness. Enzyme replacement therapy (ERT) in recent years allowed longer survival but brought new problems to the treatment of PD with increasing affection of the musculoskeletal system, particularly with a significantly higher prevalence of scoliosis. The present paper deals with the orthopedic problems in patients with PD and is the first to describe surgical treatment of scoliosis in PD patients. Patients and Methods. The orthopedic problems and treatment of eight patients with PD from orthopedic consultation for neuromuscular disorders are retrospectively presented. We analyzed the problems of scoliosis, hip dysplasia, feet deformities, and contractures and presented the orthopedic treatment options. Results. Six of our eight PD patients had scoliosis and two young patients were treated by operative spine stabilization with benefits for posture and sitting ability. Hip joint surgery, operative contracture release, and feet deformity correction were performed with benefits for independent activity. Conclusion. Orthopedic management gains importance due to extended survival and musculoskeletal involvement under ERT. Surgical treatment is indicated in distinct cases. Further investigation is required to evidence the effect of surgical spine stabilization in PD. PMID:24523658

Forst, Jürgen; Forst, Raimund

2014-01-01

137

Local infiltration of liposome bupivacaine in orthopedic trauma patients: case-based reviews.  

PubMed

Orthopedic trauma surgery is often associated with considerable postoperative pain, which can result in a cascade of direct and indirect clinical consequences. Patients undergoing orthopedic trauma surgery are at risk for the development of chronic postsurgical pain, which may persist for 2 years or longer. Effective approaches to reducing postoperative pain in orthopedic trauma surgery patients include the use of minimally invasive procedures and multimodal analgesia. Infiltration of the surgical site with EXPAREL® (bupivacaine liposome injectable suspension), an extended-release local anesthetic, represents an advance in the multimodal management of postoperative pain. As part of a multimodal regimen, EXPAREL® has been shown to provide effective, safe, and efficient analgesia across a range of surgical procedures. Two cases that illustrate the use of EXPAREL® in orthopedic trauma are described. The first case involves repair of a subtrochanteric nonunion in a 63-year-old woman with a history of bisphosphonate use and prior treatment with a cephalomedullary nail. The second case involves a young woman undergoing outpatient surgery for repair of a fractured clavicle. Both patients experienced good control of postsurgical pain, supporting the clinical utility of EXPAREL® in orthopedic trauma surgery. PMID:25303455

Hutchinson, Hank L

2014-10-01

138

Specific Distribution within the Enterobacter cloacae Complex of Strains Isolated from Infected Orthopedic Implants?  

PubMed Central

Bacteria belonging to the Enterobacter genus are frequently isolated from clinical samples but are unusual causative agents of orthopedic implant infections. Twelve genetic clusters (clusters I to XII) and one sequence crowd (sequence crowd xiii) can be distinguished within the Enterobacter cloacae nomenspecies on the basis of hsp60 sequence analysis, and until now, none of these clusters could be specifically associated with a disease. In order to investigate if specific genetic clusters would be involved in infections of orthopedic material, two series of bacterial clinical isolates identified as E. cloacae by routine phenotypic identification methods were collected either from infected orthopedic implants (n = 21) or from randomly selected samples of diverse anatomical origins (control; n = 52). Analysis of the hsp60 gene showed that genetic clusters III, VI, and VIII were the most frequent genetic clusters detected in the control group, whereas cluster III was poorly represented among the orthopedic implant isolates (P = 0.006). On the other hand, E. hormaechei (clusters VI and VIII), but not cluster III, is predominantly associated with infections of orthopedic implants and, more specifically, with infected material in the hip (P = 0.019). These results support the hypothesis that, among the isolates within the E. cloacae complex, E. hormaechei and hsp60 gene sequencing-based cluster III are involved in pathogenesis in different ways and highlight the need for more accurate routine Enterobacter identification methods. PMID:19515837

Morand, Philippe C.; Billoet, Annick; Rottman, Martin; Sivadon-Tardy, Valérie; Eyrolle, Luc; Jeanne, Luc; Tazi, Asmaa; Anract, Philippe; Courpied, Jean-Pierre; Poyart, Claire; Dumaine, Valérie

2009-01-01

139

[Further training in the faculty of orthopedics and trauma surgery. Outstanding, average or insufficient?].  

PubMed

A well structured and executed and practical residency program is important to secure a sufficient number of well trained orthopedic surgeons in the future. Some of the residents, however, see substantial shortcomings here. Additionally, orthopedic residency programs struggle to be a valid alternative for graduated medical students when comparing them to residency programs in other medical specialities or alternative job options. In improving the current situation program directors as well as residents must play a key role. A rapid improvement of structural shortcomings of German residency programs does not only provide an advantage in recruiting new residents now, but may also help to maintain the high quality in orthopedic health care in the future. PMID:23325154

Perl, M; Stange, R; Niethard, M; Münzberg, M

2013-01-01

140

Alternative Procedures for Reducing Allogeneic Blood Transfusion in Elective Orthopedic Surgery  

PubMed Central

Perioperative blood loss is a major problem in elective orthopedic surgery. Allogeneic transfusion is the standard treatment for perioperative blood loss resulting in low postoperative hemoglobin, but it has a number of well-recognized risks, complications, and costs. Alternatives to allogeneic blood transfusion include preoperative autologous donation and intraoperative salvage with postoperative autotransfusion. Orthopedic surgeons are often unaware of the different pre- and intraoperative possibilities of reducing blood loss and leave the management of coagulation and use of blood products completely to the anesthesiologists. The goal of this review is to compare alternatives to allogeneic blood transfusion from an orthopedic and anesthesia point of view focusing on estimated costs and acceptance by both parties. PMID:21886535

Kleinert, Kathrin; Theusinger, Oliver M.; Nuernberg, Johannes

2010-01-01

141

LASER Additive Manufacturing of Titanium-Tantalum Alloy Structured Interfaces for Modular Orthopedic Devices  

NASA Astrophysics Data System (ADS)

Tantalum is recognized to have better biocompatibility and osseointegrative properties than other more commonly used orthopedic grade alloys. There are several novel methods that tantalum or tantalum-titanium could be used to augment orthopedic implants. A tantalum or tantalum-titanium alloy at the bone/implant or modular component interfaces would substantially increase the longevity and performance of modular devices. Bonding a functional tantalum coating to a titanium orthopedic device is inherently difficult because of the small difference between the melting temperature of tantalum, 3017°C, and the boiling point of titanium, 3287°C. LASER powder deposition (LPD) is a fusion operation using an Nd:YAG to melt a small volume of substrate into which metal powder is sprayed achieving high temperature with a high solidification rate. LPD of Ti-Ta onto a Ti-6Al-4V substrate produced both a solid surface and structured coating with a pore size in the optimal 350-500 ?m range.

Fuerst, Jacob; Medlin, Dana; Carter, Michael; Sears, James; Vander Voort, George

2015-03-01

142

Simulation of robot manipulators  

SciTech Connect

This paper describes Oak Ridge National Laboratory`s development of an environment for the simulation of robotic manipulators. Simulation includes the modeling of kinematics, dynamics, sensors, actuators, control systems, operators, and environments. Models will be used for manipulator design, proposal evaluation, control system design and analysis, graphical preview of proposed motions, safety system development, and training. Of particular interest is the development of models for robotic manipulators having at least one flexible link. As a first application, models have been developed for the Pacific Northwest Laboratories` Flexible Beam Testbed which is a one-Degree-Of-Freedom, flexible arm with a hydraulic base actuator. Initial results show good agreement between model and experiment.

Kress, R.L.; Babcock, S.M.; Bills, K.C.; Kwon, D.S.; Schoenwald, D.A.

1995-03-01

143

A new index of serial-link manipulator performance combining dynamic manipulability and manipulating force ellipsoids  

Microsoft Academic Search

The inertia matching ellipsoid (IME) is proposed as a new index of dynamic performance for serial-link robotic manipulators. The IME integrates the existing dynamic manipulability and manipulating-force ellipsoids to achieve an accurate measure of the dynamic torque-force transmission efficiency between the joint torque and the force applied to a load held by an end-effector. The dynamic manipulability and manipulating-force ellipsoids

Ryo Kurazume; Tsutomu Hasegawa

2006-01-01

144

The TROJAN Project: Creating a Customized International Orthopedic Training Program for Junior Doctors.  

PubMed

Musculoskeletal problems account for a vast proportion of presentations encountered by doctors globally, with figures ranging from 15-36%. However, the time medical schools allocate to learning orthopedics is by no means proportional to this. This study aims to bridge this gap by developing an international orthopedic teaching program tailored to the specific knowledge and skills required by junior doctors in different countries. This prospective study asked fifty junior doctors, who had recently completed an orthopedics job, what three orthopedic teaching topics taught retrospectively would have benefitted their clinical practice. The most requested topics were used to design educational workshops for junior doctors and these consequently comprised the TROJAN (Teaching Requested by Orthopaedic Juniors And Novices) training program. Data was collected from twenty-five junior doctors in KwaZulu-Natale State, South Africa, and twenty-five in London, UK. It is therefore in these two countries that the TROJAN program was subsequently made available. Participants who selected topics were within two years of graduating medical school and had worked an orthopedic or Accident and Emergency job within the last year. 49% of topics chosen by SA doctors were practical skills such as wrist and ankle fracture reduction techniques, and management of open fractures. The most requested topic by UK doctors (11 out of 25) was management of neck of femur fractures. This is rationalized by the fact South African doctors require more hands-on responsibility in their daily practice whereas in the UK greater emphasis is placed on optimizing patients for theatre and making sound management plans. TROJAN currently develops orthopedic skills and knowledge in junior doctors in South Africa and United Kingdom with teaching customized based upon location. Feedback has been exceptionally positive with every candidate thus far rating the usefulness of TROJAN as the highest option, very useful. PMID:25874064

Kalraiya, Ashish; Buddhdev, Pranai

2015-03-01

145

Thirty-Day Readmission Rates in Orthopedics: A Systematic Review and Meta-Analysis  

PubMed Central

Background Hospital readmission rates are being used to evaluate performance. A survey of the present rates is needed before policies can be developed to decrease incidence of readmission. We address three questions: What is the present rate of 30-day readmission in orthopedics? How do factors such as orthopedic specialty, data source, patient insurance, and time of data collection affect the 30-day readmission rate? What are the causes and risk factors for 30-day readmissions? Methods/Findings A review was first registered with Prospero (CRD42014010293, 6/17/2014) and a meta-analysis was performed to assess the current 30-day readmission rate in orthopedics. Studies published after 2006 were retrieved, and 24 studies met the inclusion criteria. The 30-day readmission rate was extrapolated from each study along with the orthopedic subspecialty, data source, patient insurance, time of collection, patient demographics, and cause of readmission. A sensitivity analysis was completed on the stratified groups. The overall 30-day readmission rate across all orthopedics was 5.4 percent (95% confidence interval: 4.8,6.0). There was no significant difference between subspecialties. Studies that retrieved data from a multicenter registry had a lower 30-day readmission rate than those reporting data from a single hospital or a large national database. Patient populations that only included Medicare patients had a higher 30-day readmission rate than populations of all insurance. The 30-day readmission rate has decreased in the past ten years. Age, length of stay, discharge to skilled nursing facility, increased BMI, ASA score greater than 3, and Medicare/Medicaid insurance showed statistically positive correlation with increased 30-day readmissions in greater than 75 percent of studies. Surgical site complications accounted for 46 percent of 30-day readmissions. Conclusions This meta-analysis shows the present rate of 30-day readmissions in orthopedics. Demonstrable heterogeneity between studies underlines the importance of uniform collection and reporting of readmission rates for hospital evaluation and reimbursement. PMID:25884444

Bernatz, James T.; Tueting, Jonathan L.; Anderson, Paul A.

2015-01-01

146

The TROJAN Project: Creating a Customized International Orthopedic Training Program for Junior Doctors  

PubMed Central

Musculoskeletal problems account for a vast proportion of presentations encountered by doctors globally, with figures ranging from 15-36%. However, the time medical schools allocate to learning orthopedics is by no means proportional to this. This study aims to bridge this gap by developing an international orthopedic teaching program tailored to the specific knowledge and skills required by junior doctors in different countries. This prospective study asked fifty junior doctors, who had recently completed an orthopedics job, what three orthopedic teaching topics taught retrospectively would have benefitted their clinical practice. The most requested topics were used to design educational workshops for junior doctors and these consequently comprised the TROJAN (Teaching Requested by Orthopaedic Juniors And Novices) training program. Data was collected from twenty-five junior doctors in KwaZulu-Natale State, South Africa, and twenty-five in London, UK. It is therefore in these two countries that the TROJAN program was subsequently made available. Participants who selected topics were within two years of graduating medical school and had worked an orthopedic or Accident and Emergency job within the last year. 49% of topics chosen by SA doctors were practical skills such as wrist and ankle fracture reduction techniques, and management of open fractures. The most requested topic by UK doctors (11 out of 25) was management of neck of femur fractures. This is rationalized by the fact South African doctors require more hands-on responsibility in their daily practice whereas in the UK greater emphasis is placed on optimizing patients for theatre and making sound management plans. TROJAN currently develops orthopedic skills and knowledge in junior doctors in South Africa and United Kingdom with teaching customized based upon location. Feedback has been exceptionally positive with every candidate thus far rating the usefulness of TROJAN as the highest option, very useful.

Kalraiya, Ashish; Buddhdev, Pranai

2015-01-01

147

The Piranha algebraic manipulator  

E-print Network

In this paper we present a specialised algebraic manipulation package devoted to Celestial Mechanics. The system, called Piranha, is built on top of a generic and extensible framework, which allows to treat efficiently and in a unified way the algebraic structures most commonly encountered in Celestial Mechanics (such as multivariate polynomials and Poisson series). In this contribution we explain the architecture of the software, with special focus on the implementation of series arithmetics, show its current capabilities, and present benchmarks indicating that Piranha is competitive, performance-wise, with other specialised manipulators.

Biscani, Francesco

2009-01-01

148

Manipulating biphotonic qutrits  

E-print Network

Quantum information carriers with higher dimension than the canonical qubit offer significant advantages. However, manipulating such systems is extremely difficult. We show how measurement induced non-linearities can be employed to dramatically extend the range of possible transforms on biphotonic qutrits; the three level quantum systems formed by the polarisation of two photons in the same spatio-temporal mode. We fully characterise the biphoton-photon entanglement that underpins our technique, thereby realising the first instance of qubit-qutrit entanglement. We discuss an extension of our technique to generate qutrit-qutrit entanglement and to manipulate any bosonic encoding of quantum information.

B. P. Lanyon; T. J. Weinhold; N. K. Langford; J. L. O'Brien; K. J. Resch; A. Gilchrist; A. G. White

2007-10-16

149

Relationship between Postoperative Infectious Complications and Glycemic Control for Diabetic Patients in an Orthopedic Hospital in Kuwait  

Microsoft Academic Search

Objective: To study the relationship between postoperative infectious complications and glycemic control for diabetic patients in an orthopedic hospital in Kuwait. Subjects and Methods: Patients who underwent surgical orthopedic procedures between 2006 and 2007 were identified to provide demographic and clinical informations including age, gender, type of surgery, length of operation, HbA1c values, nature of specimens and species of the

S. M. Lamloum; L. A. Mobasher; A. H. Karar; L. Basiony; T. H. Abdallah; A. I. Al-Saleh; N. A. Al-Shamali

2009-01-01

150

Endovascular Treatment in Emergency Setting of Acute Arterial Injuries After Orthopedic Surgery  

Microsoft Academic Search

Purpose  To assess the feasibility and effectiveness of emergency endovascular treatment of acute arterial injuries after orthopedic\\u000a surgery.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and Methods  Fifteen patients (mean age 68.3 years) with acute arterial injuries after orthopedic surgery were observed, in particular,\\u000a 5 patients with pseudoaneurysm, 9 patients with active bleeding, and 1 patient with arterial dissection. Transarterial embolization\\u000a (TAE) and positioning of covered and noncovered stents

Gianpaolo Carrafiello; Federico Fontana; Monica Mangini; Anna Maria Ierardi; Domenico Laganà; Filippo Piacentino; Francesco Alberto Vizzari; Emanuela Spanò; Carlo Fugazzola

151

Staphylococcus aureus Vaccine for Orthopedic Patients: An Economic Model and Analysis  

PubMed Central

To evaluate the potential economic value of a Staphylococcus aureus vaccine for pre-operative orthopedic surgery patients, we developed an economic computer simulation model. At MRSA colonization rates as low as 1%, a $50 vaccine was cost-effective [? $50,000 per quality-adjusted life year (QALY) saved] at vaccine efficacy ?30%, and a $100 vaccine at vaccine efficacy ?70%. High MRSA prevalence (?25%) could justify a vaccine price as high as $1,000. Our results suggest that a S. aureus vaccine for the pre-operative orthopedic population would be very cost-effective over a wide range of MRSA prevalence and vaccine efficacies and costs. PMID:20064479

Lee, Bruce Y.; Wiringa, Ann E.; Bailey, Rachel R.; Lewis, G. Jonathan; Feura, Jared; Muder, Robert R.

2010-01-01

152

Rehabilitation and physical therapy for selected orthopedic conditions in veterinary patients.  

PubMed

A specific diagnosis is needed to perform optimal rehabilitation of orthopedic problems. A well-planned rehabilitation program is important for orthopedic patients when surgical repairs are mechanically weak (eg, when repairing fractures in skeletally immature patients or when repairing tendons or ligaments). Joint immobilization is sometimes used to protect weak surgical repairs. The duration of immobilization should be minimized, particularly in situations with potential loss of joint motion. Evidence-based information regarding specific modalities and techniques for rehabilitation of injured dogs and cats is generally lacking. The choice of modalities and techniques must be based on common sense, knowledge of rehabilitation techniques, and clinical experience. PMID:25432683

Henderson, Andrea L; Latimer, Christian; Millis, Darryl L

2015-01-01

153

[Professor Ireneusz Wierzejewski - his work in Konrad Biesalski's Orthopedic Institute, in the years 1910-1911 and its influence on the professional opinions of Poland's first professor in orthopedics].  

PubMed

Professor Ireneusz Wierzejewski was born in 1881. He completed his medical university training in 1908 in Munich. He obtained his doctor degree in 1909 in Lipsk, based on the work "Ueber den kongenitalen ulnadefekt" On the 01.07.1909, thanks to professor Lange's support, he got a permanent post in Berlin - Brandenburgische Kruppel - Heil und Erziehunganstalt, run by Konrad Biesalski. Here he performed the duties of the first assistant in the Institute and director of the orthopedic outpatient department until 15.09.1911. During this period I. Wierzejewski's professional personality formed: he had the chance to become acquainted with the specifics of his supervisors orthopedic thinking and he got to know basic surgical techniques in orthopedics. He was the first Polish professor in orthopedics to set up the first Polish Orthopedic Institute (in Poznan) modeled after Berlin Brandenburgische Kruppel - Heil und Erziehunganstalt. The organization and equipment was similar to K-H-E. This institution was later transformed into the first Polish orthopedic clinic. Just as in the German model, the Orthopedic Institute in Poznan had orthopedic workshops, which at the time was very unique in Poland. Indoctrinated with K. Biesalski idea of caring for the cripples in Germany, he strived to make it a reality in Poland. In his speeches during scientific congresses fought for an act analogous to the Prussian one from 06.05.1920. The time spent working in K. Biesalski's Institute formed the professional and scientific personality of Poland's first professor in orthopedics and indirectly but definitely influenced the creation of Poland's first Orthopedic Clinic. PMID:11625793

Przybyl, K

1999-01-01

154

The historic predictive value of Canadian orthopedic surgery residents’ orthopedic in-training examination scores on their success on the RCPSC certification examination  

PubMed Central

Background Positive correlation between the orthopedic in-training examination (OITE) and success in the American Board of Orthopaedic Surgery examination has been reported. Canadian training programs in internal medicine, anesthesiology and urology have found a positive correlation between in-training examination scores and performance on the Royal College of Physicians and Surgeons of Canada (RCPSC) certification examination. We sought to determine the potential predictive value of the OITE scores of Canadian orthopedic surgery residents on their success on their RCPSC examinations. Methods A total of 118 Canadian orthopedic surgery residents had their annual OITE scores during their 5 years of training matched to the RCPSC examination oral and multiple-choice questions and to overall examination pass/fail scores. We calculated Pearson correlations between the in-training examination for each postgraduate year and the certification oral and multiple-choice questions and pass/fail marks. Results There was a predictive association between the OITE and success on the RCPSC examination. The association was strongest between the OITE and the written multiple-choice examination and weakest between the OITE and the overall examination pass/fail marks. Conclusion Overall, the OITE was able to provide useful feedback to Canadian orthopedic surgery residents and their training programs in preparing them for their RCPSC examinations. However, when these data were collected, truly normative data based on a Canadian sample were not available. Further study is warranted based on a more refined analysis of the OITE, which is now being produced and includes normative percentile data based on Canadian residents. PMID:25078931

Yen, David; Athwal, George S.; Cole, Gary

2014-01-01

155

Diffy Virtual Manipulative  

NSDL National Science Digital Library

Diffy is a virtual manipulative that allows students to practice their subtraction facts with whole numbers, integers, fractions, decimals, or money. It is a puzzle of sorts with four black numbers placed at the corners of a black square. The first goal is to fill in the four blanks in the blue circles in the middle of each side of the black square.

Utah State University

2011-06-28

156

Manipulating Combinatorial Structures.  

ERIC Educational Resources Information Center

This set of transparencies shows how the manipulation of combinatorial structures in the context of modern combinatorics can easily lead to interesting teaching and learning activities at every level of education from elementary school to university. The transparencies describe: (1) the importance and relations of combinatorics to science and…

Labelle, Gilbert

157

A manipulator plays Jenga  

Microsoft Academic Search

This article describes an overview of a prototypical manipulation control system, which is able to play Jenga. The implementation of the Jenga game has been chosen to verify the integration of existing concepts such as force\\/torque control, distance control, real-time behavior of distributed control systems, sensor data fusion, online trajectory computation, and visual servoing in one exhibit. This exhibit has

Torsten Kroger; Bernd Finkemeyer; Simon Winkelbach; Lars-Oliver Eble; Sven Molkenstruck; FRIEDRICH M. WAHL

2008-01-01

158

Manipulating the Gradient  

ERIC Educational Resources Information Center

We introduce a cooperative learning, group lab for a Calculus III course to facilitate comprehension of the gradient vector and directional derivative concepts. The lab is a hands-on experience allowing students to manipulate a tangent plane and empirically measure the effect of partial derivatives on the direction of optimal ascent. (Contains 7…

Gaze, Eric C.

2005-01-01

159

Door breaching robotic manipulator  

NASA Astrophysics Data System (ADS)

As unmanned systems become more commonplace in military, police, and other security forces, they are tasked to perform missions that the original hardware was not designed for. Current military robots are built for rough outdoor conditions and have strong inflexible manipulators designed to handle a wide range of operations. However, these manipulators are not well suited for some essential indoor tasks, including opening doors. This is a complicated kinematic task that places prohibitively difficult control challenges on the robot and the operator. Honeybee and iRobot have designed a modular door-breaching manipulator that mechanically simplifies the demands upon operator and robot. The manipulator connects to the existing robotic arm of the iRobot PackBot EOD. The gripper is optimized for grasping a variety of door knobs, levers, and car-door handles. It works in conjunction with a compliant wrist and magnetic lock-out mechanism that allows the wrist to remain rigid until the gripper has a firm grasp of the handle and then bend with its rotation and the swing of the door. Once the door is unlatched, the operator simply drives the robot through the doorway while the wrist compensates for the complex, multiple degree-of-freedom motion of the door. Once in the doorway the operator releases the handle, the wrist pops back into place, and the robot is ready for the next door. The new manipulator dramatically improves a robot's ability to non-destructively breach doors and perform an inspection of a room's content, a capability that was previously out of reach of unmanned systems.

Schoenfeld, Erik; Parrington, Lawrence; von Muehlen, Stephan

2008-04-01

160

Selective laser sintering of calcium phosphate materials for orthopedic implants  

NASA Astrophysics Data System (ADS)

Two technologies, Solid Freeform Fabrication (SFF) and bioceramics are combined in this work to prepare bone replacement implants with complex geometry. SFF has emerged as a crucial technique for rapid prototyping in the last decade. Selective Laser Sintering (SLS) is one of the established SFF manufacturing processes that can build three-dimensional objects directly from computer models without part-specific tooling or human intervention. Meanwhile, there have been great efforts to develop implantable materials that can assist in regeneration of bone defects and injuries. However, little attention has been focused in shaping bones from these materials. The main thrust of this research was to develop a process that can combine those two separate efforts. The specific objective of this research is to develop a process that can construct bone replacement material of complex geometry from synthetic calcium phosphate materials by using the SLS process. The achievement of this goal can have a significant impact on the quality of health care in the sense that complete custom-fit bone and tooth structures suitable for implantation can be prepared within 24--48 hours of receipt of geometric information obtained either from patient Computed Tomographic (CT) data, from Computer Aided Design (CAD) software or from other imaging systems such as Magnetic Resonance Imaging (MRI) and Holographic Laser Range Imaging (HLRI). In this research, two different processes have been developed. First is the SLS fabrication of porous bone implants. In this effort, systematic procedures have been established and calcium phosphate implants were successfully fabricated from various sources of geometric information. These efforts include material selection and preparation, SLS process parameter optimization, and development of post-processing techniques within the 48-hour time frame. Post-processing allows accurate control of geometry and of the chemistry of calcium phosphate, as well as control of micro and macro pore structure, to maximize bone healing and provide sufficient mechanical strength. It also permits the complete removal of the polymeric binders that are resided in the SLS process. In collaboration with the University of Texas Health Science Center at San Antonio and BioMedical Enterprises, Inc., porous implants based on anatomical geometry have been successfully implanted in rabbits and dogs. These histologic animal studies reveal excellent biocompatibility and show its great potential for commercial custom-fit implant manufacture. The second research effort involves fabrication of fully dense bone for application in dental restoration and load-bearing orthopedic functions. Calcium phosphate glass melts, proven to be biocompatible in the first effort, were cast into carbon molds. Processes were developed for preparing the molds. These carbon molds of anatomic shape can be prepared from either Computer Numerical Control (CNC) milling of slab stock or SLS processing of thermoset-coated graphite powder. The CNC milling method provides accurate dimension of the molds in a short period of time, however, the capable geometries are limited; generally two pieces of molds are required for complex shapes. The SLS method provides very complex shape green molds. However, they need to go through pyrolysis of thermoset binder to provide the high temperature capability reached at calcium phosphate melt temperatures (1100°C) and noticeable shrinkage was observed during pyrolysis. The cast glass was annealed to develop polycrystalline calcium phosphate. This process also exhibits great potential.

Lee, Goonhee

161

Quantum Computation and Spin Manipulation  

E-print Network

. . . . . . . . . . . . . . . . . . . . . . . . . . 26 2 Quantum Computer Hardware 31 2.1 NMR1 Quantum Computation and Spin Manipulation 0Anthony Hams #12;Quantum Computation and Spin, Nijenborgh 4, 9747 AG Groningen, The Netherlands. Anthony Hams Quantum Computation and Spin Manipulation

162

Podiatric surgery and orthopedic surgery: a customer satisfaction survey of general practitioners  

Microsoft Academic Search

We have conducted a questionnaire survey of all general practitioners in the Doncaster area to ascertain their opinions about the relative merits of orthopedic and podiatric surgery in respect of quality of service and patient satisfaction. Eighty-three percent of 154 general practitioners replied. The great majority of general practitioners stated their preference was to refer patients with foot problems to

R. H Helm; K Ravi

2003-01-01

163

Fondaparinux vs Enoxaparin for the Prevention of Venous Thromboembolism in Major Orthopedic Surgery  

Microsoft Academic Search

Background: Orthopedic surgery remains a condition at high risk of venous thromboembolism (VTE). Fonda- parinux, the first of a new class of synthetic selective fac- tor Xa inhibitors, may further reduce this risk compared with currently available thromboprophylactic treatments. Methods: A meta-analysis of 4 multicenter, random- ized, double-blind trials in patients undergoing elective hip replacement, elective major knee surgery, and

Alexander G. G. Turpie; Kenneth A. Bauer; Bengt I. Eriksson; Michael R. Lassen

2002-01-01

164

Orthopedic trauma-induced pulmonary injury in the obese Zucker rats  

PubMed Central

Objective Obese subjects with orthopedic trauma exhibit increased inflammation and an increased risk of pulmonary edema. PGE2 production is elevated during inflammation and associated with increased vascular permeability. We hypothesize that pulmonary edema in obesity following orthopedic trauma is due to elevated PGE2 and resultant increases in pulmonary permeability. Methods Orthopedic trauma was induced in both hindlimbs in lean (LZ) and obese Zucker rats (OZ). On the following day, plasma IL-6 and PGE2 levels, pulmonary edema, and pulmonary gas exchange capability were compared between groups: LZ, OZ, LZ with trauma (LZT), and OZ with trauma (OZT). Vascular permeability in isolated lungs was measured in LZ and OZ before and after application of PGE2. Results As compared with the other groups, the OZT exhibited elevated plasma IL-6 and PGE2 levels, increased lung wet/dry weight ratio and bronchoalveolar protein concentration, and an impaired pulmonary gas exchange. Indomethacin treatment normalized plasma PGE2 levels and pulmonary edema. Basal pulmonary permeability in isolated lungs was higher in OZ than LZ, with a further increase in permeability following treatment with PGE2. Conclusions These results suggest that pulmonary edema in OZ following orthopedic trauma is due to an elevated PGE2 and resultant increases in pulmonary permeability. PMID:21044219

Xiang, Lusha; Hester, Robert L.; Fuller, William L; Sebai, Mohamad E; Mittwede, Peter N; Jones, Elizabeth K; Aneja, Arun; Russell, George V

2010-01-01

165

Orthopedic Surgery in Rural American Hospitals: A Survey of Rural Hospital Administrators  

ERIC Educational Resources Information Center

Rural American residents prefer to receive their medical care locally. Lack of specific medical services in the local community necessitates travel to a larger center which is less favorable. This study was done to identify how rural hospitals choose to provide orthopedic surgical services to their communities. Methods: All hospitals in 5 states…

Weichel, Derek

2012-01-01

166

Late orthopedic effects in children with Wilms' tumor treated with abdominal irradiation  

SciTech Connect

Between 1970 and 1984, 31 children with biopsy-proven Wilms' tumor received nephrectomy, chemotherapy, and abdominal irradiation and were followed beyond skeletal maturity. Three patients (10%) developed late orthopedic abnormalities requiring intervention. Ten children received orthovoltage irradiation, and all cases requiring orthopedic intervention or developing a scoliotic curve of greater than 20 degrees were confined to this group, for a complication frequency of 50%. Those children who developed a significant late orthopedic abnormality (SLOA) as defined were treated to a higher median dose (2,890 cGy) and a larger field size (150 cm2) than those who did not (2,580 cGy and 120 cm2). Age at irradiation, sex, and initial stage of disease did not appear to influence the risk of developing an SLOA. No child who received megavoltage irradiation developed an SLOA despite treatment up to 4,000 cGy or to field sizes of 400 cm2. We conclude that modern radiotherapy techniques rarely lead to significant late orthopedic abnormalities previously associated with abdominal irradiation in children with Wilms' tumor.

Rate, W.R.; Butler, M.S.; Robertson, W.W. Jr.; D'Angio, G.J. (Univ. of Pennsylvania School of Medicine, Philadelphia (USA))

1991-01-01

167

The Effectiveness of Active and Traditional Teaching Techniques in the Orthopedic Assessment Laboratory  

ERIC Educational Resources Information Center

Active learning is a teaching methodology with a focus on student-centered learning that engages students in the educational process. This study implemented active learning techniques in an orthopedic assessment laboratory, and the effects of these teaching techniques. Mean scores from written exams, practical exams, and final course evaluations…

Nottingham, Sara; Verscheure, Susan

2010-01-01

168

Combined regional and general anesthesia for ambulatory peripheral orthopedic surgery in children.  

PubMed

Pediatric orthopedic surgery is rarely done in an outpatient setting because of the postoperative pain. The purpose of this study was to evaluate the children's comfort and parents' satisfaction after ambulatory peripheral pediatric orthopedic surgery performed under general anesthesia combined with regional anesthesia (RA). Sixty consecutive children were enrolled in this prospective study. All children fulfilled inclusion criteria for outpatient and for RA and parents received proper information regarding their child postoperative care. Postoperative pain control was sustained for 48 h using routine paracetamol, ibuprofen, and oral tramadol if needed. A telephone survey was conducted on day 1 and day 2 to evaluate pain scores, limb motor function, occurrence of postoperative nausea and vomiting, and feeding, sleep or play disturbance. The parents were also asked about their overall satisfaction rate and the choice of ambulatory mode versus inpatient admission in case of future orthopedic procedure. A total of 34 soft tissue procedures and 26 bony procedures were performed. 63.3% recovered motor function before discharge from the postanesthesia care unit. Low pain scores and good postoperative comfort were observed. Parents' satisfaction was greater than eight out of 10 in 88.3% of the cases, and 85% of the parents would choose ambulatory surgery in case of a second procedure. RA used with level I or II analgesics is compatible with ambulatory peripheral pediatric orthopedic surgery. Resulting good analgesia and postoperative comfort render the ambulatory mode to be favored by the parents. PMID:19020468

Khoury, Claudine E L; Dagher, Christine; Ghanem, Ismat; Naccache, Nicole; Jawish, Dolly; Yazbeck, Patricia

2009-01-01

169

[Lack of new trainees in trauma surgery and orthopedics. An approach to a solution].  

PubMed

The reasons for a shortage of young people in trauma surgery and orthopedics have often been discussed. Atypical progression of medical operating levels, antisocial working hours and an inadequate financial compensation for on-call duties have been given as the reasons for a lack of interest in the discipline. Additionally a progressive feminization of the medical profession and rejection of surgical disciplines because of a mismatch with family interests and the demands of advanced surgical training have also been named. Surveys on the choice of medical specialization reveal that experiences during the course of studying have a great influence on future prospects and are immensely important for the further focusing on the future as a medical doctor. In order to increase the attractiveness of the specialization, programs for students were initiated by the heads of the Conventions of Higher Education Lecturers for Orthopedics and Trauma Surgery and the management of the German Society for Orthopedics and Trauma Surgery. Due to the enormous popularity auxiliary projects were demanded. Consequently a "Trauma Surgery and Orthopedic Day for Students" was organized on 16th February 2010 in the Musculoskeletal Centre of the Charité in Berlin. The aim was to convey practical skills and to inspire the choice of this specialization in the future. PMID:20842330

Thiele, K; Matziolis, D; Perka, C

2010-12-01

170

A Prototype Robotic Arm for Use by Severely Orthopedically Handicapped Students. Final Report.  

ERIC Educational Resources Information Center

This 18-month pilot project, which ran from October 1, 1987 to March 31, 1989, developed a prototype robotic arm for educational use by students with severe orthopedic disabilities in the Columbus (Ohio) Public Schools. The developmental effort was intended first, to provide direct access to currently available instructional materials and, second,…

Howell, Richard

171

A novel modeling framework for multilayered soft tissue deformation in virtual orthopedic surgery.  

PubMed

Realistic modeling of soft tissue deformation is crucial to virtual orthopedic surgery, especially orthopedic trauma surgery which involves layered heterogeneous soft tissues. In this paper, a novel modeling framework for multilayered soft tissue deformation is proposed in order to facilitate the development of orthopedic surgery simulators. We construct our deformable model according to the layered structure of real human organs, and this results in a multilayered model. The division of layers is based on the segmented Chinese Visible Human (CVH) dataset. This enhances the realism and accuracy in the simulation. For the sake of efficiency, we employ 3D mass-spring system to our multilayered model. The nonlinear passive biomechanical properties of skin and skeletal muscle are achieved by introducing a bilinear elasticity scheme to the springs in the mass-spring system. To efficiently and accurately reproduce the biomechanical properties of certain human tissues, an optimization approach is employed in configuring the parameters of the springs. Experimental data from biomechanics literatures are used as benchmarking references. With the employment of Physics Processing Unit (PPU) and high quality volume visualization, our framework is developed into an interactive and intuitive platform for virtual surgery training systems. Several experiments demonstrate the feasibility of the proposed framework in providing interactive and realistic deformation for orthopedic surgery simulation. PMID:20503610

Qin, Jing; Pang, Wai-Man; Chui, Yim-Pan; Wong, Tien-Tsin; Heng, Pheng-Ann

2010-06-01

172

An Evaluation Design for the Educational Programs for Pupils Who Are Orthopedically Handicapped.  

ERIC Educational Resources Information Center

The booklet provides forms for the teacher of the orthopedically handicapped to use in systematically collecting data and designing an appropriate educational blueprint for each student. Pupil development assessment sheets include columns for recording assessment date, date of mastery, level of achievement, and comments for each behavioral…

South Carolina State Dept. of Education, Columbia. Office of Programs for the Handicapped.

173

Use of orthopedic shoes in patients with degenerative disorders of the foot  

Microsoft Academic Search

Objectives: To study the actual use of orthopedic shoes by patients with degenerative foot disorders and to identify factors associated with use and nonuse, based on the parameters of the International Organization for Standardization definition of usability: effectiveness, efficiency, satisfaction, and context of use. - Design: Multicenter, prospective cohort study. - \\u000aSetting: Outpatient clinics of 7 rehabilitation centers in the

Michiel J. Jannink; Maarten J. IJzerman; Karin Groothuis-Oudshoorn; Roy E. Stewart; Johan W. Groothoff; Gustaaf J. Lankhorst

2005-01-01

174

Precision Manipulation with Cooperative Robots  

Microsoft Academic Search

We present a cooperative approach to robotic precision manipulation tasks in the context of autonomous robotic construction. Precision manipulation requires a firm grasp, which constraints the team to rigidly maintain formation during transport and manipulation. A leader\\/follower approach with force sensing to provide relative formation information and vision to provide team position relative to construction components is applied. Our approach

Ashley Stroupe; Terry Huntsberger; Avi Okon; Hrand Aghazarian

175

Cerebrovascular Complications of Neck Manipulation  

Microsoft Academic Search

The safety of spinal manipulation is an issue that demands regular and rigorous assessment, as manipulation of the upper spine has been associated with serious adverse events such as cerebrovascular accidents due to cervical artery dissection. A correlation between stroke and cervical manipulation has been reported with increasing frequency, and each new report seems to reignite debate between neurologists and

Maurizio Paciaroni; Julien Bogousslavsky

2009-01-01

176

Dexterous Manipulation: A Geometric Approach  

E-print Network

Dexterous Manipulation: A Geometric Approach (A Survey Paper) Bhubaneswar Mishra Courant Institute the theory of dexterous manipulation. In particular, we discuss the models of robot hands and analysis connection between the problems of dexterous manipulation and some classical results in combinatorial

Mishra, Bud

177

Data Evaluation, Completion and Manipulation  

E-print Network

Data Evaluation, Completion and Manipulation Prepared for the U.S. Department of Energy Office on Data Evaluation, Completion and Manipulation By GE Global Research Niskayuna, New York And University: Data Evaluation, Completion and Manipulation The objective of task 7 is to outline the additional data

178

DNA interactive manipulation  

NSDL National Science Digital Library

This site offers three interactive modules that treat teachers to a direct look at scientists who worked to unlock the mysteries of genes and the technological advancements that aided their discoveries. The modules are arranged by topics that focus on how to manipulate genes, how enzymes are used in manipulation, and the possibilities inherent in recombinant DNA technology. Each module is subdivided into additional parts. These parts include images of scientists who contributed to the history of gene discoveries. By clicking on the images, teachers are taken to a new window to watch short videos by or about the scientists. Teachers can also click on links to computer simulations, such as a tutorial to see how yeast is used to make human insulin. Copyright 2005 Eisenhower National Clearinghouse

Dolan DNA Learning Center. Cold Spring Harbor Laboratory

2005-01-01

179

Microradiographic microsphere manipulator  

DOEpatents

A method and apparatus for radiographic characterization of small hollow spherical members (microspheres), constructed of either optically transparent or opaque materials. The apparatus involves a microsphere manipulator which holds a batch of microspheres between two parallel thin plastic films for contact microradiographic characterization or projection microradiography thereof. One plastic film is translated to relative to and parallel to the other to roll the microspheres through any desired angle to allow different views of the microspheres.

Singleton, Russell M. (Livermore, CA)

1980-01-01

180

Manipulation of quantum evolution  

NASA Technical Reports Server (NTRS)

The free evolution of a non-relativistic charged particle is manipulated using time-dependent magnetic fields. It is shown that the application of a programmed sequence of magnetic pulses can invert the free evolution process, forcing an arbitrary wave packet to 'go back in time' to recover its past shape. The possibility of more general operations upon the Schrodinger wave packet is discussed.

Cabera, David Jose Fernandez; Mielnik, Bogdan

1994-01-01

181

Endocavity Ultrasound Probe Manipulators  

PubMed Central

We developed two similar structure manipulators for medical endocavity ultrasound probes with 3 and 4 degrees of freedom (DoF). These robots allow scanning with ultrasound for 3-D imaging and enable robot-assisted image-guided procedures. Both robots use remote center of motion kinematics, characteristic of medical robots. The 4-DoF robot provides unrestricted manipulation of the endocavity probe. With the 3-DoF robot the insertion motion of the probe must be adjusted manually, but the device is simpler and may also be used to manipulate external-body probes. The robots enabled a novel surgical approach of using intraoperative image-based navigation during robot-assisted laparoscopic prostatectomy (RALP), performed with concurrent use of two robotic systems (Tandem, T-RALP). Thus far, a clinical trial for evaluation of safety and feasibility has been performed successfully on 46 patients. This paper describes the architecture and design of the robots, the two prototypes, control features related to safety, preclinical experiments, and the T-RALP procedure. PMID:24795525

Stoianovici, Dan; Kim, Chunwoo; Schäfer, Felix; Huang, Chien-Ming; Zuo, Yihe; Petrisor, Doru; Han, Misop

2014-01-01

182

Welding nozzle position manipulator  

NASA Technical Reports Server (NTRS)

The present invention is directed to a welding nozzle position manipulator. The manipulator consists of an angle support to which the remaining components of the device are attached either directly or indirectly. A pair of pivotal connections attach a weld nozzle holding link to the angle support and provide a two axis freedom of movement of the holding link with respect to the support angle. The manipulator is actuated by a pair of adjusting screws angularly mounted to the angle support. These screws contact a pair of tapered friction surfaces formed on the upper portion of the welding nozzle holding link. A spring positioned between the upper portions of the support angle and the holding link provides a constant bias engagement between the friction surfaces of the holding link and the adjustment screws, so as to firmly hold the link in position and to eliminate any free play in the adjustment mechanism. The angular relationships between the adjustment screws, the angle support and the tapered friction surfaces of the weld nozzle holding link provide a geometric arrangement which permits precision adjustment of the holding link with respect to the angle support and also provides a solid holding link mount which is resistant to movement from outside forces.

Gilbert, Jeffrey L. (inventor); Gutow, David A. (inventor)

1994-01-01

183

Spatial Manipulation with Microfluidics  

PubMed Central

Biochemical gradients convey information through space, time, and concentration, and are ultimately capable of spatially resolving distinct cellular phenotypes, such as differentiation, proliferation, and migration. How these gradients develop, evolve, and function during development, homeostasis, and various disease states is a subject of intense interest across a variety of disciplines. Microfluidic technologies have become essential tools for investigating gradient sensing in vitro due to their ability to precisely manipulate fluids on demand in well-controlled environments at cellular length scales. This review will highlight their utility for studying gradient sensing along with relevant applications to biology.

Lin, Benjamin; Levchenko, Andre

2015-01-01

184

Hydraulic manipulator research at ORNL  

SciTech Connect

Recently, task requirements have dictated that manipulator payload capacity increase to accommodate greater payloads, greater manipulator length, and larger environmental interaction forces. General tasks such as waste storage tank cleanup and facility dismantlement and decommissioning require manipulator life capacities in the range of hundreds of pounds rather than tens of pounds. To meet the increased payload capacities demanded by present-day tasks, manipulator designers have turned once again to hydraulics as a means of actuation. In order to successfully design, build, and deploy a new hydraulic manipulator (or subsystem), sophisticated modeling, analysis, and control experiments are usually needed. Oak Ridge National Laboratory (ORNL) has a history of projects that incorporate hydraulics technology, including mobile robots, teleoperated manipulators, and full-scale construction equipment. In addition, to support the development and deployment of new hydraulic manipulators, ORNL has outfitted a significant experimental laboratory and has developed the software capability for research into hydraulic manipulators, hydraulic actuators, hydraulic systems, modeling of hydraulic systems, and hydraulic controls. The purpose of this article is to describe the past hydraulic manipulator developments and current hydraulic manipulator research capabilities at ORNL. Included are example experimental results from ORNL`s flexible/prismatic test stand.

Kress, R.L.; Jansen, J.F. [Oak Ridge National Lab., TN (United States); Love, L.J. [Oak Ridge Inst. for Science and Education, TN (United States)

1997-03-01

185

Dynamics and Cooperative Object Manipulation Control of Suspended Mobile Manipulators  

Microsoft Academic Search

Dynamics and control of mobile manipulators is obviously a more challenging problem compared to fixed-base robots. Including\\u000a a suspension system for these mobile platforms increases their maneuverability, but considerably adds to their complexity.\\u000a In this paper, a suspended wheeled mobile platform with two 6-DOF Puma-type manipulators is used to manipulate an object along\\u000a a given path. To apply a model-based

Mahdy Eslamy; S. Ali A. Moosavian

2010-01-01

186

Translating research into practice: is evidence-based medicine being practiced in military-relevant orthopedic trauma?  

PubMed

Orthopedic trauma remains one of the most survivable battlefield injuries seen in modern conflicts. Translating research into practice is a critical bridge that permits surgeons to further optimize medical outcomes. Orthopedic surgeons serving in the military may treat little to no trauma in their stateside practice. In conflict zones, however, the majority of their patients will have traumatic injuries. Determining risk factors for nonevidence-based practice can help identify provider knowledge gaps, which can then be targeted before deployment. Surveys were developed which sought to identify factors contributing to continued medical education and practice, as well as scenario-based questions on military-relevant orthopedic trauma. Analysis of 188 survey respondents revealed that providers with military service and less than 10 years of practice are optimally bridging research into military-relevant orthopedic trauma practice. PMID:25826350

Niles, Sarah E; Balazs, George C; Cawley, Christina; Bosse, Michael; Mackenzie, Ellen; Li, Yaunzhang; Andersen, Romney C

2015-04-01

187

ICD 10: "what orthopedic surgeons should know, how it will affect them and the cost of implementation?".  

PubMed

Orthopedic surgeons will be required to use ICD-10-CM codes for reimbursement and to substantiate the medical necessity for their services beginning October 1, 2014. Implementation of ICD10 will require significant changes in the clinical and administrative processes of orthopedic offices and hospital practices. As in other countries, implementation added costs and resulted in disruptions in physician practices with concomitant decreases in productivity and practice revenue. Through education and planning, orthopedic surgeons can mitigate the anticipated changes and reduce the potential impact these changes will have on their practices. Changes anticipated in the diagnostic part of the ICD10 coding system are reviewed with examples pertinent to orthopedic surgeons. Many will need to improve the accuracy and specificity of their documentation by using anatomically precise nomenclature and obtaining a more detailed history and physical examination. This will require eliciting external causes of patients' problems, the precise activity of causation, and the place of occurrence. PMID:23924745

Henley, M Bradford

2013-09-01

188

[Extracorporeal shockwave therapy in orthopedics. Positive results in tennis elbow and tendinosis calcarea of the shoulder].  

PubMed

Since the beginning of the 1990s scientific investigations on the use of extracorporeal shock wave therapy (ESWT) in the field of orthopedics have been carried out at the Orthopedic Department of the University of Mainz. Prospective studies demonstrated beneficial effects in chronic lateral humeral epicondylitis (tennis elbow), and in calcifying tendinitis of the shoulder in more than 50% of the cases. Additional indications for which positive results of prospective studies have been published during the past 2 years are plantar calcaneodynea and pseudoarthrosis. On the basis of the results achieved, it may be concluded that, for specific indications, extracorporeal shock wave therapy may now be taken out of the clinical testing stage and introduced into routine practice. PMID:9324482

Rompe, J D; Eysel, P; Hopf, C; Krischek, O; Vogel, J; Bürger, R; Jage, J; Heine, J

1997-06-30

189

The Medical Education and Best Practice in Orthopedic Patient Care in Poland.  

NASA Astrophysics Data System (ADS)

The leadership organization focuses on education, teamwork, customer relationship and developing strategy which help in building added value, in managing activities, time and quality. Everyday orthopedic experience shows that medical education is a mixture of: specific knowledge, skills and attitudes of people working together, and that creates effective teamwork in a hospital environment. Apart from the main reason of medical education, teaching about disease treatment and health problem solving, medical education should also concentrate on human factors and behavioral aspects of patient treatment in hospital.Assessment of an organization and medical education process by cultural and teamwork criteria, offers a powerful new way to think about performance at the frontlines of healthcare and in the future it could be gold standard for assessing the success of an organization, and standards in medical education, not only in orthopedics.

Rosiek, Anna; Leksowski, Krzysztof

2012-07-01

190

Hope versus hype: what can additive manufacturing realistically offer trauma and orthopedic surgery?  

PubMed

Additive manufacturing (AM) is a broad term encompassing 3D printing and several other varieties of material processing, which involve computer-directed layer-by-layer synthesis of materials. As the popularity of AM increases, so to do expectations of the medical therapies this process may offer. Clinical requirements and limitations of current treatment strategies in bone grafting, spinal arthrodesis, osteochondral injury and treatment of periprosthetic joint infection are discussed. The various approaches to AM are described, and the current state of clinical translation of AM across these orthopedic clinical scenarios is assessed. Finally, we attempt to distinguish between what AM may offer orthopedic surgery from the hype of what has been promised by AM. PMID:25159068

Gibbs, David M R; Vaezi, Mohammad; Yang, Shoufeng; Oreffo, Richard O C

2014-01-01

191

Effect of intravenous ketamine and lidocaine on isoflurane requirement in sheep undergoing orthopedic surgery.  

PubMed

Intravenous ketamine and lidocaine infusions may be useful adjuncts to inhalation anesthesia for sheep undergoing orthopedic surgery. In this study, 50 female sheep underwent experimental stifle surgery (29 received a meniscal implant and 21 received sham surgery). To induce anesthesia in the sheep, the authors intravenously injected ketamine and diazepam. They administered isoflurane in oxygen to maintain anesthesia and used mechanical ventilation to maintain normal arterial carbon dioxide pressure. Some sheep received intravenous infusions of ketamine and lidocaine during surgery, whereas others did not. Sheep that received a meniscal implant without ketamine-lidocaine required approximately 23% greater isoflurane concentrations than sheep that were given ketamine-lidocaine. These findings suggest that intravenous infusion of ketamine and lidocaine decreases the requirement for isoflurane during orthopedic surgery on anesthetized sheep. PMID:20164948

Raske, Tara G; Pelkey, Sheila; Wagner, Ann E; Turner, A Simon

2010-03-01

192

Clinical applicability of nursing outcomes in the evolution of orthopedic patients with Impaired Physical Mobility 1  

PubMed Central

AIM: to evaluate the clinical applicability of outcomes, according to the Nursing Outcomes Classification (NOC) in the evolution of orthopedic patients with Impaired Physical Mobility METHOD: longitudinal study conducted in 2012 in a university hospital, with 21 patients undergoing Total Hip Arthroplasty, evaluated daily by pairs of trained data collectors. Data were collected using an instrument containing five Nursing Outcomes, 16 clinical indicators and a five point Likert scale, and statistically analyzed. RESULTS: The outcomes Body Positioning: self-initiated, Mobility, Knowledge: prescribed activity, and Fall Prevention Behavior presented significant increases in mean scores when comparing the first and final evaluations (p<0.001) and (p=0.035). CONCLUSION: the use of the NOC outcomes makes it possible to demonstrate the clinical progression of orthopedic patients with Impaired Physical Mobility, as well as its applicability in this context. PMID:25806631

da Silva, Marcos Barragan; Almeida, Miriam de Abreu; Panato, Bruna Paulsen; Siqueira, Ana Paula de Oliveira; da Silva, Mariana Palma; Reisderfer, Letícia

2015-01-01

193

Orthopedics surgery trainer with PPU-accelerated blood and tissue simulation.  

PubMed

This paper presents a novel orthopedics surgery training system with both the components for modeling as well as simulating the deformation and visualization in an efficient way. By employing techniques such as optimization, segmentation and center line extraction, the modeling of deformable model can be completed with minimal manual involvement. The novel trainer can simulate rigid body, soft tissue and blood with state-of-the-art techniques, so that convincing deformation and realistic bleeding can be achieved. More important, newly released Physics Processing Unit (PPU) is adopted to tackle the high requirement for physics related computations. Experiment shows that the acceleration gain from PPU is significant for maintaining interactive frame rate under a complex surgical environments of orthopedics surgery. PMID:18044647

Pang, Wai-Man; Qin, Jing; Chui, Yim-Pan; Wong, Tien-Tsin; Leung, Kwok-Sui; Heng, Pheng-Ann

2007-01-01

194

Control System of Loading Manipulator  

Microsoft Academic Search

This paper introduces a control system of a loading manipulator in the filling and boxing line of a vinegar-producing factory. The system is composed of S7-300 PLC, S7-200, TD200 panel, servo amplifier, servomotor and manipulator. S7-300 PLC is used as the central controller which controls servo amplifier and field actuator via Profibus control network. The manipulator can do accurate speed

Xingqiao Liu; Zhenwei Shi; Yanchun Yao; Guohai Liu; Hong Zheng; Fengxiang Li

2005-01-01

195

Use of carbon-fiber-reinforced composite implants in orthopedic surgery.  

PubMed

Carbon-fiber-reinforced polyetheretherketone implants offer several benefits over traditional metal implants. Their radiolucent property permits improved, artifact-free radiographic imaging. Their lower modulus of elasticity better matches that of bone. Their fatigue strength is greater than most metal implants. This article reviews the use of these implants in orthopedic surgery, including treatment of conditions involving the spine, trauma, tumor, and infection. PMID:25437074

Hak, David J; Mauffrey, Cyril; Seligson, David; Lindeque, Bennie

2014-12-01

196

In-vivo orthopedic implant diagnostic device for sensing load, wear, and infection  

DOEpatents

A device for providing in vivo diagnostics of loads, wear, and infection in orthopedic implants having at least one load sensor associated with the implant, at least one temperature sensor associated with the implant, at least one vibration sensor associated with the implant, and at least one signal processing device operatively coupled with the sensors. The signal processing device is operable to receive the output signal from the sensors and transmit a signal corresponding with the output signal.

Evans III, Boyd McCutchen; Thundat, Thomas G.; Komistek, Richard D.; Dennis, Douglas A.; Mahfouz, Mohamed

2006-08-29

197

Risk Factors for Postoperative Ileus Following Orthopedic Surgery: The Role of Chronic Constipation  

PubMed Central

Background/Aims Distinction is vague between severe constipation and postoperative ileus (POI) in terms of pathogenesis, clinical features, and treatment options. However, no data are available regarding their associations. Methods After retrospective review of data from patients who underwent orthopedic surgery during the first 6 months of 2011, a total of 612 patients were included. Severe constipation was defined as symptoms of constipation requiring treatment using at least 2 laxatives from different classes for at least 6 months. POI was defined as paralytic ileus lasting more than 3 days post-surgery and associated with 2 or more of the following: (1) nausea/vomiting, (2) inability to tolerate an oral diet over a 24-hour period, and (3) absence of flatus over a 24-hour period. The subjects were divided into non-POI and POI groups, and we compared patient-, surgery-, and pharmaceutical-related factors. Results Thirteen (2.1%) out of 612 experienced POI. In comparisons between the non-POI and POI groups, univariate analysis showed significant differences in the mean age (51.4 vs 71.6 years), mean body mass index (24.1 vs 21.8 kg/m2), severe constipation (5.8% vs 76.9%), co-morbidities (33.2% vs 84.6%), type of orthopedic surgery (spine/hip/limb: 19.4/11.0/65.6% vs 23.1/61.5/15.4%), and estimated blood loss (50 vs 300 mL). Multivariate logistic regression analysis, after adjustment for age, body mass index, co-morbidities, type of orthopedic surgery, and estimated blood loss, showed that severe constipation was an independent risk factor for POI (OR, 35.23; 95% CI, 7.72–160.82; P < 0.001). Conclusions Severe constipation is associated with POI after orthopedic surgery. PMID:25537675

Lee, Tae Hee; Lee, Joon Seong; Hong, Su Jin; Jang, Jae Young; Jeon, Seong Ran; Byun, Dong Won; Park, Won Young; Kim, Soon Im; Choi, Hyung Suk; Lee, Jae Chul; Lee, Ji Sung

2015-01-01

198

[Clinical observation of traumatic ankle arthritis with orthopedics lotion on 60 cases].  

PubMed

Observing the clinical curative effect of orthopedics lotion to treat traumatic ankle arthritis, the outpatient department of orthopedics in Guang'anmen Hospital collected 60 cases who were diagnosed as traumatic ankle arthritis. The cases who already met the inclusion criteria, were randomly divided into the treatment group (30 cases) and control group (30 cases). Thirty patients in treatment group were received fumigation treatment with orthopedics lotion; 30 patients in control group were treated by intra-articular injection of sodium hyaluronate. After 5 weeks treatment, the effects on the both groups would be observed and analysed. Baird-Jackson scoring system was used to assess the overall curative effect. Visual analogue scales (VAS) was used to assess analgesic effect. BJ scores of pre-treatment and post-treatment in both the treatment group and the control group were compared, P <0O. 01, significantly different; and the BJ scores after treatment of two groups were compared by paired t-test, the t value is 1. 76, there was no significant difference between two groups. Both of the treatments were effective, but there was no significant difference in overall curative effect between the two kinds of treatment. The VAS scores after treatment of two groups were compared by paired t-test, the t value was 2. 282, and there was a significant difference between two groups (P <0. 05). The analgesic effect shown in treatment group was better than the control group. The results suggest that: orthopedics lotion is a effective way to treat traumatic ankle arthritis, and it has significant effect on analgesic. PMID:24946564

Zhang, Hui; Yu, Jie

2014-02-01

199

Cutting Tool System to Minimize Soft Tissue Damage for Robot-Assisted Minimally Invasive Orthopedic Surgery  

Microsoft Academic Search

Minimally invasive surgery in orthopedic field is considered to be a challenging problem with a milling robot. One objective\\u000a of this study is to minimize collision of the cutting tool with soft tissue. The authors have developed a robot with redundant\\u000a axis to avoid the collision so far. Some important components are modeled based on physical requirements, and a geometric

Naohiko Sugita; Yoshikazu Nakajima; Mamoru Mitsuishi; Shosaku Kawata; Kazuo Fujiwara; Nobuhiro Abe; Toshifumi Ozaki; Masahiko Suzuki

2007-01-01

200

Adaptation of NASA technology for the optimum design of orthopedic knee implants.  

PubMed

NASA technology originally developed for designing aircraft turbine-engine blades has been adapted and applied to orthopedic knee implants. This article describes a method for tailoring an implant for optimal interaction with the environment of the tibia. The implant components are designed to control stresses in the bone for minimizing bone degradation and preventing failures. Engineers expect the tailoring system to improve knee prosthesis design and allow customized implants for individual patients. PMID:10150099

Saravanos, D A; Mraz, P J; Davy, D T; Hopkins, D A

1991-03-01

201

A survey of recently published papers on orthopedics in the Brazilian scientific press  

PubMed Central

This paper is a review of articles published in Brazilian scientific periodicals in recent years. Its main purpose is to bring to the attention of the readership of Acta Ortopedica Brasileira original contributions to the field published in non-specialized journals. We hope that this will serve as a general scientific update for readers. The review includes works published in six ISI indexed non-orthopedic journals, following a literature search conducted in fourteen such journals. PMID:24453633

Rocha-e-Silva, Mauricio; Gomes, Ariane Maris

2012-01-01

202

Which outcomes related to regional anesthesia are most important for orthopedic surgery patients?  

PubMed

An increasing body of evidence supports the benefits of regional anesthesia in orthopedic surgery. Compared with systemic anesthetic and analgesic approaches, these benefits include more focused and sustained pain control, less systemic side effects, improved patient comfort, earlier mobilization and hospital discharge, lower rates of advanced service requirements, and lower perioperative morbidity and mortality. However, there is discussion about the various outcomes as judged by patients and heath care practitioners. This article recapitulates the literature and presents an overview of endpoints. PMID:25453663

Stundner, Ottokar; Ortmaier, Rainhold; Memtsoudis, Stavros G

2014-12-01

203

Intra-operative 3D pose estimation of fractured bone segments for image guided orthopedic surgery  

Microsoft Academic Search

The widespread adoption of minimally invasive surgical techniques have driven the need for 3D intra-operative image guidance. Hence the 3D pose estimation (position and orientation) performed through the registration of pre-operatively prepared 3D anatomical data to intra-operative 2D fluoroscopy images is one of the main research areas of image guided orthopedic surgery. The goal of this 2D-3D registration is to

P. Gamage; S. Q. Xie; P. Delmas; P. Xu; S. Mukherjee

2009-01-01

204

Torque-Limiting Manipulation Device  

NASA Technical Reports Server (NTRS)

A device for manipulating a workpiece in space includes a fixture, a stanchion assembly, a manipulation mechanism, an actuation mechanism, and a reaction mechanism. The fixture has an end onto which the workpiece affixes. The stanchion assembly has an upper and a lower end. The manipulation mechanism connects the fixture and the upper end of the stanchion assembly. The lower end of the stanchion assembly mounts, via probe and a socket, to a structure. The actuation mechanism operably connects to the manipulation mechanism, and moves the fixture in space. The reaction mechanism provides a point through which force inputs into the actuation mechanism may react.

Moetteli, John B. (Inventor)

1999-01-01

205

The Use of Carbon-Fiber-Reinforced (CFR) PEEK Material in Orthopedic Implants: A Systematic Review.  

PubMed

Carbon-fiber-reinforced polyetheretherketone (CFR-PEEK) has been successfully used in orthopedic implants. The aim of this systematic review is to investigate the properties, technical data, and safety of CFR-PEEK biomaterial and to evaluate its potential for new innovation in the design of articulating medical devices. A comprehensive search in PubMed and EMBASE was conducted to identify articles relevant to the outcomes of CFR-PEEK orthopedic implants. The search was also expanded by reviewing the reference sections of selected papers and references and benchmark reports provided by content experts. A total of 23 articles were included in this review. There is limited literature available assessing the performance of CFR-PEEK, specifically as an implant material for arthroplasty systems. Nevertheless, available studies strongly support CFR-PEEK as a promising and suitable material for orthopedic implants because of its biocompatibility, material characteristics, and mechanical durability. Future studies should continue to investigate CFR-PEEK's potential benefits. PMID:25780341

Li, Chuan Silvia; Vannabouathong, Christopher; Sprague, Sheila; Bhandari, Mohit

2015-01-01

206

Variability in Recommendations for Total Knee Arthroplasty among Rheumatologists and Orthopedic Surgeons  

PubMed Central

Objective The most rapidly growing population of patients undergoing total knee arthroplasty (TKA) is under the age of 65. The objective of this study was to gain insight into the factors influencing physicians’ recommendations for persons in this age group with moderate osteoarthritis (OA). Methods Rheumatologists and orthopedic surgeons attending national meetings were asked to complete a survey including a standardized scenario of a 62 year old person with knee OA who has moderate knee pain limiting strenuous activity despite medical management. We used an experimental 2×2×2 design to examine the effects of gender, employment status and severity of radiographic OA on physicians’ recommendations. Each physician was asked to rate a single scenario. Results The percent of physicians recommending TKA varied from 30% to 55% for scenarios describing a patient with mild radiographic OA, and from 39% to 71% for scenarios describing a patient with moderate radiographic OA. Surgeons were less likely to recommend TKA for women compared to men of the same age, employment status, symptom severity and functional status, and x-rays. Rheumatologists practicing in academic settings were more likely to recommend TKA compared to those practicing in non-academic settings, and American surgeons were more likely to recommend TKA compared to their European counterparts. Conclusion Orthopedic surgeons and rheumatologists vary significantly in their recommendations for patients with moderate knee pain and functional limitations. Both patient and physician characteristics influence physicians’ recommendations and rheumatologists and orthopedic surgeons display different patterns of decision-making. PMID:24293580

Fraenkel, Liana; Suter, Lisa; Weis, Lawrence; Hawker, Gillian

2013-01-01

207

Nanomaterials and synergistic low-intensity direct current (LIDC) stimulation technology for orthopedic implantable medical devices.  

PubMed

Nanomaterials play a significant role in biomedical research and applications because of their unique biological, mechanical, and electrical properties. In recent years, they have been utilized to improve the functionality and reliability of a wide range of implantable medical devices ranging from well-established orthopedic residual hardware devices (e.g., hip implants) that can repair defects in skeletal systems to emerging tissue engineering scaffolds that can repair or replace organ functions. This review summarizes the applications and efficacies of these nanomaterials that include synthetic or naturally occurring metals, polymers, ceramics, and composites in orthopedic implants, the largest market segment of implantable medical devices. The importance of synergistic engineering techniques that can augment or enhance the performance of nanomaterial applications in orthopedic implants is also discussed, the focus being on a low-intensity direct electric current (LIDC) stimulation technology to promote the long-term antibacterial efficacy of oligodynamic metal-based surfaces by ionization, while potentially accelerating tissue growth and osseointegration. While many nanomaterials have clearly demonstrated their ability to provide more effective implantable medical surfaces, further decisive investigations are necessary before they can translate into medically safe and commercially viable clinical applications. The article concludes with a discussion about some of the critical impending issues with the application of nanomaterials-based technologies in implantable medical devices, and potential directions to address these. PMID:23335493

Shirwaiker, Rohan A; Samberg, Meghan E; Cohen, Paul H; Wysk, Richard A; Monteiro-Riviere, Nancy A

2013-01-01

208

Survey Finds Few Orthopedic Surgeons Know The Costs Of The Devices They Implant  

PubMed Central

Orthopedic procedures represent a large expense to the Medicare program, and costs of implantable medical devices account for a large proportion of those procedures’ costs. Physicians have been encouraged to consider costs in the selection of devices, but several factors make acquiring information about costs difficult. To assess physicians’ levels of knowledge about costs, we asked orthopedic attending physicians and residents at seven academic medical centers to estimate the costs of thirteen commonly used orthopedic devices between December 2012 and March 2013. The actual cost of each device was determined at each institution; estimates within 20 percent of the actual cost were considered correct. Among the 503 physicians who completed our survey, attending physicians correctly estimated the cost of the device 21 percent of the time, and residents did so 17 percent of the time. Thirty-six percent of physicians and 75 percent of residents rated their knowledge of device costs “below average” or “poor.” However, more than 80 percent of all respondents indicated that cost should be “moderately,” “very,” or “extremely” important in the device selection process. Surgeons need increased access to information on the relative prices of devices and should be incentivized to participate in cost-containment efforts. PMID:24395941

Okike, Kanu; O’Toole, Robert V.; Pollak, Andrew N.; Bishop, Julius A.; McAndrew, Christopher M.; Mehta, Samir; Cross, William W.; Garrigues, Grant E.; Harris, Mitchel B.; Lebrun, Christopher T.

2014-01-01

209

Sol-Gel Derived Hydroxyapatite Coating on Mg-3Zn Alloy for Orthopedic Application  

NASA Astrophysics Data System (ADS)

In recent years, magnesium and its alloys have gained a lot of interest as orthopedic implant constituents because their biodegradability and mechanical properties are closer to that of human bone. However, one major concern with Mg in orthopedics is its high corrosion rate that results in the reduction of mechanical integrity before healing the bone tissue. The current study evaluates the sol-gel-derived hydroxyapatite (HA) coating on a selected Mg alloy (Mg-3Zn) for decreasing the corrosion rate and increasing the bioactivity of the Mg surface. The mechanical integrity of the coating is established as a function of the surface roughness of the substrate and the sintering temperature of the coating. Coating on a substrate roughness of 15-20 nm and sintering at 400°C shows the mechanical properties in similar range of bone, thus making it suitable to avoid the stress-shielding effect. The hydroxyapatite coating on the Mg alloy surface also increases corrosion resistance very significantly by 40 times. Bone cells are also found proliferating better in the HA-coated surface. All these benefits together establish the candidature of sol-gel HA-coated Mg-3Zn alloy in orthopedic application.

Singh, Sanjay; Manoj Kumar, R.; Kuntal, Kishor Kumar; Gupta, Pallavi; Das, Snehashish; Jayaganthan, R.; Roy, Partha; Lahiri, Debrupa

2015-03-01

210

The Factor Structure of the Hospital Anxiety and Depression Scale in Orthopedic Trauma Patients  

PubMed Central

Background Many instruments exist to assess mental disorders and anxiety, such as the hospital anxiety and depression scale (HADS). Nothing has been evaluated on the HADS factor structure for use with orthopedic trauma patients. The aim of this study was to validate the underlying structure of the HADS. Specifically, we sought to understand which of the factor structures found in the literature is appropriate for the orthopedic trauma patient population. Methods This study included 348 patients with an average age of 49.8 years (SD: 18.4; range: 18 - 95). Confirmatory data analysis was performed to analyze the latent structure of the HADS. Akaike information criterion (AIC) was used to compare all the models, with the lowest AIC being the best fitting model. Results We found that both the anxiety and the depression factors were highly correlated (with Pearson correlations greater than 0.700). After removing one item from each subscale, we found that a two-factor model was the best fitting one (AIC: 8,298.901); all other models had an AIC over 10,000. Conclusion Our results support a satisfactory two-factor structure for the HADS in the orthopedic trauma patients. Further studies are needed to test for higher factor structures in larger samples and in a different population.

Hung, Man; Bounsanga, Jerry; Tang, Philip; Chen, Wei; Cheng, Christine

2015-01-01

211

A touch probe method of operating an implantable RFID tag for orthopedic implant identification.  

PubMed

The major problem in operating an implantable radio-frequency identification (RFID) tag embedded on an orthopedic implant is low efficiency because of metallic interference. To improve the efficiency, this paper proposes a method of operating an implantable passive RFID tag using a touch probe at 13.56 MHz. This technology relies on the electric field interaction between two pairs of electrodes, one being a part of the touch probe placed on the surface of tissue and the other being a part of the tag installed under the tissue. Compared with using a conventional RFID antenna such as a loop antenna, this method has a better performance in the near field operation range to reduce interference with the orthopedic implant. Properly matching the touch probe and the tag to the tissue and the implant reduces signal attenuation and increases the overall system efficiency. The experiments have shown that this method has a great performance in the near field transcutaneous operation and can be used for orthopedic implant identification. PMID:23853323

Liu, Xiaoyu; Berger, J Lee; Ogirala, Ajay; Mickle, Marlin H

2013-06-01

212

The Use of Carbon-Fiber-Reinforced (CFR) PEEK Material in Orthopedic Implants: A Systematic Review  

PubMed Central

Carbon-fiber-reinforced polyetheretherketone (CFR-PEEK) has been successfully used in orthopedic implants. The aim of this systematic review is to investigate the properties, technical data, and safety of CFR-PEEK biomaterial and to evaluate its potential for new innovation in the design of articulating medical devices. A comprehensive search in PubMed and EMBASE was conducted to identify articles relevant to the outcomes of CFR-PEEK orthopedic implants. The search was also expanded by reviewing the reference sections of selected papers and references and benchmark reports provided by content experts. A total of 23 articles were included in this review. There is limited literature available assessing the performance of CFR-PEEK, specifically as an implant material for arthroplasty systems. Nevertheless, available studies strongly support CFR-PEEK as a promising and suitable material for orthopedic implants because of its biocompatibility, material characteristics, and mechanical durability. Future studies should continue to investigate CFR-PEEK’s potential benefits. PMID:25780341

Li, Chuan Silvia; Vannabouathong, Christopher; Sprague, Sheila; Bhandari, Mohit

2015-01-01

213

Endovascular Treatment in Emergency Setting of Acute Arterial Injuries After Orthopedic Surgery  

SciTech Connect

Purpose: To assess the feasibility and effectiveness of emergency endovascular treatment of acute arterial injuries after orthopedic surgery. Materials and Methods: Fifteen patients (mean age 68.3 years) with acute arterial injuries after orthopedic surgery were observed, in particular, 5 patients with pseudoaneurysm, 9 patients with active bleeding, and 1 patient with arterial dissection. Transarterial embolization (TAE) and positioning of covered and noncovered stents were the treatments performed. Follow-up after stent implantation (mean 36 months) was performed with color Doppler US (CDU) at 1, 3, 6, and 12 months and yearly thereafter. Plain X-ray was performed to evidence dislodgment or fracture of the graft. A minimum of 12 months' follow-up is available after TAE. Results: Immediate technical success was obtained in all cases. No major complications occurred. Overall clinical success rate was 100%. During mean follow-up, stent-graft occlusions did not occurred. No recurrence and/or consequence of TAE was registered during a minimum follow-up of 12 months. Conclusions: Percutaneous treatment is a feasible and safe tool for treating arterial injuries because it can provide fast and definitive resolution of the damage. This low-invasiveness approach can be proposed as first-line treatment in patients with acute injuries after orthopedic surgery.

Carrafiello, Gianpaolo, E-mail: gcarraf@tin.it; Fontana, Federico, E-mail: fede.fontana@libero.it; Mangini, Monica, E-mail: monica.mangini@tin.it; Ierardi, Anna Maria, E-mail: amierardi@yahoo.it; Lagana, Domenico; Piacentino, Filippo, E-mail: f.piacentino@live.it; Vizzari, Francesco Alberto, E-mail: gcarraf@tin.it; Spano, Emanuela, E-mail: gcarraf@tin.it; Fugazzola, Carlo, E-mail: carlo.fugazzola@ospedale.varese.it [Insubria University, Interventional Radiology, Department of Radiology (Italy)

2012-06-15

214

Vacuum tool manipulator  

DOEpatents

Apparatus for manipulating a vacuum hose in a reactor vessel comprises a housing with two opposing openings, an arm carried by the housing and deployable from a stowed position essentially completely within the housing to an extended position where the arm extends through the two openings in a generally horizontal position. The arm preferably has a two-fingered gripping device for gripping the vacuum hose but may carry a different end effector such as a grinding wheel. The fingers are opened and closed by one air cylinder. A second air cylinder extends the device. A third air cylinder within the housing pivotally pulls the opposing end of the arm into the housing via a pivoting member pivotally connected between the third air cylinder shaft and the arm.

Zollinger, William T. (3927 Almon Dr., Martinez, GA 30907)

1993-01-01

215

Ion manipulation device  

DOEpatents

An ion manipulation method and device is disclosed. The device includes a pair of substantially parallel surfaces. An array of inner electrodes is contained within, and extends substantially along the length of, each parallel surface. The device includes a first outer array of electrodes and a second outer array of electrodes. Each outer array of electrodes is positioned on either side of the inner electrodes, and is contained within and extends substantially along the length of each parallel surface. A DC voltage is applied to the first and second outer array of electrodes. A RF voltage, with a superimposed electric field, is applied to the inner electrodes by applying the DC voltages to each electrode. Ions either move between the parallel surfaces within an ion confinement area or along paths in the direction of the electric field, or can be trapped in the ion confinement area.

Anderson, Gordon A; Smith, Richard D; Ibrahim, Yehia M; Baker, Erin M

2014-09-16

216

Advanced servo manipulator  

DOEpatents

An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member.

Holt, William E. (Knoxville, TN); Kuban, Daniel P. (Oak Ridge, TN); Martin, H. Lee (Knoxville, TN)

1988-01-01

217

Vacuum tool manipulator  

DOEpatents

Apparatus for manipulating a vacuum hose in a reactor vessel comprises a housing with two opposing openings, an arm carried by the housing and deployable from a stowed position essentially completely within the housing to an extended position where the arm extends through the two openings in a generally horizontal position. The arm preferably has a two-fingered gripping device for gripping the vacuum hose but may carry a different end effector such as a grinding wheel. The fingers are opened and closed by one air cylinder. A second air cylinder extends the device. A third air cylinder within the housing pivotally pulls the opposing end of the arm into the housing via a pivoting member pivotally connected between the third air cylinder shaft and the arm. 6 figures.

Zollinger, W.T.

1993-11-23

218

Advanced servo manipulator  

DOEpatents

An advanced servo manipulator has modular parts. Modular motor members drive individual input gears to control shoulder roll, shoulder pitch, elbow pitch, wrist yaw, wrist pitch, wrist roll, and tong spacing. The modules include a support member, a shoulder module for controlling shoulder roll, and a sleeve module attached to the shoulder module in fixed relation thereto. The shoulder roll sleeve module has an inner cylindrical member rotatable relative to the outer cylindrical member, and upon which a gear pod assembly is mounted. A plurality of shafts are driven by the gears, which are in turn driven by individual motor modules to transmit rotary power to control elbow pitch as well as to provide four different rotary shafts across the bendable elbow joint to supply rotary motive power to a wrist member and tong member. 41 figs.

Holt, W.E.; Kuban, D.P.; Martin, H.L.

1988-10-25

219

Interactive protein manipulation  

SciTech Connect

We describe an interactive visualization and modeling program for the creation of protein structures ''from scratch''. The input to our program is an amino acid sequence -decoded from a gene- and a sequence of predicted secondary structure types for each amino acid-provided by external structure prediction programs. Our program can be used in the set-up phase of a protein structure prediction process; the structures created with it serve as input for a subsequent global internal energy minimization, or another method of protein structure prediction. Our program supports basic visualization methods for protein structures, interactive manipulation based on inverse kinematics, and visualization guides to aid a user in creating ''good'' initial structures.

SNCrivelli@lbl.gov

2003-07-01

220

Redundancy optimization for mechanical manipulators  

Microsoft Academic Search

Redundant manipulators have some advantages when compared with classical arms because they allow the trajectory optimization, both on the free space and in the presence of obstacles, and the resolution of singularities. For this type of manipulators, the proposed kinematic control algorithms adopt generalized inverse matrices. The generalized inverse control scheme is tested through several experiments which reveal the difficulties

Fernando B. M. Duarte; J. A. Tenreiro Machado

1998-01-01

221

SPHERICALLY-ACTUATED PLATFORM MANIPULATOR  

E-print Network

, entertainment, space structure modules, and robotic joints for long-reach manipulators. Many spherical actuation Athens, OH 45701 Final Manuscript Journal of Robotic Systems December, 2000 Contact author information University Athens, OH 45701 KEYWORDS: Spherical Actuation, Platform Manipulator, Parallel Robot ABSTRACT

Williams II, Robert L.

222

Modeling Manipulation in Medical Education  

ERIC Educational Resources Information Center

As residents and medical students progress through their medical training, they are presented with multiple instances in which they feel they must manipulate the healthcare system and deceive others in order to efficiently treat their patients. This, however, creates a culture of manipulation resulting in untoward effects on trainees' ethical and…

Dailey, Jason I.

2010-01-01

223

EXPERIMENTS IN CONSTRAINED PREHENSILE MANIPULATION  

E-print Network

synchronization between their actions, and there is no explicit communication between the robots. In this paper we describe a new class of distributed manipulation algo­ rithms in which multiple mobile robots manipulate as both coupling and indirect communication medium in this system, much like the hands of a dancing couple

Richardson, David

224

Elementary School Teachers' Manipulative Use  

ERIC Educational Resources Information Center

Using data from 503 inservice elementary teachers, this study investigated the relationship between teachers' background characteristics, teachers' beliefs about manipulatives, and the frequency with which teachers use manipulatives as part of their mathematics instruction. Findings from the study show that teachers' grade level and beliefs about…

Uribe-Florez, Lida J.; Wilkins, Jesse L. M.

2010-01-01

225

Towards performing everyday manipulation activities  

Microsoft Academic Search

This article investigates fundamental issues in scaling autonomous personal robots towards open-ended sets of everyday manipulation tasks which involve high complexity and vague job specifications. To achieve this, we propose a control architecture that synergetically integrates some of the most promising artificial intelligence (AI) methods that we con- sider as necessary for the performance of everyday manipulation tasks in human

Michael Beetz; Dominik Jain; Lorenz Mösenlechner; Moritz Tenorth

2010-01-01

226

Manipulating and Visualizing Proteins  

SciTech Connect

ProteinShop Gives Researchers a Hands-On Tool for Manipulating, Visualizing Protein Structures. The Human Genome Project and other biological research efforts are creating an avalanche of new data about the chemical makeup and genetic codes of living organisms. But in order to make sense of this raw data, researchers need software tools which let them explore and model data in a more intuitive fashion. With this in mind, researchers at Lawrence Berkeley National Laboratory and the University of California, Davis, have developed ProteinShop, a visualization and modeling program which allows researchers to manipulate protein structures with pinpoint control, guided in large part by their own biological and experimental instincts. Biologists have spent the last half century trying to unravel the ''protein folding problem,'' which refers to the way chains of amino acids physically fold themselves into three-dimensional proteins. This final shape, which resembles a crumpled ribbon or piece of origami, is what determines how the protein functions and translates genetic information. Understanding and modeling this geometrically complex formation is no easy matter. ProteinShop takes a given sequence of amino acids and uses visualization guides to help generate predictions about the secondary structures, identifying alpha helices and flat beta strands, and the coil regions that bind them. Once secondary structures are in place, researchers can twist and turn these pre-configurations until they come up with a number of possible tertiary structure conformations. In turn, these are fed into a computationally intensive optimization procedure that tries to find the final, three-dimensional protein structure. Most importantly, ProteinShop allows users to add human knowledge and intuition to the protein structure prediction process, thus bypassing bad configurations that would otherwise be fruitless for optimization. This saves compute cycles and accelerates the entire process, so that more and larger problems can be attempted. Currently, the program designers are working to make ProteinShop more applicable and adaptable to different protein folding methodologies. If users could manipulate structures from a biological point of view, and then put them back in the queue for more optimization, the process of experimentation and discovery in protein research could be greatly enhanced. The group is also investigating the use of stereoscopic rendering and three-dimensional input devices to remove the limitations of a two-dimensional interface. Clearly, protein-folding research will have far-reaching ramifications. It could lead to new insights about diseases ranging from Alzheimer's to Cystic fibrosis, which scientists believe are caused by protein folding gone wrong. A better understanding of protein structures could also lead to the engineering of altogether new proteins, and shed light on how drugs bind proteins to alter their structure and function. Above all, ProteinShop is an important tool that will help scientists unravel one of the most challenging problems that theoretical and computational chemistry has to offer.

Simon, Horst D.

2003-12-05

227

Tree manipulation experiment  

NASA Astrophysics Data System (ADS)

Some forest operations such as thinning and harvesting management could cause changes in N cycling and N2O emission from soils, since thinning and harvesting managements are accompanied with changes in aboveground environments such as an increase of slash falling and solar radiation on the forest floor. However, a considerable uncertainty exists in effects of thinning and harvesting on N2O fluxes regarding changes in belowground environments by cutting trees. To focus on the effect of changes in belowground environments on the N2O emissions from soils, we conducted a tree manipulation experiment in Japanese cedar (Cryptomeria japonica) stand without soil compaction and slash falling near the chambers and measured N2O flux at 50 cm and 150 cm distances from the tree trunk (stump) before and after cutting. We targeted 5 trees for the manipulation and established the measurement chambers to the 4 directions around each targeted tree relative to upper slope (upper, left, right, lower positions). We evaluated the effect of logging on the emission by using hierarchical Bayesian model. HB model can evaluate the variability in observed data and their uncertainties in the estimation with various probability distributions. Moreover, the HB model can easily accommodate the non-linear relationship among the N2O emissions and the environmental factors, and explicitly take non-independent data (nested structure of data) for the estimation into account by using random effects in the model. Our results showed tree cutting stimulated N2O emission from soils, and also that the increase of N2O flux depended on the distance from the trunk (stump): the increase of N2O flux at 50 cm from the trunk (stump) was greater than that of 150 cm from the trunk. The posterior simulation of the HB model indicated that the stimulation of N2O emission by tree cut- ting could reach up to 200 cm in our experimental plot. By tree cutting, the estimated N2O emission at 0-40 cm from the trunk doubled (the % increase of N2O emission; 54% to 213%; 95% C.I.) condition when soil temperature was 25oC and WFPS was 60%. The posterior simulation of the model estimated that 10% logging caused a 20% (15% to 24%; 95% CI) increase N2O emission in our study site (2000 trees ha-1) for the only tree cutting effects during the measurement period (about 160 day). On the basis of our findings, the belowground environmental changes by logging management would considerably contribute the stimulation of N2O emission.

Nishina, K.; Takenaka, C.; Ishizuka, S.; Hashimoto, S.; Yagai, Y.

2012-12-01

228

Manipulability, force, and compliance analysis for planar continuum manipulators  

NASA Technical Reports Server (NTRS)

Continuum manipulators, inspired by the natural capabilities of elephant trunks and octopus tentacles, may find niche applications in areas like human-robot interaction, multiarm manipulation, and unknown environment exploration. However, their true capabilities will remain largely inaccessible without proper analytical tools to evaluate their unique properties. Ellipsoids have long served as one of the foremost analytical tools available to the robotics researcher, and the purpose of this paper is to first formulate, and then to examine, three types of ellipsoids for continuum robots: manipulability, force, and compliance.

Gravagne, Ian A.; Walker, Ian D.

2002-01-01

229

Smart Hand For Manipulators  

NASA Astrophysics Data System (ADS)

Sensor based, computer controlled end effectors for mechanical arms are receiving more and more attention in the robotics industry, because commonly available grippers are only adequate for simple pick and place tasks. This paper describes the current status of the research at JPL on a smart hand for a Puma 560 robot arm. The hand is a self contained, autonomous system, capable of executing high level commands from a supervisory computer. The mechanism consists of parallel fingers, powered by a DC motor, and controlled by a microprocessor embedded in the hand housing. Special sensors are integrated in the hand for measuring the grasp force of the fingers, and for measuring forces and torques applied between the arm and the surrounding environment. Fingers can be exercised under position, velocity and force control modes. The single-chip microcomputer in the hand executes the tasks of communication, data acquisition and sensor based motor control, with a sample cycle of 2 ms and a transmission rate of 9600 baud. The smart hand described in this paper represents a new development in the area of end effector design because of its multi-functionality and autonomy. It will also be a versatile test bed for experimenting with advanced control schemes for dexterous manipulation.

Fiorini, Paolo

1987-10-01

230

RESEARCH PAPER Optothermal sample preconcentration and manipulation  

E-print Network

RESEARCH PAPER Optothermal sample preconcentration and manipulation with temperature gradient provided by a digital projector as established for particle manipulation, to achieve analogous Preconcentration Á Analyte manipulation Á Microfluidics 1 Introduction Widespread application of point-of-care (POC

Bahrami, Majid

231

Manipulator control by exact linearization  

NASA Technical Reports Server (NTRS)

Comments on the application to rigid link manipulators of geometric control theory, resolved acceleration control, operational space control, and nonlinear decoupling theory are given, and the essential unity of these techniques for externally linearizing and decoupling end effector dynamics is discussed. Exploiting the fact that the mass matrix of a rigid link manipulator is positive definite, a consequence of rigid link manipulators belonging to the class of natural physical systems, it is shown that a necessary and sufficient condition for a locally externally linearizing and output decoupling feedback law to exist is that the end effector Jacobian matrix be nonsingular. Furthermore, this linearizing feedback is easy to produce.

Kruetz, K.

1987-01-01

232

Manipulability and object recognition: is manipulability a semantic feature?  

PubMed

Several lines of evidence exist, coming from neuropsychology, neuroimaging and behavioural investigations on healthy subjects, suggesting that an interaction might exist between the systems devoted to object identification and those devoted to online object-directed actions and that the way an object is acted upon (manipulability) might indeed influence object recognition. In this series of experiments on speeded word-to-picture-matching tasks, it is shown how the presentation of pairs of objects sharing similar manipulation causes greater interference with respect to objects sharing only visual similarity (experiment 1). Moreover, (experiment 2) it is shown how the repeated presentation of pairs of objects sharing a similar type of manipulation leads to a 'negative' serial position effect, with the number of errors increasing across presentations, a behaviour that is typically found in patients with access deficits to semantic representations. By contrast, the repeated presentation of pairs of objects sharing only visual similarity leads to an opposite 'positive' serial position effect, with errors decreasing across presentations. It is argued that a negative serial position effect is linked to interference occurring within the semantic system, and therefore that the way an object is manipulated is indeed a semantic feature, critical in defining manipulable object properties at a semantic level. To our knowledge, this constitutes the first direct evidence of manipulability being a semantic dimension. The results are discussed in the light of current models of semantic memory organization. PMID:21113583

Campanella, Fabio; Shallice, Tim

2011-02-01

233

Concurrent orthopedic and neurosurgical procedures in pediatric patients with spinal deformity.  

PubMed

The management of pediatric patients with complex spinal deformity often requires both an orthopedic and a neurosurgical intervention. The reasons for multiple subspecialty involvement include, but are not limited to, the presence of a tethered cord requiring release or a syrinx requiring decompression. It has been common practice to perform these procedures in a staged manner, although there is little evidence in the literature to support separate interventions. We reviewed a series of consecutive patients who underwent spinal deformity correction and a neurosurgical intervention concurrently in an attempt to assess the safety, efficacy, and possible complications associated with such an approach. Eleven patients were reviewed who underwent concurrent orthopedic and neurosurgical procedures. Data were collected for patient demographics, preoperative diagnosis, procedures performed, intraoperative and perioperative complications, as well as any unexpected return to the operating room for any reason. Operative notes and anesthesia records were reviewed to determine estimated blood loss, surgical time, and the use of intraoperative neurological monitoring. Patient diagnoses included myelodysplasia (N=6), congenital scoliosis and/or kyphosis (N=4), and scoliosis associated with Noonan syndrome (N=1). Age at the time of surgery averaged 9 years 2 months (range=14 months to 17 years 2 months). Estimated blood loss averaged 605 ml (range=50-3000 ml). The operative time averaged 313 min (range=157-477 min). There were no intraoperative complications, including incidental dural tears or deterioration in preoperative neurological status. One patient developed a sore associated with postoperative cast immobilization that led to a deep wound infection. It appears that concurrent orthopedic and neurosurgical procedures in pediatric patients with significant spinal deformities can be performed safely and with minimal intraoperative and postoperative complications when utilizing modern surgical and neuromonitoring techniques. Level of evidence=Level IV. PMID:22863686

Mooney, James F; Glazier, Stephen S; Barfield, William R

2012-11-01

234

Quantitative determination of proximal radial and ulnar growth rates in foals using orthopedic markers  

E-print Network

OF PROXIMAL RADIAL AND ULNAR GROWTH RATES IN FOALS USING ORTHOPEDIC MARKERS Literature Review 1-5 Ulnar fractures are common injuries in the horse. The incidence reported was 1 in 100 fractures, 5 out of 5 12, 536 horses, 3 in 99 fractures, 4 cases in 3... returned to pasture. Dehiscence occurred in one or both ulnar incisions of all foals from 2 to 5 days after surgery. All wounds healed within 2 weeks with stall rest, daily cleansing, and systemic antibiotics (procaine penicillin G, 22, 000 U/kg BID...

Smith, Barbara Lynn

1988-01-01

235

Five-year surveillance of nosocomial infections following orthopedic surgery in a private medical center  

Microsoft Academic Search

Introduction  Nosocomial infections (NI) are a major problem in health care facilities, resulting in extended length of stay, substantial\\u000a morbidity and mortality, and excess cost. In this study, we aimed to know the rates, distribution profiles of NIs following\\u000a orthopedic surgery, and share our first 5-year experience, in a private medical center. \\u000a \\u000a \\u000a \\u000a Materials and methods  There is an active, prospective, and laboratory-based

Diler Coskun; Jale Aytac; Cagatay Ozturk; Mehmet Tezer; Azmi Hamzaoglu

2008-01-01

236

Development of an orthopedic load cell for stress analysis of a canine tibia  

E-print Network

will have 2 set screws at 90 degrees relative to each other to prevent any loosening after the surgery. at'on of S ra' es There are six 120 ohm strain gages attached to the shaft of the load cell with an epoxy compound. The gages, Threaded End Set... significant problems. The load cell was anchored into the hollow of the bone with methamathacrolate, a hardening substance commonly used in orthopedic surgical applications. At the time of surgery, and the immediate post-operative stage, there were...

Green, Bryan Wade

1988-01-01

237

iPhone and iPad Use in Orthopedic Surgery  

PubMed Central

Background Thousands of healthcare mobile applications (apps) are available, and physicians are increasingly recognizing that mobile technology can improve their workflow and allow them to practice medicine in a better and/or more efficient manner. Methods This article highlights apps compatible with the iPhone and iPad and their utility to the busy orthopedic surgeon. Results Currently available apps address every aspect of healthcare: patient management, reference, education, and research. Conclusion Key aspects of helpful apps include low cost (preferably free), a user-friendly interface, and simplicity.

Duncan, Scott F. M.; Hendawi, Tariq K.; Sperling, John; Kakinoki, Ryosuke; Hartsock, Landon

2015-01-01

238

Apixaban versus enoxaparin in elective major orthopedic surgery: a clinical review.  

PubMed

Despite current guidelines recommendations about anticoagulant prophylaxis, many studies have shown an high venous thromboembolism (VTE) incidence in patients undergoing total hip and knee arthroplasty. A number of anticoagulants are currently available, but they have some limitations that affect their applicability and consequently their effectiveness. Several new oral anticoagulants (NOACs) have been developed in an attempt to overcome these limitations. Apixaban is a NOAC that selectively inhibits the coagulation factor Xa; it is approved for the prevention of VTE after total hip replacement and total knee replacement surgery. This review examines the results of main trials designed to test efficacy and safety of apixaban in major elective orthopedic surgery. PMID:25125051

Maniscalco, Pietro; Caforio, Marco; Imberti, Davide; Porcellini, Giuseppe; Benedetti, Raffaella

2015-03-01

239

Non-Osteotomy and Osteotomy Large Animal Fracture Models in Orthopedic Trauma Research  

PubMed Central

Large animal fracture models are important in the field of orthopedic trauma research. New implants are tested in animals before being implanted into humans. Large animals like sheep or swine often are more properly to simulate conditions in humans, e.g. biomechanical demands, compared to rodents. Cited articles mainly analyze shock or fracture healing. Both osteotomy and non-osteotomy fracture models have been used in the past. However, comparative studies are rare and clear recommendation when to use which model are missing. This review will summarize large animal fracture models putting special emphasis on non-osteotomy fracture models. PMID:25568730

Decker, Sebastian; Reifenrath, Janin; Omar, Mohamed; Krettek, Christian; Müller, Christian W.

2014-01-01

240

The Evidence-Based Principles of Negative Pressure Wound Therapy in Trauma & Orthopedics  

PubMed Central

Negative pressure wound therapy is a popular treatment for the management of both acute and chronic wounds. Its use in trauma and orthopedics is diverse and includes the acute traumatic setting as well as chronic troublesome wounds associated with pressure sores and diabetic foot surgery. Efforts have been made to provide an evidence base to guide its use however this has been limited by a lack of good quality evidence. The following review article explores the available evidence and describes future developments for its use in trauma and orthopaedic practice. PMID:25067971

A, Novak; Khan, Wasim S; J, Palmer

2014-01-01

241

Adaptation of NASA technology for the optimization of orthopedic knee implants  

NASA Technical Reports Server (NTRS)

The NASA technology originally developed for the optimization of composite structures (engine blades) is adapted and applied to the optimization of orthopedic knee implants. A method is developed enabling the tailoring of the implant for optimal interaction with the environment of the tibia. The shape of the implant components are optimized, such that the stresses in the bone are favorably controlled to minimize bone degradation and prevent failures. A pilot tailoring system is developed and the feasibility of the concept is elevated. The optimization system is expected to provide the means for improving knee prosthesis and individual implant tailoring for each patient.

Saravanos, D. A.; Mraz, P. J.; Hopkins, D. A.

1991-01-01

242

Perioperative substance use disorder, opioid diversion, and opioid misuse by a medical professional undergoing orthopedic surgery.  

PubMed

Patients with substance use disorders can present challenges for effective perioperative pain management. Healthcare professionals with substance abuse disorders requiring medical treatment and pain management represent a unique subpopulation. The authors present a case of a nurse undergoing an orthopedic surgical procedure who was found with two large, organized tackle boxes of opioid medication in her hospital room. Although the incidence of substance use disorders in healthcare professionals is thought to be equivalent to the general population, the presentation, substances of choice, and inciting factors are unique. Further, treatment options available to such individuals have been established and proven successful. PMID:25531961

Maher, Dermot P; Kissen, Michael; Danovitch, Itai; Yumul, Roya; Louy, Charles

2014-01-01

243

Investigation of fatigue failure of a stainless steel orthopedic implant device  

NASA Astrophysics Data System (ADS)

An orthopedic implant (rush nail) fractured in a patient at a location that corresponded to the site of a prior fracture of the bone (right femur). The crack propagation in the implant proceeded from both sides of the nail, and the final fracture occurred by ductile shear in the midsection of the nail. Dimple structures and tear ridges between fatigue striation patches were observed on the fractured surface. Moreover, the device fractured within a short period of use. Contrary to post-procedure instructions, the patient placed the body’s full weight on the implanted leg at least once, perhaps twice, causing overload-induced fatigue failure of the implant.

Sivakumar, M.; Kamachi Mudali, U.; Rajeswari, S.

1994-02-01

244

[Surface modifications to improve biocompatibility and mechanical properties of orthopedic implants].  

PubMed

State of the art surface modifications on metallic materials for orthopedic and dental implants permit clinical application if implant design,manufacturing process as well as function and duration of implantation are harmonized with each other. Keeping these prerequisites in mind,hydroxylapatite is suited for closer connection of fixation elements in hard tissue. PVD or PECVD modifications can make gliding surfaces or surfaces of fixation elements abrasion resistant if the pressure-area ratio does not exceed threshold values in cases of surfaces moving relative to each other PMID:12557086

Thull, R

2003-01-01

245

Interactive Animation of Dynamic Manipulation  

E-print Network

Lifelike animation of manipulation must account for the dynamicinteraction between animated characters, objects, and their environment. Failing to do so would ignore the often significant effects objectshave on the motion ...

Abe, Yeuhi

2006-02-28

246

Robot manipulation in human environments  

E-print Network

Human environments present special challenges for robot manipulation. They are often dynamic, difficult to predict, and beyond the control of a robot engineer. Fortunately, many characteristics of these settings can be ...

Edsinger, Aaron Ladd, 1972-

2007-01-01

247

Robot Manipulation in Human Environments  

E-print Network

Human environments present special challenges for robot manipulation. They are often dynamic, difficult to predict, and beyond the control of a robot engineer. Fortunately, many characteristics of these settings can be ...

Edsinger, Aaron

2007-01-16

248

Dynamic Scaling of Manipulator Trajectories  

E-print Network

A fundamental time-scaling property of manipulator dynamics has been identified that allows modification of movement speed without complete dynamics recalculation. By exploiting this property, it can be determined ...

Hollerbach, John M.

1983-01-01

249

Manipulator Grasping and Pushing Operations  

E-print Network

The primary goal of this research is to develop theoretical tools for analysis, synthesis, application of primitive manipulator operations. The primary method is to extend and apply traditional tools of classical mechanics. ...

Mason, Matthew Thomas

1982-06-01

250

Module-type space manipulator  

NASA Astrophysics Data System (ADS)

The Communications Research Laboratory has been studying the inspection technology needed for the first step of 'Orbital Maintenance System' (OMS) that maintains space system by inspecting of satellites, re-orbiting useless satellites, and simply repairing satellites in orbit. In this paper, we introduce a re-configurable modular-type manipulator for space utilization, and its control algorithm for the inspection of satellites in orbit. The manipulator system is interconnected by a joint mechanism which can be connected and disconnected by simple robotic motion and also resist inertia during space operation. The modules are also specially designed for thermal, vacuum, and radiation conditions. The control processors are qualified in a piggyback flight on 2000. We have adopted a decentralized control algorithm for the redundant manipulator, which automatically adapts to the manipulator reconfigurations.

Kimura, Shinichi; Tsuchiya, Shigeru; Nishida, Shinichiro; Takegai, Tomoki

1999-08-01

251

Internal forces during object manipulation  

PubMed Central

Internal force is a set of contact forces that does not disturb object equilibrium. The elements of the internal force vector cancel each other and, hence, do not contribute to the resultant (manipulation) force acting on the object. The mathematical independence of the internal and manipulation forces allows for their independent (decoupled) control realized in robotic manipulators. To examine whether in humans internal force is coupled with the manipulation force and what grasping strategy the performers utilize, the subjects (n=6) were instructed to make cyclic arm movements with a customized handle. Six combinations of handle orientation and movement direction were tested. These involved: parallel manipulations (1) VV task (vertical orientation and vertical movement) and (2) HH task (horizontal orientation and horizontal movement); orthogonal manipulations (3) VH task (vertical orientation and horizontal movement) and (4) HV task (horizontal orientation and vertical movement); and diagonal manipulations (5) DV task (diagonal orientation and vertical movement) and (6) DH task (diagonal orientation and horizontal movement). Handle weight (from 3.8 to 13.8 N), and movement frequency (from 1 to 3 Hz) were systematically changed. The analysis was performed at the thumb-virtual finger level (VF, an imaginary finger that produces a wrench equal to the sum of wrenches produced by all the fingers). At this level, the forces of interest could be reduced to the internal force and internal moment. During the parallel manipulations, the internal (grip) force was coupled with the manipulation force (producing object acceleration) and the thumb-VF forces increased or decreased in phase: the thumb and VF worked in synchrony to grasp the object more strongly or more weakly. During the orthogonal manipulations, the thumb-VF forces changed out of phase: the plots of the internal force vs. object acceleration resembled an inverted letter V. The HV task was the only task where the relative phase (coupling) between the normal forces of the thumb and VF depended on oscillation frequency. During the diagonal manipulations, the coupling was different in the DV and DH tasks. A novel observation of substantial internal moments is described: the moments produced by the normal finger forces were counterbalanced by the moments produced by the tangential forces such that the resultant moments were close to zero. Implications of the findings for the notion of grasping synergies are discussed. PMID:15912369

Gao, Fan; Latash, Mark L.; Zatsiorsky, Vladimir M.

2010-01-01

252

Automatic manipulators for spray painting  

Microsoft Academic Search

with frequency control of the angular velocity. The nominal power is i0 kW and the overall dimensions of the unit equipped with manipulators is 8 x 4 x 2.5 m. The manipulator are of modular design and include (see Fig. i) a powered carriage 4, elevator 2, rod 5 with the tracking mechanism (mechanical arm module) 7. The drive 3

A. N. Chernyavskii; V. V. Serik; L. S. Zinchenko

1985-01-01

253

Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery  

PubMed Central

OBJECTIVES: to analyze the relationship between preoperative emotional state and the prevalence and intensity of postoperative pain and to explore predictors of postoperative pain. METHOD: observational retrospective study undertaken among 127 adult patients of orthopedic and trauma surgery. Postoperative pain was assessed with the verbal numeric scale and with five variables of emotional state: anxiety, sweating, stress, fear, and crying. The Chi-squared test, Student's t test or ANOVA and a multivariate logistic regression analysis were used for the statistical analysis. RESULTS: the prevalence of immediate postoperative pain was 28%. Anxiety was the most common emotional factor (72%) and a predictive risk factor for moderate to severe postoperative pain (OR: 4.60, 95% CI 1.38 to 15.3, p<0.05, AUC: 0.72, 95% CI: 0.62 to 0.83). Age exerted a protective effect (OR 0.96, 95% CI: 0.94-0.99, p<0.01). CONCLUSION: preoperative anxiety and age are predictors of postoperative pain in patients undergoing orthopedic and trauma surgery. PMID:25493674

Robleda, Gemma; Sillero-Sillero, Amalia; Puig, Teresa; Gich, Ignasi; Baños, Josep-E

2014-01-01

254

Biomimetic helical rosette nanotubes and nanocrystalline hydroxyapatite coatings on titanium for improving orthopedic implants  

PubMed Central

Natural bone consists of hard nanostructured hydroxyapatite (HA) in a nanostructured protein-based soft hydrogel template (ie, mostly collagen). For this reason, nanostructured HA has been an intriguing coating material on traditionally used titanium for improving orthopedic applications. In addition, helical rosette nanotubes (HRNs), newly developed materials which form through the self-assembly process of DNA base pair building blocks in body solutions, are soft nanotubes with a helical architecture that mimics natural collagen. Thus, the objective of this in vitro study was for the first time to combine the promising attributes of HRNs and nanocrystalline HA on titanium and assess osteoblast (bone-forming cell) functions. Different sizes of nanocrystalline HA were synthesized in this study through a wet chemical precipitation process following either hydrothermal treatment or sintering. Transmission electron microscopy images showed that HRNs aligned with nanocrystalline HA, which indicates a high affinity between both components. Some of the nanocrystalline HA formed dense coatings with HRNs on titanium. More importantly, results demonstrated enhanced osteoblast adhesion on the HRN/nanocrystalline HA-coated titanium compared with conventional uncoated titanium. Among all the HRN/nanocrystalline HA coatings tested, osteoblast adhesion was the greatest when HA nanometer particle size was the smallest. In this manner, this study demonstrated for the first time that biomimetic HRN/nanocrystalline HA coatings on titanium were cytocompatible for osteoblasts and, thus, should be further studied for improving orthopedic implants. PMID:18990941

Zhang, Lijie; Chen, Yupeng; Rodriguez, Jose; Fenniri, Hicham; Webster, Thomas J

2008-01-01

255

Magnesium biomaterials for orthopedic application: a review from a biological perspective.  

PubMed

Magnesium (Mg) has a long history of investigation as a degradable biomaterial. Physicians first began using Mg for biomedical applications in the late 19th century. Experimentation continued with varying levels of success until the mid-20th century when interest in the metal waned. In recent years the field of Mg-based biomaterials has once again become popular, likely due to advancements in technology allowing improved control of corrosion. Although this has led to success in vascular applications, continued difficulties in predicting and controlling the corrosion rate of Mg in an intraosseous environment has impeded the development of Mg-based biomaterials for orthopedic applications. In this review, an initial summary of the basic properties and the physiological role of Mg are followed by a discussion of the physical characteristics of the metal which lend it to use as a degradable biomaterial. A description of the historical and modern applications for Mg in the medical field is followed by a discussion of the methods used to control and assess Mg corrosion, with an emphasis on alloying. The second part of this review concentrates on the methods used to assess the corrosion and biocompatibility of Mg-based orthopedic biomaterials. This review provides a summary of Mg as a biomaterial from a biological perspective. PMID:24458999

Walker, Jemimah; Shadanbaz, Shaylin; Woodfield, Timothy B F; Staiger, Mark P; Dias, George J

2014-08-01

256

Nursing time study for the administration of a PRN oral analgesic on an orthopedic postoperative unit.  

PubMed

As needed (PRN) oral opioid analgesics are an integral part of many orthopedic postoperative multimodal pain management regimens. However, the unpredictable nature of this dosing method can lead to disruptions in the process of administering the medication, as well as be an interruption to regular nursing activities. This IRB approved quantitative time study tested the hypothesis that a significant amount of nursing time is required in the administration of PRN oral opioid analgesics on a postoperative orthopedic nursing unit. The purpose of this study is to evaluate the time necessary to complete the required steps related to the administration of PRN oral analgesics. Nurses from 28 nursing shifts used a personal digital assistant (PDA) to record the time needed to complete these steps. We determined that 10.9 minutes is the mean time required to administer PRN oral analgesics on this unit. Other time studies have evaluated the medication administration process as a whole. No time studies related to PRN oral analgesic administration have been reported. In phase I of our project, the data were summarized and will be used as a baseline comparison for phase II, in which we will evaluate an oral PCA medication administration system. PMID:23746873

Pizzi, Lois J; Chelly, Jacques E; Marlin, Vanessa

2014-09-01

257

Perioperative complications of orthopedic surgery for lower extremity in patients with cerebral palsy.  

PubMed

Because complications are more common in patients with cerebral palsy (CP), surgeons and anesthesiologists must be aware of perioperative morbidity and be prepared to recognize and treat perioperative complications. This study aimed to determine the incidence of and risk factors for perioperative complications of orthopedic surgery on the lower extremities in patients with CP. We reviewed the medical records of consecutive CP patients undergoing orthopedic surgery. Medical history, anesthesia emergence time, intraoperative body temperature, heart rate, blood pressure, immediate postoperative complications, Gross Motor Function Classification System (GMFCS) level, Cormack-Lehane classification, and American Society of Anesthesiologists physical status classification were analyzed. A total of 868 patients was included. Mean age at first surgery was 11.8 (7.6) yr. The incidences of intraoperative hypothermia, absolute hypotension, and absolute bradycardia were 26.2%, 4.4%, and 20.0%, respectively. Twenty (2.3%) patients had major complications, and 35 (4.0%) patients had minor complications postoperatively. The incidences of intraoperative hypothermia, absolute hypotension, and major postoperative complications were significantly higher in patients at GMFCS levels IV and V compared with patients at GMFCS levels I to III (P<0.001). History of pneumonia was associated with intraoperative absolute hypotension and major postoperative complications (P<0.001). These results revealed that GMFCS level, patient age, hip reconstructive surgery, and history of pneumonia are associated with adverse effects on intraoperative body temperature, the cardiovascular system, and immediate postoperative complications. PMID:25829819

Lee, Seung Yeol; Sohn, Hye-Min; Chung, Chin Youb; Do, Sang-Hwan; Lee, Kyoung Min; Kwon, Soon-Sun; Sung, Ki Hyuk; Lee, Sun Hyung; Park, Moon Seok

2015-04-01

258

Perioperative Complications of Orthopedic Surgery for Lower Extremity in Patients with Cerebral Palsy  

PubMed Central

Because complications are more common in patients with cerebral palsy (CP), surgeons and anesthesiologists must be aware of perioperative morbidity and be prepared to recognize and treat perioperative complications. This study aimed to determine the incidence of and risk factors for perioperative complications of orthopedic surgery on the lower extremities in patients with CP. We reviewed the medical records of consecutive CP patients undergoing orthopedic surgery. Medical history, anesthesia emergence time, intraoperative body temperature, heart rate, blood pressure, immediate postoperative complications, Gross Motor Function Classification System (GMFCS) level, Cormack-Lehane classification, and American Society of Anesthesiologists physical status classification were analyzed. A total of 868 patients was included. Mean age at first surgery was 11.8 (7.6) yr. The incidences of intraoperative hypothermia, absolute hypotension, and absolute bradycardia were 26.2%, 4.4%, and 20.0%, respectively. Twenty (2.3%) patients had major complications, and 35 (4.0%) patients had minor complications postoperatively. The incidences of intraoperative hypothermia, absolute hypotension, and major postoperative complications were significantly higher in patients at GMFCS levels IV and V compared with patients at GMFCS levels I to III (P<0.001). History of pneumonia was associated with intraoperative absolute hypotension and major postoperative complications (P<0.001). These results revealed that GMFCS level, patient age, hip reconstructive surgery, and history of pneumonia are associated with adverse effects on intraoperative body temperature, the cardiovascular system, and immediate postoperative complications.

2015-01-01

259

Short-Term and Long-Term Effects of Orthopedic Biodegradable Implants  

PubMed Central

Presently, orthopedic and oral/maxillofacial implants represent a combined $2.8 billion market, a figure expected to experience significant and continued growth. Although traditional permanent implants have been proved clinically efficacious, they are also associated with several drawbacks, including secondary revision and removal surgeries. Non-permanent, biodegradable implants offer a promising alternative for patients, as they provide temporary support and degrade at a rate matching tissue formation, and thus, eliminate the need for secondary surgeries. These implants have been in clinical use for nearly 25 years, competing directly with, or maybe even exceeding, the performance of permanent implants. The initial implantation of biodegradable materials, as with permanent materials, mounts an acute host inflammatory response. Over time, the implant degradation profile and possible degradation product toxicity mediate long-term biodegradable implant-induced inflammation. However, unlike permanent implants, this inflammation is likely to cease once the material disappears. Implant-mediated inflammation is a critical determinant for implant success. Thus, for the development of a proactive biodegradable implant that has the ability to promote optimal bone regeneration and minimal detrimental inflammation, a thorough understanding of short- and long-term inflammatory events is required. Here, we discuss an array of biodegradable orthopedic implants, their associated short- and long- term inflammatory effects, and methods to mediate these inflammatory events. PMID:22043969

Amini, Ami R.; Wallace, James S.; Nukavarapu, Syam P.

2012-01-01

260

Biocompatible evaluation of barium titanate foamed ceramic structures for orthopedic applications.  

PubMed

The potential of barium titanate (BT) to be electrically active makes it a material of interest in regenerative medicine. To enhance the understanding of this material for orthopedic applications, the in vitro biocompatibility of porous BT fabricated using a direct foaming technique was investigated. Characterization of the resultant foams yielded an overall porosity between 50 and 70% with average pore size in excess of 30 µm in diameter. A mouse osteoblast (7F2) cell line was cultured with the BT to determine the extent of the foams' toxicity using a LDH assay. After 72 h, BT foams showed a comparable cytotoxicity of 6.4?±?0.8% to the 8.4?±?1.5% of porous 45S5 Bioglass®. The in vitro inflammatory response elicited from porous BT was measured as a function of tumor necrosis factor alpha (TNF-?) secreted from a human monocytic leukemia cell line (THP-1). Results indicate that the BT foams do not cause a significant inflammatory response, eliciting a 9.4?±?1.3 pg of TNF-? per mL of media compared with 20.2?±?2.3 pg/mL from untreated cells. These results indicate that porous BT does not exhibit short term cytotoxicity and has potential for orthopedic tissue engineering applications. PMID:23894063

Ball, Jordan P; Mound, Brittnee A; Nino, Juan C; Allen, Josephine B

2014-07-01

261

Porous poly(para-phenylene) scaffolds for load-bearing orthopedic applications.  

PubMed

The focus of this study was to fabricate and investigate the mechanical behavior of porous poly(para-phenylene) (PPP) for potential use as a load-bearing orthopedic biomaterial. PPPs are known to have exceptional mechanical properties due to their aromatic backbone; however, the manufacturing and properties of PPP porous structures have not been previously investigated. Tailored porous structures with either small (150-250µm) or large (420-500µm) pore sizes were manufactured using a powder-sintering/salt-leaching technique. Porosities were systematically varied using 50 to 90vol%. Micro-computed tomography (µCT) and scanning electron microscopy (SEM) were used to verify an open-cell structure and investigate pore morphology of the scaffolds. Uniaxial mechanical behavior of solid and porous PPP samples was characterized through tensile and compressive testing. Both modulus and strength decreased with increasing porosity and matched well with foam theory. Porous scaffolds showed a significant decrease in strain-to-failure (<4%) under tensile loading and experienced linear elasticity, plastic deformation, and densification under compressive loading. Over the size ranges tested, pore size did not significantly influence the mechanical behavior of the scaffolds on a consistent basis. These results are discussed in regards to use of porous PPP for orthopedic applications and a prototype porous interbody fusion cage is presented. PMID:24374261

DiRienzo, Amy L; Yakacki, Christopher M; Frensemeier, Mareike; Schneider, Andreas S; Safranski, David L; Hoyt, Anthony J; Frick, Carl P

2014-02-01

262

Clinical use of parnaparin in major and minor orthopedic sugery: a review  

PubMed Central

Patients undergoing arthroplasty or other orthopedic surgery show a high risk of venous thromboembolism (VTE), involving mortality, morbidity, and social costs; however, the risk for VTE in minor orthopedic surgery should not be underestimated and antithrombotic prophylaxis may be required. According to the literature, low-molecular-weight heparins (LMWHs) are more effective in preventing VTE than unfractionated heparins (UFHs) or vitamin K antagonists, and have a lower hemorrhagic risk. By comparing different prophylactic regimens, it has been shown that starting the prophylaxis near the time of the operation is the most critical point for efficacy, whether or not the first dose is administered pre- or post-operatively. Moreover, most thromboembolic complications are observed after discharge and, therefore, many clinicians advocate continuing prophylaxis for longer times (6–8 weeks) in order to further reduce the rate for VTE. The literature on parnaparin, a new LMWH, in VTE prophylaxis was reviewed. Parnaparin is equally effective as UFH, but it offers the advantages of a once-daily administration and improved tolerability, thus allowing the home management of patients with no need for laboratory coagulation tests. PMID:19183746

Bugamelli, Stefano; Zangheri, Elena; Montebugnoli, Milena; Guerra, Lucia

2008-01-01

263

Adaptive compliance control for redundant manipulators  

Microsoft Academic Search

This paper presents two adaptive schemes for compliance control of redundant manipulators. The first scheme is developed using an adaptive impedance control approach for torque-controlled manipulators, while the second strategy is an adaptive admittance controller for position-controlled manipulators. The proposed controllers are very general and computationally efficient since they do not require knowledge of the manipulator dynamic model or parameter

R. Colhaugh; Kristin Glass; H. Seraji

1994-01-01

264

Iterative inverse kinematics with manipulator configuration control  

Microsoft Academic Search

A new method, termed the offset modification method (OM method), for solving the manipulator inverse kinematics problem is presented. The OM method works by modifying the link offset values of a manipulator until it is possible to derive closed-form inverse kinematics equations for the resulting manipulator (termed the model manipulator). This procedure allows one to derive a set of three

G. Z. Grudic; Peter D. Lawrence

1993-01-01

265

Manipulation Planning for Deformable Linear Objects  

Microsoft Academic Search

Research on robotic manipulation has mainly focused on manipulating rigid objects so far. However, many important application domains require manipulating deformable objects, especially deformable linear objects (DLOs), such as ropes, cables, and sutures. Such objects are far more challenging to handle, as they can exhibit a much greater diversity of behaviors, and their manipulation almost inevitably requires two robotic arms,

Mitul Saha; Pekka Isto

2007-01-01

266

Adaptive Compliant Motion Control for Dexterous Manipulators  

Microsoft Academic Search

This article presents two adaptive schemes for compliant mo tion control of dexterous manipulators. The first scheme is developed using an adaptive impedance control approach for torque-controlled manipulators, whereas the second strategy is an adaptive admittance controller for position-controlled manipulators. The proposed controllers are very general and computationally efficient, as they do not require knowledge of the manipulator dynamic model

Richard Colbaugh; Homayoun Seraji; Kristin Glass

1995-01-01

267

Manipulation strategies for massive space payloads  

NASA Technical Reports Server (NTRS)

Motion planning and control for the joints of flexible manipulators are discussed. Specific topics covered include control of a flexible braced manipulator, control of a small working robot on a large flexible manipulator to suppress vibrations, control strategies for ensuring cooperation among disparate manipulators, and motion planning for robots in free-fall.

Book, Wayne J.

1991-01-01

268

Direct Adaptive Impedance Control Of Redundant Manipulators  

NASA Technical Reports Server (NTRS)

Method of controlling mechanical impedance of end effector of robotic manipulator related to method described in "Adaptive Impedance Control of Redundant Manipulators" (NPO-18606). Present method does not require detailed knowledge and computation of dynamics and inverse kinematic transformation of manipulator. Provides for control globally stable in presence of bounded disturbances. Applicable to both nonredundant and redundant manipulators performing tasks involving impacts between manipulator and objects in its environment, and controlled contact between end effector and object, such as deburring.

Seraji, Homayoun; Colbaugh, Richard D.; Glass, Kristin L.

1995-01-01

269

High precision redundant robotic manipulator  

DOEpatents

A high precision redundant robotic manipulator for overcoming contents imposed by obstacles or imposed by a highly congested work space. One embodiment of the manipulator has four degrees of freedom and another embodiment has seven degreed of freedom. Each of the embodiments utilize a first selective compliant assembly robot arm (SCARA) configuration to provide high stiffness in the vertical plane, a second SCARA configuration to provide high stiffness in the horizontal plane. The seven degree of freedom embodiment also utilizes kinematic redundancy to provide the capability of avoiding obstacles that lie between the base of the manipulator and the end effector or link of the manipulator. These additional three degrees of freedom are added at the wrist link of the manipulator to provide pitch, yaw and roll. The seven degrees of freedom embodiment uses one revolute point per degree of freedom. For each of the revolute joints, a harmonic gear coupled to an electric motor is introduced, and together with properly designed based servo controllers provide an end point repeatability of less than 10 microns.

Young, Kar-Keung David (Mountain View, CA)

1998-01-01

270

Mobile camera-space manipulation  

NASA Technical Reports Server (NTRS)

The invention is a method of using computer vision to control systems consisting of a combination of holonomic and nonholonomic degrees of freedom such as a wheeled rover equipped with a robotic arm, a forklift, and earth-moving equipment such as a backhoe or a front-loader. Using vision sensors mounted on the mobile system and the manipulator, the system establishes a relationship between the internal joint configuration of the holonomic degrees of freedom of the manipulator and the appearance of features on the manipulator in the reference frames of the vision sensors. Then, the system, perhaps with the assistance of an operator, identifies the locations of the target object in the reference frames of the vision sensors. Using this target information, along with the relationship described above, the system determines a suitable trajectory for the nonholonomic degrees of freedom of the base to follow towards the target object. The system also determines a suitable pose or series of poses for the holonomic degrees of freedom of the manipulator. With additional visual samples, the system automatically updates the trajectory and final pose of the manipulator so as to allow for greater precision in the overall final position of the system.

Seelinger, Michael J. (Inventor); Yoder, John-David S. (Inventor); Skaar, Steven B. (Inventor)

2001-01-01

271

Mapping and manipulating facial expression.  

PubMed

Nonverbal visual cues accompany speech to supplement the meaning of spoken words, signify emotional state, indicate position in discourse, and provide back-channel feedback. This visual information includes head movements, facial expressions and body gestures. In this article we describe techniques for manipulating both verbal and nonverbal facial gestures in video sequences of people engaged in conversation. We are developing a system for use in psychological experiments, where the effects of manipulating individual components of nonverbal visual behavior during live face-to-face conversation can be studied. In particular, the techniques we describe operate in real-time at video frame-rate and the manipulation can be applied so both participants in a conversation are kept blind to the experimental conditions. PMID:19624037

Theobald, Barry-John; Matthews, Iain; Mangini, Michael; Spies, Jeffrey R; Brick, Timothy R; Cohn, Jeffrey F; Boker, Steven M

2009-01-01

272

Mapping and Manipulating Facial Expression  

PubMed Central

Non-verbal visual cues accompany speech to supplement the meaning of spoken words, signify emotional state, indicate position in discourse, and provide back-channel feedback. This visual information includes head movements, facial expressions and body gestures. In this paper we describe techniques for manipulating both verbal and non-verbal facial gestures in video sequences of people engaged in conversation. We are developing a system for use in psychological experiments, where the effects of manipulating individual components of non-verbal visual behaviour during live face-to-face conversation can be studied. In particular, the techniques we describe operate in real-time at video frame-rate and the manipulation can be applied so both participants in a conversation are kept blind to the experimental conditions. PMID:19624037

Theobald, Barry-John; Matthews, Iain; Mangini, Michael; Spies, Jeffrey R.; Brick, Timothy R.; Cohn, Jeffrey F.; Boker, Steven M.

2009-01-01

273

Manipulating Complex Light with Metamaterials  

PubMed Central

Recent developments in the field of metamaterials have revealed unparalleled opportunities for “engineering” space for light propagation; opening a new paradigm in spin- and quantum-related phenomena in optical physics. Here we show that unique optical properties of metamaterials (MMs) open unlimited prospects to “engineer” light itself. We propose and demonstrate for the first time a novel way of complex light manipulation in few-mode optical fibers using optical MMs. Most importantly, these studies highlight how unique properties of MMs, namely the ability to manipulate both electric and magnetic field components of electromagnetic (EM) waves, open new degrees of freedom in engineering complex polarization states of light at will, while preserving its orbital angular momentum (OAM) state. These results lay the first steps in manipulating complex light in optical fibers, likely providing new opportunities for high capacity communication systems, quantum information, and on-chip signal processing. PMID:24084836

Zeng, Jinwei; Wang, Xi; Sun, Jingbo; Pandey, Apra; Cartwright, Alexander N.; Litchinitser, Natalia M.

2013-01-01

274

ADMAP (automatic data manipulation program)  

NASA Technical Reports Server (NTRS)

Instructions are presented on the use of ADMAP, (automatic data manipulation program) an aerospace data manipulation computer program. The program was developed to aid in processing, reducing, plotting, and publishing electric propulsion trajectory data generated by the low thrust optimization program, HILTOP. The program has the option of generating SC4020 electric plots, and therefore requires the SC4020 routines to be available at excution time (even if not used). Several general routines are present, including a cubic spline interpolation routine, electric plotter dash line drawing routine, and single parameter and double parameter sorting routines. Many routines are tailored for the manipulation and plotting of electric propulsion data, including an automatic scale selection routine, an automatic curve labelling routine, and an automatic graph titling routine. Data are accepted from either punched cards or magnetic tape.

Mann, F. I.

1971-01-01

275

Precision Manipulation with Cooperative Robots  

NASA Technical Reports Server (NTRS)

This work addresses several challenges of cooperative transportThis work addresses several challenges of cooperative transport and precision manipulation. Precision manipulation requires a rigid grasp, which places a hard constraint on the relative rover formation that must be accommodated, even though the rovers cannot directly observe their relative poses. Additionally, rovers must jointly select appropriate actions based on all available sensor information. Lastly, rovers cannot act on independent sensor information, but must fuse information to move jointly; the methods for fusing information must be determined.

Stroupe, Ashley; Huntsberger, Terry; Okon, Avi; Aghzarian, Hrand

2005-01-01

276

Understanding pharmaceutical research manipulation in the context of accounting manipulation.  

PubMed

The problem of the manipulation of data that arises when there is both opportunity and incentive to mislead is better accepted and studied - though by no means solved - in financial accounting than in medicine. This article analyzes pharmaceutical company manipulation of medical research as part of a broader problem of corporate manipulation of data in the creation of accounting profits. The article explores how our understanding of accounting fraud and misinformation helps us understand the risk of similar information manipulation in the medical sciences. This understanding provides a framework for considering how best to improve the quality of medical research and analysis in light of the current system of medical information production. I offer three possible responses: (1) use of the Dodd-Frank whistleblower provisions to encourage reporting of medical research fraud; (2) a two-step academic journal review process for clinical trials; and (3) publicly subsidized trial-failure insurance. These would improve the release of negative information about drugs, thereby increasing the reliability of positive information. PMID:24088151

Brown, Abigail

2013-01-01

277

Seasonal variation in orthopedic health services utilization in Switzerland: The impact of winter sport tourism  

PubMed Central

Background Climate- or holiday-related seasonality in hospital admission rates is well known for many diseases. However, little research has addressed the impact of tourism on seasonality in admission rates. We therefore investigated the influence of tourism on emergency admission rates in Switzerland, where winter and summer leisure sport activities in large mountain regions can generate orthopedic injuries. Methods Using small area analysis, orthopedic hospital service areas (HSAo) were evaluated for seasonality in emergency admission rates. Winter sport areas were defined using guest bed accommodation rate patterns of guest houses and hotels located above 1000 meters altitude that show clear winter and summer peak seasons. Emergency admissions (years 2000–2002, n = 135'460) of local and nonlocal HSAo residents were evaluated. HSAo were grouped according to their area type (regular or winter sport area) and monthly analyses of admission rates were performed. Results Of HSAo within the defined winter sport areas 70.8% show a seasonal, summer-winter peak hospital admission rate pattern and only 1 HSAo outside the defined winter sport areas shows such a pattern. Seasonal hospital admission rates in HSAo in winter sport areas can be up to 4 times higher in winter than the intermediate seasons, and they are almost entirely due to admissions of nonlocal residents. These nonlocal residents are in general -and especially in winter- younger than local residents, and nonlocal residents have a shorter length of stay in winter sport than in regular areas. The overall geographic distribution of nonlocal residents admitted for emergencies shows highest rates during the winter as well as the summer in the winter sport areas. Conclusion Small area analysis using orthopedic hospital service areas is a reliable method for the evaluation of seasonality in hospital admission rates. In Switzerland, HSAo defined as winter sport areas show a clear seasonal fluctuation in admission rates of only nonlocal residents, whereas HSAo defined as regular, non-winter sport areas do not show such seasonality. We conclude that leisure sport, and especially ski/snowboard tourism demands great flexibility in hospital beds, staff and resource planning in these areas. PMID:16512923

Matter-Walstra, Klazien; Widmer, Marcel; Busato, André

2006-01-01

278

A cohort study on the incidence and outcome of pulmonary embolism in trauma and orthopedic patients  

PubMed Central

Background This study aims to determine the incidence of pulmonary embolism (PE) in trauma and orthopedic patients within a regional tertiary referral center and its association with the pattern of injury, type of treatment, co-morbidities, thromboprophylaxis and mortality. Methods All patients admitted to our institution between January 2010 and December 2011, for acute trauma or elective orthopedic procedures, were eligible to participate in this study. Our cohort was formed by identifying all patients with clinical features of PE who underwent Computed Tomography-Pulmonary Angiogram (CT-PA) to confirm or exclude the clinical suspicion of PE, within six months after the injury or the surgical procedure. Case notes and electronic databases were reviewed retrospectively to identify each patient’s venous thromboembolism (VTE) risk factors, type of treatment, thromboprophylaxis and mortality. Results Out of 18,151 patients admitted during the study period only 85 (0.47%) patients developed PE (positive CT-PA) (24 underwent elective surgery and 61 sustained acute trauma). Of these, only 76% of the patients received thromboprophylaxis. Hypertension, obesity and cardiovascular disease were the most commonly identifiable risk factors. In 39% of the cases, PE was diagnosed during the in-hospital stay. The median time of PE diagnosis, from the date of injury or the surgical intervention was 23 days (range 1 to 312). The overall mortality rate was 0.07% (13/18,151), but for those who developed PE it was 15.29% (13/85). Concomitant deep venous thrombosis (DVT) was identified in 33.3% of patients. The presence of two or more co-morbidities was significantly associated with the incidence of mortality (unadjusted odds ratio (OR)?=?3.52, 95% confidence interval (CI) (1.34, 18.99), P?=?0.034). Although there was also a similar clinical effect size for polytrauma injury on mortality (unadjusted OR?=?1.90 (0.38, 9.54), P?=?0.218), evidence was not statistically significant for this factor. Conclusions The incidence of VTE was comparable to previously reported rates, whereas the mortality rate was lower. Our local protocols that comply with the National Institute for Health and Clinical Excellence (NICE) guidelines in the UK appear to be effective in preventing VTE and reducing mortality in trauma and orthopedic patients. PMID:24589368

2014-01-01

279

ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS Registration of Cone-Beam CT and 3dMD Maxillodental Data  

E-print Network

ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS Registration of Cone-Beam CT and 3dMD Maxillodental Data that occur during orthodontic (craniofacial) treatment. Registered images obtained from Cone-Beam Computed as well as clinical evaluation of orthodontic treatments. Methods Six consecutive patients with adequate

Alberta, University of

280

Leflunomide increases the risk of early healing complications in patients with rheumatoid arthritis undergoing elective orthopedic surgery  

Microsoft Academic Search

The aim of this object is to study whether treatment with biological or leflunomide increases the risk of wound-healing complications after elective orthopedic surgery. Between March 2002 and September 2003, 201 patients participated in this study with the following inclusion criteria: (a) Rheumatoid arthritis (RA) or psoriatic arthritis (psA), (b) therapy with: MTX, leflunomide, etanercept, infliximab, adalimumab, anakinra, (c) undergoing

Martin Fuerst; Henrike Möhl; Kerstin Baumgärtel; Wolfgang Rüther

2006-01-01

281

Effect of Antibiotic Treatment on Bacterial Attachment to a DePuy EnduronTM Orthopedic Implant  

Microsoft Academic Search

Background: The increasing incidence of bacterial infections in orthopedic surgery might be related to the increasing application of artificial devices. In most cases, bacteria multiply on the surface of implants in biofilms. Poor penetration of antibiotics, frequent necessity of prosthesis removal, chronic processes and financial costs emphasize the significance of preventive measures. Method: Adhesion of bacterial strains (two Staphylococcus aureus,

Ildikó Kustos; Tamás Kustos; Ferenc Kilár; Gábor Rappai; Béla Kocsis

2005-01-01

282

Potential of Stem Cell to Tailor the Bone-Ceramic Interface for Better Fixation of Orthopedic Implants  

Microsoft Academic Search

The main cause of premature failure of an orthopedic implant in vivo is due to various biological reactions with the surrounding tissues\\/environment. Therefore, to combat this situation, continuous efforts have been concentrated to improve biocompatibility of the implant material by adopting different strategies. Extensive study is being made to modify the implants by plasma-spraying bioactive materials, introducing specific surface groups,

Jui Chakraborty; Debabrata Basu

283

In-111-labeled leukocyte scintigraphy in suspected orthopedic prosthesis infection: comparison with other imaging modalities  

SciTech Connect

When infection of prosthetic orthopedic implants is suspected, optimal management requires accurate confirmation or exclusion of infection. The authors retrospectively studied 98 patients with possible infection who underwent scanning with indium-111-labeled white blood cells (WBCs) and subsequently underwent surgery within 14 days. At surgery, 50 patients had infections, as determined by means of culture or histologic results. The diagnostic accuracy of In-111 scanning was compared with that of plain radiography, arthrography, three-phase bone scanning, and various clinical and laboratory findings classically associated with infection. Positive findings on In-111 WBC scans and elevated erythrocyte sedimentation rates were found to be the most predictive variables in the diagnosis of septic prostheses (P less than or equal to .001 and P less than or equal to .002, respectively). Likelihood ratio analysis more clearly demonstrated the superiority of In-111 WBC scanning, with positive and negative scans yielding likelihood ratios of 5.0 and 0.16, respectively.

Magnuson, J.E.; Brown, M.L.; Hauser, M.F.; Berquist, T.H.; Fitzgerald, R.H. Jr.; Klee, G.G.

1988-07-01

284

Prosthesis Infections after Orthopedic Joint Replacement: The Possible Role of Bacterial Biofilms  

PubMed Central

Prosthesis-related infection is a serious complication for patients after orthopedic joint replacement, which is currently difficult to treat with antibiotic therapy. Consequently, in most cases, removal of the infected prosthesis is the only solution to cure the infection. It is, therefore, important to understand the comprehensive interaction between the microbiological situation and the host immune responses that lead to prosthesis infections. Evidence indicates that prosthesis infections are actually biofilm-correlated infections that are highly resistant to antibiotic treatment and the host immune responses. The authors reviewed the related literature in the context of their clinical experience, and discussed the possible etiology and mechanism leading to the infections, especially problems related to bacterial biofilm, and prophylaxis and treatment of infection, including both microbiological and surgical measures. Recent progress in research into bacterial biofilm and possible future treatment options of prosthesis-related infections are discussed. PMID:23888204

Song, Zhijun; Borgwardt, Lotte; Høiby, Niels; Wu, Hong; Sørensen, Torben Sandberg; Borgwardt, Arne

2013-01-01

285

Ion beam sputter etching of orthopedic implanted alloy MP35N and resulting effects on fatigue  

NASA Technical Reports Server (NTRS)

The effects of two types of argon ion sputter etched surface structures on the tensile stress fatigue properties of orthopedic implant alloy MP35N were investigated. One surface structure was a natural texture resulting from direct bombardment by 1 keV argon ions. The other structure was a pattern of square holes milled into the surface by a 1 keV argon ion beam through a Ni screen mask. The etched surfaces were subjected to tensile stress only in fatigue tests designed to simulate the cyclic load conditions experienced by the stems of artificial hip joint implants. Both types of sputter etched surface structures were found to reduce the fatigue strength below that of smooth surface MP35N.

Wintucky, E. G.; Christopher, M.; Bahnuik, E.; Wang, S.

1981-01-01

286

[Computer-based organization and documentation in orthopedics. A 5-year experience].  

PubMed

In the orthopedic department of the University Hospital Homburg/Saar, we use since 1993 a computer-based system for clinics organisation and documentation of operations. Hardware consists of DOS/Windows PC's in a Novell-network. Our software is a combination of database-system for managing patient-data and a special coding program for ICD and IKPM-digits. Our experience shows that computer assisted clinic-management is an effective tool to help the surgeon in planning and documentation. Until now, we used the system for 31,500 patients and 8500 operations. A flexible software can meet the requirements both of the surgeons and administration. Moreover, in the University hospital Homburg/Saar, the different departments are linked by an Intranet with connection to other scientific networks and the Internet. PMID:10326203

Hess, T; Deimel, D; Fischer, R; Duchow, J

1999-03-01

287

Quaternized Chitosan as an Antimicrobial Agent: Antimicrobial Activity, Mechanism of Action and Biomedical Applications in Orthopedics  

PubMed Central

Chitosan (CS) is a linear polysaccharide with good biodegradability, biocompatibility and antimicrobial activity, which makes it potentially useful for biomedical applications, including an antimicrobial agent either alone or blended with other polymers. However, the poor solubility of CS in most solvents at neutral or high pH substantially limits its use. Quaternary ammonium CS, which was prepared by introducing a quaternary ammonium group on a dissociative hydroxyl group or amino group of the CS, exhibited improved water solubility and stronger antibacterial activity relative to CS over an entire range of pH values; thus, this quaternary modification increases the potential biomedical applications of CS in the field of anti-infection. This review discusses the current findings on the antimicrobial properties of quaternized CS synthesized using different methods and the mechanisms of its antimicrobial actions. The potential antimicrobial applications in the orthopedic field and perspectives regarding future studies in this field are also considered. PMID:23325051

Tan, Honglue; Ma, Rui; Lin, Chucheng; Liu, Ziwei; Tang, Tingting

2013-01-01

288

Cutting tool system to minimize soft tissue damage for robot-assisted minimally invasive orthopedic surgery.  

PubMed

Minimally invasive surgery in orthopedic field is considered to be a challenging problem with a milling robot. One objective of this study is to minimize collision of the cutting tool with soft tissue. The authors have developed a robot with redundant axis to avoid the collision so far. Some important components are modeled based on physical requirements, and a geometric optimization approach based on the model has been also proposed to improve performance. In this paper, a protective mechanism to cover the non-working part of the cutting edge is proposed to avoid soft tissue damage. Hardware and software have been developed for this application and the effectiveness of this technique was evaluated with urethane bone. PMID:18051155

Sugita, Naohiko; Nakajima, Yoshikazu; Mitsuishi, Mamoru; Kawata, Shosaku; Fujiwara, Kazuo; Abe, Nobuhiro; Ozaki, Toshifumi; Suzuki, Masahiko

2007-01-01

289

3D finite element modeling and analysis of dynamic force in bone drilling for orthopedic surgery.  

PubMed

Three-dimensional finite element modeling and analysis are made to simulate the dynamic process of bone drilling during the orthopedic surgery. This study is proposed to evaluate the performance of various surgical tools and the possible pre-operative biohazard. In the simulation, the strain-stress curve of the bone is divided into linear elastic region and nonlinear plastic region according to the strain range. Rigid-plasticity and elasto-plasticity are used as bone material. The performances of twist drill bit and hollow drill bit are evaluated. The results of finite element analysis give different patterns of stress distribution on the two types of bone models and drill bits. The FE simulations show dynamic drilling process that the drill bit penetrates through the bone model. In vitro drilling experiment on porcine femur is conducted to measure the drilling force for the validation of the FEM. PMID:24550166

Qi, Lin; Wang, Xiaona; Meng, Max Q

2014-09-01

290

DATACUBE: A datacube manipulation package  

NASA Astrophysics Data System (ADS)

DATACUBE is a command-line package for manipulating and visualizing data cubes. It was designed for integral field spectroscopy but has been extended to be a generic data cube tool, used in particular for sub-millimeter data cubes from the James Clerk Maxwell Telescope. It is part of the Starlink software collection (ascl:1110.012).

Allan, Alasdair; Currie, Malcolm J.

2014-05-01

291

Teaching Integration Applications Using Manipulatives  

ERIC Educational Resources Information Center

Calculus students' difficulties in understanding integration have been extensively studied. Research shows that the difficulty lies with students understanding of the definition of the definite integral as a limit of a Riemann sum and with the idea of accumulation inherent in integration. We have created a set of manipulatives and activities…

Bhatia, Kavita; Premadasa, Kirthi; Martin, Paul

2014-01-01

292

Force Control of Robot Manipulators  

Microsoft Academic Search

The state of the art of force control for robot manipulators is surveyed in this article. An overview and a unified description of the two major approaches to force control are presented. Several research topics related to force control are also surveyed

Tsuneo Yoshikawa

2000-01-01

293

Mobile Manipulation using NASA's Robonaut  

Microsoft Academic Search

The Johnson Space Center has developed a new mobile manipulation system with the combination of a Robonaut upper body mounted onto a Segway mobile base. The objective is to study a fluid and coordinated control of dexterous limbs on a mobile robot. The system has been demonstrated interacting with people, tools, and urban interfaces built for humans. Human interactions have

Robert O. Ambrose; Robert T. Savely; S. M. Goza; Philip Strawser; Myron A. Diftler; I. M. Spain; N. Radford

2004-01-01

294

Statically balanced direct drive manipulator  

Microsoft Academic Search

A practical architecture, using a four-bar-linkage, is cgnsidered for the University of Minnesota direct drive robot (8). This statically- balanced direct drive robot has been constructed for stability analysis of the robot in constrained manipulation (5 -7). As a result of the elimination of the gravity forces (without any counter weights), smaller actuators and consequently smaller amplifiers were chosen. The

H. Kazerooni; S. Kim

1989-01-01

295

COGNITION, ACTION, AND OBJECT MANIPULATION  

PubMed Central

Although psychology is the science of mental life and behavior, it has paid little attention to the means by which mental life is translated into behavior. One domain where links between cognition and action have been explored is the manipulation of objects. This article reviews psychological research on this topic, with special emphasis on the tendency to grasp objects differently depending on what one plans to do with the objects. Such differential grasping has been demonstrated in a wide range of object manipulation tasks, including grasping an object in a way that reveals anticipation of the object's future orientation, height, and required placement precision. Differential grasping has also been demonstrated in a wide range of behaviors, including one-hand grasps, two-hand grasps, walking, and transferring objects from place to place as well as from person to person. The populations in whom the tendency has been shown are also diverse, including nonhuman primates as well as human adults, children, and babies. Meanwhile, the tendency is compromised in a variety of clinical populations and in children of a surprisingly advanced age. Verbal working memory is compromised as well if words are memorized while object manipulation tasks are performed; the recency portion of the serial position curve is reduced in this circumstance. In general, the research reviewed here points to rich connections between cognition and action as revealed through the study of object manipulation. Other implications concern affordances, Donders' Law, and naturalistic observation and the teaching of psychology. PMID:22448912

Rosenbaum, David A.; Chapman, Kate M.; Weigelt, Matthias; Weiss, Daniel J.; van der Wel, Robrecht

2012-01-01

296

Ants: the supreme soil manipulators  

Technology Transfer Automated Retrieval System (TEKTRAN)

This review focuses on the semiochemical interactions between ants and their soil environment. Ants occupy virtually every ecological niche and have evolved mechanisms to not just cope with, but also manipulate soil organisms. The metapleural gland, specific to ants was thought to be the major sourc...

297

Manipulating Genetic Material in Bacteria  

NASA Technical Reports Server (NTRS)

Lisa Crawford, a graduate research assistant from the University of Toledo, works with Laurel Karr of Marshall Space Flight Center (MSFC) in the molecular biology laboratory. They are donducting genetic manipulation of bacteria and yeast for the production of large amount of desired protein. Photo credit: NASA/Marshall Space Flight Center (MSFC)

1998-01-01

298

Hyper redundant modular manipulator arm  

Microsoft Academic Search

We introduce the hyper-redundant modular manipulator arm (HRMA) ground test system, which is the ground experimental model for the technology of orbital maintenance system (OMS). OMS consists of three steps: 1) inspecting the satellite, 2) re-orbiting the useless satellite, and 3) simply repairing satellites in space. This HRMA is the arm for inspecting of satellites, the first step of OMS.

S. Kimura; S. Tsuchiya; T. Takegai; N. Iizuka; K. Moritani; S. Nishida; N. Kawashima; R. Okamura

2000-01-01

299

“I’ve never asked one question.” Understanding the barriers among orthopedic surgery residents to screening female patients for intimate partner violence  

PubMed Central

Background Intimate partner violence (IPV) is a global public health problem. Orthopedic surgery residents may identify IPV among injured patients treated in fracture clinics. Yet, these residents face a number of barriers to recognizing and discussing IPV with patients. We sought to explore orthopedic surgery residents’ knowledge of IPV and their preparedness to screen patients for IPV in academic fracture clinic settings with a view to developing targeted IPV education and training. Methods We conducted focus groups with junior and intermediate residents. Discussions explored residents’ knowledge of and experiences with IPV screening and preparedness for screening and responding to IPV among orthopedic patients. Data were analyzed iteratively using an inductive approach. Results Residents were aware of the issue of abuse generally, but had received no specific information or training on IPV in orthopedics. Residents did not see orthopedics faculty screen patients for IPV or advocate for screening. They did not view IPV screening or intervention as part of the orthopedic surgeon’s role. Residents’ clinical experiences emphasized time management and surgical intervention by effectively “getting through clinic” and “dealing with the surgical problem.” Communication with patients about other health issues was minimal or nonexistent. Conclusion Orthopedic surgery residents are entering a career path where IPV is well documented. They encounter cultural and structural barriers preventing the incorporation of IPV screening into their clinical and educational experiences. Hospitals and academic programs must collaborate in efforts to build capacity for sustainable IPV screening programs among these trainees. PMID:25421078

Conn, Lesley Gotlib; Young, Aynsely; Rotstein, Ori D.; Schemitsch, Emil

2014-01-01

300

Mechanical properties of dispersed ceramic nanoparticles in polymer composites for orthopedic applications  

PubMed Central

Ceramic/polymer composites have been considered as third-generation orthopedic biomaterials due to their ability to closely match properties (such as surface, chemistry, biological, and mechanical) of natural bone. It has already been shown that the addition of nanophase compared with conventional (or micron-scale) ceramics to polymers enhances bone cell functions. However, in order to fully take advantage of the promising nanometer size effects that nanoceramics can provide when added to polymers, it is critical to uniformly disperse them in a polymer matrix. This is critical since ceramic nanoparticles inherently have a strong tendency to form larger agglomerates in a polymer matrix which may compromise their properties. Therefore, in this study, model ceramic nanoparticles, specifically titania and hydroxyapatite (HA), were dispersed in a model polymer (PLGA, poly-lactic-co-glycolic acid) using high-power ultrasonic energy. The mechanical properties of the resulting PLGA composites with well-dispersed ceramic (either titania or HA) nanoparticles were investigated and compared with composites with agglomerated ceramic nanoparticles. Results demonstrated that well-dispersed ceramic nanoparticles (titania or HA) in PLGA improved mechanical properties compared with agglomerated ceramic nanoparticles even though the weight percentage of the ceramics was the same. Specifically, well-dispersed nanoceramics in PLGA enhanced the tensile modulus, tensile strength at yield, ultimate tensile strength, and compressive modulus compared with the more agglomerated nanoceramics in PLGA. In summary, supplemented by previous studies that demonstrated greater osteoblast (bone-forming cell) functions on well-dispersed nanophase ceramics in polymers, the present study demonstrated that the combination of PLGA with well-dispersed nanoceramics enhanced mechanical properties necessary for load-bearing orthopedic/dental applications. PMID:20463945

Liu, Huinan; Webster, Thomas J

2010-01-01

301

A novel experimental model of orthopedic trauma with acute kidney injury in obese Zucker rats.  

PubMed

Obesity is associated with an increased risk of acute kidney injury (AKI) after blunt traumatic injury in humans. Because limitations exist in studying trauma in human patients, animal models are necessary to elucidate mechanisms of remote organ injury after trauma. We developed a model of severe orthopedic trauma in lean (LZ) and obese (OZ) Zucker rats, in which OZ develop greater kidney dysfunction after trauma than LZ. Orthopedic trauma was inflicted via bilateral hindlimb soft tissue injury, fibula fracture, and injection of homogenized bone components. Mean arterial pressure (MAP) and heart rate (HR) were measured for 6 h after trauma, and again at 24 h after trauma. Urine was collected for 24 h before and after trauma to measure urine albumin excretion. Glomerular filtration rate (GFR), renal plasma flow (RPF), plasma interleukin-6 (IL-6), and renal macrophage infiltration (ED-1 [CD68 Antibody] immunostaining) were measured in animals with and without trauma. MAP and HR were similar between LZ and OZ throughout the study, with the exception that OZ had a 18 mmHg lower pressure 24 h posttrauma. GFR and RPF were decreased significantly (?50%), while urine albumin excretion, plasma IL-6, and renal ED-1-positive cells were increased in OZ 24 h after trauma compared to both OZ without trauma and LZ after trauma. In conclusion, these data are consistent with studies in humans that show that AKI develops more frequently in obese than in lean individuals. This model will be an important experimental tool to better understand the underlying mechanisms of poor outcomes after trauma in obese patients. PMID:24303169

Mittwede, Peter N; Xiang, Lusha; Lu, Silu; Clemmer, John S; Hester, Robert L

2013-10-01

302

High-strength, surface-porous polyether-ether-ketone for load-bearing orthopedic implants.  

PubMed

Despite its widespread clinical use in load-bearing orthopedic implants, polyether-ether-ketone (PEEK) is often associated with poor osseointegration. In this study, a surface-porous PEEK material (PEEK-SP) was created using a melt extrusion technique. The porous layer was 399.6±63.3 ?m thick and possessed a mean pore size of 279.9±31.6 ?m, strut spacing of 186.8±55.5 ?m, porosity of 67.3±3.1% and interconnectivity of 99.9±0.1%. Monotonic tensile tests showed that PEEK-SP preserved 73.9% of the strength (71.06±2.17 MPa) and 73.4% of the elastic modulus (2.45±0.31 GPa) of as-received, injection-molded PEEK. PEEK-SP further demonstrated a fatigue strength of 60.0 MPa at one million cycles, preserving 73.4% of the fatigue resistance of injection-molded PEEK. Interfacial shear testing showed the pore layer shear strength to be 23.96±2.26 MPa. An osseointegration model in the rat revealed substantial bone formation within the pore layer at 6 and 12 weeks via microcomputed tomography and histological evaluation. Ingrown bone was more closely apposed to the pore wall and fibrous tissue growth was reduced in PEEK-SP when compared to non-porous PEEK controls. These results indicate that PEEK-SP could provide improved osseointegration while maintaining the structural integrity necessary for load-bearing orthopedic applications. PMID:25463499

Evans, Nathan T; Torstrick, F Brennan; Lee, Christopher S D; Dupont, Kenneth M; Safranski, David L; Chang, W Allen; Macedo, Annie E; Lin, Angela S P; Boothby, Jennifer M; Whittingslow, Daniel C; Carson, Robert A; Guldberg, Robert E; Gall, Ken

2015-02-01

303

A novel experimental model of orthopedic trauma with acute kidney injury in obese Zucker rats  

PubMed Central

Obesity is associated with an increased risk of acute kidney injury (AKI) after blunt traumatic injury in humans. Because limitations exist in studying trauma in human patients, animal models are necessary to elucidate mechanisms of remote organ injury after trauma. We developed a model of severe orthopedic trauma in lean (LZ) and obese (OZ) Zucker rats, in which OZ develop greater kidney dysfunction after trauma than LZ. Orthopedic trauma was inflicted via bilateral hindlimb soft tissue injury, fibula fracture, and injection of homogenized bone components. Mean arterial pressure (MAP) and heart rate (HR) were measured for 6 h after trauma, and again at 24 h after trauma. Urine was collected for 24 h before and after trauma to measure urine albumin excretion. Glomerular filtration rate (GFR), renal plasma flow (RPF), plasma interleukin-6 (IL-6), and renal macrophage infiltration (ED-1 [CD68 Antibody] immunostaining) were measured in animals with and without trauma. MAP and HR were similar between LZ and OZ throughout the study, with the exception that OZ had a 18 mmHg lower pressure 24 h posttrauma. GFR and RPF were decreased significantly (?50%), while urine albumin excretion, plasma IL-6, and renal ED-1-positive cells were increased in OZ 24 h after trauma compared to both OZ without trauma and LZ after trauma. In conclusion, these data are consistent with studies in humans that show that AKI develops more frequently in obese than in lean individuals. This model will be an important experimental tool to better understand the underlying mechanisms of poor outcomes after trauma in obese patients. PMID:24303169

Mittwede, Peter N; Xiang, Lusha; Lu, Silu; Clemmer, John S; Hester, Robert L

2013-01-01

304

MODULAR MANIPULATOR FOR ROBOTICS APPLICATIONS  

SciTech Connect

ARM Automation, Inc. is developing a framework of modular actuators that can address the DOE's wide range of robotics needs. The objective of this effort is to demonstrate the effectiveness of this technology by constructing a manipulator from these actuators within a glovebox for Automated Plutonium Processing (APP). At the end of the project, the system of actuators was used to construct several different manipulator configurations, which accommodate common glovebox tasks such as repackaging. The modular nature and quickconnects of this system simplify installation into ''hot'' boxes and any potential modifications or repair therein. This work focused on the development of self-contained robotic actuator modules including the embedded electronic controls for the purpose of building a manipulator system. Both of the actuators developed under this project contain the control electronics, sensors, motor, gear train, wiring, system communications and mechanical interfaces of a complete robotics servo device. Test actuators and accompanying DISC{trademark}s underwent validation testing at The University of Texas at Austin and ARM Automation, Inc. following final design and fabrication. The system also included custom links, an umbilical cord, an open architecture PC-based system controller, and operational software that permitted integration into a completely functional robotic manipulator system. The open architecture on which this system is based avoids proprietary interfaces and communication protocols which only serve to limit the capabilities and flexibility of automation equipment. The system was integrated and tested in the contractor's facility for intended performance and operations. The manipulator was tested using the full-scale equipment and process mock-ups. The project produced a practical and operational system including a quantitative evaluation of its performance and cost.

Joseph W. Geisinger, Ph.D.

2001-07-31

305

Manipulability and object recognition: is manipulability a semantic feature?  

Microsoft Academic Search

Several lines of evidence exist, coming from neuropsychology, neuroimaging and behavioural investigations on healthy subjects,\\u000a suggesting that an interaction might exist between the systems devoted to object identification and those devoted to online\\u000a object-directed actions and that the way an object is acted upon (manipulability) might indeed influence object recognition.\\u000a In this series of experiments on speeded word-to-picture-matching tasks, it

Fabio Campanella; Tim Shallice

2011-01-01

306

Spinal Manipulation for Low-Back Pain  

MedlinePLUS

... manipulation is one of several options—including exercise, massage , and physical therapy—that can provide mild-to- ... manipulation is one of several options—including exercise, massage, and physical therapy—that can provide mild-to- ...

307

Motorized manipulator for positioning a TEM specimen  

Microsoft Academic Search

The invention relates to a motorized manipulator for positioning a TEM specimen holder with sub-micron resolution parallel to a y-z plane and rotating the specimen holder in the y-z plane, the manipulator comprising a base (2), and attachment means (30) for attaching the specimen holder to the manipulator, characterized in that the manipulator further comprises at least three nano-actuators (3.sup.a,

Andreas Karl Schmid; Nord Andresen

2010-01-01

308

Manipulability of Cooperating Robots with Passive Joints  

Microsoft Academic Search

We study the differential kinematics and the kineto-static manipulability indices of multiple cooperating robot arms, including active and passive joints. The kinetic manipulability indices are derived as a simple extension of previous results on cooperating robots without passive joints. The force manipulability analysis for cooperative robot systems can not be derived by “duality” arguments as it can with conventional arms,

Antonio Bicchi; Domenico Prattichizzo

1998-01-01

309

Cartesian control of a hydraulic redundant manipulator  

Microsoft Academic Search

A controller for redundant manipulators with a small, fast manipulator mounted on a positioning part has been developed. The controller distributes the fast motion to the small, fast manipulator and the slow, gross motion to the positioning part. A position reference is generated on-line to the positioning part to avoid singularities and the loss of degrees of freedom. The task

Olav Egeland

1987-01-01

310

Sensing Local Geometry for Dexterous Manipulation  

E-print Network

Sensing Local Geometry for Dexterous Manipulation William R. Provancher and Mark R. Cutkosky Center://www-cdr.stanford.edu/telemanip Abstract: We describe a new tactile sensor for use in dexterous manipulation and telemanipulation of the device. 1. INTRODUCTION Dexterous manipulation in humans and in robots requires information about

Stanford University

311

PROGRAMMING DEXTEROUS MANIPULATION BY DEMONSTRATION A DISSERTATION  

E-print Network

PROGRAMMING DEXTEROUS MANIPULATION BY DEMONSTRATION A DISSERTATION SUBMITTED TO THE DEPARTMENT ___________________________________ #12;iv ABSTRACT Programming Dexterous Manipulation by Demonstration by Michael Leo Turner Doctor in the field of dexterous manipulation has resulted in the development of multi-finger mechanical hands which

Stanford University

312

Singularity analysis of redundant parallel manipulators  

Microsoft Academic Search

The general methods of singularity analysis of a general parallel manipulator are not suitable for that of a redundant parallel manipulator, thereby This work presents a method for the identification of the singularities of redundant parallel manipulators. Firstly, the theory of singular value decomposition is employed to analyze the velocity equation of a mechanism, and the relationship between the generalized

Hengbin Liao; Tiemin Li; Xiaoqiang Tang

2004-01-01

313

Iterative inverse kinematics with manipulator configuration control  

SciTech Connect

A new method, termed the offset modification method (OM method), for solving the manipulator inverse kinematics problem is presented. The OM method works by modifying the link offset values of a manipulator until it is possible to derive closed-form inverse kinematics equations for the resulting manipulator (termed the model manipulator). This procedure allows one to derive a set of three nonlinear equations in three unknowns that, when numerically solved, give an inverse kinematics solution for the original manipulator. The OM method can be applied to manipulators with any number of degrees of freedom, as long as the manipulator satisfies a given set of conditions (Theorem 1). The OM method is tested on a 6-degree-of-freedom manipulator that has no known closed-form inverse kinematics equations. It is shown that the OM method is applicable to real-time manipulator control, can be used to guarantee convergence to a desired endpoint position and orientation (if it exists), and allows one to directly choose which inverse kinematics solution the algorithm will converge to (as specified in the model manipulator closed-form inverse kinematics equations). Applications of the method to other 6-DOF manipulator geometries and to redundant manipulators (i.e. greater than 6 DOF geometries) are discussed.

Grudic, G.Z.; Lawrence, P.D. [Univ. of British Columbia, Vancouver, British Columbia (Canada). Dept. of Electrical Engineering] [Univ. of British Columbia, Vancouver, British Columbia (Canada). Dept. of Electrical Engineering

1993-08-01

314

A remote manipulator for forestry operations  

Microsoft Academic Search

A remote manipulator was developed for forestry operations to relocate operators away from hazardous operations. The operations of tree trimming are performed in the vicinity of live electrical distribution lines, generating a hazard for the operator. The remote manipulator has two major subsystems: a three degree-of-freedom (DOF) aerial device acting as the main lifting arm, and a six DOF manipulator

A. A. Goldenberg; J. Wiercienski; P. Kuzan; C. Szymczyk; R. G. Fenton; B. Shaver

1992-01-01

315

Adaptive hybrid control of manipulators  

NASA Technical Reports Server (NTRS)

Simple methods for the design of adaptive force and position controllers for robot manipulators within the hybrid control architecuture is presented. The force controller is composed of an adaptive PID feedback controller, an auxiliary signal and a force feedforward term, and it achieves tracking of desired force setpoints in the constraint directions. The position controller consists of adaptive feedback and feedforward controllers and an auxiliary signal, and it accomplishes tracking of desired position trajectories in the free directions. The controllers are capable of compensating for dynamic cross-couplings that exist between the position and force control loops in the hybrid control architecture. The adaptive controllers do not require knowledge of the complex dynamic model or parameter values of the manipulator or the environment. The proposed control schemes are computationally fast and suitable for implementation in on-line control with high sampling rates.

Seraji, H.

1987-01-01

316

Nanoparticle manipulation by thermal gradient  

PubMed Central

A method was proposed to manipulate nanoparticles through a thermal gradient. The motion of a fullerene molecule enclosed inside a (10, 10) carbon nanotube with a thermal gradient was studied by molecular dynamics simulations. We created a one-dimensional potential valley by imposing a symmetrical thermal gradient inside the nanotube. When the temperature gradient was large enough, the fullerene sank into the valley and became trapped. The escaping velocities of the fullerene were evaluated based on the relationship between thermal gradient and thermophoretic force. We then introduced a new way to manipulate the position of nanoparticles by translating the position of thermostats with desirable thermal gradients. Compared to nanomanipulation using a scanning tunneling microscope or an atomic force microscope, our method for nanomanipulation has a great advantage by not requiring a direct contact between the probe and the object. PMID:22364240

2012-01-01

317

The laboratory telerobotic manipulator program  

NASA Technical Reports Server (NTRS)

New opportunities for the application of telerobotic systems to enhance human intelligence and dexterity in the hazardous environment of space are presented by the NASA Space Station Program. Because of the need for significant increases in extravehicular activity and the potential increase in hazards associated with space programs, emphasis is being heightened on telerobotic systems research and development. The Laboratory Telerobotic Manipulator (LTM) program is performed to develop and demonstrate ground-based telerobotic manipulator system hardware for research and demonstrations aimed at future NASA applications. The LTM incorporates traction drives, modularity, redundant kinematics, and state-of-the-art hierarchical control techniques to form a basis for merging the diverse technological domains of robust, high-dexterity teleoperations and autonomous robotic operation into common hardware to further NASA's research.

Herndon, J. N.; Babcock, S. M.; Butler, P. L.; Costello, H. M.; Glassell, R. L.; Kress, R. L.; Kuban, D. P.; Rowe, J. C.; Williams, D. M.

1989-01-01

318

Database Manipulation on Quantum Computers  

E-print Network

Manipulating a database system on a quantum computer is an essential aim to benefit from the promising speed-up of quantum computers over classical computers in areas that take a vast amount of storage and processing time such as in databases. In this paper, the basic operations for manipulating the data in a quantum database will be defined, e.g. INSERT, UPDATE, DELETE, SELECT, backing up and restoring a database file. This gives the ability to perform the data processing that usually takes a long processing time on a classical database system, in a simultaneous way on a quantum computer. Defining a quantum version of more advanced concepts used in database systems, e.g. the referential integrity and the relational algebra, is a normal extension to this work

Ahmed Younes

2007-05-29

319

A Study of File Manipulation by Novices Using Commands vs. Direct Manipulation  

E-print Network

immediate and direct. 1.1 Direct Manipulation Many people form pictures or patterns of tasks in their mindA Study of File Manipulation by Novices Using Commands vs. Direct Manipulation Sepeedeh Margono manipulation. In the past few years, these three styles have become the subject of many studies. However, few

Shneiderman, Ben

320

A hybrid nanorobotic manipulation system integrated with nanorobotic manipulators inside scanning and transmission electron microscopes  

Microsoft Academic Search

A hybrid nanorobotic manipulation system, which is integrated with a nanorobotic manipulator inside a transmission electron microscope (TEM) and nanorobotic manipulators inside a scanning electron microscope (SEM), is presented. The TEM nanomanipulator has been constructed with 4 multi-layer piezoelectric devices for driving in 3 translational degrees of freedoms (DOFs) and a passive 3-DOF sample stage driven by SEM nanorobotic manipulators.

Masahiro Nakajima; Fumihito Arai; Lixin Dong; Toshio Fukuda

2004-01-01

321

Module-type space manipulator  

Microsoft Academic Search

The Communications Research Laboratory has been studying the inspection technology needed for the first step of 'Orbital Maintenance System' (OMS) that maintains space system by inspecting of satellites, re-orbiting useless satellites, and simply repairing satellites in orbit. In this paper, we introduce a re-configurable modular-type manipulator for space utilization, and its control algorithm for the inspection of satellites in orbit.

Shinichi Kimura; Shigeru Tsuchiya; Shinichiro Nishida; Tomoki Takegai

1999-01-01

322

What is 'manipulation'? A reappraisal.  

PubMed

Due primarily to its colloquial function, 'manipulation' is a poor term for distinguishing one healthcare intervention from another. With reports continuing to associate serious adverse events with manipulation, particularly relating to its use in the cervical spine, it is essential that the term be used appropriately and in accordance with a valid definition. The purpose of this paper is to identify empirically-derived features that we propose to be necessary and collectively sufficient for the formation of a valid definition for manipulation. A final definition is not offered. However, arguments for and against the inclusion of features are presented. Importantly, these features are explicitly divided into two categories: the 'action' (that which the practitioner does to the recipient) and the 'mechanical response' (that which occurs within the recipient). The proposed features are: 1) A force is applied to the recipient; 2) The line of action of this force is perpendicular to the articular surface of the affected joint; 3) The applied force creates motion at a joint; 4) This joint motion includes articular surface separation; 5) Cavitation occurs within the affected joint. PMID:20080431

Evans, David W; Lucas, Nicholas

2010-06-01

323

Manipulation of Biofilm Microbial Ecology  

SciTech Connect

The biofilm mode of growth provides such significant advantages to the members of the consortium that most organisms in important habitats are found in biofilms. The study of factors that allow manipulation of biofilm microbes in the biofilm growth state requires that reproducible biofilms be generated. The most effective monitoring of biofilm formation, succession and desaturation is with on-line monitoring of microbial biofilms with flowcell for direct observation. The biofilm growth state incorporates a second important factor, the heterogeneity in distribution in time and space of the component members of the biofilm consortium. This heterogeneity is reflected not only in the cellular distribution but in the metabolic activity within a population of cells. Activity and cellular distribution can be mapped in four dimensions with confocal microscopy, and function can be ascertained by genetically manipulated reporter functions for specific genes or by vital stains. The methodology for understanding the microbial ecology of biofilms is now much more readily available and the capacity to manipulate biofilms is becoming an important feature of biotechnology.

White, D.C.; Palmer, R.J., Jr.; Zinn, M.; Smith, C.A.; Burkhalter, R.; Macnaughton, S.J.; Whitaker, K.W.; Kirkegaard, R.D.

1998-08-15

324

Earth orbital teleoperator manipulator system evaluation program  

NASA Technical Reports Server (NTRS)

The operator's ability to perform five manipulator tip movements while using monoptic and stereoptic video systems was assessed. Test data obtained were compared with previous results to determine the impact of camera placement and stereoptic viewing on manipulator system performance. The tests were performed using the NASA MSFC extendible stiff arm Manipulator and an analog joystick controller. Two basic manipulator tasks were utilized. The minimum position change test required the operator to move the manipulator arm to touch a target contract. The dexterity test required removal and replacement of pegs.

Brye, R. G.; Frederick, P. N.; Kirkpatrick, M., III; Shields, N. L., Jr.

1977-01-01

325

Models of remote manipulation in space  

NASA Technical Reports Server (NTRS)

Robots involved in high value manipulation must be effectively coupled to a human operator either at the work-site or remotely connected via communication links. In order to make use of experimental performance evaluation data, models must be developed. Powerful models of remote manipulation by humans can be used to predict manipulation performance in future systems based on today's laboratory systems. In this paradigm, the models are developed from experimental data, and then used to predict performance in slightly different situations. Second, accurate telemanipulation will allow design of manipulation systems which extend manipulation capability beyond its current bounds.

Hannaford, Blake

1991-01-01

326

Failure tolerant operation of kinematically redundant manipulators  

NASA Technical Reports Server (NTRS)

Redundant manipulators may compensate for failed joints with their additional degrees of freedom. In this paper such a manipulator is considered fault tolerant if it can guarantee completion of a task after any one of its joints has failed. This fault tolerance of kinematically redundant manipulators is insured here. Methods to analyze the manipulator's work space find regions inherently suitable for critical tasks because of their high level of failure tolerance. Constraints are then placed on the manipulator's range of motion to guarantee completion of a task.

Lewis, Christopher L.; Maciejewski, Anthony A.

1994-01-01

327

The locating ways of laying pipe manipulator  

NASA Astrophysics Data System (ADS)

The laying pipe manipulator is a new equipment to lay concrete pipe. This kind of manipulator makes the work of laying pipes mechanized and automated. We report here a new laying pipe manipulator. The manipulator has 5 free degrees, and is driven by the hydraulic system. In the paper, one critical question of manipulator is studied: the locating ways of the manipulator to lay concrete pipe. During the process of laying concrete pipe, how to locate the manipulator is realized by the locating system of manipulator. The locating system consists of photoelectric target, laser producer, and computer. According to different construction condition, one or two or three photoelectric targets can be used. During the process of laying concrete pipe, if the interface of pipes are jointed together, and the other segment of pipe deviates from the pipe way, one target can be used, if the angle that the manipulator rotates around the holding pipe's axes is 0°, two targets can be used, three targets can be used at any site. In the paper, according to each locating way, the theory analysis is done. And the mathematical models of the manipulator moving from original position to goal position are obtained by different locating way. And the locating experiment was done. According to the experiment result, the work principle and mathematical models of different locating way was turned out to be well adopted for requirement, the mathematical model of different locating way supplies the basic control theory for the manipulator to lay and joint concrete pipe automatically.

Wang, Dan; Li, Bin; Lei, DongLiang

2010-01-01

328

The locating ways of laying pipe manipulator  

NASA Astrophysics Data System (ADS)

The laying pipe manipulator is a new equipment to lay concrete pipe. This kind of manipulator makes the work of laying pipes mechanized and automated. We report here a new laying pipe manipulator. The manipulator has 5 free degrees, and is driven by the hydraulic system. In the paper, one critical question of manipulator is studied: the locating ways of the manipulator to lay concrete pipe. During the process of laying concrete pipe, how to locate the manipulator is realized by the locating system of manipulator. The locating system consists of photoelectric target, laser producer, and computer. According to different construction condition, one or two or three photoelectric targets can be used. During the process of laying concrete pipe, if the interface of pipes are jointed together, and the other segment of pipe deviates from the pipe way, one target can be used, if the angle that the manipulator rotates around the holding pipe's axes is 0°, two targets can be used, three targets can be used at any site. In the paper, according to each locating way, the theory analysis is done. And the mathematical models of the manipulator moving from original position to goal position are obtained by different locating way. And the locating experiment was done. According to the experiment result, the work principle and mathematical models of different locating way was turned out to be well adopted for requirement, the mathematical model of different locating way supplies the basic control theory for the manipulator to lay and joint concrete pipe automatically.

Wang, Dan; Li, Bin; Lei, Dongliang

2009-12-01

329

Risk of Orthopedic Surgical Site Infections in Patients with Rheumatoid Arthritis Treated with Antitumor Necrosis Factor Alfa Therapy  

PubMed Central

Introduction. International guidelines recommend interruption of anti-TNF medications in the perioperative period, but there are no randomized trials to support such recommendation. Objectives. To study literature evidence assessing the risk of surgical site infections in orthopedic surgery patients with RA using anti-TNF drugs, compared to untreated patients or those using conventional DMARD. Methods. Systematic review of cohort studies is concerning surgical site infections in orthopedic procedures in patients with RA. Results. Three studies were selected. Only one was considered of high-quality, albeit with low statistical power. The review resulted in inconclusive data, since the best quality study showed no significant differences between groups, while others showed increased risk of infections in patients using anti-TNF medications. Conclusion. It is unclear whether patients with RA using anti-TNF medications are at increased risk of surgical site infections. Randomized controlled trials or new high quality observational studies are needed to clarify the issue. PMID:22500176

da Cunha, Bernardo Matos; Maria Henrique da Mota, Licia; dos Santos-Neto, Leopoldo Luiz

2012-01-01

330

Improvement of corrosion resistance and antibacterial effect of NiTi orthopedic materials by chitosan and gold nanoparticles  

NASA Astrophysics Data System (ADS)

Biocomposite consists of gold nanoparticles (AuNPs) and a natural polymer as Chitosan (CS) was electrodeposited over NiTi alloy to improve biocompatibility, biostability, surface corrosion resistance and antibacterial effect for orthopedic implantation. The forming process and surface morphology of this biocomposite coats over NiTi alloy were studied. The results showed that the nm-scale gold particles were embedded in the composite forming compact, thick and smooth coat. Elemental analysis revealed significant less Ni ion release from the coated NiTi alloy compared with the uncoated one by 20 fold. Furthermore, the electrochemical corrosion measurements indicated that AuNPs/CS composite coat was effective for improving corrosion resistance in different immersion times and at all pH values, which suggests that the coated NiTi alloys have potential for orthopedic applications. Additionally, the efficiencies of the biocomposite coats for inhibiting bacterial growth indicate high antibacterial effect.

Ahmed, Rasha A.; Fadl-allah, Sahar A.; El-Bagoury, Nader; El-Rab, Sanaa M. F. Gad

2014-02-01

331

Drilling sounds are used by surgeons and intermediate residents, but not novice orthopedic trainees, to guide drilling motions  

PubMed Central

Background The purpose of our study was to investigate the impact of distracting noise on the performance on a simulated orthopedic bone drilling skill when that noise blocks routine auditory feedback associated with the sounds of the drill. Methods Medical students (n = 11), intermediate residents (postgraduate years 3–5, n = 10) and surgeons (n = 8) each drilled 20 bicortical holes in a femur bone from a lamb: 10 holes without and 10 holes with the presence of distracting noise. We quantified surgical outcome in the form of plunge depth using computer-assisted objective methods. Results Novice participants plunged more than did the intermediate trainees and surgeons (p < 0.001). With the addition of distracting noise, the plunges of both intermediate residents and surgeons were affected. Conclusion Distracting noise impairs orthopedic bone drilling performance, and the ability to use drilling sounds to guide drilling motions is part of surgical expertise. PMID:19057732

Praamsma, Monate; Carnahan, Heather; Backstein, David; Veillette, Christian J.H.; Gonzalez, David; Dubrowski, Adam

2008-01-01

332

Algorithm For Control Of Underactuated Manipulators  

NASA Technical Reports Server (NTRS)

Algorithm for improved control of underactuated multiple-link robotic manipulators developed via spatial-algebra-operator approach. Aspects of this approach described in several previous articles in NASA Tech Briefs-most recently "Robot Control Based on Spatial-Operator Algebra" (NPO-17918). Underactuated manipulator has fewer actuators than it has degrees of freedom. Complexity of underactuated systems managed by unified analysis. It has implications for fault-tolerant control, and many practical manipulators underactuated. Examples include manipulators with flexible joints and/or flexible links; space/underwater robots; manipulators that operate with some actuators that turned off because of failure or because of need to conserve energy; manipulators that grasp objects loosely, and manipulators that grasp objects with internal degrees of freedom (e.g., plungers, rollers).

Jain, Abhinandan; Rodriguez, Guillermo

1994-01-01

333

Magnesium Sulfate and Sufentanil for Patient-Controlled Analgesia in Orthopedic Surgery  

PubMed Central

Background: Postoperative analgesia is one of the concerns of anesthesiologists and patients. Systemic opioid administration is the gold standard in reducing the severe pain after the surgery but some side effects prevent the use of adequate dosage of opioids. Objectives: The aim of this study was to evaluate the result of adding magnesium sulphate to sufentanil in patient-controlled intravenous analgesia (PCIA) system. Patients and Methods: In this randomized clinical trial, 60 patients candidate for lower limb orthopedic surgery were recruited in Poursina Medical Center for six months. They were randomly classified in two group of patient-controlled intravenous analgesia for postoperative pain control, one was group S [(sufentanil) (n = 30)] and the other was group S + M [(magnesium sulphate/sufentanil) (n = 30)]. The drug infusion rate was 5 mL/h. Each mL of solution in group S contained 1 mcg of sufentanil and in group M + S, 1 mcg of sufentanil and 200 mcg magnesium sulphate, respectively. Pain score, sedation score, satisfaction score, nausea and vomiting score were evaluated 6, 12, 24, 36 and 48 hours after surgery. Results: The demographic data between two groups were not significantly different. The pain scores after 6, 12 and 24 hours in S and S + M groups were significantly different. But the comparison of Visual Analogue Scale (VAS) scores after 36 and 48 hours didn’t show significant differences (P < 0.001). Comparison of the sedation, nausea and vomiting scores between two groups did not show any difference. But the number of patient’s satisfaction in S + M group was more than S group which suggests significant differences (P < 0.05). Conclusions: This study showed that magnesium sulphate added to sufentanil through PCIA is an effective method to alleviate pain in patients undergoing lower limb orthopedic surgery. Moreover, we found fewer side effects on magnesium-sufentanil regimen in terms of in nausea, vomiting, and sedation; and patients’ satisfaction in this regimen was more rather than that in the regiment of sufentanil alone. PMID:24660152

Sedighinejad, Abass; Haghighi, Mohammad; Naderi Nabi, Bahram; Rahimzadeh, Poupak; Mirbolook, Ahmadreza; Mardani-Kivi, Mohsen; Nekufard, Majid; Biazar, Gelareh

2014-01-01

334

Measurement of the concentration and size of aerosol particles and identification of the sources in orthopedic surgeries  

Microsoft Academic Search

In this study, the measurement of the concentration and size of particles and the identification of their sources were carried out at five orthopedic surgeries. The aerosol concentration and particle size distribution, ranging from 0.3 ?m–10 ?m, were measured and related to the type of indoor activity. The handling of surgical linen and gowns, handling of the patient, use of electrosurgical apparatus,

Marcelo Luiz Pereira; Rogério Vilain; Tomaz Puga Leivas; Arlindo Tribess

2012-01-01

335

The immediate effects of thoracic spine and rib manipulation on subjects with primary complaints of shoulder pain.  

PubMed

Shoulder pain is a common orthopedic condition seen by physical therapists, with many potential contributing factors and proposed treatments. Although manual physical therapy interventions for the cervicothoracic spine and ribs have been investigated for this patient population, the specific effects of these treatments have not been reported. The purpose of this investigational study is to report the immediate effects of thoracic spine and rib manipulation in patients with primary complaints of shoulder pain. Using a test-retest design, 21 subjects with shoulder pain were treated during a single treatment session with high-velocity thrust manipulation to the thoracic spine or upper ribs. Post-treatment effects demonstrated a 51% (32mm) reduction in shoulder pain, a corresponding increase in shoulder range of motion (30 degrees -38 degrees ), and a mean patient-perceived global rating of change of 4.2 (median 5). These immediate post-treatment results suggest that thoracic and rib manipulative therapy is associated with improved shoulder pain and motion in patients with shoulder pain, and further these interventions support the concept of a regional interdependence between the thoracic spine, upper ribs, and shoulder. PMID:20140154

Strunce, Joseph B; Walker, Michael J; Boyles, Robert E; Young, Brian A

2009-01-01

336

Optimal Culture Incubation Time in Orthopedic Device-Associated Infections: a Retrospective Analysis of Prolonged 14-Day Incubation  

PubMed Central

Accurate diagnosis of orthopedic device-associated infections can be challenging. Culture of tissue biopsy specimens is often considered the gold standard; however, there is currently no consensus on the ideal incubation time for specimens. The aim of our study was to assess the yield of a 14-day incubation protocol for tissue biopsy specimens from revision surgery (joint replacements and internal fixation devices) in a general orthopedic and trauma surgery setting. Medical records were reviewed retrospectively in order to identify cases of infection according to predefined diagnostic criteria. From August 2009 to March 2012, 499 tissue biopsy specimens were sampled from 117 cases. In 70 cases (59.8%), at least one sample showed microbiological growth. Among them, 58 cases (82.9%) were considered infections and 12 cases (17.1%) were classified as contaminations. The median time to positivity in the cases of infection was 1 day (range, 1 to 10 days), compared to 6 days (range, 1 to 11 days) in the cases of contamination (P < 0.001). Fifty-six (96.6%) of the infection cases were diagnosed within 7 days of incubation. In conclusion, the results of our study show that the incubation of tissue biopsy specimens beyond 7 days is not productive in a general orthopedic and trauma surgery setting. Prolonged 14-day incubation might be of interest in particular situations, however, in which the prevalence of slow-growing microorganisms and anaerobes is higher. PMID:24153117

Wahl, Peter; Fracheboud, Dominique; Gautier, Emanuel

2014-01-01

337

Porous orthopedic steel implant as an antibiotic eluting device: prevention of post-surgical infection on an ovine model.  

PubMed

Traumatology and orthopedic surgery can benefit from the use of efficient local antibiotic-eluting systems to avoid bacterial contamination of implanted materials. In this work a new percutaneous porous-wall hollow implant was successfully used as a local antibiotic-eluting device both in vitro and in vivo. The implant is a macroporous 316 L stainless steel filter tube with a nominal filtration cut-off size of 200 nm with one open end which was used to load the synthetic antibiotic linezolid and an opposite blind end. The antibiotic release kinetics from the device on a simulated biological fluid under in vitro conditions demonstrated an increased concentration during the first five days that subsequently was sustained for at least seven days, showing a kinetic close to a zero order release. Antibiotic-loaded implants were placed in the tibia of four sheep which were trans-surgically experimentally infected with a biofilm forming strain of Staphylococcus aureus. After 7 and 9 days post infection, sheep did not show any evidence of infection as demonstrated by clinical, pathological and microbiological findings. These results demonstrate the capability of such an antibiotic-loaded implant to prevent infection in orthopedic devices in vivo. Further research is needed to assess its possible use in traumatology and orthopedic surgery. PMID:23651643

Gimeno, Marina; Pinczowski, Pedro; Vázquez, Francisco J; Pérez, Marta; Santamaría, Jesús; Arruebo, Manuel; Luján, Lluís

2013-08-16

338

Collagen Self-Assembly on Orthopedic Magnesium Biomaterials Surface and Subsequent Bone Cell Attachment  

PubMed Central

Magnesium (Mg) biomaterials are a new generation of biodegradable materials and have promising potential for orthopedic applications. After implantation in bone tissues, these materials will directly interact with extracellular matrix (ECM) biomolecules and bone cells. Type I collagen, the major component of bone ECM, forms the architecture scaffold that provides physical support for bone cell attachment. However, it is still unknown how Mg substrate affects collagen assembly on top of it as well as subsequent cell attachment and growth. Here, we studied the effects of collagen monomer concentration, pH, assembly time, and surface roughness of two Mg materials (pure Mg and AZ31) on collagen fibril formation. Results showed that formation of fibrils would not initiate until the monomer concentration reached a certain level depending on the type of Mg material. The thickness of collagen fibril increased with the increase of assembly time. The structures of collagen fibrils formed on semi-rough surfaces of Mg materials have a high similarity to that of native bone collagen. Next, cell attachment and growth after collagen assembly were examined. Materials with rough surface showed higher collagen adsorption but compromised bone cell attachment. Interestingly, surface roughness and collagen structure did not affect cell growth on AZ31 for up to a week. Findings from this work provide some insightful information on Mg-tissue interaction at the interface and guidance for future surface modifications of Mg biomaterials. PMID:25303459

Zhao, Nan; Zhu, Donghui

2014-01-01

339

Development of nanofluorapatite polymer-based composite for bioactive orthopedic implants and prostheses  

PubMed Central

Fluorapatite with low solubility is a promising biomaterial due to its structure, which is similar to hydroxyapatite. In this study a bioactive composite of nanofluorapatite (n-FA) and polyamide 12 (PA12) was fabricated. The results revealed that the mechanical properties (such as compressive strength and elastic modulus), hydrophilicity, and antibacterial properties of n-FA/PA12 composite were obviously improved by adding n-FA into PA12 as compared with PA12. In addition, cell proliferation of MC3T3-E1 cells cultured on n-FA/PA12 composite was significantly higher than with PA12, and alkaline phosphatase activity of MC3T3-E1 cells on the n-FA/PA12 composite was expressed at obviously higher levels as compared with PA12. The results suggest that n-FA/PA12 composite could support cell proliferation and differentiation, showing good cytocompatibility. Histological evaluation indicates that n-FA/PA12 composite enhances the efficiency of new bone formation with the introduction of n-FA into PA12, and the quantity of the newly formed bone for n-FA/PA12 composite is significantly higher than with PA12. In conclusion, n-FA/PA12 composite exhibits good biocompatibility and osteogenesis, which might be used for various orthopedic prostheses and dental implants. PMID:25143735

Hu, Gangfeng; Wang, Hui; Yao, Xiaocong; Bi, Dawei; Zhu, Gang; Tang, Songchao; Wei, Jie; Yang, Lili; Tong, Peijian; Xiao, Luwei

2014-01-01

340

Laser deposition and deformation behavior of Ti-Nb-Zr-Ta alloys for orthopedic implants.  

PubMed

Microstructure and mechanical properties of laser deposited complex quaternary Ti-34Nb-7Zr-7Ta (all wt%), an orthopedic load-bearing implant alloy, has been investigated in detail in both as-deposited as well as heat-treated (?-solutionized and quenched) conditions. The difference in stress-strain behavior of this alloy in the above conditions has been characterized using scanning electron microscopy (SEM), orientation imaging microscopy (OIM™) and transmission electron microscopy (TEM). Compared to the sample in heat-treated condition, the as-deposited sample showed evidence of strong growth related texture. Again in the as-deposited post tensile-tested condition formation of a high density of shear bands, possibly arising from slip localization due to shearing of ? precipitates in the ? matrix is observed. TEM investigations also show the presence of lenticular shaped deformation induced ? phase within the shear bands. In contrast, in case of the ?-solutionized sample, twinning and the formation of stress-induced plates appears to be the primary mode of deformation. The change in deformation mechanism and thus the tensile property of this alloy could be attributed to the crystallographic texture along the growth direction as well as diffusion mediated isothermal ? precipitates, that cause an enrichment of Nb and Ta in the ? matrix, during the laser-deposition process. This is no longer present after the solutionizing treatment. PMID:23137619

Nag, S; Banerjee, R

2012-12-01

341

Cyclodextrin-erythromycin complexes as a drug delivery device for orthopedic application  

PubMed Central

Background Erythromycin, a hydrophobic antibiotic used to treat infectious diseases, is now gaining attention because of its anti-inflammatory effects and ability to inhibit osteoclasts formation. The aim of this study was to explore a cyclodextrin-erythromycin (CD-EM) complex for sustained treatment of orthopedic inflammation. Methods and results Erythromycin was reacted with ?-cyclodextrin to form a nonhost-guest CD-EM complex using both kneading and stirring approaches. Physiochemical measurement data indicated that erythromycin and cyclodextrin formed a packing complex driven by intermolecular forces instead of a host-guest structure due to the limited space in the inner cavity of ?-cyclodextrin. The CD-EM complex improved the stability of erythromycin in aqueous solution and had a longer duration of bactericidal activity than free erythromycin. Cytotoxicity and cell differentiation were evaluated in both murine MC3T3 preosteoblast cells and RAW 264.7 murine macrophage cells. The CD-EM complex was noncytotoxic and showed significant inhibition of osteoclast formation but had little effect on osteoblast viability and differentiation. Conclusion These attributes are especially important for the delivery of an adequate amount of erythromycin to the site of periprosthetic inflammation and reducing local inflammation in a sustained manner. PMID:22228990

Song, Wei; Yu, Xiaowei; Wang, Sunxi; Blasier, Ralph; Markel, David C; Mao, Guangzhao; Shi, Tong; Ren, Weiping

2011-01-01

342

[Surgical treatment of orthopedic deformities due to spasticity in the lower limb].  

PubMed

Orthopedic deformities in the lower limb concern all joints (hip, knee, ankle, foot) with a wide range of clinical forms. Spasticity, contracture, stiffness, laxity, neurological deficit are assessed to establish the surgical procedure. Surgical techniques are adapted to the goals that are detailed with the patient and his family: standing, transferring, walking, hygiene, devices (shoes, orthosis, canes, wheelchair). Surgical procedures can associate: lengthening of contractured muscles (tenotomy with or without sutures, fractional lengthening at the musculo-tendinous junction or desinsertion), strengthening of antagonists (passive or active tendon transfer) and correction of joint deformity (arthrolysis, arthrodesis, arthroplasty). In adults, the most common deformities are the equinus or equinovarus foot, toe curling, hip adductum, knee flessum. Talus or knee recurvatum are less frequently observed. The association of various deformities raises questions concerning the hierarchy of surgical procedure, from an anatomical point of view (do we start with proximal or distal joint first?) as from chronological concerns (shall we do one or more procedures?). Pluridisciplinary assessment using neurological anesthetic blocs and dynamic EMG or gait analysis is necessary to detail the aims of surgery and choose the surgical procedures. PMID:12746709

Denormandie, P; Kiefer, C; Mailhan, L; Even-Schneider, A; Sorriaux, G; Martin, J-N; Judet, T

2003-05-01

343

Neuro-orthopedic management of the dysfunctional extremity in upper motor neuron syndromes.  

PubMed

Orthopedic surgery can help restore extremity function to many patients with upper motor neuron syndromes (UMN). Impairments are divided into those that cause problems with the active function of the extremity versus those that impede passive function. Limb deformities commonly result from both dynamic (spastic) and static (contractural) components. Clinical examination supplemented with dynamic electromyographic studies provides the optimal information for planning the most effective surgical procedures. In the upper extremity, selective lengthening of the shoulder adductors and extensors combined with elbow flexor lengthening can improve forward reach. Lengthening of the forearm pronators and finger flexors will improve hand use. In the lower extremity, standing balance is improved with widening the base of support by correcting hip adduction contractures and equinovarus foot deformities. Improvement of knee flexion during swing phase by a rectus femoris to gracilis transfer will enhance the fluidity and efficiency of walking. Correction of hip and knee flexion contractures will allow a upright posture and dramatically decrease the energy requirement of walking. PMID:16046936

Hebela, N; Keenan, M A E

2004-06-01

344

Extracorporeal shock wave therapy in orthopedics, basic research, and clinical implications  

NASA Astrophysics Data System (ADS)

The molecular events following shock wave treatment of bone are widely unknown. Nevertheless patients with osteonecrosis and non unions are already treated partly successful with shock waves. Concerning the first indication, the question of the permeation of the shock wave into the bone was addressed. Therefore shockwaves were applied to porcine femoral heads and the intraosseous pressure was measured. A linear correlation of the pressure to the intraosseous distance was found. Approximately 50% of the pressure are still measurable 10 mm inside the femoral head. These findings should encourage continued shock wave research on this indication. Concerning the second indication (non union), osteoblasts were subjected to 250 or 500 shock waves at 25 kV. After 24, 48, and 72 h the levels of the bone and vascular growth factors bFGF, TGFbeta1, and VEGF were examined. After 24 h there was a significant increase in bFGF levels (p<0.05) with significant correlation (p<0.05) to the number of impulses. TGFbeta1, and VEGF showed no significant changes. This may be one piece in the cascade of new bone formation following shock wave treatment and may lead to a more specific application of shock waves in orthopedic surgery.

Hausdorf, Joerg; Jansson, Volkmar; Maier, Markus; Delius, Michael

2005-04-01

345

In vitro study of nanostructured diopside coating on Mg alloy orthopedic implants.  

PubMed

The high corrosion rate of Mg alloys has hindered their application in various areas, particularly for orthopedic applications. In order to decrease the corrosion rate and to improve the bioactivity, mechanical stability and cytocompatibility of the Mg alloy, nanostructured diopside (CaMgSi2O6) has been coated on AZ91 Mg alloy using a combined micro arc oxidation (MAO) and electrophoretic deposition (EPD) method. The crystalline structure, the morphology and the composition of the samples were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). Electrochemical corrosion test, immersion test, and compression test were used to evaluate the corrosion resistance, the in vitro bioactivity and the mechanical stability of the samples, respectively. The cytocompatibility of the samples was tested by the cell viability and the cell attachment of L-929 cells. The results confirmed that the diopside coating not only slows down the corrosion rate, but also enhances the in vitro bioactivity, mechanical stability and cytocompatibility of AZ91 Mg alloy. Therefore, Mg alloy coated with nanostructured diopside offers a promising approach for biodegradable bone implants. PMID:24907750

Razavi, Mehdi; Fathi, Mohammadhossein; Savabi, Omid; Vashaee, Daryoosh; Tayebi, Lobat

2014-08-01

346

Development of Portland cement for orthopedic applications, establishing injectability and decreasing setting times.  

PubMed

The injectability of Portland cement (PC) with calcium chloride and calcium nitrate additives was investigated using a syringe with a 2 mm aperture for potential clinical applications such as vertebroplasty. Addition of either additive at 10 wt % increased the quantity of cement extruded through the syringe from approximately 25 wt % for the PC standard, to over 95 wt %. 10 wt % additions of either additive also decreased setting times from over 2 h to below 25 min. The compressive strength of the modified cements was all greater than the compressive strength of a human vertebral body. Decreasing either additive to 5 wt % generated compressive strengths after 24 h setting equal to polymethylmethacrylate, the cement used for the majority of vertebroplasty procedures. An initial early exotherm in the chloride cements was coupled with an X-ray diffraction (XRD) peak that indicated the early formation of the ettringite cement phase. In contrast, Fourier transform infrared (FTIR) spectroscopy and XRD data indicated that calcium nitrate may have stimulated early calcium silicate hydrate (C-S-H) production (the main strength producing phase of PC). Combining the two additives produced a synergistic effect with cements having increased injectabilities and compressive strengths compared with either addition used individually. This study has demonstrated that by modifying PC with nonproprietary chemicals it was possible to significantly increase cement injectability and reduce setting times whilst maintaining compressive strengths, making PC suitable for potential orthopedic applications. PMID:22887643

Wynn-Jones, Gareth; Shelton, Richard M; Hofmann, Michael P

2012-11-01

347

[Application of the hydrogen washout technique to orthopedic research (author's transl)].  

PubMed

Since the first description by Aukland and co-authors in 1964, the hydrogen washout has been shown to be an accurate method in determining regional tissue blood flow. The presence of hydrogen molecules within the tissue is detected with a platinum electrode where a small amount of current is generated by oxidation of molecular hydrogen to hydrogen ions. Therefore, construction of the suitable electrode for the tissue to be measured is essential. The author applied the hydrogen washout technique to the blood flow measurement of bone, muscle, skin, digit and peripheral nerve, and found that the technique was valuable in basic and clinical studies in orthopedics. As a typical experimental study using the hydrogen washout technique, the study on the effect of adrenaline on bone blood flow was presented and the experimental method was explained in detail. Although the hydrogen washout technique has been developed to measure the blood flow, the technique has been found useful in detecting the pathways of microcirculation between different tissues. As an example, the study on nutritional pathways of the intervertebral disk was described. Since the hydrogen gas is harmless, it is possible to apply the technique to the clinical studies including the blood flow measurement of replanted digits, diagnosis of the compartment syndrome and the blood flow measurement of skin flaps. Furthermore, several problems in the hydrogen washout technique were discussed. PMID:7310209

Ogata, K

1981-08-01

348

Isocyanate Exposure Assessment Combining Industrial Hygiene Methods with Biomonitoring for End Users of Orthopedic Casting Products  

PubMed Central

Previous studies have suggested a potential risk to healthcare workers applying isocyanate-containing casts, but the authors reached their conclusions based on immunological or clinical pulmonology test results alone. We designed a study to assess potential exposure to methylene diphenyl diisocyanate (MDI) among medical personnel applying orthopedic casts using two different application methods. Air, dermal, surface, and glove permeation sampling methods were combined with urinary biomonitoring to assess the overall risk of occupational asthma to workers handling these materials. No MDI was detected in any of the personal and area air samples obtained. No glove permeation of MDI was detected. A small proportion of surface (3/45) and dermal wipe (1/60) samples were positive for MDI, but were all from inexperienced technicians. Urinary metabolites of MDI [methylenedianiline (MDA)] were detected in three of six study participants prior to both a ‘dry’ and ‘wet’ application method, five of six after the dry method, and three of six after the wet method. All MDA results were below levels noted in worker or general populations. Our conclusion is that the risk of MDI exposure is small, but unquantifiable. Because there is some potential risk of dermal exposure, medical personnel are instructed to wear a minimum of 5-mil-thick (5 mil = 0.005 inches) nitrile gloves and avoid contact to unprotected skin. This could include gauntlets, long sleeves, and/or a laboratory coat. PMID:23680587

Pearson, Ronald L.

2013-01-01

349

Isocyanate exposure assessment combining industrial hygiene methods with biomonitoring for end users of orthopedic casting products.  

PubMed

Previous studies have suggested a potential risk to healthcare workers applying isocyanate-containing casts, but the authors reached their conclusions based on immunological or clinical pulmonology test results alone. We designed a study to assess potential exposure to methylene diphenyl diisocyanate (MDI) among medical personnel applying orthopedic casts using two different application methods. Air, dermal, surface, and glove permeation sampling methods were combined with urinary biomonitoring to assess the overall risk of occupational asthma to workers handling these materials. No MDI was detected in any of the personal and area air samples obtained. No glove permeation of MDI was detected. A small proportion of surface (3/45) and dermal wipe (1/60) samples were positive for MDI, but were all from inexperienced technicians. Urinary metabolites of MDI [methylenedianiline (MDA)] were detected in three of six study participants prior to both a 'dry' and 'wet' application method, five of six after the dry method, and three of six after the wet method. All MDA results were below levels noted in worker or general populations. Our conclusion is that the risk of MDI exposure is small, but unquantifiable. Because there is some potential risk of dermal exposure, medical personnel are instructed to wear a minimum of 5-mil-thick (5 mil = 0.005 inches) nitrile gloves and avoid contact to unprotected skin. This could include gauntlets, long sleeves, and/or a laboratory coat. PMID:23680587

Pearson, Ronald L; Logan, Perry W; Kore, Anita M; Strom, Constance M; Brosseau, Lisa M; Kingston, Richard L

2013-07-01

350

Synthesis of spherical calcium phosphate particles for dental and orthopedic applications  

PubMed Central

Calcium phosphate materials have been used increasingly in the past 40 years as bone graft substitutes in the dental and orthopedic fields. Accordingly, numerous fabrication methods have been proposed and used. However, the controlled production of spherical calcium phosphate particles remains a challenge. Since such particles are essential for the synthesis of pastes and cements delivered into the host bone by minimally-invasive approaches, the aim of the present document is to review their synthesis and applications. For that purpose, production methods were classified according to the used reagents (solutions, slurries, pastes, powders), dispersion media (gas, liquid, solid), dispersion tools (nozzle, propeller, sieve, mold), particle diameters of the end product (from 10 nm to 10 mm), and calcium phosphate phases. Low-temperature calcium phosphates such as monetite, brushite or octacalcium phosphate, as well as high-temperature calcium phosphates, such as hydroxyapatite, ?-tricalcium phosphate or tetracalcium phosphate, were considered. More than a dozen production methods and over hundred scientific publications were discussed. PMID:23719177

Bohner, Marc; Tadier, Solène; van Garderen, Noémie; de Gasparo, Alex; Döbelin, Nicola; Baroud, Gamal

2013-01-01

351

Biomaterial Co-Cr-Mo Alloys Nano Coating Calcium Phosphate Orthopedic Treatment  

NASA Astrophysics Data System (ADS)

The modem study a thermal martensitic transformation of biomedical Co-Cr-Mo alloys and ultimately offers large elongation to failure while maintaining high strength. In the future study, structural evolution and dislocation slip as an elementary process in the martensitic transformation in Co-Cr-Mo alloys were investigated to reveal the origin of their enhanced phase stability due to nitrogen addition and coating of calcium phosphate specimens with and without nitrogen addition were prepared. The N-doped alloys had a single-phase matrix, whereas the N-free alloys had a duplex microstructure. Irrespective of the nitrogen content, dislocations frequently dissociated into Shockley partial dislocations with stacking faults. The Nano range coating of calcium phosphate function as obstacles to the glide of partial dislocations and consequently significantly affect the kinetics of the martensitic transformation. As a result, the formation of marten site plays a crucial role in plastic deformation and wear behavior, the developed nanostructures modification associated with nitrogen addition must be a promising strategy for highly durable orthopedic implants.

Palaniappan, N.; Inwati, Gajendra Kumar; Singh, Man

2014-08-01

352

The use of novel oral anticoagulants for thromboprophylaxis after elective major orthopedic surgery  

PubMed Central

Venous thromboembolism is a common cause of morbidity and mortality among patients undergoing elective orthopedic surgery. Due to the high incidence of venous thromboembolism in this setting, perioperative anticoagulation is the recommended approach for thromboprophylaxis. Low molecular weight heparin (LMWH), fondaparinux and warfarin are the agents commonly used for thromboprophylaxis. The well-recognized limitations of warfarin and the inconvenience and discomfort associated with the subcutaneous administration of low molecular weight heparin and fondaparinux inspired intense investigation to develop novel oral anticoagulants (NOACs) with more predictable pharmacokinetics, fewer drug interactions and no need for regular laboratory monitoring. Three NOACs have been demonstrated to be effective for thromboprophylaxis after total hip arthroplasty (THA) and total knee arthroplasty (TKA) in large randomized controlled trials. Here we review the pharmacology of rivaroxaban, dabigatran, and apixaban, summarize the major clinical trials of these agents in thromboprophylaxis after THA and TKA, and discuss the clinical factors to be considered by providers when selecting a NOAC for their patients. PMID:24219550

Rachidi, Saleh; Aldin, Ehab Saad; Greenberg, Charles; Sachs, Barton; Streiff, Michael; Zeidan, Amer M

2014-01-01

353

Novel Approaches for Treating Musculoskeletal Diseases: Molecular Orthopedics and Systems Medicine  

PubMed Central

Molecular medicine uses knowledge about cell structure and function for disease, diagnostics, stage characterisation and treatment. The advent of genomic technologies is considerably leading to developments in the field of molecular medicine. The accumulation of detailed information about gene expression, epigenetic variability, protein transcription and functional modulation is contributing to a new era in medicine. Rapid and early diagnostic procedures, molecular characterisation of degenerative and proliferative diseases and personalized therapies are predicted to lead to advancements in health prevention and treatment of disease. Diagnostic tools and therapies based on local and /or general modulation of cellular processes for traumatic or degenerative musculoskeletal conditions are becoming available. A logical consequence of the information derived from extensive data gathering, systems biology and systemic medicine has lead to significant improvements in understanding biological structure and function in a simultaneous bottom top and integrative, holistic manner. The description of disease mechanism at an intimate, subcellular level has a dual benefit. A thorough understanding of the crosstalk involved in molecular pathways both in the normal and the diseased state are expanding scientific knowledge and simultaneously are enabling design cell-targeted and individualized therapies. This paper presents a brief overview of current molecular based treatments available to the orthopedic surgeon and introduces the concept of systemic medicine from the perspective of musculoskeletal pathology. PMID:23798982

Mashayekhi, Kaveh; O’Brien, Margaret; Zugun-Eloae, Florin; Labusca, Luminita

2013-01-01

354

Development of nanofluorapatite polymer-based composite for bioactive orthopedic implants and prostheses.  

PubMed

Fluorapatite with low solubility is a promising biomaterial due to its structure, which is similar to hydroxyapatite. In this study a bioactive composite of nanofluorapatite (n-FA) and polyamide 12 (PA12) was fabricated. The results revealed that the mechanical properties (such as compressive strength and elastic modulus), hydrophilicity, and antibacterial properties of n-FA/PA12 composite were obviously improved by adding n-FA into PA12 as compared with PA12. In addition, cell proliferation of MC3T3-E1 cells cultured on n-FA/PA12 composite was significantly higher than with PA12, and alkaline phosphatase activity of MC3T3-E1 cells on the n-FA/PA12 composite was expressed at obviously higher levels as compared with PA12. The results suggest that n-FA/PA12 composite could support cell proliferation and differentiation, showing good cytocompatibility. Histological evaluation indicates that n-FA/PA12 composite enhances the efficiency of new bone formation with the introduction of n-FA into PA12, and the quantity of the newly formed bone for n-FA/PA12 composite is significantly higher than with PA12. In conclusion, n-FA/PA12 composite exhibits good biocompatibility and osteogenesis, which might be used for various orthopedic prostheses and dental implants. PMID:25143735

Hu, Gangfeng; Wang, Hui; Yao, Xiaocong; Bi, Dawei; Zhu, Gang; Tang, Songchao; Wei, Jie; Yang, Lili; Tong, Peijian; Xiao, Luwei

2014-01-01

355

Arterial and Venous Thrombosis following Trauma and Major Orthopedic Surgery: Molecular Mechanisms and Strategies for Intervention.  

PubMed

A variety of harmful effects can be triggered by trauma and major orthopedic surgery. One of the key players involved in this process is thrombin. The clinical consequence of this process has, for several decades, been considered to be formation of deep vein thrombosis and pulmonary embolism. Controlling thrombin generation and activation has therefore been the goal of thromboprophylaxis regimens administered to patients suffering from trauma or undergoing major surgery. Protecting patients from venous thromboembolism has, for many years, been the main goal of preventive strategies. However, our knowledge of cell destruction and release of substances that may cause organ damage has expanded in recent years. Release of molecules such as RNA and histones from destroyed tissues may cause cell destruction and organ damage at distal sites if released in huge amounts and disseminated systemically. This new knowledge points toward an unmet need for therapies that prevent both vascular events and organ deterioration. This article briefly reviews molecular mechanisms associated with the occurrence of vascular events and cellular destruction in patients with major bone damage caused by trauma. PMID:25703244

Dahl, Ola E; Harenberg, Job; Wexels, Fredrik; Preissner, Klaus T

2015-03-01

356

Mathematical Outcomes and Working Memory in Children With TBI and Orthopedic Injury  

PubMed Central

This study compared mathematical outcomes in children with predominantly moderate to severe traumatic brain injury (TBI; n =50) or orthopedic injury (OI; n=47) at 2 and 24 months post-injury. Working memory and its contribution to math outcomes at 24 months post-injury was also examined. Participants were administered an experimental cognitive addition task and standardized measures of calculation, math fluency, and applied problems; as well as experimental measures of verbal and visual-spatial working memory. Although children with TBI did not have deficits in foundational math fact retrieval, they performed more poorly than OIs on standardized measures of math. In the TBI group, performance on standardized measures was predicted by age at injury, socioeconomic status, and the duration of impaired consciousness. Children with TBI showed impairments on verbal, but not visual working memory relative to children with OI. Verbal working memory mediated group differences on math calculations and applied problems at 24 months post-injury. Children with TBI have difficulties in mathematics, but do not have deficits in math fact retrieval, a signature deficit of math disabilities. Results are discussed with reference to models of mathematical cognition and disability and the role of working memory in math learning and performance for children with TBI. PMID:23164058

Raghubar, Kimberly P.; Barnes, Marcia A.; Prasad, Mary; Johnson, Chad P.; Ewing-Cobbs, Linda

2013-01-01

357

Mathematical outcomes and working memory in children with TBI and orthopedic injury.  

PubMed

This study compared mathematical outcomes in children with predominantly moderate to severe traumatic brain injury (TBI; n550) or orthopedic injury (OI; n547) at 2 and 24 months post-injury. Working memory and its contribution to math outcomes at 24 months post-injury was also examined. Participants were administered an experimental cognitive addition task and standardized measures of calculation, math fluency, and applied problems; as well as experimental measures of verbal and visual-spatial working memory. Although children with TBI did not have deficits in foundational math fact retrieval, they performed more poorly than OIs on standardized measures of math. In the TBI group, performance on standardized measures was predicted by age at injury, socioeconomic status, and the duration of impaired consciousness. Children with TBI showed impairments on verbal, but not visual working memory relative to children with OI. Verbal working memory mediated group differences on math calculations and applied problems at 24 months post-injury. Children with TBI have difficulties in mathematics, but do not have deficits in math fact retrieval, a signature deficit of math disabilities. Results are discussed with reference to models of mathematical cognition and disability and the role of working memory in math learning and performance for children with TBI. PMID:23164058

Raghubar, Kimberly P; Barnes, Marcia A; Prasad, Mary; Johnson, Chad P; Ewing-Cobbs, Linda

2013-03-01

358

Bending and abrasion fatigue of common suture materials used in arthroscopic and open orthopedic surgery.  

PubMed

In orthopedic surgery, the reattachment of tendon to bone requires suture materials that have stable and durable properties to allow time for healing at the tendon-bone interface. The suture, not rigidly restrained within the anchor eyelet, is free to move during surgery and potentially after surgery with limb motion. During such movement, the suture is subjected to bending and frictional forces that can lead to fatigue-induced failure. We investigated some common contemporary commercial number-two-grade suture materials and evaluated their resistance to bending abrasion fatigue and the consequent failure. Sutures were oscillated over a stainless steel wire at low frequency under load. Number of abrasion cycles to failure, changes in suture morphology, and fatigue-failure method was recorded for each material. Suture structure had a significant effect on abrasion resistance, with braided sutures containing large numbers of fine high tenacity core filaments performing 15-20 times better than other braided suture structures. Ultra high molecular weight polyethylene (UHMWPE) core filaments resisted bending abrasion failure better than other core materials due to the load spreading and abrasion resistance of these filaments. Sutures with UHMWPE cores also had high resistance to tensile failure. Limited correlation was observed between tensile strength and abrasion resistance. PMID:22777625

Savage, Earle; Hurren, Christopher J; Slader, Simon; Khan, Lukman A K; Sutti, Alessandra; Page, Richard S

2013-01-01

359

Evaluation of hemostatic changes using thromboelastography after crystalloid or colloid fluid administration during major orthopedic surgery  

PubMed Central

The effects of Ringer lactate, 6% hydroxyethyl starch (130/0.4) or 4% succinylated gelatin solutions on perioperative coagulability were measured by thromboelastography (TEG). Seventy-five patients (ASA I-III) who were to undergo major orthopedic procedures performed under epidural anesthesia were included in the study. Patients were randomly divided into three groups of 25 each for the administration of maintenance fluids: group RL (Ringer lactate), group HES (6% hydroxyethyl starch 130/0.4), and group JEL (4% gelofusine solution). Blood samples were obtained during the perioperative period before epidural anesthesia (t1, baseline), at the end of the surgery (t2), and 24?h after the operation (t3). TEG data, reaction time (R), coagulation time (K), angle value (?), and maximum amplitude (MA) were recorded. TEG parameters changed from normal values in all patients. In group RL, R and K times decreased compared to perioperative values while the ? angle and MA increased (P < 0.05). In group HES, R and K times increased, however, the ? angle and MA decreased (P < 0.05). In group JEL, R time increased (P < 0.05), but K time, ? angle and MA did not change significantly. In the present study, RL, 6% HES (130/0.4) and 4% JEL solutions caused changes in the coagulation system of all patients as measured by TEG, but these changes remained within normal limits. PMID:22666779

Topçu, I.; Çivi, M.; Öztürk, T.; Kele?, G.T.; Çoban, S.; Yentür, E.A.; Okçu, G.

2012-01-01

360

Bisphosphonate-Based Strategies for Bone Tissue Engineering and Orthopedic Implants  

PubMed Central

Bisphosphonates (BPs) are a group of well-established drugs that are applied in the development of metabolic bone disorder-related therapies. There is increasing interest also in the application of BPs in the context of bone tissue engineering, which is the topic of this review, in which an extensive overview of published studies on the development and applications of BPs-based strategies for bone regeneration is provided with special focus on the rationale for the use of different BPs in three-dimensional (3D) bone tissue scaffolds. The different alternatives that are investigated to address the delivery and sustained release of these therapeutic drugs in the nearby tissues are comprehensively discussed, and the most significant published approaches on bisphosphonate-conjugated drugs in multifunctional 3D scaffolds as well as the role of BPs within coatings for the improved fixation of orthopedic implants are presented and critically evaluated. Finally, the authors' views regarding the remaining challenges in the fields and directions for future research efforts are highlighted. PMID:22440082

Cattalini, Juan Pablo; Boccaccini, Aldo R.; Lucangioli, Silvia

2012-01-01

361

Computer-assisted and robotic surgery in orthopedics: where we are in 2014.  

PubMed

Successful outcomes after orthopedic surgical procedures are believed to be highly dependent on reproducible anatomic accuracy. Immediate intraoperative feedback helps surgeons to achieve this accuracy as has been demonstrated with the use of fluoroscopy. Non-image-based computer navigation has been used in joint arthroplasty, anterior cruciate ligament reconstruction, high tibial osteotomy, and cartilage procedures along with applications in hip and shoulder arthroscopy. Most short-term studies have demonstrated superior accuracy when compared with conventional techniques; however, very few studies have shown better clinical outcomes. Robotic-assisted surgery has been most popular in total and unicompartmental arthroplasty, which again has greater accuracy but similar clinical outcomes when compared with conventional techniques. Economic analyses indicate that these high-cost technologies may only be cost-effective in high-volume centers. Other studies have shown that computer navigation improves the accuracy of lower volume surgeons to a greater degree than higher volume surgeons allowing the former to have results similar to the latter. PMID:25370874

Goradia, Vipool K

2014-12-01

362

Synthesis of spherical calcium phosphate particles for dental and orthopedic applications.  

PubMed

Calcium phosphate materials have been used increasingly in the past 40 years as bone graft substitutes in the dental and orthopedic fields. Accordingly, numerous fabrication methods have been proposed and used. However, the controlled production of spherical calcium phosphate particles remains a challenge. Since such particles are essential for the synthesis of pastes and cements delivered into the host bone by minimally-invasive approaches, the aim of the present document is to review their synthesis and applications. For that purpose, production methods were classified according to the used reagents (solutions, slurries, pastes, powders), dispersion media (gas, liquid, solid), dispersion tools (nozzle, propeller, sieve, mold), particle diameters of the end product (from 10 nm to 10 mm), and calcium phosphate phases. Low-temperature calcium phosphates such as monetite, brushite or octacalcium phosphate, as well as high-temperature calcium phosphates, such as hydroxyapatite, ?-tricalcium phosphate or tetracalcium phosphate, were considered. More than a dozen production methods and over hundred scientific publications were discussed. PMID:23719177

Bohner, Marc; Tadier, Solène; van Garderen, Noémie; de Gasparo, Alex; Döbelin, Nicola; Baroud, Gamal

2013-01-01

363

[Evaluation of the effectiveness of anecaine in central segmental blockades in orthopedic-traumatologic interventions].  

PubMed

Efficacy of anecaine (A) (bupivacaine, Pliva) and marcaine (M) (bupivacaine, Astra) in central neuroaxial block combined with sedation is compared. In the group with epidural block (n = 167, ASA I-III), 102 patients were given anecaine and 65 marcaine in equivalent doses. In the group with spinal block (n = 82, ASA I-III), anecaine was administered to 52 and marcaine to 30 patients. In the epidural block group a catheter was placed at L2-3 or L3-4 with cranial direction. A test dose of bupivacaine (20 mg) was followed after 5-7 min by the main dose of 2 mg.kg-20 mg. Propofol was given for partial suppression of consciousness at a continuous infusion rate 1.6 mg.kg.hr. In spinal block group, bolus dose of bupivacaine (10-20 mg) was injected through the subarachnoidal approach at L2-3 or L3-4. Diazepam (0.1 mg.kg.hr) was used for sedation. Block onset, duration of sensor and motor block, and of effective analgesia were evaluated in all groups. Hemodynamics and respiratory function were monitored. Moderate hypotension (16-17% decline from basic values) was observed in all patients irrespective of bupivacaine brand. In a comparative non-randomized study anecaine showed a faster onset of block and longer duration of clinical effect than marcaine in epidural and spinal anesthesia for orthopedic surgery on the lower limbs. PMID:9693427

Mizikov, V M; Kukolev, D V; Galanté, V P; Lovtsevich, N V; Mokhov, A E; Abakumova, L Ia

1998-01-01

364

Nanoparticulate zinc oxide as a coating material for orthopedic and dental implants.  

PubMed

Orthopedic and dental implants are prone to infection. In this study, we describe a novel system using zinc oxide nanoparticles (nZnO) as a coating material to inhibit bacterial adhesion and promote osteoblast growth. Electrohydrodynamic atomisation (EHDA) was employed to deposit mixtures of nZnO and nanohydroxyapatite (nHA) onto the surface of glass substrates. Nano-coated substrates were exposed to Staphylococcus aureus suspended in buffered saline or bovine serum to determine antimicrobial activity. Our results indicate that 100% nZnO and 75% nZnO/25% nHA composite-coated substrates have significant antimicrobial activity. Furthermore, osteoblast function was explored by exposing cells to nZnO. UMR-106 cells exposed to nZnO supernatants showed minimal toxicity. Similarly, MG-63 cells cultured on nZnO substrates did not show release of TNF-? and IL-6 cytokines. These results were reinforced by both proliferation and differentiation studies which revealed that a substrate coated with exclusively nZnO is more efficient than composite surface coatings. Finally, electron and light microscopy, together with immunofluorescence staining, revealed that all cell types tested, including human mesenchymal cell (hMSC), were able to maintain normal cell morphology when adhered onto the surface of the nano-coated substrates. Collectively, these findings indicate that nZnO can, on its own, provide an optimal coating for future bone implants that are both antimicrobial and biocompatible. PMID:24862288

Memarzadeh, Kaveh; Sharili, Amir S; Huang, Jie; Rawlinson, Simon C F; Allaker, Robert P

2015-03-01

365

Technology for concrete pipe manipulator  

NASA Astrophysics Data System (ADS)

The pipe manipulator is a developing mechatronic system to enhance productivity and protects workers from cave-ins in the trench while excavating and laying pipe. The pipe manipulator is for installing concrete pipe into the trench. It is an optical-electro-mechanical system. The mechanism is make up of two parts, the upside and underside. The upside is for lifting the equipment by backhoe and rotating the underside mechanism. It includes rigidity lift beams, holding pad, four-bar linkages, hydraulic cylinder, rotating support, and rotating mechanism. Holding pad will press the bucket back to keep the bucket hooking the pipe man safely and stably. The underside mechanism is for lifting, holding and adjusting the pipe section's stance. The underside mechanism includes support trolley, and lift fork. The support trolley is driven by hydraulic cylinder for moving the fork forward or backward while laying a pipe into trench. The fork is with a self-lock mechanism for preventing the pipe from slide out of the prongs. A new photoelectric locating system is developed for auto-measuring the installing pipe section's stance within the work area. The laser target has been developed as a key part in the photoelectric locating systems. The photoelectric target is a rotating polar coordinate. Photodiodes are used for making the polar radius. There is an angular displacement sensor sitting on the heart-axis of the target for measuring angle of the target rotating. The pipe manipulator can be located by the system, and the locating methods have been presented at last of the paper.

Li, Bin; Wang, Dan; Lin, Renzhi

2009-12-01

366

Technology for concrete pipe manipulator  

NASA Astrophysics Data System (ADS)

The pipe manipulator is a developing mechatronic system to enhance productivity and protects workers from cave-ins in the trench while excavating and laying pipe. The pipe manipulator is for installing concrete pipe into the trench. It is an optical-electro-mechanical system. The mechanism is make up of two parts, the upside and underside. The upside is for lifting the equipment by backhoe and rotating the underside mechanism. It includes rigidity lift beams, holding pad, four-bar linkages, hydraulic cylinder, rotating support, and rotating mechanism. Holding pad will press the bucket back to keep the bucket hooking the pipe man safely and stably. The underside mechanism is for lifting, holding and adjusting the pipe section's stance. The underside mechanism includes support trolley, and lift fork. The support trolley is driven by hydraulic cylinder for moving the fork forward or backward while laying a pipe into trench. The fork is with a self-lock mechanism for preventing the pipe from slide out of the prongs. A new photoelectric locating system is developed for auto-measuring the installing pipe section's stance within the work area. The laser target has been developed as a key part in the photoelectric locating systems. The photoelectric target is a rotating polar coordinate. Photodiodes are used for making the polar radius. There is an angular displacement sensor sitting on the heart-axis of the target for measuring angle of the target rotating. The pipe manipulator can be located by the system, and the locating methods have been presented at last of the paper.

Li, Bin; Wang, Dan; Lin, Renzhi

2010-01-01

367

Effect of repeated manipulation on range of motion in patients with stiff total knee arthroplasty.  

PubMed

Although manipulation under anesthesia (MUA) has been considered effective first-line treatment for stiff total knee arthroplasty (TKA), there is no consensus regarding the usefulness of repeated MUA. The purpose of this study was to investigate the usefulness of repeated MUA performed for patients in whom satisfactory range of motion (ROM) was not achieved by MUA. The authors retrospectively reviewed 15 patients who underwent repeated MUA after failure of initial MUA for stiff TKA. Demographic and ROM data were collected. A final ROM of less than 90° was considered a failed manipulation (failure group) and a final ROM of 90° or more was considered a successful manipulation (success group). Average pre-repeated MUA ROM (72.3°±19.5°) immediately improved to 112.3°±9.7° (P<.001) in the operating room, and final ROM was 89.6°±23.9°, an overall gain of 17.3° (P=.04). However, despite this overall ROM increase, a successful final ROM (90° or more) was achieved in approximately half of patients (7 of 13; 54%). There were no significant differences in demographics between the success and failure groups, except that there was significantly less pre-TKA ROM in the failure group (P=.02). There were no complications related to either the first or the repeated MUA procedures. The findings of this study suggest that repeated MUA can improve overall ROM for stiff TKA. The success rate of repeated MUA was less than that of primary MUA; however, it is a useful treatment modality for stiff TKA. Decreased pre-TKA ROM appeared to be associated with poor outcomes after repeated MUA. [Orthopedics. 2015; 38(3):e157-e162.]. PMID:25760501

Choi, Ho-Rim; Siliski, John M; Malchau, Henrik; Kwon, Young-Min

2015-03-01

368

Validation of Orthopedic Postoperative Pain Assessment Methods for Dogs: A Prospective, Blinded, Randomized, Placebo-Controlled Study  

PubMed Central

In the context of translational research, there is growing interest in studying surgical orthopedic pain management approaches that are common to humans and dogs. The validity of postoperative pain assessment methods is uncertain with regards to responsiveness and the potential interference of analgesia. The hypothesis was that video analysis (as a reference), electrodermal activity, and two subjective pain scales (VAS and 4A-VET) would detect different levels of pain intensity in dogs after a standardized trochleoplasty procedure. In this prospective, blinded, randomized study, postoperative pain was assessed in 25 healthy dogs during a 48-hour time frame (T). Pain was managed with placebo (Group 1, n?=?10), preemptive and multimodal analgesia (Group 2, n?=?5), or preemptive analgesia consisting in oral tramadol (Group 3, n?=?10). Changes over time among groups were analyzed using generalized estimating equations. Multivariate regression tested the significance of relationships between pain scales and video analysis. Video analysis identified that one orthopedic behavior, namely ‘Walking with full weight bearing’ of the operated leg, decreased more in Group 1 at T24 (indicative of pain), whereas three behaviors indicative of sedation decreased in Group 2 at T24 (all p<0.004). Electrodermal activity was higher in Group 1 than in Groups 2 and 3 until T1 (p<0.0003). The VAS was not responsive. 4A-VET showed divergent results as its orthopedic component (4A-VETleg) detected lower pain in Group 2 until T12 (p<0.0009), but its interactive component (4A-VETbeh) was increased in Group 2 from T12 to T48 (p<0.001). Concurrent validity established that 4A-VETleg scores the painful orthopedic condition accurately and that pain assessment through 4A-VETbeh and VAS was severely biased by the sedative side-effect of the analgesics. Finally, the video analysis offered a concise template for assessment in dogs with acute orthopedic pain. However, subjective pain quantification methods and electrodermal activity need further investigation. PMID:23166681

Rialland, Pascale; Authier, Simon; Guillot, Martin; del Castillo, Jérôme R. E.; Veilleux-Lemieux, Daphnée; Frank, Diane; Gauvin, Dominique; Troncy, Eric

2012-01-01

369

Self mobile space manipulator project  

NASA Astrophysics Data System (ADS)

A relatively simple, modular, low mass, low cost robot is being developed for space EVA that is large enough to be independently mobile on a space station or platform exterior, yet versatile enough to accomplish many vital tasks. The robot comprises two long flexible links connected by a rotary joint, with 2-DOF 'wrist' joints and grippers at each end. It walks by gripping pre-positioned attachment points, such as trusswork nodes, and alternately shifting its base of support from one foot (gripper) to the other. The robot can perform useful tasks such as visual inspection, material transport, and light assembly by manipulating objects with one gripper, while stabilizing itself with the other. At SOAR '90, we reported development of 1/3 scale robot hardware, modular trusswork to serve as a locomotion substrate, and a gravity compensation system to allow laboratory tests of locomotion strategies on the horizontal face of the trusswork. In this paper, we report on project progress including the development of: (1) adaptive control for automatic adjustment to loads; (2) enhanced manipulation capabilities; (3) machine vision, including the use of neural nets, to guide autonomous locomotion; (4) locomotion between orthogonal trusswork faces; and (5) improved facilities for gravity compensation and telerobotic control.

Brown, H. Ben; Friedman, Mark; Xu, Yangsheng; Kanade, Takeo

1992-01-01

370

Actuators for a space manipulator  

NASA Technical Reports Server (NTRS)

The robotic manipulator can be decomposed into distinct subsytems. One particular area of interest of mechanical subsystems is electromechanical actuators (or drives). A drive is defined as a motor with an appropriate transmission. An overview is given of existing, as well as state-of-the-art drive systems. The scope is limited to space applications. A design philosophy and adequate requirements are the initial steps in designing a space-qualified actuator. The focus is on the d-c motor in conjunction with several types of transmissions (harmonic, tendon, traction, and gear systems). The various transmissions will be evaluated and key performance parameters will be addressed in detail. Included in the assessment is a shuttle RMS joint and a MSFC drive of the Prototype Manipulator Arm. Compound joints are also investigated. Space imposes a set of requirements for designing a high-performance drive assembly. Its inaccessibility and cryogenic conditions warrant special considerations. Some guidelines concerning these conditions are present. The goal is to gain a better understanding in designing a space actuator.

Chun, W.; Brunson, P.

1987-01-01

371

Genetic manipulation of Methanosarcina spp.  

PubMed Central

The discovery of the third domain of life, the Archaea, is one of the most exciting findings of the last century. These remarkable prokaryotes are well known for their adaptations to extreme environments; however, Archaea have also conquered moderate environments. Many of the archaeal biochemical processes, such as methane production, are unique in nature and therefore of great scientific interest. Although formerly restricted to biochemical and physiological studies, sophisticated systems for genetic manipulation have been developed during the last two decades for methanogenic archaea, halophilic archaea and thermophilic, sulfur-metabolizing archaea. The availability of these tools has allowed for more complete studies of archaeal physiology and metabolism and most importantly provides the basis for the investigation of gene expression, regulation and function. In this review we provide an overview of methods for genetic manipulation of Methanosarcina spp., a group of methanogenic archaea that are key players in the global carbon cycle and which can be found in a variety of anaerobic environments. PMID:22837755

Kohler, Petra R. A.; Metcalf, William W.

2012-01-01

372

Mobile remote manipulator vehicle system  

NASA Technical Reports Server (NTRS)

A mobile remote manipulator system is disclosed for assembly, repair and logistics transport on, around and about a space station square bay truss structure. The vehicle is supported by a square track arrangement supported by guide pins integral with the space station truss structure and located at each truss node. Propulsion is provided by a central push-pull drive mechanism that extends out from the vehicle one full structural bay over the truss and locks drive rods into the guide pins. The draw bar is now retracted and the mobile remote manipulator system is pulled onto the next adjacent structural bay. Thus, translation of the vehicle is inchworm style. The drive bar can be locked onto two guide pins while the extendable draw bar is within the vehicle and then push the vehicle away one bay providing bidirectional push-pull drive. The track switches allow the vehicle to travel in two orthogonal directions over the truss structure which coupled with the bidirectional drive, allow movement in four directions on one plane. The top layer of this trilayered vehicle is a logistics platform. This platform is capable of 369 degees of rotation and will have two astronaut foot restraint platforms and a space crane integral.

Bush, Harold G. (inventor); Mikulas, Martin M., Jr. (inventor); Wallsom, Richard E. (inventor); Jensen, J. Kermit (inventor)

1987-01-01

373

Precise control of flexible manipulators  

NASA Technical Reports Server (NTRS)

The design and experimental testing of end point position controllers for a very flexible one link lightweight manipulator are summarized. The latest upgraded version of the experimental set up, and the basic differences between conventional joint angle feedback and end point position feedback are described. A general procedure for application of modern control methods to the problem is outlined. The relationship between weighting parameters and the bandwidth and control stiffness of the resulting end point position closed loop system is shown. It is found that joint rate angle feedback in addition to the primary end point position sensor is essential for adequate disturbance rejection capability of the closed loop system. The use of a low order multivariable compensator design computer code; called Sandy is documented. A solution to the problem of control mode switching between position sensor sets is outlined. The proof of concept for endpoint position feedback for a one link flexible manipulator was demonstrated. The bandwidth obtained with the experimental end point position controller is about twice as fast as the beam's first natural cantilevered frequency, and comes within a factor of four of the absolute physical speed limit imposed by the wave propagation time of the beam.

Cannon, R. H., Jr.; Bindford, T. O.; Schmitz, E.

1984-01-01

374

Adaptive complaint motion control for dexterous manipulators  

SciTech Connect

This article presents two adaptive schemes for compliant motion control of dexterous manipulators. The first scheme is developed using an adaptive impedance control approach for torque-controlled manipulators, whereas the second strategy is an adaptive admittance controller for position-controlled manipulators. The proposed controllers are very general and computationally efficient, as they do not require knowledge of the manipulator dynamic model or parameter values of the manipulator or the environment and are implemented without calculation of the inverse dynamics or inverse kinematic trans formation. It is shown that the control strategies are globally stable in the presence of bounded disturbances and that in the absence of disturbances the ultimate bound on the size of the system errors can be made arbitrarily small. The capabilities of the proposed control schemes are illustrated through both computer simulations and laboratory experiments with a dexterous Robotics Research Corporation seven-degrees-of-freedom (DOF) manipulator. 17 refs., 4 figs.

Colbaugh, R.; Glass, K. [New Mexico State Univ., Las Cruces, NM (United States); Seraji, H. [California Inst. of Technology, Pasadena, CA (United States)

1995-06-01

375

Mobile manipulator configuration optimization using evolutionary programming  

SciTech Connect

Multi-degree-of-freedom manipulators are becoming commonplace on mobile platforms. Full autonomy of mobile manipulator robotic systems will depend on the ability to resolve the inherent kinematic redundancy in task commutation. This work investigates the application of an evolutionary search strategy for determining near-optimal mobile manipulator configurations. Joint torques, obstacle avoidance and manipulability are incorporated in a multi-criteria optimization formulation. A variety of aspects of the evolutionary programming paradigm are addressed via empirical studies on a two degree-of-freedom (DOF) manipulator. These studies investigate full configuration vector versus partial configuration vector mutation as well as mutation strategies which incorporate cost and iteration number. The results of this study are then applied to a planar three DOF manipulator mounted on a single DOF mobile base. Experiments indicate that the configuration optimization problem is amenable to a variety of mutation strategies.

McDonnell, J.R.; Andersen, B.L.; Page, W.C. (Naval Command, Control and Ocean Surveillance Center, San Diego, CA (United States)); Pin, F.G. (Oak Ridge National Lab., TN (United States))

1992-01-01

376

Mobile manipulator configuration optimization using evolutionary programming  

SciTech Connect

Multi-degree-of-freedom manipulators are becoming commonplace on mobile platforms. Full autonomy of mobile manipulator robotic systems will depend on the ability to resolve the inherent kinematic redundancy in task commutation. This work investigates the application of an evolutionary search strategy for determining near-optimal mobile manipulator configurations. Joint torques, obstacle avoidance and manipulability are incorporated in a multi-criteria optimization formulation. A variety of aspects of the evolutionary programming paradigm are addressed via empirical studies on a two degree-of-freedom (DOF) manipulator. These studies investigate full configuration vector versus partial configuration vector mutation as well as mutation strategies which incorporate cost and iteration number. The results of this study are then applied to a planar three DOF manipulator mounted on a single DOF mobile base. Experiments indicate that the configuration optimization problem is amenable to a variety of mutation strategies.

McDonnell, J.R.; Andersen, B.L.; Page, W.C. [Naval Command, Control and Ocean Surveillance Center, San Diego, CA (United States); Pin, F.G. [Oak Ridge National Lab., TN (United States)

1992-11-01

377

Research on a Reconfigurable Modular Manipulator System  

SciTech Connect

Research has been conducted on developing the theoretical basis and the technology for a Reconfigurable Modular Manipulation System (RMMS). Unlike a conventional manipulator which has a fixed configuration, the RMMS consists of a set of interchangeable modules that can be rapidly assembled into a system of manipulators with appropriate configurations depending on the specific task requirement. For effective development and use of such a versatile and flexible system a program of theoretical and experimental research has been pursued aimed at developing the basis for next generation of autonomous manipulator systems. The RMMS concept extends the idea of autonomy from sensor-based to configuration based autonomy. One of the important components is the development of design methodologies for mapping tasks into manipulator configurations and for automatic generation of manipulator specific algorithms (e.g., kinematics and dynamics) in order to make the hardware transparent to the user.(JDB)

Khosla, P.K.; Kanade, T.

1992-01-01

378

Robust manipulator controller specification and design  

NASA Technical Reports Server (NTRS)

This paper suggests the use of a model based control law which uses joint rate feedback to stabilize the contact modes, and joint velocity feedforward to provide the required freespace performance throughout a task. An additional benefit of this controller is the capability to stiffen a soft manipulator. This provides an option for impedance control to provide any desired manipulator stiffness. Impedance control is implemented as an outer Cartesian loop which uses the dynamic relationship between manipulator commanded position and applied force to change the mechanical impedance through programmable filter coefficients. The impedance control discussed in this paper does not give the capability to specify the full impedance of the manipulator. However, it does give the capability to specify the manipulator Cartesian stiffness while maintaining stability in contact with the environment. This controller was designed for the Flight Telerobotic Servicer dextrous manipulator and has been validated experimentally on a single joint controller, as well as on 3 DOF planar arms.

Goldenberg, Stewart; Clark, William

1992-01-01

379

Autonomous manipulation on a robot: Summary of manipulator software functions  

NASA Technical Reports Server (NTRS)

A six degree-of-freedom computer-controlled manipulator is examined, and the relationships between the arm's joint variables and 3-space are derived. Arm trajectories using sequences of third-degree polynomials to describe the time history of each joint variable are presented and two approaches to the avoidance of obstacles are given. The equations of motion for the arm are derived and then decomposed into time-dependent factors and time-independent coefficients. Several new and simplifying relationships among the coefficients are proven. Two sample trajectories are analyzed in detail for purposes of determining the most important contributions to total force in order that relatively simple approximations to the equations of motion can be used.

Lewis, R. A.

1974-01-01

380

Bracing micro/macro manipulators control  

SciTech Connect

This paper proposes a bracing strategy for micro/macro manipulators. The bracing micro/macro manipulator can provide advantages in accurate positioning, large work-space, and contact-task capability however, in exchange for improvement in performance one must accept the complex control problem along wit the complex dynamics. This research develops a control scheme for a bracing manipulator which makes multiple contacts with the environment. Experimental results show the feasibility of the proposed ideas for real world applications.

Lew, J.Y. [Pacific Northwest Lab., Richland, WA (United States); Book, W.J. [Georgia Inst. of Tech., Atlanta, GA (United States). School of Mechanical Engineering

1994-05-01

381

Simplified Dynamic Control Of Redundant Manipulators  

NASA Technical Reports Server (NTRS)

Simplified scheme proposed for dynamic control of robotic manipulator having redundant joints; that is, extra degrees of freedom beyond needed to perform task, to position and orient end effector at specified position and/or move it along specified trajectory. Extra degrees of freedom used to perform simultaneous subtask. Scheme adaptive and based on observed performance of manipulator. Involves neither complicated mathematical model of dynamics of manipulator nor time-consuming inverse kinematic transformation.

Seraji, Homayoun

1990-01-01

382

Spatial-Operator Algebra For Robotic Manipulators  

NASA Technical Reports Server (NTRS)

Report discusses spatial-operator algebra developed in recent studies of mathematical modeling, control, and design of trajectories of robotic manipulators. Provides succinct representation of mathematically complicated interactions among multiple joints and links of manipulator, thereby relieving analyst of most of tedium of detailed algebraic manipulations. Presents analytical formulation of spatial-operator algebra, describes some specific applications, summarizes current research, and discusses implementation of spatial-operator algebra in the Ada programming language.

Rodriguez, Guillermo; Kreutz, Kenneth K.; Milman, Mark H.

1991-01-01

383

Impedance Matching for a Serial Link Manipulator  

Microsoft Academic Search

We propose a new index for dynamic performance analysis of serial link manipulators named Impedance Matching Ellipsoid, or IME. Several indexes have been proposed for indicating static and dynamic performance of robot manipu- lators. For example, Dynamic Manipulability Ellipsoid (DME) characterizes distributions of hand acceleration produced by normalized joint torque. Manipulating-Force Ellipsoid (MFE) denotes static torque-force transmission ef£ciency from actuators

Ryo Kurazume; Tsutomu Hasegawa

2004-01-01

384

Research on embedded MAS based manipulator control  

Microsoft Academic Search

Purpose – Presents an embedded MAS (Multi-Agent System) based control method for multi link series manipulators. Design\\/methodology\\/approach – The manipulator's completing operation work is based on several agents' cooperation. The entire embedded MAS of a manipulator is implemented in one ARM7 microprocessor. The multi agents and the communications between the agents are constructed depending on the real-time multitasking capability and

Kejun Ning

2006-01-01

385

Vision-Based Robot Manipulator Design  

Microsoft Academic Search

\\u000a In this paper, a robot with a manipulator, two vision systems, and a three-wheeled omni-directional mobile platform is designed\\u000a and implemented. A shoulder, an elbow, a wrist, and a movable gripper are designed to let the robot manipulator have 5 degrees\\u000a of freedom (DOF). The forward kinematics and inverse kinematics are applied to control the manipulator. The forward kinematics\\u000a is

Ching-Chang Wong; Yi-Jiun Shen; Chih-Cheng Liu; Meng-Tzu Huang; Yu-Ren Huange; Chen-Yuo Yang

386

Generating photo manipulation tutorials by demonstration  

Microsoft Academic Search

We present a demonstration-based system for automatically generating succinct step-by-step visual tutorials of photo manipulations. An author first demonstrates the manipulation using an instrumented version of GIMP that records all changes in interface and application state. From the example recording, our system automatically generates tutorials that illustrate the manipulation using images, text, and annotations. It leverages automated image labeling (recognition

Floraine Grabler; Maneesh Agrawala; Wilmot Li; Mira Dontcheva; Takeo Igarashi

2009-01-01

387

Earth orbital teleoperator manipulator system evaluation program  

NASA Technical Reports Server (NTRS)

The performance of an orbital teleoperator system which includes small dextrous servicing manipulators to be used in satellite servicing was examined. System/operator performance testing was implemented and the results of a fine positioning control test using two different manipulator systems varying widely in manipulator configuration and control systems are presented. Fine position control is viewed as representing a fundamental requirement placed on manipulator control. The relationship of position control to more complex tasks which directly represent on-orbit servicing operations are also presented.

Kirkpatrick, M., III; Shields, N. L., Jr.; Frederick, P. N.; Brye, R.; Malone, T. B.

1975-01-01

388

Culture and Manipulation of Embryonic Cells  

PubMed Central

The direct manipulation of embryonic cells is an important tool for addressing key questions in cell and developmental biology. C. elegans is relatively unique among genetic model systems in being amenable to manipulation of embryonic cells. Embryonic cell manipulation has allowed the identification of cell interactions by direct means, and it has been an important technique for dissecting mechanisms by which cell fates are specified, cell divisions are oriented, and morphogenesis is accomplished. Here, we present detailed methods for isolating, manipulating and culturing embryonic cells of C. elegans. PMID:22226523

Edgar, Lois G.; Goldstein, Bob

2012-01-01

389

Compliant Gripper for a Robotic Manipulator  

NASA Technical Reports Server (NTRS)

A figure depicts a prototype of a robotic-manipulator gripping device that includes two passive compliant fingers, suitable for picking up and manipulating objects that have irregular shapes and/or that are, themselves, compliant. The main advantage offered by this device over other robotic-manipulator gripping devices is simplicity: Because of the compliance of the fingers, force-feedback control of the fingers is not necessary for gripping objects of a variety of sizes, shapes, textures, and degrees of compliance. Examples of objects that can be manipulated include small stones, articles of clothing, and parts of plants.

Cipra, Raymond; Das, Hari

2003-01-01

390

A Recursive Lagrangian Formulation of Manipulator Dynamics  

E-print Network

An efficient Lagrangian formulation of manipulator dynamics has been developed. The efficiency derives from recurrence relations for the velocities, accelerations, and generalized forces. The number of additions and ...

Hollerbach, John M.

1980-06-01

391

Research on reconfigurable and reliable manipulators  

SciTech Connect

We have proposed the concept of reconfigurable manipulators as a solution to tasks that require varied configurations of manipulators. Using modules of varying sizes and performance specifications, it is possible to build manipulators to suit the task at hand. Our research is not only addressing the issue of creating such manipulators but also the interesting theoretical challenges posed in mapping tasks to manipulators. We have developed strategies that allow us to determine the kinematic and dynamic configuration of a non-redundant manipulator from task specifications such as reachability, obstacle avoidance, manipulability, joint, limits, and joint velocities and accelerations. We are presently extending this design methodology for design of redundant and fault tolerant manipulator systems. Further, we are also addressing issues in automatic generation of software for kinematics, dynamics, and controllers for the configured manipulators. During the next year, we will be demonstrating automatic generation of software on the prototype system that we are building. We expect to have 4 joint and link modules available for this demonstration. The joint and link modules will also incorporate concepts for making power and data connections when the mechanical connection is made. Further, they will also include electronics, housed within the module, for communication and real-time control.

Khosla, P.K.; Kanade, T.

1993-01-01

392

Individual differences in manipulation: further studies of an emotional manipulation scale.   

E-print Network

Emotional manipulation is a strategy used by individuals to force the environment into compliance with their goals (St Clair, 1966). This study assessed the factor structure, validity and test-retest reliability of an emotional manipulation measure...

Selfridge, Amy Louise

2008-06-27

393

On stiffening cables of a long reach manipulator  

SciTech Connect

A long reach manipulator will be used for waste remediation in large underground storage tanks. The manipulator`s slenderness makes it flexible and difficult to control. A low-cost and effective method to enhance the manipulator`s stiffness is proposed in this research by using suspension cables. These cables can also be used to accurately measure the position of the manipulator`s wrist.

Wang, S.L.; Santiago, P. [North Carolina A& T State Univ., Greensboro, NC (United States). Dept. of Mechanical Engineering

1996-02-01

394

Mathematical Modeling For Control Of A Flexible Manipulator  

NASA Technical Reports Server (NTRS)

Improved method of mathematical modeling of dynamics of flexible robotic manipulators developed for use in controlling motions of manipulators. Involves accounting for effect, upon modes of vibration of manipulator, of changes in configuration of manipulator and manipulated payload(s). Flexible manipulator has one or more long, slender articulated link(s), like those used in outer space, method also applicable to terrestrial industrial robotic manipulators with relatively short, stiff links, or to such terrestrial machines as construction cranes.

Hu, Anren

1996-01-01

395

Use of commercial manipulator to handle a nuclear weapon component  

SciTech Connect

Pacific Northwest Laboratory (PNL) has developed a manipulator workcell to load and unload nuclear weapon pit assemblies from a cart. To develop this workcell, PNL procured a commercially available manipulator, equipped it with force-sensing and vision equipment, and developed manipulator control software. Manipulator workcell development demonstrated that commercially available manipulator systems can successfully perform this task if the appropriate manipulator is selected and the manipulator workcell tooling and software are carefully designed.

Baker, C.P.

1994-08-01

396

Injectable radiopaque and bioactive polycaprolactone-ceramic composites for orthopedic augmentation.  

PubMed

The aim of this study was to develop and characterize an injectable bone void filler by incorporating baghdadite (Ca3 ZrSi2 O9 ) particles (average size of 1.7 µm) into polycaprolactone (PCL). A series of PCL composites containing different volume percentages of baghdadite [1 (PCL-1%Bag), 5 (PCL-5%Bag), 10 (PCL-10%Bag), 20 (PCL-20%Bag), and 30 (PCL-30%Bag)] were prepared, and their injectability, setting time, mechanical properties, radiopacity, degradation, and cytocompatibility were investigated. PCL, PCL-1%Bag, PCL-5%Bag, and PCL-10%Bag were able to be injected through a stainless steel syringe (Length: 9.0 mm, nozzle diameter: 2.2 mm) at 75°C at injection forces of below 1.5 kN. The core temperature of the injected material at the nozzle exit ranged between 55 and 60°C and was shown to set after 2.5-3.5 min postinjection in a 37°C environment. Injection force, melt viscosity, and radiopacity of the composites increased with increasing baghdadite content. Incorporation of 10-30 vol % baghdadite into PCL increased the compressive strength of the composites from 36 to 47.1 MPa, compared with that for pure PCL (31.4 MPa). Similar trend was found for the compressive modulus of the composites, which increased from 203.8 to 741 MPa, compared with that for pure PCL (205 MPa). Flexural strain of PCL, PCL-5%Bag, and PCL-10%Bag exceeded 30%, and PCL-10%Bag showed the highest flexural strength (29.8 MPa). Primary human osteoblasts cultured on PCL-10%Bag showed a significant upregulation of osteogenic genes compared with pure PCL. In summary, our results demonstrated that PCL-10%Bag could be a promising injectable material for orthopedic and trauma application. © 2014 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2014. PMID:25449121

No, Young Jung; Roohani-Esfahani, Seyed-Iman; Lu, Zufu; Schaer, Thomas; Zreiqat, Hala

2014-11-28

397

An Investigation of Siloxane Cross-linked Hydroxyapatite-Gelatin/Copolymer Composites for Potential Orthopedic Applications†  

PubMed Central

Causes of bone deficiency are numerous, but biomimetic alloplastic grafts provide an alternative to repair tissue naturally. Previously, a hydroxyapatite-gelatin modified siloxane (HAp-Gemosil) composite was prepared by cross-linking (N, N?-bis[(3-trimethoxysilyl)propyl]ethylene diamine (enTMOS) around the HAp-Gel nanocomposite particles, to mimic the natural composition and properties of bone. However, the tensile strength remained too low for many orthopedic applications. It was hypothesized that incorporating a polymer chain into the composite could help improve long range interaction. Furthermore, designing this polymer to interact with the enTMOS siloxane cross-linked matrix would provide improved adhesion between the polymer and the ceramic composite, and improve mechanical properties. To this end, copolymers of L-Lactide (LLA), and a novel alkyne derivatized trimethylene carbonate, propargyl carbonate (PC), were synthesized. Incorporation of PC during copolymerization affects properties of copolymers such as molecular weight, Tg, and % PC incorporation. More importantly, PC monomers bear a synthetic handle, allowing copolymers to undergo post-polymerization functionalization with graft monomers to specifically tailor the properties of the final composite. For our investigation, P(LLA-co-PC) copolymers were functionalized by an azido-silane (AS) via copper catalyzed azide-alkyne cycloaddition (CuAAC) through terminal alkyne on PC monomers. The new functionalized polymer, P(LLA-co-PC)(AS) was blended with HAp-Gemosil, with the azido-silane linking the copolymer to the silsesquioxane matrix within the final composite. These HAp-Gemosil/P(LLA-co-PC)(AS) composites were subjected to mechanical and biological testing, and the results were compared with those from the HAp-Gemosil composites. This study revealed that incorporating a cross-linkable polymer served to increase the flexural strength of the composite by 50%, while maintaining the biocompatibility of HAp-Gemosil ceramics. PMID:23139457

Dyke, Jason Christopher; Knight, Kelly Jane; Zhou, Huaxing; Chiu, Chi-Kai; Ko, Ching-Chang; You, Wei

2012-01-01

398

Elastomeric high-mineral content hydrogel-hydroxyapatite composites for orthopedic applications  

PubMed Central

The design of synthetic bone grafts that mimic the structure and composition of bone and possess good surgical handling characteristics remains a major challenge. We report the development of poly(2-hydroxyethyl methacrylate) (pHEMA)-hydroxyapatite (HA) composites termed “FlexBone” that possess osteoconductive mineral content approximating that of human bone yet exhibit elastomeric properties enabling the press-fitting into a defect site. The approach involves crosslinking pHEMA hydrogel in the presence of HA using viscous ethylene glycol as a solvent. The composites exhibit excellent structural integration between the apatite mineral component and the hydroxylated hydrogel matrix. The stiffness of the composite and the ability to withstand compressive stress correlate with the microstructure and content of the mineral component. The incorporation of porous aggregates of HA nanocrystals rather than compact micrometer-sized calcined HA effectively improved the resistance of the composite to crack propagation under compression. Freeze-dried FlexBone containing 50 wt % porous HA nanocrystals could withstand hundreds-of-megapascals compressive stress and >80% compressive strain without exhibiting brittle fractures. Upon equilibration with water, FlexBone retained good structural integration and withstood repetitive moderate (megapascals) compressive stress at body temperature. When subcutaneously implanted in rats, FlexBone supported osteoblastic differentiation of the bone marrow stromal cells pre-seeded on FlexBone. Taken together, the combination of high osteoconductive mineral content, excellent organic-inorganic structural integration, elasticity, and the ability to support osteoblastic differentiation in vivo makes FlexBone a promising candidate for orthopedic applications. PMID:18546185

Song, Jie; Xu, Jianwen; Filion, Tera; Saiz, Eduardo; Tomsia, Antoni P.; Lian, Jane B.; Stein, Gary S.; Ayers, David C.; Bertozzi, Carolyn R.

2009-01-01

399

Addition of intrathecal Dexamethasone to Bupivacaine for spinal anesthesia in orthopedic surgery  

PubMed Central

Objectives: Spinal anesthesia has the advantage that profound nerve block can be produced in a large part of the body by the relatively simple injection of a small amount of local anesthetic. Intrathecal local anesthetics have limited duration. Different additives have been used to prolong spinal anesthesia. The effect of corticosteroids in prolonging the analgesic effects of local anesthetics in peripheral nerves is well documented. The purpose of this investigation was to determine whether the addition of dexamethasone to intrathecal bupivacaine would prolong the duration of sensory analgesia or not. Methods: We conducted a randomized, prospective, double-blind, case-control, clinical trial. A total of 50 patients were scheduled for orthopedic surgery under spinal anesthesia. The patients were randomly allocated to receive 15 mg hyperbaric bupivacaine 0.5% with 2 cc normal saline (control group) or 15 mg hyperbaric bupivacaine 0.5% plus 8 mg dexamethasone (case group) intrathecally. The patients were evaluated for quality, quantity, and duration of block; blood pressure, heart rate, nausea, and vomiting or other complications. Results: There were no signification differences in demographic data, sensory level, and onset time of the sensory block between two groups. Sensory block duration in the case group was 119±10.69 minutes and in the control group was 89.44±8.37 minutes which was significantly higher in the case group (P<0.001). The duration of analgesia was 401.92±72.44 minutes in the case group; whereas it was 202±43.67 minutes in the control group (P<0.001). The frequency of complications was not different between two groups. Conclusion: This study has shown that the addition of intrathecal dexamethasone to bupivacaine significantly improved the duration of sensory block in spinal anesthesia without any changes in onset time and complications. PMID:22144925

Bani-hashem, Nadia; Hassan-nasab, Bahman; Pour, Ebrahim Alijan; Maleh, Parviz Amri; Nabavi, Aliakbar; Jabbari, Ali

2011-01-01

400

Epidemiology of Hand Injuries in Children Presenting to an Orthopedic Trauma Center in Southeast of Iran  

PubMed Central

Background: Hand injuries are among the most common childhood injuries. No study has been performed regarding the epidemiology of hand injuries in the pediatric population of Iran. This study aimed to examine the epidemiology of hand injuries among children in southeast of Iran. Methods: This cross-sectional study was performed via census sampling on patients, aged 16 years or less, with a final diagnosis of hand injury. Patients presenting to the orthopedic department of Khatam-al-Anbia General Hospitalof Zahedan, Iran, were selected from March 2012 to December 2013. Data were analyzed retrospectively, using a chart review. Results: Two-hundred patients (136 males and 64 females with the mean age of 13±2.8 years) with 205 hand injuries were included in this study. As the results indicated, door-related injuries were the most common type (25%), accounting for 24% and 28% of injuries in male and female patients, respectively (P=0.016). Most injuries occurred at home (64%) and the lowest number was reported at school(22%) (P=0.012). Compared to boys, girls were more likely to be injured at home (78% vs. 57%) (P=0.13). In addition, the dominant hand was mostly injured by doors (28%). The most common type of injury was laceration(81%) and the least common type was finger amputation (7%); also, children with finger amputation were significantly younger than those with other types of hand injuries (P<0.001). Thumb alone (20%) and index and middle fingers together with anequal percentage (3.5%) were the most commonly injured digits. Also, the mean hospitalization cost was 297± 38 dollars. Conclusions: Most hand injuries occurred at home and were door-related; they were also more frequentamong younger children. Prospective studies in order to identify specific protective door devices could potentially decrease the frequency of these injures. PMID:25386587

Mirzaie, Maryam; Parsa, Ali; Salehi, Maryam; Dahmardehei, Mostafa; Moghadam, Mohammad Hallaj; Mirzaie, Neda

2014-01-01

401

Hypomelanosis of Ito presenting with pediatric orthopedic issues: a case report  

PubMed Central

Introduction Hypomelanosis of Ito was originally described as a purely cutaneous disease. Extracutaneous manifestations were described later, forming a neurocutaneous syndrome including skeletal, muscular, ocular and central nervous system symptoms. Hypomelanosis of Ito is characterized by a depigmentation along the lines of Blaschko on the trunk and extremities in certain patterns. The aim of this article was to report another case and give an overview of the related orthopedic symptoms that have been previously described. It was also our wish to contribute with recommendations for consideration with regard to bandages on eczematous rashes, especially on clubfeet. Case presentation A one-and-a-half-month-old boy of Caucasian background born with talipes equinovarus, or clubfoot, on his right foot presented with an eczematous rash after surgical correction and plaster bandaging. Conclusions It is the appearance of hypopigmentation, either alone or in combination with a congenital malformation, particularly central nervous system or musculoskeletal anomalies, which should form the basis of a presumptive diagnosis. This should then lead to further investigations and should always include skin biopsies and a test for chromosomal mosaicism. We report the case of a boy with a clinical picture consisting of a depigmented skin pattern, mental retardation, pes cavus, talipes equinovarus, clinodactyly, eczema, inverted cilia of the eye, strabismus, reduced hearing, ventral hernia, glomerulonephritis, missing testicles, leg length discrepancy with scoliosis, back pain and a syrinx. It is perhaps impossible to make any conclusions about extracutaneous symptoms. However, some symptoms such as retardation, cramps and seizures, delayed development and hypotonia cannot be ignored. Because of the possibility of creating an undesirable and long postoperative period with complications, it is very important to have this diagnosis in mind when deciding to do surgery or not if there are signs of dermatological problems before surgery. In this case, it could also be good clinical practice to test the patient’s reaction to plaster or other bandages. PMID:24886611

2014-01-01

402

Cold and compression in the management of musculoskeletal injuries and orthopedic operative procedures: a narrative review  

PubMed Central

Cold and compression are routinely applied immediately after acute injury or following surgery to alleviate pain, reduce swelling and speed functional recovery. The objective of this literature review is to describe the published clinical findings regarding combined cold and compression therapy in the management of musculoskeletal injuries and after orthopedic operative procedures. Of 33 potential articles triaged, the findings of 21 randomized controlled trials were assessed and summarized. The findings reported by these 21 studies were largely subjective pain outcomes and, to a lesser degree, swelling and range of motion, and were inconsistent and divergent, making it difficult to recommend the most appropriate, effective clinical application of cold and compression. Further, 18 of the 21 reported studies evaluated cold and static compression, where the extent and duration of the compression was not uniform within or across studies. Operative procedures may offer a more controlled environment for rigorous investigations. However, such studies must be powered sufficiently to account for variations in surgical procedure that could affect outcomes. More uniform operative procedures, such as total knee arthroplasty, represent a well circumscribed intervention for studying the clinical utility of cold compression therapy because the operative technique is standardized, surgical tissue damage is extensive, intraoperative blood loss is high, and post-operative edema and pain are severe. Findings from randomized controlled trials of knee arthroplasty generally showed cold compression therapy provides better outcomes such as pain relief than alternative interventions. While the effects of cold and static compression are clearly better than no treatment, they do not appear to be directly additive. PMID:24198548

Block, Jon E

2010-01-01

403

Stanford University: Dextrous Manipulation Laboratory  

NSDL National Science Digital Library

The Dextrous Manipulation Laboratory is a project within the Design Division of the Department of Mechanical Engineering at Stanford University. The website describes some of the lab's past and current projects on robotic hands and tactile sensors, as well as teleoperated hands using haptic information. The two current projects highlighted include work on "a new class of biologically inspired robots" and progress made in developing "a telemanipulation system that allows a person to control a dexterous robotic hand in an intuitive manner." Various conference papers and theses from the Lab are posted online. Project pages provide overviews of the lab's research and development in hardware and software as well as video footage displaying some of its accomplishments. Research methods and system designs are further detailed in the Research sections of the project websites. Links to related course pages, research labs, and images make this a dynamic resource for anyone interested in robotics research.

404

Application of a New Algebraic Manipulator Theory  

Microsoft Academic Search

We have developed a new algebraic manipulator at the Naval Observatory, for application to lunar and planetary theories. The manipulator is quite general in that it is written in IBM FORTRAN IV language, but otherwise is independent of the bit and word structure of any particular computer. If the user desires, the number of polynomial and trigonometric arguments may be

T. C. van Flandern

1982-01-01

405

PASSIVE FEEDFORWARD APPROACH TO BILATERAL TELEOPERATED MANIPULATORS  

E-print Network

PASSIVE FEEDFORWARD APPROACH TO BILATERAL TELEOPERATED MANIPULATORS #3; Perry Y. Li + and Dongjun bilateral teleoperated manipulator system which ensures that the closed loop system is energetically passive, and that the coupling between the system and any strictly passive environment is stable. The control objective

Li, Perry Y.

406

Gezielte Manipulation von Mikropartikeln in einem Plasma  

E-print Network

VIP R&D Gezielte Manipulation von Mikropartikeln in einem Plasma Manipulation of micro¨chen- modifizierung oder Beschichtung, von mi- kro-dispersen Materialien (Pulver, Granu- late, Fasern etc.) in einem Prozessplasma ist das Versta¨ndnis der Plasma-Teilchen- Wechselwirkung von gro�em Interesse. Zu diesem Zweck

Fehske, Holger

407

Experimental study of compliant base manipulator control  

Microsoft Academic Search

When a robotic manipulator is mounted to a crane, boom or mobile platform, it loses its accuracy and speed due to the compliance of the base. The paper presents a simple robust control strategy that will reduce mechanical vibrations and enable better tip positioning. The control algorithm uses sensory feedback of the base oscillation to modulate the manipulator actuators to

Jae Young Lew; Suk-Min Moon

1999-01-01

408

Experimental Simulation of Manipulator Base Compliance  

Microsoft Academic Search

Many future applications of robotic systems will require manipulators to operate from moving vehicles. Such vehicles will be compliant in comparison to the rigid bases on which most manipulators are mounted today. Base compliance can seriously degrade system performance. Statically base compliance may lead to error in the position of the end effector, and dynamically base compliance may interact with

Harry West; Norbert Hootsmans; Steven Dubowsky; Nathan Stelman

1989-01-01

409

Technology and control for hydraulic manipulators  

Microsoft Academic Search

Hydraulic manipulators are candidate for fusion reactor maintenance. Their main advantages are their large payload with respect to volume and mass, their reliability and their robustness. However, due to their force control limitations, they are disqualified for precise manipulation and are dangerous for the environment and themselves in case of unexpected collision. CEA, in collaboration with CYBERNETIX and IFREMER has

Y. Measson; O. David; F. Louveau; J. P. Friconneau

2003-01-01

410

ADAPTIVE FUZZY CONTROL FOR UNDERWATER HYDRAULIC MANIPULATORS  

Microsoft Academic Search

Underwater hydraulic manipulators are usually systems hard to be modeled and present strong non-linearities in its dynamics behavior. These types of manipulators are operated, nowadays, in a master-slave configuration with simple control algorithms performing tasks in hazardous and unstructured environments. In such conditions only low accuracy simple tasks can be performed. This paper presents the application of a special fuzzy

Leonardo Bittencourt Testi; Bruno Cardozo dos Santos; Max Suell Dutra

2004-01-01

411

Correlation matrix memories for knowledge manipulation  

Microsoft Academic Search

Extended Abstract. This talk will describe current w ork in the use of neural networks for fast matching in knowledge manipulation systems. The work builds upon work in the use of binary correlation matrix memories (CMM). Austin 1987, Austin et. al. 1994. The work differs from most of the work in the use of neural networks in kno wledge manipulation,

James Austin

412

Count on It: Congruent Manipulative Displays  

ERIC Educational Resources Information Center

Representations that create informative visual displays are powerful tools for communicating mathematical concepts. The National Council of Teachers of Mathematics encourages the use of manipulatives (NCTM 2000). Manipulative materials are often used to present initial representations of basic numerical principles to young children, and it is…

Morin, Joe; Samelson, Vicki M.

2015-01-01

413

On the Adaptive Control of Robot Manipulators  

Microsoft Academic Search

A new adaptive robot control algorithm is derived, which consists of a PD feedback part and a full dynamics feedfor ward compensation part, with the unknown manipulator and payload parameters being estimated online. The algorithm is computationally simple, because of an effective exploitation of the structure of manipulator dynamics. In particular, it requires neither feedback of joint accelerations nor inversion

Jean-Jacques E. Slotine; Weiping Li

1987-01-01

414

Robot hands and the mechanics of manipulation  

Microsoft Academic Search

The abridged contents include: Kinematic and force analysis of articulated hands: contact - freedom and constraint; contacts in groups; force application and velocity analysis; force error analysis. Manipulator grasping and pushing operations: theory of pushing; application; conclusion. Index. This book, based on the doctoral dissertations of the two authors, examines several aspects of manipulating objects. At present, the authors believe

M. T. Mason; J. K. Jr. Salisbury

1985-01-01

415

Reconfigurable Planar Three-Legged Parallel Manipulators  

E-print Network

planar platforms with three degrees of freedom (DOF) is presented for the first time. The architectureReconfigurable Planar Three-Legged Parallel Manipulators M. John D. Hayes Department of Mechanical to be missing in the body of literature is a planar three-legged parallel manipulator kinematic architecture

Hayes, John

416

Neural-network control of mobile manipulators  

Microsoft Academic Search

In this paper, a neural network (NN)-based methodology is developed for the motion control of mobile manipulators subject to kinematic constraints. The dynamics of the mobile manipulator is assumed to be completely unknown, and is identified online by the NN estimators. No preliminary learning stage of NN weights is required. The controller is capable of disturbance-rejection in the presence of

Sheng Lin; A. A. Goldenberg

2001-01-01

417

Theory and practice: micro manipulating robot  

Microsoft Academic Search

The kinematics of micro manipulating robot is analyzed deeply in this paper. An important feature of micro robot is discovered. i.e. characteristic matrix is a constant matrix. The direct and inverse input\\/output displacement equation, velocity equation, acceleration equation are obtained explicitly. It makes the analysis of the kinematics, dynamic and the control of micro manipulating robot very convenient. Through analyzing

Cai Hegao; Sun Lining; An Hui Jiangsu

1997-01-01

418

Performance Robustness of Manipulator Collision Controller  

NASA Technical Reports Server (NTRS)

In this paper, we propose that the manipulator impact control problem be approached from a stochastic optimal control perspective. The reason is that not only is such approach be able to model uncertainties in contact environment, force sensing, as well as manipulator dynamics, the controllers obtained is optimally robust in terms of performance. This result is verified by analyses and simulations.

Chiu, D.; Lee, S.

1996-01-01

419

Compliant motion control of kinematically redundant manipulators  

Microsoft Academic Search

Two control schemes, termed extended hybrid control and extended impedance control, respectively, are proposed for compliant motion control of redundant manipulators. In the two control schemes, the basic compliant motion task is accomplished while the redundancy is utilized to realize some additional constraints that optimize any user-defined objective function. Some experimental results on a three-DOF planar redundant manipulator are presented

Zhi-Xin Peng; Norihiko Adachi

1993-01-01

420

The ecological significance of manipulative parasites  

Microsoft Academic Search

The diversity of ways in which host manipulation by parasites interferes with ecological and evolutionary processes governing biotic interactions has been recently documented, and indicates that manipulative parasites are full participants in the functioning of eco- systems. Phenotypic alterations in parasitised hosts modify host population ecology, apparent competition processes, food web structure and energy and nutrient flow between habitats, as

Thierry Lefevre; Camille Lebarbenchon; Michel Gauthier-Clerc; Dorothee Misse ´; Robert Poulin; Frederic Thomas

2008-01-01

421

A remote manipulator for forestry operation  

Microsoft Academic Search

The remote manipulator described consists of two arms: a 3-DOF main lifting arm (aerial device), and a 6-DOF robot manipulator (treejib) mounted at the upper end of the aerial device. Each arm is single-joint rate controlled, with the reference joint rate being proportional to the corresponding joint displacement of a corresponding hand controller. Both controllers are kinematically equivalent to each

A. A. Goldenberg; J. Wiercienski; P. Kuzan; C. Szymczyk; R. G. Fenton; B. Shaver

1995-01-01

422

Concurrent redesign of an underactuated robot manipulator  

Microsoft Academic Search

An interesting problem in robotics is to minimize the required time to force a manipulator to travel between two specific points (positioning time). In this paper a concurrent structure-control redesign approach is proposed in order to find the minimum positioning time of an underactuated robot manipulator, by considering a synergetic combination between the structural parameters and a bang–bang control law.

Carlos A. Cruz-Villar; Jaime Alvarez-Gallegos; Miguel G. Villarreal-Cervantes

2009-01-01

423

Manipulative Tendencies of Captive Cebus albifrons  

Microsoft Academic Search

We conducted two experiments to examine the manipulative tendencies of captive Cebus albifrons. In Experiment 1 we examined hand preference for reaching by providing subjects with food either on the cage floor (to facilitate quadrupedal reaching) or at the height of an upright subject's shoulder (to facilitate bipedal reaching). In Experiment 2 we examined combinatorial manipulation by providing subjects with

Gregory Charles Westergaard; Joseph L. Wagner; Stephen J. Suomi

1999-01-01

424

Allergy/hypersensitivity reactions as a predisposing factor to complex regional pain syndrome I in orthopedic patients.  

PubMed

Several predisposing conditions have been associated with complex regional pain syndrome I (CRPS I). The purpose of this study was to determine the relationship between a history of allergy/hypersensitivity reactions and CRPS I in orthopedic patients. Orthopedic patients with CRPS I (n=115) who experienced pain relief after a successful sympathetic nerve blockade were identified for study inclusion; a control group (n=115) matched to the CRPS I group by age, sex, and location of injury was also included. All patients in the study had an average age of 42 years. In the CRPS I group, all participants were Caucasian and the majority (80.8%) were women. The skin of patients with CRPS I was described as fair (57.7%), mottled (57.7%), or sensitive (80.8%). Of the patients with CRPS I, 78 (67.8%) reported a statistically significant history of allergies compared with the 39 (33.9%) patients in the control group (P<.0001). Patients with CRPS I who experienced complete pain relief for at least 1 month following a single sympathetic nerve block were asked to answer a questionnaire (n=35), and some then underwent immediate hypersensitivity testing using a skin puncture technique (n=26). Skin hypersensitivity testing yielded an 83.3% positive predictive value with an accuracy of 76.9%. Based on these results, a positive history for allergy/hypersensitivity reactions is a predisposing condition for CRPS I in this subset of orthopedic patients. These hypersensitivity reactions may prove important in gaining a better understanding in the pathophysiology of CRPS I as a regional pain syndrome. PMID:24762157

Li, Xinning; Kenter, Keith; Newman, Ashley; O'Brien, Stephen

2014-03-01

425

Hemodynamic and oxidative mechanisms of tourniquet-induced muscle injury: near-infrared spectroscopy for the orthopedics setting  

NASA Astrophysics Data System (ADS)

During orthopedic procedures, the tourniquets used to maintain bloodless surgical fields cause ischemia and then reperfusion (I/R), leading to oxidative muscle injury. Established methods exist neither for monitoring orthopedic I/R nor for predicting the extent of tourniquet-associated oxidative injury. To develop a predictive model for tourniquet-associated oxidative muscle injury, this study combined real-time near-infrared spectroscopy (NIRS) monitoring of I/R with Western blotting (WB) for oxidized proteins. We hypothesized strong correlations between NIRS-derived I/R indices and muscle protein oxidation. In 17 patients undergoing ankle fracture repair, a thigh tourniquet was inflated on the injured limb (300 mmHg). Using a continuous-wave (CW) NIRS setup, oxygenated (O2Hb), deoxygenated (HHb), and total (tHb) hemoglobin were monitored bilaterally (tourniquet versus control) in leg muscles. Leg muscle biopsies were collected unilaterally (tourniquet side) immediately after tourniquet inflation (pre) and before deflation (post). Average ischemia duration was 43.2±14.6 min. In post-compared to pre-biopsies, muscle protein oxidation (quantified using WB) increased 172.3%±145.7% (P<0.0005). Changes in O2Hb and tHb were negatively correlated with protein oxidation (respectively: P=0.040, R2=0.25 and P=0.003, R2=0.58). Reoxygenation rate was positively correlated with protein oxidation (P=0.041, R2=0.25). These data indicate that using CW NIRS, it is possible to predict orthopedic tourniquet-associated muscle oxidative injury noninvasively.

Shadgan, Babak; Reid, W. Darlene; Harris, R. Luke; Jafari, Siavash; Powers, Scott K.; O'Brien, Peter J.

2012-08-01

426

Incidence of Deep Vein Thrombosis after Major Lower Limb Orthopedic Surgery: Analysis of a Nationwide Claim Registry  

PubMed Central

Purpose We aimed to evaluate the nationwide incidence and risk factors for symptomatic deep vein thrombosis (DVT) after major lower limb orthopedic surgeries. Materials and Methods The Korean Health Insurance Review and Assessment Service database was used to retrospectively identify International Classification of Disease-10 codes for DVT and operation codes representing hip arthroplasty, knee arthroplasty, and hip fracture surgeries. The age- and gender-adjusted annual incidence of DVT, rates of major lower limb orthopedic surgeries, and the postoperative incidence of DVT according to the surgical procedure were assessed. Results The age- and gender-adjusted annual incidence of DVT was 70.67 per 100000 persons/year. Compared to patients aged <49 years, the relative risk of DVT was five times higher in patients aged 50-69 and 10 times higher in patients aged >70 years (p<0.001). Females showed a greater relative risk for DVT than males (1.08; p<0.001). The incidence of postoperative DVT, according to the type of surgery, was significantly greater for knee replacement arthroplasty than for other forms of surgery (p<0.002). The relative risk of postoperative DVT was higher in females in knee replacement arthroplasty (1.47) and hip fracture surgery (2.25) groups, although relatively lower in those who underwent hip replacement arthroplasty (0.97). Conclusion Among major lower limb surgeries, advanced age, female gender, and undergoing a knee replacement arthroplasty were found to be risk factors for developing postoperative DVT. These findings further emphasize the need for orthopedic surgeons to consider the development of DVT after surgery in high-risk patients. PMID:25510757

Lee, Seung Yeol; Ro, Du Hyun; Chung, Chin Youb; Lee, Kyoung Min; Kwon, Soon-Sun; Sung, Ki Hyuk

2015-01-01

427

Internal Force-Based Impedance Control for Cooperating Manipulators  

Microsoft Academic Search

Internal force-based impedance control for cooperat- ing manipulators controls the motion of the objects being manipulated and the internal force on the objects by enforcing a relationship between the velocity of each manipulator and the internal force on the manipulated objects. Each manipulator is directly given the properties of an impedance by the controller, thus, eliminating the need to have

Robert G. Bonitz; Tien C. Hsia

1993-01-01

428

Improving Children's Listening Comprehension with a Manipulation Strategy  

Microsoft Academic Search

The authors examined the cognitive benefits of physical manipulation. Participants were 76 kindergarten and first-grade students randomly assigned to 2 strategies: stories with pictures or manipulation. In the pictures strategy, participants listened to story content and viewed pictures. In the manipulation strategy, participants moved manipulatives as directed by the stories. After a training period, the pictures or manipulatives were removed

Scott C. Marley; Zsuzsanna Szabo

2010-01-01

429

Interaction control of a redundant mobile manipulator  

SciTech Connect

This paper discusses the modeling and control of a spatial mobile manipulator that consists of a robotic manipulator mounted on a wheeled mobile platform. The Lagrange-d`Alembert formulation is used to obtain a concise description of the dynamics of the system, which is subject to nonholonomic constraints. The complexity of the model is increased by introducing kinematic redundancy, which is created when a multilinked manipulator is used. The kinematic redundancy is resolved by decomposing the mobile manipulator into two subsystems: the mobile platform and the manipulator. The redundancy resolution scheme employs a nonlinear interaction-control algorithm, which is developed and applied to coordinate the two subsystems` controllers. The subsystem controllers are independently designed, based on each subsystem`s dynamic characteristics. Simulation results show the promise of the developed algorithm.

Chung, J.H.; Velinsky, S.A.; Hess, R.A. [Univ. of California, Davis, CA (United States). Dept. of Mechanical and Aeronautical Engineering

1998-12-01

430

Damping control of a large flexible manipulator through inertial forces of a small manipulator  

SciTech Connect

Damping control is applied to a detailed computer model of a long- reach flexible manipulator test bed. The test bed consists of a long slender link with a dexterous manipulator mounted at its tip. The movement of the dexterous manipulator is controlled to create inertial damping forces on the long link. Parameter identification and sequential loop-closure are used to design a controller that feeds back relative tip position and velocity of the long link to control the azimuth angle of the dexterous manipulator. The controller is designed to be robust to varying manipulator loading conditions and reliable under sensor failures.

Trudnowski, D.J.; Baker, C.P.; Evans, M.S.

1993-06-01

431

[The young resident between work and family. Status quo and approaches to a solution in orthopedics and traumatology].  

PubMed

The compatibility between the family and the medical profession requires a new challenge of leadership in hospitals, politics and medical societies. The generation change in the medical profession needs the implementation of modern framework conditions in the departments of orthopedics and traumatology. Topics such as work organisation, family support and programs to assist the return to work need to be discussed and should be used as a competitive advantage. Employees of generation y need a gender-independent role model in the field of modern management methods in employee leadership. PMID:23325155

Depeweg, D; Achatz, G; Liebig, K; Lorenz, O

2013-01-01

432

Unilateral Ankylosis of Temporomandibular Joint (TMJ) with Contralateral Condylar Aplasia and Related Orthopedic Deformity – Syndromic or Nonsyndromic?  

PubMed Central

Condylar aplasia which means “failure of development” is a rare condition and can be unilateral or bilateral. Mandibular condylar Aplasia without any association with syndrome is extremely rare. Temporomandibular joint (TMJ) ankylosis results from trauma, infection and inadequate surgical treatment of the condylar area. Congenital cases are very rare. We report case of congenital unilateral aplasia of left mandibular condyle with ankylosis of right condyle, with an associated orthopedic deformity in a nine-year-old male patient, which may be a part of some unreported syndrome that has not been mentioned so far in literature. As per our best knowledge, no other case including such clinical features has been reported. PMID:25738097

Vijay, Pradkhshana; Sunil, VSB; Bajpai, Manas; Chhibber, Neha

2015-01-01

433

Choice and Participation of Career by STEM Professionals with Sensory and Orthopedic Disabilities and the Roles of Assistive Technologies  

NASA Astrophysics Data System (ADS)

This is a qualitative study about sources of self-efficacy and roles of assistive technologies (AT) associated with the science, technology, engineering and mathematics (STEM) choice and participation of STEM professionals and graduate students with sensory and orthopedic disabilities. People with disabilities are underrepresented in STEM, which can be traced back along the STEM pipeline to early undergraduate participation in STEM. Little research exists, however, about pathways and factors associated with successful STEM participation for people with disabilities at any point along their trajectories. Eighteen STEM professionals and graduate students with sensory and orthopedic disabilities were interviewed for this study. Sources of self-efficacy were sought from interview transcripts, as were emergent themes associated with the types, uses and roles of AT. Findings suggest that people with sensory and orthopedic disabilities weigh sources of self-efficacy differently from white males without disabilities in STEM and more like other underrepresented minorities in STEM. Social persuasions were most frequently reported and in far more detail than other sources, suggesting that this source may be most impactful in the development of self-efficacy beliefs for this group. Additionally, findings indicate that AT is critical to the successful participation of people with sensory and orthopedic disabilities in STEM at all points along their STEM pathways. Barriers center around issues of access to full engagement in mainstream STEM classrooms and out of school opportunities as well as the impact of ill-informed perceptions about the capabilities of people with disabilities held by parents, teachers and college faculty who can act as gatekeepers along STEM pathways. Gaps in disability specialists' knowledge about STEM-specific assistive technologies, especially at the college level, are also problematic. The prevalence of mainstream public school attendance reported by participants indicates that classroom teachers and disability-related educators have important roles in providing access to STEM mastery experiences as well as providing positive support and high expectations for students with disabilities. STEM and disability-based networks served to provide participants with role models, out of school STEM learning experiences and important long-term social connections in STEM communities.

Pacheco, Heather A.

434

Analyses and comparison of a novel, hybrid, multifunctional orthopedic composite and implant  

NASA Astrophysics Data System (ADS)

In the orthopedic/medical device industry, 2, 2' -bis-(4-(2-hydroxy-3-methacryloxypropoxy)phenyl]propane (Bis-GMA)- and diurethanedimethacrylate (DUDMA)-based polymeric biomaterials have become well-known substitutes for polymethylmethacrylate (PMMA)- and ultra-high molecular weight polyethylene (UHMWPE)-based biomaterials, respectively. The development of these polymeric biomaterials cannot continue without direct comparison studies against currently marketed materials. The initiative for this research stems wholly from developing analytical methodologies that assist in qualifying novel biomaterials under development, by evaluating their chemical properties, performance, and safety. The goals of this research were: (i) Characterize the assay/quality of every resin component and quantify elution of extractable monomers from novel, DUDMA-based RHAKOSS(TM) implant, (ii) Determine degree of conversion (alpha) and rate of polymerization (Rp) for novel, Bis-GMA-based CORTOSS(TM) composite, (iii) Assess risk for radical-induced post-surgical cytotoxicity for CORTOSS, (iv) Determine if surface radical chemistries occur for sterilized RHAKOSS and assess its oxidative stability, and (v) Quantify antibiotic elution from antibiotic-impregnated CORTOSS and identify factors that control elution. The phenomena studied necessitated the utilization of several analytical spectroscopic techniques; fluorometry, differential scanning calorimetry (DSC), electron paramagnetic resonance (EPR), ultraviolet-visible (UV-VIS), attenuated total reflectance---Fourier-transform infrared (ATR-FTIR), and high performance liquid chromatography (HPLC). A battery of lateral chemical techniques were employed as well; including molecular derivatization/tagging, phase partitioning, spin-trapping, and thermal annealing. Results demonstrated that RHAKOSS monomer percent compositions were prepared according to formulations and monomer elution was virtually undetectable, serving as an empirical gauge to portend degree of polymerization (DOP). A high alpha was reported for CORTOSS and essentially all bifunctional monomers had at least one functional group polymerized, stressing low monomer elution potential. Regarding cytotoxicity, CORTOSS impeded further production of hydroxyl radicals (•OH), whereas RHAKOSS did not facilitate the Fenton reaction but displayed some chelating abilities. Residual radicals in RHAKOSS were easily terminated, thus not projected to form oxidative degradants. Additionally, significant antibiotic concentrations, over extended durations, eluted from CORTOSS in linear-type fashion, advocating a sustained therapeutic effect, and phase partitioning correlated antibiotic release to hydrophilicity. The incurred data comprehensively argues in favor of the excellent biocompatibility that CORTOSS and RHAKOSS inherently possess, and was definitive in rendering them as advanced biomaterials, possessing favorable chemical properties.

Dicicco, Michael

435

[Clinical trials in orthopedic and trauma surgery: randomized or non-randomized?].  

PubMed

Drawing inferences on a causal relationship between a particular intervention and the observed outcome requires to conduct a clinical experiment which controls for study conditions and systematic errors (bias). This is best to be achieved by randomization in which known and unknown biological risk factors are distributed equally among treatment arms. Trauma and orthopedic surgery,however, occupies an exceptional position in clinical medicine. Random allocation of subjects is often considered difficult because of the tight time frame between patient presentation and the urgent need for surgical treatment, and the dependence of operative results upon technical skills. Evidence of a true treatment effect does not only depend on design issues (i.e., randomized or non-randomized treatment assignment), but on both the prior probability of efficacy and the observed effect size as well. Even though our knowledge of the efficacy of osteosynthesis comparing with, let's say, plaster immobilization or (fictive) placebo therapy is hardly supported by randomized trials, the biologically plausible principle of stable operative fixation of fracture fragments has established itself as the scientific basis to propagate surgical rather than other treatment options. Thus, the efficacy of a medical intervention can be well demonstrated without randomization. Regarding the ultimate goals of stabilization, pain removal, and mobilization,osteosynthesis of a pertrochanteric fracture fits these principles in terms of an all-or-none effect (so called level Ic evidence): without the intervention, effects will not be observed. On the other hand, endpoints such as healing and infection rates or duration of rehabilitation may be severely influenced by confounding factors (e.g., concomitant diseases, age, or gender). Under these circumstances,the goal of quantifying treatment effects of different interventions (i.e., interlocking nails, plates, K-wires) and of discriminating these effects from bias might be solved more reliably by a randomized than by a non-randomized trial.Obviously,the need for randomization relies on the choice of the main endpoint of interest.The postulated overestimation of treatment effects by nonrandomized trials has been proven only for methodologically weak investigations. In contrast, high quality studies led to comparable findings regardless of randomization. In conclusion, there are thinkable alternative designs to randomized trials in trauma surgery, accounting for selected clinical questions and objectives. It must be emphasized that these designs will require a similarly rigorous planning (i.e., study protocols, ethics, sample size considerations) and analysis of the results. PMID:12719849

Stengel, D; Bauwens, K; Ekkernkamp, A

2003-04-01

436

Interactive digital image manipulation system  

NASA Technical Reports Server (NTRS)

The system is designed for manipulation, analysis, interpretation, and processing of a wide variety of image data. LANDSAT (ERTS) and other data in digital form can be input directly into the system. Photographic prints and transparencies are first converted to digital form with an on-line high-resolution microdensitometer. The system is implemented on a Hewlett-Packard 3000 computer with 128 K bytes of core memory and a 47.5 megabyte disk. It includes a true color display monitor, with processing memories, graphics overlays, and a movable cursor. Image data formats are flexible so that there is no restriction to a given set of remote sensors. Conversion between data types is available to provide a basis for comparison of the various data. Multispectral data is fully supported, and there is no restriction on the number of dimensions. In this way multispectral data collected at more than one point in time may simply be treated as a data collected with twice (three times, etc.) the number of sensors. There are various libraries of functions available to the user: processing functions, display functions, system functions, and earth resources applications functions.

Henze, J.; Dezur, R.

1975-01-01

437

Manipulation of Semiclassical Photon States  

E-print Network

Gabriel F. Calvo and Antonio Picon defined a class of operators, for use in quantum communication, that allows arbitrary manipulations of the three lowest two-dimensional Hermite-Gaussian modes {|0,0>,|1,0>,|0,1>}. Our paper continues the study of those operators, and our results fall into two categories. For one, we show that the generators of the operators have infinite deficiency indices, and we explicitly describe all self-adjoint realizations. And secondly we investigate semiclassical approximations of the propagators. The basic method is to start from a semiclassical Fourier integral operator ansatz and then construct approximate solutions of the corresponding evolution equations. In doing so, we give a complete description of the Hamilton flow, which in most cases is given by elliptic functions. We find that the semiclassical approximation behaves well when acting on sufficiently localized initial conditions, for example, finite sums of semiclassical Hermite-Gaussian modes, since near the origin the Hamilton trajectories trace out the bounded components of elliptic curves.

Michael VanValkenburgh

2008-12-14

438

Manipulating duckweed through genome duplication.  

PubMed

Significant inter- and intraspecific genetic variation exists in duckweed, thus the potential for genome plasticity and manipulation is high. Polyploidy is recognised as a major mechanism of adaptation and speciation in plants. We produced several genome-duplicated lines of Landoltia punctata (Spirodela oligorrhiza) from both whole plants and regenerating explants using a colchicine-based cocktail. These lines stably maintained an enlarged frond and root morphology. DNA ploidy levels determined by florescence-activated cell sorting indicated genome duplication. Line A4 was analysed after 75 biomass doublings. Frond area, fresh and dry weights, rhizoid number and length were significantly increased versus wild type, while the growth rate was unchanged. This resulted in accumulation of biomass 17-20% faster in the A4 plants. We sought to determine if specific differences in gene products are found in the genome duplicated lines. Non-targeted ultra performance LC-quadrupole time of flight mass spectrometry was employed to compare some of the lines and the wild type to seek identification of up-regulated metabolites. We putatively identified differential metabolites in Line A65 as caffeoyl hexoses. The combination of directed genome duplication and metabolic profiling might offer a path for producing stable gene expression, leading to altered production of secondary metabolites. PMID:25040392

Vunsh, R; Heinig, U; Malitsky, S; Aharoni, A; Avidov, A; Lerner, A; Edelman, M

2015-01-01

439

Patient-focused measures of functional health status and health-related quality of life in pediatric orthopedics: A case study in measurement selection  

PubMed Central

The objectives of this report are to review the assessment of patient-focused outcomes in pediatric orthopedic surgery, to describe a framework for identifying appropriate sets of measures, and to illustrate an application of the framework to a challenging orthopedic problem. A detailed framework of study design and measurement factors is described. The factors are important for selecting appropriate instruments to measure health status and health-related quality of life (HRQL) in a particular context. A study to evaluate treatment alternatives for patients with neurofibromatosis type 1 and congenital tibial dysplasia (NF1-CTD) provides a rich illustration of the application of the framework. The application involves great variability in the instrument selection factors. Furthermore, these patients and their supportive caregivers face numerous complex health challenges with long-term implications for HRQL. Detailed summaries of important generic preference-based multi-attribute measurement systems, pediatric health profile instruments, and pediatric orthopedic-specific instruments are presented. Age-appropriate generic and specific measures are identified for study of NF1-CTD patients. Selected measures include the Activities Scale for Children, Gillette Functional Assessment Questionnaire Walking Scale, Health Utilities Index, and Pediatric Inventory of Quality of Life. Reliable and valid measures for application to pediatric orthopedics are available. There are important differences among measures. The selected measures complement each other. The framework in this report provides a guide for selecting appropriate measures. Application of appropriate sets of measures will enhance the ability to describe the morbidity of pediatric orthopedic patients and to assess the effectiveness of alternative clinical interventions. The framework for measurement of health status and HRQL from a patient perspective has relevance to many other areas of orthopedic practice. PMID:15647118

Furlong, William; Barr, Ronald D; Feeny, David; Yandow, Suzanne

2005-01-01

440

Fuzzy logic control of telerobot manipulators  

NASA Technical Reports Server (NTRS)

Telerobot systems for advanced applications will require manipulators with redundant 'degrees of freedom' (DOF) that are capable of adapting manipulator configurations to avoid obstacles while achieving the user specified goal. Conventional methods for control of manipulators (based on solution of the inverse kinematics) cannot be easily extended to these situations. Fuzzy logic control offers a possible solution to these needs. A current research program at SRI developed a fuzzy logic controller for a redundant, 4 DOF, planar manipulator. The manipulator end point trajectory can be specified by either a computer program (robot mode) or by manual input (teleoperator). The approach used expresses end-point error and the location of manipulator joints as fuzzy variables. Joint motions are determined by a fuzzy rule set without requiring solution of the inverse kinematics. Additional rules for sensor data, obstacle avoidance and preferred manipulator configuration, e.g., 'righty' or 'lefty', are easily accommodated. The procedure used to generate the fuzzy rules can be extended to higher DOF systems.

Franke, Ernest A.; Nedungadi, Ashok

1992-01-01

441

Ecological consequences of manipulative parasites: chapter 9  

USGS Publications Warehouse

Parasitic "puppet masters", with their twisted, self-serving life history strategies and impressive evolutionary takeovers of host minds, capture the imagination of listeners—even those that might not normally fi nd the topic of parasitism appealing (which includes most everyone). A favorite anecdote concerns the trematode Leucochloridium paradoxum migrating to the eyestalks of its intermediate host snail and pulsating its colored body, presumably to attract the predatory birds that are the final hosts for the worm. Identifying a parasite as “manipulative” infers that a change in host behavior or appearance is a direct consequence of the parasite’s adaptive actions that, on average, will increase the fi tness of the parasite. The list of parasites that manipulate their hosts is long and growing. Holmes and Bethel (1972) presented the earliest comprehensive review and brought the subject to mainstream ecologists. Over two decades ago, Andy Dobson (1988) listed seven cestodes, seven trematodes, ten acanthocephalans, and three nematodes that manipulated host behavior. Fifteen years later, Janice Moore (2002) filled a book with examples. The five infectious trophic strategies, typical parasites (macroparasites), pathogens, trophically transmitted parasites, parasitic castrators, and parasitoids (Kuris and Lafferty 2000; Lafferty and Kuris 2002, 2009) can modify host behavior, but the likelihood that a parasite manipulates behavior differs among strategies. The most studied infectious agents, non-trophically transmitted pathogens and macroparasites, have enormous public health, veterinary, and wildlife disease importance, yet few manipulate host behavior. The beststudied manipulative infectious agents are trophically transmitted parasites in their prey intermediate hosts. Parasitoids and parasitic castrators can also manipulate host behavior, but for different purposes and with different implications. Several studies of manipulative parasites conclude with phrases such as “may ultimately infl uence community structure” (Kiesecker and Blaustein 1999), yet few demonstrate ecological effects. Here, we consider the conditions under which manipulative parasites might have a substantial ecological effect in nature and highlight those for which evidence exists (see also Chapter 10).

Lafferty, Kevin D.; Kuris, A. M.

2012-01-01

442

Differential sensitivity of osteoblasts and bacterial pathogens to 405-nm light highlighting potential for decontamination applications in orthopedic surgery  

NASA Astrophysics Data System (ADS)

Healthcare associated infections pose a major threat to patients admitted to hospitals and infection rates following orthopedic arthroplasty surgery are as high as 4%. A 405-nm high-intensity narrow spectrum light has been proven to reduce environmental contamination in hospital isolation rooms, and there is potential to develop this technology for application in arthroplasty surgery. Cultured rat osteoblasts were exposed to varying light intensities and it was found that exposures of up to a dose of 36 J/cm2 had no significant effect on cell viability [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay], function (alkaline phosphatase activity), and proliferation rate (BrdU cell proliferation assay). High irradiance exposures (54 J/cm2) significantly affected the cell viability indicating that the effects of 405-nm light on osteoblasts are dose dependent. Additionally, exposure of a variety of clinically related bacteria to a dose of 36 J/cm2 resulted in up to 100% kill. These results demonstrating the differential sensitivity of osteoblasts and bacteria to 405-nm light are an essential step toward developing the technique for decontamination in orthopedic surgery.

Ramakrishnan, Praveen; Maclean, Michelle; MacGregor, Scott J.; Anderson, John G.; Grant, M. Helen

2014-10-01

443

An Orthopedic-, Surgical-, and Epidemiological-Based Investigation of Leprosy, in the Tamil Nadu State of India  

PubMed Central

No other research paper has ever been written about leprosy in this manner. The orthopedic and surgical implications, as well as the functional debility caused by the disease, have not been previously explained by past research as they have in such a comprehensive manner in this paper. The results of this study have regional and global implications as they pertain to disease pathology, risk factor recognition/disease prevention, and treatment. This paper is a unique, in that it also serves as a combination of a review of the current medical literature, as well as an epidemiological survey of the disease in a region of the world which has never been researched in the past. Clinical data points to the possibility of a new strain of the disease. This information is of significance because it effects prevention and improved treatment of the disease, which leads to devastating sequela. This was a cross-sectional study involving subjects diagnosed with leprosy in the Chengalpet region of the Kancheepuram District, of the Tamil Nadu state of India. The study was performed at the Tamil Nadu Medical College Teaching Hospital and Research Center. This study included various physical examinations, observation and survey of lesions, questionnaires in regard the debilitating orthopedic and medical effects of the disease, as well as treatment options. PMID:22666605

Samona, Jason; Samona, Scott; Samona, Cameron; Gopalakrishnan, S.; Shekhar, P.; Kubern, D.; Mohan Kumar, P. S.; Nassiri, Reza

2012-01-01

444

Chemical functionalization of graphene to augment stem cell osteogenesis and inhibit biofilm formation on polymer composites for orthopedic applications.  

PubMed

Toward designing the next generation of resorbable biomaterials for orthopedic applications, we studied poly(?-caprolactone) (PCL) composites containing graphene. The role, if any, of the functionalization of graphene on mechanical properties, stem cell response, and biofilm formation was systematically evaluated. PCL composites of graphene oxide (GO), reduced GO (RGO), and amine-functionalized GO (AGO) were prepared at different filler contents (1%, 3%, and 5%). Although the addition of the nanoparticles to PCL markedly increased the storage modulus, this increase was largest for GO followed by AGO and RGO. In vitro cell studies revealed that the AGO and GO particles significantly increased human mesenchymal stem cell proliferation. AGO was most effective in augmenting stem cell osteogenesis leading to mineralization. Bacterial studies revealed that interaction with functionalized GO induced bacterial cell death because of membrane damage, which was further accentuated by amine groups in AGO. As a result, AGO composites were best at inhibiting biofilm formation. The synergistic effect of oxygen containing functional groups and amine groups on AGO imparts the optimal combination of improved modulus, favorable stem cell response, and biofilm inhibition in AGO-reinforced composites desired for orthopedic applications. This work elucidates the importance of chemical functionalization of graphene in polymer composites for biomedical applications. PMID:25584679

Kumar, Sachin; Raj, Shammy; Kolanthai, Elayaraja; Sood, A K; Sampath, S; Chatterjee, Kaushik

2015-02-11

445

Bilateral Simultaneous Anterior Cruciate Ligament Injury: A Case Report and National Survey of Orthopedic Surgeon Management Preference  

PubMed Central

Unilateral anterior cruciate ligament (ACL) tear is a common injury seen by sports medicine orthopedic surgeons. However, a bilateral simultaneous ACL injury is extremely rare and has been reported only three times in the literature. We present a young female skier with simultaneous bilateral ACL tears that were managed with staged ACL reconstruction. We then conducted a nationwide survey (United States) to determine the prevalence of simultaneous bilateral ACL tear and preferred management strategies by sports medicine orthopedic surgeons. Sports medicine fellowship directors were contacted and asked to send an 8-item survey to colleagues (sports medicine fellowship trained surgeons) asking about overall number of ACL reconstructions performed, number of bilateral simultaneous ACL injuries seen and optimal management strategies of such an injury. Out of 43 responses, only 22 (51.2%) surgeons had seen a bilateral simultaneous ACL injury. Of these, 16 (76.2%) preferred staged reconstruction. Graft choice was mixed between autograft and allograft, but a large majority preferred either patellar tendon autograft (58%) or hamstring autograft (41%) were the most common choice. Staged reconstruction is the treatment of choice by surgeons surveyed in our study. PMID:25568728

Saadat, Ehsan; Curry, Emily J.; Li, Xinning; Matzkin, Elizabeth G.

2014-01-01

446

Bilateral simultaneous anterior cruciate ligament injury: a case report and national survey of orthopedic surgeon management preference.  

PubMed

Unilateral anterior cruciate ligament (ACL) tear is a common injury seen by sports medicine orthopedic surgeons. However, a bilateral simultaneous ACL injury is extremely rare and has been reported only three times in the literature. We present a young female skier with simultaneous bilateral ACL tears that were managed with staged ACL reconstruction. We then conducted a nationwide survey (United States) to determine the prevalence of simultaneous bilateral ACL tear and preferred management strategies by sports medicine orthopedic surgeons. Sports medicine fellowship directors were contacted and asked to send an 8-item survey to colleagues (sports medicine fellowship trained surgeons) asking about overall number of ACL reconstructions performed, number of bilateral simultaneous ACL injuries seen and optimal management strategies of such an injury. Out of 43 responses, only 22 (51.2%) surgeons had seen a bilateral simultaneous ACL injury. Of these, 16 (76.2%) preferred staged reconstruction. Graft choice was mixed between autograft and allograft, but a large majority preferred either patellar tendon autograft (58%) or hamstring autograft (41%) were the most common choice. Staged reconstruction is the treatment of choice by surgeons surveyed in our study. PMID:25568728

Saadat, Ehsan; Curry, Emily J; Li, Xinning; Matzkin, Elizabeth G

2014-10-27

447

Predicting Postoperative Vomiting for Orthopedic Patients Receiving Patient-Controlled Epidural Analgesia with the Application of an Artificial Neural Network  

PubMed Central

Patient-controlled epidural analgesia (PCEA) was used in many patients receiving orthopedic surgery to reduce postoperative pain but is accompanied with certain incidence of vomiting. Predictions of the vomiting event, however, were addressed by only a few authors using logistic regression (LR) models. Artificial neural networks (ANN) are pattern-recognition tools that can be used to detect complex patterns within data sets. The purpose of this study was to develop the ANN based predictive model to identify patients with high risk of vomiting during PCEA used. From January to March 2007, the PCEA records of 195 patients receiving PCEA after orthopedic surgery were used to develop the two predicting models. The ANN model had a largest area under curve (AUC) in receiver operating characteristic (ROC) curve. The areas under ROC curves of ANN and LR models were 0.900 and 0.761, respectively. The computer-based predictive model should be useful in increasing vigilance in those patients most at risk for vomiting while PCEA is used, allowing for patient-specific therapeutic intervention, or even in suggesting the use of alternative methods of analgesia. PMID:25162027

Ting, Chien-Kun; Lin, Shih-Pin

2014-01-01

448

Predicting postoperative vomiting for orthopedic patients receiving patient-controlled epidural analgesia with the application of an artificial neural network.  

PubMed

Patient-controlled epidural analgesia (PCEA) was used in many patients receiving orthopedic surgery to reduce postoperative pain but is accompanied with certain incidence of vomiting. Predictions of the vomiting event, however, were addressed by only a few authors using logistic regression (LR) models. Artificial neural networks (ANN) are pattern-recognition tools that can be used to detect complex patterns within data sets. The purpose of this study was to develop the ANN based predictive model to identify patients with high risk of vomiting during PCEA used. From January to March 2007, the PCEA records of 195 patients receiving PCEA after orthopedic surgery were used to develop the two predicting models. The ANN model had a largest area under curve (AUC) in receiver operating characteristic (ROC) curve. The areas under ROC curves of ANN and LR models were 0.900 and 0.761, respectively. The computer-based predictive model should be useful in increasing vigilance in those patients most at risk for vomiting while PCEA is used, allowing for patient-specific therapeutic intervention, or even in suggesting the use of alternative methods of analgesia. PMID:25162027

Gong, Cihun-Siyong Alex; Yu, Lu; Ting, Chien-Kun; Tsou, Mei-Yung; Chang, Kuang-Yi; Shen, Chih-Long; Lin, Shih-Pin

2014-01-01

449

Evaluation of the orthopedic residency training program in Saudi Arabia and comparison with a selected Canadian residency program  

PubMed Central

Objective The primary aim of the present study was to assess the quality of the Saudi Orthopedic Residency Program. Methodology As a comparator, a cross-sectional survey involving 76 Saudi residents from different training centers in Saudi Arabia namely; Riyadh, Jeddah, Medina, Abha, and Dammam and 15 Canadian. Results The results showed that Canadian residents read more peer-reviewed, scholarly articles compared with Saudi residents (P=0.002). The primary surgical role for residents was to hold retractors during surgery. The survey respondents strongly supported the ability to recommend removal of incompetent trainers. Saudi trainees were more apprehensive of examinations than Canadian trainees (P<0.0001). Most residents preferred studying multiple-choice questions before examinations. Saudi and Canadian participants considered their programs to be overcrowded. Unlike Canadian participants, Saudi trainees reported an inadequate level of training (P<0.0001). Conclusion Educational resources should be readily accessible and a mentorship system monitoring residents’ progress should be developed. The role of the resident must be clearly defined and resident feedback should not be ignored. Given the importance of mastering basic orthopedic operative skills for residents, meaningful remedial action should be taken with incompetent trainers. PMID:25278788

Al-Ahaideb, Abdulaziz; Alrabai, Hamza M; Alrehaili, Osama A; Aljurayyan, Abdulaziz N; Alsaif, Ranyah M; Algarni, Nizar; Al-Khawashki, Hazem M; Algarni, Abdulrahman D

2014-01-01

450

Blended learning approach improves teaching in a problem-based learning environment in orthopedics - a pilot study  

PubMed Central

Background While e-learning is enjoying increasing popularity as adjunct in modern teaching, studies on this topic should shift from mere evaluation of students’ satisfaction towards assessing its benefits on enhancement of knowledge and skills. This pilot study aimed to detect the teaching effects of a blended learning program on students of orthopedics and traumatology in the context of a problem-based learning environment. Methods The project NESTOR (network for students in traumatology and orthopedics) was offered to students in a problem-based learning course. Participants completed written tests before and directly after the course, followed by a final written test and an objective structured clinical examination (OSCE) as well as an evaluation questionnaire at the end of the semester. Results were compared within the group of NESTOR users and non-users and between these two groups. Results Participants (n?=?53) rated their experiences very positively. An enhancement in knowledge was found directly after the course and at the final written test for both groups (p?

2014-01-01

451

Bioactive ceramic coating on orthopedic implants for enhanced bone tissue integration  

NASA Astrophysics Data System (ADS)

Tissue integration between bone and orthopedic implant is essential for implant fixation and longevity. An immunological response leads to fibrous encapsulation of metallic implants leading to implant instability and failure. Bioactive ceramics have the ability to directly bond to bone; however, they have limited mechanical strength for load bearing applications. Coating bioactive ceramics on metallic implant offers the exciting opportunity to enhance bone formation without compromising the mechanical strength of the implant. In the present study, we have developed a novel bioactive silica-calcium phosphate nanocomposite (SCPC) coating on medical grade Ti-6Al-4V orthopedic implant using electrophoretic deposition (EPD) and evaluated bone tissue response to the coated implant at the cellular level. The effect of SCPC composition and suspending medium pH on the zeta potential of three different SCPC formulations; SCPC25, SCPC50 and SCPC75 were analyzed. The average zeta potential of SCPC50 in pure ethanol was more negative than that of SCPC25 or SCPC75; however the difference was not statistically significant. Ti-6Al-4V discs were passivated, coated with SCPC50 (200 nm - 10 mum) and thermally treated at 600 - 800 ºC to produce a coating thickness in the range of 43.1 +/- 5.7 to 30.1 +/- 4.6 ?m. After treatment at 600, 700 and 800 ºC, the adhesion strength at the SCPC50/Ti-6Al-4V interface was 42.6 +/- 3.6, 44.7 +/- 8.7 and 47.2 +/- 4.3 MPa, respectively. XRD analyses of SCPC50 before and after EPD coating indicated no change in the crystallinity of the material. Fracture surface analyses showed that failure occurred within the ceramic layer or at the ceramic/polymer interface; however, the ceramic/metal interface was intact in all samples. The adhesion strength of SCPC50-coated substrates after immersion in PBS for 2 days (11.7 +/- 3.9 MPa) was higher than that measured on commercially available hydroxyapatite (HA) coated substrates (5.5 +/- 2.7 MPa), although the difference was not statistically significant. SEM - EDX analyses of SCPC50-coated Ti-6Al-4V pre-immersed in PBS for 7 days showed the formation of a Ca-deficient HA surface layer. Bone cells attached to the SCPC50-coated implants expressed significantly higher (p < 0.05) alkaline phosphatase activity (82.4 +/- 25.6 nmoles p-NP/mg protein/min) than that expressed by cells attached to HA-coated or uncoated implants. Protein adsorption analyses showed that SCPC50-coated substrates adsorbed significantly more (p < 0.05) serum protein (14.9 +/- 1.2 mug) than control uncoated substrates (8.9 +/- 0.7 mug). Moreover, Western blot analysis showed that the SCPC50 coating has a high affinity for serum fibronectin. Protein conformation analyses by FTIR showed that the ratio of the