Sample records for disc replacement pitfalls

  1. Adjacent level effects of bi level disc replacement, bi level fusion and disc replacement plus fusion in cervical spine--a finite element based study.

    PubMed

    Faizan, Ahmad; Goel, Vijay K; Biyani, Ashok; Garfin, Steven R; Bono, Christopher M

    2012-03-01

    Studies delineating the adjacent level effect of single level disc replacement systems have been reported in literature. The aim of this study was to compare the adjacent level biomechanics of bi-level disc replacement, bi-level fusion and a construct having adjoining level disc replacement and fusion system. In total, biomechanics of four models- intact, bi level disc replacement, bi level fusion and fusion plus disc replacement at adjoining levels- was studied to gain insight into the effects of various instrumentation systems on cranial and caudal adjacent levels using finite element analysis (73.6N+varying moment). The bi-level fusion models are more than twice as stiff as compared to the intact model during flexion-extension, lateral bending and axial rotation. Bi-level disc replacement model required moments lower than intact model (1.5Nm). Fusion plus disc replacement model required moment 10-25% more than intact model, except in extension. Adjacent level motions, facet loads and endplate stresses increased substantially in the bi-level fusion model. On the other hand, adjacent level motions, facet loads and endplate stresses were similar to intact for the bi-level disc replacement model. For the fusion plus disc replacement model, adjacent level motions, facet loads and endplate stresses were closer to intact model rather than the bi-level fusion model, except in extension. Based on our finite element analysis, fusion plus disc replacement procedure has less severe biomechanical effects on adjacent levels when compared to bi-level fusion procedure. Bi-level disc replacement procedure did not have any adverse mechanical effects on adjacent levels. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Kinematics of a selectively constrained radiolucent anterior lumbar disc: comparisons to hybrid and circumferential fusion.

    PubMed

    Daftari, Tapan K; Chinthakunta, Suresh R; Ingalhalikar, Aditya; Gudipally, Manasa; Hussain, Mir; Khalil, Saif

    2012-10-01

    Despite encouraging clinical outcomes of one-level total disc replacements reported in literature, there is no compelling evidence regarding the stability following two-level disc replacement and hybrid constructs. The current study is aimed at evaluating the multidirectional kinematics of a two-level disc arthroplasty and hybrid construct with disc replacement adjacent to rigid circumferential fusion, compared to two-level fusion using a novel selectively constrained radiolucent anterior lumbar disc. Nine osteoligamentous lumbosacral spines (L1-S1) were tested in the following sequence: 1) Intact; 2) One-level disc replacement; 3) Hybrid; 4) Two-level disc replacement; and 5) Two-level fusion. Range of motion (at both implanted and adjacent level), and center of rotation in sagittal plane were recorded and calculated. At the level of implantation, motion was restored when one-level disc replacement was used but tended to decrease with two-level disc arthroplasty. The findings also revealed that both one-level and two-level disc replacement and hybrid constructs did not significantly change adjacent level kinematics compared to the intact condition, whereas the two-level fusion construct demonstrated a significant increase in flexibility at the adjacent level. The location of center of rotation in the sagittal plane at L4-L5 for the one-level disc replacement construct was similar to that of the intact condition. The one-level disc arthroplasty tended to mimic a motion profile similar to the intact spine. However, the two-level disc replacement construct tended to reduce motion and clinical stability of a two-level disc arthroplasty requires additional investigation. Hybrid constructs may be used as a surgical alternative for treating two-level lumbar degenerative disc disease. Published by Elsevier Ltd.

  3. Foreword: Proceedings From the First Annual Lumbar Total Disc Replacement Summit.

    PubMed

    Blumenthal, Scott; Buttermann, Glenn; Garcia, Rolando; Gornet, Matthew; Grunch, Betsy; Guyer, Richard; Janssen, Michael; Kimball, Brent; Lewis, Adam; Mesiwala, Ali; Miller, Lynn; Morreale, Joseph; Reed, William; Sandhu, Faheem; Shackleford, Ian; Yue, James; Zigler, Jack; OConnell, Brent; Ferko, Nicole; Hollmann, Sarah

    2017-12-15

    : This publication focuses on proceedings from the First Annual Lumbar Total Disc Replacement Summit, held October 25, 2016 in Boston, MA. The Summit brought together 17 thought leading surgeons who employed a modified-Delphi method to determine where consensus existed pertaining to the utilization of lumbar total disc replacement as a standard of care for a subpopulation of patients suffering from degenerative disc disease.

  4. In vitro and in silico investigations of disc nucleus replacement

    PubMed Central

    Reitmaier, Sandra; Shirazi-Adl, Aboulfazl; Bashkuev, Maxim; Wilke, Hans-Joachim; Gloria, Antonio; Schmidt, Hendrik

    2012-01-01

    Currently, numerous hydrogels are under examination as potential nucleus replacements. The clinical success, however, depends on how well the mechanical function of the host structure is restored. This study aimed to evaluate the extent to and mechanisms by which surgery for nucleus replacements influence the mechanical behaviour of the disc. The effects of an annulus defect with and without nucleus replacement on disc height and nucleus pressure were measured using 24 ovine motion segments. The following cases were considered: intact; annulus incision repaired by suture and glue; annulus incision with removal and re-implantation of nucleus tissue repaired by suture and glue or plug. To identify the likely mechanisms observed in vitro, a finite-element model of a human disc (L4–L5) was employed. Both studies were subjected to physiological cycles of compression and recovery. A repaired annulus defect did not influence the disc behaviour in vitro, whereas additional nucleus removal and replacement substantially decreased disc stiffness and nucleus pressure. Model predictions demonstrated the substantial effects of reductions in replaced nucleus water content, bulk modulus and osmotic potential on disc height loss and pressure, similar to measurements. In these events, the compression load transfer in the disc markedly altered by substantially increasing the load on the annulus when compared with the nucleus. The success of hydrogels for nucleus replacements is not only dependent on the implant material itself but also on the restoration of the environment perturbed during surgery. The substantial effects on the disc response of disruptions owing to nucleus replacements can be simulated by reduced nucleus water content, elastic modulus and osmotic potential. PMID:22337630

  5. Engineered disc-like angle-ply structures for intervertebral disc replacement.

    PubMed

    Nerurkar, Nandan L; Sen, Sounok; Huang, Alice H; Elliott, Dawn M; Mauck, Robert L

    2010-04-15

    To develop a construction algorithm in which electrospun nanofibrous scaffolds are coupled with a biocompatible hydrogel to engineer a mesenchymal stem cell (MSC)-based disc replacement. To engineer a disc-like angle-ply structure (DAPS) that replicates the multiscale architecture of the intervertebral disc. Successful engineering of a replacement for the intervertebral disc requires replication of its mechanical function and anatomic form. Despite many attempts to engineer a replacement for ailing and degenerated discs, no prior study has replicated the multiscale hierarchical architecture of the native disc, and very few have assessed the mechanical function of formed neo-tissues. A new algorithm for the construction of a disc analogue was developed, using agarose to form a central nucleus pulposus (NP) and oriented electrospun nanofibrous scaffolds to form the anulus fibrosus region (AF). Bovine MSCs were seeded into both regions and biochemical, histologic, and mechanical maturation were evaluated with in vitro culture. We show that mechanical testing in compression and torsion, loading methods commonly used to assess disc mechanics, reveal equilibrium and time-dependent behaviors that are qualitatively similar to native tissue, although lesser in magnitude. Further, we demonstrate that cells seeded into both AF and NP regions adopt distinct morphologies that mirror those seen in native tissue, and that, in the AF region, this ordered community of cells deposit matrix that is organized in an angle-ply configuration. Finally, constructs demonstrate functional development with long-term in vitro culture. These findings provide a new approach for disc tissue engineering that replicates multi-scale form and function of the intervertebral disc, providing a foundation from which to build a multi-scale, biologic, anatomically and hierarchically relevant composite disc analogue for eventual disc replacement.

  6. Translation of an Engineered Nanofibrous Disc-like Angle Ply Structure for Intervertebral Disc Replacement in a Small Animal Model

    PubMed Central

    Martin, John T.; Milby, Andrew H.; Chiaro, Joseph A.; Kim, Dong Hwa; Hebela, Nader M.; Smith, Lachlan J.; Elliott, Dawn M.; Mauck, Robert L.

    2015-01-01

    Intervertebral disc degeneration has been implicated in the etiology of low back pain; however the current surgical strategies for treating symptomatic disc disease are limited. A variety of materials have been developed to replace disc components, including the nucleus pulposus (NP), the annulus fibrosus (AF), and their combination into disc-like engineered constructs. We have previously shown that layers of electrospun poly(ε-caprolactone) scaffold, mimicking the hierarchical organization of the native AF, have functional parity with native tissue. Likewise, we have combined these structures with cell-seeded hydrogels (as an NP replacement) to form disc-like angle ply structures (DAPS). The objective of this study was to develop a model for the evaluation of DAPS in vivo. Through a series of studies, we developed a surgical approach to replace the rat caudal disc with an acellular DAPS and then stabilize the motion segment by external fixation. We then optimized cell infiltration into DAPS by including sacrificial poly(ethylene oxide) layers interspersed throughout the angle-ply structure. Our findings illustrate that DAPS are stable in the caudal spine, are infiltrated by cells from the peri-implant space, and that infiltration is expedited by providing additional routes for cell migration. These findings establish a new in vivo platform in which to evaluate and optimize the design of functional disc replacements. PMID:24560621

  7. Ulf Fernström (1915-1985) and his Contributions to the Development of Artificial Disc Replacements.

    PubMed

    Fisahn, Christian; Burgess, Brittni; Iwanaga, Joe; Chapman, Jens R; Oskouian, Rod J; Tubbs, R Shane

    2017-02-01

    Artificial disc replacements, which serve the function of separating vertebrae to allow for proper spinal alignment, can help treat debilitating low back pain in patients who have failed other conservative methods of treatment. A Swedish surgeon, Ulf Fernström, was the pioneer of artificial disc replacement, and his contribution in the form of Fernström balls dramatically altered spinal surgery and technique by showing the proper technique and implant that should be used for areas requiring motion in many planes. Ulf Fernström created his artificial disc inspired by the movement of the hip and knee joints. His implants attempted to restore disc spacing and articulation in patients who had failed conservative measures of treatment. Fernström balls were the first implants of their kind and represent the first attempt at artificial disc replacement. However, many surgeons and researchers questioned Fernström balls, claiming that their lack of elastic properties could damage patients. Of the wide range of implants on the market for the intervertebral disc space, all designs and applications of products stem from the initial discovery made by Fernström, thus making him a pioneer in disc replacement. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Patient-specific instruments: advantages and pitfalls

    PubMed Central

    Hafez, Mahmoud A.; Moholkar, Kirti

    2017-01-01

    Patient-specific instruments (PSI) aim to improve the accuracy of total knee replacement (TKR) based on computer-assisted preoperative planning. In this work, the authors describe the advantages and pitfalls of PSI based on their clinical experience. The main conclusion of this work is that PSI has direct impact on the logistical and technical features of TKR with some advantages and pitfalls. PMID:29227785

  9. Translation of an engineered nanofibrous disc-like angle-ply structure for intervertebral disc replacement in a small animal model.

    PubMed

    Martin, John T; Milby, Andrew H; Chiaro, Joseph A; Kim, Dong Hwa; Hebela, Nader M; Smith, Lachlan J; Elliott, Dawn M; Mauck, Robert L

    2014-06-01

    Intervertebral disc degeneration has been implicated in the etiology of low back pain; however, the current surgical strategies for treating symptomatic disc disease are limited. A variety of materials have been developed to replace disc components, including the nucleus pulposus (NP), the annulus fibrosus (AF) and their combination into disc-like engineered constructs. We have previously shown that layers of electrospun poly(ε-caprolactone) scaffold, mimicking the hierarchical organization of the native AF, can achieve functional parity with native tissue. Likewise, we have combined these structures with cell-seeded hydrogels (as an NP replacement) to form disc-like angle-ply structures (DAPS). The objective of this study was to develop a model for the evaluation of DAPS in vivo. Through a series of studies, we developed a surgical approach to replace the rat caudal disc with an acellular DAPS and then stabilized the motion segment via external fixation. We then optimized cell infiltration into DAPS by including sacrificial poly(ethylene oxide) layers interspersed throughout the angle-ply structure. Our findings illustrate that DAPS are stable in the caudal spine, are infiltrated by cells from the peri-implant space and that infiltration is expedited by providing additional routes for cell migration. These findings establish a new in vivo platform in which to evaluate and optimize the design of functional disc replacements. Copyright © 2014 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  10. Cervical facet force analysis after disc replacement versus fusion.

    PubMed

    Patel, Vikas V; Wuthrich, Zachary R; McGilvray, Kirk C; Lafleur, Matthew C; Lindley, Emily M; Sun, Derrick; Puttlitz, Christian M

    2017-05-01

    Cervical total disc replacement was developed to preserve motion and reduce adjacent-level degeneration relative to fusion, yet concerns remain that total disc replacement will lead to altered facet joint loading and long-term facet joint arthrosis. This study is intended to evaluate changes in facet contact force, pressure and surface area at the treated and superior adjacent levels before and after discectomy, disc replacement, and fusion. Ten fresh-frozen human cadaveric cervical spines were potted from C2 to C7 with pressure sensors placed into the facet joints of C3-C4 and C4-C5 via slits in the facet capsules. Moments were applied to the specimens to produce axial rotation, lateral bending and extension. Facet contact force and pressure were measured at both levels for intact, discectomy at C4-C5, disc replacement with ProDisc-C (Synthes Spine, West Chester, Pennsylvania, USA) at C4-C5, and anterior discectomy and fusion with Cervical Spine Locking Plate (Synthes Spine, West Chester, Pennsylvania, USA) at C4-C5. Facet contact area was calculated from the force and pressure measurements. An analysis of variance was used to determine significant differences with P-values <0.05 indicating significance. Facet contact force was elevated at the treated level under extension following both discectomy and disc replacement, while facet contact pressure and area were relatively unchanged. Facet contact force and area were decreased at the treated level following fusion for all three loading conditions. Total disc replacement preserved facet contact force for all scenarios except extension at the treated level, highlighting the importance of the anterior disco-ligamentous complex. This could promote treated-level facet joint disease. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Biomechanics of a Fixed–Center of Rotation Cervical Intervertebral Disc Prosthesis

    PubMed Central

    Crawford, Neil R.; Baek, Seungwon; Sawa, Anna G.U.; Safavi-Abbasi, Sam; Sonntag, Volker K.H.; Duggal, Neil

    2012-01-01

    Background Past in vitro experiments studying artificial discs have focused on range of motion. It is also important to understand how artificial discs affect other biomechanical parameters, especially alterations to kinematics. The purpose of this in vitro investigation was to quantify how disc replacement with a ball-and-socket disc arthroplasty device (ProDisc-C; Synthes, West Chester, Pennsylvania) alters biomechanics of the spine relative to the normal condition (positive control) and simulated fusion (negative control). Methods Specimens were tested in multiple planes by use of pure moments under load control and again in displacement control during flexion-extension with a constant 70-N compressive follower load. Optical markers measured 3-dimensional vertebral motion, and a strain gauge array measured C4-5 facet loads. Results Range of motion and lax zone after disc replacement were not significantly different from normal values except during lateral bending, whereas plating significantly reduced motion in all loading modes (P < .002). Plating but not disc replacement shifted the location of the axis of rotation anteriorly relative to the intact condition (P < 0.01). Coupled axial rotation per degree of lateral bending was 25% ± 48% greater than normal after artificial disc replacement (P = .05) but 37% ± 38% less than normal after plating (P = .002). Coupled lateral bending per degree of axial rotation was 37% ± 21% less than normal after disc replacement (P < .001) and 41% ± 36% less than normal after plating (P = .001). Facet loads did not change significantly relative to normal after anterior plating or arthroplasty, except that facet loads were decreased during flexion in both conditions (P < .03). Conclusions In all parameters studied, deviations from normal biomechanics were less substantial after artificial disc placement than after anterior plating. PMID:25694869

  12. Valve assembly having remotely replaceable bearings

    DOEpatents

    Johnson, Evan R.; Tanner, David E.

    1980-01-01

    A valve assembly having remotely replaceable bearings is disclosed wherein a valve disc is supported within a flow duct for rotation about a pair of axially aligned bearings, one of which is carried by a spindle received within a diametral bore in the valve disc, and the other of which is carried by a bearing support block releasably mounted on the duct circumferentially of an annular collar on the valve disc coaxial with its diametrical bore. The spindle and bearing support block are adapted for remote removal to facilitate servicing or replacement of the valve disc support bearings.

  13. Total disc replacement for chronic back pain in the presence of disc degeneration.

    PubMed

    Jacobs, Wilco; Van der Gaag, Niels A; Tuschel, Alexander; de Kleuver, Marinus; Peul, Wilco; Verbout, A J; Oner, F Cumhur

    2012-09-12

    In the search for better surgical treatment of chronic low-back pain (LBP) in the presence of disc degeneration, total disc replacement has received increasing attention in recent years. A possible advantage of total disc replacement compared with fusion is maintained mobility at the operated level, which has been suggested to reduce the chance of adjacent segment degeneration. The aim of this systematic review was to assess the effect of total disc replacement for chronic low-back pain in the presence of lumbar disc degeneration compared with other treatment options in terms of patient-centred improvement, motion preservation and adjacent segment degeneration. A comprehensive search in Cochrane Back Review Group (CBRG) trials register, CENTRAL, MEDLINE, EMBASE, BIOSIS, ISI, and the FDA register was conducted. We also checked the reference lists and performed citation tracking of included studies. We included randomised controlled trials (RCTs) comparing total disc replacement with any other intervention for degenerative disc disease. We assessed risk of bias per study using the criteria of the CBRG. Quality of evidence was graded according to the GRADE approach. Two review authors independently selected studies and assessed risk of bias of the studies. Results and upper bounds of confidence intervals were compared against predefined clinically relevant differences. We included 40 publications, describing seven unique RCT's. The follow-up of the studies was 24 months, with only one extended to five years. Five studies had a low risk of bias, although there is a risk of bias in the included studies due to sponsoring and absence of any kind of blinding. One study compared disc replacement against rehabilitation and found a statistically significant advantage in favour of surgery, which, however, did not reach the predefined threshold for clinical relevance. Six studies compared disc replacement against fusion and found that the mean improvement in VAS back pain was 5.2 mm (of 100 mm) higher (two studies, 676 patients; 95% confidence interval (CI) 0.18 to 10.26) with a low quality of evidence while from the same studies leg pain showed no difference. The improvement of Oswestry score at 24 months in the disc replacement group was 4.27 points more than in the fusion group (five studies; 1207 patients; 95% CI 1.85 to 6.68) with a low quality of evidence. Both upper bounds of the confidence intervals for VAS back pain and Oswestry score were below the predefined clinically relevant difference. Choice of control group (circumferential or anterior fusion) did not appear to result in different outcomes. Although statistically significant, the differences between disc replacement and conventional fusion surgery for degenerative disc disease were not beyond the generally accepted clinical important differences with respect to short-term pain relief, disability and Quality of Life. Moreover, these analyses only represent a highly selected population. The primary goal of prevention of adjacent level disease and facet joint degeneration by using total disc replacement, as noted by the manufacturers and distributors, was not properly assessed and not a research question at all. Unfortunately, evidence from observational studies could not be used because of the high risk of bias, while these could have improved external validity assessment of complications in less selected patient groups. Non-randomised studies should however be very clear about patient selection and should incorporate independent, blinded outcome assessment, which was not the case in the excluded studies. Therefore, because we believe that harm and complications may occur after years, we believe that the spine surgery community should be prudent about adopting this technology on a large scale, despite the fact that total disc replacement seems to be effective in treating low-back pain in selected patients, and in the short term is at least equivalent to fusion surgery.

  14. An evaluation of information on the Internet of a new device: the lumbar artificial disc replacement.

    PubMed

    Garcia, Ryan M; Messerschmitt, Patrick J; Ahn, Nicholas U

    2009-02-01

    An analysis of websites, accessible to the public, was conducted pertaining to the lumbar artificial disc replacement. The objective was to investigate the content of information available on the Internet pertaining to the lumbar artificial disc replacement. The Internet is widely used by patients as an educational tool for health care information. Additionally, the Internet is used as a medium for direct-to-consumer marketing. Recent approval of the lumbar artificial disc replacement has led to the emergence of numerous websites offering information about this procedure. It is thought that patients can be influenced by information found on the Internet; therefore, it is imperative that this information be accurate and as complete as possible. Three commonly used search engines were used to locate 105 (35/search engine) websites providing information about the lumbar artificial disc replacement. Each website was evaluated with regard to authorship and content. Fifty-nine percent of the websites reviewed were authorized by a private physician group, 9% by an academic physician group, 6% by industry, 11% were news reports, and 15% were not otherwise categorized. Seventy-two percent offered a mechanism for direct contact and 30% provided clear patient selection criteria. Benefits were expressed in 87% of websites, whereas associated risks were described in 28% or less. European experiences were noted in 53%, whereas only 22% of websites detailed the current US experience. The results of this study demonstrate that much of the content of Internet-derived information pertaining to the lumbar artificial disc replacement is potentially misleading. Until long-term data are available, patients should be cautioned when using the Internet as a source for health care information, particularly with regard to the lumbar artificial disc replacement.

  15. Transforaminal Endoscopic Decompression for Foot Drop Twelve Years After Lumbar Total Disc Replacment: Technical Note.

    PubMed

    Telfeian, Albert E; Oyelese, Adetokunbo; Fridley, Jared; Gokaslan, Ziya L

    2018-05-19

    Lumbar total disc replacement (LTDR) is considered for the treatment of lumbar degenerative disc disease with the hope that by preserving motion the long-term fusion complication of adjacent segment disease can be avoided. The complications of LTDR can be divided into approach-related and long-term complications. Very little has been described about the complications and treatment for complications more than 10 years after the device has been implanted. Here we describe a tranforaminal endoscopic discectomy procedure for a patient presenting with foot drop twelve years after a L5-S1 total disc replacement. Copyright © 2018. Published by Elsevier Inc.

  16. Biomechanical comparison of a two-level Maverick disc replacement with a hybrid one-level disc replacement and one-level anterior lumbar interbody fusion.

    PubMed

    Erkan, Serkan; Rivera, Yamil; Wu, Chunhui; Mehbod, Amir A; Transfeldt, Ensor E

    2009-10-01

    Multilevel lumbar disc disease (MLDD) is a common finding in many patients. Surgical solutions for MLDD include fusion or disc replacement. The hybrid model, combining fusion and disc replacement, is a potential alternative for patients who require surgical intervention at both L5-S1 and L4-L5. The indications for this hybrid model could be posterior element insufficiency, severe facet pathology, calcified ligamentum flavum, and subarticular disease confirming spinal stenosis at L5-S1 level, or previous fusion surgery at L5-S1 and new symptomatic pathology at L4-L5. Biomechanical data of the hybrid model with the Maverick disc and anterior fusion are not available in the literature. To compare the biomechanical properties of a two-level Maverick disc replacement at L4-L5, L5-S1, and a hybrid model consisting of an L4-L5 Maverick disc replacement with an L5-S1 anterior lumbar interbody fusion using multidirectional flexibility test. An in vitro human cadaveric biomechanical study. Six fresh human cadaveric lumbar specimens (L4-S1) were subjected to unconstrained load in axial torsion (AT), lateral bending (LB), flexion (F), extension (E), and flexion-extension (FE) using multidirectional flexibility test. Four surgical treatments-intact, one-level Maverick at L5-S1, two-level Maverick between L4 and S1, and the hybrid model (anterior fusion at L5-S1 and Maverick at L4-L5) were tested in sequential order. The range of motion of each treatment was calculated. The Maverick disc replacement slightly reduced intact motion in AT and LB at both levels. The total FE motion was similar to the intact motion. However, the E motion is significantly increased (approximately 50% higher) and F motion is significantly decreased (30%-50% lower). The anterior fusion using a cage and anterior plate significantly reduced spinal motion compared with the condition (p<.05). No significant differences were found between two-level Maverick disc prosthesis and the hybrid model in terms of all motion types at L4-L5 level (p>.05). The Maverick disc preserved total motion but altered the motion pattern of the intact condition. This result is similar to unconstrained devices such as Charité. The motion at L4-L5 of the hybrid model is similar to that of two-level Maverick disc replacement. The fusion procedure using an anterior plate significantly reduced intact motion. Clinical studies are recommended to validate the efficacy of the hybrid model.

  17. Transforaminal Percutaneous Endoscopic Discectomy using Transforaminal Endoscopic Spine System technique: Pitfalls that a beginner should avoid

    PubMed Central

    Kapetanakis, Stylianos; Gkasdaris, Grigorios; Angoules, Antonios G; Givissis, Panagiotis

    2017-01-01

    Transforaminal Percutaneous Endoscopic Discectomy (TPED) is a minimally invasive technique mainly used for the treatment of lumbar disc herniation from a lateral approach. Performed under local anesthesia, TPED has been proven to be a safe and effective technique which has been also associated with shorter rehabilitation period, reduced blood loss, trauma, and scar tissue compared to conventional procedures. However, the procedure should be performed by a spine surgeon experienced in the specific technique and capable of recognizing or avoiding various challenging conditions. In this review, pitfalls that a novice surgeon has to be mindful of, are reported and analyzed. PMID:29312845

  18. ProDisc-L total disc replacement: a comparison of 1-level versus 2-level arthroplasty patients with a minimum 2-year follow-up.

    PubMed

    Hannibal, Matthew; Thomas, Derek J; Low, Jeffrey; Hsu, Ken Y; Zucherman, James

    2007-10-01

    This is a retrospective analysis of data that was collected prospectively from 2 concurrent FDA IDE lumbar arthroplasty clinical trials performed at a single center. To determine if there is a clinical difference between the 1-level ProDisc patients versus the 2-level ProDisc patients at a minimum of 2 years of follow-up. Marnay's work with ProDisc I prompted the U.S. Clinical Trials of the ProDisc II under the direction of the FDA. Disc replacement surgery in the United States has shown promising results for all types of prostheses up to 6 months. Marnay and colleagues showed that their results at 10 years were still promising, and they saw no significant difference between 1-level and multilevel disc replacements. The findings of Ipsen and colleagues suggest that multilevel arthroplasty cases may be less successful than disc replacement at a single level. Patients were part of the FDA clinical trial for the Prodisc II versus circumferential fusion study at a single institution. We identified 27 patients who received ProDisc at 1 level and 32 who received it at 2 levels with at least a 2-year follow-up, for a total of 59 patients. Unpaired t tests were performed on the mean results of Visual Analog Scale, Oswestry Disability Index, SF-36 Healthy Survey Physical Component Summary, and satisfaction using 10-cm line visual scale scores to determine a clinical difference if any between the 2 populations. While patients receiving ProDisc at 2 levels scored marginally lower in all evaluation indexes, score differences in each category were also found to hold no statistical significance. This study was unable to identify a statistically significant difference in outcome between 1- and 2-level ProDisc arthroplasty patients in a cohort from a single center. The equality of clinical effectiveness between 1- and 2-level ProDisc has yet to be determined.

  19. Focal hypermobility observed in cervical arthroplasty with Mobi-C.

    PubMed

    Kerferd, Jack William; Abi-Hanna, David; Phan, Kevin; Rao, Prashanth; Mobbs, Ralph J

    2017-12-01

    In recent decades cervical arthroplasty, or cervical disc replacement, has been steadily increasing in popularity as a procedure for the treatment of degenerative pathologies of the cervical spine. This is based on an evolving body of literature that documents superior outcomes in cervical disc replacement over fusion, for both single and double level pathologies, in well selected patients. One of the more recent and popular implants currently on the market is the Mobi-C cervical artificial disc (LDR Medical; Troyes, France). In this paper we report on two cases where focal hypermobility was observed following total disc replacement using the Mobi-C cervical artificial disc. This is followed by a discussion as to potential contributing factors to this hypermobility in relation to both implant design, and operative technique, suggesting potential changes that might prevent this in future patients.

  20. Two-level total lumbar disc replacement.

    PubMed

    Di Silvestre, Mario; Bakaloudis, Georgios; Lolli, Francesco; Vommaro, Francesco; Parisini, Patrizio

    2009-06-01

    Total lumbar disc replacement (TDR) has been widely used as a treatment option for 2-level symptomatic degenerative disc disease. However, recent studies have presented conflicting results and some authors concluded that outcome deteriorated when disc replacement was performed bisegmentally, with an increase of complications for bisegmental replacements in comparison with monosegmental disc arthroplasty. The goal of the present retrospective study is to investigate results in a group of patients who have received bisegmental TDR with SB Charitè III artificial disc for degenerative disc disease with a minimum follow-up of 3 years, and to compare the results of 2-level disc replacement versus 1-level patients treated with the same prosthesis. A total of 32 patients had at least 3-years follow-up and were reviewed. The average age of the patients was 38.5 years. There were 11 males and 21 females. About 16 patients received 2-level TDR (SB Charitè III) and 16 received 1-level TDR (SB Charitè III). Both radiographic and functional outcome analysis, including patient's satisfaction, was performed. There were no signs of degenerative changes of the adjacent segments in any case of the 2- or 1-level TDR. There was no statistically significant difference between 2- and 1-level TDR both at 12 months and at 3-years follow-up on functional outcome scores. There was a statistically insignificant difference concerning the patients satisfaction between 1- and 2-level surgeries at the last follow-up (P = 0.46). In the 2-level TDR patients, there were 5 minor complications (31.25%), whereas major complications occurred in 4 more patients (25%) and required a new surgery in 2 cases (12.5%). In the 1-level cases there were 2 minor complications (12.5%) and 2 major complications (12.5%) and a new revision surgery was required in 1 patient (6.25%). In conclusion, the use of 2-level disc replacement at last follow-up presented a higher incidence of complications than in cases with 1-level replacement. At the same time it was impossible to delineate a clear difference in evaluating the questionnaires between the follow-up results of patients receiving 2- and 1-level TDR: the 2-level group presented slightly lower scores at follow-up, but none was statistically significant.

  1. In Vitro Maturation and In Vivo Integration and Function of an Engineered Cell-Seeded Disc-like Angle Ply Structure (DAPS) for Total Disc Arthroplasty.

    PubMed

    Martin, J T; Gullbrand, S E; Kim, D H; Ikuta, K; Pfeifer, C G; Ashinsky, B G; Smith, L J; Elliott, D M; Smith, H E; Mauck, R L

    2017-11-17

    Total disc replacement with an engineered substitute is a promising avenue for treating advanced intervertebral disc disease. Toward this goal, we developed cell-seeded disc-like angle ply structures (DAPS) and showed through in vitro studies that these constructs mature to match native disc composition, structure, and function with long-term culture. We then evaluated DAPS performance in an in vivo rat model of total disc replacement; over 5 weeks in vivo, DAPS maintained their structure, prevented intervertebral bony fusion, and matched native disc mechanical function at physiologic loads in situ. However, DAPS rapidly lost proteoglycan post-implantation and did not integrate into adjacent vertebrae. To address this, we modified the design to include polymer endplates to interface the DAPS with adjacent vertebrae, and showed that this modification mitigated in vivo proteoglycan loss while maintaining mechanical function and promoting integration. Together, these data demonstrate that cell-seeded engineered discs can replicate many characteristics of the native disc and are a viable option for total disc arthroplasty.

  2. Outpatient and Inpatient Single-Level Cervical Total Disc Replacement: A Comparison of 30-day Outcomes.

    PubMed

    Segal, Dale N; Wilson, Jacob M; Staley, Christopher; Yoon, Tim S

    2018-06-11

    Retrospective cohort study. To compare 30-day postoperative outcomes between patients undergoing outpatient and inpatient single-level cervical total disc replacement surgery. Cervical total disc replacement (TDR) is a motion sparing treatment for cervical radiculopathy and myelopathy. It is an alternative to anterior cervical discectomy and fusion (ACDF) with a similar complication rate. Like ACDF, it may be performed in the inpatient or outpatient setting. Efforts to reduce healthcare costs are driving spine surgery to be performed in the outpatient setting. As cervical total disc replacement surgery continues to gain popularity, the safety of treating patients on an outpatient basis needs to be validated. The National Surgical Quality Improvement Program (NSQIP) database was queried for patients who underwent single-level cervical disc replacement surgery between 2006-2015. Complication data including 30-day complications, reoperation rate, readmission rate, and length of stay data was compared between the inpatient and outpatient cohort using univariate analysis. There were 531 (34.2%) patients treated as outpatients and 1,022 (65.8%) were treated on an inpatient basis. The two groups had similar baseline characteristics. The overall 30-day complication rate was 1.4% for inpatients and 0.6% for outpatients. Reoperation rate was 0.6% for inpatient and 0.4% for outpatients. Readmission rate was 0.9% and 0.8% for inpatient and outpatient, respectively. There were no statistical differences identified in rates of readmission, reoperation, or complication between the inpatient and outpatient cohorts. There was no difference between 30-day complications, readmission and reoperation rates between inpatients and outpatients who underwent a single-level cervical total disc replacement. Furthermore, the overall 30-day complication rates were low. This study supports that single-level cervical TDR can be performed safely in an outpatient setting. 3.

  3. A solid state video recorder as a direct replacement of a mechanically driven disc recording device in a security system

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Terry, P.L.

    1989-01-01

    Whether upgrading or developing a security system, investing in a solid state video recorder may prove to be quite prudent. Even though the initial cost of a solid state recorder may be more expensive, when comparing it to a disc recorder it is practically maintenance free. Thus, the cost effectiveness of a solid state video recorder over an extended period of time more than justifies the initial expense. This document illustrates the use of a solid state video recorder as a direct replacement. It replaces a mechanically driven disc recorder that existed in a synchronized video recording system. The originalmore » system was called the Universal Video Disc Recorder System. The modified system will now be referred to as the Solid State Video Recording System. 5 figs.« less

  4. Hybrids: good for cars and the environment-are they good for the spine too?

    PubMed

    Bono, Christopher M

    2009-10-01

    Erkan S, Rivera Y, Wu C, et al. Biomechanical comparison of a two-level Maverick disc replacement with a hybrid one-level disc replacement and one-level anterior lumbar interbody fusion. Spine J 2009;9:830-835 (in this issue).

  5. The activL® Artificial Disc: a next-generation motion-preserving implant for chronic lumbar discogenic pain

    PubMed Central

    Yue, James J; Garcia, Rolando; Miller, Larry E

    2016-01-01

    Degeneration of the lumbar intervertebral discs is a leading cause of chronic low back pain in adults. Treatment options for patients with chronic lumbar discogenic pain unresponsive to conservative management include total disc replacement (TDR) or lumbar fusion. Until recently, only two lumbar TDRs had been approved by the US Food and Drug Administration − the Charité Artificial Disc in 2004 and the ProDisc-L Total Disc Replacement in 2006. In June 2015, a next-generation lumbar TDR received Food and Drug Administration approval − the activL® Artificial Disc (Aesculap Implant Systems). Compared to previous-generation lumbar TDRs, the activL® Artificial Disc incorporates specific design enhancements that result in a more precise anatomical match and allow a range of motion that better mimics the healthy spine. The results of mechanical and clinical studies demonstrate that the activL® Artificial Disc results in improved mechanical and clinical outcomes versus earlier-generation artificial discs and compares favorably to lumbar fusion. The purpose of this report is to describe the activL® Artificial Disc including implant characteristics, intended use, surgical technique, postoperative care, mechanical testing, and clinical experience to date. PMID:27274317

  6. Evaluation of Electrospun Nanofiber-Anchored Silicone for the Degenerative Intervertebral Disc

    PubMed Central

    Riahanizad, S.

    2017-01-01

    The nucleus pulposus (NP) substitution by polymeric gel is one of the promising techniques for the repair of the degenerative intervertebral disc (IVD). Silicone gel is one of the potential candidates for a NP replacement material. Electrospun fiber anchorage to silicone disc, referred as ENAS disc, may not only improve the biomechanical performances of the gel but it can also improve restoration capability of the gel, which is unknown. This study successfully produced a novel process to anchor any size and shape of NP gel with electrospun fiber mesh. Viscoelastic properties of silicone and ENAS disc were measured using standard experimental techniques and compared with the native tissue properties. Ex vivo mechanical tests were conducted on ENAS disc-implanted rabbit tails to the compare the mechanical stability between intact and ENAS implanted spines. This study found that viscoelastic properties of ENAS disc are higher than silicone disc and comparable to the viscoelastic properties of human NP. The ex vivo studies found that the ENAS disc restore the mechanical functionality of rabbit tail spine, after discectomy of native NP and replacing the NP by ENAS disc. Therefore, the PCL ENF mesh anchoring technique to a NP implant can have clinical potential. PMID:29181144

  7. 37 CFR 1.52 - Language, paper, writing, margins, compact disc specifications.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... permanent dark ink or its equivalent; and (v) Presented in a form having sufficient clarity and contrast... statement that the replacement compact disc contains no new matter. The compact disc and copy must be...

  8. An evaluation of information on the internet about a new device: the cervical artificial disc replacement.

    PubMed

    Qureshi, Sheeraz A; Koehler, Steven M; Lin, James D; Bird, Justin; Garcia, Ryan M; Hecht, Andrew C

    2012-05-01

    Cross-sectional survey. The objective of this study was to investigate the authorship, content, and quality of information available to the public on the Internet pertaining to the cervical artificial disc replacement device. The Internet is widely used by patients as an educational tool for health care information. In addition, the Internet is used as a medium for direct-to-consumer marketing. Increasing interest in cervical artificial disc replacement has led to the emergence of numerous Web sites offering information about this procedure. It is thought that patients can be influenced by information found on the Internet. A cross section of Web sites accessible to the general public was surveyed. Three commonly used search engines were used to locate 150 (50/search engine) Web sites providing information about the cervical artificial disc replacement. Each Web site was evaluated with regard to authorship and content. Fifty-three percent of the Web sites reviewed were authorized by a private physician group, 4% by an academic physician group, 13% by industry, 16% were news reports, and 14% were not otherwise categorized. Sixty-five percent of Web sites offered a mechanism for direct contact and 19% provided clear patient eligibility criteria. Benefits were expressed in 80% of Web sites, whereas associated risks were described in 35% or less. European experiences were noted in 17% of Web sites, whereas only 9% of Web sites detailed the current US experience. CONCLUSION.: The results of this study demonstrate that much of the content of the Internet-derived information pertaining to the cervical artificial disc replacement is for marketing purposes and may not represent unbiased information. Until we can confirm the content on a Web site to be accurate, patients should be cautioned when using the Internet as a source for health care information related to cervical disc replacement.

  9. 37 CFR 1.52 - Language, paper, writing, margins, compact disc specifications.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... by a typewriter or machine printer in permanent dark ink or its equivalent; and (v) Presented in a... accompanied by a statement that the replacement compact disc contains no new matter. The compact disc and copy...

  10. The Correlation between Insertion Depth of Prodisc-C Artificial Disc and Postoperative Kyphotic Deformity: Clinical Importance of Insertion Depth of Artificial Disc.

    PubMed

    Lee, Do-Youl; Kim, Se-Hoon; Suh, Jung-Keun; Cho, Tai-Hyoung; Chung, Yong-Gu

    2012-09-01

    This study was designed to investigate the correlation between insertion depth of artificial disc and postoperative kyphotic deformity after Prodisc-C total disc replacement surgery, and the range of artificial disc insertion depth which is effective in preventing postoperative whole cervical or segmental kyphotic deformity. A retrospective radiological analysis was performed in 50 patients who had undergone single level total disc replacement surgery. Records were reviewed to obtain demographic data. Preoperative and postoperative radiographs were assessed to determine C2-7 Cobb's angle and segmental angle and to investigate postoperative kyphotic deformity. A formula was introduced to calculate insertion depth of Prodisc-C artificial disc. Statistical analysis was performed to search the correlation between insertion depth of Prodisc-C artificial disc and postoperative kyphotic deformity, and to estimate insertion depth of Prodisc-C artificial disc to prevent postoperative kyphotic deformity. In this study no significant statistical correlation was observed between insertion depth of Prodisc-C artificial disc and postoperative kyphotic deformity regarding C2-7 Cobb's angle. Statistical correlation between insertion depth of Prodisc-C artificial disc and postoperative kyphotic deformity was observed regarding segmental angle (p<0.05). It failed to estimate proper insertion depth of Prodisc-C artificial disc effective in preventing postoperative kyphotic deformity. Postoperative segmental kyphotic deformity is associated with insertion depth of Prodisc-C artificial disc. Anterior located artificial disc leads to lordotic segmental angle and posterior located artificial disc leads to kyphotic segmental angle postoperatively. But C2-7 Cobb's angle is not affected by artificial disc location after the surgery.

  11. 78 FR 24426 - Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-25

    ... application for the Kineflex/C Cervical Artificial Disc sponsored by SpinalMotion. The Kineflex/C is a metal-on-metal (cobalt chrome molybdenum alloy) cervical total disc replacement device. The Kineflex/C is... degenerative disc disease (DDD) where DDD is defined as discogenic back pain with degeneration of the disc as...

  12. MECHANICAL DESIGN CRITERIA FOR INTERVERTEBRAL DISC TISSUE ENGINEERING

    PubMed Central

    Nerurkar, Nandan L.; Elliott, Dawn M.; Mauck, Robert L.

    2009-01-01

    Due to the inability of current clinical practices to restore function to degenerated intervertebral discs, the arena of disc tissue engineering has received substantial attention in recent years. Despite tremendous growth and progress in this field, translation to clinical implementation has been hindered by a lack of well-defined functional benchmarks. Because successful replacement of the disc is contingent upon replication of some or all of its complex mechanical behaviour, it is critically important that disc mechanics be well characterized in order to establish discrete functional goals for tissue engineering. In this review, the key functional signatures of the intervertebral disc are discussed and used to propose a series of native tissue benchmarks to guide the development of engineered replacement tissues. These benchmarks include measures of mechanical function under tensile, compressive and shear deformations for the disc and its substructures. In some cases, important functional measures are identified that have yet to be measured in the native tissue. Ultimately, native tissue benchmark values are compared to measurements that have been made on engineered disc tissues, identifying measures where functional equivalence was achieved, and others where there remain opportunities for advancement. Several excellent reviews exist regarding disc composition and structure, as well as recent tissue engineering strategies; therefore this review will remain focused on the functional aspects of disc tissue engineering. PMID:20080239

  13. Prospective study on serum metal levels in patients with metal-on-metal lumbar disc arthroplasty.

    PubMed

    Gornet, Matthew F; Burkus, J K; Harper, M L; Chan, F W; Skipor, A K; Jacobs, J J

    2013-04-01

    Metal-on-metal total disc replacement is a recent alternative treatment for degenerative disc disease. Wear and corrosion of these implants can lead to local and systemic transport of metal debris. This prospective longitudinal study examined the serum chromium and cobalt levels in 24 patients with cobalt-chromium alloy metal-on-metal lumbar disc replacements. Serum was assayed for chromium (Cr) and cobalt (Co) using high-resolution inductively-coupled plasma-mass spectrometry. Detection limits were 0.015 ng/mL for Cr and 0.04 ng/mL for Co. Median serum Co levels at pre-op, 3, 6, 12, 24, and 36-months post-op were 0.10, 1.03, 0.96, 0.98, 0.67, and 0.52 ng/mL, respectively. Median serum Cr levels were 0.06, 0.49, 0.65, 0.43, 0.52, and 0.50 ng/mL, respectively. In general, these results indicated that serum Co and Cr levels are elevated at all postoperative time points and are of the same order of magnitude as those observed in well-functioning metal-on-metal surface replacements of the hip and in metal-on-metal total hip replacements at similar postoperative time points.

  14. Defining the Ideal Lumbar Total Disc Replacement Patient and Standard of Care.

    PubMed

    Gornet, Matthew; Buttermann, Glenn; Guyer, Richard; Yue, James; Ferko, Nicole; Hollmann, Sarah

    2017-12-15

    : Lumbar total disc replacement, now in use since 2004, was determined by the panel to be a standard of care for the treatment of symptomatic single-level lumbar degenerative disc disease in the active patient subpopulation as outlined by the investigational device exemption study criteria. The large body of evidence supporting this statement, including surgeons' experiences, was presented and discussed. Consensus statements focusing on decision-making criteria reflected that efficacy, long-term safety, clinical outcomes with validated measures, and cost-effectiveness should form the basis of decision-making by payers. Diagnostic challenges with lumbar degenerative disc disease patients were discussed among the panel, and it was concluded that although variably used among surgeons, reliable tools exist to appropriately diagnose discogenic back pain.

  15. Intervertebral disc regeneration or repair with biomaterials and stem cell therapy--feasible or fiction?

    PubMed

    Chan, Samantha C W; Gantenbein-Ritter, Benjamin

    2012-05-31

    The "gold standard" for treatment of intervertebral disc herniations and degenerated discs is still spinal fusion, corresponding to the saying "no disc - no pain". Mechanical prostheses, which are currently implanted, do only have medium outcome success and have relatively high re-operation rates. Here, we discuss some of the biological intervertebral disc replacement approaches, which can be subdivided into at least two classes in accordance to the two different tissue types, the nucleus pulposus (NP) and the annulus fibrosus (AF). On the side of NP replacement hydrogels have been extensively tested in vitro and in vivo. However, these gels are usually a trade-off between cell biocompatibility and load-bearing capacity, hydrogels which fulfill both are still lacking. On the side of AF repair much less is known and the question of the anchoring of implants is still to be addressed. New hope for cell therapy comes from developmental biology investigations on the existence of intervertebral disc progenitor cells, which would be an ideal cell source for cell therapy. Also notochordal cells (remnants of the embryonic notochord) have been recently pushed back into focus since these cells have regenerative potential and can activate disc cells. Growth factor treatment and molecular therapies could be less problematic. The biological solutions for NP and AF replacement are still more fiction than fact. However, tissue engineering just scratched the tip of the iceberg, more satisfying solutions are yet to be added to the biomedical pipeline.

  16. Finite Element Analysis of Influence of Axial Position of Center of Rotation of a Cervical Total Disc Replacement on Biomechanical Parameters: Simulated 2-Level Replacement Based on a Validated Model.

    PubMed

    Li, Yang; Zhang, Zhenjun; Liao, Zhenhua; Mo, Zhongjun; Liu, Weiqiang

    2017-10-01

    Finite element models have been widely used to predict biomechanical parameters of the cervical spine. Previous studies investigated the influence of position of rotational centers of prostheses on cervical biomechanical parameters after 1-level total disc replacement. The purpose of this study was to explore the effects of axial position of rotational centers of prostheses on cervical biomechanics after 2-level total disc replacement. A validated finite element model of C3-C7 segments and 2 prostheses, including the rotational center located at the superior endplate (SE) and inferior endplate (IE), was developed. Four total disc replacement models were used: 1) IE inserted at C4-C5 disc space and IE inserted at C5-C6 disc space (IE-IE), 2) IE-SE, 3) SE-IE, and 4) SE-SE. All models were subjected to displacement control combined with a 50 N follower load to simulate flexion and extension motions in the sagittal plane. For each case, biomechanical parameters, including predicted moments, range of rotation at each level, facet joint stress, and von Mises stress on the ultra-high-molecular-weight polyethylene core of the prostheses, were calculated. The SE-IE model resulted in significantly lower stress at the cartilage level during extension and at the ultra-high-molecular-weight polyethylene cores when compared with the SE-SE construct and did not generate hypermotion at the C4-C5 level compared with the IE-SE and IE-IE constructs. Based on the present analysis, the SE-IE construct is recommended for treating cervical disease at the C4-C6 level. This study may provide a useful model to inform clinical operations. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Mechanical design criteria for intervertebral disc tissue engineering.

    PubMed

    Nerurkar, Nandan L; Elliott, Dawn M; Mauck, Robert L

    2010-04-19

    Due to the inability of current clinical practices to restore function to degenerated intervertebral discs, the arena of disc tissue engineering has received substantial attention in recent years. Despite tremendous growth and progress in this field, translation to clinical implementation has been hindered by a lack of well-defined functional benchmarks. Because successful replacement of the disc is contingent upon replication of some or all of its complex mechanical behaviors, it is critically important that disc mechanics be well characterized in order to establish discrete functional goals for tissue engineering. In this review, the key functional signatures of the intervertebral disc are discussed and used to propose a series of native tissue benchmarks to guide the development of engineered replacement tissues. These benchmarks include measures of mechanical function under tensile, compressive, and shear deformations for the disc and its substructures. In some cases, important functional measures are identified that have yet to be measured in the native tissue. Ultimately, native tissue benchmark values are compared to measurements that have been made on engineered disc tissues, identifying where functional equivalence was achieved, and where there remain opportunities for advancement. Several excellent reviews exist regarding disc composition and structure, as well as recent tissue engineering strategies; therefore this review will remain focused on the functional aspects of disc tissue engineering. Copyright 2009 Elsevier Ltd. All rights reserved.

  18. Lumbar Disc Replacement for Junctional Decompensation After Fusion Surgery: Clinical and Radiological Outcome at an Average Follow-Up of 33 Months

    PubMed Central

    Sliwa, Karen; Weinberg, Ian R.; Sweet, Barry MBE; de Villiers, Malan; Candy, Geoffrey P.

    2007-01-01

    Background Failed fusion surgery remains difficult to treat. Few published data on disc replacement surgery after failed fusion procedures exist. Our objective was to evaluate outcomes of junctional lumbar disc replacement after previous fusion surgery and to correlate outcome with radiological changes to parameters of sagittal balance. Methods Out of a single-center prospective registry of 290 patients with 404 lumbar disc replacements, 27 patients had had a previous lumbar fusion operation on 1 to 4 lumbar segments and had completed a mean follow- up of 33 months (range: 18–56). We correlated the clinical outcome measures (patient satisfaction, 10-point pain score, and Oswestry Disability Index [ODI] score) to parameters of spinal sagittal alignment (sacral tilt, pelvic tilt, pelvic incidence, and lumbar lordosis). Results Postoperative hospital stay averaged 3.3 days (range: 2–8). Previously-employed patients went back to their jobs with a mean of 32 days (range: 21–42) after the procedure. At the latest follow-up, 1 of the patients considered the outcome to be poor, 3 fair, 8 good, and 15 excellent. Twenty-four patients “would undergo the operation again.” Average pain score decreased from 9.1 ± 1.0 (SD) to 3.2 ± 2.1 (P < .01). Average ODI decreased from 50.2 ± 9.9 preoperatively to 21.7 ± 14.2 (P ≤ .01). We found the change in pelvic tilt to be an independent predictor of better clinical outcome by multivariate analysis (P < .05). Conclusions In patients with junctional failure adjacent to a previous posterolateral fusion, disc replacement at the junctional level(s), compared with osteotomy and fusion surgery, offers the advantage of maintaining segmental mobility and correcting the flat-back deformity through a single approach with less operative time and blood loss. Early- to intermediate-term results are promising. The influence of changes in spinal sagittal alignment on clinical outcome needs to be addressed in future research. Clinical Relevance This is the first study on “junctional disc replacement patients” correlating clinical outcome to changes in spinal/pelvic alignment. PMID:25802584

  19. Wear in ceramic on ceramic type lumbar total disc replacement: effect of radial clearance.

    PubMed

    Shankar, S; Kesavan, D

    2015-01-01

    The wear of the bearing surfaces of total disc replacement (TDR) is a key problem leads to reduction in the lifetime of the prosthesis and it mainly occurs due to the range of clearances of the articulating surface between the superior plate and core. The objective of this paper is to estimate the wear using finite element concepts considering the different radial clearances between the articulating surfaces of ceramic on ceramic type Lumbar Total Disc Replacement (LTDR). The finite element (FE) model was subjected to wear testing protocols according to loading profile of International Standards Organization (ISO) 18192 standards through 10 million cycles. The radial clearance value of 0.05 mm showed less volumetric wear when compared with other radial clearance values. Hence, low radial clearance values are suitable for LTDR to minimize the wear.

  20. Successful treatment of a patient after sudden loss of the disc in a Björk-Shiley convexo-concave mitral prosthesis.

    PubMed

    Scalia, D; Giacomin, A; Da Col, U; Valfre, C

    1987-10-01

    The patient's survival after minor strut fracture and migration of a Björk-Shiley mitral prosthetic disc is presented. The operation was carried out in two stages: first emergency replacement of the mitral prosthesis and, later, elective removal of the dislocated disc.

  1. Replacing Shox2 with human SHOX leads to congenital disc degeneration of the temporomandibular joint in mice

    PubMed Central

    Li, Xihai; Liu, Hongbing; Gu, Shuping; Liu, Chao; Sun, Cheng; Zheng, Yuqian; Chen, YiPing

    2013-01-01

    The temporomandibular joint (TMJ) consists of the glenoid fossa arising from the otic capsule through intramembranous ossification, the fibrocartilaginous disc and the condyle, derived from the secondary cartilage by endochondral ossification. We have reported previously that cranial neural crest-specific inactivation of the homeobox gene Shox2, which is expressed in the mesenchymal cells of maxilla-mandibular junction and later in the progenitor cells and perichondrium of the developing chondyle, led to dysplasia and ankylosis of the TMJ, and replacement of the mouse Shox2 with the human SHOX gene rescued the dysplastic and ankylosis phenotypes but developed a prematurely worn out articular disc. In this study, we investigated the molecular and cellular bases for the premature wear out articular disc in the TMJ of mice carrying the human SHOX replacement allele in the Shox2 locus (referred as Shox2SHOX-KI/KI). We found that the developmental process and expression of several key genes in the TMJ of Shox2SHOX-KI/KI mice appeared similar to the controls. However, the disc of the Shox2SHOX-KI/KI TMJ exhibited a reduced level of Col I and Aggrecan, accompanied by increased activities of matrix metalloproteinases (MMPs) and a down-regulation of Ihh expression. Dramatically increased cell apoptosis in the disc was also observed. These combinatory cellular and molecular defects appear to contribute to the observed disc phenotype, suggesting that while the human SHOX can exert similar function as the mouse Shox2 in regulating early TMJ development, it apparently has a distinct function in the regulation of those molecules that are involved in tissue homeostasis. PMID:24248941

  2. Biological intervertebral disc replacement: an in vivo model and comparison of two surgical techniques to approach the rat caudal disc

    PubMed Central

    Gebhard, Harry; James, Andrew R.; Bowles, Robby D.; Dyke, Jonathan P.; Saleh, Tatianna; Doty, Stephen P.; Bonassar, Lawrence J.; Härtl, Roger

    2011-01-01

    Study design: Prospective randomized animal study. Objective: To determine a surgical technique for reproducible and functional intervertebral disc replacement in an orthotopic animal model. Methods: The caudal 3/4 intervertebral disc (IVD) of the rat tail was approached by two surgical techniques: blunt dissection, stripping and retracting (Technique 1) or incising and repairing (Technique 2) the dorsal longitudinal tendons. The intervertebral disc was dissected and removed, and then either discarded or reinserted. Outcome measures were perioperative complications, spontaneous tail movement, 7T MRI (T1- and T2-sequences for measurement of disc space height (DSH) and disc hydration). Microcomputed tomographic imaging (micro CT) was additionally performed postmortem. Results: No vascular injuries occurred and no systemic or local infections were observed over the course of 1 month. Tail movements were maintained. With tendon retraction (Technique 1) gross loss of DSH occurred with both discectomy and reinsertion. Tendon division (Technique 2) maintained DSH with IVD reinsertion but not without. The DSH was demonstrated on MRI measurement. A new scoring system to assess IVD appearances was described. Conclusions: The rat tail model, with a tendon dividing surgical technique, can function as an orthotopic animal model for IVD research. Mechanical stimulation is maintained by preserved tail movements. 7T MRI is a feasible modality for longitudinal monitoring for the rat caudal disc. PMID:22956934

  3. A comparison of retraction pressure during anterior cervical plate surgery and cervical disc replacement: a cadaveric study.

    PubMed

    Tortolani, P Justin; Cunningham, Bryan W; Vigna, Franco; Hu, Nianbin; Zorn, Candace M; McAfee, Paul C

    2006-07-01

    Dysphagia is a well-recognized complication after anterior cervical discectomy and fusion, observed in as high as 50% of cases by videofluoroscopic evaluation postoperatively. Esophageal injury due to surgical retraction is a complication due to which swallowing difficulties may ensue. There are limited published data evaluating the effect of soft tissue retraction on intraesophageal pressures during anterior cervical instrumentation procedures. The purpose of this study was to (a) measure the intraesophageal pressure secondary to retraction during anterior instrumentation, (b) determine whether any pressure differences exist between plating and cervical disc replacement, and (c) determine whether the surgical level or length of the plate influences the magnitude of intraesophageal pressure during retraction. An analysis of soft tissue retraction pressure was performed for anterior single-level and 3-level cervical plating and cervical disc replacement procedures. Using a 4-cm transverse incision, a Smith-Robinson anterior approach to the cervical spine was performed on 7 fresh, frozen cadavers. The correct placement of an esophageal pressure-transducing catheter was confirmed by laryngoscopy, manual palpation of the esophagus, and fluoroscopic imaging. Three surgical instrumentation groups were used for comparisons: (a) single-level plate (b) single-level Porous Coated Motion cervical disc replacement, and (c) 3-level plate. Hand-held appendiceal retractors were used to retract the soft tissues during screw insertion into the plate and during application of the disc prosthesis into the interspace. Care was taken to exert just enough force on the retractors to allow the surgeon to move the desired implant into the correct position. In addition the individual performing the retraction was blinded to the procedure being performed-1-level plating, 3-level plating, or disk replacement. Fluoroscopy confirmed that the pressure sensors were directly behind the retractors during data acquisition. Significantly greater intraesophageal pressures were demonstrated for single-level cervical plating at C5-6 compared to that at C3-4 (P=0.036). Similarly, significantly greater pressures were recorded at C5-6 versus C3-4 for the 3-level plating group (P<0.001). In contrast, there was no statistically significant difference in pressures observed during disk replacement at C5-6 compared to that at C3-4 (P=0.084). Significantly greater pressures were recorded during single-level plating compared to disc replacement at both C3-4 (P=0.016) and C5-6 (P=0.016). Three-level plating demonstrated significantly greater pressures at C5-6 compared to disk replacement (P<0.001) but no statistically significant difference compared to disk replacement at C3-4 (P=0.333). The highest mean pressure, 154.5+/-49.5 mm Hg, was recorded at C5-6 level during insertion of the 3-level plates. On the basis of the data presented here, anterior cervical plating results in significantly greater intraesophageal pressures when performed at C5-6 compared to C3-4. This holds regardless of whether the plate spans the distance from C3 to C6 (3-level plate) or the single C5-6 level. In addition, the insertion of the cervical disc replacement seems to require less esophageal retraction and hence reduced intraesophageal pressures when compared to anterior cervical plating.

  4. Biomechanical Analysis of Cervical Disc Replacement and Fusion Using Single Level, Two Level, and Hybrid Constructs.

    PubMed

    Gandhi, Anup A; Kode, Swathi; DeVries, Nicole A; Grosland, Nicole M; Smucker, Joseph D; Fredericks, Douglas C

    2015-10-15

    A biomechanical study comparing arthroplasty with fusion using human cadaveric C2-T1 spines. To compare the kinematics of the cervical spine after arthroplasty and fusion using single level, 2 level and hybrid constructs. Previous studies have shown that spinal levels adjacent to a fusion experience increased motion and higher stress which may lead to adjacent segment disc degeneration. Cervical arthroplasty achieves similar decompression but preserves the motion at the operated level, potentially decreasing the occurrence of adjacent segment disc degeneration. 11 specimens (C2-T1) were divided into 2 groups (BRYAN and PRESTIGE LP). The specimens were tested in the following order; intact, single level total disc replacement (TDR) at C5-C6, 2-level TDR at C5-C6-C7, fusion at C5-C6 and TDR at C6-C7 (Hybrid construct), and lastly a 2-level fusion. The intact specimens were tested up to a moment of 2.0 Nm. After each surgical intervention, the specimens were loaded until the primary motion (C2-T1) matched the motion of the respective intact state (hybrid control). An arthroplasty preserved motion at the implanted level and maintained normal motion at the nonoperative levels. Arthrodesis resulted in a significant decrease in motion at the fused level and an increase in motion at the unfused levels. In the hybrid construct, the TDR adjacent to fusion preserved motion at the arthroplasty level, thereby reducing the demand on the other levels. Cervical disc arthroplasty with both the BRYAN and PRESTIGE LP discs not only preserved the motion at the operated level, but also maintained the normal motion at the adjacent levels. Under simulated physiologic loading, the motion patterns of the spine with the BRYAN or PRESTIGE LP disc were very similar and were closer than fusion to the intact motion pattern. An adjacent segment disc replacement is biomechanically favorable to a fusion in the presence of a pre-existing fusion.

  5. Comparative charge analysis of one- and two-level lumbar total disc arthroplasty versus circumferential lumbar fusion.

    PubMed

    Levin, David A; Bendo, John A; Quirno, Martin; Errico, Thomas; Goldstein, Jeffrey; Spivak, Jeffrey

    2007-12-01

    This is a retrospective, independent study comparing 2 groups of patients treated surgically for discogenic low back pain associated with degenerative disc disease (DDD) in the lumbosacral spine. To compare the surgical and hospitalization charges associated with 1- and 2-level lumbar total disc replacement and circumferential lumbar fusion. Reported series of lumbar total disc replacement have been favorable. However, economic aspects of lumbar total disc replacement (TDR) have not been published or studied. This information is important considering the recent widespread utilization of new technologies. Recent studies have demonstrated comparable short-term clinical results between TDR and lumbar fusion recipients. Relative charges may be another important indicator of the most appropriate procedure. We report a hospital charge-analysis comparing ProDisc lumbar disc replacement with circumferential fusion for discogenic low back pain. In a cohort of 53 prospectively selected patients with severe, disabling back pain and lumbar disc degeneration, 36 received Synthes ProDisc TDR and 17 underwent circumferential fusion for 1- and 2-level degenerative disc disease between L3 and S1. Randomization was performed using a 2-to-1 ratio of ProDisc recipients to control spinal fusion recipients. Charge comparisons, including operating room charges, inpatient hospital charges, and implant charges, were made from hospital records using inflation-corrected 2006 U.S. dollars. Operating room times, estimated blood loss, and length of stay were obtained from hospital records as well. Surgeon and anesthesiologist fees were, for the purposes of comparison, based on Medicare reimbursement rates. Statistical analysis was performed using a 2-tailed Student t test. For patients with 1-level disease, significant differences were noted between the TDR and fusion control group. The mean total charge for the TDR group was $35,592 versus $46,280 for the fusion group (P = 0.0018). Operating room charges were $12,000 and $18,950, respectively, for the TDR and fusion groups (P < 0.05). Implant charges averaged $13,990 for the fusion group, which is slightly higher than the $13,800 for the ProDisc (P = 0.9). Estimated blood loss averaged 794 mL in the fusion group versus 412 mL in the TDR group (P = 0.0058). Mean OR minutes averaged 344 minutes for the fusion group and 185 minutes for the TDR (P < 0.05) Mean length of stay was 4.78 days for fusion versus 4.32 days for TDR (P = 0.394). For patients with 2-level disease, charges were similar between the TDR and fusion groups. The mean total charge for the 2-level TDR group was $55,524 versus $56,823 for the fusion group (P = 0.55). Operating room charges were $15,340 and $20,560, respectively, for the TDR and fusion groups (P = 0.0003). Surgeon fees and anesthesiologist charges based on Medicare reimbursement rates were $5857 and $525 for the fusion group, respectively, versus $2826 and $331 for the TDR group (P < 0.05 for each). Implant charges were significantly lower for the fusion group (mean, $18,460) than those for 2-level Synthes ProDisc ($27,600) (P < 0.05). Operative time averaged 387 minutes for fusion versus 242 minutes for TDR (P < 0.0001). EBL and length of stay were similar. Patients undergoing 1- and 2-level ProDisc total disc replacement spent significantly less time in the OR and had less EBL than controls. Charges were significantly lower for TDR compared with circumferential fusions in the 1-level patient group, while charges were similar in the 2-level group.

  6. Mixed reality simulation of rasping procedure in artificial cervical disc replacement (ACDR) surgery.

    PubMed

    Halic, Tansel; Kockara, Sinan; Bayrak, Coskun; Rowe, Richard

    2010-10-07

    Until quite recently spinal disorder problems in the U.S. have been operated by fusing cervical vertebrae instead of replacement of the cervical disc with an artificial disc. Cervical disc replacement is a recently approved procedure in the U.S. It is one of the most challenging surgical procedures in the medical field due to the deficiencies in available diagnostic tools and insufficient number of surgical practices For physicians and surgical instrument developers, it is critical to understand how to successfully deploy the new artificial disc replacement systems. Without proper understanding and practice of the deployment procedure, it is possible to injure the vertebral body. Mixed reality (MR) and virtual reality (VR) surgical simulators are becoming an indispensable part of physicians' training, since they offer a risk free training environment. In this study, MR simulation framework and intricacies involved in the development of a MR simulator for the rasping procedure in artificial cervical disc replacement (ACDR) surgery are investigated. The major components that make up the MR surgical simulator with motion tracking system are addressed. A mixed reality surgical simulator that targets rasping procedure in the artificial cervical disc replacement surgery with a VICON motion tracking system was developed. There were several challenges in the development of MR surgical simulator. First, the assembly of different hardware components for surgical simulation development that involves knowledge and application of interdisciplinary fields such as signal processing, computer vision and graphics, along with the design and placements of sensors etc . Second challenge was the creation of a physically correct model of the rasping procedure in order to attain critical forces. This challenge was handled with finite element modeling. The third challenge was minimization of error in mapping movements of an actor in real model to a virtual model in a process called registration. This issue was overcome by a two-way (virtual object to real domain and real domain to virtual object) semi-automatic registration method. The applicability of the VICON MR setting for the ACDR surgical simulator is demonstrated. The main stream problems encountered in MR surgical simulator development are addressed. First, an effective environment for MR surgical development is constructed. Second, the strain and the stress intensities and critical forces are simulated under the various rasp instrument loadings with impacts that are applied on intervertebral surfaces of the anterior vertebrae throughout the rasping procedure. Third, two approaches are introduced to solve the registration problem in MR setting. Results show that our system creates an effective environment for surgical simulation development and solves tedious and time-consuming registration problems caused by misalignments. Further, the MR ACDR surgery simulator was tested by 5 different physicians who found that the MR simulator is effective enough to teach the anatomical details of cervical discs and to grasp the basics of the ACDR surgery and rasping procedure.

  7. Mixed reality simulation of rasping procedure in artificial cervical disc replacement (ACDR) surgery

    PubMed Central

    2010-01-01

    Background Until quite recently spinal disorder problems in the U.S. have been operated by fusing cervical vertebrae instead of replacement of the cervical disc with an artificial disc. Cervical disc replacement is a recently approved procedure in the U.S. It is one of the most challenging surgical procedures in the medical field due to the deficiencies in available diagnostic tools and insufficient number of surgical practices For physicians and surgical instrument developers, it is critical to understand how to successfully deploy the new artificial disc replacement systems. Without proper understanding and practice of the deployment procedure, it is possible to injure the vertebral body. Mixed reality (MR) and virtual reality (VR) surgical simulators are becoming an indispensable part of physicians’ training, since they offer a risk free training environment. In this study, MR simulation framework and intricacies involved in the development of a MR simulator for the rasping procedure in artificial cervical disc replacement (ACDR) surgery are investigated. The major components that make up the MR surgical simulator with motion tracking system are addressed. Findings A mixed reality surgical simulator that targets rasping procedure in the artificial cervical disc replacement surgery with a VICON motion tracking system was developed. There were several challenges in the development of MR surgical simulator. First, the assembly of different hardware components for surgical simulation development that involves knowledge and application of interdisciplinary fields such as signal processing, computer vision and graphics, along with the design and placements of sensors etc . Second challenge was the creation of a physically correct model of the rasping procedure in order to attain critical forces. This challenge was handled with finite element modeling. The third challenge was minimization of error in mapping movements of an actor in real model to a virtual model in a process called registration. This issue was overcome by a two-way (virtual object to real domain and real domain to virtual object) semi-automatic registration method. Conclusions The applicability of the VICON MR setting for the ACDR surgical simulator is demonstrated. The main stream problems encountered in MR surgical simulator development are addressed. First, an effective environment for MR surgical development is constructed. Second, the strain and the stress intensities and critical forces are simulated under the various rasp instrument loadings with impacts that are applied on intervertebral surfaces of the anterior vertebrae throughout the rasping procedure. Third, two approaches are introduced to solve the registration problem in MR setting. Results show that our system creates an effective environment for surgical simulation development and solves tedious and time-consuming registration problems caused by misalignments. Further, the MR ACDR surgery simulator was tested by 5 different physicians who found that the MR simulator is effective enough to teach the anatomical details of cervical discs and to grasp the basics of the ACDR surgery and rasping procedure PMID:20946594

  8. [Displacement and tissue remodeling of temporomandibular joint disc].

    PubMed

    Wang, M Q

    2017-03-09

    Sounding takes the highest prevalence of the signs of temporomandibular disorders (TMD). The well accepted theory of the mechanism for temporomandibular joint (TMJ) sounding is the internal derangement typically characterized by disc displacement. However, according to literature, there are approximately one third of asymptomatic joints in population had disc displacement, and, on the other hand, there are one fourth of TMJ sounding patients had not signs or very limited signs of disc displacement. Replacing the displaced disc to the normal position via methods like surgical operation did not achieve satisfactory long-term outcomes. In this review, we discuss and analyze the possible remodeling of the joint disc displacement diagnosed with imaging based on the anatomy and pathophysiology.

  9. Difference in occurrence of heterotopic ossification according to prosthesis type in the cervical artificial disc replacement.

    PubMed

    Yi, Seong; Kim, Keung Nyun; Yang, Moon Sul; Yang, Joong Won; Kim, Hoon; Ha, Yoon; Yoon, Do Heum; Shin, Hyun Chul

    2010-07-15

    Retrospective study of the difference of heterotopic ossification (HO) occurrence according to 3 different types of prosthesis. This study was designed to investigate the difference of HO occurrence according to different type of prosthesis. HO is defined as formation of the bone outside the skeletal system. Reported HO occurrence rate in cervical artificial disc replacement (ADR) was unexpectedly high and varied. But the influencing factors of HO in cervical ADR have not been elucidated well. The prosthesis-related factors for making difference of HO occurrence were investigated in this study. A total of 170 patients undergoing cervical arthroplasty with the Bryan cervical disc prosthesis (Medtroic Sofamor Danek, Memphis, TN), Mobi-C disc prosthesis (LDR Medical, Troyes, France), and ProDisc-C (Synthes, Inc., West Chester, PA) were included. Cervical lateral radiographs obtained before and after surgery were used to identify HO. Occurrence rate, occurrence-free period, location, and grade of HOs were investigated according to the different prosthesis. Each prosthesis group included patients as follows: Bryan disc, 81 patients; Mobi-C, 61 patients; and ProDisc-C, 28 patients. Overall HO rate was 40.6% (69 of 170 patients). Each HO occurrence rate by prosthesis was as follows: the Bryan disc group, 21.0%; Mobi-C group, 52.5%; and the ProDisc-C group, 71.4%. In the survival analysis, all patients showed 27.1 +/- 3.7 months as the median survival. The Bryan disc group showed statistically longer survival (48.4 +/- 7.4 months) than the other groups. Occurrence of HO is an inevitable postoperative complication after cervical ADR. The occurrence rate of HO was higher than our expectation. Moreover, definite differences in occurrence rate according to the prosthesis type were identified by this study.

  10. Finite Element Study of a Lumbar Intervertebral Disc Nucleus Replacement Device.

    PubMed

    Coogan, Jessica S; Francis, W Loren; Eliason, Travis D; Bredbenner, Todd L; Stemper, Brian D; Yoganandan, Narayan; Pintar, Frank A; Nicolella, Daniel P

    2016-01-01

    Nucleus replacement technologies are a minimally invasive alternative to spinal fusion and total disc replacement that have the potential to reduce pain and restore motion for patients with degenerative disc disease. Finite element modeling can be used to determine the biomechanics associated with nucleus replacement technologies. The current study focuses on a new nucleus replacement device designed as a conforming silicone implant with an internal void. A validated finite element model of the human lumbar L3-L4 motion segment was developed and used to investigate the influence of the nucleus replacement device on spine biomechanics. In addition, the effect of device design changes on biomechanics was determined. A 3D, L3-L4 finite element model was constructed from medical imaging data. Models were created with the normal intact nucleus, the nucleus replacement device, and a solid silicone implant. Probabilistic analysis was performed on the normal model to provide quantitative validation metrics. Sensitivity analysis was performed on the silicone Shore A durometer of the device. Models were loaded under axial compression followed by flexion/extension, lateral bending, or axial rotation. Compressive displacement, endplate stresses, reaction moment, and annulus stresses were determined and compared between the different models. The novel nucleus replacement device resulted in similar compressive displacement, endplate stress, and annulus stress and slightly higher reaction moment compared with the normal nucleus. The solid implant resulted in decreased displacement, increased endplate stress, decreased annulus stress, and decreased reaction moment compared with the novel device. With increasing silicone durometer, compressive displacement decreased, endplate stress increased, reaction moment increased, and annulus stress decreased. Finite element analysis was used to show that the novel nucleus replacement device results in similar biomechanics compared with the normal intact nucleus.

  11. Finite Element Study of a Lumbar Intervertebral Disc Nucleus Replacement Device

    PubMed Central

    Coogan, Jessica S.; Francis, W. Loren; Eliason, Travis D.; Bredbenner, Todd L.; Stemper, Brian D.; Yoganandan, Narayan; Pintar, Frank A.; Nicolella, Daniel P.

    2016-01-01

    Nucleus replacement technologies are a minimally invasive alternative to spinal fusion and total disc replacement that have the potential to reduce pain and restore motion for patients with degenerative disc disease. Finite element modeling can be used to determine the biomechanics associated with nucleus replacement technologies. The current study focuses on a new nucleus replacement device designed as a conforming silicone implant with an internal void. A validated finite element model of the human lumbar L3–L4 motion segment was developed and used to investigate the influence of the nucleus replacement device on spine biomechanics. In addition, the effect of device design changes on biomechanics was determined. A 3D, L3–L4 finite element model was constructed from medical imaging data. Models were created with the normal intact nucleus, the nucleus replacement device, and a solid silicone implant. Probabilistic analysis was performed on the normal model to provide quantitative validation metrics. Sensitivity analysis was performed on the silicone Shore A durometer of the device. Models were loaded under axial compression followed by flexion/extension, lateral bending, or axial rotation. Compressive displacement, endplate stresses, reaction moment, and annulus stresses were determined and compared between the different models. The novel nucleus replacement device resulted in similar compressive displacement, endplate stress, and annulus stress and slightly higher reaction moment compared with the normal nucleus. The solid implant resulted in decreased displacement, increased endplate stress, decreased annulus stress, and decreased reaction moment compared with the novel device. With increasing silicone durometer, compressive displacement decreased, endplate stress increased, reaction moment increased, and annulus stress decreased. Finite element analysis was used to show that the novel nucleus replacement device results in similar biomechanics compared with the normal intact nucleus. PMID:27990418

  12. A 6-DOF parallel bone-grinding robot for cervical disc replacement surgery.

    PubMed

    Tian, Heqiang; Wang, Chenchen; Dang, Xiaoqing; Sun, Lining

    2017-12-01

    Artificial cervical disc replacement surgery has become an effective and main treatment method for cervical disease, which has become a more common and serious problem for people with sedentary work. To improve cervical disc replacement surgery significantly, a 6-DOF parallel bone-grinding robot is developed for cervical bone-grinding by image navigation and surgical plan. The bone-grinding robot including mechanical design and low level control is designed. The bone-grinding robot navigation is realized by optical positioning with spatial registration coordinate system defined. And a parametric robot bone-grinding plan and high level control have been developed for plane grinding for cervical top endplate and tail endplate grinding by a cylindrical grinding drill and spherical grinding for two articular surfaces of bones by a ball grinding drill. Finally, the surgical flow for a robot-assisted cervical disc replacement surgery procedure is present. The final experiments results verified the key technologies and performance of the robot-assisted surgery system concept excellently, which points out a promising clinical application with higher operability. Finally, study innovations, study limitations, and future works of this present study are discussed, and conclusions of this paper are also summarized further. This bone-grinding robot is still in the initial stage, and there are many problems to be solved from a clinical point of view. Moreover, the technique is promising and can give a good support for surgeons in future clinical work.

  13. Cross-Shear Implementation in Sliding-Distance-Coupled Finite Element Analysis of Wear in Metal-on-Polyethylene Total Joint Arthroplasty: Intervertebral Total Disc Replacement as an Illustrative Application

    PubMed Central

    Goreham-Voss, Curtis M.; Hyde, Philip J.; Hall, Richard M.; Fisher, John; Brown, Thomas D.

    2010-01-01

    Computational simulations of wear of orthopaedic total joint replacement implants have proven to valuably complement laboratory physical simulators, for pre-clinical estimation of abrasive/adhesive wear propensity. This class of numerical formulations has primarily involved implementation of the Archard/Lancaster relationship, with local wear computed as the product of (finite element) contact stress, sliding speed, and a bearing-couple-dependent wear factor. The present study introduces an augmentation, whereby the influence of interface cross-shearing motion transverse to the prevailing molecular orientation of the polyethylene articular surface is taken into account in assigning the instantaneous local wear factor. The formulation augment is implemented within a widely-utilized commercial finite element software environment (ABAQUS). Using a contemporary metal-on-polyethylene total disc replacement (ProDisc-L) as an illustrative implant, physically validated computational results are presented to document the role of cross-shearing effects in alternative laboratory consensus testing protocols. Going forward, this formulation permits systematically accounting for cross-shear effects in parametric computational wear studies of metal-on-polyethylene joint replacements, heretofore a substantial limitation of such analyses. PMID:20399432

  14. Does location of rotation center in artificial disc affect cervical biomechanics?

    PubMed

    Mo, Zhongjun; Zhao, Yanbin; Du, Chengfei; Sun, Yu; Zhang, Ming; Fan, Yubo

    2015-04-15

    A 3-dimensional finite element investigation. To compare the biomechanical performances of different rotation centers (RCs) in the prevalent artificial cervical discs. Various configurations are applied in artificial discs. Design parameters may influence the biomechanics of implanted spine. The RC is a primary variation in the popular artificial discs. Implantation of 5 prostheses was simulated at C5-C6 on the basis of a validated finite element cervical model (C3-C7). The prostheses included ball-in-socket design with a fixed RC located on the inferior endplate (BS-FI) and on the superior endplate (BS-FS), with a mobile RC at the inferior endplate (BS-MI), dual articulation with a mobile RC between the endplates (DA-M), and sliding articulation with various RCs (SA-V). The spinal motions in flexion and extension served as a displacement loading at the C3 vertebrae. Total disc replacements reduced extension moment. The ball-in-socket designs required less flexion moment, whereas the flexion stiffness of the spines with DA-M and SA-V was similar to that of the healthy model. The contributions of the implanted level to the global motions increased in the total disc replacements, except in the SA-V and DA-M models (in flexion). Ball-in-socket designs produced severe stress distributions in facet cartilage, whereas DA-M and SA-V produced more severe stress distribution on the bone-implant interface. Cervical stability was extremely affected in extension and partially affected in flexion by total disc replacement. With the prostheses with mobile RC, cervical curvature was readjusted under a low follower load. The SA-V and BS-FS designs exhibited better performances in the entire segmental stiffness and in the stability of the operative level than the BS-MI and BS-FI designs in flexion. The 5 designs demonstrated varying advantages relative to the stress distribution in the facet cartilages and on the bone-implant interface. 5.

  15. Wnt signaling during tooth replacement in zebrafish (Danio rerio): pitfalls and perspectives

    PubMed Central

    Huysseune, Ann; Soenens, Mieke; Elderweirdt, Fien

    2014-01-01

    The canonical (β-catenin dependent) Wnt signaling pathway has emerged as a likely candidate for regulating tooth replacement in continuously renewing dentitions. So far, the involvement of canonical Wnt signaling has been experimentally demonstrated predominantly in amniotes. These studies tend to show stimulation of tooth formation by activation of the Wnt pathway, and inhibition of tooth formation when blocking the pathway. Here, we report a strong and dynamic expression of the soluble Wnt inhibitor dickkopf1 (dkk1) in developing zebrafish (Danio rerio) tooth germs, suggesting an active repression of Wnt signaling during morphogenesis and cytodifferentiation of a tooth, and derepression of Wnt signaling during start of replacement tooth formation. To further analyse the role of Wnt signaling, we used different gain-of-function approaches. These yielded disjunct results, yet none of them indicating enhanced tooth replacement. Thus, masterblind (mbl) mutants, defective in axin1, mimic overexpression of Wnt, but display a normally patterned dentition in which teeth are replaced at the appropriate times and positions. Activating the pathway with LiCl had variable outcomes, either resulting in the absence, or the delayed formation, of first-generation teeth, or yielding a regular dentition with normal replacement, but no supernumerary teeth or accelerated tooth replacement. The failure so far to influence tooth replacement in the zebrafish by perturbing Wnt signaling is discussed in the light of (i) potential technical pitfalls related to dose- or time-dependency, (ii) the complexity of the canonical Wnt pathway, and (iii) species-specific differences in the nature and activity of pathway components. Finally, we emphasize the importance of in-depth knowledge of the wild-type pattern for reliable interpretations. It is hoped that our analysis can be inspiring to critically assess and elucidate the role of Wnt signaling in tooth development in polyphyodonts. PMID:25339911

  16. Determination of the intervertebral disc space from CT images of the lumbar spine

    NASA Astrophysics Data System (ADS)

    Korez, Robert; Å tern, Darko; Likar, Boštjan; Pernuš, Franjo; Vrtovec, Tomaž

    2014-03-01

    Degenerative changes of the intervertebral disc are among the most common causes of low back pain, where for individuals with significant symptoms surgery may be needed. One of the interventions is the total disc replacement surgery, where the degenerated disc is replaced by an artificial implant. For designing implants with good bone contact and continuous force distribution, the morphology of the intervertebral disc space and vertebral body endplates is of considerable importance. In this study we propose a method for the determination of the intervertebral disc space from three-dimensional (3D) computed tomography (CT) images of the lumbar spine. The first step of the proposed method is the construction of a model of vertebral bodies in the lumbar spine. For this purpose, a chain of five elliptical cylinders is initialized in the 3D image and then deformed to resemble vertebral bodies by introducing 25 shape parameters. The parameters are obtained by aligning the chain to the vertebral bodies in the CT image according to image intensity and appearance information. The determination of the intervertebral disc space is finally achieved by finding the planes that fit the endplates of the obtained parametric 3D models, and placing points in the space between the planes of adjacent vertebrae that enable surface reconstruction of the intervertebral disc space. The morphometric analysis of images from 20 subjects yielded 11:3 +/- 2:6, 12:1 +/- 2:4, 12:8 +/- 2:0 and 12:9 +/- 2:7 cm3 in terms of L1-L2, L2-L3, L3-L4 and L4-L5 intervertebral disc space volume, respectively.

  17. Symptomatic adjacent segment disease after cervical total disc replacement: re-examining the clinical and radiological evidence with established criteria.

    PubMed

    Nunley, Pierce D; Jawahar, Ajay; Cavanaugh, David A; Gordon, Charles R; Kerr, Eubulus J; Utter, Phillip Andrew

    2013-01-01

    Although several publications in the last decade have proved equality in safety and efficacy of the total disc replacement (TDR) to the anterior fusion procedure in cervical spine, the claim that TDR may reduce the incidence of adjacent segment disease (ASD) has not been corroborated by clinical evidence. We attempt to predict the true incidence of symptomatic ASD after TDR surgery in the cervical spine at one or two levels at a median follow-up period of 4 years. A total of 763 patients were screened to participate in four different Food and Drug Administration device exemption trials for artificial cervical disc replacement at three collaborating institutions. Two hundred seventy-one patients qualified and enrolled in the trials. One hundred seventy-three randomized to receive artificial disc replacement surgery, and 167 have completed a 4-year or longer follow-up. Patients experiencing cervical radiculopathy symptoms in the follow-up period were worked-up with clinical examinations, magnetic resonance imaging of the cervical spine, and other diagnostic studies. Once a clinical correlation was established with the imaging evidence of adjacent segment degeneration, a careful record was maintained to document the subsequent medical and/or surgical treatment received by these patients. Statistical analysis was performed to determine the true incidence of and factors affecting the ASD after cervical disc replacement in these patients. Twenty-six patients (15.2%) were identified to satisfy our criteria for ASD at the median follow-up of 51 months, with the annual incidence of 3.1% as calculated by life tables. The actuarial 5-year freedom from ASD rate was 71.6%±0.6%, and the mean period for freedom from ASD was 70.4±2.1 months. The incidence of symptomatic ASD after cervical TDR is 3.1% annually regardless of the patient's age, sex, smoking habits, and design of the TDR device. The presence of osteopenia and lumbar degenerative disease significantly increase the risk of developing ASD after anterior cervical surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Material Science in Cervical Total Disc Replacement.

    PubMed

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

    2015-01-01

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

  19. Material Science in Cervical Total Disc Replacement

    PubMed Central

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

    2015-01-01

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

  20. 77 FR 16917 - Airworthiness Directives; Rolls-Royce Deutschland Ltd & Co KG Turbofan Engines

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-23

    ... turbofan engines. This AD requires replacement of the high-pressure (HP) turbine spanner retaining nut... stage 2 high-pressure turbine (HPT) disc spanner retaining nuts did not receive the proper heat... HPT disc failure, possibly leading to release of high energy debris, resulting in damage to the...

  1. Disc dislodgment in Björk Shiley mitral valve prosthesis: two successfully operated cases.

    PubMed

    Dubernet, J; Irarrázaval, M J; Urzúa, J; Maturana, G; Morán, S; Lema, G; Asenjo, F; Fajuri, A

    1986-02-01

    Two patients with Björk Shiley mitral valve replacement had migration and embolization of the occluding disc. One patient suffered migration of the disc a few hours after surgery and the other had a strut fracture with disc translocation six years after the initial operation. Clinical signs in both cases were pulmonary edema, cardiogenic shock, and absence of prosthetic sounds. Both patients were reoperated on an emergency basis, recovering after a complicated postoperative course. They are on functional Class I, 8 and 1 years later, respectively, with their dislodged discs still in the abdominal aorta. The only hope for survival in these patients is emergency reoperation, once the prosthetic mitral valve dysfunction is confirmed.

  2. Investigation of Product Performance of Al-Metal Matrix Composites Brake Disc using Finite Element Analysis

    NASA Astrophysics Data System (ADS)

    Fatchurrohman, N.; Marini, C. D.; Suraya, S.; Iqbal, AKM Asif

    2016-02-01

    The increasing demand of fuel efficiency and light weight components in automobile sectors have led to the development of advanced material parts with improved performance. A specific class of MMCs which has gained a lot of attention due to its potential is aluminium metal matrix composites (Al-MMCs). Product performance investigation of Al- MMCs is presented in this article, where an Al-MMCs brake disc is analyzed using finite element analysis. The objective is to identify the potentiality of replacing the conventional iron brake disc with Al-MMCs brake disc. The simulation results suggested that the MMCs brake disc provided better thermal and mechanical performance as compared to the conventional cast iron brake disc. Although, the Al-MMCs brake disc dissipated higher maximum temperature compared to cast iron brake disc's maximum temperature. The Al-MMCs brake disc showed a well distributed temperature than the cast iron brake disc. The high temperature developed at the ring of the disc and heat was dissipated in circumferential direction. Moreover, better thermal dissipation and conduction at brake disc rotor surface played a major influence on the stress. As a comparison, the maximum stress and strain of Al-MMCs brake disc was lower than that induced on the cast iron brake disc.

  3. Development of injectable hydrogels for nucleus pulposus replacement

    NASA Astrophysics Data System (ADS)

    Thomas, Jonathan D.

    Intervertebral disc degeneration has been reported as the underlying cause for 75% of cases of lower back pain and is marked by dehydration of the nucleus pulposus within the intervertebral disc. There have been many implant designs to replace the nucleus pulposus. Some researchers have proposed the replacement of the nucleus pulposus with hydrogel materials. The insertion of devices made from these materials further compromises the annulus of the disc. An ideal nucleus replacement could be injected into the disc space and form a solid in vivo. However, injectable replacements using curing elastomers and thermoplastic materials are not ideal because of the potentially harmful exothermic heat evolved from their reactions and the toxicity of the reactants used. We propose a hydrogel system that can be injected as a liquid at 25°C and solidified to yield a hydrogel within the intervertebral disc at 37°C. In aqueous solutions, these polymers have Lower Critical Solution Temperatures (LCST) between 25-37°C, making them unique candidate materials for this application. Poly(N-isopropylacrylamide) (PNIPAAm) is the most widely studied LCST polymer due to its drastic transition near body temperature. However, by itself, pure PNIPAAm forms a hydrogel that has low water content and can readily undergo plastic deformation. To increase the water content and impart elasticity to PNIPAAm hydrogels, grafted and branched hydrogel systems were created that incorporated the thermogelling PNIPAAm and hydrophilic poly(ethylene glycol) (PEG). In this research, the effects of polymer composition and monomer to initiator ratio, which controls polymer MW, on the in vitro swelling properties (mass, chemical, and compressive mechanical stability) of hydrogels formed from aqueous solutions of these polymers were evaluated. Immersion studies were also conducted in solutions to simulate the osmotic environment of the nucleus pulposus. The effects of repeated compression and unloading cycles on the water content and dimensional recovery of hydrogels made from three candidate polymer formulations were also determined. Unlike PNIPAAm and PEG grafted PNIPAAm hydrogels, PEG branched hydrogels have covalently linked networks. Addition of 7 mol% PEG branches to PNIPAAm resulted in a hydrogel with a higher water content and better elastic recovery than hydrogels made from pure PNIPAAm. PEG branched PNIPAAm hydrogels were shown to have mass, chemical, and compressive mechanical stability in vitro. Furthermore, these hydrogels showed superior dimensional recovery after compressive cycling than pure PNIPAAm and PEG grafted PNIPAAm hydrogels. The 7 mol% PEG branched PNIPAAm hydrogels have suitable swelling and mechanical properties to potentially serve as a nucleus pulposus replacement.

  4. There's More to Retirement than Financial Security.

    ERIC Educational Resources Information Center

    Fetridge, Guild A.

    1990-01-01

    Since hobbies and recreational activities don't generate the intellectual satisfaction and adrenaline flow of a successful and challenging career, principals need to develop new midlife careers to replace some of the emotional supports that slip away after retirement. This article offers helpful advice on avoiding retirement pitfalls and pursuing…

  5. Disc erosion in Models 103 and 104 of Beall mitral valve prostheses

    PubMed Central

    Gómez, Ricardo; Verduras, María José; Lopez-Quintana, Alfonso; Riera, Luis; Zerolo, Ignacio; Martinez-Bordiu, Cristóbal

    1981-01-01

    Three cases of severe disc variance and erosion of the Teflon-disc Beall mitral valve prosthesis (Models 103 and 104) are reported. In two patients, the Beall mitral valves were excised and replaced with two Björk-Shiley mitral valves. The remaining patient did not survive, and at autopsy, the lens was found at the aortic bifurcation level. Because of this potentially lethal complication, careful follow-up of patients with Beall mitral valve prostheses (Models 103 and 104) is recommended. Images PMID:15216211

  6. In vivo performance of an acellular disc-like angle ply structure (DAPS) for total disc replacement in a small animal model.

    PubMed

    Martin, John T; Kim, Dong Hwa; Milby, Andrew H; Pfeifer, Christian G; Smith, Lachlan J; Elliott, Dawn M; Smith, Harvey E; Mauck, Robert L

    2017-01-01

    Total intervertebral disc replacement with a biologic engineered disc may be an alternative to spinal fusion for treating end-stage disc disease. In previous work, we developed disc-like angle ply structures (DAPS) that replicate the structure and function of the native disc and a rat tail model to evaluate DAPS in vivo. Here, we evaluated a strategy in which, after in vivo implantation, endogenous cells could colonize the acellular DAPS and form an extracellular matrix organized by the DAPS topographical template. To do so, acellular DAPS were implanted into the caudal spines of rats and evaluated over 12 weeks by mechanical testing, histology, and microcomputed tomography. An external fixation device was used to stabilize the implant site and various control groups were included to evaluate the effect of immobilization. There was robust tissue formation within the DAPS after implantation and compressive mechanical properties of the implant matched that of the native motion segment. Immobilization provided a stable site for fibrous tissue formation after either a discectomy or a DAPS implantation, but bony fusion eventually resulted, with segments showing intervertebral bridging after long-term implantation, a process that was accelerated by the implanted DAPS. Thus, while compressive mechanical properties were replicated after DAPS implantation, methods to actively prevent fusion must be developed. Future work will focus on limiting fusion by remobilizing the motion segment after a period of integration, delivering pro-chondrogenic factors, and pre-seeding DAPS with cells prior to implantation. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:23-31, 2017. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  7. M6-C artificial disc placement.

    PubMed

    Coric, Domagoj; Parish, John; Boltes, Margaret O

    2017-01-01

    There has been a steady evolution of cervical total disc replacement (TDR) devices over the last decade resulting in surgical technique that closely mimics anterior cervical discectomy and fusion as well as disc design that emphasizes quality of motion. The M6-C TDR device is a modern-generation artificial disc composed of titanium endplates with tri-keel fixation as well as a polyethylene weave with a polyurethane core. Although not yet approved by the FDA, M6-C has finished a pilot and pivotal US Investigational Device Exemption (IDE) study. The authors present the surgical technique for implantation of a 2-level M6-C cervical TDR device. The video can be found here: https://youtu.be/rFEAqINLRCo .

  8. Retrieval of a leaflet escaped in a Tri-technologies bileaflet mechanical prosthetic valve.

    PubMed

    Cianciulli, Tomás F; Lax, Jorge A; Saccheri, María C; Guidoin, Robert; Salvado, César M; Fernández, Adrián J; Prezioso, Horacio A

    2008-01-01

    The escape of the prosthetic heart valve disc is one of the causes of prosthetic dysfunction that requires emergency surgery. The removal of the embolized disc should be carried out because of the risk of a progressive extrusion on the aortic wall. Several imaging techniques can be used for the detection of the missing disc localization. In this report we describe a 32-year-old man who underwent mitral valve replacement with a Tri-technologies bileaflet valve three years ago, and was admitted in cardiogenic shock. Transesophageal echocardiography showed acute-onset massive mitral regurgitation. The patient underwent emergency replacement of the prosthetic valve. Only one of the two leaflets remained in the removed prosthetic valve. The missing leaflet could not be found within the cardiac cavity. The abdominal fluoroscopic study and plain radiography were unable to detect the escaped leaflet. The abdominal computed tomography scan and the ultrasound showed the escaped leaflet in the terminal portion of the aortic bifurcation. To retrieve the embolized disc laparotomy and aortotomy were performed three months later. The escaped leaflet shows a fracture of one of the pivot systems caused by structural failure. This kind of failure mode is usually the result of high stress concentration.

  9. Total disc replacement using a tissue-engineered intervertebral disc in vivo: new animal model and initial results

    PubMed Central

    Gebhard, Harry; Bowles, Robby; Dyke, Jonathan; Saleh, Tatianna; Doty, Stephen; Bonassar, Lawrence; Härtl, Roger

    2010-01-01

    Study type: Basic science Introduction: Chronic back pain due to degenerative disc disease (DDD) is among the most important medical conditions causing morbidity and significant health care costs. Surgical treatment options include disc replacement or fusion surgery, but are associated with significant short- and long-term risks.1 Biological tissue-engineering of human intervertebral discs (IVD) could offer an important alternative.2 Recent in vitro data from our group have shown successful engineering and growth of ovine intervertebral disc composites with circumferentially aligned collagen fibrils in the annulus fibrosus (AF) (Figure 1).3 Figure 1 Tissue-engineered composite disc a Experimental steps to generate composite tissue-engineered IVDs3 b Example of different AF formulations on collagen alignment in the AF. Second harmonic generation and two-photon excited fluorescence images of seeded collagen gels (for AF) of 1 and 2.5 mg/ml over time. At seeding, cells and collagen were homogenously distributed in the gels. Over time, AF cells elongated and collagen aligned parallel to cells. Less contraction and less alignment is noted after 3 days in the 2.5 mg/mL gel. c Imaging-based creation of a virtual disc model that will serve as template for the engineered disc. Total disc dimensions (AF and NP) were retrieved from micro-computer tomography (CT) (left images), and nucleus pulposus (NP) dimensions alone were retrieved from T2-weighted MRI images (right images). Merging of MRI and micro-CT models revealed a composite disc model (middle image)—Software: Microview, GE Healthcare Inc., Princeton, NJ; and slicOmatic v4.3, TomoVision, Montreal, Canada. d Flow chart describing the process for generating multi-lamellar tissue engineered IVDs. IVDs are produced by allowing cell-seeded collagen layers to contract around a cell-seeded alginate core (NP) over time Objective: The next step is to investigate if biological disc implants survive, integrate, and restore function to the spine in vivo. A model will be developed that allows efficient in vivo testing of tissue-engineered discs of various compositions and characteristics. Methods: Athymic rats were anesthetized and a dorsal approach was chosen to perform a microsurgical discectomy in the rat caudal spine (Fig. 2,Fig. 3). Control group I (n = 6) underwent discectomy only, Control group II (n = 6) underwent discectomy, followed by reimplantation of the autologous disc. Two treatment groups (group III, n = 6, 1 month survival; group IV, n = 6, 6 months survival) received a tissue-engineered composite disc implant. The rodents were followed clinically for signs of infection, pain level and wound healing. X-rays and magnetic resonance imaging (MRI) were assessed postoperatively and up to 6 months after surgery (Fig. 6,Fig. 7). A 7 Tesla MRI (Bruker) was implemented for assessment of the operated level as well as the adjacent disc (hydration). T2-weighted sequences were interpreted by a semiquantitative score (0 = no signal, 1 = weak signal, 2 = strong signal and anatomical features of a normal disc). Histology was performed with staining for proteoglycans (Alcian blue) and collagen (Picrosirius red) (Fig. 4,Fig. 5). Figure 2 Disc replacement surgery a Operative situs with native disc that has been disassociated from both adjacent vertebrae b Native disc (left) and tissue-engineered implant (right) c Implant in situ before wound closureAF: Annulus fi brosus, nP: nucleus pulposus, eP: endplate, M: Muscle, T: Tendon, s: skin, art: artery, GP: Growth plate, B: Bone Figure 3 Disc replacement surgery. Anatomy of the rat caudal disc space a Pircrosirius red stained axial cut of native disc space b Saffranin-O stained sagittal cut of native disc space Figure 4 Histologies of three separate motion segments from three different rats. Animal one = native IVD, Animal two = status after discectomy, Animal three = tissue-engineered implant (1 month) a–c H&E (overall tissue staining for light micrsocopy) d–f Alcian blue (proteoglycans) g–i Picrosirius red (collagen I and II) Figure 5 Histology from one motion segment four months after implantation of a bio-engineered disc construct a Picrosirius red staining (collagen) b Polarized light microscopy showing collagen staining and collagen organization in AF region c Increased Safranin-O staining (proteoglycans) in NP region of the disc implant d Higher magnification of figure 5c: Integration between implanted tissue-engineered total disc replacement and vertebral body bone Figure 6 MRI a Disc space height measurements in flash/T1 sequence (top: implant (714.0 micrometer), bottom: native disc (823.5 micrometer) b T2 sequence, red circle surrounding the implant NP Figure 7 7 Tesla MRI imaging of rat tail IVDs showing axial images (preliminary pilot data) a Diffusion tensor imaging (DTI) on two explanted rat tail discs in Formalin b Higher magnification of a, showing directional alignment of collagen fibers (red and green) when compared to the color ball on top which maps fibers' directional alignment (eg, fibers directing from left to right: red, from top to bottom: blue) c Native IVD in vivo (successful imaging of top and bottom of the IVD (red) d Gradient echo sequence (GE) showing differentiation between NP (light grey) and AF (dark margin) e GE of reimplanted tail IVD at the explantation level f T1Rho sequence demonstrating the NP (grey) within the AF (dark margin), containing the yellow marked region of interest for value acquisition (preliminary data are consistent with values reported in the literature). g T2 image of native IVD in vivo for monitoring of hydration (white: NP) Results: The model allowed reproducible and complete discectomies as well as disc implantation in the rat tail spine without any surgical or postoperative complications. Discectomy resulted in immediate collapse of the disc space. Preliminary results indicate that disc space height was maintained after disc implantation in groups II, III and IV over time. MRI revealed high resolution images of normal intervertebral discs in vivo. Eight out of twelve animals (groups III and IV) showed a positive signal in T2-weighted images after 1 month (grade 0 = 4, grade 1 = 4, grade 2 = 4). Positive staining was seen for collagen as well as proteoglycans at the site of disc implantation after 1 month in each of the six animals with engineered implants (group III). Analysis of group IV showed positive T2 signal in five out of six animals and disc-height preservation in all animals after 6 months. Conclusions: This study demonstrates for the first time that tissue-engineered composite IVDs with circumferentially aligned collagen fibrils survive and integrate with surrounding vertebral bodies when placed in the rat spine for up to 6 months. Tissue-engineered composite IVDs restored function to the rat spine as indicated by maintenance of disc height and vertebral alignment. A significant finding was that maintenance of the composite structure in group III was observed, with increased proteoglycan staining in the nucleus pulposus region (Figure 4d–f). Proteoglycan and collagen matrix as well as disc height preservation and positive T2 signals in MRI are promising parameters and indicate functionality of the implants. PMID:23637671

  10. Total disc replacement using a tissue-engineered intervertebral disc in vivo: new animal model and initial results.

    PubMed

    Gebhard, Harry; Bowles, Robby; Dyke, Jonathan; Saleh, Tatianna; Doty, Stephen; Bonassar, Lawrence; Härtl, Roger

    2010-08-01

     Basic science Introduction:  Chronic back pain due to degenerative disc disease (DDD) is among the most important medical conditions causing morbidity and significant health care costs. Surgical treatment options include disc replacement or fusion surgery, but are associated with significant short- and long-term risks.1 Biological tissue-engineering of human intervertebral discs (IVD) could offer an important alternative.2 Recent in vitro data from our group have shown successful engineering and growth of ovine intervertebral disc composites with circumferentially aligned collagen fibrils in the annulus fibrosus (AF) (Figure 1).3 Figure 1 Tissue-engineered composite disc a Experimental steps to generate composite tissue-engineered IVDs3b Example of different AF formulations on collagen alignment in the AF. Second harmonic generation and two-photon excited fluorescence images of seeded collagen gels (for AF) of 1 and 2.5 mg/ml over time. At seeding, cells and collagen were homogenously distributed in the gels. Over time, AF cells elongated and collagen aligned parallel to cells. Less contraction and less alignment is noted after 3 days in the 2.5 mg/mL gel. c Imaging-based creation of a virtual disc model that will serve as template for the engineered disc. Total disc dimensions (AF and NP) were retrieved from micro-computer tomography (CT) (left images), and nucleus pulposus (NP) dimensions alone were retrieved from T2-weighted MRI images (right images). Merging of MRI and micro-CT models revealed a composite disc model (middle image)-Software: Microview, GE Healthcare Inc., Princeton, NJ; and slicOmatic v4.3, TomoVision, Montreal, Canada. d Flow chart describing the process for generating multi-lamellar tissue engineered IVDs. IVDs are produced by allowing cell-seeded collagen layers to contract around a cell-seeded alginate core (NP) over time Objective:  The next step is to investigate if biological disc implants survive, integrate, and restore function to the spine in vivo. A model will be developed that allows efficient in vivo testing of tissue-engineered discs of various compositions and characteristics.  Athymic rats were anesthetized and a dorsal approach was chosen to perform a microsurgical discectomy in the rat caudal spine (Fig. 2,Fig. 3). Control group I (n = 6) underwent discectomy only, Control group II (n = 6) underwent discectomy, followed by reimplantation of the autologous disc. Two treatment groups (group III, n = 6, 1 month survival; group IV, n = 6, 6 months survival) received a tissue-engineered composite disc implant. The rodents were followed clinically for signs of infection, pain level and wound healing. X-rays and magnetic resonance imaging (MRI) were assessed postoperatively and up to 6 months after surgery (Fig. 6,Fig. 7). A 7 Tesla MRI (Bruker) was implemented for assessment of the operated level as well as the adjacent disc (hydration). T2-weighted sequences were interpreted by a semiquantitative score (0 = no signal, 1 = weak signal, 2 = strong signal and anatomical features of a normal disc). Histology was performed with staining for proteoglycans (Alcian blue) and collagen (Picrosirius red) (Fig. 4,Fig. 5). Figure 2 Disc replacement surgery a Operative situs with native disc that has been disassociated from both adjacent vertebrae b Native disc (left) and tissue-engineered implant (right) c Implant in situ before wound closureAF: Annulus fi brosus, nP: nucleus pulposus, eP: endplate, M: Muscle, T: Tendon, s: skin, art: artery, GP: Growth plate, B: BoneFigure 3 Disc replacement surgery. Anatomy of the rat caudal disc space a Pircrosirius red stained axial cut of native disc space b Saffranin-O stained sagittal cut of native disc spaceFigure 4 Histologies of three separate motion segments from three different rats. Animal one = native IVD, Animal two = status after discectomy, Animal three = tissue-engineered implant (1 month) a-c H&E (overall tissue staining for light micrsocopy) d-f Alcian blue (proteoglycans) g-i Picrosirius red (collagen I and II)Figure 5 Histology from one motion segment four months after implantation of a bio-engineered disc construct a Picrosirius red staining (collagen) b Polarized light microscopy showing collagen staining and collagen organization in AF region c Increased Safranin-O staining (proteoglycans) in NP region of the disc implant d Higher magnification of figure 5c: Integration between implanted tissue-engineered total disc replacement and vertebral body boneFigure 6 MRI a Disc space height measurements in flash/T1 sequence (top: implant (714.0 micrometer), bottom: native disc (823.5 micrometer) b T2 sequence, red circle surrounding the implant NPFigure 7 7 Tesla MRI imaging of rat tail IVDs showing axial images (preliminary pilot data) a Diffusion tensor imaging (DTI) on two explanted rat tail discs in Formalin b Higher magnification of a, showing directional alignment of collagen fibers (red and green) when compared to the color ball on top which maps fibers' directional alignment (eg, fibers directing from left to right: red, from top to bottom: blue) c Native IVD in vivo (successful imaging of top and bottom of the IVD (red) d Gradient echo sequence (GE) showing differentiation between NP (light grey) and AF (dark margin) e GE of reimplanted tail IVD at the explantation level f T1Rho sequence demonstrating the NP (grey) within the AF (dark margin), containing the yellow marked region of interest for value acquisition (preliminary data are consistent with values reported in the literature). g T2 image of native IVD in vivo for monitoring of hydration (white: NP) Results:  The model allowed reproducible and complete discectomies as well as disc implantation in the rat tail spine without any surgical or postoperative complications. Discectomy resulted in immediate collapse of the disc space. Preliminary results indicate that disc space height was maintained after disc implantation in groups II, III and IV over time. MRI revealed high resolution images of normal intervertebral discs in vivo. Eight out of twelve animals (groups III and IV) showed a positive signal in T2-weighted images after 1 month (grade 0 = 4, grade 1 = 4, grade 2 = 4). Positive staining was seen for collagen as well as proteoglycans at the site of disc implantation after 1 month in each of the six animals with engineered implants (group III). Analysis of group IV showed positive T2 signal in five out of six animals and disc-height preservation in all animals after 6 months.  This study demonstrates for the first time that tissue-engineered composite IVDs with circumferentially aligned collagen fibrils survive and integrate with surrounding vertebral bodies when placed in the rat spine for up to 6 months. Tissue-engineered composite IVDs restored function to the rat spine as indicated by maintenance of disc height and vertebral alignment. A significant finding was that maintenance of the composite structure in group III was observed, with increased proteoglycan staining in the nucleus pulposus region (Figure 4d-f). Proteoglycan and collagen matrix as well as disc height preservation and positive T2 signals in MRI are promising parameters and indicate functionality of the implants.

  11. [LOCATION CHANGE OF ROTATION CENTER AFTER SINGLE SEGMENTAL CERVICAL DISC REPLACEMENT WITH ProDisc-C].

    PubMed

    Lou, Jigang; Liu, Hao; Rong, Xin; Gong, Quan; Song, Yueming; Li, Tao

    2015-01-01

    To evaluate the effectiveness of the single segmental cervical disc replacement with ProDisc-C, and to explore the location change of the flexion/extension center of rotation (COR) of the target level as well as its clinical significance. Between June 2010 and February 2012, 23 patients underwent single segmental cervical disc replacement with ProDisc-C, and the clinical data were retrospectively analyzed. Of 23 patients, 9 were male, and 14 were female with the age range from 27 to 65 years (mean, 45 years), and the disease duration ranged from 10 to 84 months (mean, 25 months). There were 15 patients with radiculopathy, 5 patients with myelopathy, and 3 patients with mixed cervical spondylosis. The involved segments were C4,5 in 5 cases, C5,6 in 14 cases, and C6,7 in 4 cases. Japanese Orthopaedic Association (JOA) score and neck disability index (NDI) were adopted to evaluate the effectiveness. Preoperative and Postoperative radiographic parameters, such as cervical overall range of motion (ROM), target segmental ROM, the adjacent segmental ROM, and intervertebral height were compared. Besides, the location changes of the COR of the target level were further analyzed by the alteration of its coordinates (COR-X, COR-Y), and the relationships between the location changes of the COR and the effectiveness or the radiographic results were analyzed. All the operations were completed successfully; 1 case had hoarseness after operation, which disappeared at 3 months after operation. All cases were followed up 18.3 months on average (range, 6-36 months). There was no device migration, loosening, subsidence, or fracture at last follow-up. The JOA score increased significantly and the NDI score decreased significantly at last follow-up when compared with preoperative scores (P < 0.05). No difference was found in the cervical overall ROM, target segmental ROM, the adjacent segmental ROM, and the COR-Y of the target level between pre-operation and last follow-up (P > 0.05); while the intervertebral height and the COR-X increased significantly (P < 0.05). The change of the COR-X had no obvious correlation with the postoperative JOA, NDI, and target segmental ROM (P > 0.05). According to whether the difference of the COR-X between pre- and post-operation was less than the average value 1.86 mm or not, the patients were divided into 2 groups; significant difference was shown in the postoperative target segmental ROM between 2 groups (P < 0.05), but no significant difference was found in the postoperative JOA, NDI, cervical overall ROM, adjacent segmental ROM, and the intervertebral height between 2 groups (P > 0.05). Single segmental cervical disc replacement with ProDisc-C can obtain satisfactory outcomes. The cervical overall ROM, target segmental ROM, and adjacent segmental ROM can be effectively maintained, and the intervertebral height is increased. The location of the flexion/extension COR of the target segment shifts forward after insertion of the ProDisc-C prosthesis, and the postoperative target segmental ROM becomes smaller as the distance of the displacement of the COR becomes greater.

  12. The 5-year cost-effectiveness of two-level anterior cervical discectomy and fusion or cervical disc replacement: a Markov analysis.

    PubMed

    Overley, Samuel C; McAnany, Steven J; Brochin, Robert L; Kim, Jun S; Merrill, Robert K; Qureshi, Sheeraz A

    2018-01-01

    Anterior cervical discectomy and fusion (ACDF) and cervical disc replacement (CDR) are both acceptable surgical options for the treatment of cervical myelopathy and radiculopathy. To date, there are limited economic analyses assessing the relative cost-effectiveness of two-level ACDF versus CDR. The purpose of this study was to determine the 5-year cost-effectiveness of two-level ACDF versus CDR. The study design is a secondary analysis of prospectively collected data. Patients in the Prestige cervical disc investigational device exemption (IDE) study who underwent either a two-level CDR or a two-level ACDF were included in the study. The outcome measures were cost and quality-adjusted life years (QALYs). A Markov state-transition model was used to evaluate data from the two-level Prestige cervical disc IDE study. Data from the 36-item Short Form Health Survey were converted into utilities using the short form (SF)-6D algorithm. Costs were calculated from the payer perspective. QALYs were used to represent effectiveness. A probabilistic sensitivity analysis (PSA) was performed using a Monte Carlo simulation. The base-case analysis, assuming a 40-year-old person who failed appropriate conservative care, generated a 5-year cost of $130,417 for CDR and $116,717 for ACDF. Cervical disc replacement and ACDF generated 3.45 and 3.23 QALYs, respectively. The incremental cost-effectiveness ratio (ICER) was calculated to be $62,337/QALY for CDR. The Monte Carlo simulation validated the base-case scenario. Cervical disc replacement had an average cost of $130,445 (confidence interval [CI]: $108,395-$152,761) with an average effectiveness of 3.46 (CI: 3.05-3.83). Anterior cervical discectomy and fusion had an average cost of $116,595 (CI: $95,439-$137,937) and an average effectiveness of 3.23 (CI: 2.84-3.59). The ICER was calculated at $62,133/QALY with respect to CDR. Using a $100,000/QALY willingness to pay (WTP), CDR is the more cost-effective strategy and would be selected 61.5% of the time by the simulation. Two-level CDR and ACDF are both cost-effective strategies at 5 years. Neither strategy was found to be more cost-effective with an ICER greater than the $50,000/QALY WTP threshold. The assumptions used in the analysis were strongly validated with the results of the PSA. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Effect of total lumbar disc replacement on lumbosacral lordosis.

    PubMed

    Kasliwal, Manish K; Deutsch, Harel

    2012-10-01

    Original article : To study effect of lumbar disc replacement on lumbosacral lordosis. There has been a growing interest in total disc replacement (TDR) for back pain with the rising concern of adjacent segment degeneration. Lumbar fusion surgery has been shown to lead to decrease in lumbar lordosis, which may account for postfusion pain resulting in less acceptable clinical outcome after successful fusion. TDR has recently emerged as an alternative treatment for back pain. There have been very few studies reporting lumbar sagittal outcome after TDR. Retrospective study of radiographic data of 17 patients who underwent TDR for single level degenerative disc disease at the author's institution was carried out. Study included measurement of preoperative and postoperative segmental and global lumbar lordosis and angle of lordosis. Patients age varied from 19 to 54 (mean, 35) years. Follow-up ranged from 12 to 24 months. TDR was performed at L4-5 level in 3 patients and L5-S1 level in 14 patients. The average values for segmental lordosis, global lordosis, and angle of lordosis at the operated level before and after surgery were 17.3, 49.7, and 8.6 degrees and 21.6, 54, and 9.5 degrees, respectively. There was a trend toward significant (P=0.02) and near significant (P=0.057) increase in segmental and global lordosis, respectively after TDR. Although prosthesis increased angle of lordosis at the level implanted in majority of the patients, the difference in preoperative and postoperative angle of lordosis was not significant (P=0.438). In addition, there was no correlation between the angle of implant of chosen and postoperative angle of lordosis at the operated level. The effect of TDR on sagittal balance appears favorable with an increase in global and segmental lumbar lordosis after single level TDR for degenerative disc disease. The degree of postoperative angle of lordosis was not affected by the angle of implant chosen at the operated level and varied independently of the implant angle.

  14. ReWritable Data Storage on DVD by Using Phase Change Technology

    NASA Astrophysics Data System (ADS)

    Kleine, H.; Martin, F.; Kapeller, M.; Cord, B.; Ebinger, H.

    It is expected that the next few years the VHS casette will be replaced by rewritable Digital Versatile Discs (DVD) for home video recording. At this moment three different standards DVD+RW, DVD-RW and DVD-RAM exist, out of which the DVD+RW is expected to dominate the market in Europe and the United States. The disc holds 4.7 GB of computer data, which is equivalent to several hours of high quality video content. At the heart of the disc is a thin film layer stack with a special phase change recording layer. By proper laser irradiation the disc can be overwritten up to 1000 times without noticeable quality loss. A shelf lifetime of 20-50 years is anticipated. With these characteristics the disc is well suited for consumer applications. The present article illuminates how a process engineer can control the disc recording sensitivity, the recording speed and the number of overwriting cycles by the design of the thin film layer stack.

  15. Surgical Treatment for Discogenic Low-Back Pain: Lumbar Arthroplasty Results in Superior Pain Reduction and Disability Level Improvement Compared With Lumbar Fusion

    PubMed Central

    2007-01-01

    Background The US Food and Drug Administration approved the Charité artificial disc on October 26, 2004. This approval was based on an extensive analysis and review process; 20 years of disc usage worldwide; and the results of a prospective, randomized, controlled clinical trial that compared lumbar artificial disc replacement to fusion. The results of the investigational device exemption (IDE) study led to a conclusion that clinical outcomes following lumbar arthroplasty were at least as good as outcomes from fusion. Methods The author performed a new analysis of the Visual Analog Scale pain scores and the Oswestry Disability Index scores from the Charité artificial disc IDE study and used a nonparametric statistical test, because observed data distributions were not normal. The analysis included all of the enrolled subjects in both the nonrandomized and randomized phases of the study. Results Subjects from both the treatment and control groups improved from the baseline situation (P < .001) at all follow-up times (6 weeks to 24 months). Additionally, these pain and disability levels with artificial disc replacement were superior (P < .05) to the fusion treatment at all follow-up times including 2 years. Conclusions The a priori statistical plan for an IDE study may not adequately address the final distribution of the data. Therefore, statistical analyses more appropriate to the distribution may be necessary to develop meaningful statistical conclusions from the study. A nonparametric statistical analysis of the Charité artificial disc IDE outcomes scores demonstrates superiority for lumbar arthroplasty versus fusion at all follow-up time points to 24 months. PMID:25802574

  16. When a Picture Isn't Worth 1000 Words: Learners Struggle to Find Meaning in Data Visualizations

    ERIC Educational Resources Information Center

    Stofer, Kathryn A.

    2016-01-01

    The oft-repeated phrase "a picture is worth a thousand words" supposes that an image can replace a profusion of words to more easily express complex ideas. For scientific visualizations that represent profusions of numerical data, however, an untranslated academic visualization suffers the same pitfalls untranslated jargon does. Previous…

  17. [Self-assembly tissue engineering fibrocartilage model of goat temporomandibular joint disc].

    PubMed

    Kang, Hong; Li, Zhen-Qiang; Bi, Yan-Da

    2011-06-01

    To construct self-assembly fibrocartilage model of goat temporomandibular joint disc and observe the biological characteristics of the self-assembled fibrocartilage constructs, further to provide a basis for tissue engineering of the temporomandibular joint disc and other fibrocartilage. Cells from temporomandibular joint discs of goats were harvested and cultured. 5.5 x 10(6) cells were seeded in each agarose well with diameter 5 mm x depth 10 mm, daily replace of medium, cultured for 2 weeks. One day after seeding, goat temporomandibular joint disc cells in agarose wells were gathered and began to self-assemble into a disc-shaped base, then gradually turned into a round shape. When cultured for 2 weeks, hematoxylin-eosin staining was conducted and observed that cells were round and wrapped around by the matrix. Positive Safranin-O/fast green staining for glycosaminoglycans was observed throughout the entire constructs, and picro-sirius red staining was examined and distribution of numerous type I collagen was found. Immunohistochemistry staining demonstrated brown yellow particles in cytoplasm and around extracellular matrix, which showed self-assembly construct can produce type I collagen as native temporomandibular joint disc tissue. Production of extracellular matrix in self-assembly construct as native temporomandibular joint disc tissue indicates that the use of agarose wells to construct engineered temporomandibular joint disc will be possible and practicable.

  18. Analysis of the Function of Apoptosis during Imaginal Wing Disc Regeneration in Drosophila melanogaster.

    PubMed

    Diaz-Garcia, Sandra; Ahmed, Sara; Baonza, Antonio

    2016-01-01

    Regeneration is the ability that allows organisms to replace missing organs or lost tissue after injuries. This ability requires the coordinated activity of different cellular processes, including programmed cell death. Apoptosis plays a key role as a source of signals necessary for regeneration in different organisms. The imaginal discs of Drosophila melanogaster provide a particularly well-characterised model system for studying the cellular and molecular mechanisms underlying regeneration. Although it has been shown that signals produced by apoptotic cells are needed for homeostasis and regeneration of some tissues of this organism, such as the adult midgut, the contribution of apoptosis to disc regeneration remains unclear. Using a new method for studying disc regeneration in physiological conditions, we have defined the pattern of cell death in regenerating discs. Our data indicate that during disc regeneration, cell death increases first at the wound edge, but as regeneration progresses dead cells can be observed in regions far away from the site of damage. This result indicates that apoptotic signals initiated in the wound spread throughout the disc. We also present results which suggest that the partial inhibition of apoptosis does not have a major effect on disc regeneration. Finally, our results suggest that during disc regeneration distinct apoptotic signals might be acting simultaneously.

  19. Complete Transversal Disc Fracture in a Björk-Shiley Delrin Mitral Valve Prosthesis 43 Years After Implantation.

    PubMed

    González-Santos, Jose María; Arnáiz-García, María Elena; Dalmau-Sorlí, María José; Sastre-Rincón, Jose Alfonso; Hernández-Hernández, Jesús; Pérez-Losada, María Elena; Sagredo-Meneses, Víctor; López-Rodríguez, Javier

    2016-10-01

    A patient who underwent previous implantation of a mitral valve replacement with a Björk-Shiley Delrin (BSD) mitral valve prosthesis during infancy was admitted to our institution 43 years later after an episode of syncope and cardiac arrest. Under extreme hemodynamic instability, a mitral valve prosthetic dysfunction causing massive mitral regurgitation was identified. The patient underwent an emergent cardiac operation, and a complete disc fracture with partial disc migration was found. Exceptional cases of mechanical prosthetic heart valve fracture exist. We report the first case of complete transversal disc rupture of a BSD mitral valve prosthesis after the longest period of implantation ever reported in that position. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Biomechanics of the L5-S1 motion segment after total disc replacement - Influence of iatrogenic distraction, implant positioning and preoperative disc height on the range of motion and loading of facet joints.

    PubMed

    Dreischarf, Marcel; Schmidt, Hendrik; Putzier, Michael; Zander, Thomas

    2015-09-18

    Total disc replacement has been introduced to overcome negative side effects of spinal fusion. The amount of iatrogenic distraction, preoperative disc height and implant positioning have been considered important for surgical success. However, their effect on the postoperative range of motion (RoM) and loading of the facets merits further discussion. A validated osteoligamentous finite element model of the lumbosacral spine was employed and extended with four additional models to account for different disc heights. An artificial disc with a fixed center of rotation (CoR) was implemented in L5-S1. In 4000 simulations, the influence of distraction and the CoR's location on the RoM, facet joint forces (FJFs) and facet capsule ligament forces (FCLFs) was investigated. Distraction substantially altered segmental kinematics in the sagittal plane by decreasing range of flexion (0.5° per 1mm of distraction), increasing range of extension (0.7°/mm) and slightly affecting complete sagittal RoM (0.2°/mm). The distraction already strongly increased the FCLFs during surgery (up to 230N) and in flexion (~12N/mm), with higher values in models with larger preoperative disc heights, and increased FJFs in extension. A more anterior implant location decreased the RoM in all planes. In most loading cases, a more posterior location of the implant's CoR increased the FJFs and FCLFs, whereas a more caudal location increased the FCLFs but decreased the FJFs. The results of this study may explain the worse clinical results in patients with overdistraction after TDR. The complete RoM in the sagittal plane appears to be insensitive to detecting surgery-related biomechanical changes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Barriers to and Budget Impact of Lumbar Total Disc Replacement Utilization.

    PubMed

    Sandhu, Faheem; Blumenthal, Scott; Grunch, Betsy; Kimball, Bent; Ferko, Nicole; Hollmann, Sarah

    2017-12-15

    : Evidence on the favorable efficacy, safety, and cost effectiveness of lumbar total disc replacement (TDR) compared with fusion for lumbar degenerative disc disease is mounting; however, a key barrier identified for TDR utilization is lack of coverage by US health insurers. Although economic considerations in a fee-for-service model should not be a determining factor in patient access, concerns regarding the budget impact of lumbar TDR surgery may unfortunately underlie coverage decisions. On the basis of the data available and economic modeling, the panel agreed that there is no indication that there would be a dramatic increase in patients seeking lumbar TDR. Considering several possible scenarios on potential growth in TDR utilization with coverage, as well as growth in the overall surgical pool of patients, economic modeling demonstrated that adoption of lumbar TDR would result in minimal or no budget impact for commercial insurance plans. Considering these model results and the economic literature, the panel concluded that adopting lumbar TDR within a coverage policy is expected to remain cost neutral for the insurer.

  2. Wear characteristics of an unconstrained lumbar total disc replacement under a range of in vitro test conditions

    PubMed Central

    Fisher, John; Hall, Richard M.

    2015-01-01

    Abstract The effect of kinematics, loading and centre of rotation on the wear of an unconstrained total disc replacement have been investigated using the ISO 18192‐1 standard test as a baseline. Mean volumetric wear rate and surface morphological effects were reported. Changing the phasing of the flexions to create a low (but finite) amount of crossing path motion at the bearing surfaces resulted in a significant fall in wear volume. However, the rate of wear was still much larger than previously reported values under zero cross shear conditions. Reducing the load did not result in a significant change in wear rate. Moving the centre of rotation of the disc inferiorly did significantly increase wear rate. A phenomenon of debris re‐attachment on the UHMWPE surface was observed and hypothesised to be due to a relatively harsh tribological operating regime in which lubricant replenishment and particle migration out of the bearing contact zone were limited. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 46–52, 2017. PMID:26411540

  3. Factors affecting the process of CO2 replacement of CH4 from methane hydrate in sediments - Constrained from experimental results

    NASA Astrophysics Data System (ADS)

    Lu, H.; Hu, G.; Vanderveen, J.; Liu, C.; Ratcliffe, C.; Ripmeester, J.

    2011-12-01

    CO2 replacement of CH4 from methane hydrate has been proposed as a method to produce gas from natural gas hydrate by taking advantage of both the production of natural gas and the sequestration of CO2. To examine the validity of this method DOE/Conoco-Philips is considering having a field test in Alaska. The reaction of CO2 replacing CH4 from methane hydrate has been confirmed to be thermodynamically feasible, but concern is always raised about the reaction kinetics. Some kinetic studies in the system of methane hydrate and liquid or gaseous CO2 have found that the reaction proceeds at a very low rate. Natural gas hydrate occurs in sediments with multi-components and complex structure, so matters will be even more complicated. Up to now, few investigations have been carried out concerning the factors affecting the reaction process of CO2 replacing CH4 from methane hydrate. Experiments were implemented with sands, which were recovered from Mallik 5L-38 well, Mackenzie Delta, Northwest Territory, Canada, sediment that previously contained hydrate although it had been dried completely before our experiments. The water-saturated sands were tightly charged into a plastic bottle (90 mm deep and 60 mm wide), and then this test specimen was sealed in a pressure cell. After methane hydrate was synthesized in the test specimen for 108 days under a pressure of 11 to 8 MPa and a temperature of 3 degrees Celsius, liquid CO2 was introduced into the pressure cell. The conditions under which CO2 was reacted with methane hydrate were ~5.3 MPa and 5 degrees Celsius. After reacting for 15 days, the test specimen was recovered. The test specimen was cut into ~10 mm thick discs, and sub-samples were further taken from each of the discs. In addition to the determination of hydrate saturation and the gas composition, Raman spectroscopic studies were carried out for the sub-samples obtained. The results revealed: 1) less CO2 replacement in the bottom disc of the test specimen as compared with that in the top disc, implying that diffusion was a factor that controlled the movement of CO2 in the sediments, 2) an inhomogeneous replacement reaction even within the same disc, indicating that the contact area between methane hydrate and CO2 was a factor that determined the degree of replacement of CH4 from methane hydrate 3) the separate appearance of CO2 Raman intensities and CH4 Raman intensities in some portions of the test specimen, suggesting that CO2 was present in the form of CO2 hydrate in addition to being together with CH4 in other parts of the hydrate. Further analysis found that both CO2 diffusion and the contact area for reaction were associated with the pore structure of the sediments, which were heterogeneous both in pore size and in pore shape as observed with high resolution X-ray CT.

  4. Disc-halo interactions in ΛCDM

    NASA Astrophysics Data System (ADS)

    Bauer, Jacob S.; Widrow, Lawrence M.; Erkal, Denis

    2018-05-01

    We present a new method for embedding a stellar disc in a cosmological dark matter halo and provide a worked example from a Λ cold dark matter zoom-in simulation. The disc is inserted into the halo at a redshift z = 3 as a zero-mass rigid body. Its mass and size are then increased adiabatically while its position, velocity, and orientation are determined from rigid-body dynamics. At z = 1, the rigid disc (RD) is replaced by an N-body disc whose particles sample a three-integral distribution function (DF). The simulation then proceeds to z = 0 with live disc (LD) and halo particles. By comparison, other methods assume one or more of the following: the centre of the RD during the growth phase is pinned to the minimum of the halo potential, the orientation of the RD is fixed, or the live N-body disc is constructed from a two rather than three-integral DF. In general, the presence of a disc makes the halo rounder, more centrally concentrated, and smoother, especially in the innermost regions. We find that methods in which the disc is pinned to the minimum of the halo potential tend to overestimate the amount of adiabatic contraction. Additionally, the effect of the disc on the subhalo distribution appears to be rather insensitive to the disc insertion method. The LD in our simulation develops a bar that is consistent with the bars seen in late-type spiral galaxies. In addition, particles from the disc are launched or `kicked up' to high galactic latitudes.

  5. Water and Salt Stresses, Kinetin and Protein Synthesis in Tobacco Leaves 1

    PubMed Central

    Ben-Zioni, Aliza; Itai, C.; Vaadia, Y.

    1967-01-01

    The capacity of tobacco (Nicotiana rustica) leaf discs to incorporate l-leucine 14C into proteins was measured. Leaf discs were obtained from plants which experienced soil water depletion, or which were exposed to a saline or osmotic stress in the root medium. The stresses were brief of relatively short duration and water potential did not decrease below 4 bars in the root media. Leaf discs were sampled 2 hours after stress removal, achieved by reirrigation, or replacement of saline and osmotic solutions with normal nutrient solution. Plants were always turgid when leaves were sampled. All stressed tissues showed reduced capacity to incorporate l-leucine 14C into protein. The reduction was about 50% and could not be attributed either to reduced uptake into the discs, or to possible isotopic dilution. Incorporation decreased progressively with leaf age in control discs as well as in stressed leaf discs. At all ages tested, incorporation in stressed discs was lower than that of the control. Full recovery of incorporation capacity in stressed discs was obtained when discs were sampled 72 hours after stress removal but not earlier. Kinetin pretreatment prior to incubation with labelled leucine partially restored incorporation in stressed discs. The differences in response to kinetin of stressed and control discs suggest a lower endogenous level of cytokinins in the stressed discs. The results were qualitatively similar regardless of the kind of stress given to the plants during pretreatment. This supports the hypothesis that the normal supply of root cytokinins is important in shoot metabolism. PMID:16656515

  6. The Discover artificial disc replacement versus fusion in cervical radiculopathy--a randomized controlled outcome trial with 2-year follow-up.

    PubMed

    Skeppholm, Martin; Lindgren, Lars; Henriques, Thomas; Vavruch, Ludek; Löfgren, Håkan; Olerud, Claes

    2015-06-01

    Several previous studies comparing artificial disc replacement (ADR) and fusion have been conducted with cautiously positive results in favor of ADR. This study is not, in contrast to most previous studies, an investigational device exemption study required by the Food and Drug Administration for approval to market the product in the United States. This study was partially funded with unrestricted institutional research grants by the company marketing the artificial disc used in this study. To compare outcomes between the concepts of an artificial disc to treatment with anterior cervical decompression and fusion (ACDF) and to register complications associated to the two treatments during a follow-up time of 2 years. This is a randomized controlled multicenter trial, including three spine centers in Sweden. The study included patients seeking care for cervical radiculopathy who fulfilled inclusion criteria. In total, 153 patients were included. Self-assessment with Neck Disability Index (NDI) as a primary outcome variable and EQ-5D and visual analog scale as secondary outcome variables. Patients were randomly allocated to either treatment with the Depuy Discover artificial disc or fusion with iliac crest bone graft and plating. Randomization was blinded to both patient and caregivers until time for implantation. Adverse events, complications, and revision surgery were registered as well as loss of follow-up. Data were available in 137 (91%) of the included and initially treated patients. Both groups improved significantly after surgery. NDI changed from 63.1 to 39.8 in an intention-to-treat analysis. No statistically significant difference between the ADR and the ACDF groups could be demonstrated with NDI values of 39.1 and 40.1, respectively. Nor in secondary outcome measures (EQ-5D and visual analog scale) could any statistically significant differences be demonstrated between the groups. Nine patients in the ADR group and three in the fusion group underwent secondary surgery because of various reasons. Two patients in each group underwent secondary surgery because of adjacent segment pathology. Complication rates were not statistically significant between groups. Artificial disc replacement did not result in better outcome compared to fusion measured with NDI 2 years after surgery. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Cervical Laminoplasty

    MedlinePlus

    ... Medicine Acupuncture Herbal Supplements Surgical Options Anterior Cervical Fusion Artifical Disc Replacement (ADR) Bone Graft Alternatives Bone ... Percutaneous Vertebral Augmentation (PVA) Posterior Cervical Foraminotomy Spinal ... Nonsurgical Treatments Activity Modification Chiropractic – A Conversation with ...

  8. Cost-effectiveness of lumbar artificial intervertebral disc replacement: driven by the choice of comparator.

    PubMed

    Parkinson, Bonny; Goodall, Stephen; Thavaneswaran, Prema

    2013-09-01

    Lower back pain is a common and costly condition in Australia. This paper aims to conduct an economic evaluation of lumbar artificial intervertebral disc replacement (AIDR) compared with lumbar fusion for the treatment of patients suffering from significant axial back pain and/or radicular (nerve root) pain, secondary to disc degeneration or prolapse, who have failed conservative treatment. A cost-effectiveness approach was used to compare costs and benefits of AIDR to five fusion approaches. Resource use was based on Medicare Benefits Schedule claims data and expert opinion. Effectiveness and re-operation rates were based on published randomized controlled trials. The key clinical outcomes considered were narcotic medication discontinuation, achievement of overall clinical success, achievement of Oswestry Disability Index success and quality-adjusted life-years gained. AIDR was estimated to be cost-saving compared with fusion overall ($1600/patient); however, anterior lumbar interbody fusion and posterolateral fusion were less costly by $2155 and $807, respectively. The incremental cost-effectiveness depends on the outcome considered and the comparator. AIDR is potentially a cost-saving treatment for lumbar disc degeneration, although longer-term follow-up data are required to substantiate this claim. The incremental cost-effectiveness depends on the outcome considered and the comparator, and further research is required before any firm conclusions can be drawn. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

  9. Artificial Disc Replacement

    MedlinePlus

    ... Cervical Foraminotomy Spinal Fusion Nonsurgical Treatments Activity Modification Chiropractic – A Conversation with Dr. Jordan Gliedt, DC Directional ... with non-operative care such as medication, injections, chiropractic care and/or physical therapy. Typically, you will ...

  10. The use of polyurethane materials in the surgery of the spine: a review.

    PubMed

    St John, Kenneth R

    2014-12-01

    The spine contains intervertebral discs and the interspinous and longitudinal ligaments. These structures are elastomeric or viscoelastic in their mechanical properties and serve to allow and control the movement of the bony elements of the spine. The use of metallic or hard polymeric devices to replace the intervertebral discs and the creation of fusion masses to replace discs and/or vertebral bodies changes the load transfer characteristics of the spine and the range of motion of segments of the spine. The purpose of the study was to survey the literature, regulatory information available on the Web, and industry-reported device development found on the Web to ascertain the usage and outcomes of the use of polyurethane polymers in the design and clinical use of devices for spine surgery. A systematic review of the available information from all sources concerning the subject materials' usage in spinal devices was conducted. A search of the peer-reviewed literature combining spinal surgery with polyurethane or specific types and trade names of medical polyurethanes was performed. Additionally, information available on the Food and Drug Administration Web site and for corporate Web sites was reviewed in an attempt to identify pertinent information. The review captured devices that are in testing or have entered clinical practice that use elastomeric polyurethane polymers as disc replacements, dynamic stabilization of spinal movement, or motion limitation to relieve nerve root compression and pain and as complete a listing as possible of such devices that have been designed or tested but appear to no longer be pursued. This review summarizes the available information about the uses to which polyurethanes have been tested or are being used in spinal surgery. The use of polyurethanes in medicine has expanded as modifications to the stability of the polymers in the physiological environment have been improved. The potential for the use of elastomeric materials to more closely match the mechanical properties of the structures being replaced and to maintain motion between spinal segments appears to hold promise. The published results from the use of the devices that are discussed show early success with these applications of elastomeric materials. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Heart valve replacement with the Sorin tilting-disc prosthesis. A 10-year experience.

    PubMed

    Milano, A; Bortolotti, U; Mazzucco, A; Mossuto, E; Testolin, L; Thiene, G; Gallucci, V

    1992-02-01

    From 1978 to 1988, 697 patients with a mean age of 48 +/- 11 years (range 5 to 75 years) received a Sorin tilting-disc prosthesis; 358 had had aortic valve replacement, 247 mitral valve replacement, and 92 mitral and aortic valve replacement. Operative mortality rates were 7.8%, 11.3%, and 10.8%, respectively, in the three groups. Cumulative duration of follow-up is 1650 patient-years for aortic valve replacement (maximum follow-up 11.4 years), 963 patient-years for mitral valve replacement (maximum follow-up 9.9 years) and 328 patient-years for mitral and aortic valve replacement (maximum follow-up 9.4 years). Actuarial survival at 9 years is 72% +/- 4% after mitral valve replacement, 70% +/- 3% after aortic valve replacement, and 50% +/- 12% after mitral and aortic valve replacement, and actuarial freedom from valve-related deaths is 97% +/- 2% after mitral valve replacement, 92% +/- 2% after aortic valve replacement, and 62% +/- 15% after mitral and aortic valve replacement. Thromboembolic events occurred in 21 patients with aortic valve replacement (1.3% +/- 0.2%/pt-yr), in 12 with mitral valve replacement (1.2% +/- 0.3% pt-yr), and in seven with mitral and aortic valve replacement (2.1% +/- 0.8%), with one case of prosthetic thrombosis in each group; actuarial freedom from thromboembolism at 9 years is 92% +/- 3% after mitral valve replacement, 91% +/- 3% after aortic valve replacement, and 74% +/- 16% after mitral and aortic valve replacement. Anticoagulant-related hemorrhage was observed in 15 patients after aortic valve replacement (0.9% +/- 0.2%/pt-yr), in 9 after mitral valve replacement (0.9% +/- 0.3%/pt-yr), and in 6 with mitral and aortic valve replacement (0.9% +/- 0.5%/pt-yr); actuarial freedom from this complication at 9 years is 94% +/- 2% after aortic valve replacement, 91% +/- 4% after mitral valve replacement, and 68% +/- 16% after mitral and aortic valve replacement. Actuarial freedom from reoperation at 9 years is 97% +/- 2% after mitral and aortic valve replacement, 92% +/- 4% after mitral valve replacement, and 89% +/- 3% after aortic valve replacement, with no cases of mechanical fracture. The Sorin valve has shown a satisfactory long-term overall performance, comparable with other mechanical prostheses, and an excellent durability that renders it a reliable heart valve substitute for the mitral and aortic positions.

  12. Keeping VoIP from Being the Wrong Number: Digital Phones Can Save Money for Schools but There Are Many Pitfalls

    ERIC Educational Resources Information Center

    Nadeau, Burain

    2008-01-01

    In 2004, when Gary L. Allen was considering different approaches for replacing the Amarillo Independent School District's antiquated phone system, he had a dilemma. The goal was to expand the features that the district's phones were capable of while taking advantage of its digital infrastructure and cutting costs. But, should he buy the latest…

  13. Results of the prospective, randomized, controlled multicenter Food and Drug Administration investigational device exemption study of the ProDisc-C total disc replacement versus anterior discectomy and fusion for the treatment of 1-level symptomatic cervical disc disease.

    PubMed

    Murrey, Daniel; Janssen, Michael; Delamarter, Rick; Goldstein, Jeffrey; Zigler, Jack; Tay, Bobby; Darden, Bruce

    2009-04-01

    Cervical total disc replacement (TDR) is intended to address radicular pain and preserve functional motion between two vertebral bodies in patients with symptomatic cervical disc disease (SCDD). The purpose of this trial is to compare the safety and efficacy of cervical TDR, ProDisc-C (Synthes Spine Company, L.P., West Chester, PA), to anterior cervical discectomy and fusion (ACDF) surgery for the treatment of one-level SCDD between C3 and C7. The study was conducted at 13 sites. A noninferiority design with a 1:1 randomization was used. Two hundred nine patients were randomized and treated (106 ACDF; 103 ProDisc-C). Visual analog scale (VAS) pain and intensity (neck and arm), VAS satisfaction, neck disability index (NDI), neurological exam, device success, adverse event occurrence, and short form-36 (SF-36) standardized questionnaires. A prospective, randomized, controlled clinical trial was performed. Patients were enrolled and treated in accordance with the US Food and Drug Administration (FDA)-approved protocol. Patients were assessed pre- and postoperatively at six weeks, 3, 6, 12, 18, and 24 months. Demographics were similar between the two patient groups (ProDisc-C: 42.1+/-8.4 years, 44.7% males; Fusion: 43.5 +/- 7.1 years, 46.2% males). The most commonly treated level was C5-C6 (ProDisc-C: 56.3%; Fusion=57.5%). NDI and SF-36 scores were significantly less compared with presurgery scores at all follow-up visits for both the treatment groups (p<.0001). VAS neck pain intensity and frequency as well as VAS arm pain intensity and frequency were statistically lower at all follow-up timepoints compared with preoperative levels (p<.0001) but were not different between treatments. Neurologic success (improvement or maintenance) was achieved at 24 months in 90.9% of ProDisc-C and 88.0% of Fusion patients (p=.638). Results show that at 24 months postoperatively, 84.4% of ProDisc-C patients achieved a more than or equal to 4 degrees of motion or maintained motion relative to preoperative baseline at the operated level. There was a statistically significant difference in the number of secondary surgeries with 8.5% of Fusion patients needing a re-operation, revision, or supplemental fixation within the 24 month postoperative period compared with 1.8% of ProDisc-C patients (p=.033). At 24 months, there was a statistically significant difference in medication usage with 89.9% of ProDisc-C patients not on strong narcotics or muscle relaxants, compared with 81.5% of Fusion patients. The results of this clinical trial demonstrate that ProDisc-C is a safe and effective surgical treatment for patients with disabling cervical radiculopathy because of single-level disease. By all primary and secondary measures evaluated, clinical outcomes after ProDisc-C implantation were either equivalent or superior to those same clinical outcomes after Fusion.

  14. ISASS Policy Statement – Lumbar Artificial Disc

    PubMed Central

    Garcia, Rolando

    2015-01-01

    Purpose The primary goal of this Policy Statement is to educate patients, physicians, medical providers, reviewers, adjustors, case managers, insurers, and all others involved or affected by insurance coverage decisions regarding lumbar disc replacement surgery. Procedures This Policy Statement was developed by a panel of physicians selected by the Board of Directors of ISASS for their expertise and experience with lumbar TDR. The panel's recommendation was entirely based on the best evidence-based scientific research available regarding the safety and effectiveness of lumbar TDR. PMID:25785243

  15. Reproducibility Issues: Avoiding Pitfalls in Animal Inflammation Models.

    PubMed

    Laman, Jon D; Kooistra, Susanne M; Clausen, Björn E

    2017-01-01

    In light of an enhanced awareness of ethical questions and ever increasing costs when working with animals in biomedical research, there is a dedicated and sometimes fierce debate concerning the (lack of) reproducibility of animal models and their relevance for human inflammatory diseases. Despite evident advancements in searching for alternatives, that is, replacing, reducing, and refining animal experiments-the three R's of Russel and Burch (1959)-understanding the complex interactions of the cells of the immune system, the nervous system and the affected tissue/organ during inflammation critically relies on in vivo models. Consequently, scientific advancement and ultimately novel therapeutic interventions depend on improving the reproducibility of animal inflammation models. As a prelude to the remaining hands-on protocols described in this volume, here, we summarize potential pitfalls of preclinical animal research and provide resources and background reading on how to avoid them.

  16. Cost-effectiveness of cervical total disc replacement vs fusion for the treatment of 2-level symptomatic degenerative disc disease.

    PubMed

    Ament, Jared D; Yang, Zhuo; Nunley, Pierce; Stone, Marcus B; Kim, Kee D

    2014-12-01

    Cervical total disc replacement (CTDR) was developed to treat cervical spondylosis, while preserving motion. While anterior cervical discectomy and fusion (ACDF) has been the standard of care for 2-level disease, a randomized clinical trial (RCT) suggested similar outcomes. Cost-effectiveness of this intervention has never been elucidated. To determine the cost-effectiveness of CTDR compared with ACDF. Data were derived from an RCT that followed up 330 patients over 24 months. The original RCT consisted of multi-institutional data including private and academic institutions. Using linear regression for the current study, health states were constructed based on the stratification of the Neck Disability Index and a visual analog scale. Data from the 12-item Short-Form Health Survey questionnaires were transformed into utilities values using the SF-6D mapping algorithm. Costs were calculated by extracting Diagnosis-Related Group codes from institutional billing data and then applying 2012 Medicare reimbursement rates. The costs of complications and return-to-work data were also calculated. A Markov model was built to evaluate quality-adjusted life-years (QALYs) for both treatment groups. The model adopted a third-party payer perspective and applied a 3% annual discount rate. Patients included in the original RCT had to be diagnosed as having radiculopathy or myeloradiculopathy at 2 contiguous levels from C3-C7 that was unresponsive to conservative treatment for at least 6 weeks or demonstrated progressive symptoms. Incremental cost-effectiveness ratio of CTDR compared with ACDF. A strong correlation (R2 = 0.6864; P < .001) was found by projecting a visual analog scale onto the Neck Disability Index. Cervical total disc replacement had an average of 1.58 QALYs after 24 months compared with 1.50 QALYs for ACDF recipients. Cervical total disc replacement was associated with $2139 greater average cost. The incremental cost-effectiveness ratio of CTDR compared with ACDF was $24,594 per QALY at 2 years. Despite varying input parameters in the sensitivity analysis, the incremental cost-effectiveness ratio value stays below the threshold of $50,000 per QALY in most scenarios (range, -$58,194 to $147,862 per QALY). The incremental cost-effectiveness ratio of CTDR compared with traditional ACDF is lower than the commonly accepted threshold of $50,000 per QALY. This remains true with varying input parameters in a robust sensitivity analysis, reaffirming the stability of the model and the sustainability of this intervention.

  17. Biomechanics of Hybrid Anterior Cervical Fusion and Artificial Disc Replacement in 3-Level Constructs: An In Vitro Investigation

    PubMed Central

    Liao, Zhenhua; Fogel, Guy R.; Pu, Ting; Gu, Hongsheng; Liu, Weiqiang

    2015-01-01

    Background The ideal surgical approach for cervical disk disease remains controversial, especially for multilevel cervical disease. The purpose of this study was to investigate the biomechanics of the cervical spine after 3-level hybrid surgery compared with 3-level anterior cervical discectomy and fusion (ACDF). Material/Methods Eighteen human cadaveric spines (C2-T1) were evaluated under displacement-input protocol. After intact testing, a simulated hybrid construct or fusion construct was created between C3 to C6 and tested in the following 3 conditions: 3-level disc plate disc (3DPD), 3-level plate disc plate (3PDP), and 3-level plate (3P). Results Compared to intact, almost 65~80% of motion was successfully restricted at C3-C6 fusion levels (p<0.05). 3DPD construct resulted in slight increase at the 3 instrumented levels (p>0.05). 3PDP construct resulted in significant decrease of ROM at C3-C6 levels less than 3P (p<0.05). Both 3DPD and 3PDP caused significant reduction of ROM at the arthrodesis level and produced motion increase at the arthroplasty level. For adjacent levels, 3P resulted in markedly increased contribution of both upper and lower adjacent levels (p<0.05). Significant motion increases lower than 3P were only noted at partly adjacent levels in some conditions for 3DPD and 3PDP (p<0.05). Conclusions ACDF eliminated motion within the construct and greatly increased adjacent motion. Artificial cervical disc replacement normalized motion of its segment and adjacent segments. While hybrid conditions failed to restore normal motion within the construct, they significantly normalized motion in adjacent segments compared with the 3-level ACDF condition. The artificial disc in 3-level constructs has biomechanical advantages compared to fusion in normalizing motion. PMID:26529430

  18. Biomechanics of Hybrid Anterior Cervical Fusion and Artificial Disc Replacement in 3-Level Constructs: An In Vitro Investigation.

    PubMed

    Liao, Zhenhua; Fogel, Guy R; Pu, Ting; Gu, Hongsheng; Liu, Weiqiang

    2015-11-03

    The ideal surgical approach for cervical disk disease remains controversial, especially for multilevel cervical disease. The purpose of this study was to investigate the biomechanics of the cervical spine after 3-level hybrid surgery compared with 3-level anterior cervical discectomy and fusion (ACDF). Eighteen human cadaveric spines (C2-T1) were evaluated under displacement-input protocol. After intact testing, a simulated hybrid construct or fusion construct was created between C3 to C6 and tested in the following 3 conditions: 3-level disc plate disc (3DPD), 3-level plate disc plate (3PDP), and 3-level plate (3P). Compared to intact, almost 65~80% of motion was successfully restricted at C3-C6 fusion levels (p<0.05). 3DPD construct resulted in slight increase at the 3 instrumented levels (p>0.05). 3PDP construct resulted in significant decrease of ROM at C3-C6 levels less than 3P (p<0.05). Both 3DPD and 3PDP caused significant reduction of ROM at the arthrodesis level and produced motion increase at the arthroplasty level. For adjacent levels, 3P resulted in markedly increased contribution of both upper and lower adjacent levels (p<0.05). Significant motion increases lower than 3P were only noted at partly adjacent levels in some conditions for 3DPD and 3PDP (p<0.05). ACDF eliminated motion within the construct and greatly increased adjacent motion. Artificial cervical disc replacement normalized motion of its segment and adjacent segments. While hybrid conditions failed to restore normal motion within the construct, they significantly normalized motion in adjacent segments compared with the 3-level ACDF condition. The artificial disc in 3-level constructs has biomechanical advantages compared to fusion in normalizing motion.

  19. Subsequent surgery rates after cervical total disc replacement using a Mobi-C Cervical Disc Prosthesis versus anterior cervical discectomy and fusion: a prospective randomized clinical trial with 5-year follow-up.

    PubMed

    Jackson, Robert J; Davis, Reginald J; Hoffman, Gregory A; Bae, Hyun W; Hisey, Michael S; Kim, Kee D; Gaede, Steven E; Nunley, Pierce Dalton

    2016-05-01

    OBJECTIVE Cervical total disc replacement (TDR) has been shown in a number of prospective clinical studies to be a viable treatment alternative to anterior cervical discectomy and fusion (ACDF) for the treatment of symptomatic degenerative disc disease. In addition to preserving motion, evidence suggests that cervical TDR may result in a lower incidence of subsequent surgical intervention than treatment with fusion. The goal of this study was to evaluate subsequent surgery rates up to 5 years in patients treated with TDR or ACDF at 1 or 2 contiguous levels between C-3 and C-7. METHODS This was a prospective, multicenter, randomized, unblinded clinical trial. Patients with symptomatic degenerative disc disease were enrolled to receive 1- or 2-level treatment with either TDR as the investigational device or ACDF as the control treatment. There were 260 patients in the 1-level study (179 TDR and 81 ACDF patients) and 339 patients in the 2-level study (234 TDR and 105 ACDF patients). RESULTS At 5 years, the occurrence of subsequent surgical intervention was significantly higher among ACDF patients for 1-level (TDR, 4.5% [8/179]; ACDF, 17.3% [14/81]; p = 0.0012) and 2-level (TDR, 7.3% [17/234]; ACDF, 21.0% [22/105], p = 0.0007) treatment. The TDR group demonstrated significantly fewer index- and adjacent-level subsequent surgeries in both the 1- and 2-level cohorts. CONCLUSIONS Five-year results showed treatment with cervical TDR to result in a significantly lower rate of subsequent surgical intervention than treatment with ACDF for both 1 and 2 levels of treatment. Clinical trial registration no.: NCT00389597 ( clinicaltrials.gov ).

  20. Return to Sports After Cervical Total Disc Replacement.

    PubMed

    Reinke, Andreas; Behr, Michael; Preuss, Alexander; Villard, Jimmy; Meyer, Bernhard; Ringel, Florian

    2017-01-01

    Total disc replacement (TDR) is typically indicated in young patients with a cervical soft disc herniation. There are few data on the activity level of patients after cervical TDR, in particular from young patients who are expected to have a high activity level with frequent exercising. The expectation is that returning to active sports after cervical TDR is not restricted. Fifty patients were treated with a monosegmental cervical TDR at our department between May 2006 and March 2012. Clinical status and radiographic parameters were evaluated preoperatively and during follow-up. In addition, information was gathered regarding neck disability index, pain, a questionnaire concerning athletic aspects, and a modified Tegner activity score. The study design was a prospective case series. All patients were treated with the Prestige artificial cervical disc for a single-level soft disc herniation with radiculopathy. The average age was 40 years, and the mean follow-up period was 53 months (range, 26-96). The median neck disability index during follow-up was 5, and median visual analog scale for pain was 2. Two professional athletes, 20 semiprofessionals, 24 hobby athletes, and 5 patients with a very low activity level were treated. The median time to resumption of sporting activity was 4 weeks after surgery. All professionals and semiprofessionals recovered to their previous activity level. All of the 20 hobby athletes recovered to resume their sport participation. The modified Tegner preoperative score was 4 and the postoperative score was 3.5 (P = 0.806). We found that cervical TDR did not prohibit sporting activities. All patients recovered and were able to take part in their previous activities at an appropriate intensity level. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Complications of Lumbar Artificial Disc Replacement Compared to Fusion: Results From the Prospective, Randomized, Multicenter US Food and Drug Administration Investigational Device Exemption Study of the Charité Artificial Disc

    PubMed Central

    Majd, Mohammed E.; Isaza, Jorge E.; Blumenthal, Scott L.; McAfee, Paul C.; Guyer, Richard D.; Hochschuler, Stephen H.; Geisler, Fred H.; Garcia, Rolando; Regan, John J.

    2007-01-01

    Background Previous reports of lumbar total disc replacement (TDR) have described significant complications. The US Food and Drug Administration (FDA) investigational device exemption (IDE) study of the Charité artificial disc represents the first level I data comparison of TDR to fusion. Methods In the prospective, randomized, multicenter IDE study, patients were randomized in a 2:1 ratio, with 205 patients in the Charité group and 99 patients in the control group (anterior lumbar interbody fusion [ALIF] with BAK cages). Inclusion criteria included confirmed single-level degenerative disc disease at L4-5 or L5-S1 and failure of nonoperative treatment for at least 6 months. Complications were reported throughout the study. Results The rate of approach-related complications was 9.8% in the investigational group and 10.1% in the control group. The rate of major neurological complications was similar between the 2 groups (investigational = 4.4%, control = 4.0%). There was a higher rate of superficial wound infection in the investigational group but no deep wound infections in either group. Pseudarthrosis occurred in 9.1% of control group patients. The rate of subsidence in the investigational group was 3.4%. The reoperation rate was 5.4% in the investigational group and 9.1% in the control group. Conclusions The incidence of perioperative and postoperative complications for lumbar TDR was similar to that of ALIF. Vigilance is necessary with respect to patient indications, training, and correct surgical technique to maintain TDR complications at the levels experienced in the IDE study. PMID:25802575

  2. Doughnut strikes sandwich: the geometry of hot medium in accreting black hole X-ray binaries

    NASA Astrophysics Data System (ADS)

    Poutanen, Juri; Veledina, Alexandra; Zdziarski, Andrzej A.

    2018-06-01

    We study the effects of the mutual interaction of hot plasma and cold medium in black hole binaries in their hard spectral state. We consider a number of different geometries. In contrast to previous theoretical studies, we use a modern energy-conserving code for reflection and reprocessing from cold media. We show that a static corona above an accretion disc extending to the innermost stable circular orbit produces spectra not compatible with those observed. They are either too soft or require a much higher disc ionization than that observed. This conclusion confirms a number of previous findings, but disproves a recent study claiming an agreement of that model with observations. We show that the cold disc has to be truncated in order to agree with the observed spectral hardness. However, a cold disc truncated at a large radius and replaced by a hot flow produces spectra which are too hard if the only source of seed photons for Comptonization is the accretion disc. Our favourable geometry is a truncated disc coexisting with a hot plasma either overlapping with the disc or containing some cold matter within it, also including seed photons arising from cyclo-synchrotron emission of hybrid electrons, i.e. containing both thermal and non-thermal parts.

  3. A Structurally and Functionally Biomimetic Biphasic Scaffold for Intervertebral Disc Tissue Engineering

    PubMed Central

    Choy, Andrew Tsz Hang; Chan, Barbara Pui

    2015-01-01

    Tissue engineering offers high hopes for the treatment of intervertebral disc (IVD) degeneration. Whereas scaffolds of the disc nucleus and annulus have been extensively studied, a truly biomimetic and mechanically functional biphasic scaffold using naturally occurring extracellular matrix is yet to be developed. Here, a biphasic scaffold was fabricated with collagen and glycosaminoglycans (GAGs), two of the most abundant extracellular matrix components in the IVD. Following fabrication, the scaffold was characterized and benchmarked against native disc. The biphasic scaffold was composed of a collagen-GAG co-precipitate making up the nucleus pulposus-like core, and this was encapsulated in multiple lamellae of photochemically crosslinked collagen membranes comprising the annulus fibrosus-like lamellae. On mechanical testing, the height of our engineered disc recovered by ~82-89% in an annulus-independent manner, when compared with the 99% recovery exhibited by native disc. The annulus-independent nature of disc height recovery suggests that the fluid replacement function of the engineered nucleus pulposus core might mimic this hitherto unique feature of native disc. Biphasic scaffolds comprised of 10 annulus fibrosus-like lamellae had the best overall mechanical performance among the various designs owing to their similarity to native disc in most aspects, including elastic compliance during creep and recovery, and viscous compliance during recovery. However, the dynamic mechanical performance (including dynamic stiffness and damping factor) of all the biphasic scaffolds was similar to that of the native discs. This study contributes to the rationalized design and development of a biomimetic and mechanically viable biphasic scaffold for IVD tissue engineering. PMID:26115332

  4. [Tachycardia detection in implantable cardioverter-defibrillators by Sorin/LivaNova : Algorithms, pearls and pitfalls].

    PubMed

    Kolb, Christof; Ocklenburg, Rolf

    2016-09-01

    For physicians involved in the treatment of patients with implantable cardioverter-defibrillators (ICDs) the knowledge of tachycardia detection algorithms is of paramount importance. This knowledge is essential for adequate device selection during de-novo implantation, ICD replacement, and for troubleshooting during follow-up. This review describes tachycardia detection algorithms incorporated in ICDs by Sorin/LivaNova and analyses their strengths and weaknesses.

  5. Biological treatment strategies for disc degeneration: potentials and shortcomings

    PubMed Central

    Nerlich, Andreas G.; Boos, Norbert

    2006-01-01

    Recent advances in molecular biology, cell biology and material sciences have opened a new emerging field of techniques for the treatment of musculoskeletal disorders. These new treatment modalities aim for biological repair of the affected tissues by introducing cell-based tissue replacements, genetic modifications of resident cells or a combination thereof. So far, these techniques have been successfully applied to various tissues such as bone and cartilage. However, application of these treatment modalities to cure intervertebral disc degeneration is in its very early stages and mostly limited to experimental studies in vitro or in animal studies. We will discuss the potential and possible shortcomings of current approaches to biologically cure disc degeneration by gene therapy or tissue engineering. Despite the increasing number of studies examining the therapeutic potential of biological treatment strategies, a practicable solution to routinely cure disc degeneration might not be available in the near future. However, knowledge gained from these attempts might be applied in a foreseeable future to cure the low back pain that often accompanies disc degeneration and therefore be beneficial for the patient. PMID:16983559

  6. Biomechanical Effects of the Geometry of Ball-and-Socket Artificial Disc on Lumbar Spine: A Finite Element Study.

    PubMed

    Choi, Jisoo; Shin, Dong-Ah; Kim, Sohee

    2017-03-15

    A three-dimensional finite element model of intact lumbar spine was constructed and four surgical finite element models implanted with ball-and-socket artificial discs with four different radii of curvature were compared. To investigate biomechanical effects of the curvature of ball-and-socket artificial disc using finite element analysis. Total disc replacement (TDR) has been accepted as an alternative treatment because of its advantages over spinal fusion methods in degenerative disc disease. However, the influence of the curvature of artificial ball-and-socket discs has not been fully understood. Four surgical finite element models with different radii of curvature of ball-and-socket artificial discs were constructed. The range of motion (ROM) increased with decreasing radius of curvature in extension, flexion, and lateral bending, whereas it increased with increasing radius of curvature in axial torsion. The facet contact force was minimum with the largest radius of curvature in extension, flexion, and lateral bending, whereas it was maximum with the largest radius in axial torsion. It was also affected by the disc placement, more with posterior placement than anterior placement. The stress in L4 cancellous bone increased when the radius of curvature was too large or small. The geometry of ball-and-socket artificial disc significantly affects the ROM, facet contact force, and stress in the cancellous bone at the surgical level. The implication is that in performing TDR, the ball-and-socket design may not be ideal, as ROM and facet contact force are sensitive to the disc design, which may be exaggerated by the individual difference of anatomical geometry. N/A.

  7. The Formation and Fragmentation of Primordial Protostellar Discs

    NASA Astrophysics Data System (ADS)

    Clark, Paul C.; Glover, Simon C. O.; Smith, Rowan J.; Greif, Thomas H.; Klessen, Ralf S.; Bromm, Volker

    2010-11-01

    We study the formation and evolution of the protostellar discs that form around the first stars in the Universe. Using sink particles, we replace the gravitationally bound gas at densities higher than 1015 cm-3 and radii greater than 3 AU from the central protostellar core, with an accreting point mass that is able to gravitationally interact with the surrounding gas. We find the disc is gravitationally (or `Toomre') unstable, and is dominated by a strong m = 2 spiral mode. Although the angular momentum transport is dominated by a combination of gravitational torques and Reynolds stresses, which are extremely efficient mechanisms, the disc is unable to process the infalling material and grows increasingly gravitationally unstable. During the build-up of the disc, the temperature in the gas is regulated by a combination of H2 line cooling, collision-induced emission and H2 dissociation, which together help to offset heating from the gravitational collapse and feedback from the protostar. Once the disc starts to fragment, H2 dissociation keeps the gas almost isothermal as the collapse of the fragment progresses. The fragmentation occurs when the protostar/disc system is only 230 yr old and at a distance of ~20 AU from its sibling, by which point the central protostar has a mass of ~1 Msolar. Given the angular momentum of the new protostellar system, it is likely that the protostars will grow to become a massive binary system.

  8. Reduction of CO2 Emissions Due to Wind Energy - Methods and Issues in Estimating Operational Emission Reductions

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Holttinen, Hannele; Kiviluoma, Juha; McCann, John

    2015-10-05

    This paper presents ways of estimating CO2 reductions of wind power using different methodologies. Estimates based on historical data have more pitfalls in methodology than estimates based on dispatch simulations. Taking into account exchange of electricity with neighboring regions is challenging for all methods. Results for CO2 emission reductions are shown from several countries. Wind power will reduce emissions for about 0.3-0.4 MtCO2/MWh when replacing mainly gas and up to 0.7 MtCO2/MWh when replacing mainly coal powered generation. The paper focuses on CO2 emissions from power system operation phase, but long term impacts are shortly discussed.

  9. Severe impingement of lumbar disc replacements increases the functional biological activity of polyethylene wear debris.

    PubMed

    Baxter, Ryan M; Macdonald, Daniel W; Kurtz, Steven M; Steinbeck, Marla J

    2013-06-05

    Wear, oxidation, and particularly rim impingement damage of ultra-high molecular weight polyethylene total disc replacement components have been observed following surgical revision. However, neither in vitro testing nor retrieval-based evidence has shown the effect(s) of impingement on the characteristics of polyethylene wear debris. Thus, we sought to determine (1) differences in polyethylene particle size, shape, number, or biological activity that correspond to mild or severe rim impingement and (2) in an analysis of all total disc replacements, regardless of impingement classification, whether there are correlations between the extent of regional damage and the characteristics of polyethylene wear debris. The extent of dome and rim damage was characterized for eleven retrieved polyethylene cores obtained at revision surgery after an average duration of implantation of 9.7 years (range, 4.6 to 16.1 years). Polyethylene wear debris was isolated from periprosthetic tissues with use of nitric acid and was imaged with use of environmental scanning electron microscopy. Subsequently, particle size, shape, number, biological activity, and chronic inflammation scores were determined. Grouping of particles by size ranges that represented high biological relevance (<0.1 to 1-μm particles), intermediate biological relevance (1 to 10-μm particles), and low biological relevance (>10-μm particles) revealed an increased volume fraction of particles in the <0.1 to 1-μm and 1 to 10-μm size ranges in the mild-impingement cohort as compared with the severe-impingement cohort. The increased volume fractions resulted in a higher specific biological activity per unit particle volume in the mild-impingement cohort than in the severe-impingement cohort. However, functional biological activity, which is normalized by particle volume (mm3/g of tissue), was significantly higher in the severe-impingement cohort. This increase was due to a larger volume of particles in all three size ranges. In both cohorts, the functional biological activity correlated with the chronic inflammatory response, and the extent of rim penetration positively correlated with increasing particle size, number, and functional biological activity. The results of this study suggest that severe rim impingement increases the production of biologically relevant particles from motion-preserving lumbar total disc replacement components. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  10. Severe Impingement of Lumbar Disc Replacements Increases the Functional Biological Activity of Polyethylene Wear Debris

    PubMed Central

    Baxter, Ryan M.; MacDonald, Daniel W.; Kurtz, Steven M.; Steinbeck, Marla J.

    2013-01-01

    Background: Wear, oxidation, and particularly rim impingement damage of ultra-high molecular weight polyethylene total disc replacement components have been observed following surgical revision. However, neither in vitro testing nor retrieval-based evidence has shown the effect(s) of impingement on the characteristics of polyethylene wear debris. Thus, we sought to determine (1) differences in polyethylene particle size, shape, number, or biological activity that correspond to mild or severe rim impingement and (2) in an analysis of all total disc replacements, regardless of impingement classification, whether there are correlations between the extent of regional damage and the characteristics of polyethylene wear debris. Methods: The extent of dome and rim damage was characterized for eleven retrieved polyethylene cores obtained at revision surgery after an average duration of implantation of 9.7 years (range, 4.6 to 16.1 years). Polyethylene wear debris was isolated from periprosthetic tissues with use of nitric acid and was imaged with use of environmental scanning electron microscopy. Subsequently, particle size, shape, number, biological activity, and chronic inflammation scores were determined. Results: Grouping of particles by size ranges that represented high biological relevance (<0.1 to 1-μm particles), intermediate biological relevance (1 to 10-μm particles), and low biological relevance (>10-μm particles) revealed an increased volume fraction of particles in the <0.1 to 1-μm and 1 to 10-μm size ranges in the mild-impingement cohort as compared with the severe-impingement cohort. The increased volume fractions resulted in a higher specific biological activity per unit particle volume in the mild-impingement cohort than in the severe-impingement cohort. However, functional biological activity, which is normalized by particle volume (mm3/g of tissue), was significantly higher in the severe-impingement cohort. This increase was due to a larger volume of particles in all three size ranges. In both cohorts, the functional biological activity correlated with the chronic inflammatory response, and the extent of rim penetration positively correlated with increasing particle size, number, and functional biological activity. Conclusions: The results of this study suggest that severe rim impingement increases the production of biologically relevant particles from motion-preserving lumbar total disc replacement components. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. PMID:23780545

  11. Retinal vessel tortuosity measures and their applications.

    PubMed

    Kalitzeos, Angelos A; Lip, Gregory Y H; Heitmar, Rebekka

    2013-01-01

    Structural retinal vascular characteristics, such as vessel calibers, tortuosity and bifurcation angles are increasingly quantified in an objective manner, slowly replacing subjective qualitative disease classification schemes. This paper provides an overview of the current methodologies and calculations used to compute retinal vessel tortuosity. We set out the different parameter calculations and provide an insight into the clinical applications, while critically reviewing its pitfalls and shortcomings. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Common Pitfalls in F77 Code Conversion

    DTIC Science & Technology

    2003-02-01

    implementation versus another are the source of these errors rather than typography . It is well to use the practice of commenting-out original source file lines...identifier), every I in the format field must be replaced with f followed by an appropriate floating point format designator . Floating point numeric...helps even more. Finally, libraries are a major source of non-portablility[sic], with graphics libraries one of the chief culprits. We in Fusion

  13. Geometry of the intervertebral volume and vertebral endplates of the human spine.

    PubMed

    van der Houwen, E B; Baron, P; Veldhuizen, A G; Burgerhof, J G M; van Ooijen, P M A; Verkerke, G J

    2010-01-01

    Replacement of a degenerated vertebral disc with an artificial intervertebral disc (AID) is currently possible, but poses problems, mainly in the force distribution through the vertebral column. Data on the intervertebral disc space geometry will provide a better fit of the prosthesis to the vertebrae, but current literature on vertebral disc geometry is very scarce or not suitable. In this study, existing CT-scans of 77 patients were analyzed to measure the intervertebral disc and vertebral endplate geometry of the lumbar spine. Ten adjacent points on both sides of the vertebrae (S1-superior to T12-inferior) and sagittal and transverse diameters were measured to describe the shape of the caudal and cranial vertebral planes of the vertebrae. It was found that the largest endplate depth is located in the middle or posterior regions of the vertebra, that there is a linear relationship between all inferior endplate depths and the endplate location (p < 0.0001) within the spinal column, and that the superior endplate depth increases with age by about 0.01 mm per year (p < 0.02). The wedge angle increases from T12-L1 to L5-S1. The results allow for improvement of the fit of intervertebral disc-prostheses to the vertebrae and optimized force transmission through the vertebral column.

  14. Disc replacement adjacent to cervical fusion: a biomechanical comparison of hybrid construct versus two-level fusion.

    PubMed

    Lee, Michael J; Dumonski, Mark; Phillips, Frank M; Voronov, Leonard I; Renner, Susan M; Carandang, Gerard; Havey, Robert M; Patwardhan, Avinash G

    2011-11-01

    A cadaveric biomechanical study. To investigate the biomechanical behavior of the cervical spine after cervical total disc replacement (TDR) adjacent to a fusion as compared to a two-level fusion. There are concerns regarding the biomechanical effects of cervical fusion on the mobile motion segments. Although previous biomechanical studies have demonstrated that cervical disc replacement normalizes adjacent segment motion, there is a little information regarding the function of a cervical disc replacement adjacent to an anterior cervical decompression and fusion, a potentially common clinical application. Nine cadaveric cervical spines (C3-T1, age: 60.2 ± 3.5 years) were tested under load- and displacement-control testing. After intact testing, a simulated fusion was performed at C4-C5, followed by C6-C7. The simulated fusion was then reversed, and the response of TDR at C5-C6 was measured. A hybrid construct was then tested with the TDR either below or above a single-level fusion and contrasted with a simulated two-level fusion (C4-C6 and C5-C7). The external fixator device used to simulate fusion significantly reduced range of motion (ROM) at C4-C5 and C6-C7 by 74.7 ± 8.1% and 78.1 ± 11.5%, respectively (P < 0.05). Removal of the fusion construct restored the motion response of the spinal segments to their intact state. Arthroplasty performed at C5-C6 using the porous-coated motion disc prosthesis maintained the total flexion-extension ROM to the level of the intact controls when used as a stand-alone procedure or when implanted adjacent to a single-level fusion (P > 0.05). The location of the single-level fusion, whether above or below the arthroplasty, did not significantly affect the motion response of the arthroplasty in the hybrid construct. Performing a two-level fusion significantly increased the motion demands on the nonoperated segments as compared to a hybrid TDR-plus fusion construct when the spine was required to reach the same motion end points. The spine with a hybrid construct required significantly less extension moment than the spine with a two-level fusion to reach the same extension end point. The porous-coated motion cervical prosthesis restored the ROM of the treated level to the intact state. When the porous-coated motion prosthesis was used in a hybrid construct, the TDR response was not adversely affected. A hybrid construct seems to offer significant biomechanical advantages over two-level fusion in terms of reducing compensatory adjacent-level hypermobility and also loads required to achieve a predetermined ROM.

  15. Postero-Lateral Disc Prosthesis Combined With a Unilateral Facet Replacement Device Maintains Quantity and Quality of Motion at a Single Lumbar Level

    PubMed Central

    Nayak, Aniruddh N.; Doarn, Michael C.; Gaskins, Roger B.; James, Chris R.; Cabezas, Andres F.; Castellvi, Antonio E.

    2014-01-01

    Background Mechanically replacing one or more pain generating articulations in the functional spinal unit (FSU) may be a motion preservation alternative to arthrodesis at the affected level. Baseline biomechanical data elucidating the quantity and quality of motion in such arthroplasty constructs is non-existent. Purpose The purpose of the study was to quantify the motion-preserving effect of a posterior total disc replacement (PDR) combined with a unilateral facet replacement (FR) system at a single lumbar level (L4-L5). We hypothesized that reinforcement of the FSU with unilateral FR to replace the resected, native facet joint following PDR implantation would restore quality and quantity of motion and additionally not change biomechanics at the adjacent levels. Study Design In-vitro study using human cadaveric lumbar spines. Methods Six (n = 6) cadaveric lumbar spines (L1-S1) were evaluated using a pure-moment stability testing protocol (±7.5 Nm) in flexion-extension (F/E), lateral bending (LB) and axial rotation (AR). Each specimen was tested in: (1) intact; (2) unilateral FR; and (3) unilateral FR + PDR conditions. Index and adjacent level ROM (using hybrid protocol) were determined opto-electronically. Interpedicular travel (IPT) and instantaneous center of rotation (ICR) at the index level were radiographically determined for each condition. ROM, ICR, and IPT measurements were compared (repeated measures ANOVA) between the three conditions. Results Compared to the intact spine, no significant changes in F/E, LB or AR ROM were identified as a result of unilateral FR or unilateral FR + PDR. No significant changes in adjacent L3-L4 or L5-S1 ROM were identified in any loading mode. No significant differences in IPT were identified between the three test conditions in F/E, LB or AR at the L4-L5 level. The ICRs qualitatively were similar for the intact and unilateral FR conditions and appeared to follow placement (along the anterior-posterior (AP) direction) of the PDR in the disc space Conclusion Biomechanically, quantity and quality of motion are maintained with combined unilateral FR + PDR at a single lumbar spinal level. PMID:25694929

  16. Cost Utility Analysis of the Cervical Artificial Disc vs Fusion for the Treatment of 2-Level Symptomatic Degenerative Disc Disease: 5-Year Follow-up.

    PubMed

    Ament, Jared D; Yang, Zhuo; Nunley, Pierce; Stone, Marcus B; Lee, Darrin; Kim, Kee D

    2016-07-01

    The cervical total disc replacement (cTDR) was developed to treat cervical degenerative disc disease while preserving motion. Cost-effectiveness of this intervention was established by looking at 2-year follow-up, and this update reevaluates our analysis over 5 years. Data were derived from a randomized trial of 330 patients. Data from the 12-Item Short Form Health Survey were transformed into utilities by using the SF-6D algorithm. Costs were calculated by extracting diagnosis-related group codes and then applying 2014 Medicare reimbursement rates. A Markov model evaluated quality-adjusted life years (QALYs) for both treatment groups. Univariate and multivariate sensitivity analyses were conducted to test the stability of the model. The model adopted both societal and health system perspectives and applied a 3% annual discount rate. The cTDR costs $1687 more than anterior cervical discectomy and fusion (ACDF) over 5 years. In contrast, cTDR had $34 377 less productivity loss compared with ACDF. There was a significant difference in the return-to-work rate (81.6% compared with 65.4% for cTDR and ACDF, respectively; P = .029). From a societal perspective, the incremental cost-effective ratio (ICER) for cTDR was -$165 103 per QALY. From a health system perspective, the ICER for cTDR was $8518 per QALY. In the sensitivity analysis, the ICER for cTDR remained below the US willingness-to-pay threshold of $50 000 per QALY in all scenarios (-$225 816 per QALY to $22 071 per QALY). This study is the first to report the comparative cost-effectiveness of cTDR vs ACDF for 2-level degenerative disc disease at 5 years. The authors conclude that, because of the negative ICER, cTDR is the dominant modality. ACDF, anterior cervical discectomy and fusionAWP, average wholesale priceCE, cost-effectivenessCEA, cost-effectiveness analysisCPT, Current Procedural TerminologycTDR, cervical total disc replacementCUA, cost-utility analysisDDD, degenerative disc diseaseDRG, diagnosis-related groupFDA, US Food and Drug AdministrationICER, incremental cost-effectiveness ratioIDE, Investigational Device ExemptionNDI, neck disability indexQALY, quality-adjusted life yearsRCT, randomized controlled trialRTW, return-to-workSF-12, 12-Item Short Form Health SurveyVAS, visual analog scaleWTP, willingness-to-pay.

  17. Cervical artificial disc extrusion after a paragliding accident

    PubMed Central

    Niu, Tianyi; Hoffman, Haydn; Lu, Daniel C.

    2017-01-01

    Background: Cervical total disc replacement (TDR) is an established alternative to anterior cervical discectomy and fusion (ACDF) with excellent long-term outcomes and low failure rates. Cases of implant failure and migration are scarce and primarily limited to several years postoperatively. The authors report a case of anterior extrusion of a C4-C5 ProDisc-C (DePuy Synthes, West Chester, PA, USA) cervical artificial disc (CAD) 14 months after placement due to minor trauma. Case Description: A 33-year-old female who had undergone C4-C5 CAD implantation presented with neck pain and spasm after experiencing a paragliding accident. A 4 mm anterior protrusion of the CAD was seen on x-ray. She underwent removal of the CAD followed by anterior fusion. Other cases of CAD extrusion in the literature are discussed and the device's durability and testing are considered. Conclusion: Overall, CAD extrusion is a rare event. This case is likely the result of insufficient osseous integration. Patients undergoing cervical TDR should avoid high-risk activities to prevent trauma that could compromise the disc's placement, and future design/research should focus on how to enhance osseous integration at the interface while minimizing excessive heterotopic ossification. PMID:28781915

  18. Cervical artificial disc extrusion after a paragliding accident.

    PubMed

    Niu, Tianyi; Hoffman, Haydn; Lu, Daniel C

    2017-01-01

    Cervical total disc replacement (TDR) is an established alternative to anterior cervical discectomy and fusion (ACDF) with excellent long-term outcomes and low failure rates. Cases of implant failure and migration are scarce and primarily limited to several years postoperatively. The authors report a case of anterior extrusion of a C4-C5 ProDisc-C (DePuy Synthes, West Chester, PA, USA) cervical artificial disc (CAD) 14 months after placement due to minor trauma. A 33-year-old female who had undergone C4-C5 CAD implantation presented with neck pain and spasm after experiencing a paragliding accident. A 4 mm anterior protrusion of the CAD was seen on x-ray. She underwent removal of the CAD followed by anterior fusion. Other cases of CAD extrusion in the literature are discussed and the device's durability and testing are considered. Overall, CAD extrusion is a rare event. This case is likely the result of insufficient osseous integration. Patients undergoing cervical TDR should avoid high-risk activities to prevent trauma that could compromise the disc's placement, and future design/research should focus on how to enhance osseous integration at the interface while minimizing excessive heterotopic ossification.

  19. Fatigue based design and analysis of wheel hub for Student formula car by Simulation Approach

    NASA Astrophysics Data System (ADS)

    Gowtham, V.; Ranganathan, A. S.; Satish, S.; Alexis, S. John; Siva kumar, S.

    2016-09-01

    In the existing design of Wheel hub used for Student formula cars, the brake discs cannot be removed easily since the disc is mounted in between the knuckle and hub. In case of bend or any other damage to the disc, the replacement of the disc becomes difficult. Further using OEM hub and knuckle that are used for commercial vehicles will result in increase of unsprung mass, which should be avoided in Student formula cars for improving the performance. In this design the above mentioned difficulties have been overcome by redesigning the hub in such a way that the brake disc could be removed easily by just removing the wheel and the caliper and also it will have reduced weight when compared to existing OEM hub. A CAD Model was developed based on the required fatigue life cycles. The forces acting on the hub were calculated and linear static structural analysis was performed on the wheel hub for three different materials using ANSYS Finite Element code V 16.2. The theoretical fatigue strength was compared with the stress obtained from the structural analysis for each material.

  20. The predisposing factors for the heterotopic ossification after cervical artificial disc replacement.

    PubMed

    Yi, Seong; Shin, Dong Ah; Kim, Keung Nyun; Choi, Gwihyun; Shin, Hyun Chul; Kim, Keun Su; Yoon, Do Heum

    2013-09-01

    Heterotopic ossification (HO) is defined as a formation of bone outside the skeletal system. The reported HO occurrence rate in cervical artificial disc replacement (ADR) is unexpectedly high and is known to vary. However, the predisposing factors for HO in cervical ADR have not yet been elucidated. Investigation of the predisposing factors of HO in cervical arthroplasty and the relationship between degeneration of the cervical spine and HO occurrence. Retrospective study to discover predisposing factors of HO in cervical arthroplasty. A total of 170 patients who underwent cervical ADR were enrolled including full follow-up clinical and radiologic data. Radiologic outcomes were assessed by identification of HOs according to McAfee's classifications. This study enrolled a total of 170 patients who underwent cervical ADR. Pre-existing degenerative change included anterior or posterior osteophytes, ossification of the anterior longitudinal ligament, posterior longitudinal ligament, or ligamentum nuchae. The relationships between basic patient data, pre-existing degenerative change, and HO were investigated using linear logistic regression analysis. Among all 170 patients, HO was found in 69 patients (40.6%). Among the postulated predisposing factors, only male gender and artificial disc device type were shown to be statistically significant. Unexpectedly, preoperative degenerative changes in the cervical spine exerted no significant influence on the occurrence of HOs. The odds ratio of male gender compared with female gender was 2.117. With regard to device type, the odds ratios of Mobi-C (LDR medical, Troyes, France) and ProDisc-C (Synthes, Inc., West Chester, PA, USA) were 5.262 and 7.449, respectively, compared with the Bryan disc. Definite differences in occurrence rate according to the gender of patients and the prosthesis type were identified in this study. Moreover, factors indefinably expected to influence HO in the past were not shown to be risk factors thereof, the results of which may be meaningful to future studies. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. General practice ethics: text messages and boundaries in the GP-patient relationship.

    PubMed

    Mintzker, Yishai; Rogers, Wendy

    2015-08-01

    Virtual forms of communication (eg texting) can support patients and may contribute to better care. However, these informal communication methods may intrude on the doctor’s leisure time and undermine standards of care if they replace face-to-face consultations.Texting may cross boundaries in potentially unprofessional ways, especially when particular patients are favoured with this privilege. It may disadvantage patients who are not favoured or who are not comfortable using mobile technology. We also note that GPs cannot control the distribution of their number or recall it without the inconvenience of changing the number once it has been disclosed.Virtual communication is an integral part of the way we live, despite the potential pitfalls. Each form (social media, electronic messaging systems, video consultations, mobile phones, etc) has its advantages and disadvantages. This makes it important for practices to develop policies supporting the responsible use of virtual communication. Such policies should:clarify (for patients and GPs) when its use is appropriate accommodate doctors’ individual preferences regarding technology provide guidance regarding GPs’ duties, especially for interactions that do not allow full evaluation of patients.GPs may wish to have specific criteria for providing patients with this degree of access, set very clear indications and contraindications to its use, explain the potential pitfalls, and ensure that text messages augment good care rather than replace it.

  2. Cervical disc arthroplasty: Pros and cons.

    PubMed

    Moatz, Bradley; Tortolani, P Justin

    2012-01-01

    Cervical disc arthroplasty has emerged as a promising potential alternative to anterior cervical discectomy and fusion (ACDF) in appropriately selected patients. Despite a history of excellent outcomes after ACDF, the question as to whether a fusion leads to adjacent segment degeneration remains unanswered. Numerous US investigational device exemption trials comparing cervical arthroplasty to fusion have been conducted to answer this question. This study reviews the current research regarding cervical athroplasty, and emphasizes both the pros and cons of arthroplasty as compared with ACDF. Early clinical outcomes show that cervical arthroplasty is as effective as the standard ACDF. However, this new technology is also associated with an expanding list of novel complications. Although there is no definitive evidence that cervical disc replacement reduces the incidence of adjacent segment degeneration, it does show other advantages; for example, faster return to work, and reduced need for postoperative bracing.

  3. Preferential superior surface motion in wear simulations of the Charité total disc replacement.

    PubMed

    Goreham-Voss, Curtis M; Vicars, Rachel; Hall, Richard M; Brown, Thomas D

    2012-06-01

    Laboratory wear simulations of the dual-bearing surface Charité total disc replacement (TDR) are complicated by the non-specificity of the device's center of rotation (CoR). Previous studies have suggested that articulation of the Charité preferentially occurs at the superior-bearing surface, although it is not clear how sensitive this phenomenon is to lubrication conditions or CoR location. In this study, a computational wear model is used to study the articulation kinematics and wear of the Charité TDR. Implant wear was found to be insensitive to the CoR location, although seemingly non-physiologic endplate motion can result. Articulation and wear were biased significantly to the superior-bearing surface, even in the presence of significant perturbations of loading and friction. The computational wear model provides novel insight into the mechanics and wear of the Charité TDR, allowing for better interpretation of in vivo results, and giving useful insight for designing future laboratory physical tests.

  4. [Minor strut fracture of the Björk-Shiley mitral valve].

    PubMed

    Sugita, T; Yasuda, R; Watarida, S; Onoe, M; Tabata, R; Mori, A

    1990-06-01

    In May, 1982, a 49-year-old man underwent mitral valve replacement (MVR) in our hospital with a 31 mm Björk-Shiley prosthesis for mitral regurgitation. He had been doing well until his episode of palpitation and dyspnea of sudden onset, and was transferred to our ICU with severe cardiogenic shock in Aug, 1986. Chest X-ray film revealed pulmonary edema and breakage of the valve with migration of the disc and the minor strut of the prosthesis. He was operated upon 5 hours after the onset of his complaints. The minor strut was removed from the left upper pulmonary vein and mitral valve re-replacement was done with a 29 mm Björk-Shiley Monostrut valve. The disc which had dislocated into the abdominal aorta was also recovered on the twenty-third post operative day. His postoperative course was uneventful. Immediate diagnosis and subsequent re-operation is absolute indication for rescue from acute cardiac failure due to mechanical failure of any prosthetic valve.

  5. Parametric modeling of the intervertebral disc space in 3D: application to CT images of the lumbar spine.

    PubMed

    Korez, Robert; Likar, Boštjan; Pernuš, Franjo; Vrtovec, Tomaž

    2014-10-01

    Gradual degeneration of intervertebral discs of the lumbar spine is one of the most common causes of low back pain. Although conservative treatment for low back pain may provide relief to most individuals, surgical intervention may be required for individuals with significant continuing symptoms, which is usually performed by replacing the degenerated intervertebral disc with an artificial implant. For designing implants with good bone contact and continuous force distribution, the morphology of the intervertebral disc space and vertebral body endplates is of considerable importance. In this study, we propose a method for parametric modeling of the intervertebral disc space in three dimensions (3D) and show its application to computed tomography (CT) images of the lumbar spine. The initial 3D model of the intervertebral disc space is generated according to the superquadric approach and therefore represented by a truncated elliptical cone, which is initialized by parameters obtained from 3D models of adjacent vertebral bodies. In an optimization procedure, the 3D model of the intervertebral disc space is incrementally deformed by adding parameters that provide a more detailed morphometric description of the observed shape, and aligned to the observed intervertebral disc space in the 3D image. By applying the proposed method to CT images of 20 lumbar spines, the shape and pose of each of the 100 intervertebral disc spaces were represented by a 3D parametric model. The resulting mean (±standard deviation) accuracy of modeling was 1.06±0.98mm in terms of radial Euclidean distance against manually defined ground truth points, with the corresponding success rate of 93% (i.e. 93 out of 100 intervertebral disc spaces were modeled successfully). As the resulting 3D models provide a description of the shape of intervertebral disc spaces in a complete parametric form, morphometric analysis was straightforwardly enabled and allowed the computation of the corresponding heights, widths and volumes, as well as of other geometric features that in detail describe the shape of intervertebral disc spaces. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. 2-[18 F]fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET) findings of chronic expanding intrapericardial hematoma: a potential interpretive pitfall that mimics a malignant tumor

    PubMed Central

    2013-01-01

    A 77-year-old man who had undergone mitral valve replacement 5 years previously presented with an intrapericardial mass. Computed tomography and magnetic resonance imaging showed that the mass lesion contained hematoma components. Positron-emission tomography (PET) with 2-[18 F] fluoro-2-deoxy-d-glucose (FDG) revealed uptake in the peripheral rim of the mass. These findings suggested the presence of hematoma associated with a malignant lesion. Surgical resection was performed, and the histological diagnosis was chronic expanding intrapericardial hematoma without neoplastic changes. Chronic expanding intrapericardial hematoma is a rare disease but should be considered when an expanding mass is found in a patient after cardiac surgery. The FDG-PET findings of chronic expanding hematomas, including FDG uptake in the peripheral rim of the mass as a result of inflammation, should be recognized as a potential interpretive pitfall that mimics a malignant tumor. PMID:23324446

  7. Is the behavior of disc replacement adjacent to fusion affected by the location of the fused level in hybrid surgery?

    PubMed

    Wu, Ting-Kui; Meng, Yang; Wang, Bei-Yu; Hong, Ying; Rong, Xin; Ding, Chen; Chen, Hua; Liu, Hao

    2018-04-27

    Hybrid surgery (HS), consisting of cervical disc arthroplasty (CDA) at the mobile level, along with anterior cervical discectomy and fusion at the spondylotic level, could be a promising treatment for patients with multilevel cervical degenerative disc disease (DDD). An advantage of this technique is that it uses an optimal procedure according to the status of each level. However, information is lacking regarding the influence of the relative location of the replacement and the fusion segment in vivo. We conducted the present study to investigate whether the location of the fusion affected the behavior of the disc replacement and adjacent segments in HS in vivo. This is an observational study. The numbers of patients in the arthroplasty-fusion (AF) and fusion-arthroplasty (FA) groups were 51 and 24, respectively. The Japanese Orthopedic Association (JOA), Neck Disability Index (NDI), and Visual Analog Scale (VAS) scores were evaluated. Global and segmental lordosis, the range of motion (ROM) of C2-C7, and the operated and adjacent segments were measured. Fusion rate and radiological changes at adjacent levels were observed. Between January 2010 and July 2016, 75 patients with cervical DDD at two contiguous levels undergoing a two-level HS were retrospectively reviewed. The patients were divided into AF and FA groups according to the locations of the disc replacement. Clinical outcomes were evaluated according to the JOA, NDI, and VAS scores. Radiological parameters, including global and segmental lordosis, the ROM of C2-C7, the operated and adjacent segments, and complications, were also evaluated. Although the JOA, NDI, and VAS scores were improved in both the AF and the FA groups, no significant differences were found between the two groups at any follow-up point. Both groups maintained cervical lordosis, but no difference was found between the groups. Segmental lordosis at the fusion segment was significantly improved postoperatively (p<.001), whereas it was maintained at the arthroplasty segment. The ROM of C2-C7 was significantly decreased in both groups postoperatively (AF p=.001, FA p=.014), but no difference was found between the groups. The FA group exhibited a non-significant improvement in ROM at the arthroplasty segment. The ROM adjacent to the arthroplasty segment was increased, although not significantly, whereas the ROM adjacent to the fusion segment was significantly improved after surgery in both groups (p<.001). Fusion was achieved in all patients. No significant difference in complications was found between the groups. In HS, cephalic or caudal fusion segments to the arthroplasty segment did not affect the clinical outcomes and the behavior of CDA. However, the ROM of adjacent segments was affected by the location of the fusion segment; segments adjacent to fusion segments had greater ROMs than segments adjacent to arthroplasty segments. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. Cervical disc arthroplasty: Pros and cons

    PubMed Central

    Moatz, Bradley; Tortolani, P. Justin

    2012-01-01

    Background: Cervical disc arthroplasty has emerged as a promising potential alternative to anterior cervical discectomy and fusion (ACDF) in appropriately selected patients. Despite a history of excellent outcomes after ACDF, the question as to whether a fusion leads to adjacent segment degeneration remains unanswered. Numerous US investigational device exemption trials comparing cervical arthroplasty to fusion have been conducted to answer this question. Methods: This study reviews the current research regarding cervical athroplasty, and emphasizes both the pros and cons of arthroplasty as compared with ACDF. Results: Early clinical outcomes show that cervical arthroplasty is as effective as the standard ACDF. However, this new technology is also associated with an expanding list of novel complications. Conclusion: Although there is no definitive evidence that cervical disc replacement reduces the incidence of adjacent segment degeneration, it does show other advantages; for example, faster return to work, and reduced need for postoperative bracing. PMID:22905327

  9. TTK Chitra tilting disc heart valve model TC2: An assessment of fatigue life and durability.

    PubMed

    Subhash, N N; Rajeev, Adathala; Sujesh, Sreedharan; Muraleedharan, C V

    2017-08-01

    Average age group of heart valve replacement in India and most of the Third World countries is below 30 years. Hence, the valve for such patients need to be designed to have a service life of 50 years or more which corresponds to 2000 million cycles of operation. The purpose of this study was to assess the structural performance of the TTK Chitra tilting disc heart valve model TC2 and thereby address its durability. The TC2 model tilting disc heart valves were assessed to evaluate the risks connected with potential structural failure modes. To be more specific, the studies covered the finite element analysis-based fatigue life prediction and accelerated durability testing of the tilting disc heart valves for nine different valve sizes. First, finite element analysis-based fatigue life prediction showed that all nine valve sizes were in the infinite life region. Second, accelerated durability test showed that all nine valve sizes remained functional for 400 million cycles under experimental conditions. The study ensures the continued function of TC2 model tilting disc heart valves over duration in excess of 50 years. The results imply that the TC2 model valve designs are structurally safe, reliable and durable.

  10. The Yucatan Minipig Temporomandibular Joint Disc Structure-Function Relationships Support Its Suitability for Human Comparative Studies.

    PubMed

    Vapniarsky, Natalia; Aryaei, Ashkan; Arzi, Boaz; Hatcher, David C; Hu, Jerry C; Athanasiou, Kyriacos A

    2017-11-01

    Frequent involvement of the disc in temporomandibular joint (TMJ) disorders warrants attempts to tissue engineer TMJ disc replacements. Physiologically, a great degree of similarity is seen between humans and farm pigs (FPs), but the pig's rapid growth confers a significant challenge for in vivo experiments. Minipigs have a slower growth rate and are smaller than FPs, but minipig TMJ discs have yet to be fully characterized. The objective of this study was to determine the suitability of the minipig for TMJ studies by extensive structural and functional characterization. The properties of minipig TMJ discs closely reproduced previously reported morphological, biochemical, and biomechanical values of human and FP discs. The width/length dimension ratio of the minipig TMJ disc was 1.95 (1.69 for human and 1.94 for FP). The biochemical evaluation revealed, on average per wet weight, 24.3% collagen (22.8% for human and 24.9% for FP); 0.8% glycosaminoglycan (GAG; 0.5% for human and 0.4% for FP); and 0.03% DNA (0.008% for human and 0.02% for FP). Biomechanical testing revealed, on average, compressive relaxation modulus of 50 kPa (37 kPa for human and 32 kPa for FP), compressive instantaneous modulus of 1121 kPa (1315 kPa for human and 1134 kPa for FP), and coefficient of viscosity of 13 MPa·s (9 MPa·s for human and 3 MPa·s for FP) at 20% strain. These properties also varied topographically in accordance to those of human and FP TMJ discs. Anisotropy, quantified by bidirectional tensile testing and histology, again was analogous among minipig, human, and FP TMJ discs. The minipig TMJ's ginglymoarthrodial nature was verified through cone beam computer tomography. Collectively, the similarities between minipig and human TMJ discs support the use of minipig as a relevant model for TMJ research; considering the practical advantages conferred by its growth rate and size, the minipig may be a preferred model over FP.

  11. The First Wave: CD-ROM Adoption in Offices and Libraries: I.

    ERIC Educational Resources Information Center

    Paisley, William; Butler, Matilda

    1988-01-01

    The first of two articles provides an overview of four revolutions in publishing--the movable-type printing press, mechanization, the computer, and optical disc technology. The first phases of CD-ROM development--demonstration of feasibility and testing of replacement functions--are described and compared with earlier technologies. (3 references)…

  12. Implementing Machine Learning in Radiology Practice and Research.

    PubMed

    Kohli, Marc; Prevedello, Luciano M; Filice, Ross W; Geis, J Raymond

    2017-04-01

    The purposes of this article are to describe concepts that radiologists should understand to evaluate machine learning projects, including common algorithms, supervised as opposed to unsupervised techniques, statistical pitfalls, and data considerations for training and evaluation, and to briefly describe ethical dilemmas and legal risk. Machine learning includes a broad class of computer programs that improve with experience. The complexity of creating, training, and monitoring machine learning indicates that the success of the algorithms will require radiologist involvement for years to come, leading to engagement rather than replacement.

  13. Fortifying the Bone-Implant Interface Part 1: An In Vitro Evaluation of 3D-Printed and TPS Porous Surfaces.

    PubMed

    MacBarb, Regina F; Lindsey, Derek P; Bahney, Chelsea S; Woods, Shane A; Wolfe, Mark L; Yerby, Scott A

    2017-01-01

    An aging society and concomitant rise in the incidence of impaired bone health have led to the need for advanced osteoconductive spinal implant surfaces that promote greater biological fixation ( e.g. for interbody fusion cages, sacroiliac joint fusion implants, and artificial disc replacements). Additive manufacturing, i.e. 3D-printing, may improve bone integration by generating biomimetic spinal implant surfaces that mimic bone morphology. Such surfaces may foster an enhanced cellular response compared to traditional implant surfacing processes. This study investigated the response of human osteoblasts to additive manufactured (AM) trabecular-like titanium implant surfaces compared to traditionally machined base material with titanium plasma spray (TPS) coated surfaces, with and without a nanocrystalline hydroxyapatite (HA) coating. For TPS-coated discs, wrought Ti6Al4V ELI was machined and TPS-coating was applied. For AM discs, Ti6Al4V ELI powder was 3D-printed to form a solid base and trabecular-like porous surface. The HA-coating was applied via a precipitation dip-spin method. Surface porosity, pore size, thickness, and hydrophilicity were characterized. Initial cell attachment, proliferation, alkaline phosphatase (ALP) activity, and calcium production of hFOB cells ( n =5 per group) were measured. Cells on AM discs exhibited expedited proliferative activity. While there were no differences in mean ALP expression and calcium production between TPS and AM discs, calcium production on the AM discs trended 48% higher than on TPS discs ( p =0.07). Overall, HA-coating did not further enhance results compared to uncoated TPS and AM discs. Results demonstrate that additive manufacturing allows for controlled trabecular-like surfaces that promote earlier cell proliferation and trends toward higher calcium production than TPS coating. Results further showed that nanocrystalline HA may not provide an advantage on porous titanium surfaces. Additive manufactured porous titanium surfaces may induce a more osteogenic environment compared to traditional TPS, and thus present as an attractive alternative to TPS-coating for orthopedic spinal implants.

  14. Design limitations of Bryan disc arthroplasty.

    PubMed

    Fong, Shee Yan; DuPlessis, Stephan J; Casha, Steven; Hurlbert, R John

    2006-01-01

    Disc arthroplasty is gaining momentum as a surgical procedure in the treatment of spinal degenerative disease. Results must be carefully scrutinized to recognize benefits as well as limitations. The aim of this study was to investigate factors associated with segmental kyphosis after Bryan disc replacement. Prospective study of a consecutively enrolled cohort of 10 patients treated in a single center using the Bryan cervical disc prosthesis for single-level segmental reconstruction in the surgical treatment of cervical radiculopathy and/or myelopathy. Radiographic and quality of life outcome measures. Static and dynamic lateral radiographs were digitally analyzed in patients undergoing Bryan disc arthroplasty throughout a minimum 3-month follow-up period. Observations were compared with preoperative studies looking for predictive factors of postoperative spinal alignment. Postoperative end plate angles through the Bryan disc in the neutral position were kyphotic in 9 of 10 patients. Compared with preoperative end plate angulation there was a mean change of -7 degrees (towards kyphosis) in postoperative end plate alignment (p=.007, 95% confidence interval [CI] -6 degrees to -13 degrees). This correlated significantly with postoperative reduction in posterior vertebral body height of the caudal segment (p=.011, r2=.575) and postoperative functional spine unit (FSU) kyphosis (p=.032, r2=.46). Despite intraoperative distraction, postoperative FSU height was significantly reduced, on average by 1.7 mm (p=.040, 95% CI 0.5-2.8 mm). Asymmetrical end plate preparation occurs because of suboptimal coordinates to which the milling jig is referenced. Although segmental motion is preserved, Bryan disc arthroplasty demonstrates a propensity towards kyphotic orientation through the prosthesis likely as a result of intraoperative lordotic distraction. FSU angulation tends towards kyphosis and FSU height is decreased in the postoperative state from lack of anterior column support. Limitations of Bryan cervical disc arthroplasty should be carefully considered when reconstruction or maintenance of cervical lordosis is desirable.

  15. Comparative Study Between M6-C and Mobi-C Cervical Artificial Disc Replacement: Biomechanical Outcomes and Comparison with Normative Data.

    PubMed

    Pham, My; Phan, Kevin; Teng, Ian; Mobbs, Ralph J

    2018-05-01

    Cervical spondylosis affects a huge proportion of the middle-aged population. Degenerative changes can occur in multiple regions of the cervical spine typically affecting the joints, intervertebral discs and endplates. These changes lead to compression of adjacent nervous structures, which results in radiculopathic and myelopathic pain. Various treatment modalities are currently available with non-surgical approaches the initial go to if there is no symptomatic cord compression. Anterior cervical discectomy and fusion, or arthroplasty are the two common surgical approaches if non-surgical treatments fail to relieve symptoms of the patients or there are signs of central cord compression. However, studies have shown that there is an increased risk of adjacent segment disease related to fusion. Cervical disc arthroplasty aims to restore normal range of motion (ROM) in patients with pain and disability due to degenerative disc disease resistant to conservative care. Two common disc prostheses used include M6-C and Mobi-C. Both prostheses comprise a mobile polymer segment sandwiched between two metal endplates with mechanisms resembling an actual intervertebral disc. This study aims to compare the kinematics associated with these prostheses, against the normal range of motion in the non-degenerative population. Patients who underwent M6-C or Mobi-C disc replacements by the senior author from 2012 to 2015 were identified at a single tertiary institution. Routine 3-month postoperative lateral radiographs were analyzed for flexion and extension ROM angles at the involved vertebral level by two independent authors. Data was compared to previous published studies investigating cervical spine ROM of asymptomatic patients. There was no statistical significance in the difference of overall flexion range between M6-C and Mobi-C prostheses. However, overall range of extension of Mobi-C was greater compared to M6-C (P = 0.028). At C 5-6 , the range of flexion for both implants were similar but lesser compared to asymptomatic patients (P < 0.001). Range of extension was greater in the Mobi-C group (14.2° ± 5.1°) compared to the M6-C (7.3° ± 4.6°) (P = 0.0009). At C 6-7 , there were no statistical differences in both range of flexion and extension between the two prostheses and asymptomatic patients (P > 0.05). The early results regarding restoration of ROM following cervical arthroplasty using either M6-C or Mobi-C prosthesis are encouraging. Long-term follow-up studies are necessary to observe the change in ROM over time with physiological loading and wear patterns. © 2018 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  16. Clinical experience and two-year follow-up with a one-piece viscoelastic cervical total disc replacement.

    PubMed

    Chin, Kingsley Richard; Lubinski, Jacob Ryan; Zimmers, Kari Bracher; Sands, Barry Eugene; Pencle, Fabio

    2017-12-01

    The purpose of this study is to present clinical outcome data from a 2-year post-market study of a viscoelastic one-piece cervical total disc replacement (TDR) in Europe. Thirty-nine patients were implanted at five surgical sites in an European post-market clinical study. Clinical outcomes included improvement of neck disability index (NDI) and visual analog scale scores for neck and arm pain from baseline to 2-year follow-up, neurological examinations, patients view on the success of surgery, complications, and subsequent surgical interventions. Thirty patients had the Freedom ® Cervical Disc (FCD) implanted at a single level, and nine patients were implanted at two adjacent levels. The population had a similar distribution of male [20] and female [19] subjects, with a mean age of 45 years. All self-administered outcome measures showed significant clinically important improvements from baseline to the 2-year follow-up. Mean preoperative NDI score improved from 48% to 20%, 13%, 8%, 6% and 4% at 6 weeks, 3, 6, 12, and 24 months, respectively. Average preoperative visual analog scale (VAS) scores of the neck, right and left arm pain intensity and frequency showed significant improvement. All neurological outcome measurements showed immediate improvement from preoperative values and continued improvement throughout 2 years follow-up. From pre-op to 24 months, neurological deficits declined in the population from 21% to 6% for reflex function, 62% to 17% for sensory function, and 38% to 3% for motor function. No patients experienced a deterioration in any measured outcomes compared with the preoperative situation. Patient satisfaction increased over 2 years post-op, with 83% of patients responding that they would "definitely" choose to have the same treatment for their neck/arm condition and another 11% responding that they would "probably" choose to have the same treatment. The FCD performs as expected in patients with single-level and two-level degenerative disc disease.

  17. Comparative Analysis between Total Disc Replacement and Posterior Foraminotomy for Posterolateral Soft Disc Herniation with Unilateral Radiculopathy : Clinical and Biomechanical Results of a Minimum 5 Years Follow-up

    PubMed Central

    Kim, Kyoung-Tae; Cho, Dae-Chul; Sung, Joo-Kyung; Kim, Young-Baeg; Kim, Du Hwan

    2017-01-01

    Objective To compare the clinical outcomes and biomechanical effects of total disc replacement (TDR) and posterior cervical foraminotomy (PCF) and to propose relative inclusion criteria. Methods Thirty-five patients who underwent surgery between 2006 and 2008 were included. All patients had single-level disease and only radiculopathy. The overall sagittal balance and angle and height of a functional segmental unit (FSU; upper and lower vertebral body of the operative lesion) were assessed by preoperative and follow-up radiographs. C2–7 range of motion (ROM), FSU, and the adjacent segment were also checked. Results The clinical outcome of TDR (group A) was tended to be superior to that of PCF (group B) without statistical significance. In the group A, preoperative and postoperative upper adjacent segment level motion values were 8.6±2.3 and 8.4±2.0, and lower level motion values were 8.4±2.2 and 8.3±1.9. Preoperative and postoperative FSU heights were 37.0±2.1 and 37.1±1.8. In the group B, upper level adjacent segment motion values were 8.1±2.6 and 8.2±2.8, and lower level motion values were 6.5±3.3 and 6.3±3.1. FSU heights were 37.1±2.0 and 36.2±1.8. The postoperative FSU motion and height changes were significant (p<0.05). The patient’s satisfaction rates for surgery were 88.2% in group A and 88.8% in group B. Conclusion TDR and PCF have favorable outcomes in patients with unilateral soft disc herniation. However, patients have different biomechanical backgrounds, so the patient’s biomechanical characteristics and economic status should be understood and treated using the optimal procedure. PMID:28061490

  18. A case of industrial safety appraisal for extension of service life of GTK-10-4 gas turbines used at gas transmission stations

    NASA Astrophysics Data System (ADS)

    Rybnikov, A. I.; Kovalev, A. G.; Kryukov, I. I.; Leont'ev, S. A.; Moshnikov, A. V.

    2017-04-01

    It is shown that the extended life and enhanced operational reliability of parts and subassemblies of the most popular GTK-10-4 gas transmission plants are determined by the enhanced efficiency of the control over technical condition and operational safety of turbine plants in conformity with industrial safety requirements imposed on gas pipeline compressor stations. It has been established that the materials of parts and subassemblies of gas turbine plants with different, especially with maximal operating time, shall be exposed to NDT for the purpose of determining the actual mechanical characteristics of these materials with different operating time and calculating residual life. The analysis of damageability and operating conditions has helped to identify parts and subassemblies for repair or replacement with the highest frequency of unacceptable defects. These parts and subassemblies have been shown to include base members of the axial compressor (AC), a turbine housing, an axial compressor rotor, high- and low-pressure turbine (HPT and LPT) discs, a 12-part holder, the housing of the holder of HPT and LPT guiding blades, a sealed baffler, and working and guiding AC, LPT and HPT blades. The most typical operational defects have been enumerated and analyzed. It has been determined that the primary task of the industrial safety appraisal for extending the life of GTK-10-4 with limit-exceeding operating time is to thoroughly examine HPT and LPT discs with more than 130,000 hours of operating time and establish by DT methods characteristics of materials for evaluation, taking account of their degradation, and residual life of critical turbine elements. In addition, it has been shown that the service life of HP turbine discs can be extended by replacing the disc material (EP-428 12% chromium steel) with a material with a higher linear expansion factor that somewhat exceeds the expansion factor of EI-893 nickel alloy used to melt out working blades.

  19. Biomechanics of Artificial Disc Replacements Adjacent to a 2-Level Fusion in 4-Level Hybrid Constructs: An In Vitro Investigation

    PubMed Central

    Liao, Zhenhua; Fogel, Guy R.; Wei, Na; Gu, Hongsheng; Liu, Weiqiang

    2015-01-01

    Background The ideal procedure for multilevel cervical degenerative disc diseases remains controversial. Recent studies on hybrid surgery combining anterior cervical discectomy and fusion (ACDF) and artificial cervical disc replacement (ACDR) for 2-level and 3-level constructs have been reported in the literature. The purpose of this study was to estimate the biomechanics of 3 kinds of 4-level hybrid constructs, which are more likely to be used clinically compared to 4-level arthrodesis. Material/Methods Eighteen human cadaveric spines (C2–T1) were evaluated in different testing conditions: intact, with 3 kinds of 4-level hybrid constructs (hybrid C3–4 ACDR+C4–6 ACDF+C6–7ACDR; hybrid C3–5ACDF+C5–6ACDR+C6–7ACDR; hybrid C3–4ACDR+C4–5ACDR+C5–7ACDF); and 4-level fusion. Results Four-level fusion resulted in significant decrease in the C3–C7 ROM compared with the intact spine. The 3 different 4-level hybrid treatment groups caused only slight change at the instrumented levels compared to intact except for flexion. At the adjacent levels, 4-level fusion resulted in significant increase of contribution of both upper and lower adjacent levels. However, for the 3 hybrid constructs, significant changes of motion increase far lower than 4P at adjacent levels were only noted in partial loading conditions. No destabilizing effect or hypermobility were observed in any 4-level hybrid construct. Conclusions Four-level fusion significantly eliminated motion within the construct and increased motion at the adjacent segments. For all 3 different 4-level hybrid constructs, ACDR normalized motion of the index segment and adjacent segments with no significant hypermobility. Compared with the 4-level ACDF condition, the artificial discs in 4-level hybrid constructs had biomechanical advantages compared to fusion in normalizing adjacent level motion. PMID:26694835

  20. Biomechanics of Artificial Disc Replacements Adjacent to a 2-Level Fusion in 4-Level Hybrid Constructs: An In Vitro Investigation.

    PubMed

    Liao, Zhenhua; Fogel, Guy R; Wei, Na; Gu, Hongsheng; Liu, Weiqiang

    2015-12-23

    BACKGROUND The ideal procedure for multilevel cervical degenerative disc diseases remains controversial. Recent studies on hybrid surgery combining anterior cervical discectomy and fusion (ACDF) and artificial cervical disc replacement (ACDR) for 2-level and 3-level constructs have been reported in the literature. The purpose of this study was to estimate the biomechanics of 3 kinds of 4-level hybrid constructs, which are more likely to be used clinically compared to 4-level arthrodesis. MATERIAL AND METHODS Eighteen human cadaveric spines (C2-T1) were evaluated in different testing conditions: intact, with 3 kinds of 4-level hybrid constructs (hybrid C3-4 ACDR+C4-6 ACDF+C6-7ACDR; hybrid C3-5ACDF+C5-6ACDR+C6-7ACDR; hybrid C3-4ACDR+C4-5ACDR+C5-7ACDF); and 4-level fusion. RESULTS Four-level fusion resulted in significant decrease in the C3-C7 ROM compared with the intact spine. The 3 different 4-level hybrid treatment groups caused only slight change at the instrumented levels compared to intact except for flexion. At the adjacent levels, 4-level fusion resulted in significant increase of contribution of both upper and lower adjacent levels. However, for the 3 hybrid constructs, significant changes of motion increase far lower than 4P at adjacent levels were only noted in partial loading conditions. No destabilizing effect or hypermobility were observed in any 4-level hybrid construct. CONCLUSIONS Four-level fusion significantly eliminated motion within the construct and increased motion at the adjacent segments. For all 3 different 4-level hybrid constructs, ACDR normalized motion of the index segment and adjacent segments with no significant hypermobility. Compared with the 4-level ACDF condition, the artificial discs in 4-level hybrid constructs had biomechanical advantages compared to fusion in normalizing adjacent level motion.

  1. Effects of Neonatal Enzyme Replacement Therapy and Simvastatin Treatment on Cervical Spine Disease in Mucopolysaccharidosis I Dogs

    PubMed Central

    Chiaro, Joseph A; O’Donnell, Patricia; Shore, Eileen M; Malhotra, Neil R; Ponder, Katherine P; Haskins, Mark E; Smith, Lachlan J

    2014-01-01

    Mucopolysaccharidosis I (MPS I) is a lysosomal storage disease characterized by deficient α-L-iduronidase activity, leading to the accumulation of poorly degraded glycosaminoglycans (GAGs). Children with MPS I exhibit high incidence of spine disease, including accelerated disc degeneration and vertebral dysplasia, which in turn lead to spinal cord compression and kypho-scoliosis. In this study we investigated the efficacy of neonatal enzyme replacement therapy (ERT), alone or in combination with oral simvastatin (ERT+SIM) for attenuating cervical spine disease progression in MPS I, using a canine model. Four groups were studied: normal controls; MPS I untreated; MPS I ERT treated; and MPS I ERT+SIM treated. Animals were euthanized at one year-of-age. Intervertebral disc condition and spinal cord compression were evaluated from MRIs and plain radiographs, vertebral bone condition and odontoid hypoplasia were evaluated using microcomputed tomography, and epiphyseal cartilage to bone conversion was evaluated histologically. Untreated MPS I animals exhibited more advanced disc degeneration and more severe spinal cord compression than normal animals. Both treatment groups resulted in partial preservation of disc condition and cord compression, with ERT+SIM not significantly better than ERT alone. Untreated MPS I animals had significantly lower vertebral trabecular bone volume and mineral density, while ERT treatment resulted in partial preservation of these properties. ERT+SIM treatment demonstrated similar, but not greater, efficacy. Both treatment groups partially normalized endochondral ossification in the vertebral epiphyses (as indicated by absence of persistent growth plate cartilage), and odontoid process size and morphology. These results indicate that ERT begun from a very early age attenuates the severity of cervical spine disease in MPS I, particularly for the vertebral bone and odontoid process, and that additional treatment with simvastatin does not provide a significant additional benefit over ERT alone. PMID:24898323

  2. Servo-control of water and sodium homeostasis during renal clearance measurements in conscious rats.

    PubMed

    Thomsen, Klaus; Shirley, David G

    2007-01-01

    Servo-controlled fluid and sodium replacement during clearance studies is used in order to prevent loss of body fluid and sodium following diuretic/natriuretic procedures. However, even under control conditions, the use of this technique is sometimes associated with increases in proximal tubular fluid output (assessed by lithium clearance) and excretion rates. The present study examined the reason for these increases. The first series of experiments showed that one cause is volume overloading. This can occur if the servo system is activated from the start, i.e., during the establishment of a suitably high urine flow rate by constant infusion of hypotonic glucose solution. The second series of experiments showed that replacement of blood samples with donor blood can also lead to increases in fractional lithium excretion and accompanying increases in water and sodium excretion, a problem not seen when blood samples are replaced with the animal's own red blood cells resuspended in isotonic saline. When these pitfalls are avoided, servo-controlled sodium and fluid replacement is a reliable technique that makes it possible to study the effects of natriuretic and/or diuretic stimuli without interference from unwanted changes in extracellular volume. 2007 S. Karger AG, Basel

  3. Neurological complications of lumbar artificial disc replacement and comparison of clinical results with those related to lumbar arthrodesis in the literature: results of a multicenter, prospective, randomized investigational device exemption study of Charité intervertebral disc. Invited submission from the Joint Section Meeting on Disorders of the Spine and Peripheral Nerves, March 2004.

    PubMed

    Geisler, Fred H; Blumenthal, Scott L; Guyer, Richard D; McAfee, Paul C; Regan, John J; Johnson, J Patrick; Mullin, Bradford

    2004-09-01

    Arthrodesis is the gold standard for surgical treatment of lumbar degenerative disc disease (DDD). Solid fusion, however, can cause stress and increased motion in the segments adjacent to the fused level. This may initiate and/or accelerate the adjacent-segment disease process. Artificial discs are designed to restore and maintain normal motion of the lumbar intervertebral segment. Restoring and maintaining normal motion of the segment reduces stresses and loads on adjacent level segments. A US Food and Drug Administration Investigational Device Exemptions multicentered study of the Charité artificial disc was completed. The control group consisted of individuals who underwent anterior lumbar interbody fusion involving BAK cages and iliac crest bone graft. This is the first report of Class I data in which a lumbar artificial disc is compared with lumbar fusion. Of 304 individuals enrolled in the study, 205 were randomized to the Charité disc-treated group and 99 to the BAK fusion-treated (control) group. Neurological status was equivalent between the two groups at 6, 12, and 24 months postoperatively. The number of patients with major, minor, or other neurological complications was equivalent. There was a greater incidence of both major and minor complications in the BAK fusion group at 0 to 42 days postoperatively. Compared with data reported in the lumbar fusion literature, the Charité disc-treated patients had equivalent or better mean changes in visual analog scale and Oswestry Disability Index scores. The Charité artificial disc is safe and effective for the treatment of single-level lumbar DDD, resulting in no higher incidence of neurological complications compared with BAK-assisted fusion and leading to equivalent or better outcomes compared with those obtained in the control group and those reported in the lumbar fusion literature.

  4. Rationale, principles and experimental evaluation of the concept of soft stabilization.

    PubMed

    Mulholland, Robert C; Sengupta, Dilip K

    2002-10-01

    The apparent clinical success of spinal stabilization methods that restrict rather than abolish movement in relieving mechanical back pain indicates that the concept of the aetiology of back pain should be reviewed. Further understanding of how degeneration affects disc biomechanics, and an understanding of how current soft stabilization systems alters them, may allow us to define more precisely what are the essential requirements of an ideal soft stabilization system. It appears that abnormal patterns of loading rather than abnormal movement are the reason that disc degeneration causes back pain in some patients. Abnormal load transmission is the principal cause of pain in osteoarthritic joints, and both osteotomy and, indeed, joint replacement succeed because they alter the load transmission across the joint. This concept is supported by the fact that abnormal patterns of stress distribution measured across the disc correlate with painful discs on discography. Clinically, it is often noted that back pain is primarily related to position or posture, rather than movement of the lumbar spine. Clinical success after solid fusion is unpredictable because it does not necessarily prevent painful loading across the disc, and also it may interfere with maintenance of sagittal balance in varying postures. The Graf ligament restricted flexion, and was modestly successful. It unfortunately increased the load over the posterior annulus. The Dynesys system reduces movement both in flexion and extension, and appears to be more successful. However, often it also unloads the disc to a degree that is unpredictable. The authors believe that this unloading of the disc is an important feature of a flexible stabilization system. A new a design of a flexible stabilization system has recently been described in an in vitro study, which unloads the disc by introduction of a load-sharing fulcrum near the axis of movement together with an elastic posterior ligament. This design produces maximal unloading of the disc, whilst allowing a restricted range of movement, which serves the important purpose of allowing the patient to maintain sagittal balance in varying postures.

  5. Cervical hybrid arthroplasty with 2 unique fusion techniques.

    PubMed

    Cardoso, Mario J; Mendelsohn, Audra; Rosner, Michael K

    2011-07-01

    Multilevel cervical arthroplasty achieved using the Prestige ST disc can be challenging and often unworkable. An alternative to this system is a hybrid technique composed of alternating total disc replacements (TDRs) and fusions. In the present study, the authors review the safety and radiological outcomes of cervical hybrid arthroplasty in which the Prestige ST disc is used in conjunction with 2 unique fusion techniques. After obtaining institutional review board approval, the authors completed a retrospective review of all hybrid cervical constructs in which the Prestige ST disc was used between August 2007 and November 2009 at the Walter Reed Army Medical Center. A Prestige ST total disc replacement was performed in 119 patients. Thirty-one patients received a hybrid construct defined as a TDR and fusion (TDR-anterior cervical decompression and fusion [ACDF]) or as 2 TDRs separated by a fusion (TDR-ACDF-TDR). A resorbable plate and graft system (Mystique) or stand-alone interbody spacer (Prevail) was implanted at the fusion levels. Plain radiographs were compared and evaluated for cervical lordosis, range of motion, implant complications, development of adjacent-level disease, and pseudarthrosis. In addition, charts were reviewed for clinical complications related to the index surgery. Thirty-one patients (18 men and 13 women; mean age 50 years, range 32-74 years) received a hybrid construct. All patients were diagnosed with radiculopathy and/or myelopathy. Twenty-four patients received a 2-level and 7 a 3-level hybrid construct. In 2 patients in whom a 2-level hybrid construct was implanted, a noncontiguous TDR was also performed. The mean clinical and radiological follow-up duration was 18 months. There was no significant difference in preoperative (19.3° ± 13.3°) and postoperative (19.7° ± 10.5°) cervical lordosis (p = 0.48), but there was a significant decrease in range in motion (from 50.0° ± 11.8° to 38.9° ± 12.7°) (p = 0.003). There were no instances of screw backout, implant dislodgement, progressive kyphosis, formation of heterotopic bone, pseudarthrosis, or symptomatic adjacent-level disease. Seven patients had dysphasia and 1 patient had vocal cord paralysis at 6 weeks. By 3 months, both the dysphasia and the vocal cord paralysis were resolved in all patients. Hybrid cervical arthroplasty involving the placement of a Prestige ST disc and either the Mystique resorbable plate or Prevail stand-alone interbody device is a safe and effective alternative to multilevel fusion for the management of cervical radiculopathy and myelopathy.

  6. Dysfunction of mechanical heart valve prosthesis: experience with surgical management in 48 patients

    PubMed Central

    Ma, Wei-Guo; Hou, Bin; Abdurusul, Adiljan; Gong, Ding-Xu; Tang, Yue; Chang, Qian; Xu, Jian-Ping

    2015-01-01

    Background Dysfunction of mechanical heart valve prostheses is an unusual but potentially lethal complication after mechanical prosthetic valve replacement. We seek to report our experience with mechanical valve dysfunction regarding etiology, surgical techniques and early outcomes. Methods Clinical data of 48 patients with mechanical valve dysfunction surgically treated between October 1996 and June 2011 were analyzed. Results Mean age was 43.7±10.9 years and 34 were female (70.8%). The median interval from primary valve implantation to dysfunction was 44.5 months (range, 1 hour to 20 years). There were 21 emergent and 27 elective reoperations. The etiology was thrombosis in 19 cases (39.6%), pannus in 12 (25%), thrombosis and pannus in 11 (22.9%), improper disc orientation in 2 (4.1%), missing leaflet in 1 (2.1%), excessively long knot end in 1 (2.1%), endogenous factor in 1 (2.1%) and unidentified in 1 (2.1%). Surgical procedure was mechanical valve replacement in 37 cases (77.1%), bioprosthetic valve replacement in 7 (14.9%), disc rotation in 2 (4.2%) and excision of excessive knot end in 1 (2.1%). Early deaths occurred in 7 patients (14.6%), due to low cardiac output in 3 (6.3%), multi-organ failure in 2 (4.2%) and refractory ventricular fibrillation in 2 (4.2%). Complications occurred in 10 patients (20.8%). Conclusions Surgical management of mechanical valve dysfunction is associated with significant mortality and morbidity. Earlier identification and prompt reoperation are vital to achieving better clinical outcomes. The high incidence of thrombosis in this series highlights the need for adequate anticoagulation and regular follow-up after mechanical valve replacement. PMID:26793354

  7. Early UV emission from disc-originated matter (DOM) in Type Ia supernovae in the double-degenerate scenario

    NASA Astrophysics Data System (ADS)

    Levanon, Naveh; Soker, Noam

    2017-09-01

    We show that the blue and UV excess emission in the first few days of some Type Ia supernovae (SNe Ia) can be accounted in the double-degenerate (DD) scenario by the collision of the SN ejecta with circumstellar matter that was blown by the accretion disc formed during the merger process of the two white dwarfs (WDs). We assume that in cases of excess early light, the disc blows the circumstellar matter, that we term disc-originated matter (DOM), hours to days before explosion. To perform our analysis, we first provide a model-based definition for early excess light, replacing the definition of excess light relative to a power-law fit to the rising luminosity. We then examine the light curves of the SNe Ia iPTF14atg and SN 2012cg, and find that the collision of the ejecta with a DOM in the frame of the DD scenario can account for their early excess emission. Thus, early excess light does not necessarily imply the presence of a stellar companion in the frame of the single-degenerate scenario. Our findings further increase the variety of phenomena that the DD scenario can account for, and emphasize the need to consider all different SN Ia scenarios when interpreting observations.

  8. Adaptive alterations of elastic fibers in the bilaminar zone of rabbit temporomandibular joint following disc displacement.

    PubMed

    Gu, Zhiyuan; Wu, Huiling; Feng, Jianying; Shibata, Takanori; Hu, Ji'an; Zhang, Yinkai; Xie, Zhijian

    2002-12-01

    To study the adaptive alterations of elastic fibers in the bilaminar zone (BZ) of rabbit temporomandibular joint (TMJ) following disc displacement. Twenty-eight Japanese white rabbits were used in this study. The right temporomandibular joints of 20 of 28 rabbits were subjected to the surgical procedure of anterior disc displacement (ADD). Four rabbits in the surgical group were sacrificed at 2, 4, 6, 8 and 12 weeks after operation. Their temporomandibular joints were studied histochemically. Elastic fibers were reduced in number and ran irregularly in the superior lamina of BZ from ADD rabbits. The jungly elastic fibers (EFs) could still be seen at 2 weeks after operation. At 4 weeks, the number of EFs decreased significantly; EFs lost their jungly arrangement and were shaped like rough dots, of which the arrangement and the lengths were different. Six weeks after operation, many EFs were replaced by distorted, uneven, non-oriented fine EFs, distributed unevenly and some thick or fine EFs that ran irregularly. The number of EFs decreased further and their arrangement was more deranged at 8 weeks. At 10 and 12 weeks, EFs in the superior lamina of BZ were similar to those at 8 weeks. Our results show that EFs lost their function as well as their distribution and arrangement after disc displacement.

  9. Induced pluripotent stem cells for the treatment of stroke: the potential and the pitfalls.

    PubMed

    Yu, Fenggang; Li, Yingying; Morshead, Cindi M

    2013-09-01

    The extraordinary discovery of induced pluripotent stem cells (iPSCs) has led to the very real possibility that patient-specific cell therapy can be realized. The potential to develop cell replacement therapies outside the ethical and legal limitations, has initiated a new era of hope for regenerative strategies to treat human neurological disease including stroke. In this article, we will review and compare the current approaches to derive iPSCs from different somatic cells, and the induction into neuronal phenotypes, considering the advantages and disadvantages to the methodologies of derivation. We will highlight the work relating to the use of iPSC-based therapies in models of stroke and their potential use in clinical trials. Finally, we will consider future directions and areas of exploration which may promote the realization of iPSC-based cell replacement strategies for the treatment of stroke.

  10. Prospective, Randomized Comparison of One-level Mobi-C Cervical Total Disc Replacement vs. Anterior Cervical Discectomy and Fusion: Results at 5-year Follow-up

    PubMed Central

    Zigler, Jack E.; Jackson, Robert; Nunley, Pierce D.; Bae, Hyun W.; Kim, Kee D.; Ohnmeiss, Donna D.

    2016-01-01

    Introduction There is increasing interest in the role of cervical total disc replacement (TDR) as an alternative to anterior cervical discectomy and fusion (ACDF). Multiple prospective randomized studies with minimum 2 year follow-up have shown TDR to be at least as safe and effective as ACDF in treating symptomatic degenerative disc disease at a single level. The purpose of this study was to compare outcomes of cervical TDR using the Mobi-C® with ACDF at 5-year follow-up. Methods This prospective, randomized, controlled trial was conducted as a Food and Drug Administration regulated Investigational Device Exemption trial across 23 centers with 245 patients randomized (2:1) to receive TDR with Mobi-C® Cervical Disc Prosthesis or ACDF with anterior plate and allograft. Outcome assessments included a composite overall success score, Neck Disability Index (NDI), visual analog scales (VAS) assessing neck and arm pain, Short Form-12 (SF-12) health survey, patient satisfaction, major complications, subsequent surgery, segmental range of motion, and adjacent segment degeneration. Results The 60-month follow-up rate was 85.5% for the TDR group and 78.9% for the ACDF group. The composite overall success was 61.9% with TDR vs. 52.2% with ACDF, demonstrating statistical non-inferiority. Improvements in NDI, VAS neck and arm pain, and SF-12 scores were similar between groups and were maintained from earlier follow-up through 60 months. There was no significant difference between TDR and ACDF in adverse events or major complications. Range of motion was maintained with TDR through 60 months. Device-related subsequent surgeries (TDR: 3.0%, ACDF: 11.1%, p<0.02) and adjacent segment degeneration at the superior level (TDR: 37.1%, ACDF: 54.7%, p<0.03) were significantly lower for TDR patients. Conclusions Five-year results demonstrate the safety and efficacy of TDR with the Mobi-C as a viable alternative to ACDF with the potential advantage of lower rates of reoperation and adjacent segment degeneration, in the treatment of one-level symptomatic cervical degenerative disc disease. Clinical Relevance This prospective, randomized study with 5-year follow-up adds to the existing literature indicating that cervical TDR is a viable alternative to ACDF in appropriately selected patients. Level of Evidence This is a Level I study. PMID:27162712

  11. [Surgical treatment of thoracic disc herniation].

    PubMed

    Hrabálek, L; Kalita, O; Langová, K

    2010-08-01

    The aim of this study was to compare the efficiency of different surgical approaches to thoracic disc herniation, and to show the role of segmental fusion and selection of an appropriate microsurgical decompression technique for the successful outcome of surgery. A group of 27 patients, 10 men and 17 women, between 31 and 70 years (average age, 49.33 years) were included in this prospective study. They underwent surgery for thoracic degeneration disc disease in the period from June 1994 to August 2008. In all patients, the severity of myelopathy was assessed using the grading Frankel system and JOA score, axial and radicular pain intensity was evaluated with VAS and ODI rating systems. The diagnosis was established on the basis of thoracic spine radiography, thoracic spine MRI and a CT scan of the segment. A total of 30 thoracic segments, in the range of Th4/Th5 to Th12/L1, were indicated for surgery. Localisation of the hernia was medial at 19 segments, mediolateral at three and lateral at eight segments. Soft disc herniation was found in 17 cases and hard disc protrusion at the remaining 13 segments. Surgery for significant myelopathy was carried out in 23 patients and for pain in four patients. According to the surgical procedure used, the patients were allocated to two groups: group A comprised 10 patients treated without disc replacement through a laminectomy or a costotransversectomy exposure, and group B consisted of 17 patients undergo- ing intersomatic fusion via a thoracotomy. Clinical and radiographic examinations were made at regular intervals for at least 1 year of follow-up. The results of clinical assessment, including JOA scores, JOA Recovery Rate, VAS scores at rest and after exercise and ODI, were statistically analysed for each group and compared. There was a statistically significant difference in JOA evaluation of myelopathy between the groups in group A, the mean JOA score declined from 7.9 to 7.0, i.e., -0.9 point, while in group B it increased from 6.71 to 9.12, i.e., +2.41 points. The mean JOA Recovery Rate did not reach a plus value in group A, while in group B it improved by 55 %. JOA Recovery Rate: Of the seven patients in group A evaluated for myelopathy, a fair result was in one, unchanged in two and worse in four patients. Of the 16 patients evaluated for myelopathy in group B, the results were excellent in four, good in six, fair in four and unchanged in two patients. Frankel grade function: In group A, one patient improved by one grade, two remained unchanged, two deteriorated by one grade and two by two grades. In group B, five patients improved by one grade, two patients by two grades and two patients by three grades. Eight patients remained unchanged and no patient deteriorated. The post-operative pain intensity, as assessed by the mean VAS score, was lower at rest and after exercise in both groups; the score was better in group B, but the difference was not statistically significant. The ODI was evaluated only in group B its mean value improved from 41.4% to 26.1%, i.e., by 15.3%. Between 7 to 15 % of the patients have asymptomatic thoracic disc herniation, while symptomatic herniation is very rare and accounts for only 0.25 % to 0.57 % of herniated discs in the whole spine. Severe or progressive myelopathy is a clear indication for surgical intervention in thoracic disc herniation, but the role of surgery in pain control is controversial. There are five approaches for thoracic disc herniation. Transpleural anterolateral thoracotomy has an advantage over the other methods because it permits the treatment of all types of herniation, whether localised centrally, laterally or contralaterally, i.e., soft, calcified or sequestered intradural disc herniation. The results of treatment will depend on the outcome of surgical spinal cord decompression and the degree of spinal stabilisation achieved. The surgical procedure via thoracotomy with intersomatic fusion resulted in a statistically more significant improvement of myelopathy than the posterior approach without disc replacement, and it provided greater pain relief. The authors recommend to treat thoracic disc herniation by discectomy via a thoracotomy and by intersomatic fusion.

  12. Fortifying the Bone-Implant Interface Part 1: An In Vitro Evaluation of 3D-Printed and TPS Porous Surfaces

    PubMed Central

    Lindsey, Derek P.; Bahney, Chelsea S.; Woods, Shane A.; Wolfe, Mark L.; Yerby, Scott A.

    2017-01-01

    Background An aging society and concomitant rise in the incidence of impaired bone health have led to the need for advanced osteoconductive spinal implant surfaces that promote greater biological fixation (e.g. for interbody fusion cages, sacroiliac joint fusion implants, and artificial disc replacements). Additive manufacturing, i.e. 3D-printing, may improve bone integration by generating biomimetic spinal implant surfaces that mimic bone morphology. Such surfaces may foster an enhanced cellular response compared to traditional implant surfacing processes. Methods This study investigated the response of human osteoblasts to additive manufactured (AM) trabecular-like titanium implant surfaces compared to traditionally machined base material with titanium plasma spray (TPS) coated surfaces, with and without a nanocrystalline hydroxyapatite (HA) coating. For TPS-coated discs, wrought Ti6Al4V ELI was machined and TPS-coating was applied. For AM discs, Ti6Al4V ELI powder was 3D-printed to form a solid base and trabecular-like porous surface. The HA-coating was applied via a precipitation dip-spin method. Surface porosity, pore size, thickness, and hydrophilicity were characterized. Initial cell attachment, proliferation, alkaline phosphatase (ALP) activity, and calcium production of hFOB cells (n=5 per group) were measured. Results Cells on AM discs exhibited expedited proliferative activity. While there were no differences in mean ALP expression and calcium production between TPS and AM discs, calcium production on the AM discs trended 48% higher than on TPS discs (p=0.07). Overall, HA-coating did not further enhance results compared to uncoated TPS and AM discs. Conclusions Results demonstrate that additive manufacturing allows for controlled trabecular-like surfaces that promote earlier cell proliferation and trends toward higher calcium production than TPS coating. Results further showed that nanocrystalline HA may not provide an advantage on porous titanium surfaces. Clinical Relevance Additive manufactured porous titanium surfaces may induce a more osteogenic environment compared to traditional TPS, and thus present as an attractive alternative to TPS-coating for orthopedic spinal implants. PMID:28765799

  13. Evolution of Information Management at the GSFC Earth Sciences (GES) Data and Information Services Center (DISC): 2006-2007

    NASA Technical Reports Server (NTRS)

    Kempler, Steven; Lynnes, Christopher; Vollmer, Bruce; Alcott, Gary; Berrick, Stephen

    2009-01-01

    Increasingly sophisticated National Aeronautics and Space Administration (NASA) Earth science missions have driven their associated data and data management systems from providing simple point-to-point archiving and retrieval to performing user-responsive distributed multisensor information extraction. To fully maximize the use of remote-sensor-generated Earth science data, NASA recognized the need for data systems that provide data access and manipulation capabilities responsive to research brought forth by advancing scientific analysis and the need to maximize the use and usability of the data. The decision by NASA to purposely evolve the Earth Observing System Data and Information System (EOSDIS) at the Goddard Space Flight Center (GSFC) Earth Sciences (GES) Data and Information Services Center (DISC) and other information management facilities was timely and appropriate. The GES DISC evolution was focused on replacing the EOSDIS Core System (ECS) by reusing the In-house developed disk-based Simple, Scalable, Script-based Science Product Archive (S4PA) data management system and migrating data to the disk archives. Transition was completed in December 2007

  14. Pannus-related prosthetic valve dysfunction. Case report

    PubMed Central

    MOLDOVAN, MARIA-SÎNZIANA; BEDELEANU, DANIELA; KOVACS, EMESE; CIUMĂRNEAN, LORENA; MOLNAR, ADRIAN

    2016-01-01

    Pannus-related prosthetic valve dysfunction, a complication of mechanical prosthetic valve replacement, is rare, with a slowly progressive evolution, but it can be acute, severe, requiring surgical reintervention. We present the case of a patient with a mechanical single disc aortic prosthesis, with moderate prosthesis-patient mismatch, minor pannus found on previous ultrasound examinations, who presented to our service with angina pain with a duration of 1 hour, subsequently interpreted as non-ST segment elevation myocardial infarction (NSTEMI) syndrome. Coronarography showed normal epicardial coronary arteries, an ample movement of the prosthetic disc, without evidence of coronary thromboembolism, and Gated Single-Photon Emission Computerized Tomography (SPECT) with Technetium (Tc)-99m detected no perfusion defects. Transthoracic echocardiography (TTE) evidenced a dysfunctional prosthesis due to a subvalvular mass; transesophageal echocardiography (TOE) showed the interference of this mass, with a pannus appearance, with the closure of the prosthetic disc. Under conditions of repeated angina episodes, under anticoagulant treatment, surgery was performed, with the intraoperative confirmation of pannus and its removal. Postoperative evolution was favorable. This case reflects the diagnostic and therapeutic management problems of pannus-related prosthetic valve dysfunction. PMID:27004041

  15. Pannus-related prosthetic valve dysfunction. Case report.

    PubMed

    Moldovan, Maria-Sînziana; Bedeleanu, Daniela; Kovacs, Emese; Ciumărnean, Lorena; Molnar, Adrian

    2016-01-01

    Pannus-related prosthetic valve dysfunction, a complication of mechanical prosthetic valve replacement, is rare, with a slowly progressive evolution, but it can be acute, severe, requiring surgical reintervention. We present the case of a patient with a mechanical single disc aortic prosthesis, with moderate prosthesis-patient mismatch, minor pannus found on previous ultrasound examinations, who presented to our service with angina pain with a duration of 1 hour, subsequently interpreted as non-ST segment elevation myocardial infarction (NSTEMI) syndrome. Coronarography showed normal epicardial coronary arteries, an ample movement of the prosthetic disc, without evidence of coronary thromboembolism, and Gated Single-Photon Emission Computerized Tomography (SPECT) with Technetium (Tc)-99m detected no perfusion defects. Transthoracic echocardiography (TTE) evidenced a dysfunctional prosthesis due to a subvalvular mass; transesophageal echocardiography (TOE) showed the interference of this mass, with a pannus appearance, with the closure of the prosthetic disc. Under conditions of repeated angina episodes, under anticoagulant treatment, surgery was performed, with the intraoperative confirmation of pannus and its removal. Postoperative evolution was favorable. This case reflects the diagnostic and therapeutic management problems of pannus-related prosthetic valve dysfunction.

  16. [Design and research progress of zero profile cervical Interbody cage].

    PubMed

    Zhu, Jia; Wang, Song; Liao, Zhenhua; Liu, Weiqiang

    2017-02-01

    Zero profile cervical interbody cage is an improvement of traditional fusion products and necessary supplement of emerging artificial intervertebral disc products. When applied in Anterior Cervical Decompression Fusion(ACDF), zero profile cervical interbody cage can preserve the advantages of traditional fusion and reduce the incidence of postoperative complications. Moreover, zero profile cervical interbody cage can be applied under the tabu symptoms of Artificial Cervical Disc Replacement(ACDR). This article summarizes zero profile interbody cage products that are commonly recognized and widely used in clinical practice in recent years, and reviews the progress of structure design and material research of zero profile cervical interbody cage products. Based on the latest clinical demands and research progress, this paper also discusses the future development directions of zero profile interbody cage.

  17. Problems Inherent to Augmentation of Natural Enemies in Open Agriculture.

    PubMed

    Michaud, J P

    2018-04-01

    Augmentation biological control has successfully replaced a lot of insecticide use in 'closed system' agriculture (e.g., greenhouses). The profitable commercialization of biocontrol agents in greenhouses has created an incentive to expand markets for mass-reared beneficial insects into open agricultural systems, often without sufficient scientific justification. However, the semi-contained nature of greenhouse culture is often critical to the success of augmentation and can serve to mask potential pitfalls and intrinsic limitations of this approach in open systems. Factors contributing to greenhouse successes include the reduced biological diversity of contained agroecosystems, the prevention of agent dispersal, the ability to maintain environmental conditions within a range favorable for the agent, the exclusion of competitors and natural enemies of the agent that might otherwise diminish its efficacy, and the absence of alternative prey/hosts that could divert predation/parasitism from the target pest. There are also problems arising from collection of source material from locally adapted populations, and the inadvertent imposition of artificial selection in the course of laboratory rearing. Besides highlighting these pitfalls, this paper aims to encourage more consideration of conservation approaches prior to investment in augmentation programs which entice farmers into perpetual cycles of 'rear and release.' I argue that although augmentation can benefit agriculture whenever it replaces pesticide applications, it does not constitute an ecologically sustainable solution because it requires continued inputs, and it can distract research attention away from more sustainable objectives. Sustainable biological control is best achieved through modifications to cultural practices that increasingly 'naturalize' agroecosystems, thus facilitating the natural recruitment and persistence of beneficial arthropod fauna, combined with habitat management geared to increasing overall plant and arthropod diversity in the agroecosystem.

  18. Biomechanical Characterization of an Annulus Sparing Spinal Disc Prosthesis

    PubMed Central

    Buttermann, Glenn R.; Beaubien, Brian P.

    2009-01-01

    Background Context Current spine arthroplasty devices, require disruption of the annulus fibrosus for implantation. Preliminary studies of a unique annulus sparing intervertebral prosthetic disc (IPD), found that preservation of the annulus resulted in load sharing of the annulus with the prosthesis. Purpose Determine flexibility of the IPD versus fusion constructs in normal and degenerated human spines. Study design/Setting Biomechanical comparison of motion segments in the intact, fusion and mechanical nucleus replacement states for normal and degenerated states. Patient setting Thirty lumbar motion segments. Outcomes Measures Intervertebral height; motion segment range-of-motion (ROM), neutral zone (NZ), stiffness. Methods Motion segments had multi-directional flexibility testing to 7.5 Nm for intact discs, discs reconstructed using the IPD (n=12), or after anterior/posterior fusions (n=18). Interbody height and axial compression stiffness changes were determined for the reconstructed discs by applying axial compression to 1500 N. Analysis included stratifying results to normal mobile vs. rigid degenerated intact motion segments. Results The mean interbody height increase was 1.5 mm for IPD reconstructed discs. vs 3.0 mm for fused segments. Axial compression stiffness was 3.0 ± 0.9 kN/mm for intact compared to 1.2 ± 0.4 kN/mm for IPD reconstructed segments. Reconstructed disc ROM was 9.0° ± 3.7° in flexion-extension, 10.6° ± 3.4° in lateral bending and 2.8° ± 1.4° in axial torsion which was similar to intact values and significantly greater than respective fusion values (p<0.001). Mobile intact segments exhibited significantly greater rotation after fusion vs. their more rigid counterparts (p<0.05), however, intact motion was not related to motion after IPD reconstruction. The NZ and rotational stiffness followed similar trends. Differences in NZ between mobile and rigid intact specimens tended to decrease in the IPD reconstructed state. Conclusion The annulus sparing IPD generally reproduced the intact segment biomechanics in terms of ROM, NZ, and stiffness. Furthermore, the IPD reconstructed discs imparted stability by maintaining a small neutral zone. The IPD reconstructed discs were significantly less rigid than the fusion constructs and may be an attractive alternative for the treatment of DDD. PMID:19540816

  19. Common System and Software Testing Pitfalls

    DTIC Science & Technology

    2014-11-03

    GEN- TTE -1) Target Platform Difficult to Access (GEN- TTE -2) → Inadequate Test Environments (GEN- TTE -3) Poor Fidelity of Test Environments (GEN- TTE -4...Inadequate Test Environment Quality (GEN- TTE -5) Test Environments Inadequately Tested (GEN- TTE -6) [new pitfall] Inadequate Test Configuration...Management (GEN- TTE -7) 29Common System/SW Testing PitfallsDonald G. Firesmith, 3 November 2014 General Pitfalls – Automated Testing [new pitfall category

  20. Solid radiographic fusion with a nonconstrained device 5 years after cervical arthroplasty.

    PubMed

    Heary, Robert F; Goldstein, Ira M; Getto, Katarzyna M; Agarwal, Nitin

    2014-12-01

    Cervical disc arthroplasty (CDA) has been gaining popularity as a surgical alternative to anterior cervical discectomy and fusion. Spontaneous fusion following a CDA is uncommon. A few anecdotal reports of heterotrophic ossification around the implant sites have been noted for the BRYAN, ProDisc-C, Mobi-C, PRESTIGE, and PCM devices. All CDA fusions reported to date have been in devices that are semiconstrained. The authors reported the case of a 56-year-old man who presented with left C-7 radiculopathy and neck pain for 10 weeks after an assault injury. There was evidence of disc herniation at the C6-7 level. He was otherwise healthy with functional scores on the visual analog scale (VAS, 4.2); neck disability index (NDI, 16); and the 36-item short form health survey (SF-36; physical component summary [PSC] score 43 and mental component summary [MCS] score 47). The patient underwent total disc replacement in which the DISCOVER Artificial Cervical Disc (DePuy Spine, Inc.) was used. The patient was seen at regular follow-up visits up to 60 months. At his 60-month follow-up visit, he had complete radiographic fusion at the C6-7 level with bridging trabecular bone and no motion at the index site on dynamic imaging. He was pain free, with a VAS score of 0, NDI score of 0, and SF-36 PCS and MCS scores of 61 and 55, respectively. Conclusions This is the first case report that identifies the phenomenon of fusion around a nonconstrained cervical prosthesis. Despite this unwanted radiographic outcome, the patient's clinical outcome was excellent.

  1. Rapid surface colony counts determination with three new miniaturised techniques.

    PubMed

    Malik, K A

    1977-01-01

    Three different miniaturised methods for the rapid surface viable counting are described. The methods were tried in parallel to seven different existing methods (Table 1) for viable counts and were found to be easier, quicker and insome cases more accurate. The techniques require about 10% of the material and time needed for conventional spread-plates method and the results were in no way inferior to that (Table 1 and 2). Mini agar discs were cut aseptically with an especially designed stainless steel agar disc cutter (25 mm internal and 28 mm external diameter, Fig. 1b) or with a test tube of similar diameter. The area of the resulted mini-agar-disc of 25 mm diameter was kept such (about 1/10th of the normal plate) that the ratio of the colony-bearing area to the inoculm remained the same as on big plates in spread-plate-method (Table 2). In normal Petri dishes (about 90 mm diameter) up to seven mini agar discs were possible to cut. Each small agar disc was seperated from the other mini-disc by a distance of at least 6 mm (Fig. 1a). The empty place around the disc was still enlarged during over drying of the plates and during incubation. This created complete isolation from the neighbouring disc. For micro-determination of surface viable counts 10 micronl from each dilution was delivered on a well-dired mini-disc with a piston micropipette. The inoculm was immediately spread on the whole mini-disc with a specially designed flame sterilizable platinum-Mini-spreader (Fig. 2a). No spinning of the plate was needed. Alternatively the dropping pipette and spreader was replaced by a calibrated platinum wire Loop-spreader (Fig. 2b). A loop of 3 mm internal diameter made from a platinum-iridium wire of 0.75 mm thickness proved most useful and carried a drop of 10 micronl. Differences especially in surface tension of various diluting fluids did not influence to drop of this size and no recalibration was needed for water and nutrient broth. The loop was further shaped to Loop-spreader form. From each bacterial suspension 10 micronl were carried and spread on each mini-disc. The method is useful for pathogenic organisms as the loop can readily be flame sterilized. For routine purposes where only approximate numbers of bacteria need to be known a still rapid semiquantitative method was deviced making use of a calibrated stainless steel Stamping-disc (Fig. 2c). A disc of 25mm diameter and 1 mm thickness delivered approximateyl 10 microlitres of supensions and was found to be most useful to stamp seven dilutions on a single plate. In collections and bacteriology laboratories where by conventional methods large number of plates are to be plated and counted the presented techniques could prove most convenient, rapid and economical.

  2. Organotypic three-dimensional assays based on human leiomyoma–derived matrices

    PubMed Central

    Dourado, Mauricio Rocha; Sundquist, Elias; Apu, Ehsanul Hoque; Alahuhta, Ilkka; Tuomainen, Katja; Vasara, Jenni; Al-Samadi, Ahmed

    2018-01-01

    Alongside cancer cells, tumours exhibit a complex stroma containing a repertoire of cells, matrix molecules and soluble factors that actively crosstalk between each other. Recognition of this multifaceted concept of the tumour microenvironment (TME) calls for authentic TME mimetics to study cancer in vitro. Traditionally, tumourigenesis has been investigated in non-human, three-dimensional rat type I collagen containing organotypic discs or by means of mouse sarcoma-derived gel, such as Matrigel®. However, the molecular compositions of these simplified assays do not properly simulate human TME. Here, we review the main properties and benefits of using human leiomyoma discs and their matrix Myogel for in vitro assays. Myoma discs are practical for investigating the invasion of cancer cells, as are cocultures of cancer and stromal cells in a stiff, hypoxic TME mimetic. Myoma discs contain soluble factors and matrix molecules commonly present in neoplastic stroma. In Transwell, IncuCyte, spheroid and sandwich assays, cancer cells move faster and form larger colonies in Myogel than in Matrigel®. Additionally, Myogel can replace Matrigel® in hanging-drop and tube-formation assays. Myogel also suits three-dimensional drug testing and extracellular vesicle interactions. To conclude, we describe the application of our myoma-derived matrices in 3D in vitro cancer assays. This article is part of the discussion meeting issue ‘Extracellular vesicles and the tumour microenvironment’. PMID:29158312

  3. Organotypic three-dimensional assays based on human leiomyoma-derived matrices.

    PubMed

    Salo, Tuula; Dourado, Mauricio Rocha; Sundquist, Elias; Apu, Ehsanul Hoque; Alahuhta, Ilkka; Tuomainen, Katja; Vasara, Jenni; Al-Samadi, Ahmed

    2018-01-05

    Alongside cancer cells, tumours exhibit a complex stroma containing a repertoire of cells, matrix molecules and soluble factors that actively crosstalk between each other. Recognition of this multifaceted concept of the tumour microenvironment (TME) calls for authentic TME mimetics to study cancer in vitro Traditionally, tumourigenesis has been investigated in non-human, three-dimensional rat type I collagen containing organotypic discs or by means of mouse sarcoma-derived gel, such as Matrigel ® However, the molecular compositions of these simplified assays do not properly simulate human TME. Here, we review the main properties and benefits of using human leiomyoma discs and their matrix Myogel for in vitro assays. Myoma discs are practical for investigating the invasion of cancer cells, as are cocultures of cancer and stromal cells in a stiff, hypoxic TME mimetic. Myoma discs contain soluble factors and matrix molecules commonly present in neoplastic stroma. In Transwell, IncuCyte, spheroid and sandwich assays, cancer cells move faster and form larger colonies in Myogel than in Matrigel ® Additionally, Myogel can replace Matrigel ® in hanging-drop and tube-formation assays. Myogel also suits three-dimensional drug testing and extracellular vesicle interactions. To conclude, we describe the application of our myoma-derived matrices in 3D in vitro cancer assays.This article is part of the discussion meeting issue 'Extracellular vesicles and the tumour microenvironment'. © 2017 The Authors.

  4. In vitro biomechanical comparison after fixed- and mobile-core artificial cervical disc replacement versus fusion

    PubMed Central

    Lou, Jigang; Li, Yuanchao; Wang, Beiyu; Meng, Yang; Wu, Tingkui; Liu, Hao

    2017-01-01

    Abstract In vitro biomechanical analysis after cervical disc replacement (CDR) with a novel artificial disc prosthesis (mobile core) was conducted and compared with the intact model, simulated fusion, and CDR with a fixed-core prosthesis. The purpose of this experimental study was to analyze the biomechanical changes after CDR with a novel prosthesis and the differences between fixed- and mobile-core prostheses. Six human cadaveric C2–C7 specimens were biomechanically tested sequentially in 4 different spinal models: intact specimens, simulated fusion, CDR with a fixed-core prosthesis (Discover, DePuy), and CDR with a mobile-core prosthesis (Pretic-I, Trauson). Moments up to 2 Nm with a 75 N follower load were applied in flexion–extension, left and right lateral bending, and left and right axial rotation. The total range of motion (ROM), segmental ROM, and adjacent intradiscal pressure (IDP) were calculated and analyzed in 4 different spinal models, as well as the differences between 2 disc prostheses. Compared with the intact specimens, the total ROM, segmental ROM, and IDP at the adjacent segments showed no significant difference after arthroplasty. Moreover, CDR with a mobile-core prosthesis presented a little higher values of target segment (C5/6) and total ROM than CDR with a fixed-core prosthesis (P > .05). Besides, the difference in IDP at C4/5 after CDR with 2 prostheses was without statistical significance in all the directions of motion. However, the IDP at C6/7 after CDR with a mobile-core prosthesis was lower than CDR with a fixed-core prosthesis in flexion, extension, and lateral bending, with significant difference (P < .05), but not under axial rotation. CDR with a novel prosthesis was effective to maintain the ROM at the target segment and did not affect the ROM and IDP at the adjacent segments. Moreover, CDR with a mobile-core prosthesis presented a little higher values of target segment and total ROM, but lower IDP at the inferior adjacent segment than CDR with a fixed-core prosthesis. PMID:29019902

  5. The Complicated Facial War Injury: Pitfalls and Mismanagement.

    PubMed

    Abu-Sittah, Ghassan S; Baroud, Joe; Hakim, Christopher; Wakil, Cynthia

    2017-01-01

    The aim of this paper is to share the authors' experience in the management of complicated facial war injuries using free tissue transfer. A discussion on the most commonly encountered pitfalls in management during the acute and complicated settings is presented in an effort to raise insight on facial war wound complications. Two patients of complicated facial war injuries are presented to exemplify the pitfalls in acute and chronic management of the mandibular region in the first patient and the orbito-maxillary region in the second. The examples demonstrate free tissue transfer for early as well as late definitive reconstructions. A reconstruction algorithm or consensus regarding the optimal management plan of complicated facial war injuries is not attainable. The main principles of treatment, however, remain to decrease bacterial burden by adequate aggressive debridement followed by revisit sessions, remove of all infected hardware followed by replacement with external bony fixation if necessary and reviving the affected area by coverage with well-vascularized tissues and bone. The later is feasible via local, regional, or distant tissue transfer depending on the extent of injury, surgeon's experience, and time and personnel available. Free tissue transfer has revolutionized the management of complicated facial war injuries associated with soft tissue or bone loss as it has allowed the introduction of well-vascularized tissues into a hostile wound environment. The end result is a reduced infection rate, faster recovery time, and better functional outcome compared with when loco-regional soft tissue coverage or bone grafting is used. When soft tissue or bone loss is present, free tissue transfer should be the first management plan if time and personnel are available. The ultimate treatment of a complicated war wound remains prevention by accurate initial management.

  6. Metamodels for Computer-Based Engineering Design: Survey and Recommendations

    NASA Technical Reports Server (NTRS)

    Simpson, Timothy W.; Peplinski, Jesse; Koch, Patrick N.; Allen, Janet K.

    1997-01-01

    The use of statistical techniques to build approximations of expensive computer analysis codes pervades much of todays engineering design. These statistical approximations, or metamodels, are used to replace the actual expensive computer analyses, facilitating multidisciplinary, multiobjective optimization and concept exploration. In this paper we review several of these techniques including design of experiments, response surface methodology, Taguchi methods, neural networks, inductive learning, and kriging. We survey their existing application in engineering design and then address the dangers of applying traditional statistical techniques to approximate deterministic computer analysis codes. We conclude with recommendations for the appropriate use of statistical approximation techniques in given situations and how common pitfalls can be avoided.

  7. The insight into the dark side - I. The pitfalls of the dark halo parameters estimation

    NASA Astrophysics Data System (ADS)

    Saburova, Anna S.; Kasparova, Anastasia V.; Katkov, Ivan Yu.

    2016-12-01

    We examined the reliability of estimates of pseudo-isothermal, Burkert and NFW dark halo parameters for the methods based on the mass-modelling of the rotation curves. To do it, we constructed the χ2 maps for the grid of the dark matter halo parameters for a sample of 14 disc galaxies with high-quality rotation curves from THINGS. We considered two variants of models in which: (a) the mass-to-light ratios of disc and bulge were taken as free parameters, (b) the mass-to-light ratios were fixed in a narrow range according to the models of stellar populations. To reproduce the possible observational features of the real galaxies, we made tests showing that the parameters of the three halo types change critically in the cases of a lack of kinematic data in the central or peripheral areas and for different spatial resolutions. We showed that due to the degeneracy between the central densities and the radial scales of the dark haloes there are considerable uncertainties of their concentrations estimates. Due to this reason, it is also impossible to draw any firm conclusion about universality of the dark halo column density based on mass-modelling of even a high-quality rotation curve. The problem is not solved by fixing the density of baryonic matter. In contrast, the estimates of dark halo mass within optical radius are much more reliable. We demonstrated that one can evaluate successfully the halo mass using the pure best-fitting method without any restrictions on the mass-to-light ratios.

  8. Image is everything: pearls and pitfalls of digital photography and PowerPoint presentations for the cosmetic surgeon.

    PubMed

    Niamtu, Joseph

    2004-01-01

    Cosmetic surgery and photography are inseparable. Clinical photographs serve as diagnostic aids, medical records, legal protection, and marketing tools. In the past, taking high-quality, standardized images and maintaining and using them for presentations were tasks of significant proportion when done correctly. Although the cosmetic literature is replete with articles on standardized photography, this has eluded many practitioners in part to the complexity. A paradigm shift has occurred in the past decade, and digital technology has revolutionized clinical photography and presentations. Digital technology has made it easier than ever to take high-quality, standardized images and to use them in a multitude of ways to enhance the practice of cosmetic surgery. PowerPoint presentations have become the standard for academic presentations, but many pitfalls exist, especially when taking a backup disc to play on an alternate computer at a lecture venue. Embracing digital technology has a mild to moderate learning curve but is complicated by old habits and holdovers from the days of slide photography, macro lenses, and specialized flashes. Discussion is presented to circumvent common problems involving computer glitches with PowerPoint presentations. In the past, high-quality clinical photography was complex and sometimes beyond the confines of a busy clinical practice. The digital revolution of the past decade has removed many of these associated barriers, and it has never been easier or more affordable to take images and use them in a multitude of ways for learning, judging surgical outcomes, teaching and lecturing, and marketing. Even though this technology has existed for years, many practitioners have failed to embrace it for various reasons or fears. By following a few simple techniques, even the most novice practitioner can be on the forefront of digital imaging technology. By observing a number of modified techniques with digital cameras, any practitioner can take high-quality, standardized clinical photographs and can make and use these images to enhance his or her practice. This article deals with common pitfalls of digital photography and PowerPoint presentations and presents multiple pearls to achieve proficiency quickly with digital photography and imaging as well as avoid malfunction of PowerPoint presentations in an academic lecture venue.

  9. Percutaneous Endoscopic Cervical Discectomy (PECD): An Analysis of Outcome, Causes of Reoperation.

    PubMed

    Oh, Hyeong Seok; Hwang, Byeong-Wook; Park, Sang-Joon; Hsieh, Chang-Sheng; Lee, Sang-Ho

    2017-06-01

    Percutaneous endoscopic cervical discectomy (PECD) is regarded as an effective treatment modality in cervical disc herniation, including radicular pain and lateral location of disc herniation. This study aimed to evaluate the clinical and radiologic outcomes of PECD along with the causes of reoperation and the technique itself. Between January 2007 and November 2012, 101 patients underwent PECD at the Busan Wooridul Hospital. Three patients underwent a 2-level PECD. The mean follow-up period was 34 months (range, 18-72 months). The mean age was 46.1 years; the most common operation was at the C5-C6 level (n = 45), followed by C6-C7 (n = 35), C4-C5 (n = 16), and C3-C4 (n = 8). The clinical outcomes were evaluated via the visual analog scale of the neck and arm according to the Neck Disability Index and the modified Macnab criteria. Among 101 patients, 12 underwent an additional operation at the index level. Five patients had aggravated stenosis by disc height narrowing, 4 had recurred disc, 2 had remained disc, and 1 had sustained symptoms. After PECD, there was a significant improvement in the visual analog scale and Neck Disability Index scores (P < 0.001). According to the modified Macnab criteria, excellent concordance was achieved in 65 patients, good in 22, fair in 2, and poor in 12. The reoperation performed on 12 patients improved their clinical outcomes. The mean duration was 4.8 months (2 days to 18 months) until reoperation. There were 3 PECD revisions, 3 artificial disc replacements, 2 corpectomies, 2 anterior cervical discectomies and fusion with cages, and 2 transfers to another hospital. The common feature was older age (P = 0.016) and male sex (P = 0.031). Preoperative radiologic findings were characterized by the foraminal disc (P = 0.04), disc degeneration at the index level (P = 0.05), combined bony spur (P = 0.001), concomitant adjacent level degeneration (P = 0.019), cervical kyphosis (P = 0.015), and segmental angle deterioration after PECD (P = 0.038). No statistical correlation was seen between the operation level and herniation size (P > 0.05). In total, 87% patients showed successful clinical outcome. Poor and fair outcomes at initial PECD were overcome by revision surgery, which improved outcomes. Although PECD is a promising minimally invasive procedure for cervical disc treatment, the indications for PECD should be considered carefully. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. The Black Record: A Selective Discography of Afro-Americana on Audio Discs Held by the Audio/Visual Department, John M. Olin Library.

    ERIC Educational Resources Information Center

    Dain, Bernice, Comp.; Nevin, David, Comp.

    The present revised and expanded edition of this document is an inclusive cumulation. A few items have been included which are on order as new to the collection or as replacements. This discography is intended to serve primarily as a local user's guide. The call number preceding each entry is based on the Audio-Visual Department's own, unique…

  11. Computation models simulating notochordal cell extinction during early ageing of an intervertebral disc.

    PubMed

    Louman-Gardiner, K M; Coombe, D; Hunter, C J

    2011-12-01

    Lower back pain due to intervertebral disc (IVD) degeneration is a prevalent problem which drastically affects the quality of life of millions of sufferers. Healthy IVDs begin with high populations of notochordal cells in the nucleus pulposus, while by the second stage of degeneration, these cells will be replaced by chondrocyte-like cells. Because the IVD is avascular, these cells rely on passive diffusion of nutrients to survive. It is thought that this transition in cell phenotype causes the shift of the IVD's physical properties, which impede the flow of nutrients. Our computational model of the IVD illustrates its ability to simulate the evolving chemical and mechanical environments occurring during the early ageing process. We demonstrate that, due to the insufficient nutrient supply and accompanying changes in physical properties of the IVD, there was a resultant exponential decay in the number of notochordal cells over time.

  12. The Application of Vibration Accelerations in the Assessment of Average Friction Coefficient of a Railway Brake Disc

    NASA Astrophysics Data System (ADS)

    Sawczuk, Wojciech

    2017-06-01

    Due to their wide range of friction characteristics resulting from the application of different friction materials and good heat dissipation conditions, railway disc brakes have long replaced block brakes in many rail vehicles. A block brake still remains in use, however, in low speed cargo trains. The paper presents the assessment of the braking process through the analysis of vibrations generated by the components of the brake system during braking. It presents a possibility of a wider application of vibroacoustic diagnostics (VA), which aside from the assessment of technical conditions (wear of brake pads) also enables the determination of the changes of the average friction coefficient as a function of the braking onset speed. Vibration signals of XYZ were measured and analyzed. The analysis of the results has shown that there is a relation between the values of the point measures and the wear of the brake pads.

  13. The fundamentals of biotribology and its application to spine arthroplasty

    PubMed Central

    Harper, Megan L.; Dooris, Andrew; Paré, Philippe E.

    2009-01-01

    The biological effect of wear of articulating surfaces is a continued concern with large joint replacements and, likewise, of interest for total disc replacements. There are a number of important biotribological testing parameters that can greatly affect the outcome of a wear study in addition to the implant design and material selection. The current ASTM and ISO wear testing standards/guides for spine arthroplasty leave many choices as testing parameters. These factors include but are not limited to the sequence of kinematics and load, phasing, type of lubricant, and specimen preparation (sterilization and artificial aging). The spinal community should critically assess wear studies and be cognizant of the influence of the selected parameters on the test results. PMID:25802638

  14. Quality of systematic reviews: an example of studies comparing artificial disc replacement with fusion in the cervical spine.

    PubMed

    Tashani, Osama A; El-Tumi, Hanan; Aneiba, Khaled

    2015-01-01

    Cervical artificial disc replacement (C-ADR) is now an alternative to anterior cervical discectomy and fusion (ACDF). Many studies have evaluated the efficacy of C-ADR compared with ACDF. This led to a series of systematic reviews and meta-analyses to evaluate the evidence of the superiority of one intervention against the other. The aim of the study presented here was to evaluate the quality of these reviews and meta-analyses. Medline via Ovid, Embase, and Cochrane Library were searched using the keywords: (total disk replacement, prosthesis, implantation, discectomy, and arthroplasty) AND (cervical vertebrae, cervical spine, and spine) AND (systematic reviews, reviews, and meta-analysis). Screening and data extraction were conducted by two reviewers independently. Two reviewers then assessed the quality of the selected reviews and meta-analysis using 11-item AMSTAR score which is a validated measurement tool to assess the methodological quality of systematic reviews. Screening of full reports of 46 relevant abstracts resulted in the selection of 15 systematic reviews and/or meta-analyses as eligible for this study. The two reviewers' inter-rater agreement level was high as indicated by kappa of >0.72. The AMSTAR score of the reviews ranged from 3 to 11. Only one study (a Cochrane review) scored 100% (AMSTAR 11). Five studies scored below (AMSTAR 5) indicating low-quality reviews. The most significant drawbacks of reviews of a score below 5 were not using an extensive search strategy, failure to use the scientific quality of the included studies appropriately in formulating a conclusion, not assessing publication bias, and not reporting the excluded studies. With a significant exception of a Cochrane review, the methodological quality of systematic reviews evaluating the evidence of C-ADR versus ACDF has to be improved.

  15. A Comparison of Herpetofaunal Sampling Effectiveness of Pitfall, Single-ended, and Double-ended Funnel Traps Used with Drift Fences

    Treesearch

    Cathryn H. Greenberg; Daniel G. Neary; Larry D. Harris

    1994-01-01

    We assessed the relative effectiveness of pitfalls, single-ended, and double-ended funnel traps at 12 replicate sites in sand pine scrub using drift fence arrays. Pitfalls captured fewer species but yielded more individuals of many species and higher average species richness than funnel traps. Pitfalls and funnel traps exhibited differential capture bias probably due...

  16. Cost-effectiveness of total disc replacement versus multidisciplinary rehabilitation in patients with chronic low back pain: a Norwegian multicenter RCT.

    PubMed

    Johnsen, Lars Gunnar; Hellum, Christian; Storheim, Kjersti; Nygaard, Øystein P; Brox, Jens Ivar; Rossvoll, Ivar; Rø, Magne; Andresen, Hege; Lydersen, Stian; Grundnes, Oliver; Pedersen, Marit; Leivseth, Gunnar; Olafsson, Gylfi; Borgström, Fredrik; Fritzell, Peter

    2014-01-01

    Randomized clinical trial with 2-year follow-up. To evaluate the cost-effectiveness of total disc replacement (TDR) versus multidisciplinary rehabilitation (MDR) in patients with chronic low back pain (CLBP). The existing studies on CLBP report cost-effectiveness of fusion surgery versus disc replacement and fusion versus rehabilitation. This study evaluated the cost-effectiveness of TDR versus MDR. Between April 2004 and May 2007, 173 patients with CLBP (>1 yr) were randomized to TDR (n = 86) or MDR (n = 87). Treatment effects (Euro Qol 5D [EQ-5D] and Short Form 6D [SF-6D]) and relevant direct and indirect costs at 6 weeks and at 3, 6, 12, and 24 months after treatment were assessed. Gain in quality-adjusted life years (QALYs) after 2 years was estimated. Cost-effectiveness was expressed as an incremental cost-effectiveness ratio. The mean QALYs gained (standard deviation) using EQ-5D was 1.29 (0.53) in the TDR group and 0.95 (0.52) in the MDR group, a significant difference of 0.34 (95% confidence interval 0.18-0.50). The mean total cost per patient in the TDR group was &OV0556;87,622 (58,351) compared with &OV0556;74,116 (58,237) in the MDR group, which was not significantly different (95% confidence interval: -4041 to 31,755). The incremental cost-effectiveness ratio for the TDR procedure varied from &OV0556;39,748 using EQ-5D (TDR cost-effective) to &OV0556;128,328 using SF-6D (TDR not cost-effective). The dropout rate was 20% (15% TDR group, 24% MDR group). Five patients moved from the MDR to the TDR group, whereas 9 patients randomized to TDR declined surgery. Using per-protocol analysis instead of intention-to-treat analysis indicated that TDR was not cost-effective, irrespective of the use of EQ-5D or SF-6D. In this study, TDR was cost-effective compared with MDR after 2 years when using EQ-5D for assessing QALYs gained and a willingness to pay of &OV0556;74,600 (kr500,000/QALY). TDR was not cost-effective when SF-6D was used; therefore, our results should be interpreted with caution. Longer follow-up is needed to accurately assess the cost-effectiveness of TDR. 2.

  17. Development and Translation of a Tissue-Engineered Disc in a Preclinical Rodent Model

    DTIC Science & Technology

    2013-10-01

    authors Dong Hwa Kim, John T. Martin, Dawn M. Elliott, Lachlan J. Smith , and Robert L. Mauck...Replacement in a Small Animal Model with authors John T. Martin, Andrew H. Milby, Joseph A. Chiaro, Dong Hwa Kim, Nader M. Hebela, Lachlan J. Smith , Dawn... Smith , Dawn M. Elliott, and Robert L. Mauck is now in review. To carry out this study, radiopaque scaffolds were generated from a 14.3% w/v slurry

  18. Wear of the Charité® lumbar intervertebral disc replacement investigated using an electro-mechanical spine simulator

    PubMed Central

    Moghadas, Parshia; Shepherd, Duncan ET; Hukins, David WL

    2015-01-01

    The Charité® lumbar intervertebral disc replacement was subjected to wear testing in an electro-mechanical spine simulator. Sinusoidally varying compression (0.6–2 kN, frequency 2 Hz), rotation (±2°, frequency 1 Hz), flexion–extension (6° to −3°, frequency 1 Hz) and lateral bending (±2°, frequency 1 Hz) were applied out of phase to specimens immersed in diluted calf serum at 37 °C. The mass of the ultra-high-molecular weight polyethylene component of the device was measured at intervals of 0.5, 1, 2, 3, 4 and 5 million cycles; its volume was also measured by micro-computed tomography. Total mass and volume losses were 60.3 ± 4.6 mg (mean ± standard deviation) and 64.6 ± 6.0 mm3. Corresponding wear rates were 12.0 ± 1.4 mg per million cycles and 12.8 ± 1.2 mm3 per million cycles; the rate of loss of volume corresponds to a mass loss of 11.9 ± 1.1 mg per million cycles, that is, the two sets of measurements of wear agree closely. Wear rates also agree closely with measurements made in another laboratory using the same protocol but using a conventional mechanical spine simulator. PMID:25834002

  19. Dynamic biomechanical examination of the lumbar spine with implanted total disc replacement using a pendulum testing system.

    PubMed

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

    2012-11-01

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

  20. Analysis of the spinal nerve roots in relation to the adjacent vertebral bodies with respect to a posterolateral vertebral body replacement procedure.

    PubMed

    Awwad, Waleed; Bourget-Murray, Jonathan; Zeiadin, Nadil; Mejia, Juan P; Steffen, Thomas; Algarni, Abdulrahman D; Alsaleh, Khalid; Ouellet, Jean; Weber, Michael; Jarzem, Peter F

    2017-01-01

    This study aims to improve the understanding of the anatomic variations along the thoracic and lumbar spine encountered during an all-posterior vertebrectomy, and reconstruction procedure. This information will help improve our understanding of human spine anatomy and will allow better planning for a vertebral body replacement (VBR) through either a transpedicular or costotransversectomy approach. The major challenge to a total posterior approach vertebrectomy and VBR in the thoracolumbar spine lies in the preservation of important neural structures. This was a retrospective analysis. Hundred normal magnetic resonance imaging (MRI) spinal studies (T1-L5) on sagittal T2-weighted MRI images were studied to quantify: (1) mid-sagittal vertebral body (VB) dimensions (anterior, midline, and posterior VB height), (2) midline VB and associated intervertebral discs height, (3) mean distance between adjacent spinal nerve roots (DNN) and mean distance between the inferior endplate of the superior vertebrae to its respective spinal nerve root (DNE), and (4) posterior approach expansion ratio (PAER). (1) The mean anterior VB height gradually increased craniocaudally from T1 to L5. The mean midline and posterior VB height showed a similar pattern up to L2. Mean posterior VB height was larger than the mean anterior VB height from T1 to L2, consistent with anterior wedging, and then measured less than the mean anterior VB height, indicating posterior wedging. (2) Midline VB and intervertebral disc height gradually increased from T1 to L4. (3) DNN and DNE were similar, whereby they gradually increased from T1 to L3. (5) Mean PAER varied between 1.69 (T12) and 2.27 (L5) depending on anatomic level. The dimensions of the thoracic and lumbar vertebrae and discs vary greatly. Thus, any attempt at carrying out a VBR from a posterior approach should take into account the specifications at each spinal level.

  1. ALIF and total disc replacement versus 2-level circumferential fusion with TLIF: a prospective, randomized, clinical and radiological trial.

    PubMed

    Hoff, Eike K; Strube, Patrick; Pumberger, Matthias; Zahn, Robert K; Putzier, Michael

    2016-05-01

    Prospective, randomized trial. The treatment of degenerative disc disease (DDD) with two-level fusion has been associated with a reasonable rate of complications. The aim of the present study was to compare (Hybrid) stand-alone anterior lumbar interbody fusion (ALIF) at L5/S1 with total disc replacement at L4/5 (TDR) as an alternative surgical strategy to (Fusion) 2-level circumferential fusion employing transforaminal lumbar interbody fusion (TLIF) with transpedicular stabilization at L4-S1. A total of 62 patients with symptomatic DDD of segments L5/S1 (Modic ≥2°) and L4/5 (Modic ≤2°; positive discography) were enrolled; 31 were treated with Hybrid and 31 with Fusion. Preoperatively, at 0, 12, and a mean follow-up of 37 months, clinical (ODI, VAS) and radiological evaluations (plain/extension-flexion radiographs evaluated for implant failure, fusion, global and segmental lordosis, and ROM) were performed. In 26 of 31 Hybrid and 24 of 31 Fusion patients available at the final follow-up, we found a significant clinical improvement compared to preoperatively. Hybrid patients had significantly lower VAS scores immediately postoperatively and at follow-up compared to Fusion patients. The complication rates were low and similar between the groups. Lumbar lordosis increased in both groups. The increase was mainly located at L4-S1 in the Hybrid group and at L1-L4 in the Fusion group. Hybrid patients presented with increased ROM at L4/5 and L3/4, and Fusion patients presented with increased ROM at L3/4, with significantly greater ROM at L3/4 compared to Hybrid patients at follow-up. Hybrid surgery is a viable surgical alternative for the presented indication. Approach-related inferior trauma and the balanced restoration of lumbar lordosis resulted in superior clinical outcomes compared to two-level circumferential fusion with TLIF.

  2. Loss of notochordal cell phenotype in 3D-cell cultures: implications for disc physiology and disc repair.

    PubMed

    Omlor, G W; Nerlich, A G; Tirlapur, U K; Urban, J P; Guehring, T

    2014-12-01

    Embryonic notochordal disc nucleus cells (NC) have been identified to protect disc tissue against disc degeneration but in human beings NC phenotype gets lost with aging and the pathophysiological mechanisms are poorly understood. NC may stimulate other cells via soluble factors, and NC-conditioned medium can be used to stimulate matrix production of other disc cells and mesenchymal stem cells and thus may be of special interest for biological disc repair. As this stimulatory effect is associated with the NC phenotype, we investigated how cell morphology and gene-expression of the NC phenotype changes with time in 3D-cell culture. NC and inner annulus chondrocyte-like cells (CLC) from immature pigtails (freshly isolated cells/tissue, 3D-alginate beads, 3D-clusters) were cultured for up to 16 days under normoxia and hypoxia. Protein-expression was analysed by immunohistology and gene-expression analysis was carried out on freshly isolated cells and cultured cells. Cell morphology and proliferation were analysed by two-photon-laser-microscopy. Two-photon-laser-microscopy showed a homogenous and small CLC population in the inner annulus, which differed from the large vacuole-containing NC in the nucleus. Immunohistology found 93 % KRT8 positive cells in the nucleus and intracellular and pericellular Col2, IL6, and IL12 staining while CLC were KRT8 negative. Freshly isolated NC showed significantly higher KRT8 and CAIII but lower Col2 gene-expression than CLC. NC in 3D-cultures demonstrated significant size reduction and loss of vacuoles with culture time, all indicating a loss of the characteristic NC morphology. Hypoxia reduced the rate of decrease in NC size and vacuoles. Gene-expression of KRT8 and CAIII in NC fell significantly early in culture while Col2 did not decrease significantly within the culture period. In CLC, KRT8 and CAIII gene-expression was low and did not change noticeably in culture, whereas Col2 expression fell with time in culture. 3D-culture caused a rapid loss of NC phenotype towards a CLC phenotype with disappearance of vacuoles, reduced cell size, increased proliferation, and gene-expression changes. These findings may be related to NC nutritional demands and support the latest hypothesis of NC maturation into CLC opposing the idea that NC get lost in human discs by cell death or apoptosis to be replaced by CLC from the inner annulus.

  3. PET/CT with 18F-choline: Physiological whole bio-distribution in male and female subjects and diagnostic pitfalls on 1000 prostate cancer patients: 18F-choline PET/CT bio-distribution and pitfalls. A southern Italian experience.

    PubMed

    Calabria, Ferdinando; Chiaravalloti, Agostino; Cicciò, Carmelo; Gangemi, Vincenzo; Gullà, Domenico; Rocca, Federico; Gallo, Gianpasquale; Cascini, Giuseppe Lucio; Schillaci, Orazio

    2017-08-01

    The 11 C/ 18 F-choline is a PET/CT radiopharmaceutical useful in detecting tumors with high lipogenesis. 11 C/ 18 F-choline uptake can occur in physiological conditions or tumors. The knowledge of its bio-distribution is essential to recognize physiologic variants or diagnostic pitfalls. Moreover, few information are available on the bio-distribution of this tracer in female patients. Our aim was to discuss some documented 18 F-choline PET/CT pitfalls in prostate cancer patients. Our secondary aim was to describe the 18 F-choline bio-distribution in the female body. We collected diagnostic pitfalls in three PET centers examining 1000 prostate cancer by 18 F-choline PET/CT. All pitfalls were ensured by follow-up, imaging and/or histology. We also performed whole body 18 F-choline PET/CT in 5 female patients. 169/1000 (16.9%) patients showed pitfalls not owing to prostate cancer. These findings were due to inflammation, benign tumors while, in 1% of examined patients, a concomitant neoplasm was found. In the female body, the breast showed low physiological uptake. The accurate knowledge of 18 F-choline PET/CT bio-distribution and diagnostic pitfalls is essential. Correlative imaging and histological exam are often necessary to depict pitfalls. In women, the uptake in the breast is due to the physiological gradient of 18 F-choline uptake in the exocrine glands. Our results confirm the possibility of 18 F-choline uptake in several diseases other than prostate cancer. However, our experience was acquired on a large population and shows that a conspicuous amount of 18 F-choline diagnostic pitfalls are easily recognizable and attributable to inflammation. A new advance in knowledge is the minimal difference in terms of physiological tracer bio-distribution between male and female patients. The knowledge of the physiological bio-distribution and of the potential pitfalls linked of a tracer could help physicians to choose the best diagnostic and therapeutic approaches for a better patient quality of life. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Injectible bodily prosthetics employing methacrylic copolymer gels

    DOEpatents

    Mallapragada, Surya K.; Anderson, Brian C.

    2007-02-27

    The present invention provides novel block copolymers as structural supplements for injectible bodily prosthetics employed in medical or cosmetic procedures. The invention also includes the use of such block copolymers as nucleus pulposus replacement materials for the treatment of degenerative disc disorders and spinal injuries. The copolymers are constructed by polymerization of a tertiary amine methacrylate with either a (poly(ethylene oxide)-b-poly(propylene oxide)-b-poly(ethylene oxide) polymer, such as the commercially available Pluronic.RTM. polymers, or a poly(ethylene glycol) methyl ether polymer.

  5. Positive Pitfalls

    ERIC Educational Resources Information Center

    Schneider, Michael

    2004-01-01

    This article describes how Cahokia middle and high school students conduct inquiry-based science through a pitfall trap experiment. In a collaborative effort, students designed and conducted pitfall trap investigations that combined their interest in the natural world with their love of technology. The students set up their own experiments to…

  6. Anterior surgical management of single-level cervical disc disease: a cost-effectiveness analysis.

    PubMed

    Lewis, Daniel J; Attiah, Mark A; Malhotra, Neil R; Burnett, Mark G; Stein, Sherman C

    2014-12-01

    Cost-effectiveness analysis with decision analysis and meta-analysis. To determine the relative cost-effectiveness of anterior cervical discectomy with fusion (with autograft, allograft, or spacers), anterior cervical discectomy without fusion (ACD), and cervical disc replacement (CDR) for the treatment of 1-level cervical disc disease. There is debate as to the optimal anterior surgical strategy to treat single-level cervical disc disease. Surgical strategies include 3 techniques of anterior cervical discectomy with fusion (autograft, allograft, or spacer-assisted fusion), ACD, and CDR. Several controlled trials have compared these treatments but have yielded mixed results. Decision analysis provides a structure for making a quantitative comparison of the costs and outcomes of each treatment. A literature search was performed and yielded 156 case series that fulfilled our search criteria describing nearly 17,000 cases. Data were abstracted from these publications and pooled meta-analytically to estimate the incidence of various outcomes, including index-level and adjacent-level reoperation. A decision analytic model calculated the expected costs in US dollars and outcomes in quality-adjusted life years for a typical adult patient with 1-level cervical radiculopathy subjected to each of the 5 approaches. At 5 years postoperatively, patients who had undergone ACD alone had significantly (P < 0.001) more quality-adjusted life years (4.885 ± 0.041) than those receiving other treatments. Patients with ACD also exhibited highly significant (P < 0.001) differences in costs, incurring the lowest societal costs ($16,558 ± $539). Follow-up data were inadequate for comparison beyond 5 years. The results of our decision analytic model indicate advantages for ACD, both in effectiveness and costs, over other strategies. Thus, ACD is a cost-effective alternative to anterior cervical discectomy with fusion and CDR in patients with single-level cervical disc disease. Definitive conclusions about degenerative changes after ACD and adjacent-level disease after CDR await longer follow-up. 4.

  7. Applied statistics in ecology: common pitfalls and simple solutions

    Treesearch

    E. Ashley Steel; Maureen C. Kennedy; Patrick G. Cunningham; John S. Stanovick

    2013-01-01

    The most common statistical pitfalls in ecological research are those associated with data exploration, the logic of sampling and design, and the interpretation of statistical results. Although one can find published errors in calculations, the majority of statistical pitfalls result from incorrect logic or interpretation despite correct numerical calculations. There...

  8. Limitations and pitfalls of 99mTc-EDDA/HYNIC-TOC (Tektrotyd) scintigraphy.

    PubMed

    Garai, Ildikó; Barna, Sandor; Nagy, Gabor; Forgacs, Attila

    2016-01-01

    Tektrotyd kit was developed by Polatom company for 99mTc labeling to make an alternative tracer of somatostatin receptor scintigraphy available. Since 2005, 99mTc-EDDA/HYNIC-Tyr3-Octreotide has been used in clinical imaging and achieved high impact in management of patients with neuroendocrine tumors. Knowing the limitations and pitfalls is essential to provide ac-curate diagnosis. Therefore, the potential pitfalls associated with the use of 99mTc-EDDA/HYNIC-TOC are reviewed on the basis of own experience. Data were analyzed of 310 patients who underwent somatostatin receptor scintigraphy with 99mTc-Tektrotyd. Pitfalls during radiolabeling process or acquisition can worsen the sensitivity of SRS (somatostatin receptor scintigraphy). Recognizing physi-ological and clinical pitfalls, the diagnostic accuracy will improve.

  9. Temporomandibular Joint Disorders: A Review of Etiology, Clinical Management, and Tissue Engineering Strategies

    PubMed Central

    Murphy, Meghan K.; MacBarb, Regina F.; Wong, Mark E.; Athanasiou, Kyriacos A.

    2015-01-01

    Epidemiology reports state temporomandibular joint disorders (TMD) affect up to 25% of the population, yet their etiology and progression are poorly understood. As a result, treatment options are limited and fail to meet the long-term demands of the relatively young patient population. TMD are a class of degenerative musculoskeletal conditions associated with morphological and functional deformities. In up to 70% of cases, TMD are accompanied by malpositioning of the TMJ disc, termed “internal derangement.” Though onset is not well characterized, correlations between internal derangement and osteoarthritic change have been identified. Due to the complex and unique nature of each TMD case, diagnosis requires patient-specific analysis accompanied by various diagnostic modalities. Likewise, treatment requires customized plans to address the specific characteristics of each patient’s disease. In the mechanically demanding and biochemically active environment of the TMJ, therapeutic approaches capable of restoring joint functionality while responding to changes in the joint have become a necessity. Capable of integration and adaptation in the TMJ, one such approach, tissue engineering, carries significant potential in the development of repair and replacement tissues. The following review presents a synopsis of etiology, current treatment methods, and the future of tissue engineering for repairing and/or replacing diseased joint components, specifically the mandibular condyle and TMJ disc. Preceding the current trends in tissue engineering is an analysis of native tissue characterization, toward identifying tissue engineering objectives and validation metrics for restoring healthy and functional structures of the TMJ. PMID:24278954

  10. Cervical anterior hybrid technique with bi-level Bryan artificial disc replacement and adjacent segment fusion for cervical myelopathy over three consecutive segments.

    PubMed

    Chen, Jiang; Xu, Lin; Jia, Yu-Song; Sun, Qi; Li, Jin-Yu; Zheng, Chen-Ying; Bai, Chun-Xiao; Yu, Qin-Sheng

    2016-05-01

    This study aimed to assess the preliminary clinical efficacy and feasibility of the hybrid technique for multilevel cervical myelopathy. Considering the many shortcomings of traditional treatment methods for multilevel cervical degenerative myelopathy, hybrid surgery (bi-level Bryan artificial disc [Medtronic Sofamor Danek, Memphis, TN, USA] replacement and anterior cervical discectomy and fusion) should be considered. Between March 2006 and November 2012, 108 patients (68 men and 40 women, average age 45years) underwent hybrid surgery. Based on the Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI), and Odom's criteria, the clinical symptoms and neurological function before and after surgery were evaluated. Mean surgery duration was 90minutes, with average blood loss of 30mL. Mean follow-up duration was 36months. At the final follow-up, the mean JOA (± standard deviation) scores were significantly higher compared with preoperative values (15.08±1.47 versus 9.18±1.22; P<0.01); meanwhile, NDI values were markedly decreased (12.32±1.03 versus 42.68±1.83; P<0.01). Using Odom's criteria, the clinical outcomes were rated as excellent (76 patients), good (22 patients), fair (six patients), and poor (four patients). These findings indicate that the hybrid method provides an effective treatment for cervical myelopathy over three consecutive segments, ensuring a good clinical outcome. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies.

    PubMed

    Murphy, Meghan K; MacBarb, Regina F; Wong, Mark E; Athanasiou, Kyriacos A

    2013-01-01

    Temporomandibular disorders (TMD) are a class of degenerative musculoskeletal conditions associated with morphologic and functional deformities that affect up to 25% of the population, but their etiology and progression are poorly understood and, as a result, treatment options are limited. In up to 70% of cases, TMD are accompanied by malpositioning of the temporomandibular joint (TMJ) disc, termed "internal derangement." Although the onset is not well characterized, correlations between internal derangement and osteoarthritic change have been identified. Because of the complex and unique nature of each TMD case, diagnosis requires patient-specific analysis accompanied by various diagnostic modalities. Likewise, treatment requires customized plans to address the specific characteristics of each patient's disease. In the mechanically demanding and biochemically active environment of the TMJ, therapeutic approaches that can restore joint functionality while responding to changes in the joint have become a necessity. One such approach, tissue engineering, which may be capable of integration and adaptation in the TMJ, carries significant potential for the development of repair and replacement tissues. The following review presents a synopsis of etiology, current treatment methods, and the future of tissue engineering for repairing and/or replacing diseased joint components, specifically the mandibular condyle and TMJ disc. An analysis of native tissue characterization to assist clinicians in identifying tissue engineering objectives and validation metrics for restoring healthy and functional structures of the TMJ is followed by a discussion of current trends in tissue engineering.

  12. Performance of the STAR Event Plane Detector

    NASA Astrophysics Data System (ADS)

    Ewigleben, Justin; Justin Ewigleben Collaboration

    2017-09-01

    The Beam Energy Scan (BES) program at the Relativistic Heavy-Ion Collider has shown hints of a critical point and first order phase transition at the BES energies. Key measurements for locating the critical point and determining the first order phase transition are limited by poor event plane resolution, limited statistics and a TPC-only centrality determination. A new event plane and collision centrality detector (EPD) is planned to replace the existing detector, the Beam-Beam Counter (BBC), with higher granularity and acceptance. The design of the EPD consists of two scintillator discs at z = +/- 3.75m from the center of STAR, covering 2.2 < η < 5.1. One quarter of a single disc was installed in STAR for the 2017 run for commissioning. In this talk we will discuss the detector performance during this commissioning run in both proton-proton collisions at √{ s = 510 } GeV and Au-Au collisions at √{sNN = 54.4 } GeV. NSF Grant 1614474.

  13. Pitfalls of Personal Development Plans--The User Perspective

    ERIC Educational Resources Information Center

    Grohnert, Therese; Beausaert, Simon; Segers, Mien

    2014-01-01

    This study was conducted to investigate which pitfalls users of personal development plans (PDPs) perceive in business and governmental organisations with mandatory PDP use. Hundred and thirty-one written statements of PDP users across three Dutch organisations were analysed and categorised into nine pitfalls. Next to an overall lack of use and…

  14. A radiopaque electrospun scaffold for engineering fibrous musculoskeletal tissues: Scaffold characterization and in vivo applications.

    PubMed

    Martin, John T; Milby, Andrew H; Ikuta, Kensuke; Poudel, Subash; Pfeifer, Christian G; Elliott, Dawn M; Smith, Harvey E; Mauck, Robert L

    2015-10-01

    Tissue engineering strategies have emerged in response to the growing prevalence of chronic musculoskeletal conditions, with many of these regenerative methods currently being evaluated in translational animal models. Engineered replacements for fibrous tissues such as the meniscus, annulus fibrosus, tendons, and ligaments are subjected to challenging physiologic loads, and are difficult to track in vivo using standard techniques. The diagnosis and treatment of musculoskeletal conditions depends heavily on radiographic assessment, and a number of currently available implants utilize radiopaque markers to facilitate in vivo imaging. In this study, we developed a nanofibrous scaffold in which individual fibers included radiopaque nanoparticles. Inclusion of radiopaque particles increased the tensile modulus of the scaffold and imparted radiation attenuation within the range of cortical bone. When scaffolds were seeded with bovine mesenchymal stem cells in vitro, there was no change in cell proliferation and no evidence of promiscuous conversion to an osteogenic phenotype. Scaffolds were implanted ex vivo in a model of a meniscal tear in a bovine joint and in vivo in a model of total disc replacement in the rat coccygeal spine (tail), and were visualized via fluoroscopy and microcomputed tomography. In the disc replacement model, histological analysis at 4 weeks showed that the scaffold was biocompatible and supported the deposition of fibrous tissue in vivo. Nanofibrous scaffolds that include radiopaque nanoparticles provide a biocompatible template with sufficient radiopacity for in vivo visualization in both small and large animal models. This radiopacity may facilitate image-guided implantation and non-invasive long-term evaluation of scaffold location and performance. The healing capacity of fibrous musculoskeletal tissues is limited, and injury or degeneration of these tissues compromises the standard of living of millions in the US. Tissue engineering repair strategies for the intervertebral disc, meniscus, tendon and ligament have progressed from in vitro to in vivo evaluation using a variety of animal models, and the clinical application of these technologies is imminent. The composition of most scaffold materials however does not allow for visualization by methods available to clinicians (e.g., radiography), and thus it is not possible to assess their performance in situ. In this work, we describe a radiopaque nanofibrous scaffold that can be visualized radiographically in both small and large animal models and serve as a framework for the development of an engineered fibrous tissue. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

  15. Effects of radial compression on a novel simulated intervertebral disc-like assembly using bone marrow-derived mesenchymal stem cell cell-sheets for annulus fibrosus regeneration.

    PubMed

    See, Eugene Yong-Shun; Toh, Siew Lok; Goh, James Cho-Hong

    2011-10-01

    The aim of this study was to develop a tissue engineering approach in regenerating the annulus fibrosus (AF) as part of an overall strategy to produce a tissue-engineered intervertebral disc (IVD) replacement. To determine whether a rehabilitative simulation regime on bone marrow–derived mesenchymal stem cell cell-sheet is able to aid the regeneration of the AF. No previous study has used bone marrow–derived mesenchymal stem cell cell-sheets simulated by a rehabilitative regime to regenerate the AF. The approach was to use bone marrow–derived stem cells to form cell-sheets and incorporating them onto silk scaffolds to simulate the native lamellae of the AF. The in vitro experimental model used to study the efficacy of such a system was made up of the tissue engineering AF construct wrapped around a silicone disc to form a simulated IVD-like assembly. The assembly was cultured within a custom-designed bioreactor that provided a compressive mechanical stimulation onto the silicone disc. The silicone nucleus pulposus would bulge radially and compress the simulated AF to mimic the physiological conditions. The simulated IVD-like assembly was compressed using a rehabilitative regime that lasted for 4 weeks at 0.25 Hz, for 15 minutes each day. With the rehabilitative regime, the cell-sheets remained viable but showed a decrease in cell numbers and viability. Gene expression analysis showed significant upregulation of IVD-related genes and there was an increased ratio of collagen type II to collagen type I found within the extracellular matrix. The results suggested that a rehabilitative regime caused extensive remodeling to take place within the simulated IVD-like assembly, producing extracellular matrix similar to that found in the inner AF.

  16. Biomechanical changes of the lumbar segment after total disc replacement : charite(r), prodisc(r) and maverick(r) using finite element model study.

    PubMed

    Kim, Ki-Tack; Lee, Sang-Hun; Suk, Kyung-Soo; Lee, Jung-Hee; Jeong, Bi-O

    2010-06-01

    The purpose of this study was to analyze the biomechanical effects of three different constrained types of an artificial disc on the implanted and adjacent segments in the lumbar spine using a finite element model (FEM). The created intact model was validated by comparing the flexion-extension response without pre-load with the corresponding results obtained from the published experimental studies. The validated intact lumbar model was tested after implantation of three artificial discs at L4-5. Each implanted model was subjected to a combination of 400 N follower load and 5 Nm of flexion/extension moments. ABAQUS version 6.5 (ABAQUS Inc., Providence, RI, USA) and FEMAP version 8.20 (Electronic Data Systems Corp., Plano, TX, USA) were used for meshing and analysis of geometry of the intact and implanted models. Under the flexion load, the intersegmental rotation angles of all the implanted models were similar to that of the intact model, but under the extension load, the values were greater than that of the intact model. The facet contact loads of three implanted models were greater than the loads observed with the intact model. Under the flexion load, three types of the implanted model at the L4-5 level showed the intersegmental rotation angle similar to the one measured with the intact model. Under the extension load, all of the artificial disc implanted models demonstrated an increased extension rotational angle at the operated level (L4-5), resulting in an increase under the facet contact load when compared with the adjacent segments. The increased facet load may lead to facet degeneration.

  17. Pitfalls in Persuasion: How Do Users Experience Persuasive Techniques in a Web Service?

    NASA Astrophysics Data System (ADS)

    Segerståhl, Katarina; Kotro, Tanja; Väänänen-Vainio-Mattila, Kaisa

    Persuasive technologies are designed by utilizing a variety of interactive techniques that are believed to promote target behaviors. This paper describes a field study in which the aim was to discover possible pitfalls of persuasion, i.e., situations in which persuasive techniques do not function as expected. The study investigated persuasive functionality of a web service targeting weight loss. A qualitative online questionnaire was distributed through the web service and a total of 291 responses were extracted for interpretative analysis. The Persuasive Systems Design model (PSD) was used for supporting systematic analysis of persuasive functionality. Pitfalls were identified through situations that evoked negative user experiences. The primary pitfalls discovered were associated with manual logging of eating and exercise behaviors, appropriateness of suggestions and source credibility issues related to social facilitation. These pitfalls, when recognized, can be addressed in design by applying functional and facilitative persuasive techniques in meaningful combinations.

  18. Total prosthetic replacement of atrioventricular valves in the dog

    PubMed Central

    Den Otter, G.

    1968-01-01

    The free-floating cone and cage valve, described in a previous study as being successful as a substitute for the right atrioventricular valve, does not perform well when it is inserted in the mitral ostium. A tilting cone or disc was constructed and tested in a series of 15 dogs. This prosthesis gave excellent results in 12 animals. The reasons for its failure in the remaining three is discussed. The prosthesis presented has advantages over any ball and cage valve, mainly because of its smaller volume. Images PMID:5654076

  19. Pitfall Traps and Mini-Winkler Extractor as Complementary Methods to Sample Soil Coleoptera.

    PubMed

    Carneiro, A C; Batistella, D A; Battirola, L D; Marques, M I

    2016-02-01

    We compared abundance, species richness, and capture efficiency with pitfall traps and mini-Winkler extractors to examine their use as complementary methods for sampling soil Coleoptera during dry (2010) and high water seasons (2011) in three areas, including inundated and non-inundated regions, in the Pantanal of Poconé, Mato Grosso, Brazil. We paired treatments with two 10 × 10 m plots in inundated and non-inundated locations that were repeated three times in each location for a total of 18 plots. In each plot, we used nine pitfall traps and collected 2 m(2) of leaf litter and surface soil samples with mini-Winkler extractors. We collected a total of 4260 adult beetles comprising 36 families, 113 genera, and 505 species. Most were caught in pitfalls (69%) and the remainder in the mini-Winkler extractors (31%). Each method provided distinct information about the beetle community: 252 species were captured only in pitfall traps, 147 using only the mini-Winkler extractors, and these methods shared another 106 species. Pitfall and mini-Winkler contribute in different ways for the sampling of the soil beetle community, and so they should be considered complementary for a more thorough assessment of community diversity.

  20. Clinical Evaluation and Magnetic Resonance Imaging Assessment of Intradiscal Methylene Blue Injection for the Treatment of Discogenic Low Back Pain.

    PubMed

    Zhang, XiaoJun; Hao, Jie; Hu, Zhenming; Yang, HaiTao

    2016-01-01

    Low back pain is a common worldwide health problem and has a significant socioeconomic impact on public health. Internal disc disruption has been considered as the most common cause of low back pain. Various therapies, including interbody fusion, disc replacement, injection therapies, and thermal annular procedures have been utilized for the treatment of discogenic low back pain. Recently, a new method of intradiscal methylene blue injection has been introduced to treat discogenic low back pain, but the clinical outcomes are controversial. To investigate the clinical outcomes and magnetic resonance imaging changes of intradiscal methylene blue injection for the treatment of discogenic low back pain. Observational study. An interventional low back pain management practice in a university hospital. A total of 33 patients were selected to be treated with intradiscal methylene blue injection. The clinical outcomes were evaluated by numeric rating scale and Oswestry Disability Index at pretreatment, one month, 3, 6, and 12 months after treatment. The magnetic resonance imaging changes of involved intervertebral discs were assessed by apparent diffusion coefficient and T2 values at pretreatment, 3, 6, and 12 months after treatment. All of the patients got a follow-up period up to 12 months. The mean numeric rating scale scores at pretreatment, one month, 3, 6, and 12 months after treatment were 6.54, 2.98, 3.23, 3.66, and 4.72, respectively. There was a minimum of 2 points reduction at one month, 3, and 6 months after treatment, but less than 2 points reduction at 12 months. There was at least 50% improvement on the Oswestry Disability Index at one month, 3, and 6 months after treatment, but not at 12 months. The mean apparent diffusion coefficient and T2 value were significantly higher at 6 and12 months after treatment compared to pretreatment, but there was no significant difference between pretreatment and 3 months after treatment. This is an observational study with a relatively small sample size and short-term follow-up. The intradiscal methylene blue injection might be an effective therapy for discogenic low back pain for the short-term and could improve disc degeneration condition to some extent.Key words: Low back pain, discogenic pain, internal disc disruption, provocation discography, methylene blue, intradiscal injection, disc degeneration, magnetic resonance, imaging.

  1. Blood stem cells and non-hematological clinical practice: pragmatics before therapeutics.

    PubMed

    Parker, Graham C

    2007-02-01

    There is considerable interest in biological sources for replacement, repair, as well as vascularization of tissue. The remarkable properties of blood stem cells encourage interest in their therapeutic potential. But what are these properties, and how do they influence their clinical potential and the advisability of stem cell use as a therapeutic resource? Rational assessment of the significance of in vitro and animal in vivo data should precede the rush from the bench to the bedside. Basic stem cell research is rife with examples where the truth of the subsequently demonstrated mechanism is stranger than the initial interpretation proved fiction. This review will assess tissue contribution by different blood related stem cells, differing possible mechanisms underlying observed repair phenomena, and consider the potency and pitfalls of stem cell therapeutics.

  2. An early assessment of silicone hydrogel safety: pearls and pitfalls, and current status.

    PubMed

    Keay, Lisa; Edwards, Katie; Stapleton, Fiona

    2007-11-01

    The contact lens industry has evolved and now provides many choices, including continuous wear, overnight orthokeratology, frequent-replacement lenses, daily-disposable lenses, and many alternatives in systems of care and maintenance. Epidemiologic studies to date have shown that how a lens is worn, particularly if worn overnight, can increase the risk of microbial keratitis. However, the risk of silicone hydrogel contact lenses worn on a continuous-wear basis has been evaluated only recently. This article summarizes the recent research data on extended-wear silicone hydrogel lenses and discusses the challenges of early evaluations of silicone hydrogel lens safety. Finally, the relevance of this information is discussed to practitioners and contact lens wearers making choices about the risks and benefits of different products and how they are used.

  3. Regenerative medicine technology applied to gastroenterology: current status and future perspectives.

    PubMed

    Orlando, Giuseppe

    2012-12-21

    This special issue of World Journal of Gastroenterology has been conceived to illustrate to gastroenterology operators the role that regenerative medicine (RM) will have in the progress of gastrointestinal (GI) medicine. RM is a multidisciplinary field aiming to replace, regenerate or repair diseased tissues or organs. The past decade has been marked by numerous ground-breaking achievements that led experts in the field to manufacture functional substitutes of relatively simple organs. This progress is paving the ground for investigations that aims to the bioengineering and regeneration of more complex organs like livers, pancreas and intestine. In this special issue, the reader will be introduced, hand-in-hand, to explore the field of RM and will be educated on the progress, pitfalls and promise of RM technologies as applied to GI medicine.

  4. Tricuspid Valve Dysfunction Following Pacemaker or Cardioverter-Defibrillator Implantation.

    PubMed

    Chang, James D; Manning, Warren J; Ebrille, Elisa; Zimetbaum, Peter J

    2017-05-09

    The potential for cardiac implantable electronic device leads to interfere with tricuspid valve (TV) function has gained increasing recognition as having hemodynamic and clinical consequences associated with incremental morbidity and death. The diagnosis and treatment of lead-related (as distinct from functional) tricuspid regurgitation pose unique challenges. Because of pitfalls in routine diagnostic imaging, a high level of clinical suspicion must be maintained to avoid overlooking the possibility that worsening heart failure is a consequence of mechanical interference with TV leaflet mobility or coaptation and is amenable to lead extraction or valve repair or replacement. The future of cardiac implantable electronic devices includes pacing and perhaps defibrillation without a lead traversing the TV. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Variants and pitfalls on radioiodine scans in pediatric patients with differentiated thyroid carcinoma.

    PubMed

    Mostafa, Mohamed; Vali, Reza; Chan, Jeffrey; Omarkhail, Yusuaf; Shammas, Amer

    2016-10-01

    Potentially false-positive findings on radioiodine scans in children with differentiated thyroid carcinoma can mimic functioning thyroid tissue and functioning thyroid carcinomatous tissue. Such false-positive findings comprise variants and pitfalls that can vary slightly in children as compared with adults. To determine the patterns and frequency of these potential false-positive findings on radioiodine scans in children with differentiated thyroid carcinoma. We reviewed a total of 223 radioiodine scans from 53 pediatric patients (mean age 13.3 years, 37 girls) with differentiated thyroid carcinoma. Focal or regional activity that likely did not represent functioning thyroid tissue or functioning thyroid carcinomatous tissue were categorized as variants or pitfalls. The final diagnosis was confirmed by reviewing the concurrent and follow-up clinical data, correlative ultrasonography, CT scanning, serum thyroglobulin and antithyroglobulin antibody levels. We calculated the frequency of these variants and pitfalls from diagnostic and post-therapy radioiodine scans. The most common variant on the radioiodine scans was the thymic activity (24/223, 10.8%) followed by the cardiac activity (8/223, 3.6%). Salivary contamination and star artifact, caused by prominent thyroid remnant, were the most important observed pitfalls. Variants and pitfalls that mimic functioning thyroid tissue or functioning thyroid carcinomatous tissue on radioiodine scan in children with differentiated thyroid carcinoma are not infrequent, but they decrease in frequency on successive radioiodine scans. Potential false-positive findings can be minimized with proper knowledge of the common variants and pitfalls in children and correlation with clinical, laboratory and imaging data.

  6. Straight-line drift fences and pitfall traps

    USGS Publications Warehouse

    Corn, Paul Stephen

    1994-01-01

    Straight-line drift fences typically are short barriers (5-15 m) that direct animals traveling on the substrate surface into traps places at the ends of or beside the barriers. Traps (described below) can be pitfalls, funnel traps, or a combination of the two. Drift fences with pitfall or funnel traps and pitfall traps without fences are used commonly to inventory and monitor populations of amphibians and reptiles. For example, 9 of 17 field studies reported for management of terrestrial vertebrates (Sarzo et al. 1988) used these techniques to sample amphibians. Drift fences with pitfall traps can be used to determine species richness at a site and to detect the presence of rare species. They also can yield data on relative abundances and habitat use of selected species. Pitfall traps arrayed in a grid without fences can also be used to study the population ecology and habitat use of selected species. Population density can be estimated with this latter technique if used in conjunction with mark-recapture techniques (see Chapter 8). Drift fence arrays or pitfall grids can be left in place for long-term monitoring. In this section, I discuss the use of this technique to obtain data on amphibians away from breeding ponds. Use of drift fences and traps to monitory amphibian activity at breeding ponds is discussed in the section "Drift Fences Encircling Breeding Sits", below (technique 9). Some materials and procedures are common to both techniques. Investigators contemplating the use of drift fences and traps in any context should read both accounts.

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

    PubMed Central

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

    2013-01-01

    Study Design Biomechanical cadaver investigation Objective To examine dynamic bending stiffness and energy absorption of the lumbar spine with and without implanted Total Disc Replacement (TDR) under simulated physiologic motion. Summary of background data The pendulum testing system is capable of applying physiologic compressive loads without constraining motion of functional spinal units (FSUs). The number of cycles to equilibrium observed under pendulum testing is a measure of the energy absorbed by the FSU. Methods Five unembalmed, frozen human lumbar FSUs were tested on the pendulum system with axial compressive loads of 181N, 282N, 385N, and 488N before and after Synthes ProDisc-L TDR implantation. Testing in flexion, extension, and lateral bending began by rotating the pendulum to 5° resulting in unconstrained oscillatory motion. The number of rotations to equilibrium was recorded and bending stiffness (N-m/°) was calculated and compared for each testing mode. Results In flexion/extension, the TDR constructs reached equilibrium with significantly (p<0.05) fewer cycles than the intact FSU with compressive loads of 282N, 385N and 488N. Mean dynamic bending stiffness in flexion, extension, and lateral bending increased significantly with increasing load for both the intact FSU and TDR constructs (p<0.001). In flexion, with increasing compressive loading from 181N to 488N, the bending stiffness of the intact FSUs increased from 4.0N-m/° to 5.5N-m/°, compared to 2.1N-m/° to 3.6N-m/° after TDR implantation. At each compressive load, the intact FSU was significantly more stiff than the TDR (p<0.05). Conclusion Lumbar FSUs with implanted TDR were found to be less stiff, but also absorbed more energy during cyclic loading with an unconstrained pendulum system. Although the effects on clinical performance of motion preserving devices are not fully known, these results provide further insight into the biomechanical behavior of this device under approximated physiologic loading conditions. PMID:22869057

  8. The biomechanics of a multilevel lumbar spine hybrid using nucleus replacement in conjunction with fusion.

    PubMed

    Dahl, Michael C; Ellingson, Arin M; Mehta, Hitesh P; Huelman, Justin H; Nuckley, David J

    2013-02-01

    Degenerative disc disease is commonly a multilevel pathology with varying deterioration severity. The use of fusion on multiple levels can significantly affect functionality and has been linked to persistent adjacent disc degeneration. A hybrid approach of fusion and nucleus replacement (NR) has been suggested as a solution for mildly degenerated yet painful levels adjacent to fusion. To compare the biomechanical metrics of different hybrid implant constructs, hypothesizing that an NR+fusion hybrid would be similar to a single-level fusion and perform more naturally compared with a two-level fusion. A cadaveric in vitro repeated-measures study was performed to evaluate a multilevel lumbar NR+fusion hybrid. Eight cadaveric spines (L3-S1) were tested in a Spine Kinetic Simulator (Instron, Norwood, MA, USA). Pure moments of 8 Nm were applied in flexion/extension, lateral bending, and axial rotation as well as compression loading. Specimens were tested intact; fused (using transforaminal lumbar interbody fusion instrumentation with posterior rods) at L5-S1; with a nuclectomy at L4-L5 including fusion at L5-S1; with NR at L4-L5 including fusion at L5-S1; and finally with a two-level fusion spanning L4-S1. Repeated-measures analysis of variance and corrected t tests were used to statistically compare outcomes. The NR+fusion hybrid and single-level fusion exhibited no statistical differences for range of motion (ROM), stiffness, neutral zone, and intradiscal pressure in all loading directions. Compared with two-level fusion, the hybrid affords the construct 41.9% more ROM on average. Two-level fusion stiffness was statistically higher than all other constructs and resulted in significantly lower ROM in flexion, extension, and lateral bending. The hybrid construct produced approximately half of the L3-L4 adjacent-level pressures as the two-level fusion case while generating similar pressures to the single-level fusion case. These data portend more natural functional outcomes and fewer adjacent disc complications for a multilevel NR+fusion hybrid compared with the classical two-level fusion. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Astronomers, Transits of Venus, and the Birth of Experimental Psychology

    NASA Astrophysics Data System (ADS)

    Sheehan, William; Thurber, S.

    2012-01-01

    The eighteenth century transits of Venus were regarded as the most important astronomical events of their era. Halley's expectation was that by observing the contact points between the limbs of Venus and the Sun, this distance could be determined to an accuracy of one part in 500. But in the event, it proved otherwise. But, as the British historian Agnes Clerke wrote in 1902: "A transit of Venus seems, at first sight, full of promise for solving the problem of the sun's distance. For nothing would appear easier than to determine exactly either the duration of the passage of a small, dark orb across a large brilliant disc, or the instant of its entry upon or exit from it". But in that word `exactly' what snares and pitfalls lie hid!” In the post-mortem analysis of the disappointing results, astronomers devoted a great deal of effort to understand the sources of errors. They rehearsed their observational techniques by observing, under strictly controlled conditions, transits of artificial planets across artificial Suns, and studied such parameters as attention and reflex reaction. In the process, the transits of Venus provided an important impetus to the early development of experimental psychology.

  10. Are PEEK-on-Ceramic Bearings an Option for Total Disc Arthroplasty? An In Vitro Tribology Study.

    PubMed

    Siskey, Ryan; Ciccarelli, Lauren; Lui, Melissa K C; Kurtz, Steven M

    2016-11-01

    Most contemporary total disc replacements (TDRs) use conventional orthopaedic bearing couples such as ultrahigh-molecular-weight polyethylene (polyethylene) and cobalt-chromium (CoCr). Cervical total disc replacements incorporating polyetheretherketone (PEEK) bearings (specifically PEEK-on-PEEK bearings) have been previously investigated, but little is known about PEEK-on-ceramic bearings for TDR. (1) What is the tribologic behavior of a PEEK-on-ceramic bearing for cervical TDR under idealized, clean wear test conditions? (2) How does the PEEK-on-ceramic design perform under impingement conditions? (3) How is the PEEK-on-ceramic bearing affected by abrasive wear? (4) Is the particle morphology from PEEK-on-ceramic bearings for TDRs affected by adverse wear scenarios? PEEK-on-ceramic cervical TDR bearings were subjected to a 10 million cycle ideal wear test based on ASTM F2423 and ISO 181912-1 using a six-station spine wear simulator (MTS, Eden Prairie, MN, USA) with 5 g/L bovine serum concentration at 23° ± 2° C (ambient temperature). Validated 1 million cycle impingement and 5 million cycle abrasive tests were conducted on the PEEK-on-ceramic bearings based, in part, on retrieval analysis of a comparable bearing design as well as finite element analyses. The ceramic-on-PEEK couple was characterized for damage modes, mass and volume loss, and penetration and the lubricant was subjected to particle analysis. The resulting mass wear rate, volumetric wear rate, based on material density, and particle analysis were compared with clinically available cervical disc bearing couples. The three modes of wear (idealized, impingement, and abrasive) resulted in mean mass wear rates of 0.9 ± 0.2 mg/MC, 1.9 ± 0.5 mg/MC, and 2.8 ± 0.6 mg/MC, respectively. The mass wear rates were converted to volumetric wear rates using density and found to be 0.7 ± 0.1 mm 3 /MC, 1.5 ± 0.4 mm 3 /MC, and 2.1 ± 0.5 mm 3 /MC, respectively. During each test, the PEEK endplates were the primary sources of wear and demonstrated an abrasive wear mechanism. Under idealized and impingement conditions, the ceramic core also demonstrated slight polishing of the articulating surface but the change in mass was unmeasurable. During abrasive testing, the titanium transfer on the core was shown to polish over 5 MC of testing. In all cases and consistent with previous studies of other PEEK bearing couples, the particle size was primarily < 2 µm and morphology was smooth and spheroidal. Overall, the idealized PEEK-on-ceramic wear rate (0.7 ± 0.1 mm 3 /MC) appears comparable to the published wear rates for other polymer-on-hard bearing couples (0.3-6.7 mm 3 /MC) and within the range of 0.2 to 1.9 mm 3 /MC reported for PEEK-on-PEEK cervical disc designs. The particles, based on size and morphology, also suggest the wear mechanism is comparable between the PEEK-on-ceramic couple and other polymer-on-ceramic orthopaedic couples. The PEEK-on-ceramic bearing considered in this study is a novel bearing couple for use in total disc arthroplasty devices and will require clinical evaluation to fully assess the bearing couple and total disc design. However, the wear rates under idealized and adverse conditions, and particle size and morphology, suggest that PEEK-on-ceramic bearings may be a reasonable alternative to polyethylene-on-CoCr and metal-on-metal bearings currently used in cervical TDRs.

  11. Deletion Analysis of the Tumorous-Head (tuh–3) Gene in DROSOPHILA MELANOGASTER

    PubMed Central

    Kuhn, David T.; Woods, Daniel F.; Andrew, Deborah J.

    1981-01-01

    In the presence of the naturally occurring maternal-effect alleles tuh-1h or tuh-1g, the tuh-3 mutant gene can cause the tumorous-head trait or the sac-testis trait. The tuh-3 gene functions as a semidominant in the presence of the tuh-1h maternal effect. Eye-antennal structures are replaced by posterior abdominal tergites and genital structures. If tuh-1h is replaced by its naturally occurring allele tuh-1g, tuh-3 functions as a recessive hypomorph and the defect switches from anterior to posterior structures, with a male genital-disc defect appearing with variable penetrance. Function and regulation of tuh-3+ may better be understood in light of the cytological localization of tuh-3 either adjacent to or as part of the bithorax complex. The tuh-3+ gene product appears to be essential for normal development, at least in the posterior end of the embryo. PMID:6804305

  12. Pitfalls in classical nuclear medicine: myocardial perfusion imaging

    NASA Astrophysics Data System (ADS)

    Fragkaki, C.; Giannopoulou, Ch

    2011-09-01

    Scintigraphic imaging is a complex functional procedure subject to a variety of artefacts and pitfalls that may limit its clinical and diagnostic accuracy. It is important to be aware of and to recognize them when present and to eliminate them whenever possible. Pitfalls may occur at any stage of the imaging procedure and can be related with the γ-camera or other equipment, personnel handling, patient preparation, image processing or the procedure itself. Often, potential causes of artefacts and pitfalls may overlap. In this short review, special interest will be given to cardiac scintigraphic imaging. Most common causes of artefact in myocardial perfusion imaging are soft tissue attenuation as well as motion and gating errors. Additionally, clinical problems like cardiac abnormalities may cause interpretation pitfalls and nuclear medicine physicians should be familiar with these in order to ensure the correct evaluation of the study. Artefacts or suboptimal image quality can also result from infiltrated injections, misalignment in patient positioning, power instability or interruption, flood field non-uniformities, cracked crystal and several other technical reasons.

  13. Conservative and esthetic cast gold fixed partial dentures-inlay, onlay, and partial veneer retainers, custom composite pontics, and stress-breakers: part I: fundamental design principles.

    PubMed

    Stevenson, Richard G; Refela, Jane A

    2009-01-01

    Although in today's dental world implant restorations are considered the standard of care in the replacement of missing teeth, clinical contraindications and patient nonacceptance of implant placement can be encountered. Several scenarios are discussed here in which a single missing tooth can be restored with conservative fixed partial dentures (FPD) that employ cast gold retainers; each with a customized design in order to preserve tooth structure, maintain esthetics, and provide a long-term prognosis. The abutment teeth are prepared for conservative partial coverage restorations by using Brasseler burs (Brasseler USA, Savannah, GA, USA). Impressions are taken of the preparations, along with any retentive features, utilizing either the Vented Pin Channel technique or the Shooshan Plastic Pin technique. The latter technique utilizes Kodex twist drills and corresponding impression pins (Coltene Whaledent Inc., Mahwah, NJ, USA). The conservative FPD with non-rigid connectors is fabricated by using type III gold alloy. The pontic cage portion is chemically prepared utilizing the Panavia F2.0 cement kit (Kuraray America Inc., Houston, TX, USA) or other dual-polymerizing resin cement and restored with any type of direct composite resin material. A palette of opaquers and tints are used for chairside characterization of the esthetic pontic facing. The final polish of the pontic is completed by using FlexiDisc and FlexiBuff discs (Cosmedent Inc., Chicago, IL, USA). CLINICAL SIGNIFICANCE In cases where an implant restoration is contraindicated for replacement of a single tooth, a semi-precision FPD is a conservative, functional, and esthetic alternative.

  14. The Influence of Artificial Cervical Disc Prosthesis Height on the Cervical Biomechanics: A Finite Element Study.

    PubMed

    Yuan, Wei; Zhang, Haiping; Zhou, Xiaoshu; Wu, Weidong; Zhu, Yue

    2018-05-01

    Artificial cervical disc replacement is expected to maintain normal cervical biomechanics. At present, the effect of the Prestige LP prosthesis height on cervical biomechanics has not been thoroughly studied. This finite element study of the cervical biomechanics aims to predict how the parameters, like range of motion (ROM), adjacent intradiscal pressure, facet joint force, and bone-implant interface stress, are affected by different heights of Prestige LP prostheses. The finite element model of intact cervical spine (C3-C7) was obtained from our previous study, and the model was altered to implant Prestige LP prostheses at the C5-C6 level. The effects of the height of 5, 6, and 7 mm prosthesis replacement on ROM, adjacent intradiscal pressure, facet joint force, as well as the distribution of bone-implant interface stress were examined. ROM, adjacent intradiscal pressure, and facet joint force increased with the prosthesis height, whereas ROM and facet joint force decreased at C5-C6. The maximal stress on the inferior surface of the prostheses was greater than that on the superior surface, and the stresses increased with the prosthesis height. The biomechanical changes were slightly affected by the height of 5 and 6 mm prostheses, but were strongly affected by the 7-mm prosthesis. An appropriate height of the Prestige LP prosthesis can preserve normal ROM, adjacent intradiscal pressure, and facet joint force. Prostheses with a height of ≥2 mm than normal can lead to marked changes in the cervical biomechanics and bone-implant interface stress. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. Cervical Disk Replacement With Discover Versus Fusion in a Single-Level Cervical Disk Disease: A Prospective Single-Center Randomized Trial With a Minimum 2-Year Follow-up.

    PubMed

    Rožanković, Marjan; Marasanov, Sergej M; Vukić, Miroslav

    2017-06-01

    Prospective randomized study. To compare the clinical outcome after Discover arthroplasty versus anterior cervical discectomy and fusion (ACDF) in patients treated for symptomatic single-level cervical disk disease. ACDF is still the gold standard for surgical treatment of cervical spine degenerative disk disease. However, results of many studies suggest that it may cause degenerative changes at levels immediately above and below the fusion, known as adjacent segment degenerative disease. Cervical arthroplasty has recently been introduced as an alternative to standard procedure of ACDF. It showed decreased surgical morbidity, decreased complications from postoperative immobilization, and an earlier return to previous level of function. A total of 105 consecutive patients with single-level cervical disk disease, producing radiculopathy and/or myelopathy were randomly divided into groups to undergo ACDF or Discover arthroplasty. All patients were evaluated with preoperative and postoperative serial radiographic studies and clinically, using Neck Disability Index, Visual Analog Scale and neurological status at 3, 6, 12, and 24 months. The results of our study indicate that cervical arthroplasty using Discover Artificial Cervical Disc provides favorable clinical and radiologic outcomes in a follow-up period of 24 months. There has been significant improvement in clinical parameters, Visual Analog Scale and Neck Disability Index, at 3, 6, 12, and 24 months in arthroplasty group comparing to control group. The Discover artificial cervical disc replacement offers favorable outcome compared with ACDF for a single-level cervical disk disease at short-term and long-term follow-up.

  16. Understanding United States Investigational Device Exemption Studies-Clinical Relevance and Importance for Healthcare Economics.

    PubMed

    Ament, Jared D; Mollan, Scott; Greenan, Krista; Binyamin, Tamar; Kim, Kee D

    2017-06-01

    The US Food and Drug Administration allows a previously unapproved device to be used clinically to collect safety and effectiveness data under their Investigational Device Exemption (IDE) category. The process usually falls under 3 different trial categories: noninferiority, equivalency, and superiority. To confidently inform our patients, understanding the basic concepts of these trials is paramount. The purpose of this manuscript was to provide a comprehensive review of these topics using recently published IDE trials and economic analyses of cervical total disc replacement as illustrative examples. In 2006, an IDE was initiated to study the safety and effectiveness of total disc replacement controlled against the standard of care, anterior cervical discectomy, and fusion. Under the IDE, randomized controlled trials comparing both 1 and 2 level cervical disease were completed. The sponsor designed the initial trial as noninferiority; however, using adaptive methodology, superiority could be claimed in the 2-level investigation. Healthcare economics are critical in medical decision making and reimbursement practices. Once both cost- and quality-adjusted life-year (QALY) are known for each patient, the incremental cost-effectiveness ratio is calculated. Willingness-to-pay is controversial, but a commonly cited guideline considers interventions costing below 20 000 $/QALY strongly cost effective and more than 100 000 $/QALY as not cost effective. While large Food and Drug Administration IDE studies are often besieged by complex statistical considerations and calculations, it is fundamentally important that clinicians understand at least the terminology and basic concepts on a practical level. Copyright © 2017 by the Congress of Neurological Surgeons

  17. Clinical outcomes, radiologic kinematics, and effects on sagittal balance of the 6 df LP-ESP lumbar disc prosthesis.

    PubMed

    Lazennec, Jean-Yves; Even, Julien; Skalli, Wafa; Rakover, Jean-Patrick; Brusson, Adrien; Rousseau, Marc-Antoine

    2014-09-01

    Surgical treatment of degenerative disc disease remains a controversial subject. Lumbar fusion has been associated with a potential risk of segmental junctional disease and sagittal balance misalignment. Motion preservation devices have been developed as an alternative to fusion. The LP-ESP disc is a one-piece deformable device achieving 6 df, including shock absorption and elastic return. This is the first clinical report on its use. To assess clinical outcomes and radiologic kinematics in the first 2 years after implantation. Prospective cohort of patients with LP-ESP total disc replacement (TDR) at the lumbar spine. Forty-six consecutive patients. Clinical outcomes were the visual analog scale (VAS) for pain, the Oswestry disability index (ODI), and the GHQ28 (General Health Questionnaire) psychological score. Radiologic data were the range of motion (ROM), sagittal balance parameters, and mean center of rotation (MCR). Patients had single-level TDR at L4-L5 or L5-S1. Outcomes were prospectively recorded for 2 years (before and at 3, 6, 12, and 24 months after surgery). The SpineView software was used for computed analysis of the radiographic data. Paired t tests were used for statistical comparisons. No intraoperative complication occurred. All clinical scores improved significantly at 24 months: the back pain VAS scores by a mean of 4.1 points and the ODI by 33 points. The average ROM of the instrumented level was 5.4°±4.8° at 2 years and more than 2° for 76% of prostheses. The MCR was in a physiological area in 73% of cases. The sagittal balance (pelvic tilt, sacral slope, and segmental lordosis) did not change significantly at any point of the follow-up. Results from the 2-year follow-up indicate that LP-ESP prosthesis recreates lumbar spine function similar to that of the healthy disc in terms of ROM, quality of movement, effect on sagittal balance, and absence of modification in the kinematics of the upper adjacent level. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. [Effect of Basic Fibroblast Growth Factor and Transforming Growth Factor-Β1 Combined with Bone Marrow Mesenchymal Stem Cells on the Repair of Degenerated Intervertebral Discs in Rat Models].

    PubMed

    Jiang, Chao; Li, Da-peng; Zhang, Zhi-jian; Shu, Hao-ming; Hu, Lang; Li, Zheng-nan; Huang, Yong-hui

    2015-08-01

    To evaluate the effects of the combination of basic fibroblast growth factor (bFGF), transforming growth factor-Β1 (TGF-Β1), bone marrow mesenchymal stem cells (BMSCs), and temperature-responsive chitosan hydrogel (TCH) gel on the repair of degenerative intervertebral disc in rat models. Rat models of intervertebral disc degeneration were established by acupuncture. The degenerative effects were observed under magnetic resonance imaging (MRI). The BMSCs was cultured in vitro and then transfected by adenovirus with enhanced green fluorescent protein to make it carry the gene of enhanced green fluorescent protein,which functioned as fluorescence labeling. The SD rat models of intervertebral disc degeneration were divided into four groups: group A, treated with the combination of bFGF, TGF-Β1,BMSCs,and TCH gel; group B, treated with the combination of BMSCs and TCH gel;group C, treated with the combination of bFGF,TGF-Β1, and TCH gel;and group D, treated with PBS buffer solution. After the corresponding reagents were injected into the degenerative intervertebral discs of each group, the rats were cultivated for another four weeks and then the repair effects of the intervertebral discs were observed under MRI. Furthermore,the intervertebral discs of each group were taken out and observed by HE and Masson staining. The nucleus pulposus was aspirated and the expressions of aggrecan,collagen 2,Sox-9,and collagen I of nucleus pulposus of each group were tested by reverse transcription polymerase chain reaction and Western blot. The transplanted BMSCs survived in the intervertebral disc and differentiated into nucleus pulposus-like cells. MRI showed that:the signal intensity of the nucleus pulposus of group A was much higher than that of the rest groups, the signal intensity of group B was higher than that of group C, and the signal intensity of group D was the lowest,in which the dura mater spinalis was in compression and the spinal cord changed in beaded shape. The differences of the Pfirrmann grading among the four groups had statistical significance (P<0.05). The results of the HE and Masson stains showed:the intervertebral disc of group A was well-structured,the quantity of nucleus pulposus cells was larger than that of the other three groups,and the boundary between the nucleus pulposus and the annulus fibrosus was clearly defined;the quantity of the nucleus pulposus cells of group B was larger than that of group C, and the broken annulus fibrosus was not observed in group B, while the broken annulus fibrosus could be observed in group C; and, the nucleus pulposus cells of group D were replaced by fibrous tissue. The results of the reverse transcription polymerase chain reaction and Western blot tests showed that,in terms of the expressions of aggrecan,collagen 2 and Sox-9,group A was the highest, followed by group B,group C,and group D (P<0.05); in terms of the expression of collagen 1,there was no obvious difference among these four groups (P>0.05). The transplanted BMSCs can survive in the degenerative intervertebral disc and differentiate into nucleus pulposus-like cells. The combination of bFGF, TGF-Β1, BMSCs,and TCH gel has obvious repair effect on the degenerative intervertebral discs. The effect of the combination of BMSCs and TCH gel on transplantation therapy of the degenerative intervertebral discs is better than that of the combination of bFGF, TGF-Β1 and TCH gel but worse than that of the combination of bFGF, TGF-Β1, BMSCs, and TCH gel.

  19. Applications of 3D printing in the management of severe spinal conditions.

    PubMed

    Provaggi, Elena; Leong, Julian J H; Kalaskar, Deepak M

    2017-06-01

    The latest and fastest-growing innovation in the medical field has been the advent of three-dimensional printing technologies, which have recently seen applications in the production of low-cost, patient-specific medical implants. While a wide range of three-dimensional printing systems has been explored in manufacturing anatomical models and devices for the medical setting, their applications are cutting-edge in the field of spinal surgery. This review aims to provide a comprehensive overview and classification of the current applications of three-dimensional printing technologies in spine care. Although three-dimensional printing technology has been widely used for the construction of patient-specific anatomical models of the spine and intraoperative guide templates to provide personalized surgical planning and increase pedicle screw placement accuracy, only few studies have been focused on the manufacturing of spinal implants. Therefore, three-dimensional printed custom-designed intervertebral fusion devices, artificial vertebral bodies and disc substitutes for total disc replacement, along with tissue engineering strategies focused on scaffold constructs for bone and cartilage regeneration, represent a set of promising applications towards the trend of individualized patient care.

  20. Growth of magnesium diboride films on 2 inch diameter copper discs by hybrid physical–chemical vapor deposition

    DOE PAGES

    Withanage, Wenura K.; Xi, X. X.; Nassiri, Alireza; ...

    2017-02-16

    Here, magnesium diboride (MgB 2) coating is a potential candidate to replace bulk niobium (Nb) for superconducting radio frequency cavities due to the appealing superconducting properties of MgB 2. MgB 2 coating on copper may allow cavity operation near 20–25 K as a result of the high transition temperature (T c) of MgB 2 and excellent thermal conductivity of Cu. We have grown MgB 2 films on 2 inch diameter Cu discs by hybrid physical–chemical vapor deposition for radio frequency characterization. Structural and elemental analyses showed a uniform MgB 2 coating on top of a Mg–Cu alloy layer with occasionalmore » intrusion of Mg–Cu alloy regions. High T c values of around 37 K and high critical current density (J c) on the order of 107 A cm –2 at zero field were observed. Radio frequency measurements at 11.4 GHz confirmed a high T c and showed a quality factor (Q 0) much higher than for Cu and close to that of Nb.« less

  1. Growth of magnesium diboride films on 2 inch diameter copper discs by hybrid physical–chemical vapor deposition

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Withanage, Wenura K.; Xi, X. X.; Nassiri, Alireza

    Here, magnesium diboride (MgB 2) coating is a potential candidate to replace bulk niobium (Nb) for superconducting radio frequency cavities due to the appealing superconducting properties of MgB 2. MgB 2 coating on copper may allow cavity operation near 20–25 K as a result of the high transition temperature (T c) of MgB 2 and excellent thermal conductivity of Cu. We have grown MgB 2 films on 2 inch diameter Cu discs by hybrid physical–chemical vapor deposition for radio frequency characterization. Structural and elemental analyses showed a uniform MgB 2 coating on top of a Mg–Cu alloy layer with occasionalmore » intrusion of Mg–Cu alloy regions. High T c values of around 37 K and high critical current density (J c) on the order of 107 A cm –2 at zero field were observed. Radio frequency measurements at 11.4 GHz confirmed a high T c and showed a quality factor (Q 0) much higher than for Cu and close to that of Nb.« less

  2. Growth of magnesium diboride films on 2 inch diameter copper discs by hybrid physical–chemical vapor deposition

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Withanage, Wenura K.; Xi, X. X.; Nassiri, Alireza

    Magnesium diboride (MgB2) coating is a potential candidate to replace bulk niobium (Nb) for superconducting radio frequency cavities due to the appealing superconducting properties of MgB2. MgB2 coating on copper may allow cavity operation near 20–25 K as a result of the high transition temperature (T c) of MgB2 and excellent thermal conductivity of Cu. We have grown MgB2 films on 2 inch diameter Cu discs by hybrid physical–chemical vapor deposition for radio frequency characterization. Structural and elemental analyses showed a uniform MgB2 coating on top of a Mg–Cu alloy layer with occasional intrusion of Mg–Cu alloy regions. High Tmore » c values of around 37 K and high critical current density (J c) on the order of 107 A cm-2 at zero field were observed. Radio frequency measurements at 11.4 GHz confirmed a high T c and showed a quality factor (Q 0) much higher than for Cu and close to that of Nb.« less

  3. Percutaneous Transcatheter One-Step Mechanical Aortic Disc Valve Prosthesis Implantation: A Preliminary Feasibility Study in Swine

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Sochman, Jan; Peregrin, Jan H.; Rocek, Miloslav

    Purpose. To evaluate the feasibility of one-step implantation of a new type of stent-based mechanical aortic disc valve prosthesis (MADVP) above and across the native aortic valve and its short-term function in swine with both functional and dysfunctional native valves. Methods. The MADVP consisted of a folding disc valve made of silicone elastomer attached to either a nitinol Z-stent (Z model) or a nitinol cross-braided stent (SX model). Implantation of 10 MADVPs (6 Z and 4 SX models) was attempted in 10 swine: 4 (2 Z and 2 SX models) with a functional native valve and 6 (4 Z andmore » 2 SX models) with aortic regurgitation induced either by intentional valve injury or by MADVP placement across the native valve. MADVP function was observed for up to 3 hr after implantation. Results. MADVP implantation was successful in 9 swine. One animal died of induced massive regurgitation prior to implantation. Four MADVPs implanted above functioning native valves exhibited good function. In 5 swine with regurgitation, MADVP implantation corrected the induced native valve dysfunction and the device's continuous good function was observed in 4 animals. One MADVP (SX model) placed across native valve gradually migrated into the left ventricle. Conclusion. The tested MADVP can be implanted above and across the native valve in a one-step procedure and can replace the function of the regurgitating native valve. Further technical development and testing are warranted, preferably with a manufactured MADVP.« less

  4. Biologic canine and human intervertebral disc repair by notochordal cell-derived matrix: from bench towards bedside.

    PubMed

    Bach, Frances C; Tellegen, Anna R; Beukers, Martijn; Miranda-Bedate, Alberto; Teunissen, Michelle; de Jong, Willem A M; de Vries, Stefan A H; Creemers, Laura B; Benz, Karin; Meij, Björn P; Ito, Keita; Tryfonidou, Marianna A

    2018-05-29

    The socioeconomic burden of chronic back pain related to intervertebral disc (IVD) disease is high and current treatments are only symptomatic. Minimally invasive strategies that promote biological IVD repair should address this unmet need. Notochordal cells (NCs) are replaced by chondrocyte-like cells (CLCs) during IVD maturation and degeneration. The regenerative potential of NC-secreted substances on CLCs and mesenchymal stromal cells (MSCs) has already been demonstrated. However, identification of these substances remains elusive. Innovatively, this study exploits the regenerative NC potential by using healthy porcine NC-derived matrix (NCM) and employs the dog as a clinically relevant translational model. NCM increased the glycosaminoglycan and DNA content of human and canine CLC aggregates and facilitated chondrogenic differentiation of canine MSCs in vitro . Based on these results, NCM, MSCs and NCM+MSCs were injected in mildly (spontaneously) and moderately (induced) degenerated canine IVDs in vivo and, after six months of treatment, were analyzed. NCM injected in moderately (induced) degenerated canine IVDs exerted beneficial effects at the macroscopic and MRI level, induced collagen type II-rich extracellular matrix production, improved the disc height, and ameliorated local inflammation. MSCs exerted no (additive) effects. In conclusion, NCM induced in vivo regenerative effects on degenerated canine IVDs. NCM may, comparable to demineralized bone matrix in bone regeneration, serve as 'instructive matrix', by locally releasing growth factors and facilitating tissue repair. Therefore, intradiscal NCM injection could be a promising regenerative treatment for IVD disease, circumventing the cumbersome identification of bioactive NC-secreted substances.

  5. Leaflet embolisation from Duromedics valves: a report of two cases.

    PubMed

    Kumar, N; Balasundaram, S; Rickard, M; al Halees, Z; Duran, C M

    1991-12-01

    Embolization of parts of mechanical valves has been reported since the inception of prosthetic valve implantation. We report here two cases of embolization of one hemileaflet of a Duromedic bileaflet prosthesis in the mitral position due to a pivot fracture. Both presented with moderately severe mitral regurgitation and pulmonary edema and were successfully managed by replacement of the malfunctioning prostheses. The embolised disc was located in the left common iliac artery by abdominal ultrasound and removed by an inguinal, retroperitoneal approach with low morbidity. Both patients left hospital and are doing well to-date.

  6. Validation of Tethya samaaii Ribeiro & Muricy, 2011, replacement name for the sponge Tethya rubra Samaai & Gibbons, 2005 (Demospongiae, Tethyida, Tethyidae).

    PubMed

    Samaai, Toufiek; Gibbons, Mark J; Muricy, Guilherme

    2017-11-14

    Tethya samaaii Ribeiro & Muricy, 2011 is a massive, irregularly globular or sub-spherical sponge with basal rooting processes or a disc-like attachment (Figure 1A). It was described from Oudekraal, on the west coast of South Africa as Tethya rubra Samaai & Gibbons, 2005 based on specimens collected during two surveys in 1996 (Samaai & Gibbons 2005). This species was later reported from Algoa Bay, on the southeast coast of South Africa by Waterworth et al. (2017).

  7. Advances in lens implant technology

    PubMed Central

    Kampik, Anselm; Dexl, Alois K.; Zimmermann, Nicole; Glasser, Adrian; Baumeister, Martin; Kohnen, Thomas

    2013-01-01

    Cataract surgery is one of the oldest and the most frequent outpatient clinic operations in medicine performed worldwide. The clouded human crystalline lens is replaced by an artificial intraocular lens implanted into the capsular bag. During the last six decades, cataract surgery has undergone rapid development from a traumatic, manual surgical procedure with implantation of a simple lens to a minimally invasive intervention increasingly assisted by high technology and a broad variety of implants customized for each patient’s individual requirements. This review discusses the major advances in this field and focuses on the main challenge remaining – the treatment of presbyopia. The demand for correction of presbyopia is increasing, reflecting the global growth of the ageing population. Pearls and pitfalls of currently applied methods to correct presbyopia and different approaches under investigation, both in lens implant technology and in surgical technology, are discussed. PMID:23413369

  8. Regenerative medicine technology applied to gastroenterology: Current status and future perspectives

    PubMed Central

    Orlando, Giuseppe

    2012-01-01

    This special issue of World Journal of Gastroenterology has been conceived to illustrate to gastroenterology operators the role that regenerative medicine (RM) will have in the progress of gastrointestinal (GI) medicine. RM is a multidisciplinary field aiming to replace, regenerate or repair diseased tissues or organs. The past decade has been marked by numerous ground-breaking achievements that led experts in the field to manufacture functional substitutes of relatively simple organs. This progress is paving the ground for investigations that aims to the bioengineering and regeneration of more complex organs like livers, pancreas and intestine. In this special issue, the reader will be introduced, hand-in-hand, to explore the field of RM and will be educated on the progress, pitfalls and promise of RM technologies as applied to GI medicine. PMID:23322983

  9. Ex Vivo Artifacts and Histopathologic Pitfalls in the Lung.

    PubMed

    Thunnissen, Erik; Blaauwgeers, Hans J L G; de Cuba, Erienne M V; Yick, Ching Yong; Flieder, Douglas B

    2016-03-01

    Surgical and pathologic handling of lung physically affects lung tissue. This leads to artifacts that alter the morphologic appearance of pulmonary parenchyma. To describe and illustrate mechanisms of ex vivo artifacts that may lead to diagnostic pitfalls. In this study 4 mechanisms of ex vivo artifacts and corresponding diagnostic pitfalls are described and illustrated. The 4 patterns of artifacts are: (1) surgical collapse, due to the removal of air and blood from pulmonary resections; (2) ex vivo contraction of bronchial and bronchiolar smooth muscle; (3) clamping edema of open lung biopsies; and (4) spreading of tissue fragments and individual cells through a knife surface. Morphologic pitfalls include diagnostic patterns of adenocarcinoma, asthma, constrictive bronchiolitis, and lymphedema. Four patterns of pulmonary ex vivo artifacts are important to recognize in order to avoid morphologic misinterpretations.

  10. How to avoid the ten most frequent EMS pitfalls

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Andrews, W.

    1982-04-19

    It pays to do your homework before investing in an energy management system if you want to avoid the 10 most common pitfalls listed by users, consultants, and manufacturers as: oversimplification, improper maintenance, failure to involve operating personnel, inaccurate savings estimates, failure to include monitoring capability, incompetent or fradulent firms, improper load control, not allowing for a de-bugging period, failure to include manual override, and software problems. The article describes how each of these pitfalls can lead to poor decisions and poor results. (DCK)

  11. Rational manipulation of digital EEG: pearls and pitfalls.

    PubMed

    Seneviratne, Udaya

    2014-12-01

    The advent of digital EEG has provided greater flexibility and more opportunities in data analysis to optimize the diagnostic yield. Changing the filter settings, sensitivity, montages, and time-base are possible rational manipulations to achieve this goal. The options to use polygraphy, video, and quantification are additional useful features. Aliasing and loss of data are potential pitfalls in the use of digital EEG. This review illustrates some common clinical scenarios where rational manipulations can enhance the diagnostic EEG yield and potential pitfalls in the process.

  12. Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters

    DTIC Science & Technology

    2015-12-01

    1 AD_________________ AWARD NUMBER: W81XWH-08-2-0162 TITLE: Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War...Clinical Utility and Pitfalls of Ultrasound Guided Foreign Body Removal in War Fighters 5a. CONTRACT NUMBER 5b. GRANT NUMBER: W81XWH-08-2-0162 5c...Purpose: To demonstrate that 1) ultrasound guided foreign body removal (USFBR) is superior to conventional surgery in the cadaver model, 2) USFBR can be

  13. Bone loss of vertebral bodies at the operative segment after cervical arthroplasty: a potential complication?

    PubMed

    Heo, Dong Hwa; Lee, Dong Chan; Oh, Jong Yang; Park, Choon Keun

    2017-02-01

    OBJECTIVE Bony overgrowth and spontaneous fusion are complications of cervical arthroplasty. In contrast, bone loss or bone remodeling of vertebral bodies at the operation segment after cervical arthroplasty has also been observed. The purpose of this study is to investigate a potential complication-bone loss of the anterior portion of the vertebral bodies at the surgically treated segment after cervical total disc replacement (TDR)-and discuss the clinical significance. METHODS All enrolled patients underwent follow-up for more than 24 months after cervical arthroplasty using the Baguera C disc. Clinical evaluations included recording demographic data and measuring the visual analog scale and Neck Disability Index scores. Radiographic evaluations included measurements of the functional spinal unit's range of motion and changes such as bone loss and bone remodeling. The grading of the bone loss of the operative segment was classified as follows: Grade 1, disappearance of the anterior osteophyte or small minor bone loss; Grade 2, bone loss of the anterior portion of the vertebral bodies at the operation segment without exposure of the artificial disc; or Grade 3, significant bone loss with exposure of the anterior portion of the artificial disc. RESULTS Forty-eight patients were enrolled in this study. Among them, bone loss developed in 29 patients (Grade 1 in 15 patients, Grade 2 in 6 patients, and Grade 3 in 8 patients). Grade 3 bone loss was significantly associated with postoperative neck pain (p < 0.05). Bone loss was related to the motion preservation effect of the operative segment after cervical arthroplasty in contrast to heterotopic ossification. CONCLUSIONS Bone loss may be a potential complication of cervical TDR and affect early postoperative neck pain. However, it did not affect mid- to long-term clinical outcomes or prosthetic failure at the last follow-up. Also, this phenomenon may result in the motion preservation effect in the operative segment after cervical TDR.

  14. Gabor Deconvolution as Preliminary Method to Reduce Pitfall in Deeper Target Seismic Data

    NASA Astrophysics Data System (ADS)

    Oktariena, M.; Triyoso, W.

    2018-03-01

    Anelastic attenuation process during seismic wave propagation is the trigger of seismic non-stationary characteristic. An absorption and a scattering of energy are causing the seismic energy loss as the depth increasing. A series of thin reservoir layers found in the study area is located within Talang Akar Fm. Level, showing an indication of interpretation pitfall due to attenuation effect commonly occurred in deeper level seismic data. Attenuation effect greatly influences the seismic images of deeper target level, creating pitfalls in several aspect. Seismic amplitude in deeper target level often could not represent its real subsurface character due to a low amplitude value or a chaotic event nearing the Basement. Frequency wise, the decaying could be seen as the frequency content diminishing in deeper target. Meanwhile, seismic amplitude is the simple tool to point out Direct Hydrocarbon Indicator (DHI) in preliminary Geophysical study before a further advanced interpretation method applied. A quick-look of Post-Stack Seismic Data shows the reservoir associated with a bright spot DHI while another bigger bright spot body detected in the North East area near the field edge. A horizon slice confirms a possibility that the other bright spot zone has smaller delineation; an interpretation pitfall commonly occurs in deeper level of seismic. We evaluates this pitfall by applying Gabor Deconvolution to address the attenuation problem. Gabor Deconvolution forms a Partition of Unity to factorize the trace into smaller convolution window that could be processed as stationary packets. Gabor Deconvolution estimates both the magnitudes of source signature alongside its attenuation function. The enhanced seismic shows a better imaging in the pitfall area that previously detected as a vast bright spot zone. When the enhanced seismic is used for further advanced reprocessing process, the Seismic Impedance and Vp/Vs Ratio slices show a better reservoir delineation, in which the pitfall area is reduced and some morphed as background lithology. Gabor Deconvolution removes the attenuation by performing Gabor Domain spectral division, which in extension also reduces interpretation pitfall in deeper target seismic.

  15. Does postmenopausal hormone replacement therapy affect intraocular pressure?

    PubMed

    Abramov, Yoram; Borik, Sharon; Yahalom, Claudia; Fatum, Muhammad; Avgil, Gadiel; Brzezinski, Amnon; Banin, Eyal

    2005-08-01

    To assess the effects of postmenopausal hormone replacement therapy (HRT) on intraocular pressure (IOP). This was a cross-sectional controlled study, including 107 women aged 60 to 80 years receiving HRT and 107 controls who have never received HRT. All subjects underwent IOP assessment and funduscopic photography for cup-to-disc (C/D) ratios, and completed questionnaires regarding personal and family history of glaucoma, hormone replacement therapy, lifetime estrogen and progesterone exposure, and cardiovascular risk factors. Main Outcome Measures included IOP, prevalence of increased IOP, and C/D ratios. The groups did not differ in mean IOP (15.3 versus 15.3 mm Hg), mean vertical (0.18 versus 0.21) and horizontal (0.17 versus 0.14) C/D ratios, and in prevalence of increased IOP (15% versus 14%), C/D ratio (7% versus 7%), or glaucoma (9% versus 11%). A personal history of ischemic heart disease was the only risk factor associated with increased IOP (O.R. = 4.63, P = 0.003). Lifetime estrogen and progesterone exposure, including pregnancies, deliveries, menstruation years, and the use of oral contraceptives did not significantly affect the risk for increased IOP. Hormone replacement therapy and lifetime estrogen and progesterone exposure do not seem to affect IOP or the risk for increased IOP. A personal history of ischemic heart disease may be associated with a higher risk for this disorder.

  16. Common Pitfalls in Exposure and Response Prevention (EX/RP) for OCD

    PubMed Central

    Gillihan, Seth J.; Williams, Monnica T.; Malcoun, Emily; Yadin, Elna; Foa, Edna B.

    2012-01-01

    Obsessive-compulsive disorder (OCD) is a highly debilitating disorder. Fortunately there are treatments that help the majority of OCD sufferers. The behavioral treatment with the most empirical support for its efficacy is exposure and response prevention (EX/RP). Over the years in our supervision meetings and in our clinical practice we have noted a number of relatively common therapist pitfalls that decrease the effectiveness of EX/RP. These pitfalls include not encouraging patients to approach the most distressing situations, doing imaginal exposure when in vivo is called for (and vice versa), encouraging distraction during exposure, providing reassurance, failing to address the core fear, ineffective handling of mental compulsions, and difficulty working with close others in the patient’s life. In the current article we describe these common pitfalls and how to avoid them. PMID:22924159

  17. Efficacy of Pitfall Trapping, Winkler and Berlese Extraction Methods for Measuring Ground-Dwelling Arthropods in Moist-Deciduous Forests in the Western Ghats

    PubMed Central

    Sabu, Thomas K.; Shiju, Raj T.

    2010-01-01

    The present study provides data to decide on the most appropriate method for sampling of ground-dwelling arthropods measured in a moist-deciduous forest in the Western Ghats in South India. The abundance of ground-dwelling arthropods was compared among large numbers of samples obtained using pitfall trapping, Berlese and Winkler extraction methods. Highest abundance and frequency of most of the represented taxa indicated pitfall trapping as the ideal method for sampling of ground-dwelling arthropods. However, with possible bias towards surface-active taxa, pitfall-trapping data is inappropriate for quantitative studies, and Berlese extraction is the better alternative. Berlese extraction is the better method for quantitative measurements than the other two methods, whereas pitfall trapping would be appropriate for qualitative measurements. A comparison of the Berlese and Winkler extraction data shows that in a quantitative multigroup approach, Winkler extraction was inferior to Berlese extraction because the total number of arthropods caught was the lowest; and many of the taxa that were caught from an identical sample via Berlese extraction method were not caught. Significantly a greater frequency and higher abundance of arthropods belonging to Orthoptera, Blattaria, and Diptera occurred in pitfall-trapped samples and Psocoptera and Acariformes in Berlese-extracted samples than that were obtained in the other two methods, indicating that both methods are useful, one complementing the other, eliminating a chance for possible under-representation of taxa in quantitative studies. PMID:20673122

  18. Hair Analysis in Forensic Toxicology: An Updated Review with a Special Focus on Pitfalls.

    PubMed

    Kintz, Pascal

    2017-01-01

    The detection of drugs in hair analysis has progressively emerged as a consequence of the enhanced sensitivity of analytical techniques used in forensic toxicology; a greater advantage in using this matrix with respect to classical ones (i.e. urine and blood) is an easier and non-invasive sample collection, even when the careful supervision of law enforcement officers is required to avoid the risk that the sample may be adulterated or replaced. Moreover, according to the length of the hair, the history of drug exposure can be retrospectively monitored from few weeks up to months or years since sample collection. Through a detailed revision of the existent literature, this manuscript provides information on the proper sample collection, preparation and analysis, as well as pitfalls in forensic hair analysis, and summarizes the wide range of application of this technology, including excessive alcohol drinking, doping, child abuse, and offences linked to drug use. Verification of history of psychotropic drugs, alcohol and doping agents use by hair analysis, hair testing for driving license regranting and drug facilitated crimes, and testing for drugs in hair of children have been reviewed together with recent trends in hair contamination and possibility to disclose use of new psychoactive substances by hair analysis. Hair analysis in forensic toxicology has been quickly emerged and improved in recent years; a deeper knowledge of advantages and limitations of this unique matrix is necessary for a better use in forensic caseworks. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  19. Androgens and doping tests: genetic variation and pit-falls

    PubMed Central

    Rane, Anders; Ekström, Lena

    2012-01-01

    The large variation in disposition known for most drugs is also true for anabolic androgenic steroids. Genetic factors are probably the single most important cause of this variation. Further, there are reasons to believe that there is a corresponding variation in efficacy of doping agents. Doped individuals employ a large variety of doping strategies in respect of choice of substance, dose, dose interval, duration of treatment and use of other drugs for enforcement of effects or correction of side effects. Metabolic steps up-stream and down-stream of testosterone are genetically variable and contribute substantially to the variation in disposition of testosterone, the most common doping agent in sports and in society. Large inter- and intra-ethnic variation in testosterone glucuronidation and excretion is described as well as the pit-falls in evaluation of testosterone doping test results. The hydrolysis and bioactivation of testosterone enanthate is also genetically variable yielding a 2–3 fold variation in excretion rate and serum concentration, thereby implicating a substantial variation in ‘efficacy’ of testosterone. Given this situation it is logical to adopt the new findings in the doping control programme. The population based cut-off level for the testosterone : epitestosterone ratio should be replaced by a Bayesian interpretation of consecutive tests in the same individual. When combined with the above genetic information the sensitivity of the test is considerably improved. The combination of the three approaches should reduce the rate of falsely negative or positive results and the number of expensive follow-up tests, stipulated by the World Anti-Doping Agency. PMID:22506612

  20. Common problems and pitfalls in gear design

    NASA Technical Reports Server (NTRS)

    Townsend, Dennis P.

    1986-01-01

    There are several pitfalls and problems associated with the successful design of a new gear transmission. A new design will require the knowledge and experience of several technical areas of engineering. Most of the pitfalls and problems associated with a new design are related to an inadequate evaluation of several areas, such as, the lubrication and cooling requirements, complete static and dynamic load analysis, evaluation of materials and heat treatment and the latest manufacturing technology. Some of the common problems of the gear design process are discussed with recommendations made for avoiding these conditions.

  1. Effect of neonatal gene therapy on lumbar spine disease in mucopolysaccharidosis VII dogs

    PubMed Central

    Smith, Lachlan J; Martin, John T; O'Donnell, Patricia; Wang, Ping; Elliott, Dawn M; Haskins, Mark E; Ponder, Katherine P

    2012-01-01

    Mucopolysaccharidosis VII (MPS VII) is due to deficient β-glucuronidase (GUSB) activity, which leads to accumulation of chondroitin, heparan, and dermatan sulfate glycosaminoglycans in various tissues including those of the spine. Associated spine disease can be due to abnormalities in the vertebrae, the intervertebral discs, or other spine tissues. The goal of this study was to determine if neonatal gene therapy could prevent lumbar spine disease in MPS VII dogs. MPS VII dogs were injected intravenously with a retroviral vector (RV) expressing canine GUSB at 2 to 3 days after birth, which resulted in transduction of hepatocytes that secreted GUSB into blood. Expression was stable for up to 11 years, and mean survival was increased from 0.4 years in untreated dogs to 6.1 years in treated dogs. Despite a profound positive clinical effect, 6-month-old RV-treated MPS VII dogs still had hypoplastic ventral epiphyses with reduced calcification in the lumbar spine, which resulted in a reduced stiffness and increased range of motion that was not improved relative to untreated MPS VII dogs. At six to 11 years of age, ventral vertebrae remained hypoplastic in RV-treated MPS VII dogs, and there was desiccation of the nucleus pulposus in some discs. Histochemical staining demonstrated that discs did not have detectable GUSB activity despite high serum GUSB activity, which is likely due to poor diffusion into this relatively avascular structure. Thus, neonatal gene therapy cannot prevent lumbar spine disease in MPS VII dogs, which predicts that enzyme replacement therapy (ERT) will similarly be relatively ineffective even if started at birth. PMID:22510705

  2. Competition among gene regulatory networks imposes order within the eye-antennal disc of Drosophila

    PubMed Central

    Weasner, Bonnie M.; Kumar, Justin P.

    2013-01-01

    The eye-antennal disc of Drosophila gives rise to numerous adult tissues, including the compound eyes, ocelli, antennae, maxillary palps and surrounding head capsule. The fate of each tissue is governed by the activity of unique gene regulatory networks (GRNs). The fate of the eye, for example, is controlled by a set of fourteen interlocking genes called the retinal determination (RD) network. Mutations within network members lead to replacement of the eyes with head capsule. Several studies have suggested that in these instances all retinal progenitor and precursor cells are eliminated via apoptosis and as a result the surrounding head capsule proliferates to compensate for retinal tissue loss. This model implies that the sole responsibility of the RD network is to promote the fate of the eye. We have re-analyzed eyes absent mutant discs and propose an alternative model. Our data suggests that in addition to promoting an eye fate the RD network simultaneously functions to actively repress GRNs that are responsible for directing antennal and head capsule fates. Compromising the RD network leads to the inappropriate expression of several head capsule selector genes such as cut, Lim1 and wingless. Instead of undergoing apoptosis, a population of mutant retinal progenitors and precursor cells adopt a head capsule fate. This transformation is accompanied by an adjustment of cell proliferation rates such that just enough head capsule is generated to produce an intact adult head. We propose that GRNs simultaneously promote primary fates, inhibit alternative fates and establish cell proliferation states. PMID:23222441

  3. Fluid mechanics of heart valves.

    PubMed

    Yoganathan, Ajit P; He, Zhaoming; Casey Jones, S

    2004-01-01

    Valvular heart disease is a life-threatening disease that afflicts millions of people worldwide and leads to approximately 250,000 valve repairs and/or replacements each year. Malfunction of a native valve impairs its efficient fluid mechanic/hemodynamic performance. Artificial heart valves have been used since 1960 to replace diseased native valves and have saved millions of lives. Unfortunately, despite four decades of use, these devices are less than ideal and lead to many complications. Many of these complications/problems are directly related to the fluid mechanics associated with the various mechanical and bioprosthetic valve designs. This review focuses on the state-of-the-art experimental and computational fluid mechanics of native and prosthetic heart valves in current clinical use. The fluid dynamic performance characteristics of caged-ball, tilting-disc, bileaflet mechanical valves and porcine and pericardial stented and nonstented bioprostheic valves are reviewed. Other issues related to heart valve performance, such as biomaterials, solid mechanics, tissue mechanics, and durability, are not addressed in this review.

  4. Growth factor effects on costal chondrocytes for tissue engineering fibrocartilage

    PubMed Central

    Johns, D.E.; Athanasiou, K.A.

    2010-01-01

    Tissue engineered fibrocartilage could become a feasible option for replacing tissues like the knee meniscus or temporomandibular joint disc. This study employed five growth factors insulin-like growth factor-I, transforming growth factor-β1, epidermal growth factor, platelet-derived growth factor-BB, and basic fibroblast growth factor in a scaffoldless approach with costal chondrocytes, attempting to improve biochemical and mechanical properties of engineered constructs. Samples were quantitatively assessed for total collagen, glycosaminoglycans, collagen type I, collagen type II, cells, compressive properties, and tensile properties at two time points. Most treated constructs were worse than the no growth factor control, suggesting a detrimental effect, but the IGF treatment tended to improve the constructs. Additionally, the 6wk time point was consistently better than 3wks, with total collagen, glycosaminoglycans, and aggregate modulus doubling during this time. Further optimization of the time in culture and exogenous stimuli will be important in making a more functional replacement tissue. PMID:18597118

  5. In vitro-analysis of kinematics and intradiscal pressures in cervical arthroplasty versus fusion--A biomechanical study in a sheep model with two semi-constrained prosthesis.

    PubMed

    Daentzer, Dorothea; Welke, Bastian; Hurschler, Christof; Husmann, Nathalie; Jansen, Christina; Flamme, Christian Heinrich; Richter, Berna Ida

    2015-03-24

    As an alternative technique to arthrodesis of the cervical spine, total disc replacement (TDR) has increasingly been used with the aim of restoration of the physiological function of the treated and adjacent motions segments. The purpose of this experimental study was to analyze the kinematics of the target level as well as of the adjacent segments, and to measure the pressures in the proximal and distal disc after arthrodesis as well as after arthroplasty with two different semi-constrained types of prosthesis. Twelve cadaveric ovine cervical spines underwent polysegmental (C2-5) multidirectional flexibility testing with a sensor-guided industrial serial robot. Additionally, pressures were recorded in the proximal and distal disc. The following three conditions were tested: (1) intact specimen, (2) single-level arthrodesis C3/4, (3) single-level TDR C3/4 using the Discover® in the first six specimens and the activ® C in the other six cadavers. Statistical analysis was performed for the total range of motion (ROM), the intervertebral ROM (iROM) and the intradiscal pressures (IDP) to compare both the three different conditions as well as the two disc prosthesis among each other. The relative iROM in the target level was always lowered after fusion in the three directions of motion. In almost all cases, the relative iROM of the adjacent segments was almost always higher compared to the physiologic condition. After arthroplasty, we found increased relative iROM in the treated level in comparison to intact state in almost all cases, with relative iROM in the adjacent segments observed to be lower in almost all situations. The IDP in both adjacent discs always increased in flexion and extension after arthrodesis. In all but five cases, the IDP in each of the adjacent level was decreased below the values of the intact specimens after TDR. Overall, in none of the analyzed parameters were statistically significantly differences between both types of prostheses investigated. The results of this biomechanical study indicate that single-level implantation of semi-constrained TDR lead to a certain hypermobility in the treated segments with lowering the ROM in the adjacent levels in almost all situations.

  6. Biotribological evaluation of artificial disc arthroplasty devices: influence of loading and kinematic patterns during in vitro wear simulation.

    PubMed

    Grupp, Thomas M; Yue, James J; Garcia, Rolando; Basson, Janet; Schwiesau, Jens; Fritz, Bernhard; Blömer, Wilhelm

    2009-01-01

    Wear simulation is an essential pre-clinical method to predict the mid- and long-term clinical wear behavior of newly introduced devices for total disc arthroplasty. The main requirement of a suitable method for spinal wear simulation has to be the ability to distinguish between design concepts and allow for a direct comparison of predicate devices. The objective of our study was to investigate the influence of loading and kinematic patterns based on two different protocols for spinal wear simulation (ISO/FDIS 18192-1 (2006) and ASTM F2423-05). In vitro wear simulation was performed with six activ L lumbar artificial disc devices (Aesculap Tuttlingen, Germany). The applied kinematic pattern of movement was multidirectional for ISO (elliptic track) and unidirectional with a curvilinear shape for ASTM. Testing was done for 10 million cycles in the ISO loading mode and afterwards with the same specimens for 5 million cycles according to the ASTM protocol with a customized six-station servohydraulic spinal wear simulator (EndoLab Thansau, Germany). Gravimetrical and geometrical wear assessment, a slide track analysis correlated to an optical surface characterization, and an estimation of particle size and morphology were performed. The gravimetric wear rate for the first 10 million cycles was ISO(initial) = 2.7 +/- 0.3 mg/million cycles. During the ASTM test period (10-15 million cycles) a gravimetric wear rate of 0.14 +/- 0.06 mg/million cycles was estimated. The wear rates between the ISO and ASTM driven simulations differ substantially (approximately 20-fold) and statistical analysis demonstrates a significant difference (p < 0.001) between the test groups. The main explanation of divergency between ISO and ASTM driven wear simulations is the multidirectional pattern of movement described in the ISO document resulting in a cross-shear stress on the polyethylene material. Due to previous retrieval observations, it seems to be very unlikely that a lumbar artificial disc is loaded with a linear wear path.Testing according to ASTM F2423-05 with pure unidirectional motion does not reflect the kinematics of TDA patients' daily activities. Based on our findings it seems to be more reliable to predict the clinical wear behavior of an artificial disc replacement using the ISO/FDIS 18192-1 method.

  7. Biotribological evaluation of artificial disc arthroplasty devices: influence of loading and kinematic patterns during in vitro wear simulation

    PubMed Central

    Yue, James J.; Garcia, Rolando; Basson, Janet; Schwiesau, Jens; Fritz, Bernhard; Blömer, Wilhelm

    2008-01-01

    Wear simulation is an essential pre-clinical method to predict the mid- and long-term clinical wear behavior of newly introduced devices for total disc arthroplasty. The main requirement of a suitable method for spinal wear simulation has to be the ability to distinguish between design concepts and allow for a direct comparison of predicate devices. The objective of our study was to investigate the influence of loading and kinematic patterns based on two different protocols for spinal wear simulation (ISO/FDIS 18192-1 (2006) and ASTM F2423-05). In vitro wear simulation was performed with six activ® L lumbar artificial disc devices (Aesculap Tuttlingen, Germany). The applied kinematic pattern of movement was multidirectional for ISO (elliptic track) and unidirectional with a curvilinear shape for ASTM. Testing was done for 10 million cycles in the ISO loading mode and afterwards with the same specimens for 5 million cycles according to the ASTM protocol with a customized six-station servohydraulic spinal wear simulator (EndoLab Thansau, Germany). Gravimetrical and geometrical wear assessment, a slide track analysis correlated to an optical surface characterization, and an estimation of particle size and morphology were performed. The gravimetric wear rate for the first 10 million cycles was ISOinitial = 2.7 ± 0.3 mg/million cycles. During the ASTM test period (10–15 million cycles) a gravimetric wear rate of 0.14 ± 0.06 mg/million cycles was estimated. The wear rates between the ISO and ASTM driven simulations differ substantially (approximately 20-fold) and statistical analysis demonstrates a significant difference (p < 0.001) between the test groups. The main explanation of divergency between ISO and ASTM driven wear simulations is the multidirectional pattern of movement described in the ISO document resulting in a cross-shear stress on the polyethylene material. Due to previous retrieval observations, it seems to be very unlikely that a lumbar artificial disc is loaded with a linear wear path.Testing according to ASTM F2423-05 with pure unidirectional motion does not reflect the kinematics of TDA patients‘ daily activities. Based on our findings it seems to be more reliable to predict the clinical wear behavior of an artificial disc replacement using the ISO/FDIS 18192-1 method. PMID:19050942

  8. Adjacent-level arthroplasty following cervical fusion.

    PubMed

    Rajakumar, Deshpande V; Hari, Akshay; Krishna, Murali; Konar, Subhas; Sharma, Ankit

    2017-02-01

    OBJECTIVE Adjacent-level disc degeneration following cervical fusion has been well reported. This condition poses a major treatment dilemma when it becomes symptomatic. The potential application of cervical arthroplasty to preserve motion in the affected segment is not well documented, with few studies in the literature. The authors present their initial experience of analyzing clinical and radiological results in such patients who were treated with arthroplasty for new or persistent arm and/or neck symptoms related to neural compression due to adjacent-segment disease after anterior cervical discectomy and fusion (ACDF). METHODS During a 5-year period, 11 patients who had undergone ACDF anterior cervical discectomy and fusion (ACDF) and subsequently developed recurrent neck or arm pain related to adjacent-level cervical disc disease were treated with cervical arthroplasty at the authors' institution. A total of 15 devices were implanted (range of treated levels per patient: 1-3). Clinical evaluation was performed both before and after surgery, using a visual analog scale (VAS) for pain and the Neck Disability Index (NDI). Radiological outcomes were analyzed using pre- and postoperative flexion/extension lateral radiographs measuring Cobb angle (overall C2-7 sagittal alignment), functional spinal unit (FSU) angle, and range of motion (ROM). RESULTS There were no major perioperative complications or device-related failures. Statistically significant results, obtained in all cases, were reflected by an improvement in VAS scores for neck/arm pain and NDI scores for neck pain. Radiologically, statistically significant increases in the overall lordosis (as measured by Cobb angle) and ROM at the treated disc level were observed. Three patients were lost to follow-up within the first year after arthroplasty. In the remaining 8 cases, the duration of follow-up ranged from 1 to 3 years. None of these 8 patients required surgery for the same vertebral level during the follow-up period. CONCLUSIONS Artificial cervical disc replacement in patients who have previously undergone cervical fusion surgery appears to be safe, with encouraging early clinical results based on this small case series, but more data from larger numbers of patients with long-term follow-up are needed. Arthroplasty may provide an additional tool for the management of post-fusion adjacent-level cervical disc disease in carefully selected patients.

  9. Knowledge-base for interpretation of cerebrospinal fluid data patterns. Essentials in neurology and psychiatry.

    PubMed

    Reiber, Hansotto

    2016-06-01

    The physiological and biophysical knowledge base for interpretations of cerebrospinal fluid (CSF) data and reference ranges are essential for the clinical pathologist and neurochemist. With the popular description of the CSF flow dependent barrier function, the dynamics and concentration gradients of blood-derived, brain-derived and leptomeningeal proteins in CSF or the specificity-independent functions of B-lymphocytes in brain also the neurologist, psychiatrist, neurosurgeon as well as the neuropharmacologist may find essentials for diagnosis, research or development of therapies. This review may help to replace the outdated ideas like "leakage" models of the barriers, linear immunoglobulin Index Interpretations or CSF electrophoresis. Calculations, Interpretations and analytical pitfalls are described for albumin quotients, quantitation of immunoglobulin synthesis in Reibergrams, oligoclonal IgG, IgM analysis, the polyspecific ( MRZ- ) antibody reaction, the statistical treatment of CSF data and general quality assessment in the CSF laboratory. The diagnostic relevance is documented in an accompaning review.

  10. Genome editing via delivery of Cas9 ribonucleoprotein.

    PubMed

    DeWitt, Mark A; Corn, Jacob E; Carroll, Dana

    2017-05-15

    The CRISPR-Cas genome editing system is very powerful. The format of the CRISPR reagents and the means of delivery are often important factors in targeting efficiency. Delivery of recombinant Cas9 protein and guide RNA (gRNA) as a preformed ribonucleoprotein (RNP) complex has recently emerged as a powerful and general approach to genome editing. Here we outline methods to produce and deliver Cas9 RNPs. A donor DNA carrying desired sequence changes can also be included to program precise sequence introduction or replacement. RNP delivery limits exposure to genome editing reagents, reduces off-target events, drives high rates of homology-dependent repair, and can be applied to embryos to rapidly generate animal models. RNP delivery thus minimizes some of the pitfalls of alternative editing modalities and is rapidly being adopted by the genome editing community. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Theological discourse and the postmodern condition: the case of bioethics.

    PubMed

    Dell'Oro, Roberto

    2002-01-01

    Bioethics reflects--like many other disciplines--the cultural fragmentation and the complexity of what has come to be known as the postmodern condition. The case of bioethics is particularly acute because of its epistemological indeterminacy and the moral pluralism characterizing postliberal societies. A provisional solution to this situation is the retrieval of a neo-Kantian version of ethical formalism in which concern for a consensus on rules replaces universal dialogue on moral content. The article analyzes the possible consequences of this solution with reference to theological ethics. In particular, the reduction of ethical rationality to a function of political regulation on the one hand, and the implicit legitimization of ethical relativism on the other, push any theological contribution to bioethics to the margins. The central methodological issue for the articulation of theological discourse in bioethics is how to avoid the pitfall of privatism while creating the conditions for ethical dialogue across different traditions.

  12. Crowdsourcing Stream Stage in Data Scarce Regions: Applications of CrowdHydrology

    NASA Astrophysics Data System (ADS)

    Lowry, C.; Fienen, M. N.

    2013-12-01

    Crowdsourced data collection using citizen scientists and mobile phones is a promising way to collect supplemental information in data scarce or remote regions. The research presented here explore the possibilities and pitfalls of crowdsourcing hydrologic data via mobile phone text messaging through the example of CrowdHydrology, a distributed network of over 40 stream gages in four states. Signage at the CrowdHydrology gages ask citizen scientists to answer to a simple question via text message: 'What is the water height?'. While these data in no way replace more traditional measurements of stream stage, they do provide low cost supplemental measurements in data scarce regions. Results demonstrate the accuracy of crowdsourced data and provide insight for successful future crowdsourced data collection efforts. A less recognized benefit is that even in data rich areas, crowdsourced data collection is a cost-effective way to perform quality assurance on more sophisticated, and costly, data collection efforts.

  13. Peritoneal dialysis catheter implantation: avoiding problems and optimizing outcomes.

    PubMed

    Crabtree, John H

    2015-01-01

    The success of peritoneal dialysis (PD) as renal replacement therapy is dependent upon the patient having a functional long-term peritoneal access. There are a number of identified best practices that must be adhered to during PD catheter placement to achieve a durable and infection-resistant access. The clinical setting, available resources, and the employed catheter insertion method may not always permit complete adherence to these practices; however, an attempt should be made to comply with them as closely as possible. Although omission of any one of the practices can lead to catheter loss, departures from some are committed more frequently, manifesting as commonly occurring clinical problems, such as drain pain, catheter tip migration, omental entrapment, pericatheter leaks and hernias, and poor exit-site location. Understanding the technical pitfalls in PD catheter placement that lead to these problems, enable the provider to modify practice habits to avoid them and optimize outcomes. © 2014 Wiley Periodicals, Inc.

  14. Clinical and radiographic analysis of an artificial cervical disc: 7-year follow-up from the Prestige prospective randomized controlled clinical trial: Clinical article.

    PubMed

    Burkus, J Kenneth; Traynelis, Vincent C; Haid, Regis W; Mummaneni, Praveen V

    2014-10-01

    The authors assess the long-term safety and efficacy of cervical disc replacement with the Prestige Cervical Disc in a prospective, randomized, multicenter trial at 7 years of follow-up. At 31 investigational sites, 541 patients with single-level cervical disc disease with radiculopathy were randomized to 1 of 2 treatment groups: 276 investigational group patients underwent anterior cervical discectomy and arthroplasty with the Prestige disc, and 265 control group patients underwent anterior cervical discectomy and fusion. Clinical outcomes included Neck Disability Index, the 36-Item Short-Form Health Survey, and neck and arm pain scores. Radiographs were assessed for angle of motion and fusion. Clinical and radiographic outcomes were evaluated preoperatively, intraoperatively, and at 1.5, 3, 6, 12, 24, 36, 60, and 84 months. Of the 541 patients treated, 395 patients (73%; 212 investigational and 183 control patients) completed 7 years of clinical follow-up. Significant improvements achieved by 1.5 months in both groups were sustained at 7 years. In the investigational group, mean Neck Disability Index improvements from preoperative scores were 38.2 and 37.5 at 60 and 84 months, respectively. In the control group, the corresponding means were 33.8 and 31.9. The differences between the investigational and control groups at the 60-month and 84-month periods were significant (p = 0.014 and 0.002, respectively). The overall rates of maintenance or improvement in neurological status in the investigational group were significantly higher: 92.2% and 88.2% at 60 months and 84 months, respectively, compared with 85.7% and 79.7% in the control group (p = 0.017 and 0.011, respectively). At 84 months, the percentage of working patients in the investigational group was 73.9%, and in the control group, 73.1%. Postoperatively, the implant effectively maintained average angular motion of 6.67° at 60 months and 6.75° at 84 months. Cumulative rates for surgery at the index level were lower (p < 0.001) in the investigational group (11 [4.8%] of 276) when compared with the control group (29 [13.7%] of 265) (based on life-table method), and there were statistical differences between the investigational and control groups with specific regard to the rate of subsequent revision and supplemental fixation surgical procedures. Rates for additional surgical procedures that involved adjacent levels were lower in the investigational group than in the control group (11 [4.6%] of 276 vs. 24 [11.9%] of 265, respectively). Cervical disc arthroplasty has the potential for preserving motion at the operated level while providing biomechanical stability and global neck mobility and may result in a reduction in adjacent-segment degeneration. The Prestige Cervical Disc maintains improved clinical outcomes and segmental motion after implantation at 7-year follow-up. Clinical trial registration no. NCT00642876 ( ClinicalTrials.gov ).

  15. Comparison of animal discs used in disc research to human lumbar disc: torsion mechanics and collagen content.

    PubMed

    Showalter, Brent L; Beckstein, Jesse C; Martin, John T; Beattie, Elizabeth E; Espinoza Orías, Alejandro A; Schaer, Thomas P; Vresilovic, Edward J; Elliott, Dawn M

    2012-07-01

    Experimental measurement and normalization of in vitro disc torsion mechanics and collagen content for several animal species used in intervertebral disc research and comparing these with the human disc. To aid in the selection of appropriate animal models for disc research by measuring torsional mechanical properties and collagen content. There is lack of data and variability in testing protocols for comparing animal and human disc torsion mechanics and collagen content. Intervertebral disc torsion mechanics were measured and normalized by disc height and polar moment of inertia for 11 disc types in 8 mammalian species: the calf, pig, baboon, goat, sheep, rabbit, rat, and mouse lumbar discs, and cow, rat, and mouse caudal discs. Collagen content was measured and normalized by dry weight for the same discs except the rat and the mouse. Collagen fiber stretch in torsion was calculated using an analytical model. Measured torsion parameters varied by several orders of magnitude across the different species. After geometric normalization, only the sheep and pig discs were statistically different from human discs. Fiber stretch was found to be highly dependent on the assumed initial fiber angle. The collagen content of the discs was similar, especially in the outer annulus where only the calf and goat discs were statistically different from human. Disc collagen content did not correlate with torsion mechanics. Disc torsion mechanics are comparable with human lumbar discs in 9 of 11 disc types after normalization by geometry. The normalized torsion mechanics and collagen content of the multiple animal discs presented are useful for selecting and interpreting results for animal disc models. Structural organization of the fiber angle may explain the differences that were noted between species after geometric normalization.

  16. Pitfalls in the consultant's path.

    PubMed

    Short, D

    If the consultant is to retain his skill and reputation, he must be constantly aware of the pitfalls that lie in his path. This article discusses the temptations of greed, dishonesty, arrogance, alcohol and drug abuse, and neglect of family and recreation.

  17. [Research progress of intervertebral disc endogenous stem cells for intervertebral disc regeneration].

    PubMed

    Liang, Hang; Deng, Xiangyu; Shao, Zengwu

    2017-10-01

    To summarize the research progress of intervertebral disc endogenous stem cells for intervertebral disc regeneration and deduce the therapeutic potential of endogenous repair for intervertebral disc degeneration. The original articles about intervertebral disc endogenous stem cells for intervertebral disc regeneration were extensively reviewed; the reparative potential in vivo and the extraction and identification in vitro of intervertebral disc endogenous stem cells were analyzed; the prospect of endogenous stem cells for intervertebral disc regeneration was predicted. Stem cell niche present in the intervertebral discs, from which stem cells migrate to injured tissues and contribute to tissues regeneration under certain specific microenvironment. Moreover, the migration of stem cells is regulated by chemokines system. Tissue specific progenitor cells have been identified and successfully extracted and isolated. The findings provide the basis for biological therapy of intervertebral disc endogenous stem cells. Intervertebral disc endogenous stem cells play a crucial role in intervertebral disc regeneration. Therapeutic strategy of intervertebral disc endogenous stem cells is proven to be a promising biological approach for intervertebral disc regeneration.

  18. Comparison of Animal Discs Used in Disc Research to Human Lumbar Disc: Torsion Mechanics and Collagen Content

    PubMed Central

    Showalter, Brent L.; Beckstein, Jesse C.; Martin, John T.; Beattie, Elizabeth E.; Orías, Alejandro A. Espinoza; Schaer, Thomas P.; Vresilovic, Edward J.; Elliott, Dawn M.

    2012-01-01

    Study Design Experimental measurement and normalization of in vitro disc torsion mechanics and collagen content for several animal species used in intervertebral disc research and comparing these to the human disc. Objective To aid in the selection of appropriate animal models for disc research by measuring torsional mechanical properties and collagen content. Summary of Background Data There is lack of data and variability in testing protocols for comparing animal and human disc torsion mechanics and collagen content. Methods Intervertebral disc torsion mechanics were measured and normalized by disc height and polar moment of inertia for 11 disc types in 8 mammalian species: the calf, pig, baboon, goat, sheep, rabbit, rat, and mouse lumbar, and cow, rat, and mouse caudal. Collagen content was measured and normalized by dry weight for the same discs except the rat and mouse. Collagen fiber stretch in torsion was calculated using an analytical model. Results Measured torsion parameters varied by several orders of magnitude across the different species. After geometric normalization, only the sheep and pig discs were statistically different from human. Fiber stretch was found to be highly dependent on the assumed initial fiber angle. The collagen content of the discs was similar, especially in the outer annulus where only the calf and goat discs were statistically different from human. Disc collagen content did not correlate with torsion mechanics. Conclusion Disc torsion mechanics are comparable to human lumbar discs in 9 of 11 disc types after normalization by geometry. The normalized torsion mechanics and collagen content of the multiple animal discs presented is useful for selecting and interpreting results for animal models of the disc. Structural composition of the disc, such as initial fiber angle, may explain the differences that were noted between species after geometric normalization. PMID:22333953

  19. The pitfalls of container production

    Treesearch

    Wayne Bell

    2013-01-01

    This paper summarizes ten of the biggest “pitfalls” or challenges I have encountered in my experience growing southern pine seedlings in containers over the past 30 years. Learning from challenges is an important part of growing successful nursery operations.

  20. CD-ROM: Potential and Pitfalls.

    ERIC Educational Resources Information Center

    Dreiss, L. Jack; Bashir, Shahzad

    1990-01-01

    Examines issues surrounding CD-ROM as an organizational information management tool: (1) the CD-ROM market; (2) pitfalls, including compatibility, effect on existing information systems, fear of obsolescence, protection of sensitive information, and lack of successful role models; and (3) factors that will fuel growth, including greater…

  1. Seven PC Purchasing Pitfalls.

    ERIC Educational Resources Information Center

    Wodarz, Nan

    1997-01-01

    Explores how to avoid common pitfalls when schools purchase computer equipment. Purchasing tips are provided in the areas of choosing multiple platforms, buying the cheapest model available, choosing a proprietary design, falling for untested technology, purchasing systems that are not upgradable, ignoring extended warranties, and failing to plan…

  2. Bone morphogenetic protein-2 and bone therapy: successes and pitfalls.

    PubMed

    Poon, Bonnie; Kha, Tram; Tran, Sally; Dass, Crispin R

    2016-02-01

    Bone morphogenetic proteins (BMPs), more specifically BMP-2, are being increasingly used in orthopaedic surgery due to advanced research into osteoinductive factors that may enhance and improve bone therapy. There are many areas in therapy that BMP-2 is being applied to, including dental treatment, open tibial fractures, cancer and spinal surgery. Within these areas of treatment, there are many reports of successes and pitfalls. This review explores the use of BMP-2 and its successes, pitfalls and future prospects in bone therapy. The PubMed database was consulted to compile this review. With successes in therapy, there were descriptions of a more rapid healing time with no signs of rejection or infection attributed to BMP-2 treatment. Pitfalls included BMP-2 'off-label' use, which lead to various adverse effects. Our search highlighted that optimising treatment with BMP-2 is a direction that many researchers are exploring, with areas of current research interest including concentration and dose of BMP-2, carrier type and delivery. © 2015 Royal Pharmaceutical Society.

  3. Electromagnetic versus Lense-Thirring alignment of black hole accretion discs

    NASA Astrophysics Data System (ADS)

    Polko, Peter; McKinney, Jonathan C.

    2017-01-01

    Accretion discs and black holes (BHs) have angular momenta that are generally misaligned, which can lead to warped discs and bends in any jets produced. We examine whether a disc that is misaligned at large radii can be aligned more efficiently by the torque of a Blandford-Znajek (BZ) jet than by Lense-Thirring (LT) precession. To obtain a strong result, we will assume that these torques maximally align the disc, rather than cause precession, or disc tearing. We consider several disc states that include radiatively inefficient thick discs, radiatively efficient thin discs, and super-Eddington accretion discs. The magnetic field strength of the BZ jet is chosen as either from standard equipartition arguments or from magnetically arrested disc (MAD) simulations. We show that standard thin accretion discs can reach spin-disc alignment out to large radii long before LT would play a role, due to the slow infall time that gives even a weak BZ jet time to align the disc. We show that geometrically thick radiatively inefficient discs and super-Eddington discs in the MAD state reach spin-disc alignment near the BH when density profiles are shallow as in magnetohydrodynamical simulations, while the BZ jet aligns discs with steep density profiles (as in advection-dominated accretion flows) out to larger radii. Our results imply that the BZ jet torque should affect the cosmological evolution of BH spin magnitude and direction, spin measurements in active galactic nuclei and X-ray binaries, and the interpretations for Event Horizon Telescope observations of discs or jets in strong-field gravity regimes.

  4. Potential Pitfalls Related to Space-Based Lidar Remote Sensing of the Earth With an Emphasis on Wind Measurement

    NASA Technical Reports Server (NTRS)

    Kavaya, Michael J.; Spiers, Gary D.; Frehlich, Rod G.

    2000-01-01

    A collection of issues is discussed that are potential pitfalls, if handled incorrectly, for earth-orbiting lidar remote sensing instruments. These issues arise due to the long target ranges, high lidar-to-target relative velocities, low signal levels, use of laser scanners, and other unique aspects of using lasers in earth orbit. Consequences of misunderstanding these topics range from minor inconvenience to improper calibration to total failure. We will focus on wind measurement using coherent detection Doppler lidar, but many of the potential pitfalls apply also to noncoherent lidar wind measurement, and to measurement of parameters other than wind.

  5. Kinematic Evaluation of Association between Disc Bulge Migration, Lumbar Segmental Mobility, and Disc Degeneration in the Lumbar Spine Using Positional Magnetic Resonance Imaging

    PubMed Central

    Hu, Jonathan K.; Morishita, Yuichiro; Montgomery, Scott R.; Hymanson, Henry; Taghavi, Cyrus E.; Do, Duc; Wang, Jeff C.

    2011-01-01

    Degenerative disc disease and disc bulge in the lumbar spine are common sources of lower back pain. Little is known regarding disc bulge migration and lumbar segmental mobility as the lumbar spine moves from flexion to extension. In this study, 329 symptomatic (low back pain with or without neurological symptoms) patients with an average age of 43.5 years with varying degrees of disc degeneration were examined to characterize the kinematics of the lumbar intervertebral discs through flexion, neutral, and extension weight-bearing positions. In this population, disc bulge migration associated with dynamic motion of the lumbar spine significantly increased with increased grade of disk degeneration. Although no obvious trends relating the migration of disc bulge and angular segmental mobility were seen, translational segmental mobility tended to increase with disc bulge migration in all of the degenerative disc states. It appears that many factors, both static (intervertebral disc degeneration or disc height) and dynamic (lumbar segmental mobility), affect the mechanisms of lumbar disc bulge migration. PMID:24353937

  6. Idioms and Back Translation

    ERIC Educational Resources Information Center

    Griffin, Frank

    2004-01-01

    The challenges of intercultural communication are an integral part of many undergraduate business communication courses. Marketing gaffes clearly illustrate the pitfalls of translation and underscore the importance of a knowledge of the culture with which one is attempting to communicate. A good way to approach the topic of translation pitfalls in…

  7. Intervertebral disc-derived stem cells: implications for regenerative medicine and neural repair.

    PubMed

    Erwin, W Mark; Islam, Diana; Eftekarpour, Eftekhar; Inman, Robert D; Karim, Muhammad Zia; Fehlings, Michael G

    2013-02-01

    An in vitro and in vivo evaluation of intervertebral disc (IVD)-derived stem/progenitor cells. To determine the chondrogenic, adipogenic, osteogenic, and neurogenic differentiation capacity of disc-derived stem/progenitor cells in vitro and neurogenic differentiation in vivo. Tissue repair strategies require a source of appropriate cells that could be used to replace dead or damaged cells and tissues such as stem cells. Here we examined the potential use of IVD-derived stem cells in regenerative medicine approaches and neural repair. Nonchondrodystrophic canine IVD nucleus pulposus (NP) cells were used to generate stem/progenitor cells (NP progenitor cells [NPPCs]) and the NPPCs were differentiated in vitro into chondrogenic, adipogenic, and neurogenic lineages and in vivo into the neurogenic lineage. NPPCs were compared with bone marrow-derived mesenchymal (stromal) stem cells in terms of the expression of stemness genes. The expression of the neural crest marker protein 0 and the Brachyury gene were evaluated in NP cells and NPPCs. NPPCs contain stem/progenitor cells and express "stemness" genes such as Sox2, Oct3/4, Nanog, CD133, Nestin, and neural cell adhesion molecule but differ from mesenchymal (stromal) stem cells in the higher expression of the Nanog gene by NPPCs. NPPCs do not express protein 0 or the Brachyury gene both of which are expressed by the totality of IVD NP cells. The percentage of NPPCs within the IVD is 1% of the total as derived by colony-forming assay. NPPCs are capable of differentiating along chondrogenic, adipogenic, and neurogenic lineages in vitro and into oligodendrocyte, neuron, and astroglial specific precursor cells in vivo within the compact myelin-deficient shiverer mouse. We propose that the IVD NP represents a regenerative niche suggesting that the IVD could represent a readily accessible source of precursor cells for neural repair and regeneration.

  8. Biosignatures in modern sulfates: texture, composition and depositional environments of gypsum deposits at Guerrero Negro, Baja, Mexico

    NASA Astrophysics Data System (ADS)

    Vogel, M. B.; Des Marais, D. J.; Jahnke, L. L.; Turk, K.; Kubo, M.

    2007-12-01

    Gypsum (CaSO4·H2O) is an important phase in biogeochemistry and sedimentology as a mineral sink for sulfur, a paleoclimatic indicator, and an endolithic niche for phototrophic and chemotrophic bacteria. Sulfate deposits are also important targets of exploration for evidence of habitable environments and life on Mars. Gypsum deposits from a range of sedimentary environments at the Guerrero Negro crystallizer ponds and sabkha settings were investigated for microscale structure and composition to differentiate fabrics formed under microbial influence from those formed under abiogenic conditions. Sub-sedimentary gypsum forms in sabkha environments as mm to cm scale selenite discs (termed bird beak gypsum; Warren, 2006) and selenite disc aggregates. Selenite discs and other sub-sedimentary gypsum are characterized by a sinuous axial microtexture and poikilitically enclosed detrital particles. Sub-aqueous gypsum forms as cements, granules (termed gypsooids), and massive botryoidal crusts that line the sediment water interface and margins of managed crystallizer ponds and natural anchialine pools. Sub-aqueous gypsum exhibits a wide range of textures and mineral/biofilm associations that include amorphous to euhedral, tabular, needle and lensoidal morphologies. Elemental sulfur forms rinds on prismatic, growth aligned gypsum twins and reticulate magnesian carbonate is interspersed with both twinned crystals and rosette aggregates in stratified sub-aqueous environments. Intracrystalline biofilms and cell material was observed in association with nearly all sub-aqueous morphologies but only scarce evidence has been found for intercrystalline microbial communities. Columnar microbial communities living in anchialine pools were found to host precipitation of mm scale gypsum granules in their EPS matrix. Fine scale gypsum textures are unlikely to persist through diagenetic alteration, but understanding their primary associations with sulfur and carbonates is necessary for interpreting sulfates or their replacement phases in the ancient record.

  9. Survivorship and clinical outcomes after multi-level anterior lumbar reconstruction with stand-alone anterior lumbar interbody fusion or hybrid construct.

    PubMed

    Chen, Benjamin; Akpolat, Yusuf T; Williams, Paul; Bergey, Darren; Cheng, Wayne K

    2016-06-01

    In multilevel disc disease, there is still uncertainty regarding whether multiple total disc replacement is more effective and safer than fusion. Our objective was to measure and compare the clinical outcome of multilevel hybrid constructs with stand-alone anterior lumbar interbody fusion (ALIF) using a retrospective analysis. Sixty-four patients with chronic low back pain determined to be from two or three-level degenerative disc disease were included. Thirty-three patients were treated with hybrid fusion and 31 with ALIF. Several parameters were retrospectively reviewed, including blood loss, operation time, hospital stay, Visual Analog Scale (VAS) score, Oswestry Disability Index (ODI), and survivorship without the need for revision surgery. Telephone follow-ups were conducted to ascertain survivorship, clinical outcomes (VAS, ODI) and patient satisfaction. Operation time was longer in the hybrid group (p=0.021). The hybrid group showed a significant improvement in VAS and ODI with 52.2% and 50.0% improvement versus 28.3% and 25.5% in the ALIF group (p<0.05). At the telephone follow-up for patient satisfaction, 95.7% (n=22) of the hybrid group were satisfied and 95.2% (n=21) of the ALIF group were satisfied. Seventy-four percent (n=17) in the hybrid group and 85.7% (n=18) in the ALIF group would choose to do the initial surgery again. Kaplan-Meier analysis showed 80.5% survivorship for hybrids and 75.9% for ALIF at 5years. With our clinical outcomes in VAS and ODI scores, these results, when taken together, indicate that hybrid fusion is a valid and viable alternative to ALIF fusion, with at least equal if not better clinical outcomes in terms of survivorship, back pain, and disability scores. Copyright © 2015 Elsevier Ltd. All rights reserved.

  10. Three-dimensional development of tensile pre-strained annulus fibrosus cells for tissue regeneration: An in-vitro study

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chuah, Yon Jin; Lee, Wu Chean; Wong, Hee Kit

    Prior research has investigated the immediate response after application of tensile strain on annulus fibrosus (AF) cells for the past decade. Although mechanical strain can produce either catabolic or anabolic consequences to the cell monolayer, little is known on how to translate these findings into further tissue engineering applications. Till to date, the application and effect of tensile pre-strained cells to construct a three-dimensional (3D) AF tissue remains unknown. This study aims to investigate the effect of tensile pre-strained exposure of 1 to 24 h on the development of AF pellet culture for 3 weeks. Equibiaxial cyclic tensile strain wasmore » applied on AF monolayer cells over a period of 24 h, which was subsequently developed into a cell pellet. Investigation on cellular proliferation, phenotypic gene expression, and histological changes revealed that tensile pre-strain for 24 h had significant and lasting effect on the AF tissue development, with enhanced cell proliferation, and up-regulation of collagen type I, II, and aggrecan expression. Our results demonstrated the regenerative ability of AF cell pellets subjected to 24 h tensile pre-straining. Knowledge on the effects of tensile pre-strain exposure is necessary to optimize AF development for tissue reconstruction. Moreover, the tensile pre-strained cells may further be utilized in either cell therapy to treat mild disc degeneration disease, or the development of a disc construct for total disc replacement. - Highlights: • Establishment of tensile pre-strained cell line population for annulus development. • Tensile strain limits collagen gene expression declination in monolayer culture. • Tensile pre-strained cells up-regulate their matrix protein in 3D pellet culture.« less

  11. Effect of five-membered ring and heteroatom substitution on charge transport properties of perylene discotic derivatives: A theoretical approach

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Navarro, Amparo, E-mail: anavarro@ujaen.es; Fernández-Liencres, M. Paz; Peña-Ruiz, Tomás

    2016-08-07

    Density functional theory calculations were carried out to investigate the evolvement of charge transport properties of a set of new discotic systems as a function of ring and heteroatom (B, Si, S, and Se) substitution on the basic structure of perylene. The replacement of six-membered rings by five-membered rings in the reference compound has shown a prominent effect on the electron reorganization energy that decreases ∼0.2 eV from perylene to the new carbon five-membered ring derivative. Heteroatom substitution with boron also revealed to lower the LUMO energy level and increase the electron affinity, therefore lowering the electron injection barrier comparedmore » to perylene. Since the rate of the charge transfer between two molecules in columnar discotic systems is strongly dependent on the orientation of the stacked cores, the total energy and transfer integral of a dimer as a disc is rotated with respect to the other along the stacking axis have been predicted. Aimed at obtaining a more realistic approach to the bulk structure, the molecular geometry of clusters made up of five discs was fully optimized, and charge transfer rate and mobilities were estimated for charge transport along a one dimensional pathway. Heteroatom substitution with selenium yields electron transfer integral values ∼0.3 eV with a relative disc orientation of 25°, which is the preferred angle according to the dimer energy profile. All the results indicate that the tetraselenium-substituted derivative, not synthetized so far, could be a promising candidate among those studied in this work for the fabrication of n-type semiconductors based on columnar discotic liquid crystals materials.« less

  12. Silk-based multilayered angle-ply annulus fibrosus construct to recapitulate form and function of the intervertebral disc.

    PubMed

    Bhunia, Bibhas K; Kaplan, David L; Mandal, Biman B

    2018-01-16

    Recapitulation of the form and function of complex tissue organization using appropriate biomaterials impacts success in tissue engineering endeavors. The annulus fibrosus (AF) represents a complex, multilamellar, hierarchical structure consisting of collagen, proteoglycans, and elastic fibers. To mimic the intricacy of AF anatomy, a silk protein-based multilayered, disc-like angle-ply construct was fabricated, consisting of concentric layers of lamellar sheets. Scanning electron microscopy and fluorescence image analysis revealed cross-aligned and lamellar characteristics of the construct, mimicking the native hierarchical architecture of the AF. Induction of secondary structure in the silk constructs was confirmed by infrared spectroscopy and X-ray diffraction. The constructs showed a compressive modulus of 499.18 ± 86.45 kPa. Constructs seeded with porcine AF cells and human mesenchymal stem cells (hMSCs) showed ∼2.2-fold and ∼1.7-fold increases in proliferation on day 14, respectively, compared with initial seeding. Biochemical analysis, histology, and immunohistochemistry results showed the deposition of AF-specific extracellular matrix (sulfated glycosaminoglycan and collagen type I), indicating a favorable environment for both cell types, which was further validated by the expression of AF tissue-specific genes. The constructs seeded with porcine AF cells showed ∼11-, ∼5.1-, and ∼6.7-fold increases in col I α 1 , sox 9, and aggrecan genes, respectively. The differentiation of hMSCs to AF-like tissue was evident from the enhanced expression of the AF-specific genes. Overall, the constructs supported cell proliferation, differentiation, and ECM deposition resulting in AF-like tissue features based on ECM deposition and morphology, indicating potential for future studies related to intervertebral disc replacement therapy.

  13. Effect of five-membered ring and heteroatom substitution on charge transport properties of perylene discotic derivatives: A theoretical approach.

    PubMed

    Navarro, Amparo; Fernández-Liencres, M Paz; Peña-Ruiz, Tomás; García, Gregorio; Granadino-Roldán, José M; Fernández-Gómez, Manuel

    2016-08-07

    Density functional theory calculations were carried out to investigate the evolvement of charge transport properties of a set of new discotic systems as a function of ring and heteroatom (B, Si, S, and Se) substitution on the basic structure of perylene. The replacement of six-membered rings by five-membered rings in the reference compound has shown a prominent effect on the electron reorganization energy that decreases ∼0.2 eV from perylene to the new carbon five-membered ring derivative. Heteroatom substitution with boron also revealed to lower the LUMO energy level and increase the electron affinity, therefore lowering the electron injection barrier compared to perylene. Since the rate of the charge transfer between two molecules in columnar discotic systems is strongly dependent on the orientation of the stacked cores, the total energy and transfer integral of a dimer as a disc is rotated with respect to the other along the stacking axis have been predicted. Aimed at obtaining a more realistic approach to the bulk structure, the molecular geometry of clusters made up of five discs was fully optimized, and charge transfer rate and mobilities were estimated for charge transport along a one dimensional pathway. Heteroatom substitution with selenium yields electron transfer integral values ∼0.3 eV with a relative disc orientation of 25°, which is the preferred angle according to the dimer energy profile. All the results indicate that the tetraselenium-substituted derivative, not synthetized so far, could be a promising candidate among those studied in this work for the fabrication of n-type semiconductors based on columnar discotic liquid crystals materials.

  14. Imaginal Disc Abnormalities in Lethal Mutants of Drosophila

    PubMed Central

    Shearn, Allen; Rice, Thomas; Garen, Alan; Gehring, Walter

    1971-01-01

    Late lethal mutants of Drosophila melanogaster, dying after the larval stage of development, were isolated. The homozygous mutant larvae were examined for abnormal imaginal disc morphology, and the discs were injected into normal larval hosts to test their capacities to differentiate into adult structures. In about half of the mutants analyzed, disc abnormalities were found. Included among the abnormalities were missing discs, small discs incapable of differentiating, morphologically normal discs with limited capacities for differentiation, and discs with homeotic transformations. In some mutants all discs were affected, and in others only certain discs. The most extreme abnormal phenotype is a class of “discless” mutants. The viability of these mutant larvae indicates that the discs are essential only for the development of an adult and not of a larva. The late lethals are therefore a major source of mutants for studying the genetic control of disc formation. Images PMID:5002822

  15. Intermediate mass black holes in AGN discs - I. Production and growth

    NASA Astrophysics Data System (ADS)

    McKernan, B.; Ford, K. E. S.; Lyra, W.; Perets, H. B.

    2012-09-01

    Here we propose a mechanism for efficiently growing intermediate mass black holes (IMBH) in discs around supermassive black holes. Stellar mass objects can efficiently agglomerate when facilitated by the gas disc. Stars, compact objects and binaries can migrate, accrete and merge within discs around supermassive black holes. While dynamical heating by cusp stars excites the velocity dispersion of nuclear cluster objects (NCOs) in the disc, gas in the disc damps NCO orbits. If gas damping dominates, NCOs remain in the disc with circularized orbits and large collision cross-sections. IMBH seeds can grow extremely rapidly by collisions with disc NCOs at low relative velocities, allowing for super-Eddington growth rates. Once an IMBH seed has cleared out its feeding zone of disc NCOs, growth of IMBH seeds can become dominated by gas accretion from the active galactic nucleus (AGN) disc. However, the IMBH can migrate in the disc and expand its feeding zone, permitting a super-Eddington accretion rate to continue. Growth of IMBH seeds via NCO collisions is enhanced by a pile-up of migrators. We highlight the remarkable parallel between the growth of IMBH in AGN discs with models of giant planet growth in protoplanetary discs. If an IMBH becomes massive enough it can open a gap in the AGN disc. IMBH migration in AGN discs may stall, allowing them to survive the end of the AGN phase and remain in galactic nuclei. Our proposed mechanisms should be more efficient at growing IMBH in AGN discs than the standard model of IMBH growth in stellar clusters. Dynamical heating of disc NCOs by cusp stars is transferred to the gas in an AGN disc helping to maintain the outer disc against gravitational instability. Model predictions, observational constraints and implications are discussed in a companion paper (Paper II).

  16. Empathy and Social-Emotional Learning: Pitfalls and Touchstones for School-Based Programs

    ERIC Educational Resources Information Center

    Maxwell, Bruce; DesRoches, Sarah

    2010-01-01

    This chapter identifies three common pitfalls in the use of the concept of empathy in formal social-emotional learning interventions: (1) not distinguishing between affective and cognitive empathy ("equivocation"); (2) overestimating the role of the imagination in empathizing ("Piaget's fallacy"); and (3) not accommodating the developmental and…

  17. Encounter Co-Training: Benefits and Pitfalls

    ERIC Educational Resources Information Center

    Lundberg, Joan, Lundberg, Craig

    1974-01-01

    The authors promote the position that the benefits tend to exceed the pitfalls of dual facilitation of intense small group experience and should become a more standard feature of laboratory training, for reasons of new trainer development, better learning experience for participants, and continuing skill development of experienced trainers. (AJ)

  18. Pitfalls

    NASA Technical Reports Server (NTRS)

    Triffet, Terry

    1990-01-01

    Though potentially of great benefit to the nation, the experience of the workshop participants and their discussions with Sea Grant and Land Grant officials make it clear that the Space Grant Program must avoid certain pitfalls of the past and present if it is to be successful. The most important of these are listed and briefly discussed.

  19. Synthesis of perfluoroalkylene aromatic diamines

    NASA Technical Reports Server (NTRS)

    Paciorek, K. L.; Ito, T. I.; Nakahara, J. H.; Kratzer, R. H.

    1978-01-01

    Analogues of methylene dianilines were synthesized, in which the methylene group between the two aromatic nuclei was replaced by various perfluoroalkylene linkage. The hydrolytic thermal, and thermal oxidative stabilities of PMR Polyimides derived from these diamines were determined. Three types of PMR Polyimide discs were fabricated from the dimethyl ester of 3,3', 4,4'-benzophenonetetracarboxylic acid, the methyl ester of 5-norbornene-2,3-dicarboxylic acid, and one of the following three diamines: methyl dianiline, 1,3-bis(4-aminophenyl)hexafluoropropane, and 2,2-bis(4-aminophenyl)hexafluoropropane. The polyimide based on 2,2-bis(4-aminophenyl)hexafluoropropane exhibited the best hydrolytic, thermal, and thermal oxidative stability as determined by moisture uptake and thermogravimetric analysis.

  20. Drill bit assembly for releasably retaining a drill bit cutter

    DOEpatents

    Glowka, David A.; Raymond, David W.

    2002-01-01

    A drill bit assembly is provided for releasably retaining a polycrystalline diamond compact drill bit cutter. Two adjacent cavities formed in a drill bit body house, respectively, the disc-shaped drill bit cutter and a wedge-shaped cutter lock element with a removable fastener. The cutter lock element engages one flat surface of the cutter to retain the cutter in its cavity. The drill bit assembly thus enables the cutter to be locked against axial and/or rotational movement while still providing for easy removal of a worn or damaged cutter. The ability to adjust and replace cutters in the field reduces the effect of wear, helps maintains performance and improves drilling efficiency.

  1. The effect of parental factors in children with large cup-to-disc ratios.

    PubMed

    Park, Hae-Young Lopilly; Ha, Min Ji; Shin, Sun Young

    2017-01-01

    To investigate large cup-to-disc ratios (CDR) in children and to determine the relationship between parental CDR and clinical characteristics associated with glaucoma. Two hundred thirty six children aged 6 to 12 years with CDR ≥ 0.6 were enrolled in this study. Subjects were classified into two groups based on parental CDR: disc suspect children with disc suspect (CDR ≥0.6) parents and disc suspect children without disc suspect parents. Ocular variables were compared between the two groups. Of the 236 disc suspect children, 100 (42.4%) had at least one disc suspect parent. Intraocular pressure (IOP) was higher in disc suspect children with disc suspect parents (16.52±2.66 mmHg) than in disc suspect children without disc suspect parents (14.38±2.30 mmHg, p = 0.023). In the group with disc suspect parents, vertical CDR significantly correlated with IOP (R = -0.325, p = 0.001), average retinal nerve fiber layer (RNFL) thickness (R = -0.319, p = 0.001), rim area (R = -0.740, p = 0.001), and cup volume (R = 0.499, p = 0.001). However, spherical equivalent (R = 0.333, p = 0.001), AL (R = -0.223, p = 0.009), and disc area (R = 0.325, p = 0.001) significantly correlated with vertical CDR in disc suspect children without disc suspect parents, in contrast to those with disc suspect parents. Larger vertical CDR was associated with the presence of disc suspect parents (p = 0.001), larger disc area (p = 0.001), thinner rim area (p = 0.001), larger average CDR (p = 0.001), and larger cup volume (p = 0.021). Family history of large CDR was a significant factor associated with large vertical CDR in children. In children with disc suspect parents, there were significant correlations between IOP and average RNFL thickness and vertical CDR.

  2. Effects of disc warping on the inclination evolution of star-disc-binary systems

    NASA Astrophysics Data System (ADS)

    Zanazzi, J. J.; Lai, Dong

    2018-07-01

    Several recent studies have suggested that circumstellar discs in young stellar binaries may be driven into misalignement with their host stars due to the secular gravitational interactions between the star, disc, and the binary companion. The disc in such systems is twisted/warped due to the gravitational torques from the oblate central star and the external companion. We calculate the disc warp profile, taking into account the bending wave propagation and viscosity in the disc. We show that for typical protostellar disc parameters, the disc warp is small, thereby justifying the `flat-disc' approximation adopted in previous theoretical studies. However, the viscous dissipation associated with the small disc warp/twist tends to drive the disc towards alignment with the binary or the central star. We calculate the relevant time-scales for the alignment. We find that the alignment is effective for sufficiently cold discs with strong external torques, especially for systems with rapidly rotating stars, but is ineffective for the majority of the star-disc-binary systems. Viscous warp-driven alignment may be necessary to account for the observed spin-orbit alignment in multiplanet systems if these systems are accompanied by an inclined binary companion.

  3. Simulating Dynamic Equilibria: A Class Experiment

    NASA Astrophysics Data System (ADS)

    Harrison, John A.; Buckley, Paul D.

    2000-08-01

    A first-order reversible reaction is simulated on an overhead projector using small coins or discs. A simulation is carried out in which initially there are 24 discs representing reactant A and none representing reactant B. At the end of each minute half of the reactant A discs get converted to reactant B, and one quarter of the reactant B discs get converted to reactant A discs. Equilibrium is established with 8 A discs and 16 B discs, and no further net change is observed as the simulation continues. Another simulation beginning with 48 A discs and 0 B discs leads at equilibrium to 16 A discs and 32 B discs. These results illustrate how dynamic equilibria are established and allow the introduction of the concept of an equilibrium constant. Le Châtelier's principle is illustrated by further simulations.

  4. Gas turbine sealing apparatus

    DOEpatents

    Wiebe, David J; Wessell, Brian J; Ebert, Todd; Beeck, Alexander; Liang, George; Marussich, Walter H

    2013-02-19

    A gas turbine includes forward and aft rows of rotatable blades, a row of stationary vanes between the forward and aft rows of rotatable blades, an annular intermediate disc, and a seal housing apparatus. The forward and aft rows of rotatable blades are coupled to respective first and second portions of a disc/rotor assembly. The annular intermediate disc is coupled to the disc/rotor assembly so as to be rotatable with the disc/rotor assembly during operation of the gas turbine. The annular intermediate disc includes a forward side coupled to the first portion of the disc/rotor assembly and an aft side coupled to the second portion of the disc/rotor assembly. The seal housing apparatus is coupled to the annular intermediate disc so as to be rotatable with the annular intermediate disc and the disc/rotor assembly during operation of the gas turbine.

  5. Manipulator having thermally conductive rotary joint for transferring heat from a test specimen

    DOEpatents

    Haney, S.J.; Stulen, R.H.; Toly, N.F.

    1983-05-03

    A manipulator for rotatably moving a test specimen in an ultra-high vacuum chamber includes a translational unit movable in three mutually perpendicular directions. A manipulator frame is rigidly secured to the translational unit for rotatably supporting a rotary shaft. A first copper disc is rigidly secured to an end of the rotary shaft for rotary movement within the vacuum chamber. A second copper disc is supported upon the first disc. The second disc receives a cryogenic cold head and does not rotate with the first disc. The second disc receives a cryogenic cold head and does not rotate with the first disc. A sapphire plate is interposed between the first and second discs to prevent galling of the copper material while maintaining high thermal conductivity between the first and second discs. A spring is disposed on the shaft to urge the second disc toward the first disc and compressingly engage the interposed sapphire plate. A specimen mount is secured to the first disc for rotation within the vacuum chamber. The specimen maintains high thermal conductivity with the second disc receiving the cryogenic transfer line.

  6. On the diversity and statistical properties of protostellar discs

    NASA Astrophysics Data System (ADS)

    Bate, Matthew R.

    2018-04-01

    We present results from the first population synthesis study of protostellar discs. We analyse the evolution and properties of a large sample of protostellar discs formed in a radiation hydrodynamical simulation of star cluster formation. Due to the chaotic nature of the star formation process, we find an enormous diversity of young protostellar discs, including misaligned discs, and discs whose orientations vary with time. Star-disc interactions truncate discs and produce multiple systems. Discs may be destroyed in dynamical encounters and/or through ram-pressure stripping, but reform by later gas accretion. We quantify the distributions of disc mass and radii for protostellar ages up to ≈105 yr. For low-mass protostars, disc masses tend to increase with both age and protostellar mass. Disc radii range from of order 10 to a few hundred au, grow in size on time-scales ≲ 104 yr, and are smaller around lower mass protostars. The radial surface density profiles of isolated protostellar discs are flatter than the minimum mass solar nebula model, typically scaling as Σ ∝ r-1. Disc to protostar mass ratios rarely exceed two, with a typical range of Md/M* = 0.1-1 to ages ≲ 104 yr and decreasing thereafter. We quantify the relative orientation angles of circumstellar discs and the orbit of bound pairs of protostars, finding a preference for alignment that strengths with decreasing separation. We also investigate how the orientations of the outer parts of discs differ from the protostellar and inner disc spins for isolated protostars and pairs.

  7. Novel localized heating technique on centrifugal microfluidic disc with wireless temperature monitoring system.

    PubMed

    Joseph, Karunan; Ibrahim, Fatimah; Cho, Jongman

    2015-01-01

    Recent advances in the field of centrifugal microfluidic disc suggest the need for electrical interface in the disc to perform active biomedical assays. In this paper, we have demonstrated an active application powered by the energy harvested from the rotation of the centrifugal microfluidic disc. A novel integration of power harvester disc onto centrifugal microfluidic disc to perform localized heating technique is the main idea of our paper. The power harvester disc utilizing electromagnetic induction mechanism generates electrical energy from the rotation of the disc. This contributes to the heat generation by the embedded heater on the localized heating disc. The main characteristic observed in our experiment is the heating pattern in relative to the rotation of the disc. The heating pattern is monitored wirelessly with a digital temperature sensing system also embedded on the disc. Maximum temperature achieved is 82 °C at rotational speed of 2000 RPM. The technique proves to be effective for continuous heating without the need to stop the centrifugal motion of the disc.

  8. Linear analysis of the evolution of nearly polar low-mass circumbinary discs

    NASA Astrophysics Data System (ADS)

    Lubow, Stephen H.; Martin, Rebecca G.

    2018-01-01

    In a recent paper Martin & Lubow showed through simulations that an initially tilted disc around an eccentric binary can evolve to polar alignment in which the disc lies perpendicular to the binary orbital plane. We apply linear theory to show both analytically and numerically that a nearly polar aligned low-mass circumbinary disc evolves to polar alignment and determine the alignment time-scale. Significant disc evolution towards the polar state around moderately eccentric binaries can occur for typical protostellar disc parameters in less than a typical disc lifetime for binaries with orbital periods of order 100 yr or less. Resonant torques are much less effective at truncating the inner parts of circumbinary polar discs than the inner parts of coplanar discs. For polar discs, they vanish for a binary eccentricity of unity. The results agree with the simulations in showing that discs can evolve to a polar state. Circumbinary planets may then form in such discs and reside on polar orbits.

  9. Comparative Effectiveness Research in Pediatric Respiratory Disease: Promise and Pitfalls.

    PubMed

    Ramos, Kathleen J; Somayaji, Ranjani; Nichols, David P; Goss, Christopher H

    2018-02-01

    Comparative effectiveness research (CER) has become increasing central to clinical research in medicine. CER seeks to conduct clinical trials that compare different commonly used interventions in real-world settings (pragmatic clinical trials) and use a multitude of sources of evidence (including registries and cohort studies) to inform clinical decision making. CER also ensures that stakeholders (patients, families, care providers, insurers) have a voice in the research process by integrating formal stakeholder engagement as part of the research. This innovative approach to clinical research has distinct benefits and pitfalls. This review first defines what CER is and then describes some of its benefits and then pitfalls. The focus is on the role of CER in pediatrics.

  10. Herpetological Monitoring Using a Pitfall Trapping Design in Southern California

    USGS Publications Warehouse

    Fisher, Robert; Stokes, Drew; Rochester, Carlton; Brehme, Cheryl; Hathaway, Stacie; Case, Ted

    2008-01-01

    The steps necessary to conduct a pitfall trapping survey for small terrestrial vertebrates are presented. Descriptions of the materials needed and the methods to build trapping equipment from raw materials are discussed. Recommended data collection techniques are given along with suggested data fields. Animal specimen processing procedures, including toe- and scale-clipping, are described for lizards, snakes, frogs, and salamanders. Methods are presented for conducting vegetation surveys that can be used to classify the environment associated with each pitfall trap array. Techniques for data storage and presentation are given based on commonly use computer applications. As with any study, much consideration should be given to the study design and methods before beginning any data collection effort.

  11. Potential Pitfalls Related to Space-Based Lidar Remote Sensing of the Earth with an Emphasis on Wind Measurement

    NASA Technical Reports Server (NTRS)

    Kavaya, Michael J.; Spiers, Gary D.; Frehlich, Rod G.; Arnold, James E. (Technical Monitor)

    2000-01-01

    A collection of issues is discussed that are potential pitfalls, if handled incorrectly, for earth-orbiting lidar remote sensing instruments. These issues arise due to the long target ranges, high lidar-to-target relative velocities, low signal levels, use of laser scanners, and other unique aspects of using lasers in earth orbit. Consequences of misunderstanding these topics range from minor inconvenience to improper calibration to total failure. We will focus on wind measurement using coherent detection Doppler lidar, but many of the potential pitfalls apply also to noncoherent lidar wind measurement, and to measurement of parameters other than wind. Each area will be identified as to its applicability.

  12. Twinkling artifact on color Doppler ultrasound: an advantage or a pitfall?

    PubMed

    Ozan, Ebru; Atac, Gokce Kaan; Gundogdu, Sadi

    2016-07-01

    The twinkling artifact (TA) or color comet-tail artifact is characterized by a rapidly changing mixture of red and blue color Doppler signals. Even though many diseases and clinical conditions have been shown to produce this artifact, its source is not clearly understood yet. The TA may provide additional information to gray-scale ultrasound findings in several clinical situations. However, there may be pitfalls to keep in mind. We must first be aware of the TA to benefit from the advantages and avoid the pitfalls. In this review, we aim to give practicing radiologists an overview of the mechanisms and clinical applications of the TA by illustrating sample cases we have encountered.

  13. A new in vivo animal model to create intervertebral disc degeneration characterized by MRI, radiography, CT/discogram, biochemistry, and histology.

    PubMed

    Zhou, HaoWei; Hou, ShuXun; Shang, WeiLin; Wu, WenWen; Cheng, Yao; Mei, Fang; Peng, BaoGan

    2007-04-15

    A new in vivo sheep model was developed that produced disc degeneration through the injection of 5-bromodeoxyuridine (BrdU) into the intervertebral disc. This process was studied using magnetic resonance imaging (MRI), radiography, CT/discogram, histology, and biochemistry. To develop a sheep model of intervertebral disc degeneration that more faithfully mimics the pathologic hallmarks of human intervertebral disc degeneration. Recent studies have shown age-related alterations in proteoglycan structure and organization in human intervertebral discs. An animal model that involves the use of age-related changes in disc cells can be beneficial over other more invasive degenerative models that involves directly damaging the matrix of disc tissue. Twelve sheep were injected with BrdU or vehicle (phosphate-buffered saline) into the central region of separate lumbar discs. Intact discs were used as controls. At the 2-, 6-, 10-, and 14-week time points, discs underwent MRI, radiography, histology, and biochemical analyses. A CT/discogram study was performed at the 14-week time point. MRI demonstrated a progressive loss of T2-weighted signal intensity at BrdU-injected discs over the 14-week study period. Radiograph findings included osteophyte and disc space narrowing formed by 10 weeks post-BrdU treatment. CT discography demonstrated internal disc disruption in several BrdU-treated discs at the 14-week time point. Histology showed a progressive loss of the normal architecture and cell density of discs from the 2-week time point to the 14-week time point. A progressive loss of cell proliferation capacity, water content, and proteoglycans was also documented. BrdU injection into the central region of sheep discs resulted in degeneration of intervertebral discs. This progressive, degenerative process was confirmed using MRI, histology, and by observing changes in biochemistry. Degeneration occurred in a manner that was similar to that observed in human disc degeneration.

  14. Are Collapsed Cervical Discs Amenable to Total Disc Arthroplasty?: Analysis of Prospective Clinical Data With 2-Year Follow Up.

    PubMed

    Patwardhan, Avinash G; Carandang, Gerard; Voronov, Leonard I; Havey, Robert M; Paul, Gary A; Lauryssen, Carl; Coric, Domagoj; Dimmig, Thomas; Musante, David

    2016-12-15

    Analysis of prospectively collected radiographic data. To investigate the influence of preoperative index-level range of motion (ROM) and disc height on postoperative ROM after cervical total disc arthroplasty (TDA) using compressible disc prostheses. Clinical studies demonstrate benefits of motion preservation over fusion; however, questions remain unanswered as to which preoperative factors have the ability to identify patients who are most likely to have good postoperative motion, which is the primary rationale for TDA. We analyzed prospectively collected data from a single-arm, multicenter study with 2-year follow up of 30 patients with 48 implanted levels. All received compressible cervical disc prostheses of 6 mm-height (M6C, Spinal Kinetics, Sunnyvale, CA). The influence of index-level preoperative disc height and ROM (each with two levels: below-median and above-median) on postoperative ROM was analyzed using 2 x 2 ANOVA. We further analyzed the radiographic outcomes of a subset of discs with preoperative height less than 3 mm, the so-called "collapsed" discs. Shorter (3.0 ± 0.4 mm) discs were significantly less mobile preoperatively than taller (4.4 ± 0.5 mm) discs (6.7° vs. 10.5°, P = 0.01). The postoperative ROM did not differ between the shorter and taller discs (5.6° vs. 5.0°, P = 0.63). Tall discs that were less mobile preoperatively had significantly smaller postoperative ROM than short discs with above-median preoperative mobility (P < 0.05). The "collapsed discs" (n = 8) were less mobile preoperatively compared with all discs combined (5.1° vs. 8.6°, P < 0.01). These discs were distracted to more than two times the preoperative height, from 2.6 to 5.7 mm, and had significantly greater postoperative ROM than all discs combined (7.6° vs. 5.3°, P < 0.05). We observed a significant interaction between preoperative index-level disc height and ROM in influencing postoperative ROM. Although limited by small sample size, the results suggest discs with preoperative height less than 3 mm may be amenable to disc arthroplasty using compressible disc prostheses. 2.

  15. MANAGEMENT OF ENDOCRINE DISEASE: Pitfalls on the replacement therapy for primary and central hypothyroidism in adults.

    PubMed

    de Carvalho, Gisah Amaral; Paz-Filho, Gilberto; Mesa Junior, Cleo; Graf, Hans

    2018-06-01

    Hypothyroidism is one of the most common hormone deficiencies in adults. Most of the cases, particularly those of overt hypothyroidism, are easily diagnosed and managed, with excellent outcomes if treated adequately. However, minor alterations of thyroid function determine nonspecific manifestations. Primary hypothyroidism due to chronic autoimmune thyroiditis is largely the most common cause of thyroid hormone deficiency. Central hypothyroidism is a rare and heterogeneous disorder characterized by decreased thyroid hormone secretion by an otherwise normal thyroid gland, due to lack of TSH. The standard treatment of primary and central hypothyroidism is hormone replacement therapy with levothyroxine sodium (LT4). Treatment guidelines of hypothyroidism recommend monotherapy with LT4 due to its efficacy, long-term experience, favorable side effect profile, ease of administration, good intestinal absorption, long serum half-life and low cost. Despite being easily treatable with a daily dose of LT4, many patients remain hypothyroid due to malabsorption syndromes, autoimmune gastritis, pancreatic and liver disorders, drug interactions, polymorphisms in DIO2 (iodothyronine deiodinase 2), high fiber diet, and more frequently, non-compliance to LT4 therapy. Compliance to levothyroxine treatment in hypothyroidism is compromised by daily and fasting schedule. Many adult patients remain hypothyroid due to all the above mentioned and many attempts to improve levothyroxine therapy compliance and absorption have been made. © 2018 European Society of Endocrinology.

  16. CT morphometry of adult thoracic intervertebral discs.

    PubMed

    Fletcher, Justin G R; Stringer, Mark D; Briggs, Christopher A; Davies, Tilman M; Woodley, Stephanie J

    2015-10-01

    Despite being commonly affected by degenerative disorders, there are few data on normal thoracic intervertebral disc dimensions. A morphometric analysis of adult thoracic intervertebral discs was, therefore, undertaken. Archival computed tomography scans of 128 recently deceased individuals (70 males, 58 females, 20-79 years) with no known spinal pathology were analysed to determine thoracic disc morphometry and variations with disc level, sex and age. Reliability was assessed by intraclass correlation coefficients (ICCs). Anterior and posterior intervertebral disc heights and axial dimensions were significantly greater in men (anterior disc height 4.0±1.4 vs 3.6±1.3 mm; posterior disc height 3.6±0.90 vs 3.4±0.93 mm; p<0.01). Disc heights and axial dimensions at T4-5 were similar or smaller than at T2-3, but thereafter increased caudally (mean anterior disc height T4-5 and T10-11, 2.7±0.7 and 5.4±1.2 mm, respectively, in men; 2.6±0.8 and 5.1±1.3 mm, respectively, in women; p<0.05). Except at T2-3, anterior disc height decreased with advancing age and anteroposterior and transverse disc dimensions increased; posterior and middle disc heights and indices of disc shape showed no consistent statistically significant changes. Most parameters showed substantial to almost perfect agreement for intra- and inter-rater reliability. Thoracic disc morphometry varies significantly and consistently with disc level, sex and age. This study provides unique reference data on adult thoracic intervertebral disc morphometry, which may be useful when interpreting pathological changes and for future biomechanical and functional studies.

  17. European Earwig, Forficula auricularia L. (Dermaptera: Forficulidae) at the Hanford Reach National Monument, Washington State

    USDA-ARS?s Scientific Manuscript database

    The European earwig, Forficula auricularia L., was surveyed using pitfall traps at three sites at the Hanford Reach National Monument in south central Washington state. Pitfall traps were collected weekly from April 2002 through April 2003. The earwig was consistently taken during all months of the...

  18. An Ethnographic Eye on Religion in Everyday Life

    ERIC Educational Resources Information Center

    Berglund, Jenny

    2014-01-01

    There are many pitfalls associated with teaching about religions. One such pitfall entails the risk of presenting religions as stereotypical monolithic systems; that is, all who belong to a particular religious tradition think and act in the same way. I like to call this sort of stereotyping the "robotic tendency" because it has a habit…

  19. Waiver Applicants Steer Wary Course

    ERIC Educational Resources Information Center

    McNeil, Michele

    2012-01-01

    The latest batch of states seeking relief under the No Child Left Behind Act dodge pitfalls that tripped up the first round of applicants. In the latest round of applications for waivers under the No Child Left Behind Act, states have learned lessons from their predecessors and dodged pitfalls that triggered some big revisions from first-round…

  20. Cases on Global E-Learning Practices: Successes and Pitfalls

    ERIC Educational Resources Information Center

    Sharma, Ramesh C., Ed.; Mishra, Sanjaya, Ed.

    2007-01-01

    "Cases on Global E-Learning Practices: Successes and Pitfalls" looks into global practices of e-learning, examining the successes and failures of e-learning professionals. It provides a judicious mix of practical experiences and research in the form of case studies. Written by experts from all over the globe, this book shows how to…

  1. Common pitfalls in statistical analysis: Linear regression analysis

    PubMed Central

    Aggarwal, Rakesh; Ranganathan, Priya

    2017-01-01

    In a previous article in this series, we explained correlation analysis which describes the strength of relationship between two continuous variables. In this article, we deal with linear regression analysis which predicts the value of one continuous variable from another. We also discuss the assumptions and pitfalls associated with this analysis. PMID:28447022

  2. A Comparison of the Pitfall Trap, Winkler Extractor and Berlese Funnel for Sampling Ground-Dwelling Arthropods in Tropical Montane Cloud Forests

    PubMed Central

    Sabu, Thomas K.; Shiju, Raj T.; Vinod, KV.; Nithya, S.

    2011-01-01

    Little is known about the ground-dwelling arthropod diversity in tropical montane cloud forests (TMCF). Due to unique habitat conditions in TMCFs with continuously wet substrates and a waterlogged forest floor along with the innate biases of the pitfall trap, Berlese funnel and Winkler extractor are certain to make it difficult to choose the most appropriate method to sample the ground-dwelling arthropods in TMCFs. Among the three methods, the Winkler extractor was the most efficient method for quantitative data and pitfall trapping for qualitative data for most groups. Inclusion of floatation method as a complementary method along with the Winkler extractor would enable a comprehensive quantitative survey of ground-dwelling arthropods. Pitfall trapping is essential for both quantitative and qualitative sampling of Diplopoda, Opiliones, Orthoptera, and Diptera. The Winkler extractor was the best quantitative method for Psocoptera, Araneae, Isopoda, and Formicidae; and the Berlese funnel was best for Collembola and Chilopoda. For larval forms of different insect orders and the Acari, all the three methods were equally effective. PMID:21529148

  3. Technical features and criteria in designing fiber-reinforced composite materials: from the aerospace and aeronautical field to biomedical applications.

    PubMed

    Gloria, Antonio; Ronca, Dante; Russo, Teresa; D'Amora, Ugo; Chierchia, Marianna; De Santis, Roberto; Nicolais, Luigi; Ambrosio, Luigi

    2011-01-01

    Polymer-based composite materials are ideal for applications where high stiffness-to-weight and strength-to-weight ratios are required. From aerospace and aeronautical field to biomedical applications, fiber-reinforced polymers have replaced metals, thus emerging as an interesting alternative. As widely reported, the mechanical behavior of the composite materials involves investigation on micro- and macro-scale, taking into consideration micromechanics, macromechanics and lamination theory. Clinical situations often require repairing connective tissues and the use of composite materials may be suitable for these applications because of the possibility to design tissue substitutes or implants with the required mechanical properties. Accordingly, this review aims at stressing the importance of fiber-reinforced composite materials to make advanced and biomimetic prostheses with tailored mechanical properties, starting from the basic principle design, technologies, and a brief overview of composites applications in several fields. Fiber-reinforced composite materials for artificial tendons, ligaments, and intervertebral discs, as well as for hip stems and mandible models will be reviewed, highlighting the possibility to mimic the mechanical properties of the soft and hard tissues that they replace.

  4. Quantitating Human Optic Disc Topography

    NASA Astrophysics Data System (ADS)

    Graebel, William P.; Cohan, Bruce E.; Pearch, Andrew C.

    1980-07-01

    A method is presented for quantitatively expressing the topography of the human optic disc, applicable in a clinical setting to the diagnosis and management of glaucoma. Pho-tographs of the disc illuminated by a pattern of fine, high contrast parallel lines are digitized. From the measured deviation of the lines as they traverse the disc surface, disc topography is calculated, using the principles of optical sectioning. The quantitators applied to express this topography have the the following advantages : sensitivity to disc shape; objectivity; going beyond the limits of cup-disc ratio estimates and volume calculations; perfect generality in a mathematical sense; an inherent scheme for determining a non-subjective reference frame to compare different discs or the same disc over time.

  5. Asymmetric MHD outflows/jets from accreting T Tauri stars

    NASA Astrophysics Data System (ADS)

    Dyda, S.; Lovelace, R. V. E.; Ustyugova, G. V.; Lii, P. S.; Romanova, M. M.; Koldoba, A. V.

    2015-06-01

    Observations of jets from young stellar objects reveal the asymmetric outflows from some sources. A large set of 2.5D magnetohydrodynamic simulations was carried out for axisymmetric viscous/diffusive disc accretion to rotating magnetized stars for the purpose of assessing the conditions where the outflows are asymmetric relative to the equatorial plane. We consider initial magnetic fields that are symmetric about the equatorial plane and consist of a radially distributed field threading the disc (disc field) and a stellar dipole field. (1) For pure disc-fields the symmetry or asymmetry of the outflows is affected by the mid-plane plasma β of the disc. For discs with small plasma β, outflows are symmetric to within 10 per cent over time-scales of hundreds of inner disc orbits. For higher β discs, the coupling of the upper and lower coronal plasmas is broken, and quasi-periodic field motion leads to asymmetric episodic outflows. (2) Accreting stars with a stellar dipole field and no disc-field exhibit episodic, two component outflows - a magnetospheric wind and an inner disc wind. Both are characterized by similar velocity profiles but the magnetospheric wind has densities ≳ 10 times that of the disc wind. (3) Adding a disc field parallel to the stellar dipole field enhances the magnetospheric winds but suppresses the disc wind. (4) Adding a disc field which is antiparallel to the stellar dipole field in the disc suppresses the magnetospheric and disc winds. Our simulations reproduce some key features of observations of asymmetric outflows of T Tauri stars.

  6. Ranges of Cervical Intervertebral Disc Deformation During an In Vivo Dynamic Flexion–Extension of the Neck

    PubMed Central

    Yu, Yan; Mao, Haiqing; Li, Jing-Sheng; Tsai, Tsung-Yuan; Cheng, Liming; Wood, Kirkham B.; Li, Guoan; Cha, Thomas D.

    2017-01-01

    While abnormal loading is widely believed to cause cervical spine disc diseases, in vivo cervical disc deformation during dynamic neck motion has not been well delineated. This study investigated the range of cervical disc deformation during an in vivo functional flexion–extension of the neck. Ten asymptomatic human subjects were tested using a combined dual fluoroscopic imaging system (DFIS) and magnetic resonance imaging (MRI)-based three-dimensional (3D) modeling technique. Overall disc deformation was determined using the changes of the space geometry between upper and lower endplates of each intervertebral segment (C3/4, C4/5, C5/6, and C6/7). Five points (anterior, center, posterior, left, and right) of each disc were analyzed to examine the disc deformation distributions. The data indicated that between the functional maximum flexion and extension of the neck, the anterior points of the discs experienced large changes of distraction/compression deformation and shear deformation. The higher level discs experienced higher ranges of disc deformation. No significant difference was found in deformation ranges at posterior points of all the discs. The data indicated that the range of disc deformation is disc level dependent and the anterior region experienced larger changes of deformation than the center and posterior regions, except for the C6/7 disc. The data obtained from this study could serve as baseline knowledge for the understanding of the cervical spine disc biomechanics and for investigation of the biomechanical etiology of disc diseases. These data could also provide insights for development of motion preservation surgeries for cervical spine. PMID:28334358

  7. Ranges of Cervical Intervertebral Disc Deformation During an In Vivo Dynamic Flexion-Extension of the Neck.

    PubMed

    Yu, Yan; Mao, Haiqing; Li, Jing-Sheng; Tsai, Tsung-Yuan; Cheng, Liming; Wood, Kirkham B; Li, Guoan; Cha, Thomas D

    2017-06-01

    While abnormal loading is widely believed to cause cervical spine disc diseases, in vivo cervical disc deformation during dynamic neck motion has not been well delineated. This study investigated the range of cervical disc deformation during an in vivo functional flexion-extension of the neck. Ten asymptomatic human subjects were tested using a combined dual fluoroscopic imaging system (DFIS) and magnetic resonance imaging (MRI)-based three-dimensional (3D) modeling technique. Overall disc deformation was determined using the changes of the space geometry between upper and lower endplates of each intervertebral segment (C3/4, C4/5, C5/6, and C6/7). Five points (anterior, center, posterior, left, and right) of each disc were analyzed to examine the disc deformation distributions. The data indicated that between the functional maximum flexion and extension of the neck, the anterior points of the discs experienced large changes of distraction/compression deformation and shear deformation. The higher level discs experienced higher ranges of disc deformation. No significant difference was found in deformation ranges at posterior points of all the discs. The data indicated that the range of disc deformation is disc level dependent and the anterior region experienced larger changes of deformation than the center and posterior regions, except for the C6/7 disc. The data obtained from this study could serve as baseline knowledge for the understanding of the cervical spine disc biomechanics and for investigation of the biomechanical etiology of disc diseases. These data could also provide insights for development of motion preservation surgeries for cervical spine.

  8. The presence of pleiotrophin in the human intervertebral disc is associated with increased vascularization: an immunohistologic study.

    PubMed

    Johnson, William E B; Patterson, Angela M; Eisenstein, Stephen M; Roberts, Sally

    2007-05-20

    An immunohistological study of surgical specimens of human intervertebral disc. To examine the presence of pleiotrophin in diseased or damaged intervertebral disc tissue and the association between its presence and the extent of tissue vascularization and innervation. Increased levels of pleiotrophin, a growth and differentiation factor that is active in various pathophysiologic processes, including angiogenesis, has been associated with osteoarthritic changes of human articular cartilage. The association between pleiotrophin expression and pathologic conditions of the human intervertebral disc is unknown. Specimens of human lumbar intervertebral discs, obtained following surgical discectomy, were divided into 3 groups: non-degenerated discs (n = 7), degenerated discs (n = 6), and prolapsed discs (n = 11). Serial tissue sections of each specimen were immunostained to determine the presence of pleiotrophin, blood vessels (CD34-positive endothelial cells), and nerves (neurofilament 200 kDa [NF200]-positive nerve fibers). Pleiotrophin immunoreactivity was seen in disc cells, endothelial cells, and in the extracellular matrix in most specimens of intervertebral disc but was most prevalent in vascularized tissue in prolapsed discs. There was a significant correlation between the presence of pleiotrophin-positive disc cells and that of CD34-positive blood vessels. NF200-positive nerves were seen in vascularized areas of more degenerated discs, but nerves did not appear to codistribute with blood vessels or pleiotrophin positivity in prolapsed discs. Pleiotrophin is present in pathologic human intervertebral discs, and its prevalence and distribution suggest that it may play a role in neovascularization of diseased or damaged disc tissue.

  9. Reduction of bias and variance for evaluation of computer-aided diagnostic schemes.

    PubMed

    Li, Qiang; Doi, Kunio

    2006-04-01

    Computer-aided diagnostic (CAD) schemes have been developed to assist radiologists in detecting various lesions in medical images. In addition to the development, an equally important problem is the reliable evaluation of the performance levels of various CAD schemes. It is good to see that more and more investigators are employing more reliable evaluation methods such as leave-one-out and cross validation, instead of less reliable methods such as resubstitution, for assessing their CAD schemes. However, the common applications of leave-one-out and cross-validation evaluation methods do not necessarily imply that the estimated performance levels are accurate and precise. Pitfalls often occur in the use of leave-one-out and cross-validation evaluation methods, and they lead to unreliable estimation of performance levels. In this study, we first identified a number of typical pitfalls for the evaluation of CAD schemes, and conducted a Monte Carlo simulation experiment for each of the pitfalls to demonstrate quantitatively the extent of bias and/or variance caused by the pitfall. Our experimental results indicate that considerable bias and variance may exist in the estimated performance levels of CAD schemes if one employs various flawed leave-one-out and cross-validation evaluation methods. In addition, for promoting and utilizing a high standard for reliable evaluation of CAD schemes, we attempt to make recommendations, whenever possible, for overcoming these pitfalls. We believe that, with the recommended evaluation methods, we can considerably reduce the bias and variance in the estimated performance levels of CAD schemes.

  10. Retrieval analysis of motion preserving spinal devices and periprosthetic tissues

    PubMed Central

    Kurtz, Steven M.; Steinbeck, Marla; Ianuzzi, Allyson; van Ooij, André; Punt, Ilona M.; Isaza, Jorge; Ross, E.R.S.

    2009-01-01

    This article reviews certain practical aspects of retrieval analysis for motion preserving spinal implants and periprosthetic tissues as an essential component of the overall revision strategy for these implants. At our institution, we established an international repository for motion-preserving spine implants in 2004. Our repository is currently open to all spine surgeons, and is intended to be inclusive of all cervical and lumbar implant designs such as artificial discs and posterior dynamic stabilization devices. Although a wide range of alternative materials is being investigated for nonfusion spine implants, many of the examples in this review are drawn from our existing repository of metal-on-polyethylene, metal-on-metal lumbar total disc replacements (TDRs), and polyurethane-based dynamic motion preservation devices. These devices are already approved or nearing approval for use in the United States, and hence are the most clinically relevant at the present time. This article summarizes the current literature on the retrieval analysis of these implants and concludes with recommendations for the development of new test methods that are based on the current state of knowledge of in vivo wear and damage mechanisms. Furthermore, the relevance and need to evaluate the surrounding tissue to obtain a complete understanding of the biological reaction to implant component corrosion and wear is reviewed. PMID:25802641

  11. In vitro tests of substitute lubricants for wear testing orthopaedic biomaterials.

    PubMed

    Scholes, Susan C; Joyce, Thomas J

    2013-06-01

    Bovine serum is the lubricant recommended by several international standards for the wear testing of orthopaedic biomaterials; however, there are issues over its use due to batch variation, degradation, cost and safety. For these reasons, alternative lubricants were investigated. A 50-station Super-CTPOD (circularly translating pin-on-disc) wear test rig was used, which applied multidirectional motion to ultra-high-molecular-weight polyethylene test pins rubbing against cobalt chromium discs. Thirteen possible alternative lubricants were tested. The use of soy protein as a lubricant gave statistically higher wear, while soya oil, olive oil, Channel Island milk, whole milk, whey, wheatgerm oil, 11 mg/mL egg white, albumin/globulin mix and albumin/globulin/chondroitin sulphate mix all gave statistically lower wear than bovine serum. The lubricants giving the closest wear results to bovine serum were 20 and 40 mg/mL egg white solutions. A light absorbance assay found that these egg white solutions suffered from a high degradation rate that increased with increasing protein content. While egg white solutions offer the best alternative lubricant to bovine serum due to the wear volumes produced, cost-effectiveness and safety of handling, protein degradation will still occur, leading to the need for regular lubricant replacement. Of the lubricants tested in this study, none were found to be superior to bovine serum.

  12. In-situ photopolymerized and monitored implants: successful application to an intervertebral disc replacement

    NASA Astrophysics Data System (ADS)

    Schmocker, Andreas M.; Khoushabi, Azadeh; Bourban, Pierre-Etienne; Schizas, Constantin; Pioletti, Dominique; Moser, Christophe

    2016-02-01

    Photopolymerization is a common method to harden materials initially in a liquid state. A surgeon can directly trigger the solidification of a dental implant or a bone or tissue filler by using ultra-violet light. Traditionally, photopolymerization has been used mainly in dentistry. Over the last decade advances in material development including a wide range of biocompatible gel- and cement-systems open up a new avenue for in-situ photopolymerization. We designed a miniaturized light probe where a photoactive material can be 1) mixed, pressurized and injected 2) photopolymerized or photoactivated and 3) monitored during the chemical reaction. The device enables surgeries to be conducted through a hole smaller than 500 μm in diameter. Using a combination of Raman and fluorescence spectroscopy, the current state of the photopolymerization was inferred and monitored in real time within an in-vitro tissue model. It was also possible to determine roughly the position of the probe within the tissue cavity by analysing the fluorescence signal. Using the technique hydrogels were successfully implanted into a bovine intervertebral disc model. Mechanical tests could not obstruct the functionality of the implant. Finally, the device was also used for other application such as the implantation of a hydrogel into an aneurysm tissue cavity which will be presented at the conference.

  13. MRI evaluation of spontaneous intervertebral disc degeneration in the alpaca cervical spine.

    PubMed

    Stolworthy, Dean K; Bowden, Anton E; Roeder, Beverly L; Robinson, Todd F; Holland, Jacob G; Christensen, S Loyd; Beatty, Amanda M; Bridgewater, Laura C; Eggett, Dennis L; Wendel, John D; Stieger-Vanegas, Susanne M; Taylor, Meredith D

    2015-12-01

    Animal models have historically provided an appropriate benchmark for understanding human pathology, treatment, and healing, but few animals are known to naturally develop intervertebral disc degeneration. The study of degenerative disc disease and its treatment would greatly benefit from a more comprehensive, and comparable animal model. Alpacas have recently been presented as a potential large animal model of intervertebral disc degeneration due to similarities in spinal posture, disc size, biomechanical flexibility, and natural disc pathology. This research further investigated alpacas by determining the prevalence of intervertebral disc degeneration among an aging alpaca population. Twenty healthy female alpacas comprised two age subgroups (5 young: 2-6 years; and 15 older: 10+ years) and were rated according to the Pfirrmann-grade for degeneration of the cervical intervertebral discs. Incidence rates of degeneration showed strong correlations with age and spinal level: younger alpacas were nearly immune to developing disc degeneration, and in older animals, disc degeneration had an increased incidence rate and severity at lower cervical levels. Advanced disc degeneration was present in at least one of the cervical intervertebral discs of 47% of the older alpacas, and it was most common at the two lowest cervical intervertebral discs. The prevalence of intervertebral disc degeneration encourages further investigation and application of the lower cervical spine of alpacas and similar camelids as a large animal model of intervertebral disc degeneration. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  14. Archival-grade optical disc design and international standards

    NASA Astrophysics Data System (ADS)

    Fujii, Toru; Kojyo, Shinichi; Endo, Akihisa; Kodaira, Takuo; Mori, Fumi; Shimizu, Atsuo

    2015-09-01

    Optical discs currently on the market exhibit large variations in life span among discs, making them unsuitable for certain business applications. To assess and potentially mitigate this problem, we performed accelerated degradation testing under standard ISO conditions, determined the probable disc failure mechanisms, and identified the essential criteria necessary for a stable disc composition. With these criteria as necessary conditions, we analyzed the physical and chemical changes that occur in the disc components, on the basis of which we determined technological measures to reduce these degradation processes. By applying these measures to disc fabrication, we were able to develop highly stable optical discs.

  15. Temperature effects on pitfall catches of epigeal arthropods: a model and method for bias correction.

    PubMed

    Saska, Pavel; van der Werf, Wopke; Hemerik, Lia; Luff, Martin L; Hatten, Timothy D; Honek, Alois; Pocock, Michael

    2013-02-01

    Carabids and other epigeal arthropods make important contributions to biodiversity, food webs and biocontrol of invertebrate pests and weeds. Pitfall trapping is widely used for sampling carabid populations, but this technique yields biased estimates of abundance ('activity-density') because individual activity - which is affected by climatic factors - affects the rate of catch. To date, the impact of temperature on pitfall catches, while suspected to be large, has not been quantified, and no method is available to account for it. This lack of knowledge and the unavailability of a method for bias correction affect the confidence that can be placed on results of ecological field studies based on pitfall data.Here, we develop a simple model for the effect of temperature, assuming a constant proportional change in the rate of catch per °C change in temperature, r , consistent with an exponential Q 10 response to temperature. We fit this model to 38 time series of pitfall catches and accompanying temperature records from the literature, using first differences and other detrending methods to account for seasonality. We use meta-analysis to assess consistency of the estimated parameter r among studies.The mean rate of increase in total catch across data sets was 0·0863 ± 0·0058 per °C of maximum temperature and 0·0497 ± 0·0107 per °C of minimum temperature. Multiple regression analyses of 19 data sets showed that temperature is the key climatic variable affecting total catch. Relationships between temperature and catch were also identified at species level. Correction for temperature bias had substantial effects on seasonal trends of carabid catches. Synthesis and Applications . The effect of temperature on pitfall catches is shown here to be substantial and worthy of consideration when interpreting results of pitfall trapping. The exponential model can be used both for effect estimation and for bias correction of observed data. Correcting for temperature-related trapping bias is straightforward and enables population estimates to be more comparable. It may thus improve data interpretation in ecological, conservation and monitoring studies, and assist in better management and conservation of habitats and ecosystem services. Nevertheless, field ecologists should remain vigilant for other sources of bias.

  16. Thermal analysis of disc brakes using finite element method

    NASA Astrophysics Data System (ADS)

    Jaenudin, Jamari, J.; Tauviqirrahman, M.

    2017-01-01

    Disc brakes are components of a vehicle that serve to slow or stop the rotation of the wheel. This paper discusses the phenomenon of heat distribution on the brake disc during braking. Heat distribution on the brake disc is caused by kinetic energy changing into mechanical energy. Energy changes occur during the braking process due to friction between the surface of the disc and a disc pad. The temperature resulting from this friction rises high. This thermal analysis on brake discs is aimed to evaluate the performance of an electric car in the braking process. The aim of this study is to analyze the thermal behavior of the brake discs using the Finite Element Method (FEM) through examining the heat distribution on the brake disc using 3-D modeling. Results obtained from the FEM reflect the effects of high heat due to the friction between the disc pad with the disc rotor. Results of the simulation study are used to identify the effect of the heat distribution that occurred during the braking process.

  17. Manipulator having thermally conductive rotary joint for transferring heat from a test specimen

    DOEpatents

    Haney, Steven J.; Stulen, Richard H.; Toly, Norman F.

    1985-01-01

    A manipulator for rotatably moving a test specimen in an ultra-high vacuum chamber includes a translational unit movable in three mutually perpendicular directions. A manipulator frame is rigidly secured to the translational unit for rotatably supporting a rotary shaft. A first copper disc is rigidly secured to an end of the rotary shaft for rotary movement within the vacuum chamber. A second copper disc is supported upon the first disc. The second disc receives a cryogenic cold head and does not rotate with the first disc. A sapphire plate is interposed between the first and second discs to prevent galling of the copper material while maintaining high thermal conductivity between the first and second discs. A spring is disposed on the shaft to urge the second disc toward the first disc and compressingly engage the interposed sapphire plate. A specimen mount is secured to the first disc for rotation within the vacuum chamber. The specimen maintains high thermal conductivity with the second disc receiving the cryogenic transfer line.

  18. Cervical total disc replacement exhibits similar stiffness to intact cervical functional spinal units tested on a dynamic pendulum testing system.

    PubMed

    Esmende, Sean M; Daniels, Alan H; Paller, David J; Koruprolu, Sarath; Palumbo, Mark A; Crisco, Joseph J

    2015-01-01

    The pendulum testing system is capable of applying physiologic compressive loads without constraining the motion of functional spinal units (FSUs). The number of cycles to equilibrium observed under pendulum testing is a measure of the energy absorbed by the FSU. To examine the dynamic bending stiffness and energy absorption of the cervical spine, with and without implanted cervical total disc replacement (TDR) under simulated physiologic motion. A biomechanical cadaver investigation. Nine unembalmed, frozen human cervical FSUs from levels C3-C4 and C5-C6 were tested on the pendulum system with axial compressive loads of 25, 50, and 100 N before and after TDR implantation. Testing in flexion, extension, and lateral bending began by rotating the pendulum to 5°, resulting in unconstrained oscillatory motion. The number of rotations to equilibrium was recorded and the bending stiffness (Newton-meter/°) was calculated and compared for each testing mode. In flexion/extension, with increasing compressive loading from 25 to 100 N, the average number of cycles to equilibrium for the intact FSUs increased from 6.6 to 19.1, compared with 4.1 to 12.7 after TDR implantation (p<.05 for loads of 50 and 100 N). In flexion, with increasing compressive loading from 25 to 100 N, the bending stiffness of the intact FSUs increased from 0.27 to 0.59 Nm/°, compared with 0.21 to 0.57 Nm/° after TDR implantation. No significant differences were found in stiffness between the intact FSU and the TDR in flexion/extension and lateral bending at any load (p<.05). Cervical FSUs with implanted TDR were found to have similar stiffness, but had greater energy absorption than intact FSUs during cyclic loading with an unconstrained pendulum system. These results provide further insight into the biomechanical behavior of cervical TDR under approximated physiologic loading conditions. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Comparison of the incidence of patient-reported post-operative dysphagia between ACDF with a traditional anterior plate and artificial cervical disc replacement.

    PubMed

    Yang, Yi; Ma, Litai; Liu, Hao; Liu, Yilian; Hong, Ying; Wang, Beiyu; Ding, Chen; Deng, Yuxiao; Song, Yueming; Liu, Limin

    2016-09-01

    Compared with anterior cervical discectomy and fusion (ACDF), cervical disc replacement (CDR) has provided satisfactory clinical results. The incidence of post-operative dysphagia between ACDF with a traditional anterior plate and CDR remains controversial. Considering the limited studies and knowledge in this area, a retrospective study focusing on post-operative dysphagia was conducted. The Bazaz grading system was used to assess the severity of dysphagia at post-operative intervals including 1 week, 1 month, 3 months, 6 months, 12 months and 24 months respectively. The Chi-square test, Student t-test, Mann-Whitney U tests and Ordinal Logistic regression were used for data analysis when appropriate. Statistical significance was accepted at a probability value of <0.05. Two hundred and thirty-one patients in the CDR group and one hundred and fifty-eight patients in Plate group were included in this study. The total incidences of dysphagia in the CDR and plate group were 36.58% and 60.43% at one week, 29.27% and 38.85% at one month, 21.95% and 31.65% at three months, 6.83% and 17.99% at six months, 5.85% and 14.39% at 12 months, and 4.39% and 10.07% at the final follow-up respectively (All P<0.05, Mann-Whitney U test). Ordinal Logistic regression analysis showed that female patients, two-level surgery, C4/5 surgery, and anterior cervical plating were significant risk factors for post-operative dysphagia (all P<0.05). Comparing ACDF with a plate, CDR with a Prestige LP can significantly reduce both transient and persistent post-operative dysphagia. Female patients, two-level surgery, C4/5 surgery and anterior cervical plating were associated with a higher incidence of dysphagia. Future prospective, randomized, controlled studies are needed to further validate these findings. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Comparison of sagittal parameters for anterior cervical discectomy and fusion, hybrid surgery, and total disc replacement for three levels of cervical spondylosis.

    PubMed

    Hung, Che-Wei; Wu, Ming-Fang; Yu, Gwo-Fane; Ko, Chin-Chu; Kao, Cheng-Hsing

    2018-05-01

    To analyze sagittal balance of the cervical spine after three operative methods for three consecutive levels. A retrospective case selection and observational study was performed from December 2012 to December 2015: 20 patients underwent anterior cervical discectomy and fusion, 22 patients underwent hybrid surgery (HS), and 20 patients underwent total disc replacement (TDR). Perioperative parameters, clinical outcomes, and preoperative and postoperative sagittal parameters were recorded. Clinical outcomes improved. Fusion and hybrid groups were associated with more postoperative focal lordosis than the TDR group (no significant difference). The postoperative C2-7 sagittal vertical axis (SVA) was greater in the TDR group (no significant difference). In the fusion group, the postoperative C2-7 SVA was highly correlated with the preoperative C2-7 SVA and postoperative C7 slope (C7SL). Postoperative C2-7 lordosis (C2-7L) was highly correlated with the preoperative C2-7 SVA and preoperative and postoperative C7SL. In the hybrid group, postoperative C2-7L was highly correlated with preoperative C2-7L, preoperative and postoperative focal lordosis, and C7SL. In the TDR group, the postoperative C2-7 SVA was highly correlated with the preoperative C2-7 SVA and postoperative C7 slope. The postoperative C2-7 SVA was also negatively correlated with postoperative C2-7L and focal lordosis. Postoperative C2-7L was highly correlated with postoperative focal lordosis. For three or more levels of cervical degenerative disease, good clinical outcomes can be achieved. TDR may not be a good choice for large preoperative C2-7 SVA. HS provides good cervical range of motion and restores cervical lordosis and C2-7 SVA. Copyright © 2018 Elsevier B.V. All rights reserved.

  1. Are periprosthetic tissue reactions observed after revision of total disc replacement comparable to the reactions observed after total hip or knee revision surgery?

    PubMed Central

    Punt, Ilona M.; Austen, Shennah; Cleutjens, Jack P.M.; Kurtz, Steven M.; ten Broeke, René H.M.; van Rhijn, Lodewijk W.; Willems, Paul C.; van Ooij, André

    2011-01-01

    Study design Comparative study. Objective To compare periprosthetic tissue reactions observed after total disc replacement (TDR), total hip arthroplasty (THA) and total knee arthroplasty (TKA) revision surgery. Summary of background data Prosthetic wear debris leading to particle disease, followed by osteolysis, is often observed after THA and TKA. Although the presence of polyethylene (PE) particles and periprosthetic inflammation after TDR has been proven recently, osteolysis is rarely observed. The clinical relevance of PE wear debris in the spine remains poorly understood. Methods Number, size and shape of PE particles, as well as quantity and type of inflammatory cells in periprosthetic tissue retrieved during Charité TDR (n=22), THA (n=10) and TKA (n=4) revision surgery were compared. Tissue samples were stained with hematoxylin/eosin and examined by using light microscopy with bright field and polarized light. Results After THA, large numbers of PE particles <6 µm were observed, which were mainly phagocytosed by macrophages. The TKA group had a broad size range with many larger PE particles and more giant cells. In TDR, the size range was similar to that observed in TKA. However, the smallest particles were the most prevalent with 75% of the particles being <6 µm, as seen in revision THA. In TDR, both macrophages and giant cells were present with a higher number of macrophages. Conclusions Both small and large PE particles are present after TDR revision surgery compatible with both THA and TKA wear patterns. The similarities between periprosthetic tissue reactions in the different groups may give more insight in the clinical relevance of PE particles and inflammatory cells in the lumbar spine. The current findings may help to improve TDR design as applied from technologies previously developed in THA and TKA with the goal of a longer survival of TDR. PMID:21336235

  2. Physiotherapeutic Rehabilitation Following Lumbar Total Disc Replacement: A Retrospective Study.

    PubMed

    Green, Adeline; Gilbert, Philippa; Scott-Young, Matthew; Abbott, Allan

    2016-09-01

    This study sought to answer the following questions: What are the outcomes of physiotherapy post lumbar total disc replacement (LTDR) compared with patient self-mediated rehabilitation? Is a difference in outcomes related to the number of physiotherapy sessions? This is a retrospective observational study of 600 patients post TDR. Patient outcomes for self-mediated rehabilitation (Group 1), 1-3 sessions of clinic-based physiotherapy (Group 2) and ≥4 sessions of clinic-based physiotherapy (Group 3) were analysed. Outcomes measures included the Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMQ), Short Form-36 Physical (SF-36 PCS) and Mental Subscale Components (SF-36 MCS), Visual Analogue Scale (VAS) for back and leg pain intensity. Patient's pre-operative baseline measures and post-operative follow-up measures at 3, 6, 12 and 24 months post-operatively were analysed. Oswestry Disability Index and RMQ had significantly lower scores in Group 3 compared with Group 1 at 3, 6, 12 and 24 months follow-up. Significantly lower scores for Group 2 compared with Group 1 were observed for the ODI at 3 months follow-up and for the RMQ at 3 and 6 months follow-up. Significantly lower scores were observed in Group 3 compared with Group 1 for VAS back pain at 3 months and VAS leg pain at 6 months follow-up. Significantly higher scores in Group 3 compared with Group 1 were also observed in the SF-36 PCS at 6, 12 and 24 months. Significantly higher scores in Group 2 compared with Group 1 were observed at 6 months follow up. These trends were also observed when investigating the percentage of patients with a greater 50% improvement in the outcome measure. Physiotherapy post-LTDR produces statistically significant and possibly clinically important improvements in functional disability, pain and quality of life outcomes compared with self-mediated rehabilitation. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

  3. Circumplanetary discs around young giant planets: a comparison between core-accretion and disc instability

    NASA Astrophysics Data System (ADS)

    Szulágyi, J.; Mayer, L.; Quinn, T.

    2017-01-01

    Circumplanetary discs can be found around forming giant planets, regardless of whether core accretion or gravitational instability built the planet. We carried out state-of-the-art hydrodynamical simulations of the circumplanetary discs for both formation scenarios, using as similar initial conditions as possible to unveil possible intrinsic differences in the circumplanetary disc mass and temperature between the two formation mechanisms. We found that the circumplanetary discs' mass linearly scales with the circumstellar disc mass. Therefore, in an equally massive protoplanetary disc, the circumplanetary discs formed in the disc instability model can be only a factor of 8 more massive than their core-accretion counterparts. On the other hand, the bulk circumplanetary disc temperature differs by more than an order of magnitude between the two cases. The subdiscs around planets formed by gravitational instability have a characteristic temperature below 100 K, while the core-accretion circumplanetary discs are hot, with temperatures even greater than 1000 K when embedded in massive, optically thick protoplanetary discs. We explain how this difference can be understood as the natural result of the different formation mechanisms. We argue that the different temperatures should persist up to the point when a full-fledged gas giant forms via disc instability; hence, our result provides a convenient criterion for observations to distinguish between the two main formation scenarios by measuring the bulk temperature in the planet vicinity.

  4. Planet-disc interaction in laminar and turbulent discs

    NASA Astrophysics Data System (ADS)

    Stoll, Moritz H. R.; Picogna, Giovanni; Kley, Wilhelm

    2017-07-01

    In weakly ionised discs turbulence can be generated through the vertical shear instability (VSI). Embedded planets are affected by a stochastic component in the torques acting on them, which can impact their migration. In this work we study the interplay between a growing planet embedded in a protoplanetary disc and the VSI turbulence. We performed a series of 3D hydrodynamical simulations for locally isothermal discs with embedded planets in the mass range from 5 to 100 Earth masses. We study planets embedded in an inviscid disc that is VSI unstable, becomes turbulent, and generates angular momentum transport with an effective α = 5 × 10-4. This is compared to the corresponding viscous disc using exactly this α-value. In general we find that the planets have only a weak impact on the disc turbulence. Only for the largest planet (100 M⊕) does the turbulent activity become enhanced inside of the planet. The depth and width of a gap created by the more massive planets (30,100 M⊕) in the turbulent disc equal exactly that of the corresponding viscous case, leading to very similar torque strengths acting on the planet, with small stochastic fluctuations for the VSI disc. At the gap edges vortices are generated that are stronger and longer-lived in the VSI disc. Low mass planets (with Mp ≤ 10 M⊕) do not open gaps in the disc in either case, but generate for the turbulent disc an overdensity behind the planet that exerts a significant negative torque. This can boost the inward migration in VSI turbulent discs well above the Type I rate. Owing to the finite turbulence level in realistic 3D discs the gap depth will always be limited and migration will not stall in inviscid discs.

  5. Polar alignment of a protoplanetary disc around an eccentric binary II: Effect of binary and disc parameters

    NASA Astrophysics Data System (ADS)

    Martin, Rebecca G.; Lubow, Stephen H.

    2018-06-01

    In a recent paper Martin & Lubow showed that a circumbinary disc around an eccentric binary can undergo damped nodal oscillations that lead to the polar (perpendicular) alignment of the disc relative to the binary orbit. The disc angular momentum vector aligns to the eccentricity vector of the binary. We explore the robustness of this mechanism for a low mass disc (0.001 of the binary mass) and its dependence on system parameters by means of hydrodynamic disc simulations. We describe how the evolution depends upon the disc viscosity, temperature, size, binary mass ratio, orbital eccentricity and inclination. We compare results with predictions of linear theory. We show that polar alignment of a low mass disc may occur over a wide range of binary-disc parameters. We discuss the application of our results to the formation of planetary systems around eccentric binary stars.

  6. Proto-planetary disc evolution and dispersal

    NASA Astrophysics Data System (ADS)

    Rosotti, Giovanni Pietro

    2015-05-01

    Planets form from gas and dust discs in orbit around young stars. The timescale for planet formation is constrained by the lifetime of these discs. The properties of the formed planetary systems depend thus on the evolution and final dispersal of the discs, which is the main topic of this thesis. Observations reveal the existence of a class of discs called "transitional", which lack dust in their inner regions. They are thought to be the last stage before the complete disc dispersal, and hence they may provide the key to understanding the mechanisms behind disc evolution. X-ray photoevaporation and planet formation have been studied as possible physical mechanisms responsible for the final dispersal of discs. However up to now, these two phenomena have been studied separately, neglecting any possible feedback or interaction. In this thesis we have investigated what is the interplay between these two processes. We show that the presence of a giant planet in a photo-evaporating disc can significantly shorten its lifetime, by cutting the inner regions from the mass reservoir in the exterior of the disc. This mechanism produces transition discs that for a given mass accretion rate have larger holes than in models considering only X-ray photo-evaporation, constituting a possible route to the formation of accreting transition discs with large holes. These discs are found in observations and still constitute a puzzle for the theory. Inclusion of the phenomenon called "thermal sweeping", a violent instability that can destroy a whole disc in as little as 10 4 years, shows that the outer disc left can be very short-lived (depending on the X-ray luminosity of the star), possibly explaining why very few non accreting transition discs are observed. However the mechanism does not seem to be efficient enough to reconcile with observations. In this thesis we also show that X-ray photo-evaporation naturally explains the observed correlation between stellar masses and accretion rates and is therefore the ideal candidate for driving disc evolution. Another process that can influence discs is a close encounter with another star. In this thesis we develop a model to study the effect of stellar dynamics in the natal stellar cluster on the discs, following for the first time at the same time the stellar dynamics together with the evolution of the discs. We find that, although close encounters with stars are unlikely to change significantly the mass of a disc, they can change substantially its size, hence imposing an upper limit on the observed disc radii. Finally, we investigated in this thesis whether discs can be reformed after their dispersal. If a star happens to be in a region that is currently forming stars, it can accrete material from the interstellar medium. This mechanism may result in the production of "second generation" discs such that in a given star forming region a few percent of stars may still possess a disc, in tentative agreement with observations of so called "old accretors", which are difficult to explain within the current paradigm of disc evolution and dispersal.

  7. Orbital alignment of circumbinary planets that form in misaligned circumbinary discs: the case of Kepler-413b

    NASA Astrophysics Data System (ADS)

    Pierens, A.; Nelson, R. P.

    2018-06-01

    Although most of the circumbinary planets detected by the Kepler spacecraft are on orbits that are closely aligned with the binary orbital plane, the systems Kepler-413 and Kepler-453 exhibit small misalignments of ˜2.5°. One possibility is that these planets formed in a circumbinary disc whose midplane was inclined relative to the binary orbital plane. Such a configuration is expected to lead to a warped and twisted disc, and our aim is to examine the inclination evolution of planets embedded in these discs. We employed 3D hydrodynamical simulations that examine the disc response to the presence of a modestly inclined binary with parameters that match the Kepler-413 system, as a function of disc parameters and binary inclinations. The discs all develop slowly varying warps, and generally display very small amounts of twist. Very slow solid body precession occurs because a large outer disc radius is adopted. Simulations of planets embedded in these discs resulted in the planet aligning with the binary orbit plane for disc masses close to the minimum mass solar nebular, such that nodal precession of the planet was controlled by the binary. For higher disc masses, the planet maintains near coplanarity with the local disc midplane. Our results suggest that circumbinary planets born in tilted circumbinary discs should align with the binary orbit plane as the disc ages and loses mass, even if the circumbinary disc remains misaligned from the binary orbit. This result has important implications for understanding the origins of the known circumbinary planets.

  8. Integration of Gamification into Course Design: A Noble Endeavor with Potential Pitfalls

    ERIC Educational Resources Information Center

    Moore-Russo, Deborah; Wiss, Andrew; Grabowski, Jeremiah

    2018-01-01

    In this article, we provide a commentary on the current state of gamification in higher education by reviewing the research literature, noting a lack of research focused on the design of gamified postsecondary courses. To address this issue, we discuss four potential pitfalls instructors may encounter when designing gamified learning activities.…

  9. The Pitfalls of Mobile Devices in Learning: A Different View and Implications for Pedagogical Design

    ERIC Educational Resources Information Center

    Ting, Yu-Liang

    2012-01-01

    Studies have been devoted to the design, implementation, and evaluation of mobile learning in practice. A common issue among students' responses toward this type of learning concerns the pitfalls of mobile devices, including small screen, limited input options, and low computational power. As a result, mobile devices are not always perceived by…

  10. Diagnostic pitfalls associated with a large true posterior communicating artery aneurysm: a case report.

    PubMed

    Nagatani, Kimihiro; Otani, Naoki; Seno, Soichiro; Takeuchi, Satoru; Wada, Kojiro; Mori, Kentaro

    2013-10-01

    True posterior communicating artery (PCoA) aneurysm is an aneurysm that originates from the PCoA, and large or giant true PCoA aneurysms are rare. We report a case of a large true PCoA aneurysm successfully clipped after anterior clinoidectomy and discuss the diagnostic pitfalls associated with this rare clinical entity.

  11. Using Malaise traps to sample ground beetles (Coleoptera: Carabidae)

    Treesearch

    Michael D. Ulyshen; James L. Hanula; Scott Horn

    2005-01-01

    Pitfall traps provide an easy and inexpensive way to sample ground-dwelling arthropods (Spence and Niemela 1994; Spence et al. 1997; Abildsnes and Tommeras 2000) and have been used exclusively in many studies of the abundance and diversity of ground beetles (Coleoptera: Carabidae). Despite the popularity of this trapping technique, pitfall traps have many disadvantages...

  12. Proposal Pitfalls Plaguing Researchers: Can Technical Communicators Make a Difference?

    ERIC Educational Resources Information Center

    Lemanski, Steve

    2014-01-01

    The facts bear out that the odds are against most scientific researchers and scholars--especially those just starting out--in their attempts to win funding for their research projects through their grant proposals. In this article, the author takes a close look at some of the proposal-related problems and pitfalls that have historically challenged…

  13. Habitat relationships of amphibians and reptiles in California oak woodlands

    Treesearch

    William M. Block; Michael L. Morrison

    1998-01-01

    We used pitfall traps and time-constrained searches to sample amphibians and reptiles and to describe their habitats in oak woodlands at three areas in California. We captured 766 individuals representing 15 species during pitfall trapping and 333 animals representing 15 species during the time-constrained searches. A total of 19 species were sampled. Across all study...

  14. Common pitfalls in statistical analysis: Clinical versus statistical significance

    PubMed Central

    Ranganathan, Priya; Pramesh, C. S.; Buyse, Marc

    2015-01-01

    In clinical research, study results, which are statistically significant are often interpreted as being clinically important. While statistical significance indicates the reliability of the study results, clinical significance reflects its impact on clinical practice. The third article in this series exploring pitfalls in statistical analysis clarifies the importance of differentiating between statistical significance and clinical significance. PMID:26229754

  15. Common pitfalls in statistical analysis: Understanding the properties of diagnostic tests - Part 1.

    PubMed

    Ranganathan, Priya; Aggarwal, Rakesh

    2018-01-01

    In this article in our series on common pitfalls in statistical analysis, we look at some of the attributes of diagnostic tests (i.e., tests which are used to determine whether an individual does or does not have disease). The next article in this series will focus on further issues related to diagnostic tests.

  16. Audiovisual Bounce-Inducing Effect: Attention Alone Does Not Explain Why the Discs Are Bouncing

    ERIC Educational Resources Information Center

    Grassi, Massimo; Casco, Clara

    2009-01-01

    Two discs moving from opposite points in space, overlapping and stopping at the other disc's starting point, can be seen as either bouncing or streaming through each other. With silent displays, observers report the discs as streaming, whereas if a sound is played when the discs touch each other, observers report the discs as bouncing. The origin…

  17. Reduction of turbulent skin-friction drag by oscillating discs

    NASA Astrophysics Data System (ADS)

    Wise, Daniel; Ricco, Pierre

    2013-11-01

    A new drag-reduction method, based on the active technique proposed by Ricco & Hahn (2013), i.e. steadily rotating flush-mounted discs, is studied by DNS. The effect of sinusoidally oscillating discs on the turbulent channel-flow drag is investigated at Reτ = 180 , based on the friction velocity of the stationary-wall case and the half channel height. A parametric investigation on the disc diameter, tip velocity and oscillation period yielded a maximum drag reduction of 18.5%. Regions of net power saved, calculated by considering the power spent to enforce the disc motion against the viscous resistance of the fluid, are found to reach up to 6.5% for low disc tip velocities. Significantly, the characteristic time-scale for the oscillating disc forcing is double that for the steadily rotating discs, representing a further step towards industrial implementation. The oscillating disc forcing, similar to the steadily rotating disc forcing, creates streamwise-elongated structures between the discs. These structures - largely unaffected by the periodic wall forcing and persisting throughout the entire period of the oscillation - are the main contributor to the additional Reynolds stresses term created by the disc forcing, and are important for the drag reduction mechanism.

  18. Formation of neuronal pathways in the imaginal discs of Drosophila melanogaster.

    PubMed

    Jan, Y N; Ghysen, A; Christoph, I; Barbel, S; Jan, L Y

    1985-09-01

    We have followed the formation of neuronal pathways in different imaginal discs of Drosophila. The pattern is highly reproducible for a given disc type but distinct for each type of discs: in leg discs, several neurons are present before metamorphosis and provide two major pathways that are joined by later neurons; in the wing and haltere discs, a few pairs of neurons appear after the onset of metamorphosis and pioneer the major pathways; in antenna discs, no pioneers are detected before massive neuronal differentiation begins. The mechanisms used for axonal guidance seem common to all discs, and the differences between discs can be accounted for simply by differences in the arrangement and birth time of pioneer neurons. Different subsets of pioneer neurons are deleted by mutations such as scute and engrailed.

  19. Quarantine Regulations and the Impact of Modern Detection Methods.

    PubMed

    Martin, Robert R; Constable, Fiona; Tzanetakis, Ioannis E

    2016-08-04

    Producers worldwide need access to the best plant varieties and cultivars available to be competitive in global markets. This often means moving plants across international borders as soon as they are available. At the same time, quarantine agencies are tasked with minimizing the risk of introducing exotic pests and pathogens along with imported plant material, with the goal to protect domestic agriculture and native fauna and flora. These two drivers, the movement of more plant material and reduced risk of pathogen introduction, are at odds. Improvements in large-scale or next-generation sequencing (NGS) and bioinformatics for data analysis have resulted in improved speed and accuracy of pathogen detection that could facilitate plant trade with reduced risk of pathogen movement. There are concerns to be addressed before NGS can replace existing tools used for pathogen detection in plant quarantine and certification programs. Here, we discuss the advantages and possible pitfalls of this technology for meeting the needs of plant quarantine and certification.

  20. Nanoscale Surface Modifications of Orthopaedic Implants: State of the Art and Perspectives

    PubMed Central

    Staruch, RMT; Griffin, MF; Butler, PEM

    2016-01-01

    Background: Orthopaedic implants such as the total hip or total knee replacement are examples of surgical interventions with postoperative success rates of over 90% at 10 years. Implant failure is associated with wear particles and pain that requires surgical revision. Improving the implant - bone surface interface is a key area for biomaterial research for future clinical applications. Current implants utilise mechanical, chemical or physical methods for surface modification. Methods: A review of all literature concerning the nanoscale surface modification of orthopaedic implant technology was conducted. Results: The techniques and fabrication methods of nanoscale surface modifications are discussed in detail, including benefits and potential pitfalls. Future directions for nanoscale surface technology are explored. Conclusion: Future understanding of the role of mechanical cues and protein adsorption will enable greater flexibility in surface control. The aim of this review is to investigate and summarise the current concepts and future directions for controlling the implant nanosurface to improve interactions. PMID:28217214

  1. The relationship between quantitative measures of disc height and disc signal intensity with Pfirrmann score of disc degeneration.

    PubMed

    Salamat, Sara; Hutchings, John; Kwong, Clemens; Magnussen, John; Hancock, Mark J

    2016-01-01

    To assess the relationship between quantitative measures of disc height and signal intensity with the Pfirrmann disc degeneration scoring system and to test the inter-rater reliability of the quantitative measures. Participants were 76 people who had recently recovered from their last episode of acute low back pain and underwent MRI scan on a single 3T machine. At all 380 lumbar discs, quantitative measures of disc height and signal intensity were made by 2 independent raters and compared to Pfirrmann scores from a single radiologist. For quantitative measures of disc height and signal intensity a "raw" score and 2 adjusted ratios were calculated and the relationship with Pfirrmann scores was assessed. The inter-tester reliability of quantitative measures was also investigated. There was a strong linear relationship between quantitative disc signal intensity and Pfirrmann scores for grades 1-4, but not for grades 4 and 5. For disc height only, Pfirrmann grade 5 had significantly reduced disc height compared to all other grades. Results were similar regardless of whether raw or adjusted scores were used. Inter-rater reliability for the quantitative measures was excellent (ICC > 0.97). Quantitative measures of disc signal intensity were strongly related to Pfirrmann scores from grade 1 to 4; however disc height only differentiated between grade 4 and 5 Pfirrmann scores. Using adjusted ratios for quantitative measures of disc height or signal intensity did not significantly alter the relationship with Pfirrmann scores.

  2. Effects of disc mid-plane evolution on CO snowline location

    NASA Astrophysics Data System (ADS)

    Panić, O.; Min, M.

    2017-05-01

    Temperature changes in the planet forming disc mid-planes carry important physico-chemical consequences, such as the effect on the locations of the condensation fronts of molecules - the snowlines. Snowlines impose major chemical gradients and possibly foster grain growth. The aim of this paper is to understand how disc mid-plane temperature changes with gas and dust evolution, and identify trends that may influence planet formation or allow to constrain disc evolution observationally. We calculate disc temperature, hydrostatic equilibrium and dust settling in a mutually consistent way from a grid of disc models at different stages of gas loss, grain growth and hole opening. We find that the CO snowline location depends very strongly on disc properties. The CO snowline location migrates closer to the star for increasing degrees of gas dispersal and dust growth. Around a typical A-type star, the snowline can be anywhere between several tens and a few hundred au, depending on the disc properties such as gas mass and grain size. In fact, gas loss is as efficient as dust evolution in settling discs, and flat discs may be gas-poor counterparts of flared discs. Our results, in the context of different pre-main-sequence evolution of the luminosity in low- and intermediate-mass stars suggest very different thermal (and hence chemical) histories in these two types of discs. Discs of T Tauri stars settle and cool down, while discs of Herbig Ae stars may remain rather warm throughout the pre-main sequence.

  3. Kozai-Lidov disc instability

    NASA Astrophysics Data System (ADS)

    Lubow, Stephen H.; Ogilvie, Gordon I.

    2017-08-01

    Recent results by Martin et al. showed in 3D smoothed particle hydrodynamics simulations that tilted discs in binary systems can be unstable to the development of global, damped Kozai-Lidov (KL) oscillations in which the discs exchange tilt for eccentricity. We investigate the linear stability of KL modes for tilted inviscid discs under the approximations that the disc eccentricity is small and the disc remains flat. By using 1D equations, we are able to probe regimes of large ratios of outer to inner disc edge radii that are realistic for binary systems of hundreds of astronomical unit separations and are not easily probed by multidimensional simulations. For order unity binary mass ratios, KL instability is possible for a window of disc aspect ratios H/r in the outer parts of a disc that roughly scale as (nb/n)2 ≲ H/r ≲ nb/n, for binary orbital frequency nb and orbital frequency n at the disc outer edge. We present a framework for understanding the zones of instability based on the determination of branches of marginally unstable modes. In general, multiple growing eccentric KL modes can be present in a disc. Coplanar apsidal-nodal precession resonances delineate instability branches. We determine the range of tilt angles for unstable modes as a function of disc aspect ratio. Unlike the KL instability for free particles that involves a critical (minimum) tilt angle, disc instability is possible for any non-zero tilt angle depending on the disc aspect ratio.

  4. Liquid-film electron stripper

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Gavin, B.F.

    1986-12-02

    This patent describes an improved liquid-film electron stripper for high intensity heavy ion beams comprising: at least one rotatable disc mounted in a housing, means for rotating the disc, a liquid reservoir operatively connected to the housing, means for directing liquid from the reservoir onto the rotatable disc for forming a film of liquid as liquid is spun from the disc, the disc being configured to define a sharp edge located at one side of the periphery of the disc, and configured to include a flat, smooth radially outer section located adjacent the sharp edge, the liquid being directed ontomore » the flat, smooth section of the disc, the means for directing liquid onto the disc including a nozzle positioned with respect to the disc so that liquid from the nozzle impinges at about a 90/sup 0/ angle with respect to the flat, smooth surface of the disc, and liquid film terminator means located in spaced relation to the disc and approximately perpendicular to a formed liquid film, the terminator means comprising at least one ribbon of material secured to the housing.« less

  5. Rethinking Black Hole Accretion Discs

    NASA Astrophysics Data System (ADS)

    Salvesen, Greg

    Accretion discs are staples of astrophysics. Tapping into the gravitational potential energy of the accreting material, these discs are highly efficient machines that produce copious radiation and extreme outflows. While interesting in their own right, accretion discs also act as tools to study black holes and directly influence the properties of the Universe. Black hole X-ray binaries are fantastic natural laboratories for studying accretion disc physics and black hole phenomena. Among many of the curious behaviors exhibited by these systems are black hole state transitions -- complicated cycles of dramatic brightening and dimming. Using X-ray observations with high temporal cadence, we show that the evolution of the accretion disc spectrum during black hole state transitions can be described by a variable disc atmospheric structure without invoking a radially truncated disc geometry. The accretion disc spectrum can be a powerful diagnostic for measuring black hole spin if the effects of the disc atmosphere on the emergent spectrum are well-understood; however, properties of the disc atmosphere are largely unconstrained. Using statistical methods, we decompose this black hole spin measurement technique and show that modest uncertainties regarding the disc atmosphere can lead to erroneous spin measurements. The vertical structure of the disc is difficult to constrain due to our ignorance of the contribution to hydrostatic balance by magnetic fields, which are fundamental to the accretion process. Observations of black hole X-ray binaries and the accretion environments near supermassive black holes provide mounting evidence for strong magnetization. Performing numerical simulations of accretion discs in the shearing box approximation, we impose a net vertical magnetic flux that allows us to effectively control the level of disc magnetization. We study how dynamo activity and the properties of turbulence driven by the magnetorotational instability depend on the magnetized state of the gas, spanning weak-to-strong disc magnetization regimes. We also demonstrate that a background poloidal magnetic flux is required to form and sustain a strongly magnetized accretion disc. This thesis motivates the need for understanding how magnetic fields affect the observed spectrum from black hole accretion discs.

  6. Ensuring long-term reliability of the data storage on optical disc

    NASA Astrophysics Data System (ADS)

    Chen, Ken; Pan, Longfa; Xu, Bin; Liu, Wei

    2008-12-01

    "Quality requirements and handling regulation of archival optical disc for electronic records filing" is released by The State Archives Administration of the People's Republic of China (SAAC) on its network in March 2007. This document established a complete operative managing process for optical disc data storage in archives departments. The quality requirements of the optical disc used in archives departments are stipulated. Quality check of the recorded disc before filing is considered to be necessary and the threshold of the parameter of the qualified filing disc is set down. The handling regulations for the staffs in the archives departments are described. Recommended environment conditions of the disc preservation, recording, accessing and testing are presented. The block error rate of the disc is selected as main monitoring parameter of the lifetime of the filing disc and three classes pre-alarm lines are created for marking of different quality check intervals. The strategy of monitoring the variation of the error rate curve of the filing discs and moving the data to a new disc or a new media when the error rate of the disc reaches the third class pre-alarm line will effectively guarantee the data migration before permanent loss. Only when every step of the procedure is strictly implemented, it is believed that long-term reliability of the data storage on optical disc for archives departments can be effectively ensured.

  7. How do accretion discs break?

    NASA Astrophysics Data System (ADS)

    Dogan, Suzan

    2016-07-01

    Accretion discs are common in binary systems, and they are often found to be misaligned with respect to the binary orbit. The gravitational torque from a companion induces nodal precession in misaligned disc orbits. In this study, we first calculate whether this precession is strong enough to overcome the internal disc torques communicating angular momentum. We compare the disc precession torque with the disc viscous torque to determine whether the disc should warp or break. For typical parameters precession wins: the disc breaks into distinct planes that precess effectively independently. To check our analytical findings, we perform 3D hydrodynamical numerical simulations using the PHANTOM smoothed particle hydrodynamics code, and confirm that disc breaking is widespread and enhances accretion on to the central object. For some inclinations, the disc goes through strong Kozai cycles. Disc breaking promotes markedly enhanced and variable accretion and potentially produces high-energy particles or radiation through shocks. This would have significant implications for all binary systems: e.g. accretion outbursts in X-ray binaries and fuelling supermassive black hole (SMBH) binaries. The behaviour we have discussed in this work is relevant to a variety of astrophysical systems, for example X-ray binaries, where the disc plane may be tilted by radiation warping, SMBH binaries, where accretion of misaligned gas can create effectively random inclinations and protostellar binaries, where a disc may be misaligned by a variety of effects such as binary capture/exchange, accretion after binary formation.

  8. Notochord Cells in Intervertebral Disc Development and Degeneration

    PubMed Central

    McCann, Matthew R.; Séguin, Cheryle A.

    2016-01-01

    The intervertebral disc is a complex structure responsible for flexibility, multi-axial motion, and load transmission throughout the spine. Importantly, degeneration of the intervertebral disc is thought to be an initiating factor for back pain. Due to a lack of understanding of the pathways that govern disc degeneration, there are currently no disease-modifying treatments to delay or prevent degenerative disc disease. This review presents an overview of our current understanding of the developmental processes that regulate intervertebral disc formation, with particular emphasis on the role of the notochord and notochord-derived cells in disc homeostasis and how their loss can result in degeneration. We then describe the role of small animal models in understanding the development of the disc and their use to interrogate disc degeneration and associated pathologies. Finally, we highlight essential development pathways that are associated with disc degeneration and/or implicated in the reparative response of the tissue that might serve as targets for future therapeutic approaches. PMID:27252900

  9. Developing NanoFoil-Heated Thin-Film Thermal Battery

    DTIC Science & Technology

    2013-09-01

    buffer discs (in gray) sandwiching the NanoFoil disc (in yellow). Two Microtherm discs (in dark gray) bracketed the sandwich to prevent excessive heat...of the fuse strip with a Microtherm disc. Cathode Electrolyte Anode Microtherm Heat paper NanoFoil Buffer Agilent 34970A 606.5 Nichrome wire Maccor...gray) sandwiching the NanoFoil disc (in yellow). Two Microtherm discs (in dark gray) bracketed the sandwich to prevent excessive heat loss

  10. Is there any relationship between proinflammatory mediator levels in disc material and myelopathy with cervical disc herniation and spondylosis? A non-randomized, prospective clinical study

    PubMed Central

    Asir, Alparslan; Cetinkal, Ahmet; Gedik, Nursal; Kutlay, Ahmet Murat; Çolak, Ahmet; Kurtar, Sedat; Simsek, Hakan

    2007-01-01

    The proinflammatory mediator (PIM) levels were assessed in surgically removed samples of herniated cervical intervertebral discs. The objective of this study was to investigate if there is a correlation between the levels of PIMs in disc material and myelopathy associated with cervical intervertebral disc herniation and spondylosis. The role of proinflammatory mediators in the degeneration of intervertebral disc and the inflammatory effects of disc herniations on radicular pain has been previously published. However, the possible relationship between PIMs and myelopathy related to cervical disc herniation and spondylosis has not been investigated before. Thirty-two patients undergoing surgery for cervical disc herniation and spondylosis were investigated. Surgically obtained disc materials, stored at 70°C, were classified into two groups: cervical disc herniation alone or with myelopathy. Biochemical preparation and solid phase enzyme amplified sensitivity immunoassay (ELISIA) analysis of the samples were performed to assess the concentration of mediators in the samples. Very similar values of interleukin-6 were found in both groups whereas the concentrations of mediators were significantly higher in myelopathy group. This study has demonstrated that PIMs are involved in cervical intervertebral disc degeneration with higher concentrations in the samples associated with myelopathy. PMID:17476536

  11. Proposal for a zero-gravity toilet facility for the space station

    NASA Technical Reports Server (NTRS)

    Fleri, Edgar L., Jr.; Galliano, Paul A.; Harrison, Mark E.; Johnson, William B.; Meyer, Gregory J.

    1989-01-01

    This proposed toilet facility has a straightforward design. It has few moving parts and is easily maintained. Air and water flow provide sanitary movement of the waste. The toilet's chambers are coated with Teflon which, along with the water flow, makes it self-cleaning. An added disinfectant called Betadiene kills any bacteria that may form on the chamber walls. The chair is contoured to take into account the neutral body position and the necessary strain position for defecation. Restraints at the ankles, knees, and midsection hold the body in the chair. The waste is stored in discs of Gortex material which are inside a replaceable storage chamber. This chamber can be removed, capped and stored until eventual return to earth.

  12. Resorbable poly(D,L)lactide plates and screws for osteosynthesis of condylar neck fractures in sheep.

    PubMed

    Rasse, Michael; Moser, Doris; Zahl, Christian; Gerlach, Klaus Louis; Eckelt, Uwe; Loukota, Richard

    2007-01-01

    We made osteotomies in the condylar neck in 12 adult sheep to simulate fractures, and joined the two ends with 2 poly(D,L)lactide (PDLLA) plates and 8 PDLLA screws 2mm in diameter. The animals were killed after 2, 6, and 12 months and bony healing was assessed macroscopically and histologically. The plates and screws remained intact and there was no displacement of the bony ends. The degrading plates, which were still visible in the specimens after 6 months, had been replaced by bone. At 12 months the PDLLA had been resorbed with no foreign body reaction and no resorption of underlying bone. The articular discs showed no signs of degeneration.

  13. Effect of collagen fibre orientation on intervertebral disc torsion mechanics.

    PubMed

    Yang, Bo; O'Connell, Grace D

    2017-12-01

    The intervertebral disc is a complex fibro-cartilaginous material, consisting of a pressurized nucleus pulposus surrounded by the annulus fibrosus, which has an angle-ply structure. Disc injury and degeneration are noted by significant changes in tissue structure and function, which significantly alters stress distribution and disc joint stiffness. Differences in fibre orientation are thought to contribute to changes in disc torsion mechanics. Therefore, the objective of this study was to evaluate the effect of collagen fibre orientation on internal disc mechanics under compression combined with axial rotation. We developed and validated a finite element model (FEM) to delineate changes in disc mechanics due to fibre orientation from differences in material properties. FEM simulations were performed with fibres oriented at [Formula: see text] throughout the disc (uniform by region and fibre layer). The initial model was validated by published experimental results for two load conditions, including [Formula: see text] axial compression and [Formula: see text] axial rotation. Once validated, fibre orientation was rotated by [Formula: see text] or [Formula: see text] towards the horizontal plane, resulting in a decrease in disc joint torsional stiffness. Furthermore, we observed that axial rotation caused a sinusoidal change in disc height and radial bulge, which may be beneficial for nutrient transport. In conclusion, including anatomically relevant fibre angles in disc joint FEMs is important for understanding stress distribution throughout the disc and will be important for understanding potential causes for disc injury. Future models will include regional differences in fibre orientation to better represent the fibre architecture of the native disc.

  14. Regression Analysis of Optical Coherence Tomography Disc Variables for Glaucoma Diagnosis.

    PubMed

    Richter, Grace M; Zhang, Xinbo; Tan, Ou; Francis, Brian A; Chopra, Vikas; Greenfield, David S; Varma, Rohit; Schuman, Joel S; Huang, David

    2016-08-01

    To report diagnostic accuracy of optical coherence tomography (OCT) disc variables using both time-domain (TD) and Fourier-domain (FD) OCT, and to improve the use of OCT disc variable measurements for glaucoma diagnosis through regression analyses that adjust for optic disc size and axial length-based magnification error. Observational, cross-sectional. In total, 180 normal eyes of 112 participants and 180 eyes of 138 participants with perimetric glaucoma from the Advanced Imaging for Glaucoma Study. Diagnostic variables evaluated from TD-OCT and FD-OCT were: disc area, rim area, rim volume, optic nerve head volume, vertical cup-to-disc ratio (CDR), and horizontal CDR. These were compared with overall retinal nerve fiber layer thickness and ganglion cell complex. Regression analyses were performed that corrected for optic disc size and axial length. Area-under-receiver-operating curves (AUROC) were used to assess diagnostic accuracy before and after the adjustments. An index based on multiple logistic regression that combined optic disc variables with axial length was also explored with the aim of improving diagnostic accuracy of disc variables. Comparison of diagnostic accuracy of disc variables, as measured by AUROC. The unadjusted disc variables with the highest diagnostic accuracies were: rim volume for TD-OCT (AUROC=0.864) and vertical CDR (AUROC=0.874) for FD-OCT. Magnification correction significantly worsened diagnostic accuracy for rim variables, and while optic disc size adjustments partially restored diagnostic accuracy, the adjusted AUROCs were still lower. Axial length adjustments to disc variables in the form of multiple logistic regression indices led to a slight but insignificant improvement in diagnostic accuracy. Our various regression approaches were not able to significantly improve disc-based OCT glaucoma diagnosis. However, disc rim area and vertical CDR had very high diagnostic accuracy, and these disc variables can serve to complement additional OCT measurements for diagnosis of glaucoma.

  15. Gravitational Instabilities in a Protosolar-like Disc

    NASA Astrophysics Data System (ADS)

    Evans, Mark Graham

    2018-02-01

    This thesis presents a study of protoplanetary discs around young, low mass protostars. Such discs are believed to be massive enough to develop gravitational instabilities, which subsequently form spiral structures. The dynamical and chemical evolutions of a protosolar-like, gravitationally unstable disc are explored and the spiral structure in the disc is found to shock-heat material. This affects the chemical composition via enhanced desorption rates and endothermic reaction rates and through global mixing of the disc. As a result, the gravitational instability in the model disc leads to transient and permanent changes in the disc chemistry, and also provides a chemically-rich midplane in contrast to simulations of more evolved discs. Secondly, radiative transfer calculations are performed for the dust continuum, and model-tailored grid construction is found to improve the accuracy of the resultant flux images. Continuum observations of the model disc are synthesised and the spiral structure (driven by the gravitational instability) is shown to be readily detectable with ALMA across a range of frequencies, disc inclinations and dust opacities. The derivation of disc mass from the observed flux densities is explored but the method commonly utilised is found to be unreliable and underestimate the disc mass. Therefore, it is concluded that gravitational instabilities could be retrospectively validated in discs previously thought not massive enough to be self-gravitating. Finally, radiative transfer calculations are performed for molecular line transitions. Methods for improving the accuracy of line flux images are explored and the validity of assuming local thermodynamic equilibrium is assessed. Observations of the line fluxes are synthesised without noise and the spiral structure is found to be traced to an extent by all transitions considered, which is not necessarily congruent with the underlying distribution of the molecular species. The disc is seen in absorption in all transitions considered, due to the global mixing of the disc, which suggests absorption features could be a signature of gravitational instability in young protoplanetary discs. The sensitivities required to detect flux originating in spiral features are determined and it is found that a dedicated observation with ALMA should be capable of spatially resolving spiral structure in a Class 0 disc. Whether the spiral structure can be also be determined from spectral features is explored, which is shown to only be reliable with PV diagrams of nearly edge-on discs. The derivation of protostellar mass from PV diagrams is also explored and found to most likely be unreliable for gravitationally unstable discs.

  16. Stand age and habitat influences on salamanders in Appalachian cove hardwood forests

    Treesearch

    W. Mark Ford; Brian R. Chapman; Michael A. Menzel; Richard H. Odom

    2002-01-01

    We surveyed cove hardwood stands aged 15, 25, 50, and ≥85 years following clearcutting in the southern Appalachian Mountains of northern Georgia to assess the effects of stand age and stand habitat characteristics on salamander communities using drift-fence array and pitfall methodologies from May 1994 to April 1995. Over a 60,060 pitfall trapnight effort, we...

  17. Analysis of Factors Enhancing Pitfall in Research and Teaching of the Nigerian University System

    ERIC Educational Resources Information Center

    Ahmed, Tafida; Umar, Kasim; Paul, Chima

    2015-01-01

    The paper analyses factors enhancing pitfall in research and teaching in the Nigerian university system. Using data generated from secondary sources, it was found that so many factors are responsible for the constant decay in teaching and research in the Nigerian universities. The paper however found from literature that the high rate of pitfalls…

  18. Executive Programs for Brazilian Mid-Career Public Managers: Pitfalls and Challenges

    ERIC Educational Resources Information Center

    Pacheco, Regina Silvia; Franzese, Cibele

    2017-01-01

    This paper discusses the challenges of professional education for mid-career public managers at graduate level, pointing out pitfalls to avoid and obstacles to face. Analyzing the Brazilian case, the goal is to raise issues that may also be present in other cases. The main argument developed here is that the puzzle faced by graduate programs on…

  19. The Pitfalls of Valenced Labels and the Benefits of Properly Calibrated Psychological Flexibility

    ERIC Educational Resources Information Center

    McNulty, James K.; Fincham, Frank D.

    2012-01-01

    Replies to comments by Sonja Lyubomirsky (see record 2012-27130-008), Riva Guiseppe (see record 2012-27130-009), and Alan S. Waterman (see record 2012-27130-010) on the original article by McNulty and Fincham (see record 2011-15476-001) regarding the pitfalls of valenced labels and the benefits of properly calibrated psychological flexibility.

  20. How the Irish Became CRT'd? "Greening" Critical Race Theory, and the Pitfalls of a Normative Atlantic State View

    ERIC Educational Resources Information Center

    Kitching, Karl

    2015-01-01

    This article considers the transatlantic use of Critical Race Theory (CRT) frameworks to critically interpret racism in education internationally, and the possibilities and pitfalls this has for understanding racism in Ireland. It argues for the importance of CRT's framework on a number of grounds, but echoes cautions against the assumed, or sole…

  1. Common pitfalls in statistical analysis: “P” values, statistical significance and confidence intervals

    PubMed Central

    Ranganathan, Priya; Pramesh, C. S.; Buyse, Marc

    2015-01-01

    In the second part of a series on pitfalls in statistical analysis, we look at various ways in which a statistically significant study result can be expressed. We debunk some of the myths regarding the ‘P’ value, explain the importance of ‘confidence intervals’ and clarify the importance of including both values in a paper PMID:25878958

  2. Surgery of the ear and the lateral skull base: pitfalls and complications

    PubMed Central

    Schick, Bernhard; Dlugaiczyk, Julia

    2013-01-01

    Surgery of the ear and the lateral skull base is a fascinating, yet challenging field in otorhinolaryngology. A thorough knowledge of the associated complications and pitfalls is indispensable for the surgeon, not only to provide the best possible care to his patients, but also to further improve his surgical skills. Following a summary about general aspects in pre-, intra-and postoperative care of patients with disorders of the ear/lateral skull base, this article covers the most common pitfalls and complications in stapes surgery, cochlear implantation and surgery of vestibular schwannomas and jugulotympanal paragangliomas. Based on these exemplary procedures, basic “dos and don’ts” of skull base surgery are explained, which the reader can easily transfer to other disorders. Special emphasis is laid on functional aspects, such as hearing, balance and facial nerve function. Furthermore, the topics of infection, bleeding, skull base defects, quality of life and indication for revision surgery are discussed. An open communication about complications and pitfalls in ear/lateral skull base surgery among surgeons is a prerequisite for the further advancement of this fascinating field in ENT surgery. This article is meant to be a contribution to this process. PMID:24403973

  3. [Complications and pitfalls in surgery of the ear/lateral skull base].

    PubMed

    Schick, B; Dlugaiczyk, J

    2013-04-01

    Surgery of the ear and the lateral skull base is a fascinating, yet challenging field in otorhinolaryngology. A thorough knowledge of the associated complications and pitfalls is indispensable for the surgeon, not only to provide the best possible care to his patients, but also to further improve his surgical skills.Following a summary about general aspects in pre-, intra- and postoperative care of patients with disorders of the ear/lateral skull base, this article covers the most common pitfalls and complications in stapes surgery, cochlear implantation, surgery of vestibular schwannomas, and jugulotympanal paragangliomas. Based on these exemplary procedures, basic "do's and don'ts" of skull base surgery are explained, which the reader can easily transfer to other disorders. Special emphasis is laid on functional aspects, such as hearing, balance and facial nerve function. Furthermore, the topics of infection, bleeding, skull base defects, quality of life and indication for revision surgery are discussed.An open communication about complications and pitfalls in ear/lateral skull base surgery among surgeons is a prerequisite for the further advancement of this fascinating field in ENT surgery. This article is meant to be a contribution to this process. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Enlivening Physics, a Local Video Disc Project.

    ERIC Educational Resources Information Center

    McInerney, M.

    1989-01-01

    Describes how to make and use an inexpensive video disc of physics demonstrations. Discusses the background, production of the disc, subject of the disc including angular momentum, "monkey and the hunter" experiment, Doppler shift, pressure of a constant volume of gas thermometer, and wave effects, and using the disc in classroom. (YP)

  5. Dependence of optic disc parameters on disc area according to Heidelberg Retina Tomograph: Part II.

    NASA Astrophysics Data System (ADS)

    Machekhin, V.; Manaenkova, G.; Bondarenko, O.

    2007-05-01

    With the help of Heidelberg Retina Tomograph (HRT-II) optic disc parameters in 211 eyes of 115 healthy patients with refraction Em +/- 3,0 D and 96 eyes of 72 patients with myopia 3,5-14,0 D without any signs of glaucoma were studied. Analysis of optic disc parameters were carried out in 5 groups of patients according to disc area: less than 1,5 mm2, 1,5- 2,5 mm2, 2,5-3,0 mm2, 3,0-3,5 mm2 and more than 3,5 mm2. An accurate depending on disc area was revealed for all optic disc parameters in all sectors, which was manifested by increasing cup disc and rim disc (area and volume) and other parameters. We consider it is necessary to use the proper tables for right interpretation of received data for early diagnosis of glaucoma.

  6. Automated volumetric evaluation of stereoscopic disc photography

    PubMed Central

    Xu, Juan; Ishikawa, Hiroshi; Wollstein, Gadi; Bilonick, Richard A; Kagemann, Larry; Craig, Jamie E; Mackey, David A; Hewitt, Alex W; Schuman, Joel S

    2010-01-01

    PURPOSE: To develop a fully automated algorithm (AP) to perform a volumetric measure of the optic disc using conventional stereoscopic optic nerve head (ONH) photographs, and to compare algorithm-produced parameters with manual photogrammetry (MP), scanning laser ophthalmoscope (SLO) and optical coherence tomography (OCT) measurements. METHODS: One hundred twenty-two stereoscopic optic disc photographs (61 subjects) were analyzed. Disc area, rim area, cup area, cup/disc area ratio, vertical cup/disc ratio, rim volume and cup volume were automatically computed by the algorithm. Latent variable measurement error models were used to assess measurement reproducibility for the four techniques. RESULTS: AP had better reproducibility for disc area and cup volume and worse reproducibility for cup/disc area ratio and vertical cup/disc ratio, when the measurements were compared to the MP, SLO and OCT methods. CONCLUSION: AP provides a useful technique for an objective quantitative assessment of 3D ONH structures. PMID:20588996

  7. Composite flywheels with rim and hub

    NASA Astrophysics Data System (ADS)

    Ikegami, K.; Igarashi, J.-I.; Shiratori, E.

    The possibility of obtaining a flywheel of high energy density by increasing both rotating speed and moment of inertia of the disc is investigated. As the starting point of the search process for such a flywheel, a glass cloth-laminated disc with a hole at the center is considered. The rotating speed of the disc is improved by reinforcing the central hole of the disc with the same material as that of the disc. The large moment of inertia is obtained by attaching a rim around the disc. The rim is moulded by winding carbon fiber around it. This rim also has the usual 'hoop' effect which prevents a reduction of the rotating speed of the disc because of the additional moment of inertia of the rim. The shape of the disc having a high energy density is numerically sought by varying the dimensions of the hub and the rim of the disc, and an optimal shape is proposed.

  8. [The Autocad system for planimetric study of the optic disc in glaucoma: technique and reproducibility study].

    PubMed

    Sánchez Pérez, A; Honrubia López, F M; Larrosa Poves, J M; Polo Llorens, V; Melcon Sánchez-Frieras, B

    2001-09-01

    To develop a lens planimetry technique for the optic disc using AutoCAD. To determine variability magnitude of the optic disc morphological measurements. We employed AutoCAD R.14.0 Autodesk: image acquisition, contour delimitation by multiple lines fitting or ellipse adjustment, image sectorialization and measurements quantification (optic disc and excavation, vertical diameters, optic disc area, excavation area, neuroretinal sector area and Beta atrophy area). Intraimage or operator and interimage o total reproducibility was studied by coefficient of variability (CV) (n=10) in normal and myopic optic discs. This technique allows to obtain optic disc measurement in 5 to 10 minutes time. Total or interimage variability of measurements introduced by one observer presents CV range from 1.18-4.42. Operator or intraimage measurement presents CV range from 0.30-4.21. Optic disc contour delimitation by ellipse adjustment achieved better reproducibility results than multiple lines adjustment in all measurements. Computer assisted AutoCAD planimetry is an interactive method to analyse the optic disc, feasible to incorporate to clinical practice. Reproducibility results are comparable to other analyzers in quantification optic disc morphology. Ellipse adjustment improves results in optic disc contours delimitation.

  9. Protoplanetary disc `isochrones' and the evolution of discs in the M˙-Md plane

    NASA Astrophysics Data System (ADS)

    Lodato, Giuseppe; Scardoni, Chiara E.; Manara, Carlo F.; Testi, Leonardo

    2017-12-01

    In this paper, we compare simple viscous diffusion models for the disc evolution with the results of recent surveys of the properties of young protoplanetary discs. We introduce the useful concept of 'disc isochrones' in the accretion rate-disc mass plane and explore a set of Monte Carlo realization of disc initial conditions. We find that such simple viscous models can provide a remarkable agreement with the available data in the Lupus star forming region, with the key requirement that the average viscous evolutionary time-scale of the discs is comparable to the cluster age. Our models produce naturally a correlation between mass accretion rate and disc mass that is shallower than linear, contrary to previous results and in agreement with observations. We also predict that a linear correlation, with a tighter scatter, should be found for more evolved disc populations. Finally, we find that such viscous models can reproduce the observations in the Lupus region only in the assumption that the efficiency of angular momentum transport is a growing function of radius, thus putting interesting constraints on the nature of the microscopic processes that lead to disc accretion.

  10. BP Piscium: its flaring disc imaged with SPHERE/ZIMPOL★

    NASA Astrophysics Data System (ADS)

    de Boer, J.; Girard, J. H.; Canovas, H.; Min, M.; Sitko, M.; Ginski, C.; Jeffers, S. V.; Mawet, D.; Milli, J.; Rodenhuis, M.; Snik, F.; Keller, C. U.

    2017-03-01

    Whether BP Piscium (BP Psc) is either a pre-main sequence T Tauri star at d ≈ 80 pc, or a post-main sequence G giant at d ≈ 300 pc is still not clear. As a first-ascent giant, it is the first to be observed with a molecular and dust disc. Alternatively, BP Psc would be among the nearest T Tauri stars with a protoplanetary disc (PPD). We investigate whether the disc geometry resembles typical PPDs, by comparing polarimetric images with radiative transfer models. Our Very Large Telescope/Spectro-Polarimetric High-contrast Exoplanet REsearch (SPHERE)/Zurich IMaging Polarimeter (ZIMPOL) observations allow us to perform polarimetric differential imaging, reference star differential imaging, and Richardson-Lucy deconvolution. We present the first visible light polarization and intensity images of the disc of BP Psc. Our deconvolution confirms the disc shape as detected before, mainly showing the southern side of the disc. In polarized intensity the disc is imaged at larger detail and also shows the northern side, giving it the typical shape of high-inclination flared discs. We explain the observed disc features by retrieving the large-scale geometry with MCMAX radiative transfer modelling, which yields a strongly flared model, atypical for discs of T Tauri stars.

  11. On the illumination of neutron star accretion discs

    NASA Astrophysics Data System (ADS)

    Wilkins, D. R.

    2018-03-01

    The illumination of the accretion disc in a neutron star X-ray binary by X-rays emitted from (or close to) the neutron star surface is explored through general relativistic ray tracing simulations. The applicability of the canonical suite of relativistically broadened emission line models (developed for black holes) to discs around neutron stars is evaluated. These models were found to describe well emission lines from neutron star accretion discs unless the neutron star radius is larger than the innermost stable orbit of the accretion disc at 6 rg or the disc is viewed at high inclination, above 60° where shadowing of the back side of the disc becomes important. Theoretical emissivity profiles were computed for accretion discs illuminated by hotspots on the neutron star surfaces, bands of emission and emission by the entirety of the hot, spherical star surface and in all cases, the emissivity profile of the accretion disc was found to be well represented by a single power law falling off slightly steeper than r-3. Steepening of the emissivity index was found where the emission is close to the disc plane and the disc can appear truncated when illuminated by a hotspot at high latitude. The emissivity profile of the accretion disc in Serpens X-1 was measured and found to be consistent with a single unbroken power law with index q=3.5_{-0.4}^{+0.3}, suggestive of illumination by the boundary layer between the disc and neutron star surface.

  12. In vivo biofunctional evaluation of hydrogels for disc regeneration.

    PubMed

    Reitmaier, Sandra; Kreja, Ludwika; Gruchenberg, Katharina; Kanter, Britta; Silva-Correia, Joana; Oliveira, Joaquim Miguel; Reis, Rui Luís; Perugini, Valeria; Santin, Matteo; Ignatius, Anita; Wilke, Hans-Joachim

    2014-01-01

    Regenerative strategies aim to restore the original biofunctionality of the intervertebral disc. Different biomaterials are available, which might support disc regeneration. In the present study, the prospects of success of two hydrogels functionalized with anti-angiogenic peptides and seeded with bone marrow derived mononuclear cells (BMC), respectively, were investigated in an ovine nucleotomy model. In a one-step procedure iliac crest aspirates were harvested and, subsequently, separated BMC were seeded on hydrogels and implanted into the ovine disc. For the cell-seeded approach a hyaluronic acid-based hydrogel was used. The anti-angiogenic potential of newly developed VEGF-blockers was investigated on ionically crosslinked metacrylated gellan gum hydrogels. Untreated discs served as nucleotomy controls. 24 adult merino sheep were used. After 6 weeks histological, after 12 weeks histological and biomechanical analyses were conducted. Biomechanical tests revealed no differences between any of the implanted and nucleotomized discs. All implanted discs significantly degenerated compared to intact discs. In contrast, there was no marked difference between implanted and nucleotomized discs. In tendency, albeit not significant, degeneration score and disc height index deteriorated for all but not for the cell-seeded hydrogels from 6 to 12 weeks. Cell-seeded hydrogels slightly decelerated degeneration. None of the hydrogel configurations was able to regenerate biofunctionality of the intervertebral disc. This might presumably be caused by hydrogel extrusion. Great importance should be given to the development of annulus sealants, which effectively exploit the potential of (cell-seeded) hydrogels for biological disc regeneration and restoration of intervertebral disc functioning.

  13. New Brown Dwarf Discs in Upper Scorpius Observed with WISE

    NASA Technical Reports Server (NTRS)

    Dawson, P.; Scholz, A.; Ray, T. P.; Natta, A.; Marsh, K. A.; Padgett, D.; Ressler, M. E.

    2013-01-01

    We present a census of the disc population for UKIDSS selected brown dwarfs in the 5-10 Myr old Upper Scorpius OB association. For 116 objects originally identified in UKIDSS, the majority of them not studied in previous publications, we obtain photometry from the Wide-Field Infrared Survey Explorer data base. The resulting colour magnitude and colour colour plots clearly show two separate populations of objects, interpreted as brown dwarfs with discs (class II) and without discs (class III). We identify 27 class II brown dwarfs, 14 of them not previously known. This disc fraction (27 out of 116, or 23%) among brown dwarfs was found to be similar to results for K/M stars in Upper Scorpius, suggesting that the lifetimes of discs are independent of the mass of the central object for low-mass stars and brown dwarfs. 5 out of 27 discs (19 per cent) lack excess at 3.4 and 4.6 microns and are potential transition discs (i.e. are in transition from class II to class III). The transition disc fraction is comparable to low-mass stars.We estimate that the time-scale for a typical transition from class II to class III is less than 0.4 Myr for brown dwarfs. These results suggest that the evolution of brown dwarf discs mirrors the behaviour of discs around low-mass stars, with disc lifetimes of the order of 5 10 Myr and a disc clearing time-scale significantly shorter than 1 Myr.

  14. Posterior epidural disc fragment masquerading as spinal tumor: Review of the literature.

    PubMed

    Park, Taejune; Lee, Ho Jun; Kim, Jae Seong; Nam, Kiyeun

    2018-03-09

    Posterior epidural lumbar disc fragment is infrequent because of anatomical barriers, and it is difficult to diagnose posterior epidural lumbar disc fragment because of its rare incidence and the ambiguity of radiologic evaluations. And it is difficult to differentiate it from other diseases such as spinal tumors. Differential diagnosis of posterior epidural lumbar disc fragment is clinically important because its diagnosis can affect treatment and prognosis. To investigate the incidence, anatomical concern, etiology, symptom, diagnostic tool, management and prognosis of posterior epidural lumbar disc fragment, we reviewed articles including case report. We performed a search of all clinical studies of posterior epidural lumbar disc fragment published to date. The following keywords were searched: Posterior epidural lumbar disc fragment, disc migration, posterior epidural disc, extradural migration, dorsal epidural migration, sequestrated disc, and disc fragment. We identified 40 patients of posterior epidural lumbar disc fragment from 28 studies. The most common presentation of posterior epidural lumbar disc fragment was sudden onset radiculopathy (70.0%), followed by cauda equina syndrome (27.5%). The most frequently used diagnostic modality was magnetic resonance imaging (MRI), conducted in 36 cases (90.0%), and followed by computed tomography in 14 cases (35.0%). After the imaging studies, the preoperative diagnoses were 45.0% masses, 20.0% lesions, and 12.5% tumors. Characteristic MRI findings in posterior epidural lumbar disc fragment are helpful for diagnosis; it typically displays low signals on T1-weighted images and high signals on T2-weighted images with respect to the parent disc. In addition, most of the disc fragments show peripheral rim enhancement on MRI with gadolinium administration. Electrodiagnostic testing is useful for verifying nerve damage. Surgical treatment was performed in all cases, and neurologic complications were observed in 12.5%. As posterior epidural lumbar disc fragment could be masqueraded as spinal tumor, if rim enhancement is observed in MRI scans with sudden symptoms of radiculopathy or cauda equina syndrome, it should be taken into consideration. Early diagnosis can lead to early surgery, which can reduce complications.

  15. A fully relativistic twisted disc around a slowly rotating Kerr black hole: derivation of dynamical equations and the shape of stationary configurations

    NASA Astrophysics Data System (ADS)

    Zhuravlev, V. V.; Ivanov, P. B.

    2011-08-01

    In this paper we derive equations describing the dynamics and stationary configurations of a twisted fully relativistic thin accretion disc around a slowly rotating black hole. We assume that the inclination angle of the disc is small and that the standard relativistic generalization of the α model of accretion discs is valid when the disc is flat. We find that similar to the case of non-relativistic twisted discs the disc dynamics and stationary shapes can be determined by a pair of equations formulated for two complex variables describing the orientation of the disc rings and velocity perturbations induced by the twist. We analyse analytically and numerically the shapes of stationary twisted configurations of accretion discs having non-zero inclinations with respect to the black hole equatorial plane at large distances r from the black hole. It is shown that the stationary configurations depend on two parameters - the viscosity parameter α and the parameter ?, where δ* is the opening angle (δ*˜h/r, where h is the disc half-thickness and r is large) of a flat disc and a is the black hole rotational parameter. When a > 0 and ? the shapes depend drastically on the value of α. When α is small the disc inclination angle oscillates with radius with amplitude and radial frequency of the oscillations dramatically increasing towards the last stable orbit, Rms. When α has a moderately small value the oscillations do not take place but the disc does not align with the equatorial plane at small radii. The disc inclination angle either is increasing towards Rms or exhibits a non-monotonic dependence on the radial coordinate. Finally, when α is sufficiently large the disc aligns with the equatorial plane at small radii. When a < 0 the disc aligns with the equatorial plane for all values of α. The results reported here may have implications for determining the structure and variability of accretion discs close to Rms as well as for modelling of emission spectra coming from different sources, which are supposed to contain black holes.

  16. Vortex stretching in self-gravitating protoplanetary discs

    NASA Astrophysics Data System (ADS)

    Regály, Zs.; Vorobyov, E.

    2017-10-01

    Horseshoe-shaped brightness asymmetries of several transitional discs are thought to be caused by large-scale vortices. Anticyclonic vortices efficiently collect dust particles, therefore they can play a major role in planet formation. Former studies suggest that the disc self-gravity weakens vortices formed at the edge of the gap opened by a massive planet in discs whose masses are in the range of 0.01 ≤ Mdisc/M* ≤ 0.1. Here, we present an investigation on the long-term evolution of the large-scale vortices formed at the viscosity transition of the discs' dead zone outer edge by means of two-dimensional hydrodynamic simulations taking disc self-gravity into account. We perform a numerical study of low-mass, 0.001 ≤ Mdisc/M* ≤ 0.01, discs, for which cases disc self-gravity was previously neglected. The large-scale vortices are found to be stretched due to disc self-gravity even for low-mass discs with Mdisc/M* ≳ 0.005, where initially the Toomre Q-parameter was ≲ 50 at the vortex distance. As a result of stretching, the vortex aspect ratio increases and a weaker azimuthal density contrast develops. The strength of the vortex stretching is proportional to the disc mass. The vortex stretching can be explained by a combined action of a non-vanishing gravitational torque caused by the vortex and the Keplerian shear of the disc. Self-gravitating vortices are subject to significantly faster decay than non-self-gravitating ones. We found that vortices developed at sharp viscosity transitions of self-gravitating discs can be described by a Goodman - Narayan - Goldreich (GNG) model as long as the disc viscosity is low, I.e. αdz ≤ 10-5.

  17. Intradiscal pressure study of percutaneous disc decompression with nucleoplasty in human cadavers.

    PubMed

    Chen, Yung C; Lee, Sang-heon; Chen, Darwin

    2003-04-01

    Intradiscal pressure was measured after percutaneous disc decompression by nucleoplasty in human cadavers with different degrees of disc degeneration. To assess intradiscal pressure change after disc decompression, and to analyze the influence of degeneration on the intradiscal pressure change. Partial removal of the nucleus has been shown to decompress herniated discs, relieving pressure on nerve roots and, in some cases, offering relief from disc pain. Nucleoplasty, a new minimally invasive procedure using patented Coblation technology, combines coagulation and ablation for partial removal of the nucleus. Coblated channels remove the tissue volume and may decrease the disc pressure. Three fresh human cadaver spinal specimens (T8-L5; age, 54-84 years; mean age, 70.7 years) were used in this investigation. The intradiscal pressure was measured at three points: before treatment, after each channel was created, and after treatment using a 25-guage 6-inch needle connected to a Merit Medical Systems Intellisystem Inflation Monitor. The needles were calibrated initially to approximately 30 pounds per square inch. For the control, the change in disc pressure was recorded by the same procedure without using Coblation energy. To evaluate the effectiveness of nucleoplasty, disc pressure changes were compared between treatment with and without Coblation energy. Intradiscal pressure was markedly reduced in the younger, healthy disc cadaver. In the older, degenerative disc cadavers, the change in intradiscal pressure after nucleoplasty was very small. There was an inverse correlation between the degree of disc degeneration and the change in intradiscal pressure. Pressure reduction through nucleoplasty is highly dependent on the degree of spine degeneration. Nucleoplasty markedly reduced intradiscal pressure in nondegenerative discs, but had a negligible effect on highly degenerative discs.

  18. Biometry and spectral domain optical coherence tomography parameters in children with large cupping.

    PubMed

    Jung, Jong Jin; Baek, Seung-Hee; Kim, Ungsoo Samuel

    2013-09-01

    The purpose of this study is to investigate optic nerve head using spectral domain optical coherence tomography (SD-OCT) in children with large cupping. 111 eyes (4-10 years) were divided into three groups according to the cup to disc ratio: group 1, ≤0.3; group 2, 0.4-0.6; and group 3, ≥0.7. The rim area, disc area, average cup to disc ratio, vertical cup to disc ratio, and cup volume were investigated using SD-OCT (Cirrus HD-OCT, Carl Zeiss, Jena, Germany), and the axial length and anterior chamber depth (ACD) were measured by IOL master (IOL master 500, Carl Zeiss, Jena, Germany). Next, we compared ocular biometry and SD-OCT between the three groups. The mean age of group 1 was 6.48 ± 1.42 years, 7.00 ± 1.75 years in group 2, and 6.63 ± 1.82 years in group 3 (p = 0.370). A significant difference was seen in the spherical equivalent between the groups (p = 0.001). Group 2 had the most myopic refractive errors. As the cup to disc ratio increases, disc area, average cup to disc ratio, vertical cup to disc ratio, and cup volume increase significantly. When the results of ocular biometry and SD-OCT are adjusted for axial length, only disc area showed a significant correlation with cup to disc ratio (ACD: p = 0.473, rim area: p = 0.639, disc area: p = 0.005, and cup volume: p = 0.325). Axial length is the key factor determining disc size, which in turn is important for determining cup to disc ratio. Normal children with large cupping should be examined for axial length, myopic refractive errors, and disc size.

  19. Mechanoreceptors in Diseased Cervical Intervertebral Disc and Vertigo.

    PubMed

    Yang, Liang; Yang, Cheng; Pang, Xiaodong; Li, Duanming; Yang, Hong; Zhang, Xinwu; Yang, Yi; Peng, Baogan

    2017-04-15

    We collected the samples of cervical intervertebral discs from patients with vertigo to examine the distribution and types of mechanoreceptors in diseased cervical disc. The aim of this study was to determine whether mechanoreceptors are distributed more abundantly in cervical discs from patients with cervical spondylosis, and whether they are related to vertigo. Previous limited studies have found that normal cervical intervertebral discs are supplied with mechanoreceptors that have been considered responsible for proprioceptive functions. Several clinical studies have indicated that the patients with cervical spondylosis manifested significantly impaired postural control and subjective balance disturbance. We collected 77 samples of cervical discs from 62 cervical spondylosis patients without vertigo, 61 samples from 54 patients with vertigo, and 40 control samples from 8 cadaveric donors to investigate distribution of mechanoreceptors containing neurofilament (NF200) and S-100 protein immunoreactive nerve endings. The immunohistochemical investigation revealed that the most frequently encountered mechanoreceptors were the Ruffini corpuscles in all groups of cervical disc samples. They were obviously increased in the number and deeply ingrown into inner annulus fibrosus and even into nucleus pulposus in the diseased cervical discs from patients with vertigo in comparison with the discs from patients without vertigo and control discs. Only three Golgi endings were seen in the three samples from patients with vertigo. No Pacinian corpuscles were found in any samples of cervical discs. The diseased cervical discs from patients with vertigo had more abundant distribution of Ruffini corpuscles than other discs. A positive association between the increased number and ingrowth of Ruffini corpuscles in the diseased cervical disc and the incidence of vertigo in the patients with cervical spondylosis was found, which may indicate a key role of Ruffini corpuscles in the pathogenesis of vertigo of cervical origin. 1.

  20. Star-disc interaction in galactic nuclei: formation of a central stellar disc

    NASA Astrophysics Data System (ADS)

    Panamarev, Taras; Shukirgaliyev, Bekdaulet; Meiron, Yohai; Berczik, Peter; Just, Andreas; Spurzem, Rainer; Omarov, Chingis; Vilkoviskij, Emmanuil

    2018-05-01

    We perform high-resolution direct N-body simulations to study the effect of an accretion disc on stellar dynamics in an active galactic nucleus (AGN). We show that the interaction of the nuclear stellar cluster (NSC) with the gaseous accretion disc (AD) leads to formation of a stellar disc in the central part of the NSC. The accretion of stars from the stellar disc on to the super-massive black hole is balanced by the capture of stars from the NSC into the stellar disc, yielding a stationary density profile. We derive the migration time through the AD to be 3 per cent of the half-mass relaxation time of the NSC. The mass and size of the stellar disc are 0.7 per cent of the mass and 5 per cent of the influence radius of the super-massive black hole. An AD lifetime shorter than the migration time would result in a less massive nuclear stellar disc. The detection of such a stellar disc could point to past activity of the hosting galactic nucleus.

  1. Does T2 mapping of the posterior annulus fibrosus indicate the presence of lumbar intervertebral disc herniation? A 3.0 Tesla magnetic resonance study.

    PubMed

    Messner, Alina; Stelzeneder, David; Trattnig, Stefan; Welsch, Götz H; Schinhan, Martina; Apprich, Sebastian; Brix, Martin; Windhager, Reinhard; Trattnig, Siegfried

    2017-03-01

    Indicating lumbar disc herniation via magnetic resonance imaging (MRI) T2 mapping in the posterior annulus fibrosus (AF). Sagittal T2 maps of 313 lumbar discs of 64 patients with low back pain were acquired at 3.0 Tesla (3T). The discs were rated according to disc herniation and bulging. Region of interest (ROI) analysis was performed on median, sagittal T2 maps. T2 values of the AF, in the most posterior 10% (PAF-10) and 20% of the disc (PAF-20), were compared. A significant increase in the T2 values of discs with herniations affecting the imaged area, compared to bulging discs and discs with lateral herniation, was shown in the PAF-10, where no association to the NP was apparent. The PAF-20 exhibited a moderate correlation to the nucleus pulposus (NP). High T2 values in the PAF-10 suggest the presence of disc herniation (DH). The results indicate that T2 values in the PAF-20 correspond more to changes in the NP.

  2. Segmentation of optic disc and optic cup in retinal fundus images using shape regression.

    PubMed

    Sedai, Suman; Roy, Pallab K; Mahapatra, Dwarikanath; Garnavi, Rahil

    2016-08-01

    Glaucoma is one of the leading cause of blindness. The manual examination of optic cup and disc is a standard procedure used for detecting glaucoma. This paper presents a fully automatic regression based method which accurately segments optic cup and disc in retinal colour fundus image. First, we roughly segment optic disc using circular hough transform. The approximated optic disc is then used to compute the initial optic disc and cup shapes. We propose a robust and efficient cascaded shape regression method which iteratively learns the final shape of the optic cup and disc from a given initial shape. Gradient boosted regression trees are employed to learn each regressor in the cascade. A novel data augmentation approach is proposed to improve the regressors performance by generating synthetic training data. The proposed optic cup and disc segmentation method is applied on an image set of 50 patients and demonstrate high segmentation accuracy for optic cup and disc with dice metric of 0.95 and 0.85 respectively. Comparative study shows that our proposed method outperforms state of the art optic cup and disc segmentation methods.

  3. Vertebral Augmentation can Induce Early Signs of Degeneration in the Adjacent Intervertebral Disc: Evidence from a Rabbit Model.

    PubMed

    Feng, Zhiyun; Chen, Lunhao; Hu, Xiaojian; Yang, Ge; Wang, Yue; Chen, Zhong

    2018-04-11

    An experimental study. The aim of this study was to determine the effect of polymethylmethacrylate (PMMA) augmentation on the adjacent disc. Vertebral augmentation with PMMA reportedly may predispose the adjacent vertebra to fracture. The influence of PMMA augmentation on the adjacent disc, however, remains unclear. Using a retroperitoneal approach, PMMA augmentation was performed for 23 rabbits. For each animal, at least one vertebra was augmented with 0.2 to 0.3 mL PMMA. The disc adjacent to the augmented vertebra and a proximal control disc were studied using magnetic resonance (MR) imaging, histological and molecular level evaluation at 1, 3, and 6 months postoperatively. Marrow contact channels in the endplate were quantified in histological slices and number of invalid channels (those without erythrocytes inside) was rated. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) was performed to determine disc cell apoptosis. On MR images, the signal and height of the adjacent disc did not change 6 months after vertebral augmentation. Histological scores of the adjacent disc increased over time, particularly for the nucleus pulposus. The adjacent disc had greater nucleus degeneration score than the control disc at 3 months (5.7 vs. 4.5, P < 0.01) and 6 months (6.9 vs. 4.4, P < 0.001). There were more invalid marrow contact channels in the endplate of augmented vertebra than the control (43.3% vs. 11.1%, P < 0.01). mRNA of ADAMTS-5, MMP-13, HIF-1α, and caspase-3 were significantly upregulated in the adjacent disc at 3 and 6 months (P < 0.05 for all). In addition, there were more TUNEL-positive cells in the adjacent disc than in the control disc (43.4% vs. 24.0%, P < 0.05) at 6 months postoperatively. Vertebral augmentation can induce early degenerative signs in the adjacent disc, which may be due to impaired nutrient supply to the disc. N/A.

  4. First results of the SONS survey: submillimetre detections of debris discs

    NASA Astrophysics Data System (ADS)

    Panić, O.; Holland, W. S.; Wyatt, M. C.; Kennedy, G. M.; Matthews, B. C.; Lestrade, J. F.; Sibthorpe, B.; Greaves, J. S.; Marshall, J. P.; Phillips, N. M.; Tottle, J.

    2013-10-01

    New detections of debris discs at submillimetre wavelengths present highly valuable complementary information to prior observations of these sources at shorter wavelengths. Characterization of discs through spectral energy distribution modelling including the submillimetre fluxes is essential for our basic understanding of disc mass and temperature, and presents a starting point for further studies using millimetre interferometric observations. In the framework of the ongoing SCUBA-2 Observations of Nearby Stars, the instrument SCUBA-2 on the James Clerk Maxwell Telescope was used to provide measurements of 450 and 850 μm fluxes towards a large sample of nearby main-sequence stars with debris discs detected previously at shorter wavelengths. We present the first results from the ongoing survey, concerning 850 μm detections and 450 μm upper limits towards 10 stars, the majority of which are detected at submillimetre wavelengths for the first time. One, or possibly two, of these new detections is likely a background source. We fit the spectral energy distributions of the star+disc systems with a blackbody emission approach and derive characteristic disc temperatures. We use these temperatures to convert the observed fluxes to disc masses. We obtain a range of disc masses from 0.001 to 0.1 M⊕, values similar to the prior dust mass measurements towards debris discs. There is no evidence for evolution in dust mass with age on the main sequence, and indeed the upper envelope remains relatively flat at ≈0.5 M⊕ at all ages. The inferred disc masses are lower than those from disc detections around pre-main-sequence stars, which may indicate a depletion of solid mass. This may also be due to a change in disc opacity, though limited sensitivity means that it is not yet known what fraction of pre-main-sequence stars have discs with dust masses similar to debris disc levels. New, high-sensitivity detections are a path towards investigating the trends in dust mass evolution.

  5. Comparison of Ripening Processes in Intact Tomato Fruit and Excised Pericarp Discs 1

    PubMed Central

    Campbell, Alan D.; Huysamer, Marius; Stotz, Henrik U.; Greve, L. Carl; Labavitch, John M.

    1990-01-01

    Physiological processes characteristic of ripening in tissues of intact tomato fruit (Lycopersicon esculentum Mill.) were examined in excised pericarp discs. Pericarp discs were prepared from mature-green tomato fruit and stored in 24-well culture plates, in which individual discs could be monitored for color change, ethylene biosynthesis, and respiration, and selected for cell wall analysis. Within the context of these preparation and handling procedures, most whole fruit ripening processes were maintained in pericarp discs. Pericarp discs and matched intact fruit passed through the same skin color stages at similar rates, as expressed in the L*a*b* color space, changing from green (a* < −5) to red (a* > 15) in about 6 days. Individual tissues of the pericarp discs changed color in the same sequence seen in intact fruit (exocarp, endocarp, then vascular parenchyma). Discs from different areas changed in the same spatial sequence seen in intact fruit (bottom, middle, top). Pericarp discs exhibited climacteric increases in ethylene biosynthesis and CO2 production comparable with those seen in intact fruit, but these were more tightly linked to rate of color change, reaching a peak around a* = 5. Tomato pericarp discs decreased in firmness as color changed. Cell wall carbohydrate composition changed with color as in intact fruit: the quantity of water-soluble pectin eluted from the starch-free alcohol insoluble substances steadily increased and more tightly bound, water-insoluble, pectin decreased in inverse relationship. The cell wall content of the neutral sugars arabinose, rhamnose, and galactose steadily decreased as color changed. The extractable activity of specific cell wall hydrolases changed as in intact fruit: polygalacturonase activity, not detectable in green discs (a* = −5), appeared as discs turned yellow-red (a* = 5), and increased another eight-fold as discs became full red (a* value +20). Carboxymethyl-cellulase activity, low in extracts from green discs, increased about six-fold as discs changed from yellow (a* = 0) to red. PMID:16667893

  6. Patterns of lumbar disc degeneration are different in degenerative disc disease and disc prolapse magnetic resonance imaging analysis of 224 patients.

    PubMed

    Kanna, Rishi M; Shetty, Ajoy Prasad; Rajasekaran, S

    2014-02-01

    Existing research on lumbar disc degeneration has remained inconclusive regarding its etiology, pathogenesis, symptomatology, prevention, and management. Degenerative disc disease (DDD) and disc prolapse (DP) are common diseases affecting the lumbar discs. Although they manifest clinically differently, existing studies on disc degeneration have included patients with both these features, leading to wide variations in observations. The possible relationship or disaffect between DDD and DP is not fully evaluated. To analyze the patterns of lumbar disc degeneration in patients with chronic back pain and DDD and those with acute DP. Prospective, magnetic resonance imaging-based radiological study. Two groups of patients (aged 20-50 years) were prospectively studied. Group 1 included patients requiring a single level microdiscectomy for acute DP. Group 2 included patients with chronic low back pain and DDD. Discs were assessed by magnetic resonance imaging through Pfirmann grading, Schmorl nodes, Modic changes, and the total end-plate damage score for all the five lumbar discs. Group 1 (DP) had 91 patients and group 2 (DDD) had 133 patients. DP and DDD patients differed significantly in the number, extent, and severity of degeneration. DDD patients had a significantly higher number of degenerated discs than DP patients (p<.000). The incidence of multilevel and pan-lumbar degeneration was also significantly higher in DDD group. The pattern of degeneration also differed in both the groups. DDD patients had predominant upper lumbar involvement, whereas DP patients had mainly lower lumbar degeneration. Modic changes were more common in DP patients, especially at the prolapsed level. Modic changes were present in 37% of prolapsed levels compared with 9.9% of normal discs (p<.00). The total end-plate damage score had a positive correlation with disc degeneration in both the groups. Further the mean total end-plate damage score at prolapsed level was also significantly higher. The results suggest that patients with disc prolapse, and those with back pain with DDD are clinically and radiologically different groups of patients with varying patterns, severity, and extent of disc degeneration. This is the first study in literature to compare and identify significant differences in these two commonly encountered patient groups. In patients with single-level DP, the majority of the other discs are nondegenerate, the lower lumbar spine is predominantly involved and the end-plate damage is higher. Patients with back pain and DDD have larger number of degenerate discs, early multilevel degeneration, and predominant upper lumbar degeneration. The knowledge that these two groups of patients are different clinically and radiologically is critical for our improved understanding of the disease and for future studies on disc degeneration and disc prolapse. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Signatures of broken protoplanetary discs in scattered light and in sub-millimetre observations

    NASA Astrophysics Data System (ADS)

    Facchini, Stefano; Juhász, Attila; Lodato, Giuseppe

    2018-02-01

    Spatially resolved observations of protoplanetary discs are revealing that their inner regions can be warped or broken from the outer disc. A few mechanisms are known to lead to such 3D structures; among them, the interaction with a stellar companion. We perform a 3D SPH simulation of a circumbinary disc misaligned by 60° with respect to the binary orbital plane. The inner disc breaks from the outer regions, precessing as a rigid body and leading to a complex evolution. As the inner disc precesses, the misalignment angle between the inner and outer discs varies by more than 100°. Different snapshots of the evolution are post-processed with a radiative transfer code, in order to produce observational diagnostics of the process. Even though the simulation was produced for the specific case of a circumbinary disc, most of the observational predictions hold for any disc hosting a precessing inner rim. Synthetic scattered light observations show strong azimuthal asymmetries, where the pattern depends strongly on the misalignment angle between the inner and outer discs. The asymmetric illumination of the outer disc leads to azimuthal variations of the temperature structure, in particular in the upper layers, where the cooling time is short. These variations are reflected in asymmetric surface brightness maps of optically thick lines, as CO J = 3-2. The kinematical information obtained from the gas lines is unique in determining the disc structure. The combination of scattered light images and (sub-)mm lines can distinguish between radial inflow and misaligned inner disc scenarios.

  8. Radiologic study of disc behavior following compression fracture of the thoracolumbar hinge managed by kyphoplasty: A 52-case series.

    PubMed

    Teyssédou, S; Saget, M; Gayet, L E; Pries, P; Brèque, C; Vendeuvre, T

    2016-02-01

    Kyphoplasty has proved effective for durable correction of traumatic vertebral deformity following Magerl A fracture, but subsequent behavior of the adjacent discs is unclear. The objective of the present study was to analyze evolution according to severity of initial kyphosis and quality of fracture reduction. A single-center prospective study included cases of single compression fracture of the thoracolumbar hinge managed by Kyphon Balloon Kyphoplasty with polymethylmethacrylate bone cement. Radiology focused on traumatic vertebral kyphosis (VK), disc angulation (DA) and disc height index (DHI) in the adjacent discs. Linear regression assessed the correlation between superior disc height index (SupDHI) and postoperative VK on the one hand and correction gain on the other, using the Student t test for matched pairs and Pearson correlation coefficient. Fifty-two young patients were included, with mean follow-up of 18.6 months. VK fell from 13.9° preoperatively to 8.2° at last follow-up. DHI found significant superior disc subsidence (P=0.0001) and non-significant inferior disc subsidence (P=0.116). DA showed significantly reduced superior disc lordosis (P=4*10(-5)). SupDHI correlated with VK correction (r=0.32). Preoperative VK did not correlate with radiologic degeneration of the adjacent discs. Correction of traumatic vertebral deformity avoids subsidence and loss of mechanical function in the superior adjacent disc. The underlying disc compensates for residual deformity. Balloon kyphoplasty is useful in compression fracture, providing significant reduction of traumatic vertebral deformity while conserving free and healthy adjacent discs. IV. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  9. Rat disc torsional mechanics: effect of lumbar and caudal levels and axial compression load.

    PubMed

    Espinoza Orías, Alejandro A; Malhotra, Neil R; Elliott, Dawn M

    2009-03-01

    Rat models with altered loading are used to study disc degeneration and mechano-transduction. Given the prominent role of mechanics in disc function and degeneration, it is critical to measure mechanical behavior to evaluate changes after model interventions. Axial compression mechanics of the rat disc are representative of the human disc when normalized by geometry, and differences between the lumbar and caudal disc have been quantified in axial compression. No study has quantified rat disc torsional mechanics. Compare the torsional mechanical behavior of rat lumbar and caudal discs, determine the contribution of combined axial load on torsional mechanics, and compare the torsional properties of rat discs to human lumbar discs. Cadaveric biomechanical study. Cyclic torsion without compressive load followed by cyclic torsion with a fixed compressive load was applied to rat lumbar and caudal disc levels. The apparent torsional modulus was higher in the lumbar region than in the caudal region: 0.081+/-0.026 (MPa/degrees, mean+/-SD) for lumbar axially loaded; 0.066+/-0.028 for caudal axially loaded; 0.091+/-0.033 for lumbar in pure torsion; and 0.056+/-0.035 for caudal in pure torsion. These values were similar to human disc properties reported in the literature ranging from 0.024 to 0.21 MPa/degrees. Use of the caudal disc as a model may be appropriate if the mechanical focus is within the linear region of the loading regime. These results provide support for use of this animal model in basic science studies with respect to torsional mechanics.

  10. Eccentricity evolution during planet-disc interaction

    NASA Astrophysics Data System (ADS)

    Ragusa, Enrico; Rosotti, Giovanni; Teyssandier, Jean; Booth, Richard; Clarke, Cathie J.; Lodato, Giuseppe

    2018-03-01

    During the process of planet formation, the planet-disc interactions might excite (or damp) the orbital eccentricity of the planet. In this paper, we present two long (t ˜ 3 × 105 orbits) numerical simulations: (a) one (with a relatively light disc, Md/Mp = 0.2), where the eccentricity initially stalls before growing at later times and (b) one (with a more massive disc, Md/Mp = 0.65) with fast growth and a late decrease of the eccentricity. We recover the well-known result that a more massive disc promotes a faster initial growth of the planet eccentricity. However, at late times the planet eccentricity decreases in the massive disc case, but increases in the light disc case. Both simulations show periodic eccentricity oscillations superimposed on a growing/decreasing trend and a rapid transition between fast and slow pericentre precession. The peculiar and contrasting evolution of the eccentricity of both planet and disc in the two simulations can be understood by invoking a simple toy model where the disc is treated as a second point-like gravitating body, subject to secular planet-planet interaction and eccentricity pumping/damping provided by the disc. We show how the counterintuitive result that the more massive simulation produces a lower planet eccentricity at late times can be understood in terms of the different ratios of the disc-to-planet angular momentum in the two simulations. In our interpretation, at late times the planet eccentricity can increase more in low-mass discs rather than in high-mass discs, contrary to previous claims in the literature.

  11. Novel Human Intervertebral Disc Strain Template to Quantify Regional Three-Dimensional Strains in a Population and Compare to Internal Strains Predicted by a Finite Element Model

    PubMed Central

    Showalter, Brent L.; DeLucca, John F.; Peloquin, John M.; Cortes, Daniel H.; Yoder, Jonathon H.; Jacobs, Nathan T.; Wright, Alexander C.; Gee, James C.; Vresilovic, Edward J.; Elliott, Dawn M.

    2017-01-01

    Tissue strain is an important indicator of mechanical function, but is difficult to noninvasively measure in the intervertebral disc. The objective of this study was to generate a disc strain template, a 3D average of disc strain, of a group of human L4–L5 discs loaded in axial compression. To do so, magnetic resonance images of uncompressed discs were used to create an average disc shape. Next, the strain tensors were calculated pixel-wise by using a previously developed registration algorithm. Individual disc strain tensor components were then transformed to the template space and averaged to create the disc strain template. The strain template reduced individual variability while highlighting group trends. For example, higher axial and circumferential strains were present in the lateral and posterolateral regions of the disc, which may lead to annular tears. This quantification of group-level trends in local 3D strain is a significant step forward in the study of disc biomechanics. These trends were compared to a finite element model that had been previously validated against the disc-level mechanical response. Depending on the strain component, 81–99% of the regions within the finite element model had calculated strains within one standard deviation of the template strain results. The template creation technique provides a new measurement technique useful for a wide range of studies, including more complex loading conditions, the effect of disc pathologies and degeneration, damage mechanisms, and design and evaluation of treatments. PMID:26694516

  12. Lumbar Disc Degenerative Disease: Disc Degeneration Symptoms and Magnetic Resonance Image Findings

    PubMed Central

    Saleem, Shafaq; Rehmani, Muhammad Asim Khan; Raees, Aisha; Alvi, Arsalan Ahmad; Ashraf, Junaid

    2013-01-01

    Study Design Cross sectional and observational. Purpose To evaluate the different aspects of lumbar disc degenerative disc disease and relate them with magnetic resonance image (MRI) findings and symptoms. Overview of Literature Lumbar disc degenerative disease has now been proven as the most common cause of low back pain throughout the world. It may present as disc herniation, lumbar spinal stenosis, facet joint arthropathy or any combination. Presenting symptoms of lumbar disc degeneration are lower back pain and sciatica which may be aggravated by standing, walking, bending, straining and coughing. Methods This study was conducted from January 2012 to June 2012. Study was conducted on the diagnosed patients of lumbar disc degeneration. Diagnostic criteria were based upon abnormal findings in MRI. Patients with prior back surgery, spine fractures, sacroiliac arthritis, metabolic bone disease, spinal infection, rheumatoid arthritis, active malignancy, and pregnancy were excluded. Results During the targeted months, 163 patients of lumbar disc degeneration with mean age of 43.92±11.76 years, came into Neurosurgery department. Disc degeneration was most commonly present at the level of L4/L5 105 (64.4%).Commonest types of disc degeneration were disc herniation 109 (66.9%) and lumbar spinal stenosis 37 (22.7%). Spondylolisthesis was commonly present at L5/S1 10 (6.1%) and associated mostly with lumbar spinal stenosis 7 (18.9%). Conclusions Results reported the frequent occurrence of lumbar disc degenerative disease in advance age. Research efforts should endeavor to reduce risk factors and improve the quality of life. PMID:24353850

  13. Forming disc galaxies in major mergers - III. The effect of angular momentum on the radial density profiles of disc galaxies

    NASA Astrophysics Data System (ADS)

    Peschken, N.; Athanassoula, E.; Rodionov, S. A.

    2017-06-01

    We study the effect of angular momentum on the surface density profiles of disc galaxies, using high-resolution simulations of major mergers whose remnants have downbending radial density profiles (type II). As described in the previous papers of this series, in this scenario, most of the disc mass is acquired after the collision via accretion from a hot gaseous halo. We find that the inner and outer disc scalelengths, as well as the break radius, correlate with the total angular momentum of the initial merging system, and are larger for high-angular momentum systems. We follow the angular momentum redistribution in our simulated galaxies, and find that like the mass, the disc angular momentum is acquired via accretion, I.e. to the detriment of the gaseous halo. Furthermore, high-angular momentum systems give more angular momentum to their discs, which directly affects their radial density profile. Adding simulations of isolated galaxies to our sample, we find that the correlations are valid also for disc galaxies evolved in isolation. We show that the outer part of the disc at the end of the simulation is populated mainly by inside-out stellar migration, and that in galaxies with higher angular momentum, stars travel radially further out. This, however, does not mean that outer disc stars (in type II discs) were mostly born in the inner disc. Indeed, generally the break radius increases over time, and not taking this into account leads to overestimating the number of stars born in the inner disc.

  14. The role of disc self-gravity in circumbinary planet systems - I. Disc structure and evolution

    NASA Astrophysics Data System (ADS)

    Mutter, Matthew M.; Pierens, Arnaud; Nelson, Richard P.

    2017-03-01

    We present the results of two-dimensional hydrodynamic simulations of self-gravitating circumbinary discs around binaries whose parameters match those of the circumbinary planet-hosting systems Kepler-16, Kepler-34 and Kepler-35. Previous work has shown that non-self-gravitating discs in these systems form an eccentric precessing inner cavity due to tidal truncation by the binary, and planets which form at large radii migrate until stalling at this cavity. Whilst this scenario appears to provide a natural explanation for the observed orbital locations of the circumbinary planets, previous simulations have failed to match the observed planet orbital parameters. The aim of this work is to examine the role of self-gravity in modifying circumbinary disc structure as a function of disc mass, prior to considering the evolution of embedded circumbinary planets. In agreement with previous work, we find that for disc masses between one and five times the minimum mass solar nebula (MMSN), disc self-gravity affects modest changes in the structure and evolution of circumbinary discs. Increasing the disc mass to 10 or 20 MMSN leads to two dramatic changes in disc structure. First, the scale of the inner cavity shrinks substantially, bringing its outer edge closer to the binary. Secondly, in addition to the eccentric inner cavity, additional precessing eccentric ring-like features develop in the outer regions of the discs. If planet formation starts early in the disc lifetime, these changes will have a significant impact on the formation and evolution of planets and precursor material.

  15. Importance and pitfalls of molecular analysis to parasite epidemiology.

    PubMed

    Constantine, Clare C

    2003-08-01

    Molecular tools are increasingly being used to address questions about parasite epidemiology. Parasites represent a diverse group and they might not fit traditional population genetic models. Testing hypotheses depends equally on correct sampling, appropriate tool and/or marker choice, appropriate analysis and careful interpretation. All methods of analysis make assumptions which, if violated, make the results invalid. Some guidelines to avoid common pitfalls are offered here.

  16. Benefits and Pitfalls: Simple Guidelines for the Use of Social Networking Tools in K-12 Education

    ERIC Educational Resources Information Center

    Huffman, Stephanie

    2013-01-01

    The article will outline a framework for the use of social networking tools in K-12 education framed around four thought provoking questions: 1) what are the benefits and pitfalls of using social networking tools in P-12 education, 2) how do we plan effectively for the use of social networking tool, 3) what role does professional development play…

  17. Two new planthopper species (Hemiptera, Fulgoroidea, Caliscelidae) collected in pitfall traps in Zambia.

    PubMed

    Chmurova, Lucia; Webb, Michael D

    2016-08-22

    Two new species of planthoppers in the family Caliscelidae (Hemiptera: Fulgoroidea) are described from Zambia, i.e., Afronaso spinosa sp. n. and Calampocus zambiaensis sp. n. All specimens are flightless males and nearly all were collected from baited pitfall traps (except for one specimen collected from a yellow pan trap), suggesting that they live near to or on the ground.

  18. Short-term response of shrews to prescribed fire and mechanical fuelr eduction in a Southern Appalachian upland hardwood forest

    Treesearch

    Cathryn H. Greenberg; Stanlee Miller; Thomas A. Waldrop

    2007-01-01

    As part of the multidisciplinary National Fire and Fire Surrogate study, we used drift fences with pitfall traps from May to September 2003 and 2004 to determine how three fuel reduction techniques affected shrews in the Southern Appalachian Mountains of North Carolina. Ground dwelling macroarthropods also were collected from a subset of pitfall traps to assess...

  19. Common pitfalls in statistical analysis: Absolute risk reduction, relative risk reduction, and number needed to treat

    PubMed Central

    Ranganathan, Priya; Pramesh, C. S.; Aggarwal, Rakesh

    2016-01-01

    In the previous article in this series on common pitfalls in statistical analysis, we looked at the difference between risk and odds. Risk, which refers to the probability of occurrence of an event or outcome, can be defined in absolute or relative terms. Understanding what these measures represent is essential for the accurate interpretation of study results. PMID:26952180

  20. Radial modes of laterally stiffened piezoelectric disc transducers for ultrasonic collimated beam generation

    DOE PAGES

    Chillara, Vamshi Krishna; Pantea, Cristian; Sinha, Dipen N.

    2017-07-15

    Here, we numerically investigate the resonance and vibration characteristics of radial modes of laterally stiffened piezoelectric disc transducers. Lateral stiffening is modeled using a spring and vibration characteristics of the piezo-disc are investigated with increasing lateral stiffness. It is found that the resonant frequency response of the radial modes follows an asymptotic behavior approaching that of a clamped disc with increasing lateral stiffness. The radial mode vibration pattern of the discs is also found to be affected by lateral stiffness. While the vibration pattern of a free disc corresponds to a Bessel function, laterally stiffened discs show edge-effects where theymore » depart from the Bessel-like behavior. In addition, a fully clamped piezo-disc is found to have an extra side-lobe when compared to a free disc. Ultrasonic beam profiles generated from radial modes of laterally stiffened discs are numerically investigated. It is found that the free piezo-disc generates a Bessel beam that has multiple side-lobes. Increasing the lateral stiffness results in a significant reduction of side-lobes in the beam profile. This technique of generating a collimated beam with side-lobe reduction finds significant applications in imaging through concrete, drilling mud, and other highly attenuating materials.« less

  1. Construction Strategy and Progress of Whole Intervertebral Disc Tissue Engineering.

    PubMed

    Yang, Qiang; Xu, Hai-wei; Hurday, Sookesh; Xu, Bao-shan

    2016-02-01

    Degenerative disc disease (DDD) is the major cause of low back pain, which usually leads to work absenteeism, medical visits and hospitalization. Because the current conservative procedures and surgical approaches to treatment of DDD only aim to relieve the symptoms of disease but not to regenerate the diseased disc, their long-term efficiency is limited. With the rapid developments in medical science, tissue engineering techniques have progressed markedly in recent years, providing a novel regenerative strategy for managing intervertebral disc disease. However, there are as yet no ideal methods for constructing tissue-engineered intervertebral discs. This paper reviews published reports pertaining to intervertebral disc tissue engineering and summarizes data concerning the seed cells and scaffold materials for tissue-engineered intervertebral discs, construction of tissue-engineered whole intervertebral discs, relevant animal experiments and effects of mechanics on the construction of tissue-engineered intervertebral disc and outlines the existing problems and future directions. Although the perfect regenerative strategy for treating DDD has not yet been developed, great progress has been achieved in the construction of tissue-engineered intervertebral discs. It is believed that ongoing research on intervertebral disc tissue engineering will result in revolutionary progress in the treatment of DDD. © 2016 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  2. Formation of precessing jets by tilted black hole discs in 3D general relativistic MHD simulations

    NASA Astrophysics Data System (ADS)

    Liska, M.; Hesp, C.; Tchekhovskoy, A.; Ingram, A.; van der Klis, M.; Markoff, S.

    2018-02-01

    Gas falling into a black hole (BH) from large distances is unaware of BH spin direction, and misalignment between the accretion disc and BH spin is expected to be common. However, the physics of tilted discs (e.g. angular momentum transport and jet formation) is poorly understood. Using our new GPU-accelerated code H-AMR, we performed 3D general relativistic magnetohydrodynamic simulations of tilted thick accretion discs around rapidly spinning BHs, at the highest resolution to date. We explored the limit where disc thermal pressure dominates magnetic pressure, and showed for the first time that, for different magnetic field strengths on the BH, these flows launch magnetized relativistic jets propagating along the rotation axis of the tilted disc (rather than of the BH). If strong large-scale magnetic flux reaches the BH, it bends the inner few gravitational radii of the disc and jets into partial alignment with the BH spin. On longer time-scales, the simulated disc-jet system as a whole undergoes Lense-Thirring precession and approaches alignment, demonstrating for the first time that jets can be used as probes of disc precession. When the disc turbulence is well resolved, our isolated discs spread out, causing both the alignment and precession to slow down.

  3. Extended transiting discs and rings around planets and brown dwarfs: theoretical constraints

    NASA Astrophysics Data System (ADS)

    Zanazzi, J. J.; Lai, Dong

    2017-02-01

    Newly formed planets (or brown dwarfs) may possess discs or rings which occupy an appreciable fraction of the planet's Hill sphere and extend beyond the Laplace radius, where the tidal torque from the host star dominates over the torque from the oblate planet. Such a disc/ring can exhibit unique, detectable transit signatures, provided that the disc/ring is significantly misaligned with the orbital plane of the planet. There exists tentative evidence for an extended ring system around the young K5 star 1 SWASP J140747-354542. We present a general theoretical study of the inclination (warp) profile of circumplanetary discs under the combined influences of the tidal torque from the central star, the torque from the oblate planet, and the self-gravity of the disc. We calculate the equilibrium warp profile (`generalized Laplace surface') and investigate the condition for coherent precession of the disc. We find that to maintain a non-negligible misalignment between the extended outer disc and the planet's orbital plane, and to ensure coherent disc precession, the disc surface density must be sufficiently large so that the self-gravity torque overcomes the tidal torque from the central star. Our analysis and quantitative results can be used to constrain the parameters of transiting circumplanetary discs which may be detected in the future.

  4. The Diversity of Assembly Histories Leading to Disc Galaxy Formation in a ΛCDM Model

    NASA Astrophysics Data System (ADS)

    Font, Andreea S.; McCarthy, Ian G.; Le Brun, Amandine M. C.; Crain, Robert A.; Kelvin, Lee S.

    2017-11-01

    Disc galaxies forming in a LambdaCDM cosmology often experience violent mergers. The fact that disc galaxies are ubiquitous suggests that quiescent histories are not necessary. Modern cosmological simulations can now obtain realistic populations of disc galaxies, but it is still unclear how discs manage to survive massive mergers. Here we use a suite of hydrodynamical cosmological simulations to elucidate the fate of discs encountering massive mergers. We follow the changes in the post-merger disc-to-total ratios (D/T) of simulated galaxies and examine the relations between their present-day morphology, assembly history and gas fractions. We find that approximately half of present-day disc galaxies underwent at least one merger with a satellite more massive the host's stellar component and a third had mergers with satellites three times as massive. These mergers lead to a sharp, but often temporary, decrease in the D/T of the hosts, implying that discs are usually disrupted but then quickly re-grow. To do so, high cold gas fractions are required post-merger, as well as a relatively quiescent recent history (over a few Gyrs before z = 0). Our results show that discs can form via diverse merger pathways and that quiescent histories are not the dominant mode of disc formation.

  5. Senescent intervertebral disc cells exhibit perturbed matrix homeostasis phenotype.

    PubMed

    Ngo, Kevin; Patil, Prashanti; McGowan, Sara J; Niedernhofer, Laura J; Robbins, Paul D; Kang, James; Sowa, Gwendolyn; Vo, Nam

    2017-09-01

    Aging greatly increases the risk for intervertebral disc degeneration (IDD) as a result of proteoglycan loss due to reduced synthesis and enhanced degradation of the disc matrix proteoglycan (PG). How disc matrix PG homeostasis becomes perturbed with age is not known. The goal of this study is to determine whether cellular senescence is a source of this perturbation. We demonstrated that disc cellular senescence is dramatically increased in the DNA repair-deficient Ercc1 -/Δ mouse model of human progeria. In these accelerated aging mice, increased disc cellular senescence is closely associated with the rapid loss of disc PG. We also directly examine PG homeostasis in oxidative damage-induced senescent human cells using an in vitro cell culture model system. Senescence of human disc cells treated with hydrogen peroxide was confirmed by growth arrest, senescence-associated β-galactosidase activity, γH2AX foci, and acquisition of senescence-associated secretory phenotype. Senescent human disc cells also exhibited perturbed matrix PG homeostasis as evidenced by their decreased capacity to synthesize new matrix PG and enhanced degradation of aggrecan, a major matrix PG. of the disc. Our in vivo and in vitro findings altogether suggest that disc cellular senescence is an important driver of PG matrix homeostatic perturbation and PG loss. Published by Elsevier B.V.

  6. 26 CFR 1.921-1T - Temporary regulations providing transition rules for DISCs and FSCs.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... a DISC's taxable year? A-1: Without regard to the annual accounting period of the DISC, the last... distribution of previously taxed income have on the earnings and profits of corporate shareholders of the former DISC? A-8: The earnings and profits of the corporate shareholders of the former DISC will be...

  7. Trapping of low-mass planets outside the truncated inner edges of protoplanetary discs

    NASA Astrophysics Data System (ADS)

    Miranda, Ryan; Lai, Dong

    2018-02-01

    We investigate the migration of a low-mass (≲10 M⊕) planet near the inner edge of a protoplanetary disc using two-dimensional viscous hydrodynamics simulations. We employ an inner boundary condition representing the truncation of the disc at the stellar corotation radius. As described by Tsang, wave reflection at the inner disc boundary modifies the Type I migration torque on the planet, allowing migration to be halted before the planet reaches the inner edge of the disc. For low-viscosity discs (α ≲ 10-3), planets may be trapped with semi-major axes as large as three to five times the inner disc radius. In general, planets are trapped closer to the inner edge as either the planet mass or the disc viscosity parameter α increases, and farther from the inner edge as the disc thickness is increased. This planet trapping mechanism may impact the formation and migration history of close-in compact multiplanet systems.

  8. Correlation between direction and severity of temporomandibular joint disc displacement and reduction ability during mouth opening.

    PubMed

    Litko, M; Berger, M; Szkutnik, J; Różyło-Kalinowska, I

    2017-12-01

    The most common temporomandibular joint (TMJ) internal derangement is an abnormal relationship of the disc with respect to the mandibular condyle, articular eminence and glenoid fossa-disc displacement. The aim of our study was to analyse the correlation between partial/complete disc displacement in the intercuspal position (IP) and its reduction in the open-mouth position (OMP) in both oblique sagittal and coronal planes on magnetic resonance imaging (MRI) in patients with temporomandibular disorders. Multisection MRI analysis of 382 TMJs was conducted in 191 patients with disc displacement according to the RDC/TMD criteria (148 women, 43 men; aged 14-60 years). The disc position was evaluated on all oblique sagittal and coronal images in the IP and the OMP. Univariate logistic regression analysis showed that the severity of disc displacement in the sagittal plane is a statistically significant predictor of reduction ability during mouth opening (B = 3.118; P < .001). Moreover, the severity of disc displacement in both planes is also a significant predictor of disc reduction in OMP (B = 2.200; P < .05). In conclusion, reduction ability during mouth opening is associated with the severity of disc displacement in IP, in both sagittal and coronal planes. Multisection analysis of all MR images allows distinguishing the correct disc position from disc displacement and can improve the ability to distinguish between various stages of TMJ internal derangement. © 2017 John Wiley & Sons Ltd.

  9. Comparison of Optic Disc Margin Identified by Color Disc Photography and High-Speed Ultrahigh-Resolution Optical Coherence Tomography

    PubMed Central

    Manassakorn, Anita; Ishikawa, Hiroshi; Kim, Jong S.; Wollstein, Gadi; Bilonick, Richard A.; Kagemann, Larry; Gabriele, Michelle L.; Sung, Kyung Rim; Mumcuoglu, Tarkan; Duker, Jay S.; Fujimoto, James G.; Schuman, Joel S.

    2009-01-01

    Objective To determine the correspondence between optic disc margins evaluated using disc photography (DP) and optical coherence tomography (OCT). Methods From May 1, 2005, through November 10, 2005, 17 healthy volunteers (17 eyes) had raster scans (180 frames, 501 samplings per frame) centered on the optic disc taken with stereo-optic DP and high-speed ultrahigh-resolution OCT (hsUHR-OCT). Two image outputs were derived from the hsUHR-OCT data set: an en face hsUHR-OCT fundus image and a set of 180 frames of cross-sectional images. Three ophthalmologists independently and in a masked, randomized fashion marked the disc margin on the DP, hsUHR-OCT fundus, and cross-sectional images using custom software. Disc size (area and horizontal and vertical diameters) and location of the geometric disc center were compared among the 3 types of images. Results The hsUHR-OCT fundus image definition showed a significantly smaller disc size than the DP definition (P<.001, mixed-effects analysis). The hsUHR-OCT cross-sectional image definition showed a significantly larger disc size than the DP definition (P<.001). The geometric disc center location was similar among the 3 types of images except for the y-coordinate, which was significantly smaller in the hsUHR-OCT fundus images than in the DP images. Conclusion The optic disc margin as defined by hsUHR-OCT was significantly different than the margin defined by DP. PMID:18195219

  10. Instability of warped discs

    NASA Astrophysics Data System (ADS)

    Doǧan, S.; Nixon, C. J.; King, A. R.; Pringle, J. E.

    2018-05-01

    Accretion discs are generally warped. If a warp in a disc is too large, the disc can `break' apart into two or more distinct planes, with only tenuous connections between them. Further, if an initially planar disc is subject to a strong differential precession, then it can be torn apart into discrete annuli that precess effectively independently. In previous investigations, torque-balance formulae have been used to predict where and when the disc breaks into distinct parts. In this work, focusing on discs with Keplerian rotation and where the shearing motions driving the radial communication of the warp are damped locally by turbulence (the `diffusive' regime), we investigate the stability of warped discs to determine the precise criterion for an isolated warped disc to break. We find and solve the dispersion relation, which, in general, yields three roots. We provide a comprehensive analysis of this viscous-warp instability and the emergent growth rates and their dependence on disc parameters. The physics of the instability can be understood as a combination of (1) a term that would generally encapsulate the classical Lightman-Eardley instability in planar discs (given by ∂(νΣ)/∂Σ < 0) but is here modified by the warp to include ∂(ν1|ψ|)/∂|ψ| < 0, and (2) a similar condition acting on the diffusion of the warp amplitude given in simplified form by ∂(ν2|ψ|)/∂|ψ| < 0. We discuss our findings in the context of discs with an imposed precession, and comment on the implications for different astrophysical systems.

  11. DISC1 Protein Regulates γ-Aminobutyric Acid, Type A (GABAA) Receptor Trafficking and Inhibitory Synaptic Transmission in Cortical Neurons.

    PubMed

    Wei, Jing; Graziane, Nicholas M; Gu, Zhenglin; Yan, Zhen

    2015-11-13

    Association studies have suggested that Disrupted-in-Schizophrenia 1 (DISC1) confers a genetic risk at the level of endophenotypes that underlies many major mental disorders. Despite the progress in understanding the significance of DISC1 at neural development, the mechanisms underlying DISC1 regulation of synaptic functions remain elusive. Because alterations in the cortical GABA system have been strongly linked to the pathophysiology of schizophrenia, one potential target of DISC1 that is critically involved in the regulation of cognition and emotion is the GABAA receptor (GABAAR). We found that cellular knockdown of DISC1 significantly reduced GABAAR-mediated synaptic and whole-cell current, whereas overexpression of wild-type DISC1, but not the C-terminal-truncated DISC1 (a schizophrenia-related mutant), significantly increased GABAAR currents in pyramidal neurons of the prefrontal cortex. These effects were accompanied by DISC1-induced changes in surface GABAAR expression. Moreover, the regulation of GABAARs by DISC1 knockdown or overexpression depends on the microtubule motor protein kinesin 1 (KIF5). Our results suggest that DISC1 exerts an important effect on GABAergic inhibitory transmission by regulating KIF5/microtubule-based GABAAR trafficking in the cortex. The knowledge gained from this study would shed light on how DISC1 and the GABA system are linked mechanistically and how their interactions are critical for maintaining a normal mental state. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

  12. Revolution evolution: tracing angular momentum during star and planetary system formation

    NASA Astrophysics Data System (ADS)

    Davies, Claire Louise

    2015-04-01

    Stars form via the gravitational collapse of molecular clouds during which time the protostellar object contracts by over seven orders of magnitude. If all the angular momentum present in the natal cloud was conserved during collapse, stars would approach rotational velocities rapid enough to tear themselves apart within just a few Myr. In contrast to this, observations of pre-main sequence rotation rates are relatively slow (∼ 1 - 15 days) indicating that significant quantities of angular momentum must be removed from the star. I use observations of fully convective pre-main sequence stars in two well-studied, nearby regions of star formation (namely the Orion Nebula Cluster and Taurus-Auriga) to determine the removal rate of stellar angular momentum. I find the accretion disc-hosting stars to be rotating at a slower rate and contain less specific angular momentum than the disc-less stars. I interpret this as indicating a period of accretion disc-regulated angular momentum evolution followed by near-constant rotational evolution following disc dispersal. Furthermore, assuming that the age spread inferred from the Hertzsprung-Russell diagram constructed for the star forming region is real, I find that the removal rate of angular momentum during the accretion-disc hosting phase to be more rapid than that expected from simple disc-locking theory whereby contraction occurs at a fixed rotation period. This indicates a more efficient process of angular momentum removal must operate, most likely in the form of an accretion-driven stellar wind or outflow emanating from the star-disc interaction. The initial circumstellar envelope that surrounds a protostellar object during the earliest stages of star formation is rotationally flattened into a disc as the star contracts. An effective viscosity, present within the disc, enables the disc to evolve: mass accretes inwards through the disc and onto the star while momentum migrates outwards, forcing the outer regions of the disc to expand. I used spatially resolved submillimetre detections of the dust and gas components of protoplanetary discs, gathered from the literature, to measure the radial extent of discs around low-mass pre-main sequence stars of ∼ 1-10 Myr and probe their viscous evolution. I find no clear observational evidence for the radial expansion of the dust component. However, I find tentative evidence for the expansion ofthe gas component. This suggests that the evolution of the gas and dust components of protoplanetary discs are likely governed by different astrophysical processes. Observations of jets and outflows emanating from protostars and pre-main sequence stars highlight that it may also be possible to remove angular momentum from the circumstellar material. Using the sample of spatially resolved protoplanetary discs, I find no evidence for angular momentum removal during disc evolution. I also use the spatially resolved debris discs from the Submillimetre Common-User Bolometer Array-2 Observations of Nearby Stars survey to constrain the amount of angular momentum retained within planetary systems. This sample is compared to the protoplanetary disc angular momenta and to the angular momentum contained within pre-stellar cores. I find that significant quantities of angular momentum must be removed during disc formation and disc dispersal. This likely occurs via magnetic braking during the formation of the disc, via the launching of a disc or photo-evaporative wind, and/or via ejection of planetary material following dynamical interactions.

  13. Type II Modic Changes May not Always Represent Fat Degeneration: A Study Using MR Fat Suppression Sequence.

    PubMed

    Feng, Zhiyun; Liu, Yuanhao; Wei, Wei; Hu, Shengping; Wang, Yue

    2016-08-15

    A radiological study of type II Modic changes (MCs). The aim of this study was to determine the characteristics of type II MCs on fat suppression (FS) magnetic resonance (MR) images and its association with radiological disc degeneration. Type II MCs are common endplate signal changes on MR images. On the basis of limited histological samples, type II MCs are thought to be stable fat degeneration. FS technique on MR, which can quantify fat content, may be an alternative to explore the pathology of MCs. To date, however, the characteristics of type II MCs on FS sequence have not been studied. Lumbar MR images conducted in a single hospital during a defined period were reviewed to include those with type II MCs and FS images. On FS images, signal status of type II MCs was visually classified as suppressed or not-suppressed. Signal intensity of vertebral regions with and without MCs was measured quantitatively on T2-weighted (T2W) and FS images to calculate fat content index and validate the visual classification. Using image analysis program Osirix, MCs size and adjacent disc degeneration were measured quantitatively. Paired t-tests and logistic regressions were used to determine the associations studied. Sixty-four lumbar MRIs were included and 150 endplates with type II MCs were studied. Although signal of 37 (24.7%) type II MCs was suppressed on FS images, that of 113 (75.3%) was not suppressed. The discs adjacent to type II MCs had lower signal intensity (0.13 ± 0.003 vs. 0.14 ± 0.004, P < 0.001), lesser disc height (9.73 ± 1.97 vs. 11.07 ± 1.99, P < 0.001) and greater bulging area (80.0 ± 31.4 vs. 61.3 ± 27.5 for anterior bulging, 33.72 ± 21.24 vs. 27.93 ± 12.79 for posterior bulging, and 113.7 ± 39.9 vs. 89.2 ± 35.2 for total bulging, P < 0.05) than normal controls. Type II MCs that were not suppressed on FS image were associated with greater age [odds ratio (OR) = 1.11, P < 0.001], lower height (OR = 0.94, P < 0.05), and greater posterior bulging (OR = 1.05, P < 0.001) at the adjacent disc. Signal of most type II MCs was not suppressed on FS MR images, suggesting that there are ongoing complicated pathologies. Type II MCs may not merely represent fat replacement. 3.

  14. Rossby wave instability in astrophysical discs

    NASA Astrophysics Data System (ADS)

    Lovelace, R. V. E.; Romanova, M. M.

    2014-08-01

    A brief review is given of the Rossby wave instability in astrophysical discs. In non-self-gravitating discs, around for example a newly forming stars, the instability can be triggered by an axisymmetric bump at some radius r0 in the disc surface mass-density. It gives rise to exponentially growing non-axisymmetric perturbation (\\propto \\exp \\,({ { i}}m\\phi ) , m = 1,2,…) in the vicinity of r0 consisting of anticyclonic vortices. These vortices are regions of high pressure and consequently act to trap dust particles which in turn can facilitate planetesimal growth in proto-planetary discs. The Rossby vortices in the discs around stars and black holes may cause the observed quasi-periodic modulations of the disc's thermal emission.

  15. Disc Golf: Teaching a Lifetime Activity

    ERIC Educational Resources Information Center

    Eastham, Susan L.

    2015-01-01

    Disc golf is a lifetime activity that can be enjoyed by students of varying skill levels and abilities. Disc golf follows the principles of ball golf but is generally easier for students to play and enjoy success. The object of disc golf is similar to ball golf and involves throwing a disc from the teeing area to the target in as few throws as…

  16. 26 CFR 1.995-1 - Taxation of DISC income to shareholders.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 10 2011-04-01 2011-04-01 false Taxation of DISC income to shareholders. 1.995... Taxation of DISC income to shareholders. (a) In general. (1) Under § 1.991-1(a), a corporation which is a... DISC, are subject to taxation on the earnings and profits of the DISC in accordance with the provisions...

  17. Modeling and optimization of an elastic arthroplastic disc for a degenerated disc

    NASA Astrophysics Data System (ADS)

    Ghouchani, Azadeh; Ravari, Mohammad; Mahmoudi, Farid

    2011-10-01

    A three-dimensional finite element model (FEM) of the L3-L4 motion segment using ABAQUS v 6.9 has been developed. The model took into account the material nonlinearities and is imposed different loading conditions. In this study, we validated the model by comparison of its predictions with several sets of experimental data. Disc deformation under compression and segmental rotational motions under moment loads for the normal disc model agreed well with the corresponding in vivo studies. By linking ABAQUS with MATLAB 2010.a, we determined the optimal Young s modulus as well as the Poisson's ratio for the artificial disc under different physiologic loading conditions. The results of the present study confirmed that a well-designed elastic arthroplastic disc preferably has an annulus modulus of 19.1 MPa and 1.24 MPa for nucleus section and Poisson ratio of 0.41 and 0.47 respectively. Elastic artificial disc with such properties can then achieve the goal of restoring the disc height and mechanical function of intact disc under different loading conditions and so can reduce low back pain which is mostly caused due to disc degeneration.

  18. DOE Office of Scientific and Technical Information (OSTI.GOV)

    Chillara, Vamshi Krishna; Pantea, Cristian; Sinha, Dipen N.

    Here, we numerically investigate the resonance and vibration characteristics of radial modes of laterally stiffened piezoelectric disc transducers. Lateral stiffening is modeled using a spring and vibration characteristics of the piezo-disc are investigated with increasing lateral stiffness. It is found that the resonant frequency response of the radial modes follows an asymptotic behavior approaching that of a clamped disc with increasing lateral stiffness. The radial mode vibration pattern of the discs is also found to be affected by lateral stiffness. While the vibration pattern of a free disc corresponds to a Bessel function, laterally stiffened discs show edge-effects where theymore » depart from the Bessel-like behavior. In addition, a fully clamped piezo-disc is found to have an extra side-lobe when compared to a free disc. Ultrasonic beam profiles generated from radial modes of laterally stiffened discs are numerically investigated. It is found that the free piezo-disc generates a Bessel beam that has multiple side-lobes. Increasing the lateral stiffness results in a significant reduction of side-lobes in the beam profile. This technique of generating a collimated beam with side-lobe reduction finds significant applications in imaging through concrete, drilling mud, and other highly attenuating materials.« less

  19. Fragmentation of protoplanetary discs around M-dwarfs

    NASA Astrophysics Data System (ADS)

    Backus, Isaac; Quinn, Thomas

    2016-12-01

    We investigate the conditions required for planet formation via gravitational instability (GI) and protoplanetary disc (PPD) fragmentation around M-dwarfs. Using a suite of 64 SPH simulations with 106 particles, the parameter space of disc mass, temperature, and radius is explored, bracketing reasonable values based on theory and observation. Our model consists of an equilibrium, gaseous, and locally isothermal disc orbiting a central star of mass M* = M⊙/3. Discs with a minimum Toomre Q of Qmin ≲ 0.9 will fragment and form gravitationally bound clumps. Some previous literature has found Qmin < 1.3-1.5 to be sufficient for fragmentation. Increasing disc height tends to stabilize discs, and when incorporated into Q as Qeff ∝ Q(H/R)α for α = 0.18 is sufficient to predict fragmentation. Some discrepancies in the literature regarding Qcrit may be due to different methods of generating initial conditions (ICs). A series of 15 simulations demonstrates that perturbing ICs slightly out of equilibrium can cause discs to fragment for higher Q. Our method for generating ICs is presented in detail. We argue that GI likely plays a role in PPDs around M-dwarfs and that disc fragmentation at large radii is a plausible outcome for these discs.

  20. Spontaneous regression of posterior epidural migrated lumbar disc fragments: case series.

    PubMed

    Tarukado, Kiyoshi; Ikuta, Ko; Fukutoku, Yoshiaki; Tono, Osamu; Doi, Toshio

    2015-06-01

    Posterior epidural migrated lumbar disc fragments is an extremely rare disorder. Surgical treatment was performed in all reported cases. To the best of our knowledge, there are no reported cases of the use of conservative treatment for posterior epidural migrated lumbar disc fragments. To report the possibility of a spontaneous regression of posterior epidural migrated lumbar disc fragments. Case series. Four patients with posterior epidural migrated lumbar disc fragments were treated at Karatsu Red Cross Hospital between April 2008 and August 2010. Spontaneous regression of the posterior epidural migrated lumbar disc fragments with relief of symptoms was observed on magnetic resonance imaging (MRI) in three cases. Another patient underwent surgical treatment. The present and previously reported cases of posterior epidural migrated lumbar disc fragments were analyzed with respect to patient age, imaging features on MRI, the level of the lesion, clinical symptoms, treatment, and outcomes. Conservative treatment was successful, and spontaneous lesion regression was seen on MRI with symptom relief in three cases. Although posterior epidural migrated lumbar disc fragment cases are generally treated surgically, the condition can regress spontaneously over time, as do sequestrated disc fragments. Spontaneous regression of lumbar disc herniations is a widely accepted observation at present. Posterior epidural migrated lumbar disc fragments fall under the sequestrated type of disc herniation. In fact, the course of treatment for posterior epidural migrated lumbar disc fragments should be determined based on the symptoms and examination findings, as in cases of ordinary herniation. However, providing early surgical treatment is important if the patient has acute cauda equina syndrome or the neurologic symptoms worsen over time. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Disrupted-in-Schizophrenia-1 Attenuates Amyloid-β Generation and Cognitive Deficits in APP/PS1 Transgenic Mice by Reduction of β-Site APP-Cleaving Enzyme 1 Levels

    PubMed Central

    Deng, Qing-Shan; Dong, Xing-Yu; Wu, Hao; Wang, Wang; Wang, Zhao-Tao; Zhu, Jian-Wei; Liu, Chun-Feng; Jia, Wei-Qiang; Zhang, Yan; Schachner, Melitta; Ma, Quan-Hong; Xu, Ru-Xiang

    2016-01-01

    Disrupted-in-Schizophrenia-1 (DISC1) is a genetic risk factor for a wide range of major mental disorders, including schizophrenia, major depression, and bipolar disorders. Recent reports suggest a potential role of DISC1 in the pathogenesis of Alzheimer's disease (AD), by referring to an interaction between DISC1 and amyloid precursor protein (APP), and to an association of a single-nucleotide polymorphism in a DISC1 intron and late onset of AD. However, the function of DISC1 in AD remains unknown. In this study, decreased levels of DISC1 were observed in the cortex and hippocampus of 8-month-old APP/PS1 transgenic mice, an animal model of AD. Overexpression of DISC1 reduced, whereas knockdown of DISC1 increased protein levels, but not mRNA levels of β-site APP-Cleaving Enzyme 1 (BACE1), a key enzyme in amyloid-β (Aβ) generation. Reduction of BACE1 protein levels by overexpression of DISC1 was accompanied by an accelerating decline rate of BACE1, and was blocked by the lysosomal inhibitor chloroquine, rather than proteasome inhibitor MG-132. Moreover, overexpression of DISC1 in the hippocampus with an adeno-associated virus reduced the levels of BACE1, soluble Aβ40/42, amyloid plaque density, and rescued cognitive deficits of APP/PS1 transgenic mice. These results indicate that DISC1 attenuates Aβ generation and cognitive deficits of APP/PS1 transgenic mice through promoting lysosomal degradation of BACE1. Our findings provide new insights into the role of DISC1 in AD pathogenesis and link a potential function of DISC1 to the psychiatric symptoms of AD. PMID:26062786

  2. Rat Disc Torsional Mechanics: Effect of Lumbar and Caudal Levels and Axial Compression Load

    PubMed Central

    Elliott, Dawn M; Espinoza Orías, Alejandro A; Malhotra, Neil R

    2009-01-01

    Background Context Rat models with altered loading are used to study disc degeneration and mechano-transduction. Given the prominent role of mechanics in disc function and degeneration, it is critical to measure mechanical behavior in order to evaluate changes following model interventions. Axial compression mechanics of the rat disc are representative of the human disc when normalized by geometry, and differences between the lumbar and caudal disc have been quantified in axial compression. No study has quantified rat disc torsional mechanics. Purpose Compare the torsional mechanical behavior of rat lumbar and caudal discs, determine the contribution of combined axial load on torsional mechanics, and compare the torsional properties of rat discs to human lumbar discs. Study Design Cadaveric biomechanical study. Methods Cyclic torsion without compressive load followed by cyclic torsion with a fixed compressive load was applied to rat lumbar and caudal disc levels. Results The apparent torsional modulus was higher in the lumbar region than in the caudal region,: 0.081±0.026 (MPa/°, Mean±SD) for lumbar axially loaded; 0.066±0.028 caudal axially loaded; 0.091±0.033 for lumbar in pure torsion; and 0.056±0.035 for caudal in pure torsion. These values were similar to human disc properties reported in the literature ranging from 0.024 to 0.21 MPa/°. Conclusions Use of the caudal disc as a model may be appropriate if the mechanical focus is within the linear region of the loading regime. These results provide support for use of this animal model in basic science studies with respect to torsional mechanics. PMID:18495544

  3. Changes in intervertebral disc cross-sectional area with bed rest and space flight

    NASA Technical Reports Server (NTRS)

    LeBlanc, A. D.; Evans, H. J.; Schneider, V. S.; Wendt, R. E. 3rd; Hedrick, T. D.

    1994-01-01

    STUDY DESIGN. We measured the cross-sectional area of the intervertebral discs of normal volunteers after an overnight rest; before, during, and after 5 or 17 weeks of bed rest; and before and after 8 days of weightlessness. OBJECTIVES. This study sought to determine the degree of expansion of the lumbar discs resulting from bed rest and space flight. SUMMARY OF BACKGROUND DATA. Weightlessness and bed rest, an analog for weightlessness, reduce the mechanical loading on the musculoskeletal system. When unloaded, intervertebral discs will expand, increasing the nutritional diffusion distance and altering the mechanical properties of the spine. METHODS. Magnetic resonance imaging was used to measure the cross-sectional area and transverse relaxation time (T2) of the intervertebral discs. RESULTS. Overnight or longer bed rest causes expansion of the disc area, which reaches an equilibrium value of about 22% (range 10-40%) above baseline within 4 days. Increases in disc area were associated with modest increases in disc T2. During bed rest, disc height increased approximately 1 mm, about one-half of previous estimates based on body height measurements. After 5 weeks of bed rest, disc area returned to baseline within a few days of ambulation, whereas after 17 weeks, disc area remained above baseline 6 weeks after reambulation. After 8 days of weightlessness, T2, disc area, and lumbar length were not significantly different from baseline values 24 hours after landing. CONCLUSIONS. Significant adaptive changes in the intervertebral discs can be expected during weightlessness. These changes, which are rapidly reversible after short-duration flights, may be an important factor during and after long-duration missions.

  4. The comparative analysis of rocks' resistance to forward-slanting disc cutters and traditionally installed disc cutters

    NASA Astrophysics Data System (ADS)

    Zhang, Zhao-Huang; Fei, Sun; Liang, Meng

    2016-08-01

    At present, disc cutters of a full face rock tunnel boring machine are mostly mounted in the traditional way. Practical use in engineering projects reveals that this installation method not only heavily affects the operation life of disc cutters, but also increases the energy consumption of a full face rock tunnel boring machine. To straighten out this issue, therefore, a rock-breaking model is developed for disc cutters' movement after the research on the rock breaking of forward-slanting disc cutters. Equations of its displacement are established based on the analysis of velocity vector of a disc cutter's rock-breaking point. The functional relations then are brought forward between the displacement parameters of a rock-breaking point and its coordinate through the analysis of micro displacement of a rock-breaking point. Thus, the geometric equations of rock deformation are derived for the forward-slanting installation of disc cutters. With a linear relationship remaining between the acting force and its deformation either before or after the leap breaking, the constitutive relation of rock deformation can be expressed in the form of generalized Hooke law, hence the comparative analysis of the variation in the resistance of rock to the disc cutters mounted in the forward-slanting way with that in the traditional way. It is discovered that with the same penetration, strain of the rock in contact with forward-slanting disc cutters is apparently on the decline, in other words, the resistance of rock to disc cutters is reduced. Thus wear of disc cutters resulted from friction is lowered and energy consumption is correspondingly decreased. It will be useful for the development of installation and design theory of disc cutters, and significant for the breakthrough in the design of full face rock tunnel boring machine.

  5. The vertical structure of gaseous galaxy discs in cold dark matter haloes

    NASA Astrophysics Data System (ADS)

    Benítez-Llambay, Alejandro; Navarro, Julio F.; Frenk, Carlos S.; Ludlow, Aaron D.

    2018-01-01

    We study the vertical structure of polytropic centrifugally supported gaseous discs embedded in cold dark matter (CDM) haloes. At fixed radius, R, the shape of the vertical density profile depends weakly on whether the disc is self-gravitating (SG) or non-self-gravitating (NSG). The disc 'characteristic' thickness, zH, set by the midplane sound speed and circular velocity, zNSG = (cs/Vc)R, in the NSG case, and by the sound speed and surface density, z_SG = c_s^2/GΣ, in SG discs, is smaller than zSG and zNSG. SG discs are typically Toomre unstable, NSG discs are stable. Exponential discs in CDM haloes with roughly flat circular velocity curves 'flare' outwards. Flares in mono abundance or coeval populations in galaxies like the Milky Way are thus not necessarily due to radial migration. For the polytropic equation of state of the Evolution and Assembly of GaLaxies and their Environments (EAGLE) simulations, discs that match observational constraints are NSG for Md < 3 × 109 M⊙ and SG at higher masses, if fully gaseous. We test these analytic results using a set of idealized smoothed particle hydrodynamic simulations and find excellent agreement. Our results clarify the role of the gravitational softening on the thickness of simulated discs, and on the onset of radial instabilities. EAGLE low-mass discs are NSG so the softening plays no role in their vertical structure. High-mass discs are expected to be SG and unstable, and may be artificially thickened and stabilized unless gravity is well resolved. Simulations with spatial resolution high enough to not compromise the vertical structure of a disc also resolve the onset of their instabilities, but the converse is not true.

  6. Effects of pitfall trap preservative on collections of carabid beetles (Coleoptera: Carabidae)

    USGS Publications Warehouse

    McCravy, K.W.; Willand, J.E.

    2007-01-01

    Effects of six pitfall trap preservatives (5% acetic acid solution, distilled water, 70% ethanol, 50% ethylene glycol solution, 50% propylene glycol solution, and 10% saline solution) on collections of carabid beetles (Coleoptera: Carabidae) were studied in a west-central Illinois deciduous forest from May to October 2005. A total of 819 carabids, representing 33 species and 19 genera, were collected. Saline produced significantly fewer captures than did acetic acid, ethanol, ethylene glycol, and propylene glycol, while distilled water produced significantly fewer captures than did acetic acid. Significant associations between numbers of captures and treatment were seen in four species: Amphasia interstitialis (Say), Calathus opaculus LeConte, Chlaenius nemoralis Say, and Cyclotrachelus sodalis (LeConte). Results of this study suggest that type of preservative used can have substantial effects on abundance and species composition of carabids collected in pitfall traps.

  7. Modelling the chemistry of a gravitationally unstable protoplanetary disc

    NASA Astrophysics Data System (ADS)

    Ilee, J. D.; Boley, A. C.; Caselli, P.; Durisen, R. H.; Hartquist, T. W.; Rawlings, J. M. C.

    2011-05-01

    Until now, axisymmetric, α-disc simulations have been adopted to describe the dynamics used in the construction of chemical models of protoplanetary discs. While this approach is reasonable for many discs, it is not appropriate for young, massive discs in which self-gravity is important. Spiral waves and shocks cause significant temperature and density variations which affect the chemistry. We have used a dynamical model of solar mass star surrounded by a massive (0.39 M⊙), self-gravitating disc to model the chemistry of one of these objects.

  8. Dissemination of aerosol and splatter during ultrasonic scaling: a pilot study.

    PubMed

    Veena, H R; Mahantesha, S; Joseph, Preethi A; Patil, Sudhir R; Patil, Suvarna H

    2015-01-01

    Routine dental procedures produce aerosol and splatter, which pose a potential risk to the clinician and dental personnel, as well as the immunocompromised patient. Reports indicate that the ultrasonic scaler is the greatest producer of aerosol and splatter. The study aimed to evaluate the contamination distance, contamination amount and contamination duration of aerosol produced during ultrasonic scaling. The study was performed on a mannequin fitted with phantom jaws on a dental chair. Mock scaling was done for 15 min using an auto-tuned magnetostrictive ultrasonic scaler with the simultaneous use of a low volume saliva ejector. An ultrafiltrate-containing fluorescent dye was used in the reservoir supplying the scaler unit. Filter paper discs were placed in different positions and distances in the operatory. Immediately following scaling, the filter paper discs were replaced with new ones. This was done every 30 min for a total duration of 90 min. Maximum contamination was found on the right arm of the operator and left arm of the assistant. Contamination was also found on the head, chest and inner surface of the face mask of the operator and of the assistant. The aerosol was found to remain in the air up to 30 min after scaling. The occupational health hazards of dental aerosols can be minimized by following simple, inexpensive precautions. Copyright © 2014 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  9. Interaction of micron and nano-sized particles with cells of the dura mater.

    PubMed

    Papageorgiou, Iraklis; Marsh, Rainy; Tipper, Joanne L; Hall, Richard M; Fisher, John; Ingham, Eileen

    2014-10-01

    Intervertebral total disc replacements (TDR) are used in the treatment of degenerative spinal disc disease. There are, however, concerns that they may be subject to long-term failure due to wear. The adverse effects of TDR wear have the potential to manifest in the dura mater and surrounding tissues. The aim of this study was to investigate the physiological structure of the dura mater, isolate the resident dural epithelial and stromal cells and analyse the capacity of these cells to internalise model polymer particles. The porcine dura mater was a collagen-rich structure encompassing regularly arranged fibroblastic cells within an outermost epithelial cell layer. The isolated dural epithelial cells had endothelial cell characteristics (positive for von Willebrand factor, CD31, E-cadherin and desmoplakin) and barrier functionality whereas the fibroblastic cells were positive for collagen I and III, tenascin and actin. The capacity of the dural cells to take up model particles was dependent on particle size. Nanometer sized particles readily penetrated both types of cells. However, dural fibroblasts engulfed micron-sized particles at a much higher rate than dural epithelial cells. The study suggested that dural epithelial cells may offer some barrier to the penetration of micron-sized particles but not nanometer sized particles. © 2014 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials Published by Wiley Periodicals, Inc.

  10. Evaluation of the quality of information on the Internet available to patients undergoing cervical spine surgery.

    PubMed

    Weil, Alexander G; Bojanowski, Michel W; Jamart, Jacques; Gustin, Thierry; Lévêque, Marc

    2014-01-01

    To evaluate the quality of information available on the Internet to patients with a cervical pathology undergoing elective cervical spine surgery. Six key words ("cervical discectomy," "cervical foraminotomy," "cervical fusion," "cervical disc replacement," "cervical arthroplasty," "cervical artificial disc") were entered into two different search engines (Google, Yahoo!). For each key word, the first 50 websites were evaluated for accessibility, comprehensibility, and website quality using the DISCERN tool, transparency and honesty criteria, and an accuracy and exhaustivity scale. Of 5,098,500 evaluable websites, 600 were visited; 97 (16%) of these websites were evaluated for quality and comprehensiveness. Overall, 3% of sites obtained an excellent global quality score, 7% obtained a good score, 25% obtained an above average score, 15% obtained an average score, 37% obtained a poor score, and 13% obtained a very poor score. High-quality websites were affiliated with a professional society (P = 0.021), had bibliographical references (P = 0.030), and had a recent update within 6 months (r = 0.277, P < 0.001). No correlation between global quality score and other variables was observed. This study shows that the search for medical information on the Internet is time-consuming and often disappointing. The Internet is a potentially misleading source of information. Surgeons and professional societies must use the Internet as an ally in providing optimal information to patients. Copyright © 2014. Published by Elsevier Inc.

  11. Defining the phenotype of young healthy nucleus pulposus cells: recommendations of the Spine Research Interest Group at the 2014 annual ORS meeting.

    PubMed

    Risbud, Makarand V; Schoepflin, Zachary R; Mwale, Fackson; Kandel, Rita A; Grad, Sibylle; Iatridis, James C; Sakai, Daisuke; Hoyland, Judith A

    2015-03-01

    Low back pain is a major physical and socioeconomic problem. Degeneration of the intervertebral disc and especially that of nucleus pulposus (NP) has been linked to low back pain. In spite of much research focusing on the NP, consensus among the research community is lacking in defining the NP cell phenotype. A consensus agreement will allow easier distinguishing of NP cells from annulus fibrosus (AF) cells and endplate chondrocytes, a better gauge of therapeutic success, and a better guidance of tissue-engineering-based regenerative strategies that attempt to replace lost NP tissue. Most importantly, a clear definition will further the understanding of physiology and function of NP cells, ultimately driving development of novel cell-based therapeutic modalities. The Spine Research Interest Group at the 2014 Annual ORS Meeting in New Orleans convened with the task of compiling a working definition of the NP cell phenotype with hope that a consensus statement will propel disc research forward into the future. Based on evaluation of recent studies describing characteristic NP markers and their physiologic relevance, we make the recommendation of the following healthy NP phenotypic markers: stabilized expression of HIF-1α, GLUT-1, aggrecan/collagen II ratio >20, Shh, Brachyury, KRT18/19, CA12, and CD24. © 2014 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  12. Minimally invasive photopolymerization in intervertebral disc tissue cavities

    NASA Astrophysics Data System (ADS)

    Schmocker, Andreas M.; Khoushabi, Azadeh; Gantenbein-Ritter, Benjamin; Chan, Samantha; Bonél, Harald Marcel; Bourban, Pierre-Etienne; Mânson, Jan Anders; Schizas, Constantin; Pioletti, Dominique; Moser, Christophe

    2014-03-01

    Photopolymerized hydrogels are commonly used for a broad range of biomedical applications. As long as the polymer volume is accessible, gels can easily be hardened using light illumination. However, in clinics, especially for minimally invasive surgery, it becomes highly challenging to control photopolymerization. The ratios between polymerizationvolume and radiating-surface-area are several orders of magnitude higher than for ex-vivo settings. Also tissue scattering occurs and influences the reaction. We developed a Monte Carlo model for photopolymerization, which takes into account the solid/liquid phase changes, moving solid/liquid-boundaries and refraction on these boundaries as well as tissue scattering in arbitrarily designable tissue cavities. The model provides a tool to tailor both the light probe and the scattering/absorption properties of the photopolymer for applications such as medical implants or tissue replacements. Based on the simulations, we have previously shown that by adding scattering additives to the liquid monomer, the photopolymerized volume was considerably increased. In this study, we have used bovine intervertebral disc cavities, as a model for spinal degeneration, to study photopolymerization in-vitro. The cavity is created by enzyme digestion. Using a custom designed probe, hydrogels were injected and photopolymerized. Magnetic resonance imaging (MRI) and visual inspection tools were employed to investigate the successful photopolymerization outcomes. The results provide insights for the development of novel endoscopic light-scattering polymerization probes paving the way for a new generation of implantable hydrogels.

  13. A distinct X-linked syndrome involving joint contractures, keloids, large optic cup-to-disc ratio, and renal stones results from a filamin A (FLNA) mutation.

    PubMed

    Lah, Melissa; Niranjan, Tejasvi; Srikanth, Sujata; Holloway, Lynda; Schwartz, Charles E; Wang, Tao; Weaver, David D

    2016-04-01

    We further evaluated a previously reported family with an apparently undescribed X-linked syndrome involving joint contractures, keloids, an increased optic cup-to-disc ratio, and renal stones to elucidate the genetic cause. To do this, we obtained medical histories and performed physical examination on 14 individuals in the family, five of whom are affected males and three are obligate carrier females. Linkage analysis was performed on all but one individual and chromosome X-exome sequencing was done on two affected males. The analysis localized the putative gene to Xq27-qter and chromosome X-exome sequencing revealed a mutation in exon 28 (c.4726G>A) of the filamin A (FLNA) gene, predicting that a conserved glycine had been replaced by arginine at amino acid 1576 (p.G1576R). Segregation analysis demonstrated that all known carrier females tested were heterozygous (G/A), all affected males were hemizygous for the mutation (A allele) and all normal males were hemizygous for the normal G allele. The data and the bioinformatic analysis indicate that the G1576R mutation in the FLNA gene is very likely pathogenic in this family. The syndrome affecting the family shares phenotypic overlap with other syndromes caused by FLNA mutations, but appears to be a distinct phenotype, likely representing a unique genetic syndrome. © 2016 Wiley Periodicals, Inc.

  14. Morphological Features and Important Parameters of Large Optic Discs for Diagnosing Glaucoma

    PubMed Central

    Okimoto, Satoshi; Yamashita, Keiko; Shibata, Tetsuo; Kiuchi, Yoshiaki

    2015-01-01

    Purpose To compare the optic disc parameters of glaucomatous eyes to those of non-glaucomatous eyes with large discs. Methods We studied 225 consecutive eyes with large optic discs (>2.82 mm2): 91 eyes with glaucoma and 134 eyes without glaucoma. An eye was diagnosed with glaucoma when visual field defects were detected by the Humphrey Field Analyzer. All of the Heidelberg Retina Tomograph II (HRT II) parameters were compared between the non-glaucomatous and glaucomatous eyes. A logistic regression analysis of the HRT II parameters was used to establish a new formula for diagnosing glaucoma, and the sensitivity and specificity of the Moorfields Regression Analysis (MRA) was compared to the findings made by our analyses. Results The mean disc area was 3.44±0.50 mm2 in the non-glaucomatous group and 3.40±0.52 mm2 in the glaucoma group. The cup area, cup volume, cup-to-disc area ratio, linear cup/disc ratio, mean cup depth, and the maximum cup depth were significantly larger in glaucomatous eyes than in the non-glaucomatous eyes. The rim area, rim volume, cup shape measurement, mean retinal nerve fiber layer (RNFL) thickness, and RFNL cross-sectional area were significantly smaller in glaucomatous eyes than in non-glaucomatous eyes. The cup-to-disc area ratio, the height variation contour (HVC), and the RNFL cross-sectional area were important parameters for diagnosing the early stage glaucoma, and the cup-to-disc area ratio and cup volume were useful for diagnosing advanced stage glaucoma in eyes with a large optic disc. The new formula had higher sensitivity and specificity for diagnosing glaucoma than MRA. Conclusions The cup-to-disc area ratio, HVC, RNFL cross-sectional area, and cup volume were important parameters for diagnosing glaucoma in eyes with a large optic disc. The important disc parameters to diagnose glaucoma depend on the stage of glaucoma in patients with large discs. PMID:25798580

  15. [In situ analysis of pathomechanisms of human intervertebral disc degeneration].

    PubMed

    Weiler, C

    2013-11-01

    Low back pain is one of the major causes of pain and disability in the western world, with a constantly rising life-time prevalence of approximately 60-85 %. Degeneration of the intervertebral disc is believed to be a major cause of low back pain. Semiquantitative macroscopic and microscopic changes of the intervertebral disc were assessed and classified. Furthermore additional methods, such as immunohistochemistry, in situ hybridization and in situ zymography were used to analyze phenotypic cellular and matrix changes. We have developed and tested a practicable, valid and reliable histological classification system for lumbar discs which can serve as a morphological reference framework to allow more sophisticated molecular biological studies on the pathogenesis of ageing and degeneration of discs. Secondly, we were able to demonstrate that intrinsic (genetic) and extrinsic (e.g. overweight) factors have a profound effect on the process of disc degeneration. Cells with a notochord-like phenotype are present in a considerable fraction of adult lumbar intervertebral discs. The presence of these cells is associated with distinct features of (early) age-related disc degeneration. During the process of disc degeneration, the intervertebral disc shows a progressive and significant reduction in height due to tissue resorption. This matrix loss is related to an imbalance between matrix synthesis and degradation. During this process an inflammatory reaction takes place and resident disc cells are causatively involved. In summary, disc degeneration is a multifactorial disease with a strong intrinsic (hereditary) and extrinsic (e.g. mechanical factors) background. The process starts as early as in the second decade of life and shows high interindividual differences. The loss of regenerative capacity in the intervertebral disc is probably related to the loss of stem cells, e.g. notochord-like cells. Resident disc cells are involved in the inflammatory reaction with increased matrix degradation, resorption and reduced matrix synthesis.

  16. Structure and function of the temporomandibular joint disc: implications for tissue engineering.

    PubMed

    Detamore, Michael S; Athanasiou, Kyriacos A

    2003-04-01

    The temporomandibular joint (TMJ) disc is a little understood structure that, unfortunately, exhibits a plethora of pathologic disorders. Tissue engineering approaches may be warranted to address TMJ disc pathophysiology, but first a clear understanding of structure-function relationships needs to be developed, especially as they relate to the regenerative potential of the tissue. In this review, we correlate the biochemical content of the TMJ disc to its mechanical behavior and discuss what this correlation infers for tissue engineering studies of the TMJ disc. The disc of the TMJ exhibits a somewhat biconcave shape, being thicker in the anterior and posterior bands and thinner in the intermediate zone. The disc, which is certainly an anisotropic and nonhomogeneous tissue, consists almost entirely of type I collagen with trace amounts of type II and other types. In general, collagen fibers in the intermediate zone appear to run primarily in an anteroposterior direction and in a ringlike fashion around the periphery. Collagen orientation is reflected in higher tensile stiffness and strength in the center anteroposteriorly than mediolaterally and in the anterior and posterior bands than the intermediate zone mediolaterally. Tensile tests have shown the disc is stiffer and stronger in the direction of the collagen fibers. Elastin fibers in general appear along the collagen fibers and most likely function in restoring and retaining disc form after loading. The 2 primary glycosaminoglycans of the disc by far are chondroitin sulfate and dermatan sulfate, although their distribution is not clear. Compression studies are conflicting, but evidence suggests the disc is compressively stiffest in the center. Only a few tissue engineering studies of the TMJ disc have been performed to date. Tissue engineering studies must take advantage of existing information for experimental design and construct validation, and more research is necessary to characterize the disc to create a clearer picture of our goals in tissue engineering the TMJ disc. Copyright 2003 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 61:494-506, 2003

  17. Optical Coherence Tomography Angiography of Optic Disc Perfusion in Glaucoma

    PubMed Central

    Jia, Yali; Wei, Eric; Wang, Xiaogang; Zhang, Xinbo; Morrison, John C.; Parikh, Mansi; Lombardi, Lori H.; Gattey, Devin M.; Armour, Rebecca L.; Edmunds, Beth; Kraus, Martin F.; Fujimoto, James G.; Huang, David

    2014-01-01

    Purpose To compare optic disc perfusion between normal and glaucoma subjects using optical coherence tomography (OCT) angiography and detect optic disc perfusion changes in glaucoma. Design Observational, cross-sectional study. Participants Twenty-four normal subjects and 11 glaucoma patients were included. Methods One eye of each subject was scanned by a high-speed 1050 nm wavelength swept-source OCT instrument. The split-spectrum amplitude-decorrelation angiography algorithm (SSADA) was used to compute three-dimensional optic disc angiography. A disc flow index was computed from four registered scans. Confocal scanning laser ophthalmoscopy (cSLO) was used to measure disc rim area, and stereo photography was used to evaluate cup/disc ratios. Wide field OCT scans over the discs were used to measure retinal nerve fiber layer (NFL) thickness. Main Outcome Measurements Variability was assessed by coefficient of variation (CV). Diagnostic accuracy was assessed by sensitivity and specificity. Comparisons between glaucoma and normal groups were analyzed by Wilcoxon rank-sum test. Correlations between disc flow index, structural assessments, and visual field (VF) parameters were assessed by linear regression. Results In normal discs, a dense microvascular network was visible on OCT angiography. This network was visibly attenuated in glaucoma subjects. The intra-visit repeatability, inter-visit reproducibility, and normal population variability of the optic disc flow index were 1.2%, 4.2%, and 5.0% CV respectively. The disc flow index was reduced by 25% in the glaucoma group (p = 0.003). Sensitivity and specificity were both 100% using an optimized cutoff. The flow index was highly correlated with VF pattern standard deviation (R2 = 0.752, p = 0.001). These correlations were significant even after accounting for age, cup/disc area ratio, NFL, and rim area. Conclusions OCT angiography, generated by the new SSADA algorithm, repeatably measures optic disc perfusion. OCT angiography could be useful in the evaluation of glaucoma and glaucoma progression. PMID:24629312

  18. Counter-rotating accretion discs

    NASA Astrophysics Data System (ADS)

    Dyda, S.; Lovelace, R. V. E.; Ustyugova, G. V.; Romanova, M. M.; Koldoba, A. V.

    2015-01-01

    Counter-rotating discs can arise from the accretion of a counter-rotating gas cloud on to the surface of an existing corotating disc or from the counter-rotating gas moving radially inwards to the outer edge of an existing disc. At the interface, the two components mix to produce gas or plasma with zero net angular momentum which tends to free-fall towards the disc centre. We discuss high-resolution axisymmetric hydrodynamic simulations of viscous counter-rotating discs for the cases where the two components are vertically separated and radially separated. The viscosity is described by an isotropic α-viscosity including all terms in the viscous stress tensor. For the vertically separated components, a shear layer forms between them and the middle part of this layer free-falls to the disc centre. The accretion rates are increased by factors of ˜102-104 over that for a conventional disc rotating in one direction with the same viscosity. The vertical width of the shear layer and the accretion rate are strongly dependent on the viscosity and the mass fraction of the counter-rotating gas. In the case of radially separated components where the inner disc corotates and the outer disc rotates in the opposite direction, a gap between the two components opens and closes quasi-periodically. The accretion rates are ≳25 times larger than those for a disc rotating in one direction with the same viscosity.

  19. Effect of Air-Polishing on Titanium Surfaces, Biofilm Removal, and Biocompatibility: A Pilot Study

    PubMed Central

    Bennani, Vincent; Hwang, Linda; Tawse-Smith, Andrew; Dias, George J.; Cannon, Richard D.

    2015-01-01

    Purpose. The aims of this in vitro study were to evaluate morphological changes induced by glycine powder air-polishing on titanium surfaces, biofilm removal, and biocompatibility. Material and Methods. Titanium grade IV discs were allocated into two groups: (1) discs without biofilm and (2) discs for Streptococcus mutans biofilm formation. Discs in each group were further subdivided into (a) no treatment and (b) air-polishing treatment with glycine powder. Discs were characterized by scanning electron microscopy (SEM), electron-dispersive spectroscopy (EDS), and confocal microscopy. Bacterial biofilms were quantified using a crystal violet dye-binding assay. Biocompatibility was evaluated by measuring the coverage and viability of L929 fibroblast cells cultured on the discs. Results. Air-polishing increased the roughness of treated discs (P < 0.05). EDS analysis did not show significant differences in the chemical composition of treated and nontreated discs. The amount of residual biofilm on treated discs was 8.6-fold lower than untreated controls (P < 0.05). Coverage of treated discs by fibroblasts was half that of untreated discs (P < 0.05) although both groups had the same cell viability. Conclusions. Air-polishing removed a significant amount of biofilm from titanium surfaces. The “polishing” was accompanied by increased surface roughness, but there were no changes in chemical and elemental compositions, nor the biocompatibility. PMID:26881198

  20. Use NASA GES DISC Data in ArcGIS

    NASA Technical Reports Server (NTRS)

    Yang, Wenli; Pham, Long B.; Kempler, Steve

    2015-01-01

    This presentation describes GIS relevant data at NASA Goddard Earth Sciences Data and Information Services Center (GES DISC), GES DISC Services and Support for GIS Users, and use cases of GES DISC data in ArcGIS.

  1. Accretion disc wind variability in the states of the microquasar GRS 1915+105

    NASA Astrophysics Data System (ADS)

    Neilsen, Joseph; Petschek, Andrew J.; Lee, Julia C.

    2012-03-01

    Continuing our study of the role and evolution of accretion disc winds in the microquasar GRS 1915+105, we present high-resolution spectral variability analysis of the β and γ states with the Chandra High-Energy Transmission Grating Spectrometer. By tracking changes in the absorption lines from the accretion disc wind, we find new evidence that radiation links the inner and outer accretion discs on a range of time-scales. As the central X-ray flux rises during the high-luminosity γ state, we observe the progressive overionization of the wind. In the β state, we argue that changes in the inner disc leading to the ejection of a transient 'baby jet' also quench the highly ionized wind from the outer disc. Our analysis reveals how the state, structure and X-ray luminosity of the inner accretion disc all conspire to drive the formation and variability of highly ionized accretion disc winds.

  2. Uncovertebral hypertrophy is a significant risk factor for the occurrence of heterotopic ossification after cervical disc replacement: survivorship analysis of Bryan disc for single-level cervical arthroplasty.

    PubMed

    Chung, Sang-Bong; Muradov, Johongir M; Lee, Sun-Ho; Eoh, Whan; Kim, Eun-Sang

    2012-06-01

    The purpose of this study is to investigate the incidence of heterotopic ossification (HO) in the Bryan cervical arthroplasty group and to identify associations between preoperative factors and the development of HO. We performed a retrospective review of clinical and radiological data on patients who underwent single-level cervical arthroplasty with Bryan prosthesis between January 2005 and September 2007. Patients were postoperatively followed-up at 1, 3, 6, 12 months and every year thereafter. The clinical assessment was conducted using Odom's criteria. The presence of HO was evaluated on the basis of X-ray at each time-point according to the McAfee classification. In this study, we focused on survivorship of Bryan prosthesis for single-level arthroplasty. The occurrence of ROM-affecting HO was defined as a functional failure and was used as an endpoint for determining survivorship. Through the analysis of 19 cases of Bryan disc arthroplasty for cervical radiculopathy and/or myelopathy, we revealed that ROM-affecting HO occurs in as many as 36.8% of cases and found that 37% of patients had ROM-affecting HO within 24 months following surgery. The overall survival time to the occurrence of ROM-affecting HO was 36.4 ± 4.4 months. Survival time of the prosthesis in the patient group without preoperative uncovertebral hypertrophy was significantly longer than that in the patient group with preoperative uncovertebral hypertrophy (47.2 months vs 25.5 months, p = 0.02). Cox regression proportional hazard analysis illustrated that preoperative uncovertebral hypertrophy was determined as a significant risk factor for the occurrence of ROM-affecting HO (hazard ratio = 12.30; 95% confidential interval = 1.10-137.03; p = 0.04). These findings suggest that the condition of the uncovertebral joint must be evaluated in preoperative planning for Bryan cervical arthroplasty.

  3. Common pitfalls in statistical analysis: Odds versus risk

    PubMed Central

    Ranganathan, Priya; Aggarwal, Rakesh; Pramesh, C. S.

    2015-01-01

    In biomedical research, we are often interested in quantifying the relationship between an exposure and an outcome. “Odds” and “Risk” are the most common terms which are used as measures of association between variables. In this article, which is the fourth in the series of common pitfalls in statistical analysis, we explain the meaning of risk and odds and the difference between the two. PMID:26623395

  4. [Diagnostic imaging of changes of the canine intervertebral disc].

    PubMed

    Harder, Lisa K

    2016-10-12

    Intervertebral disc degeneration can cause intervertebral disc herniation. Diagnostic imaging, including radiography, computed tomography and magnetic resonance imaging, is the most important tool in diagnosis. Firstly, an overview of macroscopic and biochemical physiology and pathology of the intervertebral disc will be given. Subsequently, the physics of diagnostic imaging and the appearance of intervertebral disc degeneration and displacement in several imaging methods are described.

  5. 108. DETAIL OF DENVER DISC FILTER IN CO91107, SUCTION END. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    108. DETAIL OF DENVER DISC FILTER IN CO-91-107, SUCTION END. NOTE BEARING HOUSING WITH CAST LOGO, SUCTION PIPE GOING OFF TO THE RIGHT, AND FILTER DISC IN BACKGROUND. VACUUM INSIDE DISCS FURTHER DEWATERED CONCENTRATE. AS DISC SLOWLY ROTATED A BAR SCRAPED DRIED CONCENTRATE FROM OUTSIDE OF FILTER CLOTH. - Shenandoah-Dives Mill, 135 County Road 2, Silverton, San Juan County, CO

  6. Line-driven ablation of circumstellar discs - I. Optically thin decretion discs of classical Oe/Be stars.

    PubMed

    Kee, Nathaniel Dylan; Owocki, Stanley; Sundqvist, J O

    2016-05-21

    The extreme luminosities of massive, hot OB stars drive strong stellar winds through line-scattering of the star's UV continuum radiation. For OB stars with an orbiting circumstellar disc, we explore here the effect of such line-scattering in driving an ablation of material from the disc's surface layers, with initial focus on the marginally optically thin decretion discs of classical Oe and Be stars. For this we apply a multidimensional radiation-hydrodynamics code that assumes simple optically thin ray tracing for the stellar continuum, but uses a multiray Sobolev treatment of the line transfer; this fully accounts for the efficient driving by non-radial rays, due to desaturation of line-absorption by velocity gradients associated with the Keplerian shear in the disc. Results show a dense, intermediate-speed surface ablation, consistent with the strong, blueshifted absorption of UV wind lines seen in Be shell stars that are observed from near the disc plane. A key overall result is that, after an initial adjustment to the introduction of the disc, the asymptotic disc destruction rate is typically just an order-unity factor times the stellar wind mass-loss rate. For optically thin Be discs, this leads to a disc destruction time of order months to years, consistent with observationally inferred disc decay times. The much stronger radiative forces of O stars reduce this time to order days, making it more difficult for decretion processes to sustain a disc in earlier spectral types, and so providing a natural explanation for the relative rarity of Oe stars in the Galaxy. Moreover, the decrease in line-driving at lower metallicity implies both a reduction in the winds that help spin-down stars from near-critical rotation, and a reduction in the ablation of any decretion disc; together these provide a natural explanation for the higher fraction of classical Be stars, as well as the presence of Oe stars, in the lower metallicity Magellanic Clouds. We conclude with a discussion of future extensions to study line-driven ablation of denser, optically thick, accretion discs of pre-main-sequence massive stars.

  7. Genome-wide analysis of pain-, nerve- and neurotrophin -related gene expression in the degenerating human annulus

    PubMed Central

    2012-01-01

    Background In spite of its high clinical relevance, the relationship between disc degeneration and low back pain is still not well understood. Recent studies have shown that genome-wide gene expression studies utilizing ontology searches provide an efficient and valuable methodology for identification of clinically relevant genes. Here we use this approach in analysis of pain-, nerve-, and neurotrophin-related gene expression patterns in specimens of human disc tissue. Control, non-herniated clinical, and herniated clinical specimens of human annulus tissue were studied following Institutional Review Board approval. Results Analyses were performed on more generated (Thompson grade IV and V) discs vs. less degenerated discs (grades I-III), on surgically operated discs vs. control discs, and on herniated vs. control discs. Analyses of more degenerated vs. less degenerated discs identified significant upregulation of well-recognized pain-related genes (bradykinin receptor B1, calcitonin gene-related peptide and catechol-0-methyltransferase). Nerve growth factor was significantly upregulated in surgical vs. control and in herniated vs. control discs. All three analyses also found significant changes in numerous proinflammatory cytokine- and chemokine-related genes. Nerve, neurotrophin and pain-ontology searches identified many matrix, signaling and functional genes which have known importance in the disc. Immunohistochemistry was utilized to confirm the presence of calcitonin gene-related peptide, catechol-0-methyltransferase and bradykinin receptor B1 at the protein level in the human annulus. Conclusions Findings point to the utility of microarray analyses in identification of pain-, neurotrophin and nerve-related genes in the disc, and point to the importance of future work exploring functional interactions between nerve and disc cells in vitro and in vivo. Nerve, pain and neurotrophin ontology searches identified numerous changes in proinflammatory cytokines and chemokines which also have significant relevance to disc biology. Since the degenerating human disc is primarily an avascular tissue site into which disc cells have contributed high levels of proinflammatory cytokines, these substances are not cleared from the tissue and remain there over time. We hypothesize that as nerves grow into the human annulus, they encounter a proinflammatory cytokine-rich milieu which may sensitize nociceptors and exacerbate pain production. PMID:22963171

  8. Line-driven ablation of circumstellar discs – I. Optically thin decretion discs of classical Oe/Be stars

    PubMed Central

    Kee, Nathaniel Dylan; Owocki, Stanley; Sundqvist, J. O.

    2016-01-01

    The extreme luminosities of massive, hot OB stars drive strong stellar winds through line-scattering of the star's UV continuum radiation. For OB stars with an orbiting circumstellar disc, we explore here the effect of such line-scattering in driving an ablation of material from the disc's surface layers, with initial focus on the marginally optically thin decretion discs of classical Oe and Be stars. For this we apply a multidimensional radiation-hydrodynamics code that assumes simple optically thin ray tracing for the stellar continuum, but uses a multiray Sobolev treatment of the line transfer; this fully accounts for the efficient driving by non-radial rays, due to desaturation of line-absorption by velocity gradients associated with the Keplerian shear in the disc. Results show a dense, intermediate-speed surface ablation, consistent with the strong, blueshifted absorption of UV wind lines seen in Be shell stars that are observed from near the disc plane. A key overall result is that, after an initial adjustment to the introduction of the disc, the asymptotic disc destruction rate is typically just an order-unity factor times the stellar wind mass-loss rate. For optically thin Be discs, this leads to a disc destruction time of order months to years, consistent with observationally inferred disc decay times. The much stronger radiative forces of O stars reduce this time to order days, making it more difficult for decretion processes to sustain a disc in earlier spectral types, and so providing a natural explanation for the relative rarity of Oe stars in the Galaxy. Moreover, the decrease in line-driving at lower metallicity implies both a reduction in the winds that help spin-down stars from near-critical rotation, and a reduction in the ablation of any decretion disc; together these provide a natural explanation for the higher fraction of classical Be stars, as well as the presence of Oe stars, in the lower metallicity Magellanic Clouds. We conclude with a discussion of future extensions to study line-driven ablation of denser, optically thick, accretion discs of pre-main-sequence massive stars. PMID:27346978

  9. A t(1;11) translocation linked to schizophrenia and affective disorders gives rise to aberrant chimeric DISC1 transcripts that encode structurally altered, deleterious mitochondrial proteins

    PubMed Central

    Eykelenboom, Jennifer E.; Briggs, Gareth J.; Bradshaw, Nicholas J.; Soares, Dinesh C.; Ogawa, Fumiaki; Christie, Sheila; Malavasi, Elise L.V.; Makedonopoulou, Paraskevi; Mackie, Shaun; Malloy, Mary P.; Wear, Martin A.; Blackburn, Elizabeth A.; Bramham, Janice; McIntosh, Andrew M.; Blackwood, Douglas H.; Muir, Walter J.; Porteous, David J.; Millar, J. Kirsty

    2012-01-01

    Disrupted-In-Schizophrenia 1 (DISC1) was identified as a risk factor for psychiatric illness through its disruption by a balanced chromosomal translocation, t(1;11)(q42.1;q14.3), that co-segregates with schizophrenia, bipolar disorder and depression. We previously reported that the translocation reduces DISC1 expression, consistent with a haploinsufficiency disease model. Here we report that, in lymphoblastoid cell lines, the translocation additionally results in the production of abnormal transcripts due to the fusion of DISC1 with a disrupted gene on chromosome 11 (DISC1FP1/Boymaw). These chimeric transcripts encode abnormal proteins, designated CP1, CP60 and CP69, consisting of DISC1 amino acids 1–597 plus 1, 60 or 69 amino acids, respectively. The novel 69 amino acids in CP69 induce increased α-helical content and formation of large stable protein assemblies. The same is predicted for CP60. Both CP60 and CP69 exhibit profoundly altered functional properties within cell lines and neurons. Both are predominantly targeted to mitochondria, where they induce clustering and loss of membrane potential, indicative of severe mitochondrial dysfunction. There is currently no access to neural material from translocation carriers to confirm these findings, but there is no reason to suppose that these chimeric transcripts will not also be expressed in the brain. There is thus potential for the production of abnormal chimeric proteins in the brains of translocation carriers, although at substantially lower levels than for native DISC1. The mechanism by which inheritance of the translocation increases risk of psychiatric illness may therefore involve both DISC1 haploinsufficiency and mitochondrial deficiency due to the effects of abnormal chimeric protein expression. GenBank accession numbers: DISC1FP1 (EU302123), Boymaw (GU134617), der 11 chimeric transcript DISC1FP1 exon 2 to DISC1 exon 9 (JQ650115), der 1 chimeric transcript DISC1 exon 4 to DISC1FP1 exon 4 (JQ650116), der 1 chimeric transcript DISC1 exon 6 to DISC1FP1 exon 3a (JQ650117). PMID:22547224

  10. A study of the effect of bulges on bar formation in disc galaxies

    NASA Astrophysics Data System (ADS)

    Kataria, Sandeep Kumar; Das, Mousumi

    2018-04-01

    We use N-body simulations of bar formation in isolated galaxies to study the effect of bulge mass and bulge concentration on bar formation. Bars are global disc instabilities that evolve by transferring angular momentum from the inner to outer discs and to the dark matter halo. It is well known that a massive spherical component such as halo in a disc galaxy can make it bar stable. In this study, we explore the effect of another spherical component, the bulge, on bar formation in disc galaxies. In our models, we vary both the bulge mass and concentration. We have used two sets of models: one that has a dense bulge and high surface density disc, and the other model has a less concentrated bulge and a lighter disc. In both models, we vary the bulge to disc mass fraction from 0 to 0.7. Simulations of both the models show that there is an upper cut-off in bulge-to-disc mass ratio Mb/Md above which bars cannot form; the cut-off is smaller for denser bulges (Mb/Md = 0.2) compared to less denser ones (Mb/Md = 0.5). We define a new criterion for bar formation in terms of the ratio of bulge to total radial force (Fb/Ftot) at the disc scale lengths above which bars cannot form. We find that if Fb/Ftot > 0.35, a disc is stable and a bar cannot form. Our results indicate that early-type disc galaxies can still form strong bars in spite of having massive bulges.

  11. A tilted and warped inner accretion disc around a spinning black hole: an analytical solution

    NASA Astrophysics Data System (ADS)

    Chakraborty, Chandrachur; Bhattacharyya, Sudip

    2017-08-01

    Inner accretion disc around a black hole provides a rare, natural probe to understand the fundamental physics of the strong gravity regime. A possible tilt of such a disc, with respect to the black hole spin equator, is important. This is because such a tilt affects the observed spectral and timing properties of the disc X-ray emission via Lense-Thirring precession, which could be used to test the theoretical predictions regarding the strong gravity. Here, we analytically solve the steady, warped accretion disc equation of Scheurer and Feiler, and find an expression of the radial profile of the disc tilt angle. In our exact solution, considering a prograde disc around a slowly spinning black hole, we include the inner part of the disc, which was not done earlier in this formalism. Such a solution is timely, as a tilted inner disc has recently been inferred from X-ray spectral and timing features of the accreting black hole H1743-322. Our tilt angle radial profile expression includes observationally measurable parameters, such as black hole mass and Kerr parameter, and the disc inner edge tilt angle Win, and hence can be ideal to confront observations. Our solution shows that the disc tilt angle in 10-100 gravitational radii is a significant fraction of the disc outer edge tilt angle, even for Win = 0. Moreover, tilt angle radial profiles have humps in ˜10-1000 gravitational radii for some sets of parameter values, which should have implications for observed X-ray features.

  12. Optic Disc Drusen in Children

    PubMed Central

    Chang, Melinda Y.; Pineles, Stacy L.

    2016-01-01

    Optic disc drusen occur in 0.4% of children and consist of acellular intracellular and extracellular deposits that often become calcified over time. They are typically buried early in life and generally become superficial, and therefore visible, later in childhood, at the average age of 12 years. Their main clinical significance lies in the ability of optic disc drusen, particularly when buried, to simulate true optic disc edema. Misdiagnosing drusen as true disc edema may lead to an invasive and unnecessary workup for elevated intracranial pressure. Ancillary testing, including ultrasonography, fluorescein angiography, fundus autofluorescence, and optical coherence tomography, may aid in the correct diagnosis of optic disc drusen. Complications of optic disc drusen in children include visual field defects, hemorrhages, choroidal neovascular membrane, non-arteritic anterior ischemic optic neuropathy, and retinal vascular occlusions. Treatment options for these complications include ocular hypotensive agents for visual field defects and intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents for choroidal neovascular membranes. In most cases, however, children with optic disc drusen can be managed by observation with serial examinations and visual field testing, once true optic disc edema has been excluded. PMID:27033945

  13. Effects of annulus defects and implantation of poly(lactic-co-glycolic acid) (PLGA)/fibrin gel scaffolds on nerves ingrowth in a rabbit model of annular injury disc degeneration.

    PubMed

    Xin, Long; Xu, Weixing; Yu, Leijun; Fan, Shunwu; Wang, Wei; Yu, Fang; Wang, Zhenbin

    2017-05-12

    Growth of nerve fibers has been shown to occur in a rabbit model of intravertebral disc degeneration (IVD) induced by needle puncture. As nerve growth may underlie the process of chronic pain in humans affected by disc degeneration, we sought to investigate the factors underlying nerve ingrowth in a minimally invasive annulotomy rabbit model of IVD by comparing the effects of empty disc defects with those of defects filled with poly(lactic-co-glycolic acid)/fibrin gel (PLGA) plugs. New Zealand white rabbits (n = 24) received annular injuries at three lumbar levels (L3/4, L4/5, and L5/6). The discs were randomly assigned to four groups: (a) annular defect (1.8-mm diameter; 4-mm depth) by mini-trephine, (b) annular defect implanted with a PLGA scaffold containing a fibrin gel, (c) annular puncture by a 16G needle (5-mm depth), and (d) uninjured L2/3 disc (control). Disc degeneration was evaluated by radiography, MRI, histology, real-time PCR, and analysis of proteoglycan (PG) content. Nerve ingrowth into the discs was assessed by immunostaining with the nerve marker protein gene product 9.5. Injured discs showed a progressive disc space narrowing with significant disc degeneration and proteoglycan loss, as confirmed by imaging results, molecular and compositional analysis, and histological examinations. In 16G punctured discs, nerve ingrowth was observed on the surface of scar tissue. In annular defects, nerve fibers were found to be distributed along small fissures within the fibrocartilaginous-like tissue that filled the AF. In discs filled with PLGA/ fibrin gel, more nerve fibers were observed growing deeper into the inner AF along the open annular track.  In addition, innervations scores showed significantly higher than those of punctured discs and empty defects. A limited vascular proliferation was found in the injured sites and regenerated tissues. Nerve ingrowth was significantly higher in PLGA/fibrin-filled discs than in empty defects. Possible explanations include (i) annular fissures along the defect and early loss of proteoglycan may facilitate the ingrowth process and (ii) biodegradable PLGA/fibrin gel may promote adverse growth of nerves and blood vessels into deeper parts of injured disc. The rabbit annular defect model of disc degeneration appears suitable to investigate the effects of nerve ingrowth in relation to pain generation.

  14. The reports of thick discs' deaths are greatly exaggerated. Thick discs are NOT artefacts caused by diffuse scattered light

    NASA Astrophysics Data System (ADS)

    Comerón, S.; Salo, H.; Knapen, J. H.

    2018-02-01

    Recent studies have made the community aware of the importance of accounting for scattered light when examining low-surface-brightness galaxy features such as thick discs. In our past studies of the thick discs of edge-on galaxies in the Spitzer Survey of Stellar Structure in Galaxies - the S4G - we modelled the point spread function as a Gaussian. In this paper we re-examine our results using a revised point spread function model that accounts for extended wings out to more than 2\\farcm5. We study the 3.6 μm images of 141 edge-on galaxies from the S4G and its early-type galaxy extension. Thus, we more than double the samples examined in our past studies. We decompose the surface-brightness profiles of the galaxies perpendicular to their mid-planes assuming that discs are made of two stellar discs in hydrostatic equilibrium. We decompose the axial surface-brightness profiles of galaxies to model the central mass concentration - described by a Sérsic function - and the disc - described by a broken exponential disc seen edge-on. Our improved treatment fully confirms the ubiquitous occurrence of thick discs. The main difference between our current fits and those presented in our previous papers is that now the scattered light from the thin disc dominates the surface brightness at levels below μ 26 mag arcsec-2. We stress that those extended thin disc tails are not physical, but pure scattered light. This change, however, does not drastically affect any of our previously presented results: 1) Thick discs are nearly ubiquitous. They are not an artefact caused by scattered light as has been suggested elsewhere. 2) Thick discs have masses comparable to those of thin discs in low-mass galaxies - with circular velocities vc< 120 km s-1 - whereas they are typically less massive than the thin discs in high-mass galaxies. 3) Thick discs and central mass concentrations seem to have formed at the same epoch from a common material reservoir. 4) Approximately 50% of the up-bending breaks in face-on galaxies are caused by the superposition of a thin and a thick disc where the scale-length of the latter is the largest. Data of Figs. B.1 and C.1 are only available at the CDS via anonymous ftp to http://cdsarc.u-strasbg.fr (http://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/610/A5

  15. Preparation of ormetoprim-sulfadimethoxine-medicated discs for disc diffusion assay

    USDA-ARS?s Scientific Manuscript database

    Romet ( a blend of ormetoprim and sulfadimethoxine) is a type A medicated article for the manufacture of medicated feed in the catfish industry. Recently, the commercial manufacture of ormetoprim-sulfadimethoxine susceptibility discs was discontinued. Ormetoprim-sulfadimethoxine discs were prepare...

  16. What's NEW at the GES DISC: Evolution of Data Management and Services for Aura Mission and Beyond

    NASA Technical Reports Server (NTRS)

    Wei, Jennifer

    2016-01-01

    GES DISC world. Aura data usage and trend. Aura data users requests. GES DISC update (before/after); New Access method (ftp to http) with Earthdata Login System, New Website (DISC/Mirador to New Interface), New Giovanni (Giovanni to Now Federated). GES DISC support beyond Aura Mission; Multi-sensor coincident data subsets, Level 2 support (Sub-setter, Visualization), Data List.

  17. Non-reclosing pressure relief device for vacuum systems

    DOEpatents

    Swansiger, William A.

    1994-01-01

    A non-reclosing overpressure protection device such as a rupture disc provides a non-reclosing opening upon forcible contact with a knife blade. A bellows, having an inlet capable of being sealably connected to a source of pressure (the vacuum system) and an outlet containing the rupture disc, transmits the pressure in the system to the disc. The bellows maintains the disc away from the knife when the pressure is below an overpressure amount, and carries the disc to a position when the pressure is above an overpressure amount where the disc is ruptured by the knife.

  18. Non-reclosing pressure relief device for vacuum systems

    DOEpatents

    Swansiger, W.A.

    1994-02-08

    A non-reclosing overpressure protection device such as a rupture disc provides a non-reclosing opening upon forcible contact with a knife blade. A bellows, having an inlet capable of being sealably connected to a source of pressure (the vacuum system) and an outlet containing the rupture disc, transmits the pressure in the system to the disc. The bellows maintains the disc away from the knife when the pressure is below an overpressure amount, and carries the disc to a position when the pressure is above an overpressure amount where the disc is ruptured by the knife. 6 figures.

  19. Developments in intervertebral disc disease research: pathophysiology, mechanobiology, and therapeutics.

    PubMed

    Weber, Kathryn T; Jacobsen, Timothy D; Maidhof, Robert; Virojanapa, Justin; Overby, Chris; Bloom, Ona; Quraishi, Shaheda; Levine, Mitchell; Chahine, Nadeen O

    2015-03-01

    Low back pain is a leading cause of disability worldwide and the second most common cause of physician visits. There are many causes of back pain, and among them, disc herniation and intervertebral disc degeneration are the most common diagnoses and targets for intervention. Currently, clinical treatment outcomes are not strongly correlated with diagnoses, emphasizing the importance for characterizing more completely the mechanisms of degeneration and their relationships with symptoms. This review covers recent studies elucidating cellular and molecular changes associated with disc mechanobiology, as it relates to degeneration and regeneration. Specifically, we review findings on the biochemical changes in disc diseases, including cytokines, chemokines, and proteases; advancements in disc disease diagnostics using imaging modalities; updates on studies examining the response of the intervertebral disc to injury; and recent developments in repair strategies, including cell-based repair, biomaterials, and tissue engineering. Findings on the effects of the omega-6 fatty acid, linoleic acid, on nucleus pulposus tissue engineering are presented. Studies described in this review provide greater insights into the pathogenesis of disc degeneration and may define new paradigms for early or differential diagnostics of degeneration using new techniques such as systemic biomarkers. In addition, research on the mechanobiology of disease enriches the development of therapeutics for disc repair, with potential to diminish pain and disability associated with disc degeneration.

  20. On fragmentation of turbulent self-gravitating discs in the long cooling time regime

    NASA Astrophysics Data System (ADS)

    Rice, Ken; Nayakshin, Sergei

    2018-03-01

    It has recently been suggested that in the presence of driven turbulence discs may be much less stable against gravitational collapse than their non-turbulent analogues, due to stochastic density fluctuations in turbulent flows. This mode of fragmentation would be especially important for gas giant planet formation. Here, we argue, however, that stochastic density fluctuations due to turbulence do not enhance gravitational instability and disc fragmentation in the long cooling time limit appropriate for planet forming discs. These fluctuations evolve adiabatically and dissipate away by decompression faster than they could collapse. We investigate these issues numerically in two dimensions via shearing box simulations with driven turbulence and also in three dimensions with a model of instantaneously applied turbulent velocity kicks. In the former setting turbulent driving leads to additional disc heating that tends to make discs more, rather than less, stable to gravitational instability. In the latter setting, the formation of high-density regions due to convergent velocity kicks is found to be quickly followed by decompression, as expected. We therefore conclude that driven turbulence does not promote disc fragmentation in protoplanetary discs and instead tends to make the discs more stable. We also argue that sustaining supersonic turbulence is very difficult in discs that cool slowly.

  1. Metallicity gradient of the thick disc progenitor at high redshift

    NASA Astrophysics Data System (ADS)

    Kawata, Daisuke; Allende Prieto, Carlos; Brook, Chris B.; Casagrande, Luca; Ciucă, Ioana; Gibson, Brad K.; Grand, Robert J. J.; Hayden, Michael R.; Hunt, Jason A. S.

    2018-01-01

    We have developed a novel Markov Chain Monte Carlo chemical 'painting' technique to explore possible radial and vertical metallicity gradients for the thick disc progenitor. In our analysis, we match an N-body simulation to the data from the Apache Point Observatory Galactic Evolution Experiment survey. We assume that the thick disc has a constant scaleheight and has completed its formation at an early epoch, after which time radial mixing of its stars has taken place. Under these assumptions, we find that the initial radial metallicity gradient of the thick disc progenitor should not be negative, but either flat or even positive, to explain the current negative vertical metallicity gradient of the thick disc. Our study suggests that the thick disc was built-up in an inside-out and upside-down fashion, and older, smaller and thicker populations are more metal poor. In this case, star-forming discs at different epochs of the thick disc formation are allowed to have different radial metallicity gradients, including a negative one, which helps to explain a variety of slopes observed in high-redshift disc galaxies. This scenario helps to explain the positive slope of the metallicity-rotation velocity relation observed for the Galactic thick disc. On the other hand, radial mixing flattens the slope of an existing gradient.

  2. The Location of the Deepest Point of the Eyeball Determines the Optic Disc Configuration.

    PubMed

    Kim, Yong Chan; Jung, Younhea; Park, Hae-Young Lopilly; Park, Chan Kee

    2017-07-19

    Tilted and rotated appearances are hallmarks of the myopic optic disc. As the eyeball grows axially, the posterior pole elongates not only globally but in a localized manner as well. In this process, the optic disc is pulled towards the deepest point of the elongated eyeball, which might result in a change in optic disc configuration. Thus, we hypothesized that analyzing the variation of posterior pole contour can play a major role in understanding optic disc configuration in myopic subjects. By analyzing consecutive images of swept source OCT coronal sections at the posterior pole, the deepest interface between Bruch's membrane and the choroid could be identified as the deepest point of the eyeball (DPE). The location and the properties of the DPE differed significantly between the 125 eyes of non-glaucomatous myopic group and the 40 eyes of non-glaucomatous emmetropic group classified based on 24 mm axial length. The results suggested that the larger disc to DPE angle and the larger disc to DPE depth strongly predicts the optic disc torsion degree and the optic disc tilt. Our findings suggest that identifying the posterior pole profile plays a major role in understanding the optic disc alterations found in myopic subjects.

  3. An unbiased study of debris discs around A-type stars with Herschel

    NASA Astrophysics Data System (ADS)

    Thureau, N. D.; Greaves, J. S.; Matthews, B. C.; Kennedy, G.; Phillips, N.; Booth, M.; Duchêne, G.; Horner, J.; Rodriguez, D. R.; Sibthorpe, B.; Wyatt, M. C.

    2014-12-01

    The Herschel DEBRIS (Disc Emission via a Bias-free Reconnaissance in the Infrared/Submillimetre) survey brings us a unique perspective on the study of debris discs around main-sequence A-type stars. Bias-free by design, the survey offers a remarkable data set with which to investigate the cold disc properties. The statistical analysis of the 100 and 160 μm data for 86 main-sequence A stars yields a lower than previously found debris disc rate. Considering better than 3σ excess sources, we find a detection rate ≥24 ± 5 per cent at 100 μm which is similar to the debris disc rate around main-sequence F/G/K-spectral type stars. While the 100 and 160 μm excesses slowly decline with time, debris discs with large excesses are found around some of the oldest A stars in our sample, evidence that the debris phenomenon can survive throughout the length of the main sequence (˜1 Gyr). Debris discs are predominantly detected around the youngest and hottest stars in our sample. Stellar properties such as metallicity are found to have no effect on the debris disc incidence. Debris discs are found around A stars in single systems and multiple systems at similar rates. While tight and wide binaries (<1 and >100 au, respectively) host debris discs with a similar frequency and global properties, no intermediate separation debris systems were detected in our sample.

  4. The evolution of photoevaporating viscous discs in binaries

    NASA Astrophysics Data System (ADS)

    Rosotti, Giovanni P.; Clarke, Cathie J.

    2018-02-01

    A large fraction of stars are in binary systems, yet the evolution of protoplanetary discs in binaries has been little explored from the theoretical side. In this paper, we investigate the evolution of the discs surrounding the primary and secondary components of binary systems on the assumption that this is driven by photoevaporation induced by X-rays from the respective star. We show how for close enough separations (20-30 au for average X-ray luminosities) the tidal torque of the companion changes the qualitative behaviour of disc dispersal from inside out to outside in. Fewer transition discs created by photoevaporation are thus expected in binaries. We also demonstrate that in close binaries the reduction in viscous time leads to accelerated disc clearing around both components, consistent with unresolved observations. When looking at the differential disc evolution around the two components, in close binaries discs around the secondary clear first due to the shorter viscous time-scale associated with the smaller outer radius. In wide binaries instead the difference in photoevaporation rate makes the secondaries longer lived, though this is somewhat dependent on the assumed scaling of viscosity with stellar mass. We find that our models are broadly compatible with the growing sample of resolved observations of discs in binaries. We also predict that binaries have higher accretion rates than single stars for the same disc mass. Thus, binaries probably contribute to the observed scatter in the relationship between disc mass and accretion rate in young stars.

  5. Self-gravity in thin discs and edge effects: an extension of Paczynski's approximation

    NASA Astrophysics Data System (ADS)

    Trova, Audrey; Huré, Jean-Marc; Hersant, Franck

    2014-03-01

    Because hydrostatic equilibrium of gaseous discs is partly governed by the gravity field, we have estimated the component caused by a vertically homogeneous disc with particular attention to the outer regions where self-gravity appears most often. The accuracy of the integral formula is better than 1% regardless of the disc thickness, radial extension and radial density profile. At order zero, the field is even algebraic for thin discs and reads -4πGΣ(R) × fedges(R) at disc surface, which means a correction of Paczynski's formula by a multiplying factor fedges ≲ ½, which depends on the relative distance to the edges and the local disc thickness. For very centrally condensed discs, however, this local contribution can be surpassed by the action of mass stored in the inner regions, possibly resulting in fedges ≫ 1. A criterion setting the limit between these two regimes is derived. These results are robust in the sense that the details of vertical stratification are not critical. We briefly discuss how hydrostatic equilibrium is affected. In particular, the disc flaring probably does not reverse in the self-gravitating region, which contradicts what is usually obtained from Paczynski's formula. This suggests that i) these outer regions are probably not fully shadowed by the inner ones (when the disc is illuminated by a central star); and ii) the flared shape of discs does not firmly prove the absence or weakness of self-gravity.

  6. Lessons from the Auriga discs: the hunt for the Milky Way's ex situ disc is not yet over

    NASA Astrophysics Data System (ADS)

    Gómez, Facundo A.; Grand, Robert J. J.; Monachesi, Antonela; White, Simon D. M.; Bustamante, Sebastian; Marinacci, Federico; Pakmor, Rüdiger; Simpson, Christine M.; Springel, Volker; Frenk, Carlos S.

    2017-12-01

    We characterize the contribution from accreted material to the galactic discs of the Auriga Project, a set of high-resolution magnetohydrodynamic cosmological simulations of late-type galaxies performed with the moving-mesh code AREPO. Our goal is to explore whether a significant accreted (or ex situ) stellar component in the Milky Way disc could be hidden within the near-circular orbit population, which is strongly dominated by stars born in situ. One-third of our models shows a significant ex situ disc but this fraction would be larger if constraints on orbital circularity were relaxed. Most of the ex situ material (≳50 per cent) comes from single massive satellites (>6 × 1010 M⊙). These satellites are accreted with a wide range of infall times and inclination angles (up to 85°). Ex situ discs are thicker, older and more metal poor than their in situ counterparts. They show a flat median age profile, which differs from the negative gradient observed in the in situ component. As a result, the likelihood of identifying an ex situ disc in samples of old stars on near-circular orbits increases towards the outskirts of the disc. We show three examples that, in addition to ex situ discs, have a strongly rotating dark matter component. Interestingly, two of these ex situ stellar discs show an orbital circularity distribution that is consistent with that of the in situ disc. Thus, they would not be detected in typical kinematic studies.

  7. Human disc degeneration is associated with increased MMP 7 expression.

    PubMed

    Le Maitre, C L; Freemont, A J; Hoyland, J A

    2006-01-01

    During intervertebral disc (IVD) degeneration, normal matrix synthesis decreases and degradation of disc matrix increases. A number of proteases that are increased during disc degeneration are thought to be involved in its pathogenesis. Matrix metalloproteinase 7 (MMP 7) (Matrilysin, PUMP-1) is known to cleave the major matrix molecules found within the IVD, i.e., the proteoglycan aggrecan and collagen type II. To date, however, it is not known how its expression changes with degeneration or its exact location. We investigated the localization of MMP 7 in human, histologically graded, nondegenerate, degenerated and prolapsed discs to ascertain whether MMP 7 is up-regulated during disc degeneration. Samples of human IVD tissue were fixed in neutral buffered formalin, embedded in paraffin, and sections stained with hematoxylin and eosin to score the degree of morphological degeneration. Immunohistochemistry was performed to localize MMP 7 in 41 human IVDs with varying degrees of degeneration. We found that the chondrocyte-like cells of the nucleus pulposus and inner annulus fibrosus were MMP 7 immunopositive; little immunopositivity was observed in the outer annulus. Nondegenerate discs showed few immunopositive cells. A significant increase in the proportion of MMP 7 immunopositive cells was seen in the nucleus pulposus of discs classified as showing intermediate levels of degeneration and a further increase was seen in discs with severe degeneration. Prolapsed discs showed more MMP 7 immunopositive cells compared to nondegenerated discs, but fewer than those seen in cases of severe degeneration.

  8. Observations of warm molecular gas and kinematics in the disc around HD 100546

    NASA Astrophysics Data System (ADS)

    Panić, O.; van Dishoeck, E. F.; Hogerheijde, M. R.; Belloche, A.; Güsten, R.; Boland, W.; Baryshev, A.

    2010-09-01

    Context. The disc around the Herbig Ae/Be star HD 100546 is one of the most extensively studied discs in the southern sky. Although there is a wealth of information about its dust content and composition, not much is known about its gas and large-scale kinematics. Many recent results have stressed the importance of studying both the gas and dust in discs. 12CO is an excellent gas tracer in the submillimetre, and the intensity ratio between lines originating from low and high rotational levels probes the gas temperature. Emerging submillimetre facilities in the Southern hemisphere allow us to characterise the gas and dust content in objects like HD 100546 better. Aims: Our aim is to establish whether the disc is gas-rich and to study the disc temperature and kinematics. Methods: We detected and studied the molecular gas in the disc at spatial resolution from 7.7 arcsec to 18.9 arcsec using the Atacama Pathfinder Experiment telescope (This publication is based on data acquired with the Atacama Pathfinder Experiment (APEX). APEX is a collaboration between the Max-Planck-Institut für Radioastronomie, the European Southern Observatory, and the Onsala Space Observatory.). We observed the lines 12CO J = 7-6, J = 6-5, J = 3-2, 13CO J = 3-2 and [C I] 3P2-3P1, as diagnostics of disc temperature, size, chemistry, and kinematics. We use parametric disc models that reproduce the low-J 12CO emission from Herbig Ae stars and we vary the basic disc parameters - temperature, mass, and size. With the help of a molecular excitation and radiative transfer code we fit the observed spectral line profiles. Results: Our observations are consistent with more than 10-3 M⊙ of molecular gas in a disc of ≈400 AU radius in Keplerian rotation around a 2.5 M⊙ star, seen at an inclination of 50°. The detected 12CO lines are dominated by gas at 30-70 K. Not detecting the [C I] line indicates excess ultraviolet emission above that of a B9 type model stellar atmosphere. Asymmetry in the 12CO line emission suggests that one side of the outer disc is colder by 10-20 K than the other. A plausible scenario is a warped geometry in the inner disc casting a partial shaddow on the outer disc. We exclude pointing offsets, foreground cloud absorption, and asymmetry in the disc extent as possible causes of the observed line asymmetry. Conclusions: Efficient heating of the outer disc by the star HD 100546 ensures that low- and high-J 12CO lines are dominated by the outermost disc regions, indicating a 400 AU radius. The 12CO J = 6-5 line arises from a disc layer higher than disc midplane, and warmer by 15-20 K than the layer emitting the J = 3-2 line. The existing models of discs around Herbig Ae stars, asuming a B9.5 type model stellar atmosphere, overproduce the [CI] 3P2-3P1 line intensity from HD 100546 by an order of magnitude.

  9. Preparation of ormetoprim sulfadimethoxine medicated discs for disc diffusion assay

    USDA-ARS?s Scientific Manuscript database

    Romet (a blend of ormetoprim and sulfadimethoxine) is a typeA medicated article for the manufacture of medicated feed in the catfish industry. Recently, the commercial manufacture of ormetoprim–sulfadimethoxine susceptibility discs was discontinued. Ormetoprim–sulfadimethoxine discs were prepared at...

  10. Biomaterials for intervertebral disc regeneration and repair.

    PubMed

    Bowles, Robert D; Setton, Lori A

    2017-06-01

    The intervertebral disc contributes to motion, weight bearing, and flexibility of the spine, but is susceptible to damage and morphological changes that contribute to pathology with age and injury. Engineering strategies that rely upon synthetic materials or composite implants that do not interface with the biological components of the disc have not met with widespread use or desirable outcomes in the treatment of intervertebral disc pathology. Here we review bioengineering advances to treat disc disorders, using cell-supplemented materials, or acellular, biologically based materials, that provide opportunity for cell-material interactions and remodeling in the treatment of intervertebral disc disorders. While a field still in early development, bioengineering-based strategies employing novel biomaterials are emerging as promising alternatives for clinical treatment of intervertebral disc disorders. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Anomalous optic discs in a patient with a Dandy-Walker cyst.

    PubMed

    Orcutt, J C; Bunt, A H

    1982-03-01

    A 19-month-old female infant with a Dandy-Walker cyst had anomalous optic discs, each of which appeared to divide to form an accessory optic nerve. The discs probably lie within the spectrum of anomalous discs including optic nerve aplasia and hypoplasia, megallopapillae, morning glory disc, optic disc dysplasia, and optic nerve colobomas. The association of anomalous optic discs with a Dandy-Walker cyst has not been previously recognized. The ocular and brain malformations in this patient likely occurred during the fourth to eighth week of gestation, when the retinal ganglion cell axons were penetrating the optic nerve, and the rhombic lips were enlarging in early cerebellar development. The etiology of these anomalies is not known; however, teratogens, sporadic events, and genetic disorders should be considered.

  12. Enclosed rotary disc air pulser

    DOEpatents

    Olson, A. L.; Batcheller, Tom A.; Rindfleisch, J. A.; Morgan, John M.

    1989-01-01

    An enclosed rotary disc air pulser for use with a solvent extraction pulse olumn includes a housing having inlet, exhaust and pulse leg ports, a shaft mounted in the housing and adapted for axial rotation therein, first and second disc members secured to the shaft within the housing in spaced relation to each other to define a chamber therebetween, the chamber being in communication with the pulse leg port, the first disc member located adjacent the inlet port, the second disc member being located adjacent the exhaust port, each disc member having a milled out portion, the disc members positioned on the shaft so that as the shaft rotates, the milled out portions permit alternative cyclical communication between the inlet port and the chamber and the exhaust port and the chamber.

  13. Circumstellar disc lifetimes in numerous galactic young stellar clusters

    NASA Astrophysics Data System (ADS)

    Richert, A. J. W.; Getman, K. V.; Feigelson, E. D.; Kuhn, M. A.; Broos, P. S.; Povich, M. S.; Bate, M. R.; Garmire, G. P.

    2018-07-01

    Photometric detections of dust circumstellar discs around pre-main sequence (PMS) stars, coupled with estimates of stellar ages, provide constraints on the time available for planet formation. Most previous studies on disc longevity, starting with Haisch, Lada & Lada, use star samples from PMS clusters but do not consider data sets with homogeneous photometric sensitivities and/or ages placed on a uniform time-scale. Here we conduct the largest study to date of the longevity of inner dust discs using X-ray and 1-8 µm infrared photometry from the MYStIX and SFiNCs projects for 69 young clusters in 32 nearby star-forming regions with ages t ≤ 5 Myr. Cluster ages are derived by combining the empirical AgeJX method with PMS evolutionary models, which treat dynamo-generated magnetic fields in different ways. Leveraging X-ray data to identify disc-free objects, we impose similar stellar mass sensitivity limits for disc-bearing and disc-free young stellar objects while extending the analysis to stellar masses as low as M ˜ 0.1 M⊙. We find that the disc longevity estimates are strongly affected by the choice of PMS evolutionary model. Assuming a disc fraction of 100 per cent at zero age, the inferred disc half-life changes significantly, from t1/2 ˜ 1.3-2 Myr to t1/2 ˜ 3.5 Myr when switching from non-magnetic to magnetic PMS models. In addition, we find no statistically significant evidence that disc fraction varies with stellar mass within the first few Myr of life for stars with masses <2 M⊙, but our samples may not be complete for more massive stars. The effects of initial disc fraction and star-forming environment are also explored.

  14. Evidence for the concurrent growth of thick discs and central mass concentrations from S4G imaging

    NASA Astrophysics Data System (ADS)

    Comerón, S.; Elmegreen, B. G.; Salo, H.; Laurikainen, E.; Holwerda, B. W.; Knapen, J. H.

    2014-11-01

    We have produced 3.6 μm + 4.5 μm vertically integrated radial luminosity profiles of 69 edge-on galaxies from the Spitzer Survey of Stellar Structure in Galaxies (S4G). We decomposed the luminosity profiles into a disc and a central mass concentration (CMC). These fits, combined with thin/thick disc decompositions from our previous studies, allow us to estimate the masses of the CMCs, the thick discs, and the thin discs (ℳCMC, ℳT, and ℳT). We obtained atomic disc masses (ℳg) from the literature. We then consider the CMC and the thick disc to be dynamically hot components and the thin disc and the gas disc to be dynamically cold components. We find that the ratio between the mass of the hot components and that of the cold components, (ℳCMC + ℳT)/(ℳt + ℳg), does not depend on the total galaxy mass as described by circular velocities (vc). We also find that the higher the vc, the more concentrated the hot component of a galaxy. We suggest that our results are compatible with having CMCs and thick discs built in a short and early high star forming intensity phase. These components were born thick because of the large scale height of the turbulent gas disc in which they originated. Our results indicate that the ratio between the star forming rate in the former phase and that of the formation of the thin disc is of the order of 10, but the value depends on the duration of the high star forming intensity phase. Appendix A is available in electronic form at http://www.aanda.org

  15. Expression of DISC1-interactome members correlates with cognitive phenotypes related to schizophrenia.

    PubMed

    Rampino, Antonio; Walker, Rosie May; Torrance, Helen Scott; Anderson, Susan Maguire; Fazio, Leonardo; Di Giorgio, Annabella; Taurisano, Paolo; Gelao, Barbara; Romano, Raffaella; Masellis, Rita; Ursini, Gianluca; Caforio, Grazia; Blasi, Giuseppe; Millar, J Kirsty; Porteous, David John; Thomson, Pippa Ann; Bertolino, Alessandro; Evans, Kathryn Louise

    2014-01-01

    Cognitive dysfunction is central to the schizophrenia phenotype. Genetic and functional studies have implicated Disrupted-in-Schizophrenia 1 (DISC1), a leading candidate gene for schizophrenia and related psychiatric conditions, in cognitive function. Altered expression of DISC1 and DISC1-interactors has been identified in schizophrenia. Dysregulated expression of DISC1-interactome genes might, therefore, contribute to schizophrenia susceptibility via disruption of molecular systems required for normal cognitive function. Here, the blood RNA expression levels of DISC1 and DISC1-interacting proteins were measured in 63 control subjects. Cognitive function was assessed using neuropsychiatric tests and functional magnetic resonance imaging was used to assess the activity of prefrontal cortical regions during the N-back working memory task, which is abnormal in schizophrenia. Pairwise correlations between gene expression levels and the relationship between gene expression levels and cognitive function and N-back-elicited brain activity were assessed. Finally, the expression levels of DISC1, AKAP9, FEZ1, NDEL1 and PCM1 were compared between 63 controls and 69 schizophrenic subjects. We found that DISC1-interactome genes showed correlated expression in the blood of healthy individuals. The expression levels of several interactome members were correlated with cognitive performance and N-back-elicited activity in the prefrontal cortex. In addition, DISC1 and NDEL1 showed decreased expression in schizophrenic subjects compared to healthy controls. Our findings highlight the importance of the coordinated expression of DISC1-interactome genes for normal cognitive function and suggest that dysregulated DISC1 and NDEL1 expression might, in part, contribute to susceptibility for schizophrenia via disruption of prefrontal cortex-dependent cognitive functions.

  16. Expression of DISC1-Interactome Members Correlates with Cognitive Phenotypes Related to Schizophrenia

    PubMed Central

    Rampino, Antonio; Walker, Rosie May; Torrance, Helen Scott; Anderson, Susan Maguire; Fazio, Leonardo; Di Giorgio, Annabella; Taurisano, Paolo; Gelao, Barbara; Romano, Raffaella; Masellis, Rita; Ursini, Gianluca; Caforio, Grazia; Blasi, Giuseppe; Millar, J. Kirsty; Porteous, David John; Thomson, Pippa Ann; Bertolino, Alessandro; Evans, Kathryn Louise

    2014-01-01

    Cognitive dysfunction is central to the schizophrenia phenotype. Genetic and functional studies have implicated Disrupted-in-Schizophrenia 1 (DISC1), a leading candidate gene for schizophrenia and related psychiatric conditions, in cognitive function. Altered expression of DISC1 and DISC1-interactors has been identified in schizophrenia. Dysregulated expression of DISC1-interactome genes might, therefore, contribute to schizophrenia susceptibility via disruption of molecular systems required for normal cognitive function. Here, the blood RNA expression levels of DISC1 and DISC1-interacting proteins were measured in 63 control subjects. Cognitive function was assessed using neuropsychiatric tests and functional magnetic resonance imaging was used to assess the activity of prefrontal cortical regions during the N-back working memory task, which is abnormal in schizophrenia. Pairwise correlations between gene expression levels and the relationship between gene expression levels and cognitive function and N-back-elicited brain activity were assessed. Finally, the expression levels of DISC1, AKAP9, FEZ1, NDEL1 and PCM1 were compared between 63 controls and 69 schizophrenic subjects. We found that DISC1-interactome genes showed correlated expression in the blood of healthy individuals. The expression levels of several interactome members were correlated with cognitive performance and N-back-elicited activity in the prefrontal cortex. In addition, DISC1 and NDEL1 showed decreased expression in schizophrenic subjects compared to healthy controls. Our findings highlight the importance of the coordinated expression of DISC1-interactome genes for normal cognitive function and suggest that dysregulated DISC1 and NDEL1 expression might, in part, contribute to susceptibility for schizophrenia via disruption of prefrontal cortex-dependent cognitive functions. PMID:24940743

  17. Modelling and observations of molecules in discs around young stars

    NASA Astrophysics Data System (ADS)

    Ilee, John David

    2013-04-01

    This thesis contains a study of molecules within circumstellar discs around young stars. Firstly, the chemistry of a disc around a young, Class 0 protostar is modelled. Such discs are thought to be massive, and thus experience gravitational instabilities, which produce spiral density waves. These affect the chemistry in three ways; by desorbing molecules from dust grains, by providing extra energy for new reactions to take place, and by mixing the internal structure of the disc to provide a rich chemistry near the midplane. Secondly, high resolution near-infrared spectra of 20 massive young stellar objects are presented. The objects display CO first overtone bandhead emission, which is excited in the conditions expected within circumstellar discs. The emission is modelled using a simple analytic model of a Keplerian disc, and good fits are found to all spectra. On average, the discs correspond to being geometrically thin, spread across a wide range of inclinations. The discs are located within the dust sublimation radius, providing strong evidence that the CO emission originates in small gaseous discs, supporting the scenario in which massive stars form via disc accretion. Finally, medium resolution near-infrared spectra of 5 Herbig Ae/Be stars are presented. The spectra cover both CO bandhead and Br gamma emission. Accretion rates are derived from the measuring the Br gamma emission and through modelling the CO emission, however these accretion rates are found to be inconsistent. High resolution archival data of one of the targets is presented, and it is shown that this CO disc model is unable to fit the high resolution data. Therefore, it is concluded that to properly fit CO spectra, high resolution data are needed, and that previously published information determined from low resolution spectra should be treated with caution.

  18. A Large Animal Model that Recapitulates the Spectrum of Human Intervertebral Disc Degeneration

    PubMed Central

    Gullbrand, Sarah E.; Malhotra, Neil R.; Schaer, Thomas P.; Zawacki, Zosia; Martin, John T.; Bendigo, Justin R.; Milby, Andrew H.; Dodge, George R.; Vresilovic, Edward J.; Elliott, Dawn M.; Mauck, Robert L.; Smith, Lachlan J.

    2016-01-01

    Objective The objective of this study was to establish a large animal model that recapitulates the spectrum of intervertebral disc degeneration that occurs in humans and which is suitable for pre-clinical evaluation of a wide range of experimental therapeutics. Design Degeneration was induced in the lumbar intervertebral discs of large frame goats by either intradiscal injection of chondroitinase ABC (ChABC) over a range of dosages (0.1U, 1U or 5U) or subtotal nucleotomy. Radiographs were used to assess disc height changes over 12 weeks. Degenerative changes to the discs and endplates were assessed via magnetic resonance imaging (MRI), semi-quantitative histological grading, micro-computed tomography (µCT), and measurement of disc biomechanical properties. Results Degenerative changes were observed for all interventions that ranged from mild (0.1U ChABC) to moderate (1U ChABC and nucleotomy) to severe (5U ChABC). All groups showed progressive reductions in disc height over 12 weeks. Histological scores were significantly increased in the 1U and 5U ChABC groups. Reductions in T2 and T1ρ, and increased Pfirrmann grade were observed on MRI. Resorption and remodeling of the cortical boney endplate adjacent to ChABC injected discs also occurred. Spine segment range of motion was greater and compressive modulus was lower in 1U ChABC and nucleotomy discs compared to intact. Conclusions A large animal model of disc degeneration was established that recapitulates the spectrum of structural, compositional and biomechanical features of human disc degeneration. This model may serve as a robust platform for evaluating the efficacy of therapeutics targeted towards varying degrees of disc degeneration. PMID:27568573

  19. Global variation of the dust-to-gas ratio in evolving protoplanetary discs

    NASA Astrophysics Data System (ADS)

    Hughes, Anna L. H.; Armitage, Philip J.

    2012-06-01

    Recent theories suggest planetesimal formation via streaming and/or gravitational instabilities may be triggered by localized enhancements in the dust-to-gas ratio, and one hypothesis is that sufficient enhancements may be produced in the pile-up of small solid particles inspiralling under aerodynamic drag from the large mass reservoir in the outer disc. Studies of particle pile-up in static gas discs have provided partial support for this hypothesis. Here, we study the radial and temporal evolution of the dust-to-gas ratio in turbulent discs that evolve under the action of viscosity and photoevaporation. We find that particle pile-ups do not generically occur within evolving discs, particularly if the introduction of large grains is restricted to the inner, dense regions of a disc. Instead, radial drift results in depletion of solids from the outer disc, while the inner disc maintains a dust-to-gas ratio that is within a factor of ˜2 of the initial value. We attribute this result to the short time-scales for turbulent diffusion and radial advection (with the mean gas flow) in the inner disc. We show that the qualitative evolution of the dust-to-gas ratio depends only weakly upon the parameters of the disc model (the disc mass, size, viscosity and value of the Schmidt number), and discuss the implications for planetesimal formation via collective instabilities. Our results suggest that in discs where there is a significant level of midplane turbulence and accretion, planetesimal formation would need to be possible in the absence of large-scale enhancements. Instead, trapping and concentration of particles within local turbulent structures may be required as a first stage of planetesimal formation.

  20. Gravitational instabilities in a protosolar-like disc - I. Dynamics and chemistry

    NASA Astrophysics Data System (ADS)

    Evans, M. G.; Ilee, J. D.; Boley, A. C.; Caselli, P.; Durisen, R. H.; Hartquist, T. W.; Rawlings, J. M. C.

    2015-10-01

    To date, most simulations of the chemistry in protoplanetary discs have used 1 + 1D or 2D axisymmetric α-disc models to determine chemical compositions within young systems. This assumption is inappropriate for non-axisymmetric, gravitationally unstable discs, which may be a significant stage in early protoplanetary disc evolution. Using 3D radiative hydrodynamics, we have modelled the physical and chemical evolution of a 0.17 M⊙ self-gravitating disc over a period of 2000 yr. The 0.8 M⊙ central protostar is likely to evolve into a solar-like star, and hence this Class 0 or early Class I young stellar object may be analogous to our early Solar system. Shocks driven by gravitational instabilities enhance the desorption rates, which dominate the changes in gas-phase fractional abundances for most species. We find that at the end of the simulation, a number of species distinctly trace the spiral structure of our relatively low-mass disc, particularly CN. We compare our simulation to that of a more massive disc, and conclude that mass differences between gravitationally unstable discs may not have a strong impact on the chemical composition. We find that over the duration of our simulation, successive shock heating has a permanent effect on the abundances of HNO, CN and NH3, which may have significant implications for both simulations and observations. We also find that HCO+ may be a useful tracer of disc mass. We conclude that gravitational instabilities induced in lower mass discs can significantly, and permanently, affect the chemical evolution, and that observations with high-resolution instruments such as Atacama Large Millimeter/submillimeter Array (ALMA) offer a promising means of characterizing gravitational instabilities in protosolar discs.

  1. In vivo dynamic stiffness of the porcine lumbar spine exposed to cyclic loading: influence of load and degeneration.

    PubMed

    Kaigle, A; Ekström, L; Holm, S; Rostedt, M; Hansson, T

    1998-02-01

    The dynamic axial stiffness of the L2-3 motion segment subjected to vibratory loading under intact and injured states of the intervertebral disc was studied using an in vivo porcine model. Three groups of animals with the following states of the intervertebral discs were studied: intact disc, acutely injured disc, and degenerated disc. A miniaturized servo-hydraulic exciter was used to sinusoidally vibrate the motion segment from 0.05 to 25 Hz under a compressive load with a peak value of either 100 or 200 N. The dynamic axial stiffness of the intervertebral disc was calculated at 1-Hz intervals over the frequency range. The results showed that the dynamic axial stiffness was frequency dependent. A positive relationship was found between an increase in mean dynamic stiffness and load magnitude. An increase in mean stiffness with successive exposures at the same load magnitude was observed, despite the allowance of a recovery period between loading. The greatest difference was noted between the first and second load sets. No significant change in stiffness was found due to an acute disc injury, whereas a significant increase in mean stiffness was found for the degenerated disc group as compared with the intact group. The form of the frequency response curve, however, remained relatively unaltered regardless of the degenerated state of the disc. With heavier loads, repeated loading, and/or disc degeneration, the stiffness of the intervertebral disc increases. An increase in stiffness can mean a reduction in the amount of allowable motion within the motion segment or a potentially harmful increase in force to obtain the desired motion. This may locally result in greater stresses due to an altered ability of the disc to distribute loads.

  2. A RCT comparing 7-year clinical outcomes of one level symptomatic cervical disc disease (SCDD) following ProDisc-C total disc arthroplasty (TDA) versus anterior cervical discectomy and fusion (ACDF).

    PubMed

    Loumeau, Thomas P; Darden, Bruce V; Kesman, Thomas J; Odum, Susan M; Van Doren, Bryce A; Laxer, Eric B; Murrey, Daniel B

    2016-07-01

    The objective of this trial was to compare the safety and efficacy of TDA using the ProDisc-C implant to ACDF in patients with single-level SCDD between C3 and C7. We report on the single-site results from a larger multicenter trial of 13 sites using an approved US Food and Drug Administration protocol (prospective, randomized controlled non-inferiority design). Patients were randomized one-to-one to either the ProDisc-C device or ACDF. All enrollees were evaluated pre- and post-operatively at regular intervals through month 84. Visual Analog Scale (VAS) for neck and arm pain/intensity, Neck Disability Index (NDI), Short-Form 36 (SF-36), and satisfaction were assessed. Twenty-two patients were randomized to each arm of the study. Nineteen additional patients received the ProDisc-C via continued access. NDI improved with the ProDisc-C more than with ACDF. Total range of motion was maintained with the ProDisc-C, but diminished with ACDF. Neck and arm pain improved more in the ProDisc-C than ACDF group. Patient satisfaction remained higher in the ProDisc-C group at 7 years. SF-36 scores were higher in the TDA group than ACDF group at 7 years; the difference was not clinically significant. Six additional operations (two at the same level; four at an adjacent level) were performed in the ACDF, but none in the ProDisc-C group. The ProDisc-C implant appears to be safe and effective for the treatment of SCDD. Patients with the implant retained motion at the involved segment and had a lower reoperation rate than those with an ACDF.

  3. The Gas Content Of Protoplanetary Herbig Ae/be Discs As Seen With Herschel

    NASA Astrophysics Data System (ADS)

    Meeus, Gwendolyn; Herschel OTKP, GASPS; Dent, B.

    2011-09-01

    The mechanisms determining planet formation are not (yet) well-understood. Primordial protoplanetary discs consist 99% out of gas, and only 1% out of dust. With time, those discs are believed to evolve from a flaring geometry into a flat geometry, as the initially small dust grains grow to larger sizes and settle towards the mid-plane. In the mean time, the gas will disperse, until so little is left that giant planets no longer can form. As an important piece of the puzzle of planet formation, it is important to understand the influence of the gas heating/cooling processes on the young disc structure, its chemical composition and finally how fast gas gets dispersed. In this talk, we study the protoplanetary discs around Herbig Ae/Be stars, young objects of intermediate mass, in the context of its gas content. We present Herschel PACS spectroscopic observations for a sample that was obtained within the GASPS (Gas in Protoplanetary Systems) Open Time Key Project, concentrating on the detection and characterisation of emission lines of the [OI], [CII], and CO, tracing the disc between 5 and 500 AU. We look for correlations between the observed line fluxes and stellar properties such as effective temperature, Halpha emission, accretion rates and UV flux, as well as the disc properties: degree of flaring, presence and strength of PAH emission and disc mass. We will present a few cases to show how simultaneous modeling (using the thermo-chemical disc code ProDiMo) of the atomic fine structure lines and both molecular lines can constrain the disc gas mass, once the disc structure is derived. Finally, we compare our gas line observations with those of young debris disc stars, for which the HAEBE stars are thought to be progenitors.

  4. Abundance and species richness of snakes along the Middle Rio Grande riparian forest in New Mexico

    Treesearch

    Heather L. Bateman; Alice Chung-MacCoubrey; Howard L. Snell; Deborah M. Finch

    2009-01-01

    To understand the effects of removal of non-native plants and fuels on wildlife in the riparian forest of the Middle Rio Grande in New Mexico, we monitored snakes from 2000 to 2006 using trap arrays of drift fences, pitfalls, and funnel traps. We recorded 158 captures of 13 species of snakes from 12 study sites. We captured more snakes in funnel traps than in pitfalls...

  5. Avoiding pitfalls in estimating heritability with the common options approach

    PubMed Central

    Danchin, Etienne; Wajnberg, Eric; Wagner, Richard H.

    2014-01-01

    In many circumstances, heritability estimates are subject to two potentially interacting pitfalls: the spatial and the regression to the mean (RTM) fallacies. The spatial fallacy occurs when the set of potential movement options differs among individuals according to where individuals depart. The RTM fallacy occurs when extreme measurements are followed by measurements that are closer to the mean. We simulated data from the largest published heritability study of a behavioural trait, colony size choice, to examine the operation of the two fallacies. We found that spurious heritabilities are generated under a wide range of conditions both in experimental and correlative estimates of heritability. Classically designed cross-foster experiments can actually increase the frequency of spurious heritabilities. Simulations showed that experiments providing all individuals with the identical set of options, such as by fostering all offspring in the same breeding location, are immune to the two pitfalls. PMID:24865284

  6. Gene Ontology: Pitfalls, Biases, and Remedies.

    PubMed

    Gaudet, Pascale; Dessimoz, Christophe

    2017-01-01

    The Gene Ontology (GO) is a formidable resource, but there are several considerations about it that are essential to understand the data and interpret it correctly. The GO is sufficiently simple that it can be used without deep understanding of its structure or how it is developed, which is both a strength and a weakness. In this chapter, we discuss some common misinterpretations of the ontology and the annotations. A better understanding of the pitfalls and the biases in the GO should help users make the most of this very rich resource. We also review some of the misconceptions and misleading assumptions commonly made about GO, including the effect of data incompleteness, the importance of annotation qualifiers, and the transitivity or lack thereof associated with different ontology relations. We also discuss several biases that can confound aggregate analyses such as gene enrichment analyses. For each of these pitfalls and biases, we suggest remedies and best practices.

  7. Complexities and potential pitfalls of clinical study design and data analysis in assisted reproduction.

    PubMed

    Patounakis, George; Hill, Micah J

    2018-06-01

    The purpose of the current review is to describe the common pitfalls in design and statistical analysis of reproductive medicine studies. It serves to guide both authors and reviewers toward reducing the incidence of spurious statistical results and erroneous conclusions. The large amount of data gathered in IVF cycles leads to problems with multiplicity, multicollinearity, and over fitting of regression models. Furthermore, the use of the word 'trend' to describe nonsignificant results has increased in recent years. Finally, methods to accurately account for female age in infertility research models are becoming more common and necessary. The pitfalls of study design and analysis reviewed provide a framework for authors and reviewers to approach clinical research in the field of reproductive medicine. By providing a more rigorous approach to study design and analysis, the literature in reproductive medicine will have more reliable conclusions that can stand the test of time.

  8. Ground-foraging ants (Hymenoptera: Formicidae) and rainfall effect on pitfall trapping in a deciduous thorn woodland (caatinga), Northeastern Brazil.

    PubMed

    Nunes, Francyregis A; Segundo, Glauco B Martins; Vasconcelos, Yuri B; Azevedo, Raul; Quinet, Yves

    2011-12-01

    The semi-arid Caatinga is the fourth largest biome of Brazil, which biota still remains one of the most poorly known, especially with regard to invertebrate groups. In this study, a ground-foraging ant assemblage was surveyed during one year and the effect of rainfall on pitfall trapping was assessed. The study was performed in an area located in the municipality of Pentecoste (3 degrees 48' S - 39 degrees 20' W), in the State of Ceará. A 200m transect with 20 equidistant sampling points was established. Transect sampling was performed once a month during 12 months, over the period August 2008-August 2009. At each sampling point, a pitfall trap partially filled with a mixture of ethanol and monoethylene glycol was placed at the beginning of each month and remained in the field for seven days. 39 species belonging to six subfamilies and 19 genera, plus two unidentified species, were collected, with Pheidole (10 spp.) and Camponotus (8 spp.) being the taxa with the most species. 23 species were frequent, being found in more than 50% of the 12 transect samplings. Five species had an intermediate frequency (25 to 50%), while 13 were relatively infrequent (less than 25%). Most of the species (22) showed low occurrence, being found in less than 10% of the 240 samples (20 samples each month, during 12 months). Only five species were collected in more than 50% of the samples, those species being also responsible for most of the total abundance (number of captured individuals of all species) observed each month. The species-accumulation curves (observed and estimated) indicated that sampling sufficiency was attained, and that about 92% of the estimated ground-foraging ant fauna had been collected. 40 and 29 species were collected in the dry and rainy season, respectively, with monthly species richness ranging from 13 to 28. The total ant abundance showed a drastic decrease during the rainy season, and a negative linear correlation was found between rainfall and total ant abundance (R2 = 0.68). A similar negative linear correlation was found for species occurrences against rainfall (R2 = 0.71), and for mean number of species per pitfall trap against rainfall (R2 = 0.71). However, some species showed equal abundance, occurrence and mean number of individuals per pitfall trap in both seasons, while others showed a much higher abundance and occurrence during the rainy season. Pitfall trapping as a method to sample ground-foraging ant assemblage of the Caatinga biome and potential factors responsible for lower pitfall trap performance during rainy season are discussed.

  9. A SCUBA-2 850-μm survey of protoplanetary discs in the IC 348 cluster

    NASA Astrophysics Data System (ADS)

    Cieza, L.; Williams, J.; Kourkchi, E.; Andrews, S.; Casassus, S.; Graves, S.; Schreiber, M. R.

    2015-12-01

    We present 850-μm observations of the 2-3 Myr cluster IC 348 in the Perseus molecular cloud using the SCUBA-2 camera on the James Clerk Maxwell Telescope. Our SCUBA-2 map has a diameter of 30 arcmin and contains ˜370 cluster members, including ˜200 objects with IR excesses. We detect a total of 13 discs. Assuming standard dust properties and a gas-to-dust-mass ratio of 100, we derive disc masses ranging from 1.5 to 16 MJUP. We also detect six Class 0/I protostars. We find that the most massive discs (MD > 3 MJUP; 850-μm flux > 10 mJy) in IC 348 tend to be transition objects according to the characteristic `dip' in their infrared spectral energy distributions (SEDs). This trend is also seen in other regions. We speculate that this could be an initial conditions effect (e.g. more massive discs tend to form giant planets that result in transition disc SEDs) and/or a disc evolution effect (the formation of one or more massive planets results in both a transition disc SED and a reduction of the accretion rate, increasing the lifetime of the outer disc). A stacking analysis of the discs that remain undetected in our SCUBA-2 observations suggests that their median 850-μm flux should be ≲1 mJy, corresponding to a disc mass ≲0.3 MJUP (gas plus dust) or ≲1 M⊕ of dust. While the available data are not deep enough to allow a meaningful comparison of the disc luminosity functions between IC 348 and other young stellar clusters, our results imply that disc masses exceeding the minimum-mass solar nebula are very rare (≲1per cent) at the age of IC 348, especially around very low-mass stars.

  10. Thoracolumbar Intervertebral Disc Area Morphometry in Elderly Chinese Men and Women: Radiographic Quantifications at Baseline and Changes at Year-4 Follow-up.

    PubMed

    Wáng, Jùn-Qīng; Káplár, Zoltán; Deng, Min; Griffith, James F; Leung, Jason C S; Kwok, Anthony W L; Kwok, Timothy; Leung, Ping Chung; Wáng, Yì Xiáng J

    2018-05-15

    A population-based radiographic study with longitudinal follow-up. To develop a quantitative index for lumbar disc space narrowing (DSN) evaluation in elderly subjects; to determine how DSN in the elderly is influenced by osteoporosis and sex. There is paucity of research on quantitative classification of lumbar DSN based on disc areal morphometry. With the database of Osteoporotic Fractures in Men (Hong Kong) and Osteoporotic Fractures in Women (Hong Kong) Studies and those who attended the year-4 follow-up (n = 1519 for men and n = 1546 for women), data of 491 women and 592 men were randomly selected. The anterior, middle, and posterior heights; anteroposterior diameter; and area of intervertebral discs (T4T5 to L4L5) were measured on lateral radiographs. Disc area index for lumbar spine (DAIL, disc area divided by the mean of the sum of square of the adjacent upper and lower vertebrae mid-height anterior-posterior diameter) was developed and compared with semiquantitative DSN expert grading. DAIL correlated with semiquantitative grading, with sensitivity and specificity varying from 87.3% to 96.8% for grade 1 DSN (<30% reduction in disc height), and 92.9% to 100% for grade 3 DSN (>60% reduction in disc height). The thoracolumbar disc area loss among men and women during 4-years' follow-up period varied between 1.32% and 3.56%, and it was greater for women (mean: 2.44%) than for men (mean: 1.90%, P = 0.044). Majority of lumbar DSN progressions during 72 to 76 years old were progression from normal disc space to grade 1 DSN. Osteoporosis was associated with greater disc area decrease, both for thoracic and lumbar discs. Lumbar DSN can be quantified using DAIL. In elderly Chinese, intervertebral disc narrowing over a 4-year period was greater in women than men, and associated with the presence of osteoporosis. 3.

  11. Low rate loading-induced convection enhances net transport into the intervertebral disc in vivo.

    PubMed

    Gullbrand, Sarah E; Peterson, Joshua; Mastropolo, Rosemarie; Roberts, Timothy T; Lawrence, James P; Glennon, Joseph C; DiRisio, Darryl J; Ledet, Eric H

    2015-05-01

    The intervertebral disc primarily relies on trans-endplate diffusion for the uptake of nutrients and the clearance of byproducts. In degenerative discs, diffusion is often diminished by endplate sclerosis and reduced proteoglycan content. Mechanical loading-induced convection has the potential to augment diffusion and enhance net transport into the disc. The ability of convection to augment disc transport is controversial and has not been demonstrated in vivo. To determine if loading-induced convection can enhance small molecule transport into the intervertebral disc in vivo. Net transport was quantified via postcontrast enhanced magnetic resonance imaging (MRI) into the discs of the New Zealand white rabbit lumbar spine subjected to in vivo cyclic low rate loading. Animals were administered the MRI contrast agent gadodiamide intravenously and subjected to in vivo low rate loading (0.5 Hz, 200 N) via a custom external loading apparatus for either 2.5, 5, 10, 15, or 20 minutes. Animals were then euthanized and the lumbar spines imaged using postcontrast enhanced MRI. The T1 constants in the nucleus, annulus, and cartilage endplates were quantified as a measure of gadodiamide transport into the loaded discs compared with the adjacent unloaded discs. Microcomputed tomography was used to quantify subchondral bone density. Low rate loading caused the rapid uptake and clearance of gadodiamide in the nucleus compared with unloaded discs, which exhibited a slower rate of uptake. Relative to unloaded discs, low rate loading caused a maximum increase in transport into the nucleus of 16.8% after 5 minutes of loading. Low rate loading increased the concentration of gadodiamide in the cartilage endplates at each time point compared with unloaded levels. Results from this study indicate that forced convection accelerated small molecule uptake and clearance in the disc induced by low rate mechanical loading. Low rate loading may, therefore, be therapeutic to the disc as it may enhance the nutrient uptake and waste product clearance. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Biomechanical analysis of disc pressure and facet contact force after simulated two-level cervical surgeries (fusion and arthroplasty) and hybrid surgery.

    PubMed

    Park, Jon; Shin, Jun Jae; Lim, Jesse

    2014-12-01

    The objective of this study was designed to compare 2-level cervical disc surgery (2-level anterior cervical discectomy and fusion [ACDF] or disc arthroplasty) and hybrid surgery (ACDF/arthroplasty) in terms of postoperative adjacent-level intradiscal pressure (IDP) and facet contact force (FCF). Twenty-four cadaveric cervical spines (C3-T2) were tested in various modes, including extension, flexion, and bilateral axial rotation, to compare adjacent-level IDP and FCF after specified treatments as follows: 1) C5-C6 arthroplasty using ProDisc-C (Synthes Spine, West Chester, Pennsylvania, USA) and C6-C7 ACDF, 2) C5-C6 ACDF and C6-C7 arthroplasty using ProDisc-C, 3) 2-level C5-C6/C6-C7 disc arthroplasties, and 4) 2-level C5-C6/C6-C7 ACDF. IDPs were recorded at anterior, central, and posterior disc portions. After 2-level cervical arthrodesis (ACDF), IDP increased significantly at the anterior annulus of distal adjacent-level disc during flexion and axial rotation and at the center of proximal adjacent-level disc during flexion. In contrast, after cervical specified treatments, including disc arthroplasty (2-level disc arthroplasties and hybrid surgery), IDP decreased significantly at the anterior annulus of distal adjacent-level disc during flexion and extension and was unchanged at the center of proximal adjacent-level disc during flexion. Two-level cervical arthrodesis also tended to adversely impact facet loads, increasing distal rather than proximal adjacent-level FCF. Both hybrid surgery and 2-level arthroplasties seem to offer significant advantages over 2-level arthrodesis by reducing IDP at adjacent levels and approximating FCF of an intact spine. These findings suggest that cervical arthroplasties and hybrid surgery are an alternative to reduce IDP and facet loads at adjacent levels. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. X-ray and multiwavelength insights into the inner structure of high-luminosity disc-like emitters

    NASA Astrophysics Data System (ADS)

    Luo, B.; Brandt, W. N.; Eracleous, M.; Wu, Jian; Hall, P. B.; Rafiee, A.; Schneider, D. P.; Wu, Jianfeng

    2013-02-01

    We present X-ray and multiwavelength studies of a sample of eight high-luminosity active galactic nuclei (AGN) with disc-like Hβ emission-line profiles selected from the Sloan Digital Sky Survey Data Release 7. These sources have higher redshift (z ≈ 0.6) than the majority of the known disc-like emitters, and they occupy a largely unexplored space in the luminosity-redshift plane. Seven sources have typical AGN X-ray spectra with power-law photon indices of Γ ≈ 1.4-2.0; two of them show some X-ray absorption (column density NH ≈ 1021-1022 cm-2 for neutral gas). The other source, J0850+4451, has only three hard X-ray photons detected and is probably heavily obscured (NH ≳ 3 × 1023 cm-2). This object is also identified as a low-ionization broad absorption line (BAL) quasar based on Mg II λ2799 absorption; it is the first disc-like emitter reported that is also a BAL quasar. The infrared-to-ultraviolet (UV) spectral energy distributions (SEDs) of these eight sources are similar to the mean SEDs of typical quasars with a UV `bump', suggestive of standard accretion discs radiating with high efficiency, which differs from low-luminosity disc-like emitters. Studies of the X-ray-to-optical power-law slope parameters (αOX) indicate that there is no significant excess X-ray emission in these high-luminosity disc-like emitters. Energy budget analysis suggests that for disc-like emitters in general, the inner disc must illuminate and ionize the outer disc efficiently (≈15 per cent of the nuclear ionizing radiation is required on average) via direct illumination and/or scattering. Warped accretion discs are probably needed for direct illumination to work in high-luminosity objects, as their geometrically thin inner discs decrease the amount of direct illumination possible for a flat disc.

  14. Which iodinated contrast media is the least cytotoxic to human disc cells?

    PubMed

    Kim, Kyung-Hyun; Park, Jeong-Yoon; Park, Hyo-Suk; Kuh, Sung-Uk; Chin, Dong-Kyu; Kim, Keun-Su; Cho, Yong-Eun

    2015-05-01

    Iodinated contrast media (CM) is commonly used for various intradiscal injections such as in discography and endoscopic spinal surgery. However, CM has been shown to be toxic to renal tissue due to its ionic strength and osmolarity and as a result of iodine-induced cytotoxicity, which has raised concern over whether there are similar negative effects on disc cells. This in vitro study was designed to identify the least cytotoxic iodinated CM to the human disc cell among four different physiochemical iodinated contrast dyes. In vitro laboratory study. Intervertebral disc tissue was obtained by discectomy from a total of 10 lumbar disc patients undergoing surgery and disc cells were isolated. The human disc cells were grown in 3D alginate bead culture with 0, 0.1, 10, and 100 mg/mL CM solutions (ionic dimer, ionic monomer, non-ionic dimer, and non-ionic monomer) and mannitol as a control for 2 days. The living cells were analyzed with trypan blue staining. Fluorescence-activated cell sorting analysis was performed using Annexin V and propidium iodide (PI) and 3D alginate bead immunostaining to identify live, apoptotic, and necrotic cells. Human disc cell death was time- and dose-dependent in response to CM and more necrosis was observed than apoptosis. In addition, non-ionic dimeric CM (iodixanol) showed the least toxic effect on human disc cells, followed by non-ionic monomeric (iopromide), ionic dimeric (ioxaglate), and ionic monomeric CM (ioxithalamate). Contrast media is cytotoxic to human disc cells in a dose- and time-dependent manner. This in vitro study revealed that, among four different CM preparations, non-ionic dimeric CM is the least detrimental to human disc cell viability. Careful attention should be paid to the type of CM chosen for discography and endoscopic spinal surgery. It is also necessary to investigate the detrimental effects of CM on disc cells and disc degeneration in further in vivo studies. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Molecules in Protoplanetary HAEBE discs as seen with Herschel.

    NASA Astrophysics Data System (ADS)

    Meeus, G.

    2011-05-01

    The discovery of planets around other stars has revealed that planet formation is ubiquitous. However, the mechanisms determining planet formation are not (yet) well-understood. Primordial protoplanetary discs consist 99% out of gas, and only 1% out of dust. With time, those discs are believed to evolve from a flaring geometry into a flat geometry, as the initially small dust grains grow to larger sizes and settle towards the mid-plane. In the mean time, the gas will disperse, until so little is left that giant planets no longer can form. It is thus important to understand the chemical composition of the disc and the influence of the gas heating/cooling processes on the disc structure, and finally how gas gets dispersed as a pieces of the puzzle of planet formation. In this contribution, we study the protoplanetary discs around Herbig Ae/Be stars, young objects of intermediate mass, in the context of gas chemistry. We present Herschel PACS spectroscopic observations for a sample that was obtained within the GASPS (Gas in Protoplanetary Systems) Open Time Key Project, concentrating on the detection and characterisation of emission lines of the molecules H20, CO and CH+ (besides [OI] and [CII]), tracing the disc between 5 and 500 AU. We look for correlations between the observed line fluxes and stellar properties such as effective temperature, Halpha emission, accretion rates and UV flux, as well as the disc properties: degree of flaring, presence and strength of PAH emission and disc mass. We will present a few cases to show how simultaneous modeling (using the thermo-chemical disc code ProDiMo) of the atomic fine structure lines and both Space Telescope and ground-based molecular lines can constrain the disc gas mass, once the disc structure is derived (here with the radiative transfer code MCFost). Finally, we compare our gas line observations with those of young debris disc stars, for which the HAEBE stars are thought to be progenitors.

  16. Comparison of optic disc topography in non-glaucomatous eyes of children with juvenile diabetes mellitus and normal children.

    PubMed

    Elgin, Ufuk; Cankaya, Bülent; Simsek, Tulay; Batman, Aygen

    2010-01-01

    To compare the optic disc topography parameters of children with juvenile diabetes mellitus and normal children using the Heidelberg Retinal Tomograph (HRT III) (Heidelberg Engineering, Heidelberg, Germany). The topographic optic disc parameters (cup volume, cup area, rim volume, rim area, disc area, mean cup-to-disc ratio, and mean cup depth) of 28 non-glaucomatous eyes of 28 children with type 1 diabetes mellitus and 28 eyes of 28 age-matched healthy children were compared using the nonparametric Mann-Whitney U test. No statistically significant differences were found between cup volume (P = .782), cup area (P = .878), rim volume (P = .853), disc area (P = .452), mean cup-to-disc ratio (P = .852), and mean cup depth (P = .711) of eyes of cases with diabetes mellitus and normal subjects. This result suggests that non-glaucomatous eyes of children with type 1 diabetes mellitus and healthy subjects have similar topographic optic disc characteristics. Copyright 2010, SLACK Incorporated.

  17. Optic disc size and other parameters from optical coherence tomography in Vietnamese-Americans.

    PubMed

    Peng, Pai-Huei; Fu, Sheena; Nguyen, Ngoc; Porco, Travis; Lin, Shan C

    2011-08-01

    To investigate the optic disc parameters by optical coherence tomography (OCT) in Vietnamese with various types of glaucoma. Medical charts of Vietnamese and White patients within a single practice were reviewed. Disc and rim areas by OCT were compared among nonglaucoma controls, different types of glaucoma, and glaucoma suspect. The association of these parameters with demographic and ocular features was evaluated. Data from 1416 Vietnamese and 57 White patients were included. A larger mean disc area was observed in eyes with primary angle-closure glaucoma than in eyes with primary angle-closure and primary angle-closure suspect (both P<0.001). There was no association between disc size with central corneal thickness (P=0.051) and sex (P=0.155). Vietnamese patients with glaucoma and glaucoma suspicion had larger discs than diagnosis-matched Whites (P=0.043 and 0.021, respectively). Vietnamese patients with glaucoma seem to have larger optic discs than White patients. Central corneal thickness had no association with disc area in this study population.

  18. On the inner disc structure of MWC480: evidence for asymmetries?

    NASA Astrophysics Data System (ADS)

    Jamialahmadi, N.; Lopez, B.; Berio, Ph.; Matter, A.; Flament, S.; Fathivavsari, H.; Ratzka, T.; Sitko, M. L.; Spang, A.; Russell, R. W.

    2018-01-01

    Studying the physical conditions structuring the young circumstellar discs is required for understanding the onset of planet formation. Of particular interest is the protoplanetary disc surrounding the Herbig star MWC480. The structure and properties of the circumstellar disc of MWC480 are studied by infrared interferometry and interpreted from a modelling approach. New observations are driving this study, in particular, some recent Very Large Telescope Interferometer (VLTI)/MIDI data acquired in 2013 December. Our one-component disc model could not reproduce simultaneously all our data: the spectral energy distribution, the near-infrared Keck Interferometer data and the mid-infrared data obtained with the MIDI instrument. In order to explain all measurements, one possibility is to add an asymmetry in our one-component disc model with the assumption that the structure of the disc of MWC480 has not varied with time. Several scenarios are tested, and the one considering the presence of an azimuthal bright feature in the inner component of the disc model provides a better fit of the data.

  19. [Epidemiology investigation and biomechanics analyses for the correlation between sacroiliac joint disorder and lumbar intervertebral disc degeneration].

    PubMed

    Shi, Ning-Ning; Shen, Guo-Quan; He, Shui-Yong; Guo, Ru-Bao

    2014-07-01

    To study the correlation between lumber disc degeneration and sacroiliac joint disorder, in order to provides a new understanding concepts and therapeutic approach for the prevention and treatment of chronic intractable low back pain. From August 2009 to October 2010,129 cases with lumbar disc herniation were studied with epidemiological methods. Among them, 61 patients with L4, disc herniation included 37 males and 24 females, ranging in aged from 20 to 75 years old, duration of the disease ranged from 1 to 144 months; The other 68 patients with L5S1 disc herniation included 32 males and 36 females,ranging in aged froml8 to 76 years old,duration of the disease ranged from 0.5 to 240 months. The clinical data, symptoms and signs,X-ray characteristics of lumbar spine and pelvis of the patients were investigated by epidemiological. The risk of lumbar disc herniation was calculated with case-control study; independent variables were screened with single factor analysis; the risk factors for lumbar disc herniation were determined with logistic regression analysis, and biomechanics analyses were taken. Among 129 patients with lumbar disc herniation, 88 cases associated with sacroiliac joint disorders, sacroiliac joint disorder was a risk factor of lumbar disc herniation (OR = 4.61, P = 0.00); 47 cases associated with sacroiliac joint disorders in 61 patients with L4,5 disc herniation, iliac crest uneven caused by iliac rotational displacement was a high risk factor of L4,5 disc herniation (OR = 11.27, P = 0.00); 41 cases associated with sacroiliac joint disorders in 68 patients with L5S1 disc herniation, lumbar sacral angle abnormalities caused by sacral tilt shift was a high risk factor L5S1 disc herniation (OR = 2.31, P = 0.03). Lumbar disc herniation and sacroiliac joint disorder are two of fallot, the two factors affect each other and there is a causal relationship. They are common exists in low back pain.

  20. Bilateral optic disc drusen mimicking papilledema.

    PubMed

    Sahin, Alparslan; Cingü, Abdullah Kürşat; Ari, Seyhmus; Cinar, Yasin; Caça, Ihsan

    2012-06-01

    Optic disc drusen, which are calcified deposits that form anterior to the lamina cribrosa in the optic nerve, may mimic papilledema. We report herein three cases referred to us with suspicion of disc swelling and papilledema. Following ophthalmologic evaluation with B-scan ultrasound, red-free fundus photography, and computed tomography, the diagnosis of papilledema was excluded in all cases and optic disc drusen was diagnosed. Clinical suspicion of optic disc drusen in cases presenting with swelling of the optic nerve head is important in order to avoid unnecessary interventions and anxiety. The reported cases highlight the commonly encountered clinical presentations and the practical aspects of diagnosis and management of optic disc drusen.

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