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Sample records for pedicle axis view

  1. Cervical pedicle screw fixation in traumatic cervical subluxation after laminectomy using the pedicle axis view technique under fluoroscopy.

    PubMed

    Machino, Masaaki; Yukawa, Yasutsugu; Ito, Keigo; Nakashima, Hiroaki; Kanbara, Shunsuke; Morita, Daigo; Kato, Fumihiko

    2012-10-10

    Cervical pedicle screw (CPS) fixation has recently been performed in patients in need of cervical reconstruction. We report the case of a 50-year-old man who was operated for traumatic cervical vertebra subluxation using CPS fixation, in whom laminectomy had been performed in the past. We performed CPS fixation using the pedicle axis view technique under fluoroscopy. The four pedicle screws were accurately inserted within the pedicles without perforating the bone cortex of the pedicles. A navigation system is useful for cervical spine surgery because it enables a surgeon to perform relatively safe and accurate surgery during transpedicular screw fixation. However, attachment of the stereotactic reference arc to the spinous process is impossible, and the application of a navigation system is limited in cases in which laminectomy has been performed in the past. We have been using the pedicle axis view technique under fluoroscopy and have found that if we take care of the entry point accurately, we can safely insert the pedicle screw in cases with fewer landmarks.

  2. True anteroposterior view pedicle screw insertion technique

    PubMed Central

    Bai, Jia-yue; Zhang, Wei; An, Ji-long; Sun, Ya-peng; Ding, Wen-yuan; Shen, Yong

    2016-01-01

    Background The wide use of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) surgery in the treatment of degenerative disc disease of lumbar spine in spinal surgery highlights the gradual decrease in the use of traditional pedicle screw insertion technology. This study aims to analyze the accuracy of the true anteroposterior view pedicle screw insertion technique in MIS-TLIF surgery, compare it with conventional pedicle screw insertion technology, and discuss its clinical application value. Methods Fifty-two patients undergoing true anteroposterior view (group A) and 87 patients undergoing conventional pedicle screw insertion (group B) were diagnosed with lumbar disc herniation or lumbar spinal stenosis. Time for screw placement, intraoperative irradiation exposure, accuracy rate of pedicle screw insertion, and incidence of neurovascular injury were compared between the two groups. Results The time for screw placement and intraoperative irradiation exposure was significantly less in group A. Penetration rates of the paries lateralis of vertebral pedicle, medial wall of vertebral pedicle, and anterior vertebral wall were 1.44%, 0%, and 2.40%, respectively, all of which were significantly lower than that in group B. No additional serious complications caused by the placement of screw were observed during the follow-up period in patients in group A, but two patients with medial penetration underwent revision for unbearable radicular pain. Conclusion The application of true anteroposterior view pedicle screw insertion technique in MIS-TLIF surgery shortens time for screw placement and reduces the intraoperative irradiation exposure along with a higher accuracy rate of screw placement, which makes it a safe, accurate, and efficient technique. PMID:27418828

  3. Surgeon's view of pedicle screw implantation for the monitoring neurophysiologist.

    PubMed

    Joglekar, Siddharth B; Mehbod, Amir A

    2012-12-01

    Pedicle screws have become the gold standard of spinal instrumentation over the past decade owing to their biomechanical superiority. Despite their advantages, pedicle screw instrumentation is potentially dangerous, and surgeons wish to improve accuracy of screw placement to avoid complications associated with screw misplacement. The anatomy of the pedicles is variable throughout the spine, and several landmarks and trajectories have been suggested to aid safe placement of pedicle screws in the spine. Several techniques such as x-ray and computed tomography scan imaging coupled with computer-aided navigation are available to improve accuracy of screw insertion. Intraoperative neuromonitoring with the help of triggered electromyographic recordings has evolved as an objective evidence of assessing pedicle breach and proximity of the screw to neural structures. While all imaging and electrophysiological modalities should be applied on an individualized basis, finally no adjunctive technique can fully replace the need for surgical expertise and experience.

  4. Accuracy of Percutaneous Lumbosacral Pedicle Screw Placement Using the Oblique Fluoroscopic View Based on Computed Tomography Evaluations

    PubMed Central

    Sato, Koji; Kanemura, Tokumi; Iwase, Toshiki; Togawa, Daisuke; Matsuyama, Yukihiro

    2016-01-01

    Study Design Retrospective. Purpose This study aims to investigate the accuracy of the oblique fluoroscopic view, based on preoperative computed tomography (CT) images for accurate placement of lumbosacral percutaneous pedicle screws (PPS). Overview of Literature Although PPS misplacement has been reported as one of the main complications in minimally invasive spine surgery, there is no comparative data on the misplacement rate among different fluoroscopic techniques, or comparing such techniques with open procedures. Methods We retrospectively selected 230 consecutive patients who underwent posterior spinal fusion with a pedicle screw construct for degenerative lumbar disease, and divided them into 3 groups, those who had undergone: minimally invasive percutaneous procedure using biplane (lateral and anterior-posterior views using a single C-arm) fluoroscope views (group M-1), minimally invasive percutaneous procedure using the oblique fluoroscopic view based on preoperative CT (group M-2), and conventional open procedure using a lateral fluoroscopic view (group O: controls). The relative position of the screw to the pedicle was graded for the pedicle breach as no breach, <2 mm, 2–4 mm, or >4 mm. Inaccuracy was calculated and assessed according to the spinal level, direction and neurological deficit. Inter-group radiation exposure was estimated using fluoroscopy time. Results Inaccuracy involved an incline toward L5, causing medial or lateral perforation of pedicles in group M-1, but it was distributed relatively equally throughout multiple levels in groups M-2 and controls. The mean fluoroscopy time/case ranged from 1.6 to 3.9 minutes. Conclusions Minimally invasive lumbosacral PPS placement using the conventional fluoroscopic technique carries an increased risk of inaccurate screw placement and resultant neurological deficits, compared with that of the open procedure. Inaccuracy tended to be distributed between medial and lateral perforations of the L5 pedicle

  5. 14. A VIEW ALONG AXIS OF OGEE SECTION OF THE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    14. A VIEW ALONG AXIS OF OGEE SECTION OF THE SPILLWAY STRUCTURE... Volume XVII, No. 14, November 29, 1939. - Prado Dam, Spillway, Santa Ana River near junction of State Highways 71 & 91, Corona, Riverside County, CA

  6. 10. View west along carillon tower axis from base of ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. View west along carillon tower axis from base of tower to gates in western estate wall at SR 141 - A. I. Du Pont Estate, Junction of State Route 141 & Rockland Road, Wilmington, New Castle County, DE

  7. 23. VIEW NORTHWEST ON VIRGINIA AVENUE AXIS SHOWING NEW JERSEY ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    23. VIEW NORTHWEST ON VIRGINIA AVENUE AXIS SHOWING NEW JERSEY AVENUE OVERPASS AND WASHINGTON MONUMENT. TAKEN FROM UNDERNEATH THE SOUTHEAST/SOUTHWEST FREEWAY. - Virginia Avenue, Washington, District of Columbia, DC

  8. 22. VIEW SOUTHWEST ON VIRGINIA AVENUE AXIS SHOWING SOUTH SIDE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    22. VIEW SOUTHWEST ON VIRGINIA AVENUE AXIS SHOWING SOUTH SIDE OF GARFIELD PARK, NARROW ROADWAY, RAILROAD TRACKS ENTERING THE TUNNEL, AND THE SOUTHEAST/SOUTHWEST FREEWAY. TAKEN FROM THE NEW JERSEY AVENUE OVERPASS. - Virginia Avenue, Washington, District of Columbia, DC

  9. 6. GENERAL CONSTRUCTION VIEW ALONG AXIS OF DAM FROM THE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    6. GENERAL CONSTRUCTION VIEW ALONG AXIS OF DAM FROM THE EAST ABUTMENT.... Volume XVII, No. 18, December 18, 1939. - Prado Dam, Embankment, Santa Ana River near junction of State Highways 71 & 91, Corona, Riverside County, CA

  10. 3. AERIAL VIEW LOOKING NORTHWEST ON THE VIRGINIA AVENUE AXIS ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. AERIAL VIEW LOOKING NORTHWEST ON THE VIRGINIA AVENUE AXIS FROM THE ANACOSTIA RIVER TO THE WASHINGTON MONUMENT. (Photograph enlarged from 4x5 negative.) - Virginia Avenue, Washington, District of Columbia, DC

  11. 5. GENERAL VIEW FROM EAST ABUTMENT ALONG AXIS OF DAM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. GENERAL VIEW FROM EAST ABUTMENT ALONG AXIS OF DAM SHOWING STEEL SHEET PILE CUTOFF WALL COMPLETED, AND EMBANKMENT MATERIAL BEING COMPACTED INTO POSITION. Volume XVI, No. 11, July 21, 1939. - Prado Dam, Embankment, Santa Ana River near junction of State Highways 71 & 91, Corona, Riverside County, CA

  12. 8. VIEW LOOKING NORTHWEST DOWN CENTRAL AXIS OF ROOM 110. ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    8. VIEW LOOKING NORTHWEST DOWN CENTRAL AXIS OF ROOM 110. NOTE CHANGE IN CEILING TREATMENT: WOOD PLANKS IN CENTER, ALL OTHER AREAS ARE GYPSUM BOARD. FLOOR IN CENTRAL AREA IS CONCRETE. POSTS AND BEAMS ARE ALL WOOD CONSTRUCTION. - Presidio of San Francisco, Cavalry Stables, Cowles Street, between Lincoln Boulevard & McDowell Street, San Francisco, San Francisco County, CA

  13. "No. 64. View of Grand River looking along the axis ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    "No. 64. View of Grand River looking along the axis of proposed diversion dam. H.T.C., Aug. 20, 1913." - Grand Valley Diversion Dam, Half a mile north of intersection of I-70 & Colorado State Route 65, Cameo, Mesa County, CO

  14. 5. VIEW FROM NORTH TERRACE ALONG AXIS OF HOUSE TO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. VIEW FROM NORTH TERRACE ALONG AXIS OF HOUSE TO SSW ON PARALLEL CAMERA AXES Copy photograph of photogrammetric plate LC-HABS-GS01-B-1979-1405R. - Rose Pauson House (Ruins), Thirty-Second Street, Phoenix, Maricopa County, AZ

  15. Segmental Analysis of Cardiac Short-Axis Views Using Lagrangian Radial and Circumferential Strain.

    PubMed

    Ma, Chi; Wang, Xiao; Varghese, Tomy

    2016-11-01

    Accurate description of myocardial deformation in the left ventricle is a three-dimensional problem, requiring three normal strain components along its natural axis, that is, longitudinal, radial, and circumferential strains. Although longitudinal strains are best estimated from long-axis views, radial and circumferential strains are best depicted in short-axis views. An algorithm that utilizes a polar grid for short-axis views previously developed in our laboratory for a Lagrangian description of tissue deformation is utilized for radial and circumferential displacement and strain estimation. Deformation of the myocardial wall, utilizing numerical simulations with ANSYS, and a finite-element analysis-based canine heart model were adapted as the input to a frequency-domain ultrasound simulation program to generate radiofrequency echo signals. Clinical in vivo data were also acquired from a healthy volunteer. Local displacements estimated along and perpendicular to the ultrasound beam propagation direction are then transformed into radial and circumferential displacements and strains using the polar grid based on a pre-determined centroid location. Lagrangian strain variations demonstrate good agreement with the ideal strain when compared with Eulerian results. Lagrangian radial and circumferential strain estimation results are also demonstrated for experimental data on a healthy volunteer. Lagrangian radial and circumferential strain tracking provide accurate results with the assistance of the polar grid, as demonstrated using both numerical simulations and in vivo study.

  16. In vitro study of accuracy of cervical pedicle screw insertion using an electronic conductivity device (ATPS part III).

    PubMed

    Koller, Heiko; Hitzl, Wolfgang; Acosta, Frank; Tauber, Mark; Zenner, Juliane; Resch, Herbert; Yukawa, Yasutsugu; Meier, Oliver; Schmidt, Rene; Mayer, Michael

    2009-09-01

    anterior pedicle screw tract preparation with the exclusion of dense cortical pedicles was shown to be a successful and clinically sound concept with high-accuracy rates for ATPS and pCPS. In concert with fluoroscopic guidance and pedicle axis views, application of an ECD and exclusion of dense cortical pedicles might increase comfort and safety with the clinical use of pCPS. In addition, we presented a reasonable laboratory setting for the clinical introduction of an ATPS-plate system.

  17. Towards a synthetic view of axis specification mechanisms in vertebrates: insights from the dogfish.

    PubMed

    Coolen, Marion; Menuet, Arnaud; Mazan, Sylvie

    2009-01-01

    The genetic mechanisms, which control axis specification, apparently extensively diverge across vertebrates. In amphibians and teleosts, they are tightly linked to the establishment of an early dorso-ventral polarity. This polarity has no equivalent in amniotes, which unlike the former, retain a considerable plasticity for their site of axis formation until blastula stages and rely on signals secreted by extra-embryonic tissues for the establishment of their early rostro-caudal pattern. In order to better understand the links between these seemingly highly divergent mechanisms, we have used an evo-devo approach, aimed at reconstructing the gnathostome ancestral state and focussed on a chondrichthyan, the dogfish Scyliorhinus canicula. A detailed molecular characterization of the dogfish embryo at blastula and gastrula stages highlights striking similarities with all vertebrate model organisms including amniotes. It suggests the presence in the dogfish of territories homologous to the hypoblast and extra-embryonic ectoderm of the latter, which may therefore reflect the primitive condition of jawed vertebrates. In the ancestral state, these territories are specified at opposite sides of an early axis of bilateral symmetry, homologous to the dorso-ventral axis of amphibians and teleosts, and aligned with the later forming embryonic axis, from head to tail. Amniotes have diverged from this pattern through a posterior expansion of extra-embryonic ectoderm, resulting in an apparently radial symmetry at late blastula stages. These data delineate the broad outlines of the gnathostome ancestral pattern of axis specification and highlight an unexpected unity of mechanisms across jawed vertebrates. They illustrate the complementarity of comparative and genetic approaches for a comprehensive view of developmental mechanisms themselves.

  18. A pedicled muscle flap based solely on a neural pedicle.

    PubMed

    Avci, Gulden; Akan, Mithat; Akoz, Tayfun; Kuzon, William; Gul, Aylin Ege

    2009-01-01

    We tested the hypothesis that the intrinsic vascular plexus of the motor nerve could support viability in a rat hindlimb muscle flap. In a preliminary study, we examined the course and vascularity of the sciatic nerve, the peroneal nerve, and the peroneous longus muscle in the rat hindlimb via anatomic dissection, microangiography, and histologic study (n = 10 animals). On the basis of this examination, the peroneous longus muscle was chosen as our experimental model in this study. In 12 animals, the peroneus longus was acutely elevated, which severed all tendinous and vascular structures, this left the muscle pedicled on the motor nerve only (Group I). Animals in Group II underwent a staged elevation of the flap with division of the vascular pedicle, the tendon of insertion, and the tendon of origin during separate procedures that were 5 days apart (n = 12). Muscle viability was evaluated by gross inspection, measurement of muscle weight and length, nitroblue tetrazlium (NBT) staining, microangiography, and histology. NBT staining demonstrated that immediate elevation of the peroneus longus muscle flaps led to an average necrotic area of 80.6% +/- 9.8% (Group I). A significant improvement in viability was observed for muscle flaps of animals in Group II, with peroneus longus muscle necrosis averaging 25.6% +/- 9.3%. Microangiography demonstrated that the intrinsic vascularity of nerve was increased dramatically in Group II. These data support the hypothesis that the intrinsic vascular plexus of the motor nerve of a skeletal muscle can support at least partial viability of a muscle flap. However, this vascular axis is inadequate to support complete viability of a muscle flap if the flap is elevated immediately. If a staged elevation affects a surgical delay, the viability of a muscle flap elevated on a neural pedicle can be increased significantly. With adjustments in the delay procedure, this strategy may allow transfer of muscle flaps when maintenance or

  19. Medially-shifted rather than high-riding vertebral arteries preclude safe pedicle screw insertion.

    PubMed

    Maki, Satoshi; Koda, Masao; Iijima, Yasushi; Furuya, Takeo; Inada, Taigo; Kamiya, Koshiro; Ota, Mitsutoshi; Saito, Junya; Okawa, Akihiko; Takahashi, Kazuhisa; Yamazaki, Masashi

    2016-07-01

    We enrolled 100 patients who underwent preoperative CT angiography before cervical spine instrumentation and investigated the morphology of the C2 pedicle from the perspective of pedicle screw (PS) trajectory using volume rendering and multiplanar reconstruction. The narrowest portion of the pedicle was identified as the pedicle isthmus. Safe C2 PS insertion was regarded to be not feasible when the height of the medullary cavity of the pedicle isthmus and/or width of the medullary cavity of the pedicle isthmus was ⩽4mm. Forty-five (22.5%) pedicles were ⩽4mm in width, and safe insertion of a PS was determined to be not feasible. Among these, seven pedicles were ⩽4mm in both height and width. The remaining 38 pedicles were ⩽4mm in width with heights >4mm. There was no pedicle with a width >4mm and height <4mm. In other words, short pedicles were always concomitantly narrow. Therefore, the seven pedicles ⩽4mm in both height and width were considered to be morphologically narrow. The heights of the pedicle isthmus were not limited by the vertebral artery groove (VAG) and safe C2 PS insertion can be considered feasible where the VAG is marginally cranial, whereas the widths of the pedicle isthmus are limited by the VAG. Therefore, safe C2 PS insertion is precluded only when the VAG courses cranially and medially. It is a medially-shifted, rather than a high-riding, vertebral artery that precludes safe C2 PS insertion. Therefore to avoid vertebral artery injury an axial CT scan, parallel to the pedicle axis, should be evaluated before C2 PS insertion.

  20. Subendocardial motion in hypertrophic cardiomyopathy: assessment from long- and short-axis views by pulsed tissue Doppler imaging

    NASA Technical Reports Server (NTRS)

    Tabata, T.; Oki, T.; Yamada, H.; Abe, M.; Onose, Y.; Thomas, J. D.

    2000-01-01

    BACKGROUND: Tissue Doppler imaging (TDI) is a recently developed technique that allows the instantaneous measurement of intrinsic regional myocardial motion velocity. Pulsed TDI is capable of separately assessing left ventricular (LV) regional motion velocity caused by circumferential and longitudinal fiber contraction. This particular feature of function is still controversial in patients with hypertrophic cardiomyopathy (HC). METHODS: To better characterize intrinsic circumferential and longitudinal LV systolic myocardial function in HC, we used pulsed TDI to measure short- and long-axis LV motion velocities, respectively. The subendocardial motion velocity patterns at the middle of the LV posterior wall (PW) and ventricular septum (IVS) in LV parasternal and apical long-axis views were recorded by pulsed TDI in 19 patients with nonobstructive HC and in 21 normal controls (NC). RESULTS: Peak short- and long-axis systolic subendocardial velocities in both the LV PW and IVS were significantly smaller in the HC group than in the NC group, and the time to peak velocity was significantly delayed. Furthermore, peak PW systolic velocity was significantly greater along the long axis than along the short axis in the NC group (8.8 +/- 1.5 cm/s vs 8.2 +/- 1.4 cm/s, P <.05), whereas the opposite was observed in the HC group (6.1 +/- 1.2 cm/s vs 7.5 +/- 1.0 cm/s, P <.0001). No significant differences were found in either group between the long- and short-axis IVS velocities (HC: 5.9 +/- 1.4 cm/s vs 5.5 +/- 1.3 cm/s; NC: 7.8 +/- 1.3 cm/s vs 7.9 +/- 1.6 cm/s). CONCLUSIONS: By using the capability of pulsed TDI for the evaluation of intrinsic myocardial velocity instantaneously in a specific region and direction, we found impairment of LV myocardial systolic function in patients with HC not only in the hypertrophied IVS but also in the nonhypertrophied LV PW. We also found a greater decrease in LV PW velocities along the long axis than the short axis, suggesting greater

  1. Morphological study of subaxial cervical pedicles by using three-dimensional computed tomography reconstruction image.

    PubMed

    Wasinpongwanich, Kanthika; Paholpak, Permsak; Tuamsuk, Panya; Sirichativapee, Winai; Wisanuyotin, Taweechok; Kosuwon, Weerachai; Jeeravipoolvarn, Polasak

    2014-01-01

    Malpositioning of cervical screws risks neurovascular injury. A cervical screw fixation system can provide proper rigidity, alignment correction, and high rates of fusion afforded by high pullout biomechanical strength. The objective is to assess the dimensions and axis of the C3-C7 cervical pedicles. A 1-mm slice thickness computed tomography (CT) scan of the cervical spine of 30 patients (15 males, 15 females) were analyzed and reconstructed in three-dimensions using Mimics(®) 10.01 software. We measured pedicle axis length (PAL), pedicle and lateral mass length (PL-LM), pedicle length (PL), outer pedicle width (OPW), and pedicle transverse angle (PTA) from the axial image and outer pedicle height (OPH) and pedicle sagittal angle (PSA) from the sagittal image. The OPH and OPW at all subaxial cervical spines were suitable for insertion of 3.5 mm cervical pedicle screws. PSA was directed cranially at C3 to C5 (13.84, 7.09, and 2.71) and directed caudally at C6 and C7 (-4.55, -6.94). PTA was greatest at C5 and smallest at C7. The respective difference between the left and right side for nearly all parameters was not statistically significant (except for C6 PL and C7 OPH). Females had a significantly smaller OPH and OPW than males at nearly all levels. The PTA was not significantly different between the sexes. Cervical pedicle screw fixation in the Thai population can be safely performed and guidelines for insertion at each vertebra documented. Appropriate preoperative planning is necessary to achieve safe and accurate placement of the screws.

  2. Subaxial cervical pedicle screw insertion with newly defined entry point and trajectory: accuracy evaluation in cadavers.

    PubMed

    Zheng, Xiujun; Chaudhari, Rahul; Wu, Chunhui; Mehbod, Amir A; Transfeldt, Ensor E

    2010-01-01

    Successful placement of cervical pedicle screws requires accurate identification of both entry point and trajectory. However, literature has not provided consistent recommendations regarding the direction of pedicle screw insertion and entry point location. The objective of this study was to define a guideline regarding the optimal entry point and trajectory in placing subaxial cervical pedicle screws and to evaluate the screw accuracy in cadaver cervical spines. The guideline for entry point and trajectory for each vertebra was established based on the recently published morphometric data. Six fresh frozen cervical spines (C3-C7) were used. There were two men and four women. After posterior exposure, the entry point was determined and the cortical bone of the entry point was removed using a 2-mm burr. Pilot holes were created with a cervical probe based on the guideline using fluoroscopy. After tapping, 3.5-mm screws with appropriate length were inserted. After screw insertion, every vertebra was dissected and inspected for pedicle breach. The pedicle width, height, pedicle transverse angulation and actual screw insertion angle were measured. A total of 60 pedicle screws were inserted. No statistical difference in pedicle width and height was found between the left and right sides for each level. The overall accuracy of pedicle screws was 83.3%. The remaining 13.3% screws had noncritical breach, and 3.3% had critical breach. The critical breach was not caused by the guideline. There was no statistical difference between the pedicle transverse angulation and the actual screw trajectory created using the guideline. There was statistical difference in pedicle width between the breach and non-breach screws. In conclusion, high success rate of subaxial cervical pedicle screw placement can be achieved using the recently proposed operative guideline and oblique views of fluoroscopy. However, careful preoperative planning and good surgical skills are still required to

  3. A ventral view on antidepressant action: roles for adult hippocampal neurogenesis along the dorsoventral axis.

    PubMed

    O'Leary, Olivia F; Cryan, John F

    2014-12-01

    Adult hippocampal neurogenesis is implicated in antidepressant action, stress responses, and cognitive functioning. The hippocampus is functionally segregated along its longitudinal axis into dorsal (dHi) and ventral (vHi) regions in rodents, and analogous posterior and anterior regions in primates, whereby the vHi preferentially regulates stress and anxiety, while the dHi preferentially regulates spatial learning and memory. Given the role of neurogenesis in functions preferentially regulated by the dHi or vHi, it is plausible that neurogenesis is preferentially regulated in either the dHi or vHi depending upon the stimulus. We appraise here the literature on the effects of stress and antidepressants on neurogenesis along the hippocampal longitudinal axis and explore whether preferential regulation of neurogenesis in the vHi/anterior hippocampus contributes to stress resilience and antidepressant action.

  4. Off-axis three-mirror freeform telescope with a large linear field of view based on an integration mirror.

    PubMed

    Meng, Qingyu; Wang, Hongyuan; Wang, Kejun; Wang, Yan; Ji, Zhenhua; Wang, Dong

    2016-11-10

    We report on the design of an off-axis three-mirror freeform telescope with a large field of view (FOV) based on an integration mirror (IM). This design is the continuation of the authors' previous work. Based on aberration theory, we established a suitable nonrelayed three-mirror-anastigmat initial configuration for integration mirror design. For an optical freeform surface, we analyzed the qualitative aberration correction ability of a x-y polynomial surface that can provide a simple, convenient, and user-friendly relationship between freeform surface term coefficients and aberrations and then applied the x-y polynomial surface on the tertiary mirror to improve the system optimization degrees of freedom. In an example with a focal length of 1200 mm, an F-number of 12, and a FOV of 1°×30°, the tolerance performance was analyzed, and the system presented a good imaging performance. In addition, the IM structure and opto-mechanics support structure were designed and analyzed. The confirmatory design results showed that the integration of the primary mirror and tertiary mirror can improve opto-mechanical properties judged by multiple criteria. In conclusion, the integration of the primary mirror and tertiary mirror not only offers alignment convenience as described previously but also improves system opto-mechanical properties in multiple perspectives. We believe this large linear FOV system based on IM has broad future applications in the optical remote sensing field.

  5. Robot assisted navigated drilling for percutaneous pedicle screw placement: A preliminary animal study

    PubMed Central

    Wang, Hongwei; Zhou, Yue; Liu, Jun; Han, Jianda; Xiang, Liangbi

    2015-01-01

    Background: There is much more radiation exposure to the surgeons during minimally invasive pedicle screws placement. In order to ease the surgeon's hand-eye coordination and to reduce the iatrogenic radiation injury to the surgeons, a robot assisted percutaneous pedicle screw placement is useful. This study assesses the feasibility and clinical value of robot assisted navigated drilling for pedicle screw placement and the results thus achieved formed the basis for the development of a new robot for pedicle screw fixation surgery. Materials and Methods: Preoperative computed tomography (CT) of eight bovine lumbar spines (L1–L5) in axial plane were captured for each vertebra, the entry points and trajectories of the screws were preoperatively planned. On the basis of preoperative CT scans and intraoperative fluoroscopy, we aligned the robot drill to the desired entry point and trajectory, as dictated by the surgeon's preoperative plan. Eight bovine lumbar spines were inserted 80 K-wires using the spine robot system. The time for system registration and pedicle drilling, fluoroscopy times were measured and recorded. Postoperative CT scans were used to assess the position of the K-wires. Results: Assisted by spine robot system, the average time for system registration was (343.4 ± 18.4) s, the average time for procedure of drilling one pedicle screw trajectory was (89.5 ± 6.1) s, times of fluoroscopy for drilling one pedicle screw were (2.9 ± 0.8) times. Overall, 12 (15.0%) of the 80 K-wires violated the pedicle wall. Four screws (5.0%) were medial to the pedicle and 8 (10.5%) were lateral. The number of K-wires wholly within the pedicle were 68 (85%). Conclusions: The preliminary study supports the view that computer assisted pedicle screw fixation using spinal robot is feasible and the robot can decrease the intraoperative fluoroscopy time during the minimally invasive pedicle screw fixation surgery. As spine robotic surgery is still in its infancy, further

  6. Time- and space-resolved measurements of soft x-ray emissions viewed 4x from the z axis at Z

    SciTech Connect

    Lazier, S.; McKenney, J.; Jobe, D.; Derzon, M.; Nash, T.; Chandler, G.

    1999-07-01

    The authors have developed a near-axis time-resolved x-ray imaging capability to make measurements of the emission profile for foam targets on the Z accelerator. By slit-imaging spectrally filtered x-ray emission from the z-pinch target to an array of scintillator coupled fiber-optics, they obtain an emission profile as a function of time sampling every 260 {micro}m viewing 4{degree} from the z axis. The plasma run in and reexpansion are observed. Implosion velocities, and compressed sizes for annular and foam targets have been measured. They describe the diagnostics, results from the instrument and instrument characterization.

  7. Congenitally absent lumbar pedicle: a reappraisal

    SciTech Connect

    Wortzman, G.; Steinhardt, M.I.

    1984-09-01

    Three patients who had a diagnosis of congenitally absent lumbar pedicle underwent CT examination. Findings showed that each patient had an aberrant hypoplastic pedicle plus a retroisthmic defect in their ipsilateral lamina rather than an absent pedicle. Axial CT was the diagnostic modality of choice; reformated images were of little value. The differential diagnosis to be considered from the findings of plain film radiography includes pediculate thinning, neoplastic disease, neurofibroma, mesodermal dysplasia associated with neurofibromatosis, and vascular anomalies.

  8. Individualized 3D printing navigation template for pedicle screw fixation in upper cervical spine

    PubMed Central

    Guo, Fei; Dai, Jianhao; Zhang, Junxiang; Ma, Yichuan; Zhu, Guanghui; Shen, Junjie; Niu, Guoqi

    2017-01-01

    Purpose Pedicle screw fixation in the upper cervical spine is a difficult and high-risk procedure. The screw is difficult to place rapidly and accurately, and can lead to serious injury of spinal cord or vertebral artery. The aim of this study was to design an individualized 3D printing navigation template for pedicle screw fixation in the upper cervical spine. Methods Using CT thin slices data, we employed computer software to design the navigation template for pedicle screw fixation in the upper cervical spine (atlas and axis). The upper cervical spine models and navigation templates were produced by 3D printer with equal proportion, two sets for each case. In one set (Test group), pedicle screws fixation were guided by the navigation template; in the second set (Control group), the screws were fixed under fluoroscopy. According to the degree of pedicle cortex perforation and whether the screw needed to be refitted, the fixation effects were divided into 3 types: Type I, screw is fully located within the vertebral pedicle; Type II, degree of pedicle cortex perforation is <1 mm, but with good internal fixation stability and no need to renovate; Type III, degree of pedicle cortex perforation is >1 mm or with the poor internal fixation stability and in need of renovation. Type I and Type II were acceptable placements; Type III placements were unacceptable. Results A total of 19 upper cervical spine and 19 navigation templates were printed, and 37 pedicle screws were fixed in each group. Type I screw-placements in the test group totaled 32; Type II totaled 3; and Type III totaled 2; with an acceptable rate of 94.60%. Type I screw placements in the control group totaled 23; Type II totaled 3; and Type III totaled 11, with an acceptable rate of 70.27%. The acceptability rate in test group was higher than the rate in control group. The operation time and fluoroscopic frequency for each screw were decreased, compared with control group. Conclusion The individualized 3D

  9. An automatic registration system of multi-view 3D measurement data using two-axis turntables

    NASA Astrophysics Data System (ADS)

    He, Dong; Liu, Xiaoli; Cai, Zewei; Chen, Hailong; Peng, Xiang

    2016-09-01

    Automatic registration is a key researcher issue in 3D measurement field. In this work, we developed the automatic registration system, which is composed of a stereo system with structured light and two axis turntables. To realize the fully automatically 3D point registration, the novel method is proposed for calibration the stereo system and the two turntable direction vector simultaneously. The plane calibration rig with marked points was placed on the turntable and was captured by the left and right cameras of the stereo system with different rotation angles of the two axis turntable. By the shot images, a stereo system (intrinsically and extrinsically) was calibrated with classics camera model, and reconstruction 3D coordinates of the marked points with different angle of the two turntable. The marked point in different angle posted the specific circle, and the normal line of the circle around the turntable axis direction vector. For the each turntable, different points have different circle and normal line, and the turntable axis direction vector is calculated by averaging the different normal line. And the result show that, the proposed registration system can precisely register point cloud under the different scanning angles. In addition, there are no the ICP iterative procedures, and that make it can be used in registration of the point cloud without the obvious features like sphere, cylinder comes and the other rotator.

  10. Innovative approach in the development of computer assisted algorithm for spine pedicle screw placement.

    PubMed

    Solitro, Giovanni F; Amirouche, Farid

    2016-04-01

    Pedicle screws are typically used for fusion, percutaneous fixation, and means of gripping a spinal segment. The screws act as a rigid and stable anchor points to bridge and connect with a rod as part of a construct. The foundation of the fusion is directly related to the placement of these screws. Malposition of pedicle screws causes intraoperative complications such as pedicle fractures and dural lesions and is a contributing factor to fusion failure. Computer assisted spine surgery (CASS) and patient-specific drill templates were developed to reduce this failure rate, but the trajectory of the screws remains a decision driven by anatomical landmarks often not easily defined. Current data shows the need of a robust and reliable technique that prevents screw misplacement. Furthermore, there is a need to enhance screw insertion guides to overcome the distortion of anatomical landmarks, which is viewed as a limiting factor by current techniques. The objective of this study is to develop a method and mathematical lemmas that are fundamental to the development of computer algorithms for pedicle screw placement. Using the proposed methodology, we show how we can generate automated optimal safe screw insertion trajectories based on the identification of a set of intrinsic parameters. The results, obtained from the validation of the proposed method on two full thoracic segments, are similar to previous morphological studies. The simplicity of the method, being pedicle arch based, is applicable to vertebrae where landmarks are either not well defined, altered or distorted.

  11. Biomechanical effects of pedicle screw fixation on adjacent segments.

    PubMed

    Kyaw, Thein Aung; Wang, Zhuo; Sakakibara, Toshihiko; Yoshikawa, Takamasa; Inaba, Tadashi; Kasai, Yuichi

    2014-07-01

    Various biomechanical investigations have attempted to clarify the aetiology of adjacent segment disease (ASD). However, no biomechanical study has examined in detail the deformation behaviour of the adjacent segments when both pure torque and an angular displacement load are applied to the vertebrae along multiple segments. The purpose of this study is to investigate the biomechanical effects of pedicle screw fixation on adjacent segments. Ten cadaveric lumbar spines (L2-L5) of boars were used. Control and fusion models were prepared by disc damage and pedicle screw fixation of each specimen, and then, bending and rotation tests were performed using a six-axis material tester. In the biomechanical tests regulated by an angular displacement load, the range of motion (ROM) of the cranial and caudal adjacent segments in antero-posterior flexion and lateral bending was increased by about 20 % (p < 0.05), and the maximal torque in the fusion model was about threefold (p < 0.05) that in the control model. And in axial rotation, the ROM of cranial and caudal adjacent segments was increased by about 100 % (p < 0.001), and the maximal torque was about sixfold (p < 0.01) that in the control model. The ROM of adjacent segments was significantly increased after pedicle screw fixation as assessed by biomechanical tests regulated by an angular displacement load, but not in those regulated by torque. We present the results of biomechanical tests regulated by torque and angular displacement and show that the maximum torque of the fusion model was larger than that of the control model in the biomechanical test regulated by an angular displacement load, suggesting that mechanical stress on the segments adjacent to the fused segment is large. We think that ASD arises after spinal fusion surgery as a mechanism to compensate for the ROM lost due to excessive fusion by pedicle screw fixation, so that a large torque may be applied to adjacent segments within a physiologically

  12. An asymmetric energetic type Ic supernova viewed off-axis, and a link to gamma ray bursts.

    PubMed

    Mazzali, Paolo A; Kawabata, Koji S; Maeda, Keiichi; Nomoto, Ken'ichi; Filippenko, Alexei V; Ramirez-Ruiz, Enrico; Benetti, Stefano; Pian, Elena; Deng, Jinsong; Tominaga, Nozomu; Ohyama, Youichi; Iye, Masanori; Foley, Ryan J; Matheson, Thomas; Wang, Lifan; Gal-Yam, Avishay

    2005-05-27

    Type Ic supernovae, the explosions after the core collapse of massive stars that have previously lost their hydrogen and helium envelopes, are particularly interesting because of their link with long-duration gamma ray bursts. Although indications exist that these explosions are aspherical, direct evidence has been missing. Late-time observations of supernova SN 2003jd, a luminous type Ic supernova, provide such evidence. Recent Subaru and Keck spectra reveal double-peaked profiles in the nebular lines of neutral oxygen and magnesium. These profiles are different from those of known type Ic supernovae, with or without a gamma ray burst, and they can be understood if SN 2003jd was an aspherical axisymmetric explosion viewed from near the equatorial plane. If SN 2003jd was associated with a gamma ray burst, we missed the burst because it was pointing away from us.

  13. Reliability of the Planned Pedicle Screw Trajectory versus the Actual Pedicle Screw Trajectory using Intra-operative 3D CT and Image Guidance

    PubMed Central

    Ledonio, Charles G.; Hunt, Matthew A.; Siddiq, Farhan; Polly, David W.

    2016-01-01

    Background Technological advances, including navigation, have been made to improve safety and accuracy of pedicle screw fixation. We evaluated the accuracy of the virtual screw placement (Stealth projection) compared to actual screw placement (intra-operative O-Arm) and examined for differences based on the distance from the reference frame. Methods A retrospective evaluation of prospectively collected data was conducted from January 2013 to September 2013. We evaluated thoracic and lumbosacral pedicle screws placed using intraoperative O-arm and Stealth navigation by obtaining virtual screw projections and intraoperative O-arm images after screw placement. The screw trajectory angle to the midsagittal line and superior endplate was compared in the axial and sagittal views, respectively. Percent error and paired t-test statistics were then performed. Results Thirty-one patients with 240 pedicle screws were analyzed. The mean angular difference between the virtual and actual image in all screws was 2.17° ± 2.20° on axial images and 2.16° ± 2.24° on sagittal images. There was excellent agreement between actual and virtual pedicle screw trajectories in the axial and sagittal plane with ICC = 0.99 (95%CI: 0.992-0.995) (p<0.001) and ICC= 0.81 (95%CI: 0.759-0.855) (p<0.001) respectively. When comparing thoracic and lumbar screws, there was a significant difference in the sagittal angulation between the two distributions. No statistical differences were found distance from the reference frame. Conclusion The virtual projection view is clinically accurate compared to the actual placement on intra-operative CT in both the axial and sagittal views. There is slight imprecision (~2°) in the axial and sagittal planes and a minor difference in the sagittal thoracic and lumbar angulation, although these did not affect clinical outcomes. In general, we find that pedicle screw placement using intraoperative cone beam CT and navigation to be accurate and reliable, and as such

  14. Predictive value of pedicle involvement with MRI in spine metastases

    PubMed Central

    Bian, Chong; Liang, Yun; Jiang, Libo; Qian, Chen; Dong, Jian

    2016-01-01

    Objectives The study aimed to retrospectively evaluate the accuracy and value of magnetic resonance imaging (MRI) in predicting pedicle involvement for patients with spine metastases. Methods Forty-five patients with a vertebral metastasis encroaching at least one pedicle were studied using MRI before surgery and regularly after surgery. Patients were categorized on the basis of their numbers of pedicle involvement (Group 1: one pedicle was involved, n = 23; Group 2: two pedicles were involved, n = 22). The diagnostic accuracy was calculated, and comparisons of intraoperative blood loss and recurrence rate between the two groups were performed. Results The overall performance of MRI in predicting the pedicle involvement was as follows: accuracy, 94.4%; sensitivity, 95.5%; and specificity, 91.3%. Less intraoperative blood loss was observed for Group 1 compared with Group 2 (1,661 ± 672 ml and 2,173 ± 790 ml, respectively, P = 0.024). Tumor relapse occurred in 8.7% (2/23) of Group 1 and in 22.7% (5/22) of Group 2 with median recurrence free survival time 14 and 9 months, respectively. Conclusions MRI is a reliable approach to assess pedicle involvement. It has potential for use in the evaluation of the clinical characteristics of patients with spine metastases. PMID:27486876

  15. Spondylolisthesis Accompanying Bilateral Pedicle Stress Fracture at Two Vertebrae

    PubMed Central

    Kim, Hyeun Sung; Lee, Won Tae

    2012-01-01

    There has been no report of bilateral pedicle stress fractures involving two vertebrae. The authors describe a unique case of spondylolisthesis accompanying a bilateral pedicle stress fracture involving two vertebrae. De novo development of spondylolisthesis at the L5-S1 vertebrae accompanying a bilateral pedicle stress fracture at L4 and L5 was observed in a 70-year-old woman. The patient's medical history was unremarkable and she did not have any predisposing factors except severe osteoporosis. Interbody fusion with bone cement augmented screw fixation was performed. Surgical treatment resulted in good pain management and improved functional recovery. PMID:22949973

  16. Recording triggered EMG thresholds from axillary chest wall electrodes: a new refined technique for accurate upper thoracic (T2-T6) pedicle screw placement.

    PubMed

    Regidor, Ignacio; de Blas, Gema; Barrios, Carlos; Burgos, Jesús; Montes, Elena; García-Urquiza, Sergio; Hevia, Edurado

    2011-10-01

    This study was aimed at evaluating the sensitivity and safety of a new technique to record triggered EMG thresholds from axillary chest wall electrodes when inserting pedicle screws in the upper thoracic spine (T2-T6). A total of 248 (36.6%) of a total of 677 thoracic screws were placed at the T2-T6 levels in 92 patients with adolescent idiopathic scoliosis. A single electrode placed at the axillary midline was able to record potentials during surgery from all T2-T6 myotomes at each side. Eleven screws were removed during surgery because of malposition according to intraoperative fluoroscopic views. Screw position was evaluated after surgery in the remaining 237 screws using a CT scan. Malposition was detected in 35 pedicle screws (14.7%). Pedicle medial cortex was breached in 24 (10.1%). Six screws (2.5%) were located inside the spinal canal. Mean EMG threshold was 24.44 ± 11.30 mA in well-positioned screws, 17.98 ± 8.24 mA (p < 0.01) in screws violating the pedicle medial cortex, and 10.38 ± 3.33 mA (p < 0.005) in screws located inside the spinal canal. Below a threshold of 12 mA, 33.4% of the screws (10/30) were malpositioned. Furthermore, 36% of the pedicle screws with t-EMG stimulation thresholds within the range 6-12 mA were malpositioned. In conclusion, assessment of upper thoracic pedicle screw placement by recording tEMG at a single axillary electrode was highly reliable. Thresholds below 12 mA should alert surgeons to suspect screw malposition. This technique simplifies tEMG potential recording to facilitate safe placement of pedicle screws at upper thoracic levels.

  17. Isthmus-guided cortical bone trajectory for pedicle screw insertion.

    PubMed

    Iwatsuki, Koichi; Yoshimine, Toshiki; Ohnishi, Yu-ichiro; Ninomiya, Kosi; Ohkawa, Toshika

    2014-08-01

    Herein is described cortical bone trajectory (CBT), a new path for pedicle screw insertion for lumbar vertebral fusion. Because the points of insertion are under the end of the inferior articular process, and because the screws are inserted toward the lateral side, there is less soft tissue development than with the conventional technique; the CBT technique therefore enables less invasive surgery than the conventional technique. However, it has some drawbacks. For example, in the original CBT approach, the points of insertion are in the vicinity of the end of the inferior articular process. Because this joint has been destroyed in many patients who have indications for intervertebral fusion surgery, it is sometimes difficult to use it as a reference point for screw insertion location. With severe lateral slippage, the screw insertion site can become significantly dislocated sideways, with possible resultant damaging to the spinal canal and/or nerve root. The CBT technique here involved inserting the screws while keeping clear of the intervertebral foramen with the assistance of side view X-ray fluoroscopy and using the end of the inferior articular process and the isthmus as points of reference for screw location.

  18. [Cement augmentation of pedicle screws : Pros and cons].

    PubMed

    Schnake, K J; Blattert, T R; Liljenqvist, U

    2016-09-01

    Cement augmentation of pedicle screws biomechanically increases screw purchase in the bone. However, clinical complications may occur. The pros and cons of the technique are discussed from different clinical perspectives.

  19. The use of pedicle-screw internal fixation for the operative treatment of spinal disorders.

    PubMed

    Gaines, R W

    2000-10-01

    Pedicle screws have dramatically improved the outcomes of spinal reconstruction requiring spinal fusion. Short-segment surgical treatments based on the use of pedicle screws for the treatment of neoplastic, developmental, congenital, traumatic, and degenerative conditions have been proved to be practical, safe, and effective. The Funnel Technique provides a straightforward, direct, and inexpensive way to very safely apply pedicle screws in the cervical, thoracic, or lumbar spine. Carefully applied pedicle-screw fixation does not produce severe or frequent complications. Pedicle-screw fixation can be effectively and safely used wherever a vertebral pedicle can accommodate a pedicle screw--that is, in the cervical, thoracic, or lumbar spine. Training in pedicle-screw application should be standard in orthopaedic training programs since pedicle-screw fixation represents the so-called gold standard of spinal internal fixation.

  20. Multiple axis reticle

    NASA Technical Reports Server (NTRS)

    Barns, Chris E. (Inventor); Gunter, William D. (Inventor)

    1990-01-01

    A reticle permits the alignment of three orthogonal axes (X, Y and Z) that intersect at a common target point. Thin, straight filaments are supported on a frame. The filaments are each contained in a different orthogonal plane (S sub xy, S sub xz, and S sub yz) and each filament intersects two of the three orthogonal axes. The filaments, as viewed along the frame axis, give the appearance of a triangle with a V extending from each triangle vertex. When axial alignment is achieved, the filament portions adjacent to a triangle vertex are seen (along the axis of interest) as a right-angle cross, whereas these filament portions are seen to intersect at an oblique angle when axial misalignment occurs. The reticle is open in the region near the target point leaving ample space for alignment aids such as a pentaprism or a cube mirror.

  1. Visually induced motion sickness when viewing visual oscillations of different frequencies along the fore-and-aft axis: keeping velocity versus amplitude constant.

    PubMed

    Chen, Daniel Jinzhao; Bao, Beisheng; Zhao, Yue; So, Richard H Y

    2016-04-01

    Exposure to visual oscillations (VOs) can lead to visually induced motion sickness (VIMS). The level of VIMS among viewers has been shown to vary when the frequency of the VOs is changed either by manipulating their amplitude or velocity. The present study investigates whether the level of VIMS would change if we keep the root mean square (rms) velocity or amplitude of VOs constant while manipulating the VO frequency. A total of 25 individuals were exposed to random-dot and checkerboard VOs along the fore-and-aft axis in two experiments. Changing the amplitude (or frequency) of VOs while keeping the rms velocity constant did not affect the level of VIMS; however, increasing the rms velocity (or frequency) of VOs while keeping the amplitude constant made VIMS significantly worse. Practitioner Summary: Exposure to VOs of the same frequency can cause different levels of nausea depending on the combination of oscillation amplitude and velocity. Results suggest an opportunity for game designers to reduce symptoms of game sickness by using the correct combinations of velocity and amplitude of the visual motions.

  2. Congenital hypoplasia of the lumbar pedicle with spondylolisthesis: report of 2 cases.

    PubMed

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

    2017-04-01

    Congenital hypoplasia of the spinal pedicle is a rare condition. Previously reported cases were treated conservatively or with posterior instrumented fusion. However, the absence or hypoplasia of the lumbar pedicle may increase the difficulty of pedicle screw fixation and fusion. Herein, the authors describe 2 cases of rare adult congenital hypoplasia of the right lumbar pedicles associated with spondylolisthesis. The patients underwent anterior lumbar interbody fusion with a stand-alone cage as well as percutaneous pedicle screw fixation. This method was used to avoid the difficulties associated with pedicle screw fixation and to attain solid fusion. Both patients achieved satisfactory outcomes after a minimum of 2 years of follow-up. This method may be an alternative for patients with congenital hypoplasia of the lumbar spinal pedicle.

  3. Safety of thoracic pedicle screw application using the funnel technique in Asians: a cadaveric evaluation.

    PubMed

    Chan, Chris Yin Wei; Kwan, Mun Keong; Saw, Lim Beng

    2010-01-01

    The objective of this cadaveric study is to determine the safety and outcome of thoracic pedicle screw placement in Asians using the funnel technique. Pedicle screws have superior biomechanical as well as clinical data when compared to other methods of instrumentation. However, misplacement in the thoracic spine can result in major neurological implications. There is great variability of the thoracic pedicle morphometry between the Western and the Asian population. The feasibility of thoracic pedicle screw insertion in Asians has not been fully elucidated yet. A pre-insertion radiograph was performed and surgeons were blinded to the morphometry of the thoracic pedicles. 240 pedicle screws were inserted in ten Asian cadavers from T1 to T12 using the funnel technique. 5.0 mm screws were used from T1 to T6 while 6.0 mm screws were used from T7 to T12. Perforations were detected by direct visualization via a wide laminectomy. The narrowest pedicles are found between T3 and T6. T5 pedicle width is smallest measuring 4.1 +/- 1.3 mm. There were 24 (10.0%) Grade 1 perforations and only 1 (0.4%) Grade 2 perforation. Grade 2 or worse perforation is considered significant perforation which would threaten the neural structures. There were twice as many lateral and inferior perforations compared to medial perforations. 48.0% of the perforations occurred at T1, T2 and T3 pedicles. Pedicle fracture occurred in 10.4% of pedicles. Intra-operatively, the absence of funnel was found in 24.5% of pedicles. In conclusion, thoracic pedicle screws using 5.0 mm at T1-T6 and 6.0 mm at T7-T12 can be inserted safely in Asian cadavers using the funnel technique despite having smaller thoracic pedicle morphometry.

  4. Transverse axis fluid turbine

    SciTech Connect

    Brenneman, B.

    1983-11-15

    A fluid turbine, the rotation axis of which is transverse to the direction of fluid flow, has at least two blade assemblies mounted for rotation about the rotation axis. Each blade assembly includes a streamlined elongated blade having a span parallel to the rotation axis. Each blade is pivotable about a pivot axis parallel to and spaced from the rotation axis. The pivot axis is located circumferentially ahead of the blade center of pressure with respect to the direction of turbine rotation. Each blade assembly is so constructed that its center of mass is located either at its pivot axis or circumferentially at its pivot axis and radially outboard of its pivot axis.

  5. Virtual estimates of fastening strength for pedicle screw implantation procedures

    NASA Astrophysics Data System (ADS)

    Linte, Cristian A.; Camp, Jon J.; Augustine, Kurt E.; Huddleston, Paul M.; Robb, Richard A.; Holmes, David R.

    2014-03-01

    Traditional 2D images provide limited use for accurate planning of spine interventions, mainly due to the complex 3D anatomy of the spine and close proximity of nerve bundles and vascular structures that must be avoided during the procedure. Our previously developed clinician-friendly platform for spine surgery planning takes advantage of 3D pre-operative images, to enable oblique reformatting and 3D rendering of individual or multiple vertebrae, interactive templating, and placement of virtual pedicle implants. Here we extend the capabilities of the planning platform and demonstrate how the virtual templating approach not only assists with the selection of the optimal implant size and trajectory, but can also be augmented to provide surrogate estimates of the fastening strength of the implanted pedicle screws based on implant dimension and bone mineral density of the displaced bone substrate. According to the failure theories, each screw withstands a maximum holding power that is directly proportional to the screw diameter (D), the length of the in-bone segm,ent of the screw (L), and the density (i.e., bone mineral density) of the pedicle body. In this application, voxel intensity is used as a surrogate measure of the bone mineral density (BMD) of the pedicle body segment displaced by the screw. We conducted an initial assessment of the developed platform using retrospective pre- and post-operative clinical 3D CT data from four patients who underwent spine surgery, consisting of a total of 26 pedicle screws implanted in the lumbar spine. The Fastening Strength of the planned implants was directly assessed by estimating the intensity - area product across the pedicle volume displaced by the virtually implanted screw. For post-operative assessment, each vertebra was registered to its homologous counterpart in the pre-operative image using an intensity-based rigid registration followed by manual adjustment. Following registration, the Fastening Strength was computed

  6. Pullout performance comparison of novel expandable pedicle screw with expandable poly-ether-ether-ketone shells and cement-augmented pedicle screws.

    PubMed

    Aycan, Mehmet Fatih; Tolunay, Tolga; Demir, Teyfik; Yaman, Mesut Emre; Usta, Yusuf

    2017-02-01

    Aim of this study is to assess the pullout performance of various pedicle screws in different test materials. Polyurethane foams (Grade 10 and Grade 40) produced in laboratory and bovine vertebrae were instrumented with normal, cannulated (cemented), novel expandable and normal (cemented) pedicle screws. Test samples were prepared according to the ASTM F543 standard testing protocols and surgical guidelines. To examine the screw placement and cement distribution, anteriosuperior and oblique radiographs were taken from each sample after insertion process was completed. Pullout tests were performed in an Instron 3369 testing device. Load versus displacement graphs were recorded and the ultimate pullout force was defined as the maximum load (pullout strength) sustained before failure of screw. Student's t-test was performed on each group whether the differences between pullout strength of pedicle screws were significant or not. While normal pedicle screws have the lowest pullout strength in all test materials, normal pedicle screws cemented with polymethylmethacrylate exhibit significantly higher pullout performance than others. For all test materials, there is a significant improvement in pullout strength of normal screws by augmentation. While novel expandable pedicle screws with expandable poly-ether-ether-ketone shells exhibited lower pullout performance than normal screws cemented with polymethylmethacrylate, their pullout performances in all groups were higher than the ones of normal and cannulated pedicle screws. For all test materials, although cannulated pedicle screws exhibit higher pullout strength than normal pedicle screws, there are no significant differences between the two groups. The novel expandable pedicle screws with expandable poly-ether-ether-ketone shells may be used instead of normal and cannulated pedicle screws cemented with polymethylmethacrylate due to their good performances.

  7. Unilateral Pedicle Stress Fracture in a Long-Term Hemodialysis Patient with Isthmic Spondylolisthesis

    PubMed Central

    Maruo, Keishi; Tachibana, Toshiya; Inoue, Shinichi; Arizumi, Fumihiro; Yoshiya, Shinichi

    2015-01-01

    Most unilateral pedicle stress fractures occur on the contralateral side of patients with unilateral spondylolysis. However, there are few reports of unilateral pedicle stress fractures in patients with bilateral spondylolysis and spondylolisthesis. We report a unique case of unilateral pedicle stress fracture in a long-term hemodialysis patient with isthmic spondylolisthesis. A 65-year-old man who had undergone hemodialysis presented with lower back pain that had persisted for several years. The patient experienced severe right lower extremity pain with no history of trauma. Computed tomography revealed unilateral pedicle fracture with bilateral L5 spondylolysis and spondylolisthesis with progression of scoliosis. The patient underwent Gill laminectomy of L5 with pedicle screw fixation at L4-S1 and interbody fusion at L5-S1. The patient's leg pain ceased immediately, and he began walking without leg pain. In our present patient, development of scoliosis caused by destructive spondyloarthropathy may have contributed to a unilateral pedicle fracture. PMID:25737789

  8. Thoracic Aortic Stent-Graft Placement for Safe Removal of a Malpositioned Pedicle Screw

    SciTech Connect

    Hu Hongtao; Shin, Ji Hoon Hwang, Jae-Yeon; Cho, Young Jun; Ko, Gi-Young; Yoon, Hyun-Ki

    2010-10-15

    We describe a case of percutaneous placement of a thoracic aortic stent-graft for safe removal of a malpositioned pedicle screw in a 52-year-old man. The patient had undergone posterior thoracic spinal instrumentation for pyogenic spondylitis and spinal deformity 8 months previously. Follow-up CT images showed a malpositioned pedicle screw which was abutting the thoracic aorta at the T5 level. After percutaneous stent-graft placement, the malpositioned pedicle screw was safely and successfully removed.

  9. [Hypogastric abdominal wall reconstruction with a pedicled anterolateral thigh flap].

    PubMed

    Moullot, P; Philandrianos, C; Gonnelli, D; Casanova, D

    2014-10-01

    Looking at a full-thickness abdominal wall defect, it is necessary to use reconstructive surgery techniques. The authors present an original case of reconstruction of the abdominal wall, using an anterolateral thigh flap (ALT) harvested with vascularised fascia lata. We describe the advantages of this technique, which has rarely been used for this indication. An 80-year-old woman presenting a full-thickness abdominal wall defect of 15×18cm was reconstructed by a pedicled ALT flap. Skin wound healing was obtained within 15 days, with no complication. There was no donor site sequela. The pedicled ALT flap appears to be a good solution for hypogastric abdominal wall defect in a one step procedure. Vacularised fascia lata bring with the cutaneous flap is useful to reconstruct the abdominal fascia.

  10. The usefulness of electrical stimulation for assessing pedicle screw placements.

    PubMed

    Toleikis, J R; Skelly, J P; Carlvin, A O; Toleikis, S C; Bernard, T N; Burkus, J K; Burr, M E; Dorchak, J D; Goldman, M S; Walsh, T R

    2000-08-01

    The purpose of this study was to further establish the efficacy of pedicle screw stimulation as a monitoring technique to avoid nerve root injury during screw placement. The study population consisted of 662 patients in whom 3,409 pedicle screws were placed and tested by electrical stimulation. If stimulation resulted in a myogenic response at a stimulation intensity of 10 mA or less, the placement of the screw was inspected. Inspection was necessary for 3.9% of the screw placements in 15.4% of the study population. None of the patients in the study experienced any new postoperative neurologic deficits. These findings provide guidelines for the interpretation of stimulation data and support the use of this technique as an easy, inexpensive, and quick method to reliably assess screw placements and protecting neurological function.

  11. Segmental gracilis free flap based on secondary pedicles: anatomical study and clinical series.

    PubMed

    Cavadas, Pedro C; Sanz-Giménez-Rico, Juan R; Landín, Luis; Martínez-Soriano, Francisco

    2004-09-01

    The gracilis muscle has been used extensively in reconstructive surgery, based on the proximal dominant pedicle. In the literature, little attention has been paid to the secondary distal pedicles. The distribution of the secondary pedicles of the gracilis muscle was investigated in 20 cadaver thighs. The mean number of secondary pedicles was 2.2 (range, two to three). When two pedicles were present-the most common situation-they were located at a mean distance of 12.4 and 17.5 cm from the knee joint line. The most proximal secondary pedicle was injected with barium sulfate in five specimens, and constant and abundant connections with the main pedicle were noted. A series of seven clinical cases of segmental gracilis free muscle flaps based on a secondary pedicle is reported. The flaps were successfully transferred to reconstruct traumatic defects of limited size, with one case of partial necrosis caused by a technical error. The morbidity of this flap is minimal, the scar is well hidden, the muscle need not be sacrificed, elevation is fast and straightforward under tourniquet control, and the pedicle is sizable. This flap should be considered a viable option when a small, straightforward free flap is needed.

  12. Cortical bone trajectory screws placement via pedicle or pedicle rib unit in the pediatric thoracic spine (T9-T12)

    PubMed Central

    Xuan, Jun; Chen, Jian; He, Hui; Jin, Hai-Ming; Zhang, Di; Wu, Yao-Sen; Tian, Nai-Feng; Wang, Xiang-Yang

    2017-01-01

    Abstract Thoracic cortical bone trajectory (CBT) screw fixation can maximize the thread contact with cortical bone, and it is 53.8% higher than that of the traditional pedicle screws. Moreover, it can also enable less tissue dissection and retraction for reduced muscle disruption. Eighty pediatric patients are divided into 4 age groups and their thoracic vertebrae are analyzed on computed tomography (CT) images. The maximal screw length, maximal screw diameter, screw diameter, and the cephalad angle are measured. The statistical analysis is performed using the Student's t-test and Pearson's correlation analysis. Maximal screw length increases from T9 to T12 and there are significant differences between girls and boys at T9, T10, T11, and T12 in majority of groups (P < 0.05). The maximal screw diameter and screw diameter increase from T9 to T12. The maximal screw diameter ranges from 6.27 mm to 10.20 mm, whereas the screw diameter ranges from 3.87 mm to 6.75 mm. Meanwhile, the maximum cephalad angle is 23.06° and the minimum is 13.11°. No statistically significant differences in the cephalad angle are found at all levels. Our study establishes the feasibility of 4.5 to 5.5 mm CBT screws fixation via pedicle or pedicle rib unit in the pediatric thoracic spine. The entry point of the pediatric thoracic CBT screws is 6 o’clock orientation of the pedicle. Findings of our study also provide insights into the screw insertion angle and screw size decision. PMID:28151859

  13. A biomechanical study of two different pedicle screw methods for fixation in osteoporotic and nonosteoporotic vertebrae.

    PubMed

    Higashino, Kosaku; Kim, Jin Hwan; Horton, William C; Hutton, William C

    2012-01-01

    In reconstruction of the osteoporotic spine, patients often show poor outcome because of pedicle screw failure. This study used osteoporotic and nonosteoporotic vertebrae to determine the difference in fixation strength between pedicle screws inserted straight forward and pedicle screws inserted in an upward trajectory toward the superior end plate (i.e., end-plate screws). There is some evidence to suggest that end-plate screws have a strength advantage. The particular focus was on osteoporotic vertebrae. Thirty-three vertebrae (T10-L2) were harvested. The bone mineral density (BMD) was measured: 15 vertebrae were greater than 0.8 g/cm(2) and designated as nonosteoporotic (average BMD 1.146 ± 0.186 g/cm(2)) and 18 vertebrae were designated as osteoporotic (average BMD 0.643 ± 0.088 g/cm(2)). On one pedicle the screw was inserted straight forward and on the other pedicle the screw was inserted as an end-plate screw. The torque of insertion was measured (Proto 6106 torque screwdriver). Using an MTS Mini Bionix, two types of mechanical testing were carried out on each pedicle: (a) cephalocaudad toggling was first carried out to simulate some physiological type loading: 500 cycles at 0.3 Hz, at ±50 N; and (b) then each pedicle screw was pulled out at a displacement rate of 12.5 cm/min.There was no difference in pullout force between the pedicle screws inserted straight forward and the pedicle screws inserted as end-plate screws. This result applies whether the vertebrae were osteoporotic or nonosteoporotic. For both the straight-forward screws and the end-plate screws, a statistically significant correlation was observed between torque of insertion and pullout force. The results of this experiment indicate that pedicle screws inserted as end-plate screws do not provide a strength advantage over pedicle screws inserted straight forward, whether the vertebrae are osteoporotic or not.

  14. Quantitative comparison between the straight-forward and anatomical insertion technique for pedicle screw placement

    NASA Astrophysics Data System (ADS)

    Knez, Dejan; Mohar, Janez; Likar, Boštjan; Pernuš, Franjo; Vrtovec, Tomaž

    2016-03-01

    Spinal deformity correction with vertebral fixation is nowadays the preferred surgical treatment, where pedicle screws are inserted through pedicles into corresponding vertebral bodies and afterwards connected with rods. In clinical practice, the straight-forward and anatomical insertion technique are currently being used for pedicle screw placement surgery. However, it is difficult to quantitatively compare both techniques and determine which technique is more adequate for each planned pedicle screw before surgery (i.e. preoperatively). In this paper, we therefore describe a framework for quantitative comparison between the straight-forward and anatomical insertion technique for pedicle screw placement surgery by evaluating the screw fastening strength. Quantitative comparisons were performed on computed tomography images of 11 patients with 74 manually planned pedicle screws, who underwent the vertebral fixation procedure. The first quantitative comparison was performed between the straight-forward and anatomical pedicle screw insertion technique, which resulted in a relatively high agreement with mean absolute difference of 0.0mm in screw diameter, 2.9mm in screw length, 1.2mm in pedicle crossing point and 6.5° in screw inclinations. The second quantitative comparison was performed between the best resulting pedicle screw insertion technique and manually obtained pedicle screw plans, which again resulted in a relatively high agreement with mean absolute difference of 0.5mm in screw diameter, 4.7mm in screw length, 2.4mm in pedicle crossing point and 6.0° in screw inclinations. Both the straight-forward and anatomical insertion technique proved approximately equal in terms of the screw fastening strength.

  15. Prediction of Deformity Correction by Pedicle Screw Instrumentation in Thoracolumbar Scoliosis Surgery

    NASA Astrophysics Data System (ADS)

    Kiriyama, Yoshimori; Yamazaki, Nobutoshi; Nagura, Takeo; Matsumoto, Morio; Chiba, Kazuhiro; Toyama, Yoshiaki

    In segmental pedicle screw instrumentation, the relationship between the combinations of pedicle screw placements and the degree of deformity correction was investigated with a three-dimensional rigid body and spring model. The virtual thoracolumbar scoliosis (Cobb’s angle of 47 deg.) was corrected using six different combinations of pedicle-screw placements. As a result, better correction in the axial rotation was obtained with the pedicle screws placed at or close to the apical vertebra than with the screws placed close to the end vertebrae, while the correction in the frontal plane was better with the screws close to the end vertebrae than with those close to the apical vertebra. Additionally, two screws placed in the convex side above and below the apical vertebra provided better correction than two screws placed in the concave side. Effective deformity corrections of scoliosis were obtained with the proper combinations of pedicle screw placements.

  16. SU-E-T-609: Perturbation Effects of Pedicle Screws On Radiotherapy Dose Distributions

    SciTech Connect

    Bar-Deroma, R; Borzov, E; Nevelsky, A

    2015-06-15

    Purpose: Radiation therapy in conjunction with surgical implant fixation is a common combined treatment in case of bone metastases. However, metal implants generally used in orthopedic implants perturb radiation dose distributions. Carbon-Fiber Reinforced (CFR) PEEK material has been recently introduced for production of intramedullary screws and plates. Gold powder can be added to the CFR-PEEK material in order to enhance visibility of the screws during intraoperative imaging procedures. In this work, we investigated the perturbation effects of the pedicle screws made of CFR-PEEK, CFR-PEEK with added gold powder (CFR-PEEK-AU) and Titanium (Ti) on radiotherapy dose distributions. Methods: Monte Carlo (MC) simulations were performed using the EGSnrc code package for 6MV beams with 10×10 fields at SSD=100cm. By means of MC simulations, dose distributions around titanium, CFR- PEEK and CFR-PEEK-AU screws (manufactured by Carbo-Fix Orthopedics LTD, Israel) placed in a water phantom were calculated. The screw axis was either parallel or perpendicular to the beam axis. Dose perturbation (relative to dose in homogeneous water phantom) was assessed. Results: Maximum overdose due to backscatter was 10% for the Ti screws, 5% for the CFR-PEEK-AU screws and effectively zero for the CFR-PEEK screws. Maximum underdose due to attenuation was 25% for the Ti screws, 15% for the CFR-PEEK-AU screws and 5% for the CFR-PEEK screws. Conclusion: Titanium screws introduce the largest distortion on the radiation dose distribution. The gold powder added to the CFR-PEEK material improves visibility at the cost of increased dose perturbation. CFR-PEEK screws caused minimal alteration on the dose distribution. This can decrease possible over and underdose of adjacent tissue and thus favorably influence treatment efficiency. The use of such implants has potential clinical advantage in the treatment of neoplastic bone disease.

  17. Novel Landmark for Cervical Pedicle Screw Insertion Point from Computed Tomography-Based Study

    PubMed Central

    2017-01-01

    Study Design Cross-sectional study. Purpose The purpose of this study was to evaluate a novel landmark for the cervical pedicle screw insertion point. Overview of Literature To improve the accuracy of pedicle screw placement, several studies have employed the lateral mass, lateral vertical notch, and/or inferior articular process as landmarks; however, we often encounter patients in whom we cannot identify accurate insertion points for pedicle screws using these landmarks because of degenerative changes in the facet joints. The superomedial edge of the lamina is less affected by degenerative changes, and we hypothesized that it could be a new landmark for identifying an accurate cervical pedicle screw insertion point. Methods A total of 327 consecutive patients, who had undergone neck computed tomographic scanning for determination of neck disease in our institute, were included in the study. At first, the line was drawn parallel to the superior border of the pedicle in the sagittal plane and parallel to the vertical body in the coronal plane. The line was moved downward in 1-mm increments to the inferior border of the pedicle. We determined whether the line passing through the superomedial edge of the lamina (termed the “N-line”) was located between the superior and inferior borders of the pedicle in the sagittal plane. Results The percentages of N-lines located between the superior and inferior borders of the pedicle were 100% at C3, 100% at C4, 99% at C5, 96% at C6, and 97% at C7. The lower cervical spine has the higher N-line location. Conclusions The N-line was frequently located at the level of the pedicle of each cervical spine in the sagittal plane. The superomedial edge of the lamina could be a new landmark for the insertion point of the cervical pedicle screw. PMID:28243374

  18. Accuracy of pedicle screw placement using intraoperative neurophysiological monitoring and computed tomography.

    PubMed

    Mavrogenis, Andreas F; Papagelopoulos, Panayiotis J; Korres, Demetrios S; Papadopoulos, Konstantinos; Sakas, Damianos E; Pneumaticos, Spiros

    2009-01-01

    Fifty consecutive patients with posterior thoracolumbar spine fusion were included in a prospective study to determine the accuracy of intraoperative neurophysiological monitoring (IONM) for safe pedicle screw placement using postoperative computed tomography (CT). The patients were allocated into two equal groups. Pedicle screw placement was evaluated intraoperatively by using the image intensifier. In group A, the integrity of the pedicle wall was evaluated intraoperatively with monopolar stimulation of each screw head with a hand-held single-tip stimulator; the compound muscle action potentials were recorded. A constant current threshold of 7 mA was considered indicative of pedicle breach; < 7 mA was considered as direct contact with neural elements, and > 7mA was considered normal. In group B, pedicle screw placement was performed without IONM. Overall, 306 pedicle screws were inserted in both groups. Postoperatively, all patients underwent CT scans of the spine to evaluate pedicle screw placement. Intraoperatively, five screws in respective group A patients had to be repositioned after IONM (threshold of < 7 mA); in these patients, postoperative CT scans showed proper screw placement. Postoperative CT scans showed eight misdirected screws; two screws (1.26%) in group A patients and six screws (4%) in group B patients. Two screws were misdirected through the medial pedicle wall and six screws were misdirected through the lateral pedicle wall. Both medially misdirected screws were observed in group B patients (1.35%); these patients developed neurologic symptoms postoperatively and underwent revision surgery, with redirection of the misdirected screws and subsequent resolution of the neurologic symptoms. Two of the six laterally misdirected screws were observed in group A patients (1.26%); the remaining four laterally misdirected screws were observed in group B patients (2.7%). None of these patients had neurologic sequelae; no revision surgery was required. The

  19. Spectacles under Pedicles: Eyewear Modification with the Paramedian Forehead Flap

    PubMed Central

    Qu, Linda T.; Kelpin, John P.; Komorowska-Timek, Ewa

    2016-01-01

    Summary: The paramedian forehead flap is a widely used method of nasal reconstruction. The flap requires a bridge of tissue from forehead to the nose, for a period of 2 to 3 weeks, before it can be divided at a second procedure. During this time, patients often have difficulty positioning and wearing their eyewear underneath the pedicle of the flap. Here we present a novel approach to the problem. It requires only a simple modification to the patient’s eyewear and greatly facilitates wear and removal. PMID:27622084

  20. Periosteal Pedicle Flap Harvested during Vestibular Extension for Root Coverage

    PubMed Central

    Kumar, Shubham; Gupta, Krishna Kumar; Agrawal, Rahul; Srivastava, Pratima; Soni, Shalabh

    2015-01-01

    Root exposure along with inadequate vestibular depth is a common clinical finding. Treatment option includes many techniques to treat such defects for obtaining predictable root coverage. Normally, the vestibular depth is increased first followed by a second surgery for root coverage. The present case report describes a single-stage technique for vestibular extension and root coverage in a single tooth by using the Periosteal Pedicle Flap (PPF). This technique involves no donor site morbidity and allows for reflection of sufficient amount of periosteal flap tissue with its own blood supply at the surgical site, thus increasing the chances of success of root coverage with simultaneous increase in vestibular depth. PMID:26788377

  1. Anatomical evaluation of the groove for the vertebral artery in the axis vertebrae for atlanto-axial transarticular screw fixation technique.

    PubMed

    Kazan, S; Yildirim, F; Sindel, M; Tuncer, R

    2000-01-01

    Anatomical measurements were studied on 40 dry axis vertebrae to determine the suitability of the groove for the vertebral artery for atlanto-axial transarticular screw fixation technique. We measured 13 parameters including three angular and 10 linear dimensions related to the groove of the vertebral artery, pedicle, and pars interarticularis and evaluated 80 measurements for each parameter. All measurements were done after placing a Kischner guide wire through the pedicle. We found that differences between measurements on the left and right sides of each vertebra were nonsignificant. In spite of the variability in measurements such as height, width, and median angle of the pedicle, the decline angle for instrumentation, the depth of the groove for the vertebral artery, and the internal height of the pars interarticularis, all of these had good symmetry. However, there were statistically significant differences between the sides in measurements for both the width (P=0.05) and the angle (P<0.02) of the pedicle allowing instrumentation and they did not show good symmetry. The risk of vertebral artery injury was found to be 22.5% per specimen, or 16.25% per screw inserted because the internal height of the pars interarticularis at point of fixation was pedicle width allowing instrumentation was not suitable in 12.5% of screws inserted because their values were pedicle for instrumentation and the internal height of the pars interarticularis were both evaluated together, we also found that this technique would be extremely dangerous in 7.5% of specimens. In conclusion, the internal height of the pars interarticularis and the width of the pedicle for instrumentation should be evaluated together in thin CT sections preoperatively, because of the risk of vertebral artery injury in patients upon which atlanto-axial transarticular screw fixation is to be performed.

  2. Traumatic Fracture of Thin Pedicles Secondary to Extradural Meningeal Cyst

    PubMed Central

    Yanni, Daniel S.; Mammis, Antonios; Thaker, Nikhil G.; Goldstein, Ira M.

    2011-01-01

    Spinal dural meningoceles and diverticula are meningeal cysts that have a myriad of clinical presentations and sequelae, secondary to local mass effect. Our objective is to report a technical case report, illustrating a traumatic spinal injury with multiple pedicle fractures, secondary to atrophic lumbar pedicles as well as the diagnostic workup and surgical management of this problem. Posterior lumbar decompression, resection of the meningeal cyst, ligation of the cyst ostium, instrumentation, and fusion were performed with the assistance of intraoperative isocentric fluoroscopy. The cyst's point of communication was successfully located with intraoperative fluoroscopy and the lesion was successfully excised. We suggest that patients with traumatic spinal injuries, having evidence of pre-existing anomalous bony architecture, undergo advanced imaging studies, to rule out intraspinal pathology. The positive clinical and radiographic results support the removal and closure of the pre-existing meningeal cyst at the time of treatment of traumatic spinal injury. Intraoperative isocentric fluoroscopy is a helpful tool in the operative management of these lesions. PMID:22022654

  3. Evaluation of pedicle screw insertion monitored by intraoperative evoked electromyography.

    PubMed

    Darden, B V; Wood, K E; Hatley, M K; Owen, J H; Kostuik, J

    1996-02-01

    The insertion of pedicle screws monitored by evoked electromyography (EMG) was prospectively evaluated in the 132 consecutive patients. The technique involved constant-voltage stimulation and was statistically evaluated at both the arbitrary 20- and 40-V settings. The patients were postoperatively evaluated clinically and radiographically. Computed tomography (CT) scanning was performed for new neurologic deficits. Results were divided into three groups: type 1, a negative EMG response; type 2, a positive EMG response, but no corrective action taken; and type 3, a positive EMG response and corrective action undertaken. Nonparametric statistics were used to evaluate the results at both the 20- and 40-V settings. In the type 3 group, in which corrective action was undertaken, there were no neurologic injuries or screw removals, a statistically significant result. Looking at the two intensity levels, at 20- and 40-V settings, there were no statistically significant differences in the three classifications at either intensity level. We concluded the evoked EMG for monitoring pedicle screw insertion is an efficacious adjunct. A positive response at < 20 V with the constant-voltage technique warrants corrective action.

  4. Fetal and Neonatal HPA Axis.

    PubMed

    Wood, Charles E; Walker, Claire-Dominique

    2015-12-15

    Stress is an integral part of life. Activation of the hypothalamus-pituitary-adrenal (HPA) axis in the adult can be viewed as mostly adaptive to restore homeostasis in the short term. When stress occurs during development, and specifically during periods of vulnerability in maturing systems, it can significantly reprogram function, leading to pathologies in the adult. Thus, it is critical to understand how the HPA axis is regulated during developmental periods and what are the factors contributing to shape its activity and reactivity to environmental stressors. The HPA axis is not a passive system. It can actively participate in critical physiological regulation, inducing parturition in the sheep for instance or being a center stage actor in the preparation of the fetus to aerobic life (lung maturation). It is also a major player in orchestrating mental function, metabolic, and cardiovascular function often reprogrammed by stressors even prior to conception through epigenetic modifications of gametes. In this review, we review the ontogeny of the HPA axis with an emphasis on two species that have been widely studied-sheep and rodents-because they each share many similar regulatory mechanism applicable to our understanding of the human HPA axis. The studies discussed in this review should ultimately inform us about windows of susceptibility in the developing brain and the crucial importance of early preconception, prenatal, and postnatal interventions designed to improve parental competence and offspring outcome. Only through informed studies will our public health system be able to curb the expansion of many stress-related or stress-induced pathologies and forge a better future for upcoming generations.

  5. Using the Anatomical Axis as an Alternative to the Mechanical Axis to Assess Knee Alignment.

    PubMed

    Tipton, Shane C; Sutherland, John; Schwarzkopf, Ran

    2015-12-01

    The treatment of knee osteoarthritis and the preparation for total knee arthroplasty require repetitive imaging to guide preoperative planning and operative technique. Full-length standing anteroposterior images are the gold standard in assessing the alignment of the limb via the measurement of the mechanical axis of the knee. The anatomical axis can be obtained from a more limited image of the knee, and as such is less expensive and exposes the patient to less ionizing radiation. The objective of this cross-sectional prospective study was to examine the extent to which the anatomical axis measured on a fixed-flexed posteroanterior (Rosenberg view) radiograph correlates with the mechanical axis. The data of 209 total knee arthroplasty radiographs were analyzed to compare the preoperative correlation between the mechanical and anatomical axis. The anatomical axis correlated with the mechanical axis when it was measured from both the standing full-length anteroposterior radiograph and from a fixed-flexed posteroanterior radiograph. Using an angle of offset found from linear regression, these correlations become closer. Body mass index and Kellgren-Lawrence grade were not found to have a significant effect. It is the conclusion of this study that the anatomical axis, as measured from a limited knee radiography, may serve as a plausible estimate of the mechanical axis when done with a neutral angle of offset, and that offset angle depends on gender and the imaging technique used to determine the anatomical axis.

  6. Vertical Axis Wind Turbine

    SciTech Connect

    Homicz, Greg

    2002-04-01

    Blade fatigue life is an important element in determining the economic viability of the Vertical-Axis Wind Turbine (VAWT). VAWT-SAL Vertical Axis Wind Turbine- Stochastic Aerodynamic Loads Ver 3.2 numerically simulates the stochastic (random0 aerodynamic loads of the Vertical-Axis Wind Turbine (VAWT) created by the atomspheric turbulence. The program takes into account the rotor geometry, operating conditions, and assumed turbulence properties.

  7. Comparison Between Gearshift And Drill Techniques For Pedicle Screw Placement By Resident Surgeons

    PubMed Central

    Allen, Jonathan; Akpolat, Yusuf T.; Kishan, Shyam; Peppers, Tim; Asgarzadie, Farbod

    2015-01-01

    Background Various techniques have been described for pedicle screw placement with established clinical and radiological success. Suboptimal screw trajectories can compromise bony purchase and, worse yet, cause neurological and vascular injuries. Thus, it is of paramount importance to achieve maximum accuracy of screw placement. Our objective is to evaluate the accuracy of pedicle screw placement in the thoracolumbar spine by resident surgeons. Two popular techniques, gearshift versus drill, were compared. Methods This is a a cadaveric surgical technique comparison study. Six resident surgeons instrumented the spine from T1 to S1 using both gearshift and drill techniques. Each pedicle was randomly assigned to either of the techniques. Pedicle screws were placed freehand without radiographic guidance. Violations (medial, lateral, anterior, superior and inferior) were recorded by studying the computerized tomographic scans of instrumented cadavers by blinded observers. Critical perforations were defined as greater than 2mm breach of the pedicle wall. Results A total of 100 vertebrae (200 pedicles) were instrumented in the six cadavers. 103 pedicles were breached (51.5% of total pedicles). Lateral violations were the most encountered (65% of violations, 67 total, 48 critical, 19 noncritical) followed by medial (24%, 25 total, 13 critical, 12 noncritical), and the rest were anterior (3%), superior (4%) and inferior (4%). There was no overall difference in violations comparing the gearshift technique (49.5%, 51 total, 37 critical, 14 noncritical) with drill technique (50.5%, 52 total, 33 critical, 19 noncritical). Analyzing the breaches at individual vertebra indicated most violations at T6 (11), T5 (10), followed by T3 (9) and T4 (9), decreasing towards the lumbosacral vertebrae. Conclusion The results of this study suggest that the gearshift and drill techniques for placement of pedicle screws in the thoracolumbar spine fare similarly with regards to risk of breach

  8. Unilateral Pedicle Screw Fixation with Bone Graft vs. Bilateral Pedicle Screw Fixation with Bone Graft or Cage: A Comparative Study

    PubMed Central

    Yang, Si-Dong; Chen, Qian; Ding, Wen-Yuan; Zhao, Jian-Qiang; Zhang, Ying-Ze; Shen, Yong; Yang, Da-Long

    2016-01-01

    Background The aim of this study was to explore the clinical efficacy of unilateral pedicle screw fixation with bone graft (UPSFB) in treating single-segment lumbar degenerative diseases (LDD), as compared to bilateral pedicle screw fixation with bone graft (BPSFB) or with cage (BPSFC). Material/Methods Medical records were retrospectively collected between 01/2010 and 02/2015 in Longyao County Hospital. According to surgical methods used, all patients were divided into 3 groups: UPSFB group, BPSFB group, and BPSFC group. Clinical outcomes were evaluated by blood loss, blood transfusion, duration of operation, hospital stay, postoperative complications, interbody fusion rate, reoperation rate, medical expenses, patient satisfaction survey, and JOA score. Results Ninety-five patients were included and underwent 2.5-year follow-up, with 7 patients lost to regular follow-up. As compared to the BPSFB group and BPSFC group, the UPSFB group had less blood loss and less blood transfusion, as well as shorter hospital stay (p<0.05). Medical expenses were far lower in the UPSFB group (p<0.001). There were no significant differences among the 3 groups in postoperative complications, interbody fusion rate, reoperation rate, JOA score, and patient satisfaction (all p>0.05). Conclusions As compared to BPSFB and BPSFC, UPSFB has the same reliability and effectiveness in treating single-segment LDD with unilateral radicular symptoms in a single lower extremity, with the additional advantage being less expensive. PMID:26988532

  9. Electrical conductivity measurement: a new technique to detect iatrogenic initial pedicle perforation.

    PubMed

    Bolger, Ciaran; Kelleher, Michael O; McEvoy, Linda; Brayda-Bruno, M; Kaelin, A; Lazennec, J-Y; Le Huec, J-C; Logroscino, C; Mata, P; Moreta, P; Saillant, G; Zeller, R

    2007-11-01

    Pedicle screw fixation has achieved significant popularity amongst spinal surgeons for both single and multi-level spinal fusion. Misplacement and pedicle cortical violation occurs in over 20% of screw placement and can result in potential complications such as dysthesia, paraparesis or paraplegia. There have been many advances in techniques available for navigating through the pedicle; however, these techniques are not without drawbacks. A new electrical conductivity-measuring device, previously evaluated on the porcine model to detect the pedicle violation, was evaluated amongst nine European Hospitals to be used in conjunction with the methods currently used in that centre. This new device is based on two original principles; the device is integrated in the drilling or screwing tool. The technology allows real-time detection of perforation through two independent parameters, impedance variation and evoked muscle contractions. Data was collected twofold. Initially, the surgeon was given the device and a comparison was made between the devices ability to detect a breech and the surgeon's ability to detect one using his traditional methods of pedicle preparation. In the second module of the study, the surgeon was limited to using the electrical conductivity detection device as their sole guide to detect pedicle breaches. A comparison was made between the detection ability of the device and the other detection possibilities. Post-operative fine cut CT scanning was used to detect the pedicle breaches. Overall, the 11 trial surgeons performed a total of 521 pedicle drillings on 97 patients. Initially there were 147 drillings with 23 breaches detected. The detection rate of these breaches were 22/23 for the device compared to 10/23 by the surgeon. Over both parts of the study 64 breaches (12.3%) were confirmed on post-operative CT imaging. The electrical conductivity detection device detected 63 of the 64 breaches (98.4%). There was one false negative and four false

  10. Subcutaneous pedicled V-Y advancement flap for surgical reconstruction of the auricle of the ear.

    PubMed

    González-Sixto, B; Pérez-Bustillo, A; Otero-Rivas, M M; Rodríguez-Prieto, M Á

    2014-05-01

    The subcutaneous pedicled V-Y advancement flap is useful for the repair of small and medium-sized defects in areas where it is easy to obtain a good subcutaneous pedicle (upper lip, cheek, eyebrow, and nasal tip and ala). The almost complete absence of subcutaneous tissue on the anterior aspect of the auricle of the ear can limit the use of this approach in this region. We present 4 patients in whom subcutaneous pedicled V-Y advancement flaps were used to repair surgical defects of the helix, scaphoid fossa, and antitragus, achieving a good functional and aesthetic result in all cases.

  11. The "medio-latero-superior trajectory technique": an alternative cortical trajectory for pedicle fixation.

    PubMed

    Mobbs, Ralph J

    2013-02-01

    An alternative pedicle trajectory for use at the superior end of a construct to limit dissection of the mobile superior facet joint and reduce incision length and muscle dissection, thus minimizing approach-related trauma during pedicle fixation, is reported. The medio-latero-superior trajectory technique involves a starting point on the medial aspect of the pars and angulation of the pedicle screw in a mediolateral and caudocranial direction. This approach takes advantage of a predominantly cortical trajectory to assist with bone fixation. Drawbacks of this new screw trajectory are discussed along with its potential benefits.

  12. Spinal pedicle screw planning using deformable atlas registration

    NASA Astrophysics Data System (ADS)

    Goerres, J.; Uneri, A.; De Silva, T.; Ketcha, M.; Reaungamornrat, S.; Jacobson, M.; Vogt, S.; Kleinszig, G.; Osgood, G.; Wolinsky, J.-P.; Siewerdsen, J. H.

    2017-04-01

    Spinal screw placement is a challenging task due to small bone corridors and high risk of neurological or vascular complications, benefiting from precision guidance/navigation and quality assurance (QA). Implicit to both guidance and QA is the definition of a surgical plan—i.e. the desired trajectories and device selection for target vertebrae—conventionally requiring time-consuming manual annotations by a skilled surgeon. We propose automation of such planning by deriving the pedicle trajectory and device selection from a patient’s preoperative CT or MRI. An atlas of vertebrae surfaces was created to provide the underlying basis for automatic planning—in this work, comprising 40 exemplary vertebrae at three levels of the spine (T7, T8, and L3). The atlas was enriched with ideal trajectory annotations for 60 pedicles in total. To define trajectories for a given patient, sparse deformation fields from the atlas surfaces to the input (CT or MR image) are applied on the annotated trajectories. Mean value coordinates are used to interpolate dense deformation fields. The pose of a straight trajectory is optimized by image-based registration to an accumulated volume of the deformed annotations. For evaluation, input deformation fields were created using coherent point drift (CPD) to perform a leave-one-out analysis over the atlas surfaces. CPD registration demonstrated surface error of 0.89  ±  0.10 mm (median  ±  interquartile range) for T7/T8 and 1.29  ±  0.15 mm for L3. At the pedicle center, registered trajectories deviated from the expert reference by 0.56  ±  0.63 mm (T7/T8) and 1.12  ±  0.67 mm (L3). The predicted maximum screw diameter differed by 0.45  ±  0.62 mm (T7/T8), and 1.26  ±  1.19 mm (L3). The automated planning method avoided screw collisions in all cases and demonstrated close agreement overall with expert reference plans, offering a potentially valuable tool in support

  13. Periosteal pedicle graft: A novel root coverage approach.

    PubMed

    Shah, Mishal Piyush; Patel, Akash Prahlad; Shah, Kinnari Mishal

    2015-01-01

    Gingival recession along with reduced width of attached gingiva and inadequate vestibular depth is a very common finding. Many techniques have been adopted in order to treat such defects and obtain predictable root coverage. Several graft procedures are used to obtain the coverage, but they have not been able to deliver predictable and satisfactory results (except connective tissue graft). Some of them also resulted in the secondary surgical site that was very uncomfortable for the patients. There was an intense need for a technique that provides not only good and predictable root coverage, but also reduces the need for secondary surgical site. Hence, this paper describes a single stage technique for increasing the width of attached gingiva and root coverage by using the periosteal pedicle graft.

  14. Long Term Follow up and Patient Satisfaction after Reduction Mammoplasty: Superomedial versus Inferior Pedicle

    PubMed Central

    Makboul, Mohamed; Abdelhamid, Mahmoud; Al-Attar, Ghada

    2017-01-01

    BACKGROUND Surgery for hypertrophied breast represents a challenge for plastic surgeons. The search for a good cosmetic breast has led to the development of many techniques. Objectives for reduction mammoplasty are to achieve elevated, symmetrical breasts, with round shape, good projection, small cicatrices that are not very perceptible, and a lasting result. METHODS This study was carried out on 60 cases who had done reduction mammoplasty from January 2009 to December 2014. All patients were examined and asked for late post-operative results and overall patients’ satisfaction. RESULTS Long term projection and contour of the breast were more satisfactory among patients who had superomedial pedicle with a statistical significant difference. No statistical significant difference was observed between patients undergone either types of operations concerning breast symmetry, nipple symmetry and sensation. The mean score of satisfaction was higher among patients undergone superomedial pedicle than inferior pedicle. CONCLUSION The superomedial pedicle shows better long term cosmetic result in reduction mammoplasty. PMID:28289618

  15. Simultaneous anterior and posterior screw fixations confined to the axis for stabilization of a 3-part fracture of the axis (odontoid, dens, and hangman fractures): report of 2 cases.

    PubMed

    Shinbo, Jun; Sameda, Hiroaki; Ikenoue, Sumio; Takase, Kan; Yamaguchi, Takeshi; Hashimoto, Eiko; Enomoto, Takahiro; Kanazuka, Aya; Mimura, Masaya

    2014-03-01

    Fractures of the axis are considered to be one of the most common injuries to the cervical spine, accounting for more than 20% of all cervical spine fractures. Multiple fractures of the axis are much rarer, accounting for 1% of all cervical fractures. Management of such complex fractures is still challenging, and there is no strong consensus for the treatment. The authors describe the cases of 2 patients who presented with 3-part fractures of the axis consisting of an odontoid Type II fracture and a Levine-Edwards Type IA fracture, which were treated with concurrent insertion of an anterior odontoid screw and bilateral posterior pedicle screws. The cases presented were characterized by 1) a Type II odontoid fracture; 2) a Type IA traumatic spondylolisthesis with no or a little translation and angulation of C-2 on C-3 in a ring fracture of the axis; and 3) no disorders at the C2-3 disc on MR images. Therefore, the authors performed surgery confined to the axis by concurrently inserting an anterior odontoid screw and posterior bilateral pedicle screws without arthrodesis of C2-3. This was followed with cervical soft collar fixation for only 1-2 weeks. The outcomes were favorable, including good osteosynthesis, high primary stability, early patient mobilization, and preserved range of motion of the cervical spine at C2-3 as well as at C1-2.

  16. Utilization of paraspinal muscles for triggered EMG during thoracic pedicle screw placement.

    PubMed

    Silverstein, Justin W; Mermelstein, Laurence E

    2010-03-01

    A novel intraoperative neurophysiological technique for testing the integrity of the pedicle during screw fixation for spinal deformity surgery is presented. The thoracic paraspinal muscles at the appropriate level are used as the electromyogram (EMG) pick-up for direct current stimulation of the thoracic pedicle screw at that level. This technique is shown to give reliable and reproducible results. This technique is found to produce more reliable data than the methods most commonly used at this time.

  17. A new alternative to expandable pedicle screws: Expandable poly-ether-ether-ketone shell.

    PubMed

    Demir, Teyfik

    2015-05-01

    Screw pullout is a very common problem in the fixation of sacrum with pedicle screws. The principal cause of this problem is that the cyclic micro motions in the fixation of sacrum are higher than the other regions of the vertebrae that limit the osteo-integration between bone and screw. In addition to that, the bone quality is very poor at sacrum region. This study investigated a possible solution to the pullout problem without the expandable screws' handicaps. Newly designed poly-ether-ether-ketone expandable shell and classical pedicle screws were biomechanically compared. Torsion test, pullout tests, fatigue tests, flexion/extension moment test, axial gripping capacity tests and torsional gripping capacity tests were conducted in accordance with ASTM F543, F1798 and F1717. Standard polyurethane foam and calf vertebrae were used as embedding medium for pullout tests. Classical pedicle screw pullout load on polyurethane foam was 564.8 N compared to the failure load for calf vertebrae's 1264 N. Under the same test conditions, expandable poly-ether-ether-ketone shell system's pullout loads from polyurethane foam and calf vertebrae were 1196.3 and 1890 N, respectively. The pullout values for expandable poly-ether-ether-ketone shell were 33% and 53% higher than classical pedicle screw on polyurethane foam and calf vertebrae, respectively. The expandable poly-ether-ether-ketone shell exhibited endurance on its 90% of yield load. Contrary to poly-ether-ether-ketone shell, classical pedicle screw exhibited endurance on 70% of its yield load. Expandable poly-ether-ether-ketone shell exhibited much higher pullout performance than classical pedicle screw. Fatigue performance of expandable poly-ether-ether-ketone shell is also higher than classical pedicle screw due to damping the micro motion capacity of the poly-ether-ether-ketone. Expandable poly-ether-ether-ketone shell is a safe alternative to all other expandable pedicle screw systems on mechanical perspective.

  18. Intradermal Infiltration of Local Anesthetic—Rapid and Bloodless Deepithelialization of the Breast Pedicle

    PubMed Central

    Bennett, Katelyn G.

    2017-01-01

    Summary: Breast reduction is one of the most commonly performed plastic surgery procedures, and pedicle deepithelialization remains a time-consuming step of the operation. This is especially true when using an inferior pedicle. We present a novel technique of intradermal infiltration of the breast pedicle with local anesthetic to facilitate efficient, bloodless deepithelialization. The senior author uses a 20-ml syringe to inject 0.25% lidocaine and 1:400,000 epinephrine just beneath the epidermis of the breast pedicle to create a series of wheals. Approximately 20 ml of local anesthetic is used per pedicle. After injection of local anesthetic, the breast pedicle is deepithelialized in less than 3 minutes. The plane is bloodless, allowing improved visualization secondary to the epinephrine-induced hemostasis. The senior author has had only one case of nipple necrosis in 20 years of experience. Intradermal infiltration of local anesthetic with epinephrine hydrodissects between the epidermis and dermis and provides hemostasis to facilitate rapid deepithelialization. PMID:28280667

  19. Comparative analysis of pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery

    PubMed Central

    Rafi, Sohail; Munshi, Naseem; Abbas, Asad; Shaikh, Rabia Hassan; Hashmi, Imtiaz

    2016-01-01

    Introduction: Adolescent idiopathic scoliosis is the most common type of scoliosis. A Cobb angle of 50° will progress beyond the age of spinal maturity. Surgery over bracing is advised at a Cobb angle above or equal to 50°. The aim of surgery is to bring the Cobb angle down below 50° to prevent reprogression as well as improve the quality of life. The objective of the study is to analyze the efficacy and significance in lifestyle improvement of pedicle screw-only fixation system versus the more common hybrid instrumentation system used for the surgical treatment of adolescent idiopathic scoliosis. Materials and Methods: A prospective cohort study was conducted involving two groups of patients were included in the study. One group was operated with pedicle screw-only method while the other with hybrid instrumentation system. The pre- and post-operative Cobb's angles were taken across a follow-up of 4 years. An SRS-30 questionnaire was given in a yearly follow-up to assess the lifestyle improvement of the patient. Results: Pedicle screw-only method was significantly more effective in reducing Cobb's angle (P = 0.0487). It was showed less loss of correction (P = 0.009) pedicle screw-only surgery was also better at reducing thoracic curves (P = 0.001). There seemed a better recovery time with pedicle screw surgery (P = 0.003). Conclusion: Pedicle screws are more effective and durable than hybrid systems at when treating adolescent idiopathic scoliosis. PMID:27695235

  20. Thoracic Pedicle Screw Placement Guide Plate Produced by Three-Dimensional (3-D) Laser Printing

    PubMed Central

    Chen, Hongliang; Guo, Kaijing; Yang, Huilin; Wu, Dongying; Yuan, Feng

    2016-01-01

    Background The aim of this study was to evaluate the accuracy and feasibility of an individualized thoracic pedicle screw placement guide plate produced by 3-D laser printing. Material/Methods Thoracic pedicle samples of 3 adult cadavers were randomly assigned for 3-D CT scans. The 3-D thoracic models were established by using medical Mimics software, and a screw path was designed with scanned data. Then the individualized thoracic pedicle screw placement guide plate models, matched to the backside of thoracic vertebral plates, were produced with a 3-D laser printer. Screws were placed with assistance of a guide plate. Then, the placement was assessed. Results With the data provided by CT scans, 27 individualized guide plates were produced by 3-D printing. There was no significant difference in sex and relevant parameters of left and right sides among individuals (P>0.05). Screws were placed with assistance of guide plates, and all screws were in the correct positions without penetration of pedicles, under direct observation and anatomic evaluation post-operatively. Conclusions A thoracic pedicle screw placement guide plate can be produced by 3-D printing. With a high accuracy in placement and convenient operation, it provides a new method for accurate placement of thoracic pedicle screws. PMID:27194139

  1. Single-Axis Accelerometer

    NASA Technical Reports Server (NTRS)

    Tucker, Dennis Stephen (Inventor); Capo-Lugo, Pedro A. (Inventor)

    2016-01-01

    A single-axis accelerometer includes a housing defining a sleeve. An object/mass is disposed in the sleeve for sliding movement therein in a direction aligned with the sleeve's longitudinal axis. A first piezoelectric strip, attached to a first side of the object and to the housing, is longitudinally aligned with the sleeve's longitudinal axis. The first piezoelectric strip includes a first strip of a piezoelectric material with carbon nanotubes substantially aligned along a length thereof. A second piezoelectric strip, attached to a second side of the object and to the housing, is longitudinally aligned with the sleeve's longitudinal axis. The second piezoelectric strip includes a second strip of the piezoelectric material with carbon nanotubes substantially aligned along a length thereof. A voltage sensor is electrically coupled to at least one of the first and second piezoelectric strips.

  2. Detail of the center axis pivotwindows set over the main ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Detail of the center axis pivot-windows set over the main entry. View facing southeast - U.S. Naval Base, Pearl Harbor, Paint & Oil Storehouse, Avenue D near Seventh Street intersection, Pearl City, Honolulu County, HI

  3. Current trends in pedicle screw stimulation techniques: lumbosacral, thoracic, and cervical levels.

    PubMed

    Isley, Michael R; Zhang, Xiao-Feng; Balzer, Jeffrey R; Leppanen, Ronald E

    2012-06-01

    Unequivocally, pedicle screw instrumentation has evolved as a primary construct for the treatment of both common and complex spinal disorders. However an inevitable and potentially major complication associated with this type of surgery is misplacement of a pedicle screw(s) which may result in neural and vascular complications, as well as impair the biomechanical stability of the spinal instrumentation resulting in loss of fixation. In light of these potential surgical complications, critical reviews of outcome data for treatment of chronic, low-back pain using pedicle screw instrumentation concluded that "pedicle screw fixation improves radiographically demonstrated fusion rates;" however the expense and complication rates for such constructs are considerable in light of the clinical benefit (Resnick et al. 2005a). Currently, neuromonitoring using free-run and evoked (triggered) electromyography (EMG) is widely used and advocated for safer and more accurate placement of pedicle screws during open instrumentation procedures, and more recently, guiding percutaneous placement (minimally invasive) where the pedicle cannot be easily inspected visually. The latter technique, evoked or triggered EMG when applied to pedicle screw instrumentation surgeries, has been referred to as the pedicle screw stimulation technique. As concluded in the Position Statement by the American Society of Neurophysiological Monitoring (ASNM), multimodality neuromonitoring using free-run EMG and the pedicle screw stimulation technique was considered a practice option and not yet a standard of care (Leppanen 2005). Subsequently, the American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Joint Section on Disorders of the Spine and Peripheral Nerves published their "Guidelines for the Performance of Fusion Procedures for Degenerative Disease of the Lumbar Spine" (Heary 2005, Resnick et al. 2005a, Resnick et al. 2005b). It was concluded that the "primary

  4. Central pedicled breast reduction technique in male patients after massive weight loss.

    PubMed

    Stoff, Alexander; Velasco-Laguardia, Fernando J; Richter, Dirk F

    2012-03-01

    Male patients after massive weight loss often suffer from redundant skin and soft tissue in the anterior and lateral chest region, causing various deformities of pseudogynecomastia. Techniques with free or pedicled nipple-areola complex (NAC) transposition are widely accepted. The authors present their approach to male breast reduction with preservation of the NAC on a central dermoglandular pedicle and a wide elliptical tissue excision of breast and lateral thorax tissue in combination with liposuction. Male breast reduction was performed on patients after moderate to massive weight loss due to diet or bariatric procedures. Former procedures included free nipple-areola grafts or inferior pedicled techniques for NAC preservation. As a modification, we performed a central pedicled breast reduction on nine male patients with excessive liposuction of the pedicle and a horizontal elliptical skin removal, allowing for sufficient tissue removal at the lateral thorax. From October 2010 until June 2011, nine male patients had central pedicled breast reconstructions after massive weight loss. Mean age was 29.1 years, mean preoperative body mass index was 29.2, and mean preoperative weight loss was 63.9 kg. The chest wall improvement was rated "very good" by eight patients. No major complications occurred in all nine patients. Male chest deformities after massive weight loss can be dealt by several approaches. The optimal scar positioning and the preservation of NAC may be the most challenging aspects of these procedures. Therefore, the preservation of the NAC on a central dermoglandular pedicle with a horizontal submammary scar course may optimize the esthetic outcome.

  5. Clinical application of a pedicle nail system with polymethylmethacrylate for osteoporotic vertebral fracture

    PubMed Central

    Tanaka, Masato; Sugimoto, Yoshihisa; Takigawa, Tomoyuki; Ozaki, Toshifumi; Konishi, Hitoshi

    2010-01-01

    The instrumentation of the osteoporotic spine may sometimes result in failure due to the loosening or pullout of the conventional pedicle screw. Moreover, augmentation of screws with polymethylmethacrylate (PMMA) has risks of complications. We developed a new and original pedicle nail system with PMMA for osteoporotic vertebral fractures. A clinical evaluation of this novel pedicle nail system utilized in patients with an osteoporotic vertebral collapse was performed to determine the effectiveness and safety of this technique. Thirty-four elderly patients who suffered from osteoporotic compression fractures were treated by posterolateral fusion using the pedicle nail system. The mean follow-up period was 37 months. Of the 25 patients with neurological symptoms, two patients improved two stages at the Frankel level. Fifteen patients improved one stage at the Frankel level, and eight other patients improved, however, their improvement did not exceed a Frankel level. Nine cases with neuralgia symptoms improved from 4.4 to 2.2 points on average on the Denis pain scale (p < 0.01). The fusion rate was 94% as determined by X-rays of flexion and extension, and the correction of the compression fracture site was maintained well. A pedicle nail system stabilizes the spinal column with osteoporosis and reduces the instrumentation failure. The technique for the insertion of the pedicle nail reduces complication from cement augmentation. The authors speculate that the strategy using the pedicle nail system for osteoporotic spine may be effective and safe when the surgery is performed through a posterior approach. PMID:20414689

  6. Outside the brain: an inside view on transgenic animal and stem cell-based models to examine neuronal serotonin-dependent regulation of HPA axis-controlled events during development and adult stages

    PubMed Central

    Waider, Jonas; Ziegler, Janina

    2016-01-01

    Recently, Trista North and colleagues showed that neuronal synthesis of serotonin is an essential key process for embryonic hematopoietic stem (HPS) cell production in zebrafish. Using their experimental design, they were able to show that neuronal serotonin activates the stress-responsive hypothalamic-pituitary-adrenal (HPA) axis and glucocorticoid receptor activity which in turn induces HPS cell formation. In our perspective, we give a short overview on established experimental approaches for serotonergic neurotransmission in vivo and in vitro and their potential to address putative contributions of serotonergic neurotransmission to physiological processes beyond the central nervous systems (CNS). We briefly introduce common features of brain serotonin-depleted, tryptophan hydroxylase-2 knockout mice, which can be applied to investigate the contribution of brain-derived serotonin to developmental and adult physiological processes outside the CNS. These models allow to analyzing gender-specific, HPA axis-dependent processes in female and male knockout mice during developmental and adult stages. We also highlight the application of human and mouse stem cell-derived serotonergic neurons as an independent research model as well as complementary experimental approach to transgenic animal models. In case of human serotonergic neurotransmission, human in vitro-generated neurons present a very promising and highly valuable experimental approach to address characteristics of human neuronal serotonin signaling on a molecular and cellular level. The combination of transgenic animal models and newly established stem cell technologies will provide powerful research platforms, which will help to answer yet unsolved mysteries of serotonergic neurotransmission. PMID:28078274

  7. Outside the brain: an inside view on transgenic animal and stem cell-based models to examine neuronal serotonin-dependent regulation of HPA axis-controlled events during development and adult stages.

    PubMed

    Waider, Jonas; Ziegler, Janina; Lau, Thorsten

    2016-01-01

    Recently, Trista North and colleagues showed that neuronal synthesis of serotonin is an essential key process for embryonic hematopoietic stem (HPS) cell production in zebrafish. Using their experimental design, they were able to show that neuronal serotonin activates the stress-responsive hypothalamic-pituitary-adrenal (HPA) axis and glucocorticoid receptor activity which in turn induces HPS cell formation. In our perspective, we give a short overview on established experimental approaches for serotonergic neurotransmission in vivo and in vitro and their potential to address putative contributions of serotonergic neurotransmission to physiological processes beyond the central nervous systems (CNS). We briefly introduce common features of brain serotonin-depleted, tryptophan hydroxylase-2 knockout mice, which can be applied to investigate the contribution of brain-derived serotonin to developmental and adult physiological processes outside the CNS. These models allow to analyzing gender-specific, HPA axis-dependent processes in female and male knockout mice during developmental and adult stages. We also highlight the application of human and mouse stem cell-derived serotonergic neurons as an independent research model as well as complementary experimental approach to transgenic animal models. In case of human serotonergic neurotransmission, human in vitro-generated neurons present a very promising and highly valuable experimental approach to address characteristics of human neuronal serotonin signaling on a molecular and cellular level. The combination of transgenic animal models and newly established stem cell technologies will provide powerful research platforms, which will help to answer yet unsolved mysteries of serotonergic neurotransmission.

  8. Plan to procedure: combining 3D templating with rapid prototyping to enhance pedicle screw placement

    NASA Astrophysics Data System (ADS)

    Augustine, Kurt E.; Stans, Anthony A.; Morris, Jonathan M.; Huddleston, Paul M.; Matsumoto, Jane M.; Holmes, David R., III; Robb, Richard A.

    2010-02-01

    Spinal fusion procedures involving the implantation of pedicle screws have steadily increased over the past decade because of demonstrated improvement in biomechanical stability of the spine. However, current methods of spinal fusion carries a risk of serious vascular, visceral, and neurological injury caused by inaccurate placement or inappropriately sized instrumentation, which may lead to patient paralysis or even fatality. 3D spine templating software developed by the Biomedical Imaging Resource (BIR) at Mayo Clinic allows the surgeon to virtually place pedicle screws using pre-operative 3D CT image data. With the template plan incorporated, a patient-specific 3D anatomic model is produced using a commercial rapid prototyping system. The pre-surgical plan and the patient-specific model then are used in the procedure room to provide real-time visualization and quantitative guidance for accurate placement of each pedicle screw, significantly reducing risk of injury. A pilot study was conducted at Mayo Clinic by the Department of Radiology, the Department of Orthopedics, and the BIR, involving seven complicated pediatric spine cases. In each case, pre-operative 3D templating was carried out and patient specific models were generated. The plans and the models were used intra-operatively, providing precise pedicle screw starting points and trajectories. Postoperative assessment by the surgeon confirmed all seven operations were successful. Results from the study suggest that patient-specific, 3D anatomic models successfully acquired from 3D templating tools are valuable for planning and conducting pedicle screw insertion procedures.

  9. Long-term follow-up and patient satisfaction after reduction mammoplasty: Superomedial versus inferior pedicle

    PubMed Central

    Makboul, Mohamed; Abdelhamid, Mahmoud S.; Al-Attar, Ghada S.

    2016-01-01

    Background: Surgery for hypertrophied breasts represents a challenge for plastic surgeons. The search for a good post-surgical cosmetic breast has led to the development of many techniques. Objectives for reduction mammoplasty are to achieve elevated, symmetrical breasts, a round shape, good projection, small cicatrices that are not very perceptible, and a lasting result. Patients and Methods: This study was carried out on sixty cases who had done reduction mammoplasty from January 2009 to December 2014. All patients were examined and were asked for late post-operative results and overall patients' satisfaction. Results: Long-term projection and contour of the breast were more satisfactory among patients who had superomedial pedicle with a statistically significant difference. No statistically significant difference was observed between patients underwent either superomedial or inferior pedicle reduction mammoplasty with regard to breast shape symmetry, nipple symmetry and sensation. The mean score for satisfaction was higher among patients who underwent superomedial pedicle rather than the inferior pedicle method. Conclusion: The superomedial pedicle shows better long-term cosmetic results. PMID:27833284

  10. Pedicled posteromedial thigh (PMT) flap: A new alternative for groin defect reconstruction.

    PubMed

    Scaglioni, Mario F; Enrique Carrillo Jimenez, Leonardo; Kuo, Yur-Ren; Chen, Yen-Chou

    2015-11-26

    The posterior medial thigh is mainly vascularized by the profunda femoris artery (PFA), which nourishes the adductor magnus muscle and overlying skin, to supply a number of perforators that can potentially be used as pedicles for local perforator flaps. Here we present two cases utilizing the pedicled posteromedial thigh flap (PMT) to reconstruct the groin defects. Two patients underwent resection for metastatic malignant melanoma resulting in large defects of the groin with exposure of major inguinal vessels; the dimensions of the skin defects were 15 cm × 5 cm and 16 cm × 6 cm, two ipsilateral pedicled PMT flaps were designed to cover the defects. The pedicled PMT flaps were based on perforators arising from the PFA and were transposed through a submuscular tunnel into the defect. The postoperative course was uneventful and the wounds were reconstructed successfully. The pedicled PMT flap may be an option for reconstruction of groin defects and could be incorporated into the armamentarium of the reconstructive microsurgeon. © 2015 Wiley Periodicals, Inc. Microsurgery, 2015.

  11. Vertical axis windmill

    SciTech Connect

    Campbell, J.S.

    1980-04-08

    A vertical axis windmill is described which involves a rotatable central vertical shaft having horizontal arms pivotally supporting three sails that are free to function in the wind like the main sail on a sail boat, and means for disabling the sails to allow the windmill to be stopped in a blowing wind.

  12. Assessing the Intraoperative Accuracy of Pedicle Screw Placement by Using a Bone-Mounted Miniature Robot System through Secondary Registration

    PubMed Central

    Wu, Chieh-Hsin; Tsai, Cheng-Yu; Chang, Chih-Hui; Lin, Chih-Lung; Tsai, Tai-Hsin

    2016-01-01

    Introduction Pedicle screws are commonly employed to restore spinal stability and correct deformities. The Renaissance robotic system was developed to improve the accuracy of pedicle screw placement. Purpose In this study, we developed an intraoperative classification system for evaluating the accuracy of pedicle screw placements through secondary registration. Furthermore, we evaluated the benefits of using the Renaissance robotic system in pedicle screw placement and postoperative evaluations. Finally, we examined the factors affecting the accuracy of pedicle screw implantation. Results Through use of the Renaissance robotic system, the accuracy of Kirschner-wire (K-wire) placements deviating <3 mm from the planned trajectory was determined to be 98.74%. According to our classification system, the robot-guided pedicle screw implantation attained an accuracy of 94.00% before repositioning and 98.74% after repositioning. However, the malposition rate before repositioning was 5.99%; among these placements, 4.73% were immediately repositioned using the robot system and 1.26% were manually repositioned after a failed robot repositioning attempt. Most K-wire entry points deviated caudally and laterally. Conclusion The Renaissance robotic system offers high accuracy in pedicle screw placement. Secondary registration improves the accuracy through increasing the precision of the positioning; moreover, intraoperative evaluation enables immediate repositioning. Furthermore, the K-wire tends to deviate caudally and laterally from the entry point because of skiving, which is characteristic of robot-assisted pedicle screw placement. PMID:27054360

  13. Radius graft pedicled on the anterior interosseous artery for recurrent ulnar nonunion.

    PubMed

    Andro, C; Richou, J; Schiele, P; Hu, W; Le Nen, D

    2011-06-01

    Recurrent ulnar nonunion challenges the functional prognosis and raises major problems concerning the best therapeutic strategy to follow. The case of a female patient presenting recurrent nonunion of the ulnar diaphysis despite successive treatments is reported. The radius graft pedicled on the anterior interosseous artery from a retrograde approach obtained bone union in 3 months with no functional sequelae. For the first time, we propose a therapeutic alternative calling on a proximally pedicled anterior interosseous flap. This technique can be performed under locoregional anesthesia and does not sacrifice the main artery of the forearm. However, the size of the graft does not entirely compensate for segmentary bone loss. The radius graft pedicled on the anterior interosseus artery is an inventive technique that can solve the problem of difficult ulna nonunions without the disadvantages of vascularized fibula harvesting.

  14. The use of the serratus anterior muscle vascular pedicle as recipient site in DIEP flap transfer for breast reconstruction.

    PubMed

    Santanelli di Pompeo, Fabio; Longo, Benedetto; Laporta, Rosaria; Pagnoni, Marco; Cavalieri, Enrico

    2014-04-01

    Currently, the choice for recipient vessels in microvascular breast reconstruction is made between axillary and internal mammary regions. The authors report their experience with anastomosis to a new, unconventional, axillary recipient vessel, the serratus anterior muscle vascular pedicle. Among 340 deep inferior epigastric perforator (DIEP) flap breast reconstructions performed between 2004 and 2013, 11 were successfully revascularised to the serratus anterior (SA) pedicle: In three cases, complications led to a salvage procedure, while in eight cases, anastomosis to this recipient site was electively planned. The pedicle was constantly present, with calibre always comparable to that of flap's pedicle. At the mean 24-month follow-up, no recipient site complications were observed. The SA muscle pedicle resulted as a reliable choice in salvage procedures and a suitable option for recipient vessel selection in elective cases.

  15. Research of misalignment between dithered ring laser gyro angle rate input axis and dither axis

    NASA Astrophysics Data System (ADS)

    Li, Geng; Wu, Wenqi; FAN, Zhenfang; LU, Guangfeng; Hu, Shaomin; Luo, Hui; Long, Xingwu

    2014-12-01

    The strap-down inertial navigation system (SINS), especially the SINS composed by dithered ring laser gyroscope (DRLG) is a kind of equipment, which providing high reliability and performance for moving vehicles. However, the mechanical dither which is used to eliminate the "Lock-In" effect can cause vibration disturbance to the INS and lead to dithering coupling problem in the inertial measurement unit (IMU) gyroscope triad, so its further application is limited. Among DRLG errors between the true gyro rotation rate and the measured rotation rate, the frequently considered one is the input axis misalignment between input reference axis which is perpendicular to the mounting surface and gyro angular rate input axis. But the misalignment angle between DRLG dither axis and gyro angular rate input axis is often ignored by researchers, which is amplified by dither coupling problem and that would lead to negative effects especially in high accuracy SINS. In order to study the problem more clearly, the concept of misalignment between DRLG dither axis and gyro angle rate input axis is researched. Considering the error of misalignment is of the order of 10-3 rad. or even smaller, the best way to measure it is using DRLG itself by means of an angle exciter as an auxiliary. In this paper, the concept of dither axis misalignment is explained explicitly firstly, based on this, the frequency of angle exciter is induced as reference parameter, when DRLG is mounted on the angle exciter in a certain angle, the projections of angle exciter rotation rate and mechanical oscillation rate on the gyro input axis are both sensed by DRLG. If the dither axis has misalignment error with the gyro input axis, there will be four major frequencies detected: the frequency of angle exciter, the dither mechanical frequency, sum and difference frequencies of the former two frequencies. Then the amplitude spectrum of DRLG output signal obtained by the using LabVIEW program. if there are only angle

  16. Dynamic Change of CD34 Level during the Survival Process of Narrow Pedicle Flap

    PubMed Central

    Wu, Lijun; Zhao, Tianlan; Yu, Daojiang; Chen, Qi; Han, Wenya; Yu, Wenyuan; Sun, Wei

    2015-01-01

    Objective To evaluate the dynamic change of CD34 level during the survival process of narrow pedicle flaps. Methods Twenty-five white pigs were randomly and equally divided into 5 experimental groups. Five different type of narrow pedicle with different length-to-width ratio were employed, and each type of narrow pedicle was covered with 5 different size random flaps and which was classified into A, B, C, D and E for 5 groups. Group A was control group. Each type narrow pedicle with 5 different skin flaps were implanted onto the back of the pigs along the midline of back with a reverse direction. A 0.3 cm×0.3 cm full thickness skin flap in the middle of distal segment was collected and on 3rd, 5th, 7th and 14th days of post-operation. The expression of CD34 was measured by immunohistochemistry and enzyme-linked immunosorbent (ELISA). Results Histological examination showed that with the increasing of length-to-width ratio of the narrow pedicle skin flaps, the expression of CD34 increased in the skin flaps. Increased level of CD34 was found on 3rd day post-operation, and the peak expression was found on 7th day. Persistent high level of CD34 was found until 14th day. Conclusion Increased CD34 level in the distal skin flap, there is the association between CD34 level and ischemia injury. Moreover, CD34 expression plays an important role during the repair processes of pedicle flaps. PMID:26561392

  17. The USS pedicle hook system: a morphometric analysis of its safety in the thoracic spine. Universal Spine System.

    PubMed

    Berlet, G C; Boubez, G; Gurr, K R; Bailey, S I

    1999-06-01

    The Universal Spine System (USS) pedicle hook design includes a fixation screw that passes obliquely in the anterocranial direction in the pedicle. The addition of the fixation screw was to address concerns with rotation of the hook and hook disengagement. This study was designed to evaluate the safety of the USS screw locked pedicle hook. Eleven cadaveric thoracic spines were instrumented posteriorly with USS pedicle hooks from T1 to T12. Spinal instrumentation was performed by a spinal surgeon experienced with the USS system. Spinal deformity was created prior to instrumentation, ranging from 0 to 55 degrees in the horizontal plane (rotation) and from 0 to 50 degrees in the frontal plane (scoliosis). Radiographs, computed tomography (CT), and segmental dissection were used for data acquisition. Morphometric CT analysis before instrumentation demonstrated that the transverse pedicular diameter was the smallest at T5 with a mean of 3.7 mm. The transverse pedicular angle (TPA) was found to always point toward the midline. The largest TPA was observed at T1 with a mean TPA of 28.4 degrees. The pedicle with the least angular deviation from the midline was T11 with a mean TPA of 7 degrees. Postinstrumentation CT analysis and segmental dissection revealed perforations of the pedicle cortex by the fixation screw in 15% of instrumented pedicles (26/172). There were 6 medial and 20 lateral perforations. Medial perforations occurred exclusively in the three most proximal spinal segments, whereas the lateral perforations occurred throughout the thoracic spine. The mean encroachment of the fixation screw was 1.67 mm medially and 1.95 mm laterally. This study demonstrates the variation in caliber and direction of the thoracic pedicles. Medial and lateral perforations of the pedicle can occur with the USS pedicle hook instrumented system.

  18. Salvage of extensively burned upper limbs by a pedicled latissimus dorsi flap.

    PubMed

    Delay, E; Foyatier, J L; el Kollali, R; Comparin, J P; Weil, E; Latarjet, J

    1995-09-01

    Very deep burns of the arm and elbow lead to soft tissue necrosis and infection with exposure of important structures. Aggressive debridement should be performed as early as possible to cut the vicious circle, and the defect, which may be extensive, should be covered by well-vascularized tissues. The reliability and versatility of the pedicled latissimus dorsi muscle or musculocutaneous flap make it our first choice in the management of this problem. A retrospective study of three patients for whom salvage of the upper limb has been achieved by the use of a pedicled latissimus dorsi flap is presented, illustrating the advantages of this technique.

  19. Breast-feeding after inferior pedicle reduction mammaplasty.

    PubMed

    Brzozowski, D; Niessen, M; Evans, H B; Hurst, L N

    2000-02-01

    The breast-feeding practices of a series of postpartum women, who had undergone prior reduction mammaplasty by means of an inferior pedicle approach, are reported in this retrospective study. Also identified are the factors that influenced the decision to breast-feed postoperatively. From a patient pool of 544 individuals who elected to have reduction mammaplasty between 1984 and 1994 (age range, 15 to 35 years), 334 could be contacted and interviewed by means of telephone by using a standardized questionnaire. Successful breast-feeding was defined as the ability to feed for a duration equal to or greater than 2 weeks. Seventy-eight patients had children after their breast reduction surgery. Fifteen of the 78 patients (19.2 percent) breast-fed exclusively, 8 (10.3 percent) breast-fed with formula supplementation, 14 (17.9 percent) had an unsuccessful breast-feeding attempt, and 41 (52.6 percent) did not attempt breast-feeding. Of the 41 patients not attempting to breast-feed, 9 patients did so as a direct consequence of discouragement by a health care professional. Further reasons for feeding with supplementation, having an unsuccessful attempt, and not attempting to breast-feed are presented. Of the 78 women who had children postoperatively, a total of 27 were discouraged from breast-feeding by medical professionals with only 8 of the 27 (29.6 percent) subsequently attempting, despite this recommendation. In comparison, 26 patients were encouraged to breast-feed; nineteen (73.1 percent) of them did subsequently attempt breast-feeding. This rate is statistically significant by using a chi2 test with 1 df(p = 0.0016). Postpartum breast engorgement and lactation was experienced by 31 of the 41 patients not attempting to breast-feed. Of these 31 patients, 19 believed that they would have been able to breast-feed due to the extent of breast engorgement and lactation experienced. Given the use of an inferior flap mammaplasty technique and patient encouragement, the

  20. Vertical axis wind turbines

    DOEpatents

    Krivcov, Vladimir [Miass, RU; Krivospitski, Vladimir [Miass, RU; Maksimov, Vasili [Miass, RU; Halstead, Richard [Rohnert Park, CA; Grahov, Jurij [Miass, RU

    2011-03-08

    A vertical axis wind turbine is described. The wind turbine can include a top ring, a middle ring and a lower ring, wherein a plurality of vertical airfoils are disposed between the rings. For example, three vertical airfoils can be attached between the upper ring and the middle ring. In addition, three more vertical airfoils can be attached between the lower ring and the middle ring. When wind contacts the vertically arranged airfoils the rings begin to spin. By connecting the rings to a center pole which spins an alternator, electricity can be generated from wind.

  1. Single Axis Piezoceramic Gimbal

    NASA Technical Reports Server (NTRS)

    Horner, Garnett C.; Taleghani, Barmac K.

    1999-01-01

    This paper describes the fabrication, testing, and analysis of a single axis piezoceramic gimbal. The fabrication process consist of pre-stressing a piezoceramic wafer using a high-temperature thermoplastic polyimide and a metal foil. The differential thermal expansion between the ceramic and metal induces a curvature. The pre-stressed, curved piezoceramic is mounted on a support mechanism and a mirror is attached to the piezoceramic. A plot of gimbal angle versus applied voltage to the piezoceramic is presented. A finite element analysis of the piezoceramic gimbal is described. The predicted gimbal angle versus applied voltage is compared to experimental results.

  2. Identification of key tissue type for antler regeneration through pedicle periosteum deletion.

    PubMed

    Li, Chunyi; Mackintosh, Colin G; Martin, Shirley K; Clark, Dawn E

    2007-04-01

    Epimorphic regeneration is the "holy grail" of regenerative medicine. Research aimed at investigating the various models of epimorphic regeneration is essential if a fundamental understanding of the factors underpinning this process are to be established. Deer antlers are the only mammalian appendages that are subject to an annual cycle of epimorphic regeneration. In our previous studies, we have reported that histogenesis of antler regeneration relies on cells resident within the pedicle periosteum (PP). The present study elaborates this finding by means of functional studies involving the deletion of PP. Four yearling and four 2-year-old stags were selected for total PP deletion or partial PP deletion experiments. Of the animals in the total PP deletion group, one showed no signs of antler regeneration throughout the antler growth season. Two showed substantial and one showed marginal delays in antler regeneration (at 34, 20 and 7 days, respectively) compared with the corresponding sham-operated sides. Histological investigation revealed that the delayed antlers were derived from regenerated PP. Unexpectedly, the regenerative capacity of the antler from the total periosteum-deleted pedicles depended on antler length at surgery. Of the four deer that had partial PP deletion, two regenerated antlers exclusively from the left-over PP on the pedicle shafts in the absence of participation from the pedicle bone proper. The combined results from the PP deletion experiments convincingly demonstrate that the cells of the PP are responsible for antler regeneration.

  3. Complications and oncologic outcomes of pedicled transverse rectus abdominis myocutaneous flap in breast cancer patients

    PubMed Central

    Somintara, Ongart; Lertsithichai, Panuwat; Kongdan, Youwanush; Supsamutchai, Chairat; Sukpanich, Rupporn

    2016-01-01

    Background There are several techniques for harvesting the pedicled transverse rectus abdominis myocutaneous (TRAM) flap after mastectomy in breast cancer patients. We examined the whole muscle with partial sheath sparing technique and determined factors associated with its complications and oncological outcomes. Methods We retrospectively reviewed the results of 168 TRAM flaps performed between January 2003 and December 2010, focusing on complications and oncologic outcomes. Results Among the 168 pedicled TRAM flap procedures in 158 patients, flap complications occurred in 34%. Most of the flap complications included some degree of fat necrosis. There was no total flap loss. Flap complications were associated with elderly patients and the presence of major donor site complications. Abdominal bulging and hernia occurred in 12% of patients. The bi-pedicled TRAM flap and higher body mass index (BMI) were significant factors associated with increased donor site complications. Seven patients (4%) developed loco-regional recurrence. Within a median follow-up of 27 months, distant metastasis and death occurred in 6% and 4% of patients, respectively. Conclusions The pedicled TRAM flap using the whole muscle with partial sheath sparing technique in the present study is consistent with the results from previous studies in flap complication rates and oncological outcomes. PMID:27563562

  4. An extended approach for the vascular pedicle of the lateral arm free flap.

    PubMed

    Moffett, T R; Madison, S A; Derr, J W; Acland, R D

    1992-02-01

    We present an extension of the surgical approach for harvesting the lateral upper arm free flap by which an additional 6 to 8 cm of pedicle length may be gained. First, the flap is raised by the standard lateral approach. Then, by proceeding proximally and posteriorly, the triceps muscle is split between its lateral and long heads to expose the entire length of the profunda brachii vessels in the spiral groove. A tunnel is developed beneath the lateral head of the triceps, and the flap or its pedicle is delivered through this. We describe the surgical technique and present details of a dissection study on 25 fresh cadaver limbs. The nerve branches to the lateral head of the triceps, which are close to the vessels of the flap, are highly variable in number and location. When unusually short and distally placed, they are at risk of damage, but damage can be avoided if the tunnel is not unduly widened. We present our early clinical experience in 10 consecutive cases using the extended-pedicle lateral arm flap. The free pedicle length in this series ranged from 8 to 13 cm. The maximum flap size was 5 x 19 cm. All cases were successful, although one required reoperation for venous thrombosis. Although postoperative testing of upper arm muscle function showed some weakness and impaired endurance, this was found equally in the surgically disturbed triceps and in the untouched elbow flexors and thus could not be attributed to motor nerve damage to the triceps muscle.

  5. A new Simplified Method of Selective Exposure of Hepatic Pedicles for Controlled Hepatectomies

    PubMed Central

    Karagiulian, S. R.

    1989-01-01

    Our experience of 90 hepatectomies (HE) and examinations of 64 cadaver livers resulted in the elaboration of a simplified technique for the exposure of hepatic pedicles (HP) and the rapid selective ligation without significant normothermal ischemia of the retained parts of the liver. The method comprises 4 consecutive steps: 1) a superficial T-shaped incision of Glisson's capsule at the site of HP projection on the liver's inferior surface, 2) introduction of the surgeon's forefinger into the liver parenchyma, controlled by clamping the hepatoduodenal ligament, the fingertip finding a tubular structure well distinguished by its smooth elastic surface from the friable parenchyma and bending the finger to hook the pedicle, 3) drawing the hooked pedicle downwards through the slit in the capsule and temporarily clamping it, while releasing the hepatoduodenal ligament so as to restore blood supply to the retained parts of the liver, 4) checking for correct ligature position on the HP before its final ligation by matching the actual ischemic area with the intended line of resection and moving the clamp proximally or distally along the exposed pedicle for the release or clamping of lateral branches as necessary. Whereupon resection can be performed by any of the known methods. This method has been used in 8 major HE, allowing to reduce intraoperative blood loss from 2200±247 ml to 1000±225 ml and reducing general liver ischemia from 10 minutes and more to 2–3 minutes. PMID:2487059

  6. Mammaplasty with a single, vertical, superiorly-based pedicle to support the nipple-areola.

    PubMed

    Arufe, H N; Erenfryd, A; Saubidet, M

    1977-08-01

    We present our technique for mammaplasty, using a vertical, single-pedicled, flap with a superior base. The procedure is simple, and it allows final determination of the areola and nipple location after the newly shaped and positioned mound is closed.

  7. Intraoperative stimulation of pedicle screws: a new method for verification of screw placement.

    PubMed

    Young, W F; Morledge, D E; Martin, W; Park, K B

    1995-12-01

    Pedicular fixation of the lumbosacral spine has become a popular procedure for improving fusion rates. Even in experienced hands, it can be associated with a significant rate of screw malpositioning and potential nerve root injury. In this report, we describe a technique for improving screw localization utilizing evoked electromyography responses from direct stimulation of pedicle instrumentation.

  8. Pedicle screw fixation combined with intermediate screw at the fracture level for treatment of thoracolumbar fractures

    PubMed Central

    Li, Kunpeng; Zhang, Wen; Liu, Dan; Xu, Hui; Geng, Wei; Luo, Dawei; Ma, Jinzhu

    2016-01-01

    Abstract Background: Use of a pedicle screw at the level of fracture, also known as an intermediate screw, has been shown to improve clinical results in managing thoracolumbar(TL) fractures, but there is a paucity of powerful evidence to support the claim. The aim of this study was to compare outcomes between pedicle screw fixation combined with intermediate screw at the fracture level and conventional pedicle screw fixation (one level above and one level below the fracture level) for thoracolumbar (TL) fractures. Methods: A meta-analysis of cohort studies was conducted between pedicle screw fixation combined with intermediate screw at the fracture level (combined screw group) and conventional pedicle screw fixation (conventional group) for the treatment of TL fractures from their inception to December 2015. An extensive search of studies was performed in PubMed, Medline, Embase, and the Cochrane library. The following outcome measures were extracted: visual analogue scale (VAS), operation time and intraoperative blood loss, Cobb angle and anterior vertebral height (AVH), and complications. Data analysis was conducted with RevMan 5.3.5. Results: From 10 relevant studies identified, 283 patients undergoing pedicle screw fixation combined with intermediate screw at the fracture level were compared with 285 conventional pedicle screw procedures. The pooled analysis showed that there was statistically significant difference in terms of postoperative Cobb angle (95% confidence interval (CI), −3.00, −0.75; P = 0.001) and AVH (95% CI, 0.04, 12.23; P = 0.05), correction loss (Cobb angle: P < 0.0001; AVH: P < 0.0001) and implant failure rate (95% CI, 0.06, 0.62; P = 0.006), and blood loss (W 95% CI, 2.22, 23.60; P = 0.02) between 2 groups. But in terms of other complications, there were no differences between 2 groups (95% CI, 0.23, 2.04; P = 0.50). No difference was found in operation time (95% CI, −5.36, 14.67; P = 0.36) and VAS scores (95% CI, −0.44, 0

  9. Accuracy and safety of pedicle screw placement in neuromuscular scoliosis with free-hand technique.

    PubMed

    Modi, Hitesh N; Suh, Seung Woo; Fernandez, Harry; Yang, Jae Hyuk; Song, Hae-Ryong

    2008-12-01

    It is a retrospective analytic study of 1,009 transpedicular screws (689 thoracic and 320 lumbosacral), inserted with free-hand technique in neuromuscular scoliosis using postoperative CT scan. The aim of paper was to determine the accuracy and safety of transpedicular screw placement with free-hand technique in neuromuscular scoliosis and to compare the accuracy at different levels in such population. All studies regarding accuracy and safety of pedicle screw in scoliosis represent idiopathic scoliosis using various techniques such as free-hand, navigation, image intensifier, etc., for screw insertion. Anatomies of vertebrae and pedicle are distorted in scoliosis, hence accurate and safe placement of pedicle screw is prerequisite for surgery. Between 2004 and 2006, 37 consecutive patients, average age 20 years (9-44 years), of neuromuscular scoliosis were operated with posterior pedicle screw fixation using free-hand technique. Accuracy of pedicle screws was studied on postoperative CT scan. Placement up to 2 mm medial side and 4 mm lateral side was considered within-safe zone. Of the 1,009 screws, 273 screws were displaced medially, laterally or on the anterior side showing that 73% screws (68% in thoracic and 82.5% in lumbar spine) were accurately placed within pedicle. Considering the safe zone, 93.3% (942/1009, 92.4% in thoracic and 95.3% in lumbar spine) of the screws were within the safe zone. Comparing accuracy according to severity of curve, accuracy was 75% in group 1 (curve <90 degrees ) and 69% in group 2 (curve >90 degrees) with a safety of 94.8 and 91.2%, respectively (P = 0.35). Comparing the accuracy at different thoracic levels, it showed 67, 64 and 72% accuracy in upper, middle and lower thoracic levels with safety of 96.6, 89.2 and 93.1%, respectively, exhibiting no statistical significant difference (P = 0.17). Pedicle screw placement in neuromuscular scoliosis with free-hand technique is accurate and safe as other conditions.

  10. Fibromyxoma of the axis.

    PubMed

    Mavrogenis, Andreas F; Casadei, Roberto; Gambarotti, Marco; Ruggieri, Pietro

    2012-07-01

    Fibromyxoma of bone is a rare benign tumor of fibrous tissue origin. The typical location is the jaws. Sporadic extragnathic cases have been reported, but fibromyxoma of the spine has not been reported. The histological appearance of fibromyxoma is benign and includes abundant extracellular fibrous and myxoid stroma with varying amounts of calcification and ossification. Myxoid changes are usually extensive. Extragnathic fibromyxoma of bone should be distinguished from benign cartilage-forming bone tumors, such as chondromyxoid and myxoid chondrosarcoma and myxoma of bone. It has also been suggested that fibromyxoma is a variant of myxoid fibrous dysplasia, whereas other authors reported extragnathic fibromyxoma resulting from myxoid degeneration of bone tumors, such as chondrosarcoma or fibrosarcoma. The overtreatment of patients with fibromyxoma of bone due to an aggressive imaging appearance should be avoided; the prognosis is excellent compared with the jaw variant and depends on the location and extent of the tumor. This article describes a case of a 21-year-old woman with fibromyxoma of bone originating from the spinous process of the axis. Clinical examination showed a tender mass in the midline of the posterior aspect the neck and slight limitation of neck range of motion; neurologic examination was normal. Diagnosis was obtained with a preoperative biopsy. Marginal excision of the lesion with posterior laminectomy of the axis was performed. The facets were preserved, and no fusion was performed. At last follow-up 2 years after diagnosis and treatment, the patient was asymptomatic with no evidence of local recurrence.

  11. Shot H3837: Darht's First Dual-Axis Explosive Experiment

    NASA Astrophysics Data System (ADS)

    Mendez, Jacob; McNeil, Wendy Vogan; Harsh, James; Hull, Lawrence

    2011-06-01

    Test H3837 was the first explosive shot performed in front of both flash x-ray axes at the Los Alamos Dual Axis Radiographic HydroTest (DARHT) facility. Executed in November 2009, the shot was an explosively-driven metal flyer plate in a series of experiments designed to explore equation-of-state properties of shocked materials. Imaging the initial shock wave traveling through the flyer plate, DARHT Axis II captured the range of motion from the shock front emergence in the flyer to breakout at the free surface; the Axis I pulse provided a perpendicular perspective of the shot at a time coinciding with the third pulse of Axis II. Since the days of the Manhattan Project, penetrating radiography with multiple frames from different viewing angles has remained a high-profile goal at the Laboratory. H3837 is merely the beginning of a bright future for two-axis penetrating radiography.

  12. Misalignment induced aberration off-axis optical system

    NASA Astrophysics Data System (ADS)

    Pang, Zhihai; Fan, Xuewu; Ma, Zhen; Zou, Gangyi

    2016-10-01

    Through introducing transformed pupil vector and shifted center of aberration fields vector into the nodal aberration expansions of an axially symmetric optical system, the aberration expression in third order of an off-axis optical system and misaligned off-axis optical system are detailed. Nodal aberration characteristics of misaligned off-axis optical system are revealed only by analyzing the pupil decentration vector, aberration fields shifted vector and the aberration coefficients of the axially symmetric optical system. Actually, it is well demonstrated that the 3rd spherical aberration, 3rd coma, 3rd astigmatism in a misalignment off-axis system are comparable to the aberrations in a misalignment axially symmetric system. Otherwise it will not only induced constant 3rd spherical aberration but also constant 3rd coma and 3rd astigmatism over the field of view, when aligned an off-axis optical system elements with error axial spacing.

  13. Early clinical results with cortically based pedicle screw trajectory for fusion of the degenerative lumbar spine.

    PubMed

    Glennie, R Andrew; Dea, Nicolas; Kwon, Brian K; Street, John T

    2015-06-01

    This study reviews the outcomes and revision rates of degenerative lumbar fusion surgery using cortical trajectory pedicle screws in lieu of traditional pedicle screw instrumentation. Pedicle screw fixation can be a challenge in patients with low bone mineral density. Wide posterior approaches to the lumbar spine exposing lateral to the facet joints and onto transverse processes causes an additional degree of muscular damage and blood loss not present with a simple laminectomy. A cortical bone trajectory pedicle screw has been proposed as an alternative to prevent screw pullout and decrease the morbidity associated with the wide posterior approach to the spine. We present a series of eight consecutive patients using a cortical bone trajectory instead of traditional pedicle screw fixation for degenerative conditions of the lumbar spine. A retrospective review of our institutional registry data identified eight patients who had cortical screws placed with the assistance of O-arm Stealth navigation (Medtronic Sofamor Danek, Memphis, TN, USA) from 2010-2013. We analyzed the need for revision, the maintenance of reduction and the incidence of screw pullout or breakage. Our review demonstrated that two of eight patients were revised at an average of 12months. The reasons for these revisions were pseudarthrosis and caudal adjacent segment failure. All patients who were revised had frank screw loosening. We present early clinical results of a new technique that has been shown to have a better fixation profile in laboratory testing. Our less than favorable early clinical results should be interpreted with caution and highlight important technical issues which should be considered.

  14. Accuracy of robot-assisted pedicle screw placement for adolescent idiopathic scoliosis in the pediatric population.

    PubMed

    Macke, Jeremy J; Woo, Raymund; Varich, Laura

    2016-06-01

    This is a retrospective review of pedicle screw placement in adolescent idiopathic scoliosis (AIS) patients under 18 years of age who underwent robot-assisted corrective surgery. Our primary objective was to characterize the accuracy of pedicle screw placement with evaluation by computed tomography (CT) after robot-assisted surgery in AIS patients. Screw malposition is the most frequent complication of pedicle screw placement and is more frequent in AIS. Given the potential for serious complications, the need for improved accuracy of screw placement has spurred multiple innovations including robot-assisted guidance devices. No studies to date have evaluated this robot-assisted technique using CT exclusively within the AIS population. Fifty patients were included in the study. All operative procedures were performed at a single institution by a single pediatric orthopedic surgeon. We evaluated the grade of screw breach, the direction of screw breach, and the positioning of the patient for preoperative scan (supine versus prone). Of 662 screws evaluated, 48 screws (7.2 %) demonstrated a breach of greater than 2 mm. With preoperative prone position CT scanning, only 2.4 % of screws were found to have this degree of breach. Medial malposition was found in 3 % of screws, a rate which decreased to 0 % with preoperative prone position scanning. Based on our results, we conclude that the proper use of image-guided robot-assisted surgery can improve the accuracy and safety of thoracic pedicle screw placement in patients with adolescent idiopathic scoliosis. This is the first study to evaluate the accuracy of pedicle screw placement using CT assessment in robot-assisted surgical correction of patients with AIS. In our study, the robot-assisted screw misplacement rate was lower than similarly constructed studies evaluating conventional (non-robot-assisted) procedures. If patients are preoperatively scanned in the prone position, the misplacement rate is further

  15. Morphometric analysis of the seventh cervical vertebra for pedicle screw insertion

    PubMed Central

    Liao, Wensheng; Guo, Liangbing; Bao, Heng; Wang, Limin

    2015-01-01

    Background: Anatomy of the pedicles of the seventh cervical vertebra (C7) at the cervicothoracic junction is different from other cervical vertebrae. Fixation of C7 is required during cervical vertebra and upper thoracic injuries in clinical practice. However, the typical pedicle screw insertion methods may have problems in clinical practice based on the anatomical features of C7. This study is to explore a new pedicle screw insertion technique for C7 and to provide anatomical and radiographic basis for clinical application. Materials and Methods: C7 vertebral specimens from six human cadavers were observed for the relative position between the posterior bony landmark and the pedicle projection. Computed tomography (CT) was performed for 30 patients with cervical spondylosis (26–61 years old, mean age was 42.3 years old). The CT scan data were processed by Mimics 8.1 software for associated parameter measurement. Appropriate screw entry points (Eps) and insertion angles were selected. A total of 12 pedicle screws were inserted and then observed. The six specimens were observed after inserting the screw using this method. The junction site of the middle 1/3 and outer 1/3 segment of line G [The junction between point A (the intersection point of the superior margin of the lamina of C7 and the medial margin of the superior articular process) and point B (the intersection point of the lateral margin of the inferior articular process and the transverse process)] was taken as the Ep. The screw insertion direction parallel horizontally to the upper terminal lamina of C7 and the sagittal angle was between 35° and 45°. Results: Gross and imaging observations revealed that pedicle projection was on the line (line G) between point A (the intersection point of the superior margin of the lamina of C7 and the medial margin of the superior articular process) and point B (the intersection point of the lateral margin of the inferior articular process and the transverse process

  16. Short-Term Results of Transforaminal Lumbar Interbody Fusion Using Pedicle Screw with Cortical Bone Trajectory Compared with Conventional Trajectory

    PubMed Central

    Miyakoshi, Naohisa; Hongo, Michio; Ishikawa, Yoshinori; Kudo, Daisuke; Shimada, Yoichi

    2015-01-01

    Study Design Case-control study. Purpose To evaluate clinical and radiological results of transforaminal lumbar interbody fusion (TLIF) performed with cortical bone trajectory (CBT) pedicle screw insertion with those of TLIF using 'conventional' or percutaneous pedicle screw insertion. Overview of Literature CBT is a new trajectory for pedicle screw insertion in the lumbar spine; clinical and radiological results of TLIF using pedicle screws inserted with CBT are unclear. Methods In total, 26 patients (11 males, 15 females) were enrolled in this retrospective study and divided into three groups: TLIF with pedicle screw insertion by conventional minimally invasive methods via the Wiltse approach (M-TLIF, n=10), TLIF with percutaneous pedicle screw insertion (P-TLIF, n=6), and TLIF with pedicle screw insertion with CBT (CBT-TLIF, n=10). Surgical results and preand postoperative radiological findings were evaluated and compared. Results Intraoperative blood loss was significantly less with CBT-TLIF (p=0.03) than with M-TLIF. Postoperative lordotic angles did not differ significantly among the three groups. Complete fusions were obtained in 10 of 12 levels (83%) with M-TLIF, in seven levels (100%) with P-TLIF, and in 10 of 11 levels (91%) with CBT-TLIF. On postoperative computed tomography, correct positioning was seen in 84.1% of M-TLIF screws, 88.5% of P-TLIF screws, and 90% of CBT-TLIF screws. Conclusions CBT-TLIF resulted in less blood loss and a shorter operative duration than M-TLIF or P-TLIF. Postoperative rates of bone union, maintenance of lordotic angles, and accuracy of pedicle screw positions were similar among the three groups. PMID:26097661

  17. Fretting corrosion behavior of nitinol spinal rods in conjunction with titanium pedicle screws.

    PubMed

    Lukina, Elena; Kollerov, Mikhail; Meswania, Jay; Khon, Alla; Panin, Pavel; Blunn, Gordon W

    2017-03-01

    Untypical corrosion damage including erosions combined with the build-up of titanium oxide as a corrosion product on the surface of explanted Nitinol spinal rods in the areas where it was in contact with titanium pedicle screw head is reported. It was suggested that Nitinol rods might have inferior fretting corrosion resistance compared with that made of titanium or CoCr. Fretting corrosion of Nitinol spinal rods with titanium (Ti6Al4V) pedicle screws were tested in-vitro by conducting a series of potentiostatic measurements of the peak-to-peak values of fretting corrosion current under bending in a 10% solution of calf serum in PBS. The test included Nitinol rods locked in titanium pedicle screws of different designs. Performance of commercially available titanium (Ti6Al4V) and CoCr spinal rods was also investigated for a comparison. Corrosion damage observed after the in-vitro tests was studied using SEM and EDAX analysis and was compared with patterns on Nitinol rods retrieved 12months after initial surgery. Metal ions level was measured in the test media after in-vitro experiments and in the blood and tissues of the patients who had the rods explanted. The results of this study revealed that Nitinol spinal rods locked in Ti pedicle screws are susceptible to fretting corrosion demonstrating higher fretting corrosion current compared with commercially used Ti6Al4V and CoCr rods. On the surface of Nitinol rods after in-vitro tests and on those retrieved from the patients similar corrosion patterns were observed. Improved resistance to fretting corrosion was observed with Nitinol rods in the in-vitro tests where pedicle screws were used with a stiffer locking mechanism. Since the development of the localized corrosion damage might increase the risk of premature fatigue failure of the rods and result in leaching of Ni ions, it is concluded that Nitinol rods should not be used in conjunction with Ti pedicle screws without special protection especially where the

  18. Biomechanical comparison of anatomic trajectory pedicle screw versus injectable calcium sulfate graft-augmented pedicle screw for salvage in cadaveric thoracic bone.

    PubMed

    Derincek, Alihan; Wu, Chunhui; Mehbod, Amir; Transfeldt, Ensor E

    2006-06-01

    Many salvage options for failed thoracic pedicle screws exist including the use of a different trajectory or the augmentation of the screw with polymethylmethacrylate cement. Although polymethylmethacrylate immediately increases the construct stiffness and the pull-out strength, it may cause bone necrosis, toxin relaxation, and/or neural injury. On the other hand, calcium sulfate bone grafts have a high potential for biologic incorporation and no thermal damage effect. In the current study, polyaxial pedicle screws were first inserted with a straightforward approach on both sides in 17 fresh human cadaveric thoracic vertebrae. The maximal insertion torque for each screw was measured and then the pull-out strengths were recorded. Afterward, these pedicle screws were randomly assigned to be replaced either by graft augmentation or by anatomic trajectory technique for salvage. The graft-augmented screws were placed using the previous holes. The maximum insertional torque for each anatomic trajectory screw was measured. Finally, the pull-out strengths of the revision screws were recorded. The mean maximum insertional torque decreased with the anatomic trajectory salvage technique when compared with the straightforward approach, 0.23 versus 0.38 Nm, respectively (P=0.003). The anatomic trajectory revision resulted in decreased pull-out strength when compared with the pull-out strength of the straightforward technique, 297 versus 469 N, respectively (P=0.003). The calcium sulfate graft augmentation increased the pull-out strength when compared with the pull-out strength of the straightforward technique, 680 versus 477 N, respectively (P=0.017). The mean pull-out strength ratio of revised screw to original was 0.71 for anatomic trajectory and 1.8 for graft-augmented screws, a statistically significant difference (P=0.002).

  19. Known-Component 3D-2D Registration for Image Guidance and Quality Assurance in Spine Surgery Pedicle Screw Placement

    PubMed Central

    Uneri, A.; Stayman, J. W.; De Silva, T.; Wang, A. S.; Kleinszig, G.; Vogt, S.; Khanna, A. J.; Wolinsky, J.-P.; Gokaslan, Z. L.; Siewerdsen, J. H.

    2015-01-01

    Purpose To extend the functionality of radiographic/fluoroscopic imaging systems already within standard spine surgery workflow to: 1) provide guidance of surgical device analogous to an external tracking system; and 2) provide intraoperative quality assurance (QA) of the surgical product. Methods Using fast, robust 3D-2D registration in combination with 3D models of known components (surgical devices), the 3D pose determination was solved to relate known components to 2D projection images and 3D preoperative CT in near-real-time. Exact and parametric models of the components were used as input to the algorithm to evaluate the effects of model fidelity. The proposed algorithm employs the covariance matrix adaptation evolution strategy (CMA-ES) to maximize gradient correlation (GC) between measured projections and simulated forward projections of components. Geometric accuracy was evaluated in a spine phantom in terms of target registration error at the tool tip (TREx), and angular deviation (TREϕ) from planned trajectory. Results Transpedicle surgical devices (probe tool and spine screws) were successfully guided with TREx <2 mm and TREϕ<0.5° given projection views separated by at least >30° (easily accommodated on a mobile C-arm). QA of the surgical product based on 3D-2D registration demonstrated the detection of pedicle screw breach with TREx <1 mm, demonstrating a trend of improved accuracy correlated to the fidelity of the component model employed. Conclusions 3D-2D registration combined with 3D models of known surgical components provides a novel method for near-real-time guidance and quality assurance using a mobile C-arm without external trackers or fiducial markers. Ongoing work includes determination of optimal views based on component shape and trajectory, improved robustness to anatomical deformation, and expanded preclinical testing in spine and intracranial surgeries. PMID:26028805

  20. Known-component 3D-2D registration for image guidance and quality assurance in spine surgery pedicle screw placement

    NASA Astrophysics Data System (ADS)

    Uneri, A.; Stayman, J. W.; De Silva, T.; Wang, A. S.; Kleinszig, G.; Vogt, S.; Khanna, A. J.; Wolinsky, J.-P.; Gokaslan, Z. L.; Siewerdsen, J. H.

    2015-03-01

    Purpose. To extend the functionality of radiographic / fluoroscopic imaging systems already within standard spine surgery workflow to: 1) provide guidance of surgical device analogous to an external tracking system; and 2) provide intraoperative quality assurance (QA) of the surgical product. Methods. Using fast, robust 3D-2D registration in combination with 3D models of known components (surgical devices), the 3D pose determination was solved to relate known components to 2D projection images and 3D preoperative CT in near-real-time. Exact and parametric models of the components were used as input to the algorithm to evaluate the effects of model fidelity. The proposed algorithm employs the covariance matrix adaptation evolution strategy (CMA-ES) to maximize gradient correlation (GC) between measured projections and simulated forward projections of components. Geometric accuracy was evaluated in a spine phantom in terms of target registration error at the tool tip (TREx), and angular deviation (TREΦ) from planned trajectory. Results. Transpedicle surgical devices (probe tool and spine screws) were successfully guided with TREx<2 mm and TREΦ <0.5° given projection views separated by at least >30° (easily accommodated on a mobile C-arm). QA of the surgical product based on 3D-2D registration demonstrated the detection of pedicle screw breach with TREx<1 mm, demonstrating a trend of improved accuracy correlated to the fidelity of the component model employed. Conclusions. 3D-2D registration combined with 3D models of known surgical components provides a novel method for near-real-time guidance and quality assurance using a mobile C-arm without external trackers or fiducial markers. Ongoing work includes determination of optimal views based on component shape and trajectory, improved robustness to anatomical deformation, and expanded preclinical testing in spine and intracranial surgeries.

  1. [Surgical correction of post-vertebroplasty kyphosis by pedicle substraction osteotomy. Regarding three cases].

    PubMed

    Bachour, E; Coloma, P; Freitas, E; Messerer, R; Michel, F; Barrey, C

    2016-12-01

    We report a case of three patients treated with pedicle subtraction osteotomy for post-vertebroplasty kyphosis. These patients were initially treated with a vertebroplasty for vertebral fracture (two cases) and spinal lymphoma (1 case). All of these patients worsened progressively on a clinical and radiographic level with progression of the spinal deformity in the form of kyphosis. The surgery consisted of transpedicular osteotomy instrumented at the level of the vertebra cemented with maximum removal of intra-corporeal cement. One of the three patients required a supplementary anterior approach to achieve good quality bone fusion. In all three cases the post-vertebroplasty kyphosis was able to be reduced by at least 50 % emphasizing the feasibility and relevance of the pedicle subtraction osteotomy in a context of cemented vertebra.

  2. Misdiagnosing Absent Pedicle of Cervical Spine in the Acute Trauma Setting

    PubMed Central

    Rossel, Felipe; Nooh, Anas; Jarzem, Peter

    2015-01-01

    Congenital absence of cervical spine pedicle can be easily misdiagnosed as facet dislocation on plain radiographs especially in the acute trauma setting. Additional imaging, including computed tomography (CT)-scan with careful interpretation is required in order to not misdiagnose cervical posterior arch malformation with subsequent inappropriate management. A 39-year-old patient presented to the emergency unit of our university hospital after being trampled by a cow over her back and head followed by loss of consciousness, retrograde amnesia and neck pain. Her initial cervical CT-scan showed possible C5-C6 dislocation, then, it became clear that her problem was a misdiagnosed congenital cervical abnormality. Patient was treated symptomatically without consequences. The congenital absence of a cervical pedicle is a very unusual condition that is easily misdiagnosed. Diagnosis can be accurately confirmed with a CT-scan of the cervical spine. Symptomatic conservative treatment will result in resolution of the symptoms. PMID:26605026

  3. Conjunctival pedicle flap in management of open globe injury with corneal tissue loss.

    PubMed

    Nawani, Nishant; Vazirani, Jayesh; Ojha, Hindukush; Sangwan, Virender S

    2016-03-14

    Accidental injury with scissors led to an open globe injury with iris prolapse and corneal tissue loss in the right eye of a 15-year-old girl. Attempts to suture the laceration normally, led to persistent aqueous leak, and tight suturing was leading to unacceptable distortion of the corneal contour. In the absence of donor tissue or tissue glue, a bulbar conjunctival pedicle flap was used to augment sutures placed without undue tension, and watertight closure of the globe was achieved. Postoperatively, the flap retracted, and excellent tectonic, cosmetic and refractive outcomes were achieved. A conjunctival pedicle flap can be a useful adjunct in the armamentarium of the corneal surgeon while dealing with open globe injuries with corneal tissue loss.

  4. Reconstruction of the distal humerus and elbow joint using a pedicled scapular flap: case report.

    PubMed

    Nthumba, Peter; George, Susan; Jami, Michael; Nyoro, Partick

    2013-06-01

    Loss of elbow function resulting from major bone loss negatively affects quality of life and leaves limited options for reconstruction and restoration of function. To overcome this disabling problem, we reconstructed the distal humerus of a child in a single stage using a scapular flap based on the angular branch of the thoracodorsal artery as a pedicled flap. We also reconstructed the proximal ulna using an iliac crest bone graft with dermal graft interposition arthroplasty, which enabled the restoration of useful elbow function.

  5. Metabolism in pedicled and free TRAM flaps: a comparison using the microdialysis technique.

    PubMed

    Edsander-Nord, Asa; Röjdmark, Jonas; Wickman, Marie

    2002-02-01

    The most common complication in flap surgery is of a circulatory nature. Impeded blood flow leads to altered metabolism in the tissue. Possible metabolic differences between different zones of the transverse rectus abdominis muscle (TRAM) flap were studied and the metabolism of pedicled and free TRAM flaps was compared intraoperatively and postoperatively. The method used was microdialysis, which is a useful technique for following local metabolic changes continuously in various tissues.Twenty-two patients with a pedicled or free TRAM flap were monitored using the microdialysis technique. Two microdialysis catheters were placed subcutaneously in the flap (zone I and zone II), and a third one was placed subcutaneously in the flank to serve as a control. The flaps were monitored intraoperatively and postoperatively for 3 days with repeated analyses of extracellular glucose, lactate, and glycerol concentrations. An additional analysis of pyruvate was performed in some patients to calculate the lactate-to-pyruvate ratio. This study showed that glucose, lactate, and glycerol change in a characteristic way when complete ischemia (i.e., complete inhibition of the blood circulation) is present. A slower stabilization with prolonged metabolic signs of ischemia, such as lower glucose and higher lactate and glycerol concentrations, was seen in zone II compared with zone I, and more pronounced metabolic signs of ischemia, but with a faster recovery, were detected in the free TRAM flap group than in the pedicled TRAM flap group. The fact that the metabolites returned to normal earlier in free flaps than in pedicled flaps may indicate that free TRAM flaps sustain less ischemic damage because of better and more vigorous perfusion.

  6. Management of complications following radiofrequency ablation of a pedicle osteoid osteoma.

    PubMed

    Owen, Joseph W; Bridwell, Keith H; Gilula, Louis A

    2014-06-01

    Radiofrequency ablation (RFA) has become an accepted first-line treatment for osteoid osteomas. Ablation of spinal osteoid osteomas has presented a particular challenge because of their proximity to delicate neural structures. Although many case series have reported multiple successfully treated spinal osteoid osteomas, there are no reports of thermal injury or insufficiency fracture associated with RFA of spinal osteoid osteomas. We report the management of complications that result from treating a spinal osteoid osteoma within a pedicle.

  7. Successfully treated descending necrotizing mediastinitis through thoracotomy using a pedicled muscular serratus anterior flap.

    PubMed

    Haremza, Céline; De Dominicis, Florence; Merlusca, Geoni; Berna, Pascal

    2011-10-01

    Descending necrotizing mediastinitis (DNM) is rare and aggressive. A 68-year-old female with no medical history, was admitted to our institution for cervical cellulitis. After a conventional medical treatment, multiple abscesses of the upper mediastinum appeared on computed tomography (CT) findings. Although two cervicotomies were performed, a new necrotic abscess appeared in the anterior upper and middle mediastinum. An extensive debridement of cellulitis and abscess extended to the pericardium was made by thoracotomy. Middle mediastinum and pericardium were covered and reconstructed by a right pedicled serratus anterior flap. After radical surgery, follow-up was uneventful. Early extensive and complete debridement of cervical and mediastinal collections and irrigation with broad-spectrum intravenous antibiotics is essential. Combined surgery is the best approach in DNM. The use of a pedicled muscular flap helps control the sepsis. In such cases, serratus anterior flap is a flap of choice because it is reliable and always available even in a skinny patient, contrary to omentum. In this life-threatening disease, an early aggressive combined surgery with debridement of all necrotic tissues extended to the pericardium if necessary associated with a pedicled flap is mandatory.

  8. The regenerating antler blastema: the derivative of stem cells resident in a pedicle stump.

    PubMed

    Li, Chunyi; Chu, Wenhui

    2016-01-01

    Antlers of the deer are the only mammalian organs that can fully grow back once lost from their pedicles, hence offer the only opportunity to learn how nature has bestowed mammalian epimorphic regeneration. Investigations have demonstrated that it is the proliferation and differentiation of pedicle periosteal cells (PPCs), but not dedifferentiation of the local differentiated cells, that give rise to the antler blastema. PPCs express key embryonic stem cell markers and can be induced to differentiate into multiple cell lineages, so are termed antler stem cells. Further research has found that PPCs can initiate antler regeneration only when they have interacted with cells of the pedicle skin. Histologically, the process of early antler regeneration resembles that of healing of a mouse leg stump wound. However what sets these two apart is the difference in proliferation potential between the PPCs and the periosteal cells of the long bone. We believe that if we can impart a greater proliferation potential to the long bone periosteal cells, we might be able to achieve the dream of regenerating limbs in mammals.

  9. Effect of the pilot hole preparation on the anchorage of pedicle screws

    PubMed Central

    Abrahão, Gustavo Silva; Rosa, Rodrigo César; Okubo, Rodrigo; Shimano, Antônio Carlos

    2012-01-01

    Objective We evaluated the influence of the diameter and the preparation of the pilot hole on the resistance to the pulling out and the strength when inserting pedicle screws with conical internal diameter. Methods Mechanical experiments were performed with pedicle conical screws of 4.2 mm and 5.2 mm diameter. They were inserted in the vertebral pedicles of swine. The hole was manufactured with a drill and probes with different diameters. Results While testing the 4.2 mm screw, the perforation of holes with measure equal or inferior to the lesser internal diameter of the screw increased the torque and the resistance to pull-out strength. Perforations with different instruments have presented similar results. Perforations with probes allowed the holes manufactured with dimensions superior to the lesser internal diameter of the screw to show similar resistance to that of the perforations with dimensions equal to the lesser internal diameter of the implant, made with probes and drills. Conclusion For 4.2 mm screws, the diameter and the preparation of the hole influence the torque and the resistance. For 5.2 mm screws, there is only influence on the insertion torque. There is no correlation between pulling out strength and insertion torque. Level of Evidence II, Therapeutic Studies - Investigating the Results of Treatment. PMID:24453617

  10. The rate of screw misplacement in segmental pedicle screw fixation in adolescent idiopathic scoliosis

    PubMed Central

    2011-01-01

    Background and purpose There are no reports in the literature on the influence of learning on the pedicle screw insertion. We studied the effect of learning on the rate of screw misplacement in patients with adolescent idiopathic scoliosis treated with segmental pedicle screw fixation. Method We retrospectively evaluated low-dose spine computed tomography of 116 consecutive patients (aged 16 (12–24) years, 94 females) who were operated during 4 periods over 2005–2009 (group 1: patients operated autumn 2005–2006; group 2: 2007; group 3: 2008; and group 4: 2009). 5 types of misplacement were recorded: medial cortical perforation, lateral cortical perforation, anterior cortical perforation of the vertebral body, endplate perforation, and perforation of the neural foramen. Reslts 2,201 pedicle screws were evaluated, with an average of 19 screws per patient. The rate of screw misplacement for the whole study was 14%. The rate of lateral and medial cortical perforation was 7% and 5%. There was an inverse correlation between the occurrence of misplacement and the patient number, i.e. the date of operation (r = –0.35; p < 0.001). The skillfulness of screw insertion improved with reduction of the rate of screw misplacement from 20% in 2005–2006 to 11% in 2009, with a breakpoint at the end of the first study period (34 patients). Interpretation We found a substantial learning curve; cumulative experience may have contributed to continued reduction of misplacement rate. PMID:21189100

  11. Resolution of seven-axis manipulator redundancy: A heuristic issue

    NASA Technical Reports Server (NTRS)

    Chen, I.

    1990-01-01

    An approach is presented for the resolution of the redundancy of a seven-axis manipulator arm from the AI and expert systems point of view. This approach is heuristic, analytical, and globally resolves the redundancy at the position level. When compared with other approaches, this approach has several improved performance capabilities, including singularity avoidance, repeatability, stability, and simplicity.

  12. Inter- and Intra-Observer Reliability of Measurement of Pedicle Screw Breach Assessed by Postoperative CT Scans

    PubMed Central

    Ranade, Ashish; Samdani, Amer F.; Gaughan, John P.; D'Andrea, Linda P.; Betz, Randal R.

    2014-01-01

    Background Pedicle screws are used increasingly in spine surgery. Concerns of complications associated with screw breach necessitates accurate pedicle screw placement. Postoperative CT imaging helps to detect screw malposition and assess its severity. However, accuracy is dependent on the reading of the CT scans. Inter- and intra-observer variability could affect the reliability of CT scans to assess multiple screw types and sites. The purpose of this study was to assess the reliability of multi-observer analysis of CT scans for determining pedicle screw breach for various screw types and sites in patients with spinal deformity or degenerative pathologies. Methods Axial CT scan images of 23 patients (286 screws) were read by four experienced spine surgeons. Pedicle screw placement was considered 'In' when the screw was fully contained and/or the pedicle wall breach was ≤2 mm. 'Out' was defined as a breach in the medial or lateral pedicle wall >2 mm. Intra-class coefficients (ICC) were calculated to assess the inter- and intra-observer reliability. Results Marked inter- and intra-observer variability was noticed. The overall inter-observer ICC was 0.45 (95% confidence limits 0.25 to 0.65). The intra-observer ICC was 0.49 (95% confidence limits 0.29 to 0.69). Underlying spinal pathology, screw type, and patient age did not seem to impact the reliability of our CT assessments. Conclusion Our results indicate the evaluation of pedicle screw breach on CT by a single surgeon is highly variable, and care should be taken when using individual CT evaluations of millimeters of breach as a basis for screw removal. This was a Level III study. PMID:25694925

  13. Pull-out strength of cemented solid versus fenestrated pedicle screws in osteoporotic vertebrae

    PubMed Central

    Leichtle, C. I.; Rothstock, S.; Happel, J.; Walter, F.; Shiozawa, T.; Leichtle, U. G.

    2016-01-01

    Objectives Cement augmentation of pedicle screws could be used to improve screw stability, especially in osteoporotic vertebrae. However, little is known concerning the influence of different screw types and amount of cement applied. Therefore, the aim of this biomechanical in vitro study was to evaluate the effect of cement augmentation on the screw pull-out force in osteoporotic vertebrae, comparing different pedicle screws (solid and fenestrated) and cement volumes (0 mL, 1 mL or 3 mL). Materials and Methods A total of 54 osteoporotic human cadaver thoracic and lumbar vertebrae were instrumented with pedicle screws (uncemented, solid cemented or fenestrated cemented) and augmented with high-viscosity PMMA cement (0 mL, 1 mL or 3 mL). The insertion torque and bone mineral density were determined. Radiographs and CT scans were undertaken to evaluate cement distribution and cement leakage. Pull-out testing was performed with a material testing machine to measure failure load and stiffness. The paired t-test was used to compare the two screws within each vertebra. Results Mean failure load was significantly greater for fenestrated cemented screws (+622 N; p ⩽ 0.001) and solid cemented screws (+460 N; p ⩽ 0.001) than for uncemented screws. There was no significant difference between the solid and fenestrated cemented screws (p = 0.5). In the lower thoracic vertebrae, 1 mL cement was enough to significantly increase failure load, while 3 mL led to further significant improvement in the upper thoracic, lower thoracic and lumbar regions. Conclusion Conventional, solid pedicle screws augmented with high-viscosity cement provided comparable screw stability in pull-out testing to that of sophisticated and more expensive fenestrated screws. In terms of cement volume, we recommend the use of at least 1 mL in the thoracic and 3 mL in the lumbar spine. Cite this article: C. I. Leichtle, A. Lorenz, S. Rothstock, J. Happel, F. Walter, T. Shiozawa, U. G. Leichtle. Pull

  14. Computer navigation versus fluoroscopy-guided navigation for thoracic pedicle screw placement: a meta-analysis.

    PubMed

    Meng, Xiao-Tong; Guan, Xiao-Fei; Zhang, Hai-Long; He, Shi-Sheng

    2016-07-01

    Although application of intraoperative computer navigation technique had been integrated into placement of pedicle screws (PSs) in thoracic fusion for years, its security and practicability remain controversial. The aim of this study is to evaluate the accuracy, the operative time consumption, the amount of intraoperative blood loss, time of pedicle insertion and the incidence of complications of thoracic pedicle screw placement in patients with thoracic diseases such as scoliosis and kyphosis. Pubmed, Web of Knowledge, and Google scholar were searched to identify comparative studies of thoracic pedicle screw placement between intraoperative computer navigation and fluoroscopy-guided navigation. Outcomes of malposition rate, operative time consumption, insertion time, intraoperative blood loss, and the incidence of complications are evaluated. Fourteen articles including 1723 patients and 9019 PSs were identified matching inclusion criteria. The malposition rate was lower (RR: 0.33, 95 % CI: 0.28-0.38, P < 0.01) in computer navigation group than that in fluoroscopy-guided navigation group; the operative time was significantly longer [weighted mean difference (WMD) = 23.66, 95 % CI: 14.74-32.57, P < 0.01] in computer navigation group than that in fluoroscopy-guided navigation group. The time of insertion was shorter (WMD = -1.88, 95 % CI: -2.25- -1.52, P < 0.01) in computer navigation group than that in fluoroscopy-guided navigation group. The incidence of complications was lower (RR = 0. 23, 95 % CI: 0.12-0.46, P < 0.01) in computer navigation group than that in the other group. The intraoperative blood loss was fewer (WMD = -167.49, 95 % CI: -266.39- -68.58, P < 0.01) in computer navigation group than that in the other. In conclusion, the meta-analysis of thoracic pedicle screw placement studies clearly demonstrated lower malposition rate, less intraoperative blood loss, and fewer complications when using computer

  15. Wide field of view telescope

    DOEpatents

    Ackermann, Mark R.; McGraw, John T.; Zimmer, Peter C.

    2008-01-15

    A wide field of view telescope having two concave and two convex reflective surfaces, each with an aspheric surface contour, has a flat focal plane array. Each of the primary, secondary, tertiary, and quaternary reflective surfaces are rotationally symmetric about the optical axis. The combination of the reflective surfaces results in a wide field of view in the range of approximately 3.8.degree. to approximately 6.5.degree.. The length of the telescope along the optical axis is approximately equal to or less than the diameter of the largest of the reflective surfaces.

  16. A Modified Personalized Image-Based Drill Guide Template for Atlantoaxial Pedicle Screw Placement: A Clinical Study

    PubMed Central

    Jiang, Lianghai; Dong, Liang; Tan, Mingsheng; Qi, Yingna; Yang, Feng; Yi, Ping; Tang, Xiangsheng

    2017-01-01

    Background Atlantoaxial posterior pedicle screw fixation has been widely used for treatment of atlantoaxial instability (AAI). However, precise and safe insertion of atlantoaxial pedicle screws remains challenging. This study presents a modified drill guide template based on a previous template for atlantoaxial pedicle screw placement. Material/Methods Our study included 54 patients (34 males and 20 females) with AAI. All the patients underwent posterior atlantoaxial pedicle screw fixation: 25 patients underwent surgery with the use of a modified drill guide template (template group) and 29 patients underwent surgery via the conventional method (conventional group). In the template group, a modified drill guide template was designed for each patient. The modified drill guide template and intraoperative fluoroscopy were used for surgery in the template group, while only intraoperative fluoroscopy was used in the conventional group. Results Of the 54 patients, 52 (96.3%) completed the follow-up for more than 12 months. The template group had significantly lower intraoperative fluoroscopy frequency (p<0.001) and higher accuracy of screw insertion (p=0.045) than the conventional group. There were no significant differences in surgical duration, intraoperative blood loss, or improvement of neurological function between the 2 groups (p>0.05). Conclusions Based on the results of this study, it is feasible to use the modified drill guide template for atlantoaxial pedicle screw placement. Using the template can significantly lower the screw malposition rate and the frequency of intraoperative fluoroscopy. PMID:28301445

  17. Systematic extrahepatic Glissonean pedicle isolation for anatomical liver resection based on Laennec's capsule: proposal of a novel comprehensive surgical anatomy of the liver

    PubMed Central

    Sugioka, Atsushi; Kato, Yutaro; Tanahashi, Yoshinao

    2017-01-01

    Abstract Anatomical liver resection with the Glissonean pedicle isolation is widely approved as an essential procedure for safety and curability. Especially, the extrahepatic Glissonean pedicle isolation without parenchymal destruction should be an ideal procedure. However, the surgical technique has not been standardized due to a lack of anatomical understanding. Herein, we proposed a novel comprehensive surgical anatomy of the liver based on Laennec's capsule that would give a theoretical background to the extrahepatic Glissonean pedicle isolation. Laennec's capsule is the proper membrane that covers not only the entire surface of the liver including the bare area but also the intrahepatic parenchyma surrounding the Glissonean pedicles. Consequently, there exists a gap between the Glissonean pedicle and Laennec's capsule that could be reached extrahepatically and allows us to isolate the extrahepatic Glissonean pedicle without parenchymal destruction systematically. For standardization, it is essential to approach the “six gates” indicated by the “four anatomical landmarks”: the Arantius plate, the umbilical plate, the cystic plate and the Glissonean pedicle of the caudate process (G1c). This novel anatomy would contribute to standardize the surgical techniques of the systematic extrahepatic Glissonean pedicle isolation for anatomical liver resection including laparoscopic or robotic liver resection and to bring innovative changes in hepatobiliary surgery for spreading safe and curable liver resection. PMID:28156078

  18. The structure of pedicle and hard antler bone in the European roe deer (Capreolus capreolus): a light microscope and backscattered electron imaging study

    PubMed Central

    Kierdorf, Uwe; Flohr, Stefan; Gomez, Santiago; Landete-Castillejos, Tomas; Kierdorf, Horst

    2013-01-01

    Deer antlers are deciduous bony structures that develop from permanent frontal outgrowths, the pedicles. While growth and bone architecture of antlers have been studied in greater detail, information on pedicle formation and structure is scarce. The present study provides information on the structure of pedicle and hard antler bone in the European roe deer. A pronounced seasonal variation in pedicle architecture was observed, with high porosity around antler casting and a very compact bone structure during the hard antler stage. These observations suggest a corresponding marked variation also in the biomechanical properties of the pedicles. The seasonally alternating extensive resorption and formation processes make the pedicles of older deer heavily remodeled structures. Pedicles increase in thickness by apposition of primary bone that subsequently becomes replaced by secondary osteons. The antler cortex of roe deer is largely composed of a tubular framework of woven bone trabeculae with some remnants of mineralized cartilage, and primary osteons that have filled in the intertrabecular spaces. Secondary osteons are scarce, denoting little remodeling in antlers, which can be related to their short lifespan. The occurrence of cement lines around primary osteons indicates resorption on the trabecular scaffold prior to infilling of the intertrabecular spaces. The outer cortex showed a higher autofluorescence and a more immature structure than the main cortex, suggesting that it was secondarily formed by periosteal activity. Pedicles and antlers constitute a functional entity, and future histological and/or biomechanical studies should therefore consider both components of the cranial appendages. PMID:23961846

  19. Use of the Composite Pedicled Pectoralis Minor Flap after Resection of Soft Tissue Sarcoma in Reconstruction of the Glenohumeral Joint

    PubMed Central

    van de Sande, Michiel A. J.; Cosker, Tom; McDonnell, Stephen M.; Gibbons, C. L. M. H.; Giele, Henk

    2014-01-01

    The surgical repair of an extensive anterior glenohumeral soft tissue defect is complicated by glenohumeral instability and subsequent significant functional deficit. This surgical note offers a relatively simple reconstruction of the anterior capsule and subscapularis muscle using a pectoralis minor pedicle flap. This reconstruction is supplemented with functional reconstruction of the anterior glenohumeral joint. A conventional deltopectoral approach is utilized and pectoralis minor is freed from its coracoid insertion, released, and mobilized without compromising the pedicle entering from the dorsum and inferior one-third of the muscle. The mobilized pectoralis minor vascular pedicle has sufficient length for the pectoralis minor to be transferred to provide coverage of the anterior shoulder joint even in full external rotation, providing anterior stability. To further improve glenohumeral stability and shoulder function, the pectoralis major muscle can be split with the clavicular part reinserted lateral to the bicipital groove onto the lesser tuberosity replacing subscapularis function while stabilising the glenohumeral joint. PMID:25610683

  20. Preventing postoperative congestion in reverse pedicle digital island flaps when reconstructing composite tissue defects in the fingertip: a patient series.

    PubMed

    Matsuzaki, Hironori; Kouda, Hisao; Yamashita, Haruyoshi

    2012-01-01

    For reconstructing an injured fingertip, a reverse pedicle digital island flap can restore excellent function and appearance. However, postoperative flap congestion may lead to flap necrosis. We tested a method for dissecting the vascular pedicle to prevent congestion and to provide more reliable results. Between August 2002 and December 2010, we reconstructed 14 fingertips in 13 patients (average age, 43 years; range, 24 to 68 years; 9 men). Through a small zigzag incision, the digital artery and a 4-mm-wide subcutaneous venous network were elevated in retrograde fashion to facilitate venous drainage. All flaps healed completely without severe congestion or necrosis. Slight flexion contractures remained in the PIP (mean, 12°) and DIP (mean, 14°) joints. Our procedure is simpler and more reliable than other techniques, such as adding a narrow skin bridge to the pedicle or a venous anastomosis to prevent venous congestion, and it assures the survival of the flap.

  1. Surgical safety of cervical pedicle screw placement with computer navigation system.

    PubMed

    Shimokawa, Nobuyuki; Takami, Toshihiro

    2017-04-01

    Cervical pedicle screw (CPS) may be the biomechanically best system for posterior cervical segmental fixation, but may carry a surgery-related risk. The purpose of this study was to evaluate the safety of CPS placement using computer navigation system for posterior cervical instrumented fixation and discuss its complication avoidance and management. Posterior cervical instrumented fixation using CPS was performed in a total of 128 patients during the period between 2007 and 2015. Intraoperative image guidance was achieved using a preoperative 3D CT-based or an intraoperative 3D CT-based navigation system. A total of 762 CPSs were placed in the spine level of C2 to Th3. The radiological accuracy of CPS placement was evaluated using postoperative CT. Accuracy of CPS placement using a preoperative 3D CT-based navigation system was 93.6 % (423 of 452 screws) in grade 0; the screw was completely contained in the pedicle, and accuracy of CPS placement using an intraoperative 3D CT-based navigation system was a little bit improved to 97.1 % (301 of 310 screws) in grade 0. CPS misplacement (more than half of screw) was 3.3 % (15 of 452 screws) using a preoperative 3D CT-based navigation system, and CPS misplacement (more than half of screw) was 0.6 % (2 of 310 screws) using an intraoperative 3D CT-based navigation system. In total, 38 screws (5.0 %) were found to perforate the cortex of pedicle, although any neural or vascular complications closely associated with CPS placement were not encountered. Twenty nine of 38 screws (76.3 %) were found to perforate laterally, and seven screws (18.4 %) were found to perforate medially. Image-guided CPS placement has been an important advancement to secure the safe surgery, although the use of CPS placement needs to be carefully determined based on the individual pathology.

  2. Pedicle screw placement accuracy of bone-mounted miniature robot system.

    PubMed

    Tsai, Tai-Hsin; Tzou, Rong-Dar; Su, Yu-Feng; Wu, Chieh-Hsin; Tsai, Cheng-Yu; Lin, Chih-Lung

    2017-01-01

    This article describes factors affecting the accuracy of transpedicle screw placements performed with the Renaissance robot-guided system and reviews the relevant literature. Between January 2013 and January 2015, Renaissance robot-guided spinal surgery was performed in 125 patients at Kaohsiung Medical University Hospital in Kaohsiung, Taiwan. The surgeries included 662 transpedicle screw implants and 49 Kirschner wire (K-wire) reimplants performed by intraoperative repositioning. The lead author evaluated the accuracy of all K-wire insertions and classified their accuracy into 3 categories relative to the preoperative plan for transpedicle screw placement. For cases in which screws required repositioning after the registration step, factors affecting pedicle screw placement were determined according to the consensus of 3 experienced spinal surgeons. According to the scheme developed by Kuo et al (PLoS One 2016;11:e0153235), the K-wire placement accuracies before and after repositioning were respectively classified as follows: 76.1% and 77.6% in type I; 12.2% and 17.7% in type IIa; 4.3% and 4.5% in type IIb; 6.4% and 0% in type IIIa; and 1% and 1% in type IIIb. The percentage of screws requiring repositioning due to drilling error was 85.7% (42/49). Comparisons of preoperative and postoperative function showed significantly improved accuracy. This study showed that inaccurate pedicle screw placement mainly results from errors in preoperative planning, mounting, registration, drilling, and robot assembly. Pedicle screw placement using a bone-mounted miniature robot system requires meticulous preoperative planning to minimize these errors.

  3. C1-c2 pedicle screw fixation for treatment of old odontoid fractures.

    PubMed

    Qi, Lei; Li, Mu; Zhang, Shuai; Si, Haipeng; Xue, Jingsong

    2015-02-01

    Nonunion and C1-C2 instability of odontoid fractures usually result from delayed diagnosis and inappropriate treatment. However, the available treatment options for odontoid fractures remain controversial. The authors evaluated the effectiveness of internal screw fixation via the C1 and C2 pedicle in cases of old odontoid fractures. This retrospective study included 21 patients with old odontoid fractures (13 men and 8 women; mean age, 46.5 years; range, 24-69 years). Internal screw fixation via the C1 and C2 pedicle was performed in all patients. Fracture reduction and C1-C2 fusion were assessed with imaging. The neck pain visual analog scale score and cervical spinal cord functional Japanese Orthopaedic Association score (for those who had cervical spinal cord injury) were used to evaluate the effectiveness of treatment. Postoperative complications were recorded. Postoperative imaging showed that the C1-C2 dislocation was satisfactorily repositioned in all patients. Bone fusion was observed 1 year after surgery in all patients. No loosening or breaking of internal fixation occurred. The preoperative neck pain visual analog scale score was 5.9±1.5 and improved significantly to 1.8±0.8 after surgery (P<.001). The Japanese Orthopaedic Association score in patients with cervical spinal injury (n=14) was 9.2±1.9 and also significantly improved to 13.8±1.9 at the last follow-up examination (P<.001), with an average improvement rate of 61.0%. No iatrogenic vertebral artery injury or severe spinal cord injury occurred. Screw fixation via the C1 and C2 pedicle was found to be an effective and safe surgical approach for the treatment of old odontoid fractures with C1-C2 dislocation or instability.

  4. Pedicle screw placement accuracy of bone-mounted miniature robot system

    PubMed Central

    Tsai, Tai-Hsin; Tzou, Rong-Dar; Su, Yu-Feng; Wu, Chieh-Hsin; Tsai, Cheng-Yu; Lin, Chih-Lung

    2017-01-01

    Abstract This article describes factors affecting the accuracy of transpedicle screw placements performed with the Renaissance robot-guided system and reviews the relevant literature. Between January 2013 and January 2015, Renaissance robot-guided spinal surgery was performed in 125 patients at Kaohsiung Medical University Hospital in Kaohsiung, Taiwan. The surgeries included 662 transpedicle screw implants and 49 Kirschner wire (K-wire) reimplants performed by intraoperative repositioning. The lead author evaluated the accuracy of all K-wire insertions and classified their accuracy into 3 categories relative to the preoperative plan for transpedicle screw placement. For cases in which screws required repositioning after the registration step, factors affecting pedicle screw placement were determined according to the consensus of 3 experienced spinal surgeons. According to the scheme developed by Kuo et al (PLoS One 2016;11:e0153235), the K-wire placement accuracies before and after repositioning were respectively classified as follows: 76.1% and 77.6% in type I; 12.2% and 17.7% in type IIa; 4.3% and 4.5% in type IIb; 6.4% and 0% in type IIIa; and 1% and 1% in type IIIb. The percentage of screws requiring repositioning due to drilling error was 85.7% (42/49). Comparisons of preoperative and postoperative function showed significantly improved accuracy. This study showed that inaccurate pedicle screw placement mainly results from errors in preoperative planning, mounting, registration, drilling, and robot assembly. Pedicle screw placement using a bone-mounted miniature robot system requires meticulous preoperative planning to minimize these errors. PMID:28099339

  5. Effect of pedicle fixation combined with 125I seed implantation for metastatic thoracolumbar tumors

    PubMed Central

    Qian, Jiale; Bao, Zhaohua; Zou, Jun; Yang, Huilin

    2016-01-01

    Purpose The aim of this study was to investigate the clinical efficacy of pedicle fixation combined with 125I brachytherapy in treating metastatic thoracolumbar tumors. Patients and methods A retrospective analysis of the clinical data of seven metastatic thoracolumbar tumor patients who received pedicle fixation combined with radioactive 125I seed implantation brachytherapy in our department between January 2009 and December 2013 was performed. The visual analog scale (VAS) for pain and the Karnofsky performance status (KPS) score before the operation and 1, 6, and 12 months after the operation were observed and recorded. The changes in the scores at each time point were compared. Results All the patients underwent a successful operation, without any complications during their hospitalization. All the patients received postoperative follow-up, and the duration of follow-up was 15–50 months, with an average of 32.2 months. One pancreatic cancer patient died of liver failure and hypoproteinemia 28 months post surgery. The VAS scores of patients before the operation and 1, 6, and 12 months after the operation were 7.43±0.98, 2.71±0.49, 3.00±0.82, and 4.29±0.98, respectively; the KPS scores were 52.9±9.5, 84.3±5.3, 75.7±5.3, and 72.9±4.9, respectively. These results suggest that the VAS score at each time point was significantly decreased compared with that before the operation, while the KPS score was significantly increased compared with that before the operation. Both differences had statistical significance (P<0.05). Conclusion As a therapy for advanced malignant tumors with thoracolumbar metastasis, pedicle fixation combined with 125I brachytherapy can effectively relieve short-term pain and improve patient’s quality of life. PMID:27274307

  6. Reconstruction of the Foot and Ankle Using Pedicled or Free Flaps: Perioperative Flap Survival Analysis

    PubMed Central

    Li, Xiucun; Cui, Jianli; Maharjan, Suraj; Lu, Laijin; Gong, Xu

    2016-01-01

    Objective The purpose of this study is to determine the correlation between non-technical risk factors and the perioperative flap survival rate and to evaluate the choice of skin flap for the reconstruction of foot and ankle. Methods This was a clinical retrospective study. Nine variables were identified. The Kaplan-Meier method coupled with a log-rank test and a Cox regression model was used to predict the risk factors that influence the perioperative flap survival rate. The relationship between postoperative wound infection and risk factors was also analyzed using a logistic regression model. Results The overall flap survival rate was 85.42%. The necrosis rates of free flaps and pedicled flaps were 5.26% and 20.69%, respectively. According to the Cox regression model, flap type (hazard ratio [HR] = 2.592; 95% confidence interval [CI] (1.606, 4.184); P < 0.001) and postoperative wound infection (HR = 0.266; 95% CI (0.134, 0.529); P < 0.001) were found to be statistically significant risk factors associated with flap necrosis. Based on the logistic regression model, preoperative wound bed inflammation (odds ratio [OR] = 11.371,95% CI (3.117, 41.478), P < 0.001) was a statistically significant risk factor for postoperative wound infection. Conclusion Flap type and postoperative wound infection were both independent risk factors influencing the flap survival rate in the foot and ankle. However, postoperative wound infection was a risk factor for the pedicled flap but not for the free flap. Microvascular anastomosis is a major cause of free flap necrosis. To reconstruct complex or wide soft tissue defects of the foot or ankle, free flaps are safer and more reliable than pedicled flaps and should thus be the primary choice. PMID:27930679

  7. Treatment strategies for early neurological deficits related to malpositioned pedicle screws in the lumbosacral canal

    PubMed Central

    Du, J-Y.; Wu, J-S.; Wen, Z-Q.

    2016-01-01

    Objectives To employ a simple and fast method to evaluate those patients with neurological deficits and misplaced screws in relatively safe lumbosacral spine, and to determine if it is necessary to undertake revision surgery. Methods A total of 316 patients were treated by fixation of lumbar and lumbosacral transpedicle screws at our institution from January 2011 to December 2012. We designed the criteria for post-operative revision scores of pedicle screw malpositioning (PRSPSM) in the lumbosacral canal. We recommend the revision of the misplaced pedicle screw in patients with PRSPSM = 5′ as early as possible. However, patients with PRSPSM < 5′ need to follow the next consecutive assessment procedures. A total of 15 patients were included according to at least three-stage follow-up. Results Five patients with neurological complications (PRSPSM = 5′) underwent revision surgery at an early stage. The other ten patients with PRSPSM < 5′ were treated by conservative methods for seven days. At three-month follow-up, only one patient showed delayed onset of neurological complications (PRSPSM 7′) while refusing revision. Seven months later, PRSPSM decreased to 3′ with complete rehabilitation. Conclusions This study highlights the significance of consecutively dynamic assessments of PRSPSMs, which are unlike previous implementations based on purely anatomical assessment or early onset of neurological deficits.and also confirms our hypothesis that patients with early neurological complications may not need revision procedures in the relatively broad margin of the lumbosacral canal. Cite this article: X-J. Lin. Treatment strategies for early neurological deficits related to malpositioned pedicle screws in the lumbosacral canal: A pilot study. Bone Joint Res 2016;5:46–51. DOI: 10.1302/2046-3758.52.2000477. PMID:26868892

  8. Three-dimensional Fluoroscopy-based Navigation for the Pedicle Screw Placement in Patients with Primary Invasive Spinal Tumors

    PubMed Central

    Jin, Bo; Su, Yi-Bing; Zhao, Ji-Zong

    2016-01-01

    Background: Although pedicle screw placement (PSP) is a well-established technique for spine surgery, the treatment of patients with primary invasive spinal tumor (PIST) has high surgical risks secondary to destroyed pedicles. Intraoperative three-dimensional fluoroscopy-based navigation (ITFN) system permits safe and accurate instrumentation of the spine with the advantage of obtaining intraoperative real-time three-dimensional images and automatic registration. The aim of this study is to evaluate the feasibility and accuracy of PSP using ITFN system for patients afflicted with PIST in the thoracic spine. Methods: Fifty-one patients diagnosed with PISTs were retrospectively analyzed, and 157 pedicles screws were implanted in 23 patients using the free-hand technique (free-hand group) and 197 pedicle screws were implanted in 28 patients using the ITFN system (ITFN group). Modified classification of Gertzbein and Robbins was used to evaluate the accuracy of PSP, and McCormick classification was applied for assessment of neurological function. Demographic data and factors affecting accuracy of screw insertion were compared using independent t-test while comparison of accuracy of screw insertion between the two groups was analyzed with Chi-square test. Results: Of 51 patients, 39 demonstrated improved neurological status and the other 12 patients reported that symptoms remained the same. In the free-hand group, 145 screws (92.4%) were Grade I, 9 screws (5.7%) were Grade II, and 3 screws (1.9%) were Grade III. In the ITFN group, 192 screws (97.4%) were Grade I, 5 screws (2.6%) were Grade II, and no Grade III screw was detected. Statistical analysis showed that the accuracies of pedicle screws in the two groups are significantly different (χ2 = 4.981, P = 0.026). Conclusions: The treatments of PISTs include total tumor resection and reconstruction of spine stability. The ITFN system provides a high accuracy of pedicle screw placement. PMID:27779161

  9. Three axis attitude control system

    NASA Technical Reports Server (NTRS)

    Studer, Philip A. (Inventor)

    1988-01-01

    A three-axis attitude control system for an orbiting body comprised of a motor driven flywheel supported by a torque producing active magnetic bearing is described. Free rotation of the flywheel is provided about its central axis and together with limited angular torsional deflections of the flywheel about two orthogonal axes which are perpendicular to the central axis. The motor comprises an electronically commutated DC motor, while the magnetic bearing comprises a radially servoed permanent magnet biased magnetic bearing capable of producing cross-axis torques on the flywheel. Three body attitude sensors for pitch, yaw and roll generate respective command signals along three mutually orthogonal axes (x, y, z) which are coupled to circuit means for energizing a set of control coils for producing torques about two of the axes (x and y) and speed control of the flywheel about the third (z) axis. An energy recovery system, which is operative during motor deceleration, is also included which permits the use of a high-speed motor to perform effectively as a reactive wheel suspended in the magnetic bearing.

  10. Bilateral Pedicled Superficial Inferior Epigastric Artery Flap in the Treatment of Hidradenitis Suppurativa

    PubMed Central

    Hoang, Don; Saber, Sepideh; Patel, Ketan; Carey, Joseph

    2016-01-01

    Summary: The authors present a new technique in surgically treating hidradenitis suppurativa (HS), a debilitating skin condition. In HS, surgical treatment is often the best option because of the high recurrence rates despite extensive medical treatment. A commonly successful surgical method is using skin flaps after excision of the affected area. A superficial inferior epigastric artery flap is demonstrated here as a new alternative approach to treating a case of extensive HS of the groin. By using the pedicled superficial inferior epigastric artery flap for groin reconstruction, inguinal HS can be widely excised and reconstructed with minimal donor-site morbidity and a good aesthetic outcome. PMID:27622101

  11. Biomechanical Analysis of a Pedicle Screw-Rod System with a Novel Cross-Link Configuration

    PubMed Central

    Hara, Masahito; Umebayashi, Daisuke; Haimoto, Shoichi; Yamamoto, Yu; Nishimura, Yusuke; Wakabayashi, Toshihiko

    2016-01-01

    Study Design The strength effects of a pedicle screw-rod system supplemented with a novel cross-link configuration were biomechanically evaluated in porcine spines. Purpose To assess the biomechanical differences between a conventional cross-link pedicle screw-rod system versus a novel cross-link instrumentation, and to determine the effect of the cross-links. Overview of Literature Transverse cross-link systems affect torsional rigidity, but are thought to have little impact on the sagittal motion of spinal constructs. We tested the strength effects in pullout and flexion-compression tests of novel cross-link pedicle screw constructs using porcine thoracic and lumbar vertebrae. Methods Five matched thoracic and lumbar vertebral segments from 15 porcine spines were instrumented with 5.0-mm pedicle screws, which were then connected with 6.0-mm rods after partial corpectomy in the middle vertebral body. The forces required for construct failure in pullout and flexion-compression tests were examined in a randomized manner for three different cross-link configurations: un-cross-link control, conventional cross-link, and cross-link passing through the base of the spinous process. Statistical comparisons of strength data were analyzed using Student's t-tests. Results The spinous process group required a significantly greater pullout force for construct failure than the control group (p=0.036). No difference was found between the control and cross-link groups, or the cross-link and spinous process groups in pullout testing. In flexion-compression testing, the spinous processes group required significantly greater forces for construct failure than the control and cross-link groups (p<0.001 and p=0.003, respectively). However, there was no difference between the control and cross-link groups. Conclusions A novel cross-link configuration that features cross-link devices passing through the base of the spinous processes increased the mechanical resistance in pullout and

  12. Role of adipose-derived stromal cells in pedicle skin flap survival in experimental animal models.

    PubMed

    Foroglou, Pericles; Karathanasis, Vasileios; Demiri, Efterpi; Koliakos, George; Papadakis, Marios

    2016-03-26

    The use of skin flaps in reconstructive surgery is the first-line surgical treatment for the reconstruction of skin defects and is essentially considered the starting point of plastic surgery. Despite their excellent usability, their application includes general surgical risks or possible complications, the primary and most common is necrosis of the flap. To improve flap survival, researchers have used different methods, including the use of adipose-derived stem cells, with significant positive results. In our research we will report the use of adipose-derived stem cells in pedicle skin flap survival based on current literature on various experimental models in animals.

  13. Role of adipose-derived stromal cells in pedicle skin flap survival in experimental animal models

    PubMed Central

    Foroglou, Pericles; Karathanasis, Vasileios; Demiri, Efterpi; Koliakos, George; Papadakis, Marios

    2016-01-01

    The use of skin flaps in reconstructive surgery is the first-line surgical treatment for the reconstruction of skin defects and is essentially considered the starting point of plastic surgery. Despite their excellent usability, their application includes general surgical risks or possible complications, the primary and most common is necrosis of the flap. To improve flap survival, researchers have used different methods, including the use of adipose-derived stem cells, with significant positive results. In our research we will report the use of adipose-derived stem cells in pedicle skin flap survival based on current literature on various experimental models in animals. PMID:27022440

  14. Free Microsurgical and Pedicled Flaps for Oncological Mandibular Reconstruction: Technical Aspects and Evaluation of Patient Comorbidities

    PubMed Central

    Hassid, Victor J.; Maqusi, Suhair; Culligan, Emmett; Cohen, Mimis N.; Antony, Anuja K.

    2012-01-01

    Oncologic mandibular reconstruction has changed significantly over the years and continues to evolve with the introduction of newer technologies and techniques. Patient demographic, reconstructive, and complication data were obtained from a prospectively maintained clinical database of patients who underwent head and neck reconstruction at our institution. The free fibular flap is now considered the gold standard for mandibular reconstruction. However, in patients with multiple comorbidities, lengthy procedures may be less optimal and pedicled flaps, with specific modifications, can yield reasonable outcomes. Technical aspects and comorbidity profiles are examined in the oncological mandibular reconstruction cohort. PMID:22550602

  15. A comparative study of pedicle screw fixation in dorsolumbar spine by freehand versus image-assisted technique: A cadaveric study

    PubMed Central

    Agarwal, Archit; Chauhan, Vijendra; Singh, Deepa; Shailendra, Raghuvanshi; Maheshwari, Rajesh; Juyal, Anil

    2016-01-01

    Background: New and expensive technology such as three-dimensional computer assisted surgery is being used for pedicle screw fixation in dorsolumbar spine. Their availability, expenses and amount of radiation exposure are issues in a developing country. On the contrary, freehand technique of pedicle screw placement utilizes anatomic landmarks and tactile palpation without fluoroscopy or navigation to place pedicle screws. The purpose of this study was to analyze and compare the accuracy of freehand and image-assisted technique to place pedicle screws in the dorsolumbar spine of cadavers by an experienced surgeon and a resident. Evaluation was done using dissection of pedicle and computed tomography (CT) imaging. Materials and Methods: Ten cadaveric dorsolumbar spines were exposed by a posterior approach. Titanium pedicle screws were inserted from D5 to L5 vertebrae by freehand and image-assisted technique on either side by an experienced surgeon and a resident. CT was obtained. A blinded radiologist reviewed the imaging. The spines were then dissected to do a macroscopic examination. Screws, having evidence of cortical perforation of more than 2 mm on CT, were considered to be a significant breach. Results: A total of 260 pedicle screws were placed. The surgeon and the resident placed 130 screws each. Out of 130 screws, both of them placed 65 screws each by freehand and image- assisted technique each. The resident had a rate of 7.69% significant medial and 10.76% significant lateral breach with freehand technique while with image-assisted had a rate of 3.07% significant medial and 9.23% significant lateral breach. The expert surgeon had a rate of 6.15% significant medial and 1.53% significant lateral breach with freehand technique while with image-assisted had a rate of 3.07% significant medial and 6.15% significant lateral breach on CT evaluation. Conclusion: Freehand technique is as good as the image-assisted technique. Under appropriate supervision, residents

  16. Vertical axis wind turbine airfoil

    DOEpatents

    Krivcov, Vladimir; Krivospitski, Vladimir; Maksimov, Vasili; Halstead, Richard; Grahov, Jurij Vasiljevich

    2012-12-18

    A vertical axis wind turbine airfoil is described. The wind turbine airfoil can include a leading edge, a trailing edge, an upper curved surface, a lower curved surface, and a centerline running between the upper surface and the lower surface and from the leading edge to the trailing edge. The airfoil can be configured so that the distance between the centerline and the upper surface is the same as the distance between the centerline and the lower surface at all points along the length of the airfoil. A plurality of such airfoils can be included in a vertical axis wind turbine. These airfoils can be vertically disposed and can rotate about a vertical axis.

  17. Canonical Views of Dynamic Scenes

    ERIC Educational Resources Information Center

    Garsoffky, Barbel; Schwan, Stephan; Huff, Markus

    2009-01-01

    The visual recognition of dynamic scenes was examined. The authors hypothesized that the notion of canonical views, which has received strong empirical support for static objects, also holds for dynamic scenes. In Experiment 1, viewpoints orthogonal to the main axis of movement in the scene were preferred over other viewpoints, whereas viewpoints…

  18. Gut Microbiota-brain Axis

    PubMed Central

    Wang, Hong-Xing; Wang, Yu-Ping

    2016-01-01

    Objective: To systematically review the updated information about the gut microbiota-brain axis. Data Sources: All articles about gut microbiota-brain axis published up to July 18, 2016, were identified through a literature search on PubMed, ScienceDirect, and Web of Science, with the keywords of “gut microbiota”, “gut-brain axis”, and “neuroscience”. Study Selection: All relevant articles on gut microbiota and gut-brain axis were included and carefully reviewed, with no limitation of study design. Results: It is well-recognized that gut microbiota affects the brain's physiological, behavioral, and cognitive functions although its precise mechanism has not yet been fully understood. Gut microbiota-brain axis may include gut microbiota and their metabolic products, enteric nervous system, sympathetic and parasympathetic branches within the autonomic nervous system, neural-immune system, neuroendocrine system, and central nervous system. Moreover, there may be five communication routes between gut microbiota and brain, including the gut-brain's neural network, neuroendocrine-hypothalamic-pituitary-adrenal axis, gut immune system, some neurotransmitters and neural regulators synthesized by gut bacteria, and barrier paths including intestinal mucosal barrier and blood-brain barrier. The microbiome is used to define the composition and functional characteristics of gut microbiota, and metagenomics is an appropriate technique to characterize gut microbiota. Conclusions: Gut microbiota-brain axis refers to a bidirectional information network between the gut microbiota and the brain, which may provide a new way to protect the brain in the near future. PMID:27647198

  19. Helical axis stellarator equilibrium model

    SciTech Connect

    Koniges, A.E.; Johnson, J.L.

    1985-02-01

    An asymptotic model is developed to study MHD equilibria in toroidal systems with a helical magnetic axis. Using a characteristic coordinate system based on the vacuum field lines, the equilibrium problem is reduced to a two-dimensional generalized partial differential equation of the Grad-Shafranov type. A stellarator-expansion free-boundary equilibrium code is modified to solve the helical-axis equations. The expansion model is used to predict the equilibrium properties of Asperators NP-3 and NP-4. Numerically determined flux surfaces, magnetic well, transform, and shear are presented. The equilibria show a toroidal Shafranov shift.

  20. Two-axis angular effector

    DOEpatents

    Vaughn, Mark R.; Robinett, III, Rush D.; Phelan, John R.; Van Zuiden, Don M.

    1997-01-21

    A new class of coplanar two-axis angular effectors. These effectors combine a two-axis rotational joint analogous to a Cardan joint with linear actuators in a manner to produce a wider range of rotational motion about both axes defined by the joint. This new class of effectors also allows design of robotic manipulators having very high strength and efficiency. These effectors are particularly suited for remote operation in unknown surroundings, because of their extraordinary versatility. An immediate application is to the problems which arise in nuclear waste remediation.

  1. Viewing angle changeable display

    NASA Astrophysics Data System (ADS)

    Leng, Jinbi; Huang, Ziqiang; Yang, Wenjun; Chen, Xiaoxi

    2010-10-01

    Viewing angle changeable display can change the display viewing angle as needed: In the public place the display could have a narrow viewing angle for privacy, while in the private place the displays could have a wide viewing angle for the convenience of the operation and better viewing experience. This article propose a novel adjustable optical transmission device to realize the viewing angle changes for LCD by using the principle of guest- host effect of liquid crystal. The major technology is to insert a special equipment between the backlight and the LCD, through which the backlight will display either parallel or scattered features to get an either narrow or wide viewing angle. The equipment is an adjustable transmission cell (ATC) which is actually a black G-H LC cell. This ATC is the main focus of our invention. The ATC consists of a polarizer sheet and a special guest-host liquid crystal device filled with the two-phase dye (called as GH-LC in this report), to achieve the viewing angle change in the LCD. When an electrical field charges to the ATC, only the so-called near-axis lights can pass through the ATC within a relatively small angle, while the other scattered lights are absorbed sequentially by GH-LC and the polarizer sheet. On the other hand, when there is no electrical charge to the ATC, the cell behaves like a normal polarizer; and the scattered light can pass through the cell and polarizer in a normal way. This paper describes the principle and structure of the device, applies the electric field on the sample to observe the electro-optical properties, combine the theoretical and experimental research, getting the viewing angle effects of the display.

  2. Treatment of a Femur Nonunion with Microsurgical Corticoperiosteal Pedicled Flap from the Medial Femoral Condyle

    PubMed Central

    Guzzini, Matteo; Guidi, Marco; Civitenga, Carolina; Ferri, Germano; Ferretti, Andrea

    2016-01-01

    Introduction. The vascularized corticoperiosteal flap is harvested from the medial femoral condyle and it is nourished by the articular branch of the descending genicular artery and the superomedial genicular artery. This flap is usually harvested as a free flap for the reconstruction of bone defects at forearm, distal radius, carpus, hand, and recently at lower limb too. Case Report. A 50-year-old Caucasian man referred to our department for hypertrophic nonunion of the distal femur, refractory to the conservative treatments. The first surgical choice was the revision of the nail and the bone reconstruction with a corticoperiosteal pedicled flap from the medial femoral condyle. We considered union to have occurred 3.5 months after surgery when radiographs showed bridging of at least three of the four bony cortices and clinically the patient was able to walk with full weight bearing without any pain. At the last follow-up (25 months), the patient was completely satisfied with the procedure. Discussion. The corticoperiosteal flap allows a faster healing of fractures with a minimal morbidity at the donor site. We suggest that the corticoperiosteal pedicled flap graft is a reliable and effective treatment for distal femur nonunion. PMID:27064589

  3. Elective thoracotomy for pedicle screw removal to prevent severe aortic bleeding

    PubMed Central

    Decker, Sebastian; Omar, Mohamed; Krettek, Christian; Müller, Christian W

    2014-01-01

    We present a case of a 33-year-old female who sustained multiple injuries of her spine, including spinous process fractures of C5 to C7 and a lamina fracture of C6 and C7. Her thoracic spine showed transverse process fractures of T4 to T10, a compression fracture and lamina fracture of T3, spinous process and transverse process fractures of T4 and T5, a rotation injury of T6, as well as a compression fracture of L1. Thirteen months after posterior thoracic spinal instrumentation, a pedicle screw was suspected to be in contact with the aorta, which was proved by computed tomography angiograms. Consequently, implant removal was planned with direct exposure of the aorta in order to allow for immediate repair if needed. So far, studies that compare different techniques to remove pedicle screws that are suspected to penetrate the aorta are missing. However, different techniques have been described in case reports, mainly minimally invasive endovascular techniques vs open techniques such as thoracotomy. PMID:24749121

  4. Secondary Cleft Lip Reconstruction and the Use of Pedicled, Deepithelialized Scar Tissue

    PubMed Central

    Nadjmi, Nasser; Amadori, Sara; Van de Casteele, Elke

    2016-01-01

    Background: The optimal time to create symmetry in a cleft lip is during primary repair; a secondary effort later is more difficult due to potential scarring and possible tissue deficiency of the repaired cleft lip. A plethora of methods for secondary correction have been described that have the goal of constructing the philtral column, ameliorating bad scar results, and augmenting lip volume, for example. Nevertheless, there is no single procedure that yields completely satisfactory results. In addition, the appropriate timing for secondary surgical corrections of the cleft lip is still under debate. Methods: We present a new technique for secondary lip reconstruction of unilateral and bilateral cleft patients using pedicled, de-epithelialized cleft scar tissue as an autologous graft to obtain sustainable lip volume. Our results were evaluated by physicians and patient-parent satisfaction surveys. Results: The esthetic outcomes of 29 patients were assessed using a patient satisfaction questionnaire and a physician survey based on the preoperative and postoperative clinical images. The success of the procedure was evaluated using a 5-point scale. The total scores of both the physician and patient assessments were high, although no correlation was found between the scores. Conclusions: Cleft lip reconstruction using pedicled, deepithelialized scar tissue leads to excellent physician and patient satisfaction scores; this technique can be executed at any patient age and as a secondary repair for any given primary type of cleft disorder. PMID:27826467

  5. Active Pedicle Epithelial Flap Transposition Combined with Amniotic Membrane Transplantation for Treatment of Nonhealing Corneal Ulcers

    PubMed Central

    Zhang, Ting; Wang, Yuexin; Jia, Yanni; Liu, Dongle; Li, Suxia; Shi, Weiyun

    2016-01-01

    Introduction. The objective was to evaluate the efficacy of active pedicle epithelial flap transposition combined with amniotic membrane transplantation (AMT) in treating nonhealing corneal ulcers. Material and Methods. Eleven patients (11 eyes) with nonhealing corneal ulcer who underwent the combined surgery were included. Postoperatively, ulcer healing time was detected by corneal fluorescein staining. Visual acuity, intraocular pressure, surgical complications, and recurrence were recorded. Corneal status was inspected by the laser scanning confocal microscopy and anterior segment optical coherence tomography (AS-OCT). Results. The primary diseases were herpes simplex keratitis (8 eyes), corneal graft ulcer (2 eyes), and Stevens-Johnson syndrome (1 eye). All epithelial flaps were intact following surgery, without shedding or displacement. Mean ulcer healing time was 10.8 ± 3.1 days, with a healing rate of 91%. Vision significantly improved from 1.70 to 0.82 log MAR (P = 0.001). A significant decrease in inflammatory cell infiltration and corneal stromal edema was revealed 2 months postoperatively by confocal microscopy and AS-OCT. Corneal ulcer recurred in 1 eye. None of the patients developed major complications. Conclusion. Active pedicle epithelial flap transposition combined with AMT is a simple and effective treatment for nonhealing corneal ulcers. PMID:27830086

  6. Feasibility study of patient-specific surgical templates for the fixation of pedicle screws.

    PubMed

    Salako, F; Aubin, C-E; Fortin, C; Labelle, H

    2002-01-01

    Surgery for scoliosis, as well as other posterior spinal surgeries, frequently uses pedicle screws to fix an instrumentation on the spine. Misplacement of a screw can lead to intra- and post-operative complications. The objective of this study is to design patient-specific surgical templates to guide the drilling operation. From the CT-scan of a vertebra, the optimal drilling direction and limit angles are computed from an inverse projection of the pedicle limits. The first template design uses a surface-to-surface registration method and was constructed in a CAD system by subtracting the vertebra from a rectangular prism and a cylinder with the optimal orientation. This template and the vertebra were built using rapid prototyping. The second design uses a point-to-surface registration method and has 6 adjustable screws to adjust the orientation and length of the drilling support device. A mechanism was designed to hold it in place on the spinal process. A virtual prototype was build with CATIA software. During the operation, the surgeon places either template on patient's vertebra until a perfect match is obtained before drilling. The second design seems better than the first one because it can be reused on different vertebra and is less sensible to registration errors. The next step is to build the second design and make experimental and simulations tests to evaluate the benefits of this template during a scoliosis operation.

  7. Transforaminal lumbar interbody fusion using unilateral pedicle screws and a translaminar screw

    PubMed Central

    Lee, Sandra; Vaidya, Rahul

    2008-01-01

    Lumbar spinal fusion is advancing with minimally invasive techniques, bone graft alternatives, and new implants. This has resulted in significant reductions of operative time, duration of hospitalization, and higher success in fusion rates. However, costs have increased as many new technologies are expensive. This study was carried out to investigate the clinical outcomes and fusion rates of a low implant load construct of unilateral pedicle screws and a translaminar screw in transforaminal lumbar interbody fusion (TLIF) which reduced the cost of the posterior implants by almost 50%. Nineteen consecutive patients who underwent single level TLIF with this construct were included in the study. Sixteen patients had a TLIF allograft interbody spacer placed, while in three a polyetheretherketone (PEEK) cage was used. Follow-up ranged from 15 to 54 months with a mean of 32 months. A clinical and radiographic evaluation was carried out preoperatively and at multiple time points following surgery. An overall improvement in Oswestry scores and visual analogue scales for leg and back pain (VAS) was observed. Three patients underwent revision surgery due to recurrence of back pain. All patients showed radiographic evidence of fusion from 9 to 26 months (mean 19) following surgery. This study suggests that unilateral pedicle screws and a contralateral translaminar screw are a cheaper and viable option for single level lumbar fusion. PMID:19015896

  8. Designs and Techniques That Improve the Pullout Strength of Pedicle Screws in Osteoporotic Vertebrae: Current Status

    PubMed Central

    Shea, Thomas M.; Laun, Jake; Gonzalez-Blohm, Sabrina A.; Doulgeris, James J.; Lee, William E.; Vrionis, Frank D.

    2014-01-01

    Osteoporosis is a medical condition affecting men and women of different age groups and populations. The compromised bone quality caused by this disease represents an important challenge when a surgical procedure (e.g., spinal fusion) is needed after failure of conservative treatments. Different pedicle screw designs and instrumentation techniques have been explored to enhance spinal device fixation in bone of compromised quality. These include alterations of screw thread design, optimization of pilot hole size for non-self-tapping screws, modification of the implant's trajectory, and bone cement augmentation. While the true benefits and limitations of any procedure may not be realized until they are observed in a clinical setting, axial pullout tests, due in large part to their reproducibility and ease of execution, are commonly used to estimate the device's effectiveness by quantifying the change in force required to remove the screw from the body. The objective of this investigation is to provide an overview of the different pedicle screw designs and the associated surgical techniques either currently utilized or proposed to improve pullout strength in osteoporotic patients. Mechanical comparisons as well as potential advantages and disadvantages of each consideration are provided herein. PMID:24724097

  9. Triggered electromyography for placement of thoracic pedicle screws: is it reliable?

    PubMed

    Samdani, Amer F; Tantorski, Mark; Cahill, Patrick J; Ranade, Ashish; Koch, Stephen; Clements, David H; Betz, Randal R; Asghar, Jahangir

    2011-06-01

    Reliable electromyography (EMG) thresholds for detecting medial breaches in the thoracic spine are lacking, and there is a paucity of reports evaluating this modality in patients with adolescent idiopathic scoliosis (AIS). This retrospective analysis evaluates the ability of triggered EMG to detect medial breaches with thoracic pedicle screws in patients with AIS. We reviewed 50 patients (937 pedicle screws) undergoing posterior spinal fusion (PSF) with intraoperative EMG testing. Postoperative CT scans were used for breach identification, and EMG values were analyzed. There were 47 medial breaches noted with a mean threshold stimulus of 10.2 mA (milliamperes). Only 8/47 breaches stimulated at 2-6 mA. Thirteen of the forty-seven screws tested at an EMG value ≤6 mA and/or a decrease of ≥65% compared with intraosseously placed screws. The sensitivity and positive predictive value for EMG was 0.28 and 0.21. A subanalysis of T10-T12 screws identified six of seven medial breaches. Using guidelines from the current literature, EMG does not appear to be reliable in detecting medial breaches from T2 to T9 but may have some utility from T10 to T12.

  10. Free medial thigh perforator-based flaps: new definition of the pedicle vessels and versatile application.

    PubMed

    Koshima, I; Hosoda, M; Inagawa, K; Moriguchi, T; Orita, Y

    1996-11-01

    The medial thigh flap is a perforator-based flap nourished with septocutaneous or muscle perforators originating from the femoral vessels. To date, 8 patients have been repaired with this flap and extended or connected flaps including this flap: 4 patients with lower leg defects and 4 patients with intraoral and neck defects. The advantages of this flap are (1) several pedicle perforators exist for this flap, which makes possible duplicated vascular anastomoses to establish reliable circulation of the transferred flap; (2) the flap can be extended or connected to other neighboring flaps in the anterior thigh, so that extensively wide defects can be closed in one stage; (3) the great saphenous vein can be simultaneously used as a vein graft or for venous drainage for the flap; (4) the anterior branch of the femoral nerve can be used for sensory potential; and (5) there is minimum morbidity of the donor defect and a large dominant vessel for the leg can be preserved. The suitable indications for this flap are defects after removal of skin cancer in the foot or lower leg and wide defects after resection of head and neck cancer, which can be reconstructed with the flap connected to neighboring skin flaps. The disadvantages of this flap are that it has a small, short vascular pedicle and the bulkiness of the flap's fatty tissue often requires thinning.

  11. Anatomical study of the gastrointestinal tract in free-living axis deer (Axis axis).

    PubMed

    Pérez, W; Erdogan, S; Ungerfeld, R

    2015-02-01

    The macroscopic anatomy of the stomach and intestines of adult axis deer (Axis axis), a cervid species considered intermediate/mixed feeder, was observed and recorded. Nine adult wild axis deers of both sexes were used and studied by simple dissection. The ruminal papillae were distributed unevenly in the overall area of the inner surface of rumen and primarily were more large and abundant within the atrium. The ruminal pillars had no papillae. There was an additional ruminal pillar located between the right longitudinal and right coronary ventral pillars connected to the caudal pillar. No dorsal coronary pillars were found, and the ventral coronary pillars are connected. The reticulum was the third compartment in size, and the maximum height of the reticular crests was 1.0 mm. The Cellulae reticuli were not divided and rarely contained secondary crests. There were no Papillae unguiculiformes. The omasum was the smallest gastric compartment. The abomasum had about twelve spiral plicae, and a small pyloric torus was present. The intraruminal papillation was similar to those species that are characterized by a higher proportion of grass in their natural diet. The finding of the small reticular crests is typical for browser ruminants and was coincident with data reported for other deer. The comparative ratio of the small intestine to the large intestine was 1.69, in terms of length measurements in axis deer and appears below of the 'browser range'. We concluded that the gastrointestinal system of axis deer reflected similar morphological characteristics of the both types of ruminants: browser and grazer, and we consider it as an intermediate feeder.

  12. Three axis velocity probe system

    DOEpatents

    Fasching, George E.; Smith, Jr., Nelson S.; Utt, Carroll E.

    1992-01-01

    A three-axis velocity probe system for determining three-axis positional velocities of small particles in fluidized bed systems and similar applications. This system has a sensor head containing four closely-spaced sensing electrodes of small wires that have flat ends to establish a two axis plane, e.g. a X-Y plane. Two of the sensing electrodes are positioned along one of the axes and the other two are along the second axis. These four sensing electrodes are surrounded by a guard electrode, and the outer surface is a ground electrode and support member for the sensing head. The electrodes are excited by, for example, sinusoidal voltage having a peak-to-peak voltage of up to 500 volts at a frequency of 2 MHz. Capacitive currents flowing between the four sensing electrodes and the ground electrode are influenced by the presence and position of a particle passing the sensing head. Any changes in these currents due to the particle are amplified and synchronously detected to produce positional signal values that are converted to digital form. Using these digital forms and two values of time permit generation of values of the three components of the particle vector and thus the total velocity vector.

  13. Thoracic pedicle subtraction osteotomy in the treatment of severe pediatric deformities.

    PubMed

    Bakaloudis, Georgios; Lolli, Francesco; Di Silvestre, Mario; Greggi, Tiziana; Astolfi, Stefano; Martikos, Konstantinos; Vommaro, Francesco; Barbanti-Brodano, Giovanni; Cioni, Alfredo; Giacomini, Stefano

    2011-05-01

    The traditional surgical treatment of severe spinal deformities, both in adult and pediatric patients, consisted of a 360° approach. Posterior-based spinal osteotomy has recently been reported as a useful and safe technique in maximizing kyphosis and/or kyphoscoliosis correction. It obviates the deleterious effects of an anterior approach and can increase the magnitude of correction both in the coronal and sagittal plane. There are few reports in the literature focusing on the surgical treatment of severe spinal deformities in large pediatric-only series (age <16 years old) by means of a posterior-based spinal osteotomy, with no consistent results on the use of a single posterior-based thoracic pedicle subtraction osteotomy in the treatment of such challenging group of patients. The purpose of the present study was to review our operative experience with pediatric patients undergoing a single level PSO for the correction of thoracic kyphosis/kyphoscoliosis in the region of the spinal cord (T12 and cephalad), and determine the safety and efficacy of posterior thoracic pedicle subtraction osteotomy (PSO) in the treatment of severe pediatric deformities. A retrospective review was performed on 12 consecutive pediatric patients (6 F, 6 M) treated by means of a posterior thoracic PSO between 2002 and 2006 in a single Institution. Average age at surgery was 12.6 years (range, 9-16), whereas the deformity was due to a severe juvenile idiopathic scoliosis in seven cases (average preoperative main thoracic 113°; 90-135); an infantile idiopathic scoliosis in two cases (preoperative main thoracic of 95° and 105°, respectively); a post-laminectomy kypho-scoliosis of 95° (for a intra-medullar ependimoma); an angular kypho-scoliosis due to a spondylo-epiphisary dysplasia (already operated on four times); and a sharp congenital kypho-scoliosis (already operated on by means of a anterior-posterior in situ fusion). In all patients a pedicle screws instrumentation was used

  14. Short Segment versus Long Segment Pedicle Screws Fixation in Management of Thoracolumbar Burst Fractures: Meta-Analysis

    PubMed Central

    2017-01-01

    Posterior pedicle screw fixation has become a popular method for treating thoracolumbar burst fractures. However, it remains unclear whether additional fixation of more segments could improve clinical and radiological outcomes. This meta-analysis was performed to evaluate the effectiveness of fixation levels with pedicle screw fixation for thoracolumbar burst fractures. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Springer, and Google Scholar were searched for relevant randomized and quasirandomized controlled trials that compared the clinical and radiological efficacy of short versus long segment for thoracolumbar burst fractures managed by posterior pedicle screw fixation. Risk of bias in included studies was assessed using the Cochrane Risk of Bias tool. Based on predefined inclusion criteria, Nine eligible trials with a total of 365 patients were included in this meta-analysis. Results were expressed as risk difference for dichotomous outcomes and standard mean difference for continuous outcomes with 95% confidence interval. Baseline characteristics were similar between the short and long segment fixation groups. No significant difference was identified between the two groups regarding radiological outcome, functional outcome, neurologic improvement, and implant failure rate. The results of this meta-analysis suggested that extension of fixation was not necessary when thoracolumbar burst fracture was treated by posterior pedicle screw fixation. More randomized controlled trials with high quality are still needed in the future. PMID:28243383

  15. Pedicle screw placement in the thoracic spine: a comparison study of computer-assisted navigation and conventional techniques.

    PubMed

    Han, Wu; Gao, Zhong-li; Wang, Jin-cheng; Li, Ying-pu; Peng, Xia; Rui, Jiang; Jun, Wei

    2010-08-11

    The technique of computer-assisted pedicle screw installation and its clinical benefit as compared with conventional pedicle screw installation was evaluated. Twenty-two patients had thoracic screw insertion under 3-dimentional computer-assisted navigation (92 screws) and 20 patients under conventional fluoroscopic control (84 screws). The 2 groups were compared for accuracy of screw placement, screw insertion time by postoperative thin-cut computed tomography scans, and statistical analysis. The cortical perforations were graded by 2-mm increments. In the computer group, 88 (95.65%) were grade I (good), 4 (4.35%) were grade II (<2 mm), and 0 were grade III (>2 mm) violations. There were 4 cortical violations (3.57%). In the conventional group, there were 14 cortical violations (16.67%), 70 (83.33%) were grade I (good), 11 (13.1%) were grade II (<2 mm), and 3 (3.57%) were grade III (>2 mm) violations (P<.001). The number (19.57%) of upper thoracic pedicle screws (T1-T4) inserted under 3-dimensional computer-assisted navigation was significantly higher than that (3.57%) by conventional fluoroscopic control (P<.001). Average screw insertion time in the conventional group was more than in the computer group (P<.001). Three-dimensional computer-assisted navigation pedicle screw placement can increase accuracy, reduce surgical time, and be performed safely and effectively at all levels of the thoracic spine, particularly the upper thoracic spine.

  16. Pedicled myocutaneous flap of latissimus dorsi muscle for reconstruction of anterior and middle skull defects: an alternative.

    PubMed

    Seckel, B R; Upton, J; Freidberg, S R; Gilbert, K P; Murray, J E

    1986-01-01

    Three cases are presented demonstrating the use of a pedicled myocutaneous flap of latissimus dorsi muscle to reconstruct large defects of the anterior and middle skull after ablative surgery for carcinoma. This method is proposed as an alternative to reconstruction with a free myocutaneous flap in selected patients.

  17. “Emergency” definitive reconstruction of a necrotising fasciitis thigh debridement defect with a pedicled TRAM flap

    PubMed Central

    Hughes, Tom; Yu, Jonathan T.S.; Wong, Kai Yuen; Malata, Charles M.

    2013-01-01

    INTRODUCTION Necrotising fasciitis (NF) is a rare, severe, rapidly progressing and life-threatening synergistic infection primarily affecting the superficial fascia. A novel method of definitive and aesthetic reconstruction of NF thigh defects by using a pedicled transverse rectus abdominis myocutaneous (TRAM) flap without recourse to temporising skin grafts is presented. PRESENTATION OF CASE A 30-year-old parous woman presented in extremis with fulminant NF of her left anteromedial thigh. Following emergency radical debridement and intensive care stabilisation she was reconstructed 48 h later in a single stage with a pedicled TRAM flap islanded on the ipsilateral deep inferior epigastric vessels. There was excellent contour restoration of her thigh and coverage of the exposed femoral vessels. DISCUSSION Pedicled flaps based on the rectus abdominis muscle provide a large, readily available reconstructive option for correction of substantial regional defects as herein illustrated. They are robust when based on dominant inferior vascular pedicle with a long reach and wide arc of rotation when designed transversely (as a TRAM flap). CONCLUSION This case also illustrates that definitive flap reconstruction of NF can be successfully undertaken in the emergent setting, thereby negating the need for large areas of skin grafting which can lead to contractures with consequent functional impairment and suboptimal aesthetic results. PMID:23548707

  18. Load-bearing evaluation of spinal posterior column by measuring surface strain from lumbar pedicles. An in vitro study.

    PubMed

    Sun, Peidong; Zhao, Weidong; Bi, Zhenyu; Wu, Changfu; Ouyang, Jun

    2012-01-01

    An understanding of the load transfer within spinal posterior column of lumbar spine is necessary to determine the influence of mechanical factors on potential mechanisms of the motion-sparing implant such as artificial intervertebral disc and the dynamic spine stabilization systems. In this study, a new method has been developed for evaluating the load bearing of spinal posterior column by the surface strain of spinal pedicle response to the loading of spinal segment. Six cadaveric lumbar spine segments were biomechanically evaluated between levels L1 and L5 in intact condition and the strain gauges were pasted to an inferior surface of L2 pedicles. Multidirectional flexibility testing used the Panjabi testing protocol; pure moments for the intact condition with overall spinal motion and unconstrained intact moments of ±8 Nm were used for flexion-extension and lateral bending testing. High correlation coefficient (0.967-0.998) indicated a good agreement between the load of spinal segment and the surface strain of pedicle in all loading directions. Principal compressive strain could be observed in flexion direction and tensile strain in extension direction, respectively. In conclusion, the new method seems to be effective for evaluating posterior spinal column loads using pedicles' surface strain data collected during biomechanical testing of spine segments.

  19. A Biomechanical Comparison of Expansive Pedicle Screws for Severe Osteoporosis: The Effects of Screw Design and Cement Augmentation

    PubMed Central

    Tai, Ching-Lung; Tsai, Tsung-Ting; Lai, Po-Liang; Chen, Yi-Lu; Liu, Mu-Yi; Chen, Lih-Huei

    2015-01-01

    Expansive pedicle screws significantly improve fixation strength in osteoporotic spines. However, the previous literature does not adequately address the effects of the number of lengthwise slits and the extent of screw expansion on the strength of the bone/screw interface when expansive screws are used with or without cement augmentation. Herein, four designs for expansive pedicle screws with different numbers of lengthwise slits and different screw expansion levels were evaluated. Synthetic bones simulating severe osteoporosis were used to provide a comparative platform for each screw design. The prepared specimens were then tested for axial pullout failure. Regardless of screw design, screws with cement augmentation demonstrated significantly higher pullout strength than pedicle screws without cement augmentation (p < 0.001). For screws without cement augmentation, solid screws exhibited the lowest pullout strength compared to the four expansive groups (p < 0.01). No significant differences in pullout strength were observed between the expansive screws with different designs (p > 0.05). Taken together, our results show that pedicle screws combined with cement augmentation may greatly increase screw fixation regardless of screws with or without expansion. An increase in both the number of slits and the extent of screw expansion had little impact on the screw-anchoring strength. Cement augmentation is the most influential factor for improving screw pullout strength. PMID:26720724

  20. Control of Pedicle Screw Placement with an Electrical Conductivity Measurement Device: Initial Evaluation in the Thoracic and Lumbar Spine

    PubMed Central

    Schomacher, Markus

    2016-01-01

    Aim. Transpedicular screw fixation is widely used in spinal surgery. But the insertion of pedicle screws can sometimes be challenging because of the variability in pedicle size and the proximity of nerve roots. Methods. We detected intraoperatively the sensitivity for iatrogenic pedicel perforation with a hand-held electronic conductivity measurement device (ECD) that measures electrical conductivity of tissue-medium surrounding the instrument tip. ECD was used to guide the placement of 84 pedicle screws in 15 patients undergoing surgery for tumor or degenerative spinal disease at various spinal levels from T8 to L5. Additionally a CT-scan controlled screw positioning postoperatively. Results. The placement was “correct” (no mediocaudal pedicle wall penetration) for 78 of 84 (92,8%) screws, “suboptimal but acceptable” (0–2 mm penetration) for 4 of 84 (4,8%) screws, and “misplaced” (penetration > 2 mm) for 2 of 84 (2,4%) screws. Conclusion. Although this study was not designed to compare electronic conductivity technique to other guidance methods, such as fluoroscopy or navigation, a convincing “proof of concept” for ECD use in spinal instrumentation could be demonstrated. Advantages include easy handling without time-consuming setup and reduced X-ray exposure. However, further investigations are necessary to evaluate i.a. the economic aspects for this single-use developed instrument. PMID:27699203

  1. Axis of ageing: telomeres, p53 and mitochondria

    PubMed Central

    Sahin, Ergün; DePinho, Ronald A.

    2013-01-01

    Progressive DNA damage and mitochondrial decline are both considered to be prime instigators of natural ageing. Traditionally, these two pathways have been viewed largely in isolation. However, recent studies have revealed a molecular circuit that directly links DNA damage to compromised mitochondrial biogenesis and function via p53. This axis of ageing may account for both organ decline and disease development associated with advanced age and could illuminate a path for the development of relevant therapeutics. PMID:22588366

  2. Stress and the Reproductive Axis

    PubMed Central

    Toufexis, Donna; Rivarola, Maria Angelica; Lara, Hernan; Viau, Victor

    2014-01-01

    There exists a reciprocal relationship between the hypothalamic-pituitary-adrenal (HPA) and the hypothalamic-pituitary-gonadal (HPG) axes wherein the activation of one affects the function of the other and vice versa. For instance, both testosterone and oestrogen modulate the response of the HPA axis, while activation of the stress axis, especially activation that is repeating or chronic, has an inhibitory effect upon oestrogen and testosterone secretion. Alterations in maternal care can produce significant effects on both HPG and HPA physiology and behaviour in the offspring at adulthood. For example, changes in reproductive behaviour induced by altered maternal care may alter the expression of sex hormone receptors like ERα that govern sexual behaviour, and may be particularly important in determining the sexual strategies utilized by females. Stress in adulthood continues to mediate HPG activity in females through activation of a sympathetic neural pathway originating in the hypothalamus and releasing norepinephrine (NE) into the ovary, which produces a non-cyclic anovulatory ovary that develops cysts. In the opposite direction, sex differences and sex steroid hormones regulate the HPA axis. For example, although serotonin (5-HT) has a stimulatory effect on the HPA axis in humans and rodents that is mediated by the 5-HT1A receptor, only male rodents respond to 5-HT1A antagonism to show increased corticosterone responses to stress. Furthermore, oestrogen appears to decrease 5-HT1A receptor function at presynaptic sites, yet increase 5-HT1A receptor expression at postsynaptic sites. These mechanisms could explain heightened stress HPA axis responses in females compared to males. Studies on female rhesus macaques show that chronic stress in socially subordinate female monkeys produces a distinct behavioral phenotype that is largely unaffected by oestrogen, a hypo-responsive HPA axis that is hypersensitive to the modulating effects of oestrogen, and changes in 5-HT

  3. Clinical Comparison of Full and Partial Double Pedicle Flaps with Connective Tissue Grafts for Treatment of Gingival Recession

    PubMed Central

    Ranjbari, Ardeshir; Gholami, Gholam Ali; Amid, Reza; Kadkhodazadeh, Mahdi; Youssefi, Navid; Mehdizadeh, Amir Reza; Aghaloo, Maryam

    2016-01-01

    Statement of the Problem Gingival recession has been considered as the most challenging issue in the field of periodontal plastic surgery. Purpose The purpose of this study was to evaluate the clinical efficacy of root coverage procedures by using partial thickness double pedicle graft and compare it with full thickness double pedicle graft. Materials and Method Eight patients, aged 15 to 58 years including 6 females and 2 males with 20 paired (mirror image) defects with class I and II gingival recession were randomly assigned into two groups. Clinical parameters such as recession depth, recession width, clinical attachment level, probing depth, and width of keratinized tissue were measured at the baseline and 6 months post-surgery. A mucosal double papillary flap was elevated and the respective root was thoroughly planed. The connective tissue graft was harvested from the palate, and then adapted over the root. The pedicle flap was secured over the connective tissue graft and sutured. The surgical technique was similar in the control group except for the prepared double pedicle graft which was full thickness. Results The mean root coverage was 88.14% (2.83 mm) in the test group and 85.7% (2.75 mm) in the control group. No statistical differences were found in the mean reduction of vertical recession, width of recession, or probing depth between the test and control groups. In both procedures, the width of keratinized tissue increased after three months and the difference between the two groups was not statistically significant in this respect. Conclusion Connective tissue with partial and full thickness double pedicle grafts can be successfully used for treatment of marginal gingival recession. PMID:27602394

  4. Electromagnetic Navigation in Minimally Invasive Spine Surgery: Results of a Cadaveric Study to Evaluate Percutaneous Pedicle Screw Insertion

    PubMed Central

    Fraser, Justin F.; Von Jako, Ron; Carrino, John A.

    2008-01-01

    Background This cadaveric study compared efficacy and safety of an electromagnetic (EM) guidance system versus conventional fluoroscopy for percutaneous pedicle screw fixation. As percutaneous pedicle screw fixation becomes increasingly common in spinal surgery, intraoperative imaging systems that maximize efficiency while minimizing radiation exposure and inaccurate trajectories will be progressively more important. Published studies have validated the safety of percutaneous screw fixation using conventional fluoroscopic guidance and frameless optical stereotaxy, though EM guidance systems have not been evaluated for percutaneous placement in the lumbosacral spine. The aim of the study was to evaluate the clinical applicability of an EM system for minimally invasive spine fusion in the lumbosacral spine. Methods Five human cadaveric specimens underwent bilateral lumbosacral percutaneous screw fixation from L1 to S1 using conventional anteroposterior (AP) and lateral fluoroscopic techniques on one side and 2-dimesional (2D) EM guidance on each matching side. Intraoperative efficiency was evaluated, and pedicle, vertebral, and critical breach rates were assessed on postoperative computed tomography (CT). Results Overall mean fluoroscopy time per screw was 58.9 ± 44.7 seconds for conventional fluoroscopy compared to 27.4 ± 13.5 seconds for electromagnetic guidance (P = .0003). Pedicle, vertebral, and critical breach rates for the L1-S1 were 32.1%, 10.7%, and 25.0% for conventional fluoroscopy and 42.8%, 10.7%, and 14.1% for electromagnetic guidance (difference not statistically significant [ns]). In comparing critical breaches in the lumbar spine (L1-L5), there was a significant difference between 2-D EM guidance (0) and CF guidance (6) (P = .02). Conclusions Two-dimensional EM navigation provides a modality for lumbosacral percutaneous pedicle screw fixation that is more efficient and safer than conventional fluoroscopy. This data provides a foundation for further

  5. Study on the efficacies of splenic pedicle transection by using manual manipulation and Endo-GIA procedure for laparoscopic splenectomy.

    PubMed

    Fan, Yong; Liu, Yong-Yong; Wang, Ping; Wang, Chen; Li, Xu-Sheng; Kang, Ying-Xin; Kang, Bo-Xiong; Zhao, Yan-Hui; Zhang, You-Cheng

    2015-01-01

    Laparoscopy splenectomy (LS) was adopted in surgery from 1980s, it has become the main way of exploring for treating spleen diseases. Compared with conventional open surgery, LS has been gradually accepted by physicians and patients due to its advantages, including minimal surgical injury, less intraoperative blood loss, quick postoperative recovery, shorter hospital period, better cosmetic result, less risk of postoperative infections and improved postoperative quality of life Here, we try to investigate the splenic pedicle transection by using Endo-GIA (a linear stapling device) procedure and manual manipulation of secondary splenic pedicle for LS. A retrospective study was conducted on 60 patients who underwent LS. And patients were divided into two groups. 30 patients (group A) received splenic pedicle transection with Endo-GIA procedure and in the other 30 patients (group B) underwent secondary splenic pedicle transection for LS. Perioperative outcome measures of each group were recorded, including operation duration, intraoperative blood loss, postoperative flatus pass time, postoperative complications, drainage duration, hospital cost and length of hospital stay. Surgeries were successfully achieved in 60 patients. The operative duration of group A was significantly shorter than that of group B. However, group B was significantly superior over Endo-GIA group in terms of the intraoperative blood loss, postoperative flatus pass time, drainage duration, length of hospital stay and total cost of hospital stays. No significant differences were observed in postoperative fever, ascites and hyperamylasemia between two groups. Both of these two approaches for LS are safe and feasible. However, compared with Endo-GIA procedure, manual manipulation of secondary splenic pedicle for LS may leading to less intraoperative blood loss, results in less hospital expense, and hence can be widely adopted in clinical practice.

  6. Angle interferometer cross axis errors

    SciTech Connect

    Bryan, J.B.; Carter, D.L.; Thompson, S.L.

    1994-01-01

    Angle interferometers are commonly used to measure surface plate flatness. An error can exist when the centerline of the double comer cube mirror assembly is not square to the surface plate and the guide bar for the mirror sled is curved. Typical errors can be one to two microns per meter. A similar error can exist in the calibration of rotary tables when the centerline of the double comer cube mirror assembly is not square to the axes of rotation of the angle calibrator and the calibrator axis is not parallel to the rotary table axis. Commercial double comer cube assemblies typically have non-parallelism errors of ten milli-radians between their centerlines and their sides and similar values for non-squareness between their centerlines and end surfaces. The authors have developed a simple method for measuring these errors and correcting them by remachining the reference surfaces.

  7. Angle interferometer cross axis errors

    NASA Astrophysics Data System (ADS)

    Bryan, J. B.; Carter, D. L.; Thompson, S. L.

    1994-01-01

    Angle interferometers are commonly used to measure surface plate flatness. An error can exist when the centerline of the double comer cube mirror assembly is not square to the surface plate and the guide bar for the mirror sled is curved. Typical errors can be one to two microns per meter. A similar error can exist in the calibration of rotary tables when the centerline of the double comer cube mirror assembly is not square to the axes of rotation of the angle calibrator and the calibrator axis is not parallel to the rotary table axis. Commercial double comer cube assemblies typically have non-parallelism errors of ten milli-radians between their centerlines and their sides and similar values for non-squareness between their centerlines and end surfaces. The authors have developed a simple method for measuring these errors and correcting them.

  8. The aging reproductive neuroendocrine axis.

    PubMed

    Brann, Darrell W; Mahesh, Virendra B

    2005-04-01

    It is well known that the reproductive system is one of the first biological systems to show age-related decline. While depletion of ovarian follicles clearly relates to the end of reproductive function in females, evidence is accumulating that a hypothalamic defect is critical in the transition from cyclicity to acyclicity. This minireview attempts to present a concise review on aging of the female reproductive neuroendocrine axis and provide thought-provoking analysis and insights into potential future directions for this field. Evidence will be reviewed, which shows that a defect in pulsatile and surge gonadotropin hormone-releasing hormone (GnRH) secretion exists in normal cycling middle-aged female rats, which is thought to explain the significantly attenuated pulsatile and surge luteinizing hormone (LH) secretion at middle-age. Evidence is also presented, which supports the age-related defect in GnRH secretion as being due to a reduced activation of GnRH neurons. Along these lines, stimulation of GnRH secretion by the major excitatory transmitter glutamate is shown to be significantly attenuated in middle-aged proestrous rats. Corresponding age-related defects in other major excitatory regulatory factors, such as catecholamines, neuropeptide Y, and astrocytes, have also been demonstrated. Age-related changes in hypothalamic concentrations of neurotransmitter receptors, steroid receptors, and circulating steroid hormone levels are also reviewed, and discussion is presented on the complex interrelationships of the hypothalamus-pituitary-ovarian (HPO) axis during aging, with attention to how a defect in one level of the axis can induce defects in other levels, and thereby potentiate the dysfunction of the entire HPO axis.

  9. Addressing Stretch Myelopathy in Multilevel Cervical Kyphosis with Posterior Surgery Using Cervical Pedicle Screws

    PubMed Central

    Mahesh, Bijjawara; Vijay, Shekarappa; Arun, Kumar; Srinivasa, Reddy

    2016-01-01

    Study Design Technique description and retrospective data analysis. Purpose To describe the technique of cervical kyphosis correction with partial facetectomies and evaluate the outcome of single-stage posterior decompression and kyphosis correction in multilevel cervical myelopathy. Overview of Literature Kyphosis correction in multilevel cervical myelopathy involves anterior and posterior surgery. With the advent of cervical pedicle screw-rod instrumentation, single-stage posterior kyphosis correction is feasible and can address stretch myelopathy by posterior shortening. Methods Nine patients underwent single-stage posterior decompression and kyphosis correction for multilevel cervical myelopathy using cervical pedicle screw instrumentation from March 2011 to February 2014 and were evaluated preoperatively and postoperatively with modified Japanese Orthopaedic Association (mJOA) scoring and computed tomography scans for radiological measurements. Kyphosis assessment was made with Ishihara curvature index and C2–C7 Cobb's angle. The linear length of the spinal canal and the actual spinal canal length were also evaluated. The average follow-up was 40.56 months (range, 20 to 53 months). Results The average preoperative C2–7 Cobb's angle of 6.3° (1° to 12°) improved to 2° (10° to −9°). Ishihara index improved from −15.8% (−30.5% to −4.7%) to −3.66% (−14.5% to +12.6%). The actual spinal canal length decreased from 83.64 mm (range, 76.8 to 91.82 mm) to 82.68 mm (range, 75.85 to 90.78 mm). The preoperative mJOA score of 7.8 (range, 3 to 11) improved to 15.0 (range, 13 to 17). Conclusions Single-stage posterior decompression and kyphosis correction using cervical pedicle screws for multilevel cervical myelopathy may address stretch myelopathy, in addition to decompression in the transverse plane. However, cervical lordosis was not achieved with this method as predictably as by the anterior approach. The present study shows evidence of mild

  10. [Ageing, genetics and the somatotropic axis].

    PubMed

    Kappeler, Laurent; De Magalhaes Filho, Carlos; Le Bouc, Yves; Holzenberger, Martin

    2006-03-01

    Research on ageing made a big leap forward when genes regulating lifespan were discovered about a decade ago. First isolated by screening the genome of the nematode Caenorhabditis elegans, most of these genes belong to an essential signalling pathway that is highly conserved during animal evolution. Orthologous genes in vertebrate species are the families of genes coding for insulin, insulin-like growth factors (IGF) and related proteins. Intensively studied and well-known for their pivotal roles in proliferation, differentiation, survival and metabolism of most cells, we now discover their multiples functions with respect to the control of longevity and their ability to modulate the cell's responses to oxidative stress, a major cause of cellular and organismal ageing. The activity of IGF signalling in mammals depends on a complex interplay of endocrine signals that together constitute the somatotropic axis. Accordingly, several components of this hormone axis, like growth hormone or growth hormone releasing hormone receptors, regulate efficiently animal longevity, which has been elegantly demonstrated by studies performed in genetically modified mouse models. From this and other work, it becomes increasingly clear that the control of ageing is a question of hormonal regulations. We here present several of these models and discuss the respective contributions of insulin and IGF signalling to the regulation of lifespan. We review data on the Klotho gene that acts on lifespan via surprising and not yet fully understood molecular mechanisms, connecting this new, hormone-like substance to IGF and insulin signalling. We further report recent evidence showing that human lifespan might be controlled in similar ways. Finally, we shed some light on clinical GH treatment in humans, from an endocrinologist's point of view.

  11. Percutaneous pedicle screw for unstable spine fractures in polytraumatized patients: A report of two cases

    PubMed Central

    Tan, Boon Beng; Chan, Chris Yin Wei; Saw, Lim Beng; Kwan, Mun Keong

    2012-01-01

    Unstable spine fractures commonly occur in the setting of a polytraumatized patient. The aim of management is to balance the need for early operative stabilization and prevent additional trauma due to the surgery. Recent published literature has demonstrated the benefits of early stabilization of an unstable spine fracture particularly in patients with higher injury severity score (ISS). We report two cases of polytrauma with unstable spine fractures stabilized with a minimally invasive percutaneous pedicle screw instrumentation system as a form of damage control surgery. The patients had good recovery from the polytrauma injuries. These two cases illustrate the role of minimally invasive stabilization, its limitations and technical pitfalls in the management of unstable spine fractures in the polytrauma setting as a form of damage control surgery. PMID:23325978

  12. “United Pedicle Flap” for management of multiple gingival recessions

    PubMed Central

    Chopra, Aditi; Sivaraman, Karthik; Bhat, Subraya Giliyar

    2016-01-01

    Numerous surgical procedures have evolved and are being modified with time to treat gingival recession by manipulating gingival or mucosal tissues in various ways. However, the decision to choose the most appropriate technique for a given recession site still remains a challenging task for clinicians. Mucogingival deformities such as shallow vestibule, frenal pull, or inadequate attached gingiva complicate the decision and limit the treatment options to an invasive procedure involving soft tissue grafts. The situation is further comprised if there is a nonavailability of adequate donor tissue and patients' unwillingness for procedures involving a second surgical site. In such situations, the recession either remains untreated or has poor treatment outcomes. This case report presents a modified pedicle graft technique for treatment of multiple gingival recessions with shallow vestibule and inadequate attached gingiva. The technique is a promising therapeutic alternative to invasive surgical procedures such as soft tissue grafts for treatment of multiple gingival recessions. PMID:27563212

  13. Evaluation of the influence of pedicle-lengthening osteotomy on lumbar stability

    PubMed Central

    Gao, Maofeng; Zou, Jun; Zhang, Zhigang; Luo, Zongping; Yang, Huilin

    2016-01-01

    Pedicle-lengthening osteotomy (PLO) is a minimally invasive and effective surgical procedure for lumbar spinal stenosis syndrome. Compared with traditional surgery, PLO can effectively enlarge the spinal canal while minimizing the disruption of posterior anatomical structures of the lumbar vertebra, leading to reduced postoperative perineural scarring adhesion and good clinical outcomes using minimally invasive procedures. However, PLO is still in its early stages, and only a few relevant experimental and clinical studies have been reported. The present study was performed to investigate the influence of PLO on the stability of lumbar vertebrae. The results indicated that PLO can effectively enlarge the spinal canal, and no lumbar spondylolisthesis or other complications occurred in this study. Moreover, this procedure does not significantly affect the stability of the lumbar spine, suggesting a possible clinical application. PMID:27347315

  14. Chest wall reconstruction in thoracoabdominal ectopia cordis: using the pedicled osteomuscular latissimus dorsi composite flap.

    PubMed

    Lampert, Joshua A; Harmaty, Marco; Thompson, Elizabeth Chabner; Sett, Suvro; Koch, R Michael

    2010-11-01

    Ectopia cordis is a rare congenital defect characterized by complete or partial displacement of the heart outside the thoracic cavity. Repair of ectopia cordis can present a reconstructive challenge often requiring a staged approach. Ideally, structural integrity and protection of the heart are restored using autologous tissues capable of growth. In addition, reconstruction of the thorax must proceed without compromise to pulmonary or cardiovascular stability. The following article describes repair of thoracoabdominal ectopia cordis in a patient with pentalogy of Cantrell. Reconstruction of the chest wall was accomplished using a musculoosseus composite flap involving segments of the 9th and 10th ribs and overlying pedicled latissimus dorsi muscle. This is the first report known to the authors of such a repair.

  15. Trans-vastus Intermedius Transfer of the Pedicled Anterolateral Thigh Flap for Posterior Thigh Reconstruction

    PubMed Central

    Batdorf, Niles J.; Lettieri, Salvatore C.

    2013-01-01

    Summary: Proximal, posterior thigh wounds from oncologic or traumatic defects can be difficult wounds to reconstruct if local flap options have been sacrificed during the trauma or oncologic resection. Free flap options to cover these defects are also difficult because of the lack of convenient recipient vessels in the region. The authors present 2 cases (oncologic and traumatic) wherein a myocutaneous anterolateral thigh (ALT) flap was harvested and tunneled from the anterior muscle compartment to the posterior muscle compartment of the thigh through a medially based transmuscular tunnel, decreasing the required pedicle distance to the wound. This technique of transmuscular tunneling of the ALT flap expands the indications and utility of the ALT flap to cover posterior thigh wounds. PMID:25289275

  16. Pedicled Supraclavicular Artery Island Flap Versus Free Radial Forearm Flap for Tongue Reconstruction Following Hemiglossectomy.

    PubMed

    Zhang, Senlin; Chen, Wei; Cao, Gang; Dong, Zhen

    2015-09-01

    This study investigated the tongue function and donor-site morbidity of patients with malignant tumors who had undergone immediate flap reconstruction surgery. Twenty-seven patients who had undergone immediate reconstruction after hemiglossectomy were observed. Twelve patients were reconstructed using the pedicled supraclavicular artery island flap (PSAIF) and 15 patients using the free radial forearm flap (FRFF). Flap survival, speech and swallowing function, and donor-site morbidity at the 6-month follow-up were evaluated. All the flaps were successfully transferred. No obvious complications were found in either the transferred flaps or donor regions. Age, sex, defect extent, speech and swallowing function were comparable between the 2 groups. Donor-site complications were less frequent with PSAIF reconstruction than FRFF reconstruction. The PSAIF is reliable and well suited for hemiglossectomy defect. It has few significant complications, and allows preservation of oral function.

  17. The frenectomy combined with a laterally positioned pedicle graft. Functional and esthetic considerations.

    PubMed

    Miller, P D

    1985-02-01

    In many cases it is necessary to perform a frenectomy to prevent reopening of a midline diastema following closure by orthodontic therapy. Often the loss of the interdental papilla between the maxillary incisors during the classic frenectomy creates an unacceptable esthetic result. A surgical technique combining a frenectomy with a laterally positioned pedicle graft is presented. The interdental papilla is left surgically undisturbed if it is of physiologic size. If it is enlarged, gingivoplasty is performed to reduce it to an appropriate size. Closure across the midline by laterally positioning gingiva and healing by primary intention results in attached gingiva across the midline. This attached gingiva may have a bracing effect and thus aid in preventing orthodontic relapse (reopening of the diastema). Twenty-seven cases were treated. No relapse was found in 24 cases and in 3 cases only minimal relapse was noted (less than 1 mm). The esthetic result is superior to that obtained with the classic frenectomy technique.

  18. A case of nonisland pedicled foot fillet flap for below-knee amputation stump wound: treatment option for compartment syndrome after fibular free flap surgery.

    PubMed

    Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

    2014-02-01

    Despite the frequent use of the fibular free flap, there have been no reports of severe compartment syndrome of the donor leg that necessitated limb amputation. A 66-yr-old man had a fibular osseous free flap transfer from the left leg to the mandible that was complicated by postoperative compartment syndrome. An extensive chronic leg wound resulted, which was treated with multiple debridements and finally with below-knee amputation. Successful coverage of the below-knee amputation stump was accomplished with a nonisland pedicled foot fillet flap. Various foot fillet flaps may be used acutely as a free or an island pedicled flap, but dissection of the vascular pedicle may be difficult in a chronically inflamed wound because of inflammation and adhesions to surrounding tissue. The nonisland pedicled foot fillet flap may be considered as a useful option for treatment of a chronically inflamed stump wound after below-knee amputation.

  19. Mid-Term Results of Computer-Assisted Cervical Pedicle Screw Fixation

    PubMed Central

    Uehara, Masashi; Mukaiyama, Keijiro; Kuraishi, Shugo; Shimizu, Masayuki; Ikegami, Shota; Futatsugi, Toshimasa; Ogihara, Nobuhide; Hashidate, Hiroyuki; Hirabayashi, Hiroki; Kato, Hiroyuki

    2014-01-01

    Study Design A retrospective study. Purpose The present study aimed to evaluate mid-term results of cervical pedicle screw (CPS) fixation for cervical instability. Overview of Literature CPS fixation has widely used in the treatment of cervical spinal instability from various causes; however, there are few reports on mid-term surgical results of CPS fixation. Methods Record of 19 patients who underwent cervical and/or upper thoracic (C2-T1) pedicle screw fixation for cervical instability was reviewed. The mean observation period was 90.2 months. Evaluated items included Japanese Orthopaedic Association (JOA) score and C2-7 lordotic angle before surgery and at 5 years after surgery. Postoperative computerized tomography was used to determine the accuracy of screw placement. Visual analog scale (VAS) for neck pain and radiological evidence of adjacent segment degeneration (ASD) at the 5-year follow-up were also evaluated. Results Mean JOA score was significantly improved from 9.0 points before surgery to 12.8 at 5 years after surgery (p=0.001). The C2-7 lordotic angle of the neutral position improved from 6.4° to 7.8° at 5 years after surgery, but this was not significant. The major perforation rate was 5.0%. There were no clinically significant complications such as vertebral artery injury, spinal cord injury, or nerve root injury caused by any screw perforation. Mean VAS for neck pain was 49.4 at 5 years after surgery. The rate of ASD was 21.1%. Conclusions Our mid-term results showed that CPS fixation was useful for treating cervical instability. Severe complications were prevented with the assistance of a computed tomography-based navigation system. PMID:25558318

  20. Sartorius muscle pedicle iliac bone graft for the treatment of avascular necrosis of femur head.

    PubMed

    Vaishya, Raju; Agarwal, Amit Kumar; Gupta, Nishint; Vijay, Vipul

    2016-08-01

    Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks. All the patients were followed clinically and radiologically at regular intervals. The operated femoral heads, were grouped according to Ficat's staging: 24 in stage IIA (45.3%), 22 in stage IIB (41.5%) and 07 in stage III (13.2%). The average duration of surgery was 85 min (range: 55-130 min). The total duration of follow-up was average 4.2 years (range: 2.2-15 years).The Harris hip score was excellent (>90) in 18 hips (33.96%), good (80-89) in 24 hips (45.28%), fair (70-79) in 9 hips (17%) and poor (<70) in 2 hips (3.7%). AVN of the femoral head is a painful and disabling condition in young adults. Sartorius muscle pedicle bone graft technique allows adequate decompression, re vascularization and osteogenesis of the femur head in Ficat's stage IIa, IIb and III, in young adults. This is an effective and easy technique to adopt with excellent to good results in 80% cases and is associated with only minimal complications.

  1. Sartorius muscle pedicle iliac bone graft for the treatment of avascular necrosis of femur head

    PubMed Central

    Vaishya, Raju; Agarwal, Amit Kumar; Gupta, Nishint; Vijay, Vipul

    2016-01-01

    Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks. All the patients were followed clinically and radiologically at regular intervals. The operated femoral heads, were grouped according to Ficat’s staging: 24 in stage IIA (45.3%), 22 in stage IIB (41.5%) and 07 in stage III (13.2%). The average duration of surgery was 85 min (range: 55–130 min). The total duration of follow-up was average 4.2 years (range: 2.2–15 years).The Harris hip score was excellent (>90) in 18 hips (33.96%), good (80–89) in 24 hips (45.28%), fair (70–79) in 9 hips (17%) and poor (<70) in 2 hips (3.7%). AVN of the femoral head is a painful and disabling condition in young adults. Sartorius muscle pedicle bone graft technique allows adequate decompression, re vascularization and osteogenesis of the femur head in Ficat’s stage IIa, IIb and III, in young adults. This is an effective and easy technique to adopt with excellent to good results in 80% cases and is associated with only minimal complications. PMID:27583161

  2. The Internal Pudendal Artery Perforator Thigh Flap: A New Freestyle Pedicle Flap for the Ischial Region

    PubMed Central

    Goishi, Keiichi; Abe, Yoshiro; Takaku, Mitsuru; Seike, Takuya; Harada, Hiroshi; Nakanishi, Hideki

    2014-01-01

    Background: Recurrence and complication rates of pressure sores are highest in the ischial region, and other donor sites are needed for recurrent pressure sores. The potential of a new freestyle pedicle flap for ischial lesions, an internal pudendal artery perforator (iPap) thigh flap, was examined through anatomical and theoretical analyses and a case series using computed tomography angiography. Methods: The skin flap was designed in the thigh region based on an iPap. The skin perforators were marked with a Doppler probe. One patient underwent computed tomography angiography with fistulography to identify the damage to or effects on the pedicle vessels of the flap. Debridement of ischial lesions and flap elevation were performed in the jackknife position. Results: The iPap thigh flaps were performed in 5 patients, 4 with ischial pressure sores and 1 with calcinosis cutis of the ischial region. The width and length of the flaps ranged from 5 to 8 cm (mean, 6.6 cm) and 10 to 17 cm (mean, 12.6 cm), respectively. Three patients underwent partial osteotomy of the ischial bone. No complications, including flap necrosis or wound dehiscence of the donor and reconstructed sites, were observed. Conclusions: The perforator vessels of the internal pudendal artery are very close to the ischial tuberosity. Blood flow to the flap is reliable when careful debridement of the pressure sore is performed. The iPap thigh flap is a new option for soft-tissue defects in the ischial region, including ischial pressure sores. PMID:25289335

  3. Fluoroscopy-guided pedicle screw accuracy with a mini-open approach: a tomographic evaluation of 470 screws in 125 patients

    PubMed Central

    Soriano-Sánchez, José Antonio; Gutiérrez-Partida, Carlos Francisco; Ramírez-Barrios, Luis Rodolfo; Ortíz-Leyva, Ramses Uriel; Rodríguez-García, Manuel; Sánchez-Escandón, Oscar

    2015-01-01

    Background Transpedicular screws are currently placed with open free hand and minimally invasive techniques assisted with either fluoroscopy or navigation. Screw placement accuracy had been investigated with several methods reaching accuracy rates from 71.9% to 98.8%. The objective of this study was to assess the accuracy and safety for 2-D fluoroscopy-guided screw placement assisted with electrophysiological monitoring and the inter-observer agreement for the breach classification. Methods A retrospective review was performed on 125 consecutive patients who underwent minimally invasive transforaminal lumbar interbody fusion and transpedicular screws placement between the levels of T-12 and S-1. Screw accuracy was evaluated using a postoperative computed tomography by three independent observers. Pedicle breach was documented when there was a violation in any direction of the pedicle. Inter-observer agreement was assessed with the Kappa coefficient. Results A total of 470 transpedicular screws were evaluated between the levels of T-12 and S-1. In 57 patients the instrumentation was bilateral and in 68 unilateral. A substantial degree of agreement was found between the observers AB (κ=0.769) and A-C (κ=0.784) and almost perfect agreement between observers B-C (κ=0.928). There were a total of 427.33 (90.92%) screws without breach, 39.33 (8.37%) minor breach pedicles and 3.33 (0.71%) major breach pedicles. The pedicle breach rate was 9.08% Trajectory pedicle breach percentages were as follows: minor medial pedicle breach 4.68%, minor lateral pedicle breach 3.47%, minor inferior pedicle breach 0.22%, and major medial breach 0.70%. No intraoperative instrumentation-related or postoperative clinical complications were encountered and no surgical revision was needed. Conclusions Our study demonstrated a high accuracy (90.2%) for 2-D fluoroscopy-guided pedicle screw using electromonitoring. Only 0.71% of the 470 screws had a major breach. Knowing the radiological spine

  4. Io's Volcanoes: Possible Influence on Spin Axis

    NASA Astrophysics Data System (ADS)

    Stoddard, P. R.; Jurdy, D. M.

    2002-03-01

    Massive outpourings of lava in short intervals could cause an instability in Io's rotation and a reorientation of its spin axis. The volcanos and mountains exhibit a complementary distribution, with the maximum principal inertia axis for volcanos close to the position of the rotation axis.

  5. The Radical Axis: A Motion Study

    ERIC Educational Resources Information Center

    McGivney, Ray; McKim, Jim

    2006-01-01

    Interesting problems sometimes have surprising sources. In this paper we take an innocent looking problem from a calculus book and rediscover the radical axis of classical geometry. For intersecting circles the radical axis is the line through the two points of intersection. For nonintersecting, nonconcentric circles, the radical axis still…

  6. Heterotopic ossification in the submental triangle remote from the vascular pedicle after reconstruction with a fibular free flap: a previously unreported complication.

    PubMed

    Panaretou, E; Blythe, J N St J; Conti, M; Brennan, P A

    2016-05-01

    Fibular free flaps are routinely used to reconstruct segmental mandibular defects after resection. While ossification of the vascular pedicle is uncommon but well reported, to our knowledge, heterotopic ossification remote from the pedicle has not previously been described. We report a case in which this occurred. It serves as a reminder that bony, hard lumps in the neck can present years after reconstruction with a fibular flap.

  7. Relative effectiveness of electrically- vs mechanically-elicited EMGs in detecting pedicle wall perforation and surgically-induced nerve root damage.

    PubMed

    Kobara, N; Owen, J H; Kostuik, J; Huckell, C; Tooke, S M

    2000-02-01

    Electrical stimulation of a pedicle hole and screw with recording EMGs from the lower extremities has been used as an indicator in detecting perforations of the pedicle. Mechanically-elicited EMGs are reported to be sensitive to mechanical irritation of nerve roots. This study analyzed the sensitivity of the data elicited by two EMG monitoring methods in the presence of a neurologic deficit caused by a malpositioned screw to determine the relative effectiveness of electrically- vs mechanically-elicited EMGs in detecting pedicle wall perforations and nerve root damage in patients undergoing spinal surgery utilizing transpedicular instrumentation. One hundred and four surgeries were monitored using the two EMG methods. Six hundred and fifty-four pedicle holes were prepared and 650 placed pedicle screws were electrically tested. Mechanically-elicited EMGs were monitored from a total of 618 muscles. Electrically-elicited EMGs showed a 62% true-positive rate and a 0.2% false-negative rate in detecting pedicle wall perforations. None of the patients who initially demonstrated abnormal electrically-elicited EMGs demonstrated any post-operative neurologic problems due to an incorrect screw placement. Only one patient who had abnormal mechanically-elicited EMGs during the procedures related to instrumentation developed new L4 radiculopathy immediately post-operatively which was consistent with the level of mechanically-elicited EMGs. Mechanically-elicited EMGs showed a 100% true-positive rate for nerve root irritation and a 3.5% false-negative rate in detecting pedicle wall perforations by malpositioned screw. In conclusion, although mechanically-elicited EMGs were an insensitive technique in detecting a perforation of the pedicle, mechanically-elicited EMGs were more beneficial than electrically-elicited EMGs in detecting the risk of nerve root irritation.

  8. AxiSketcher: Interactive Nonlinear Axis Mapping of Visualizations through User Drawings.

    PubMed

    Kwon, Bum Chul; Kim, Hannah; Wall, Emily; Choo, Jaegul; Park, Haesun; Endert, Alex

    2017-01-01

    Visual analytics techniques help users explore high-dimensional data. However, it is often challenging for users to express their domain knowledge in order to steer the underlying data model, especially when they have little attribute-level knowledge. Furthermore, users' complex, high-level domain knowledge, compared to low-level attributes, posits even greater challenges. To overcome these challenges, we introduce a technique to interpret a user's drawings with an interactive, nonlinear axis mapping approach called AxiSketcher. This technique enables users to impose their domain knowledge on a visualization by allowing interaction with data entries rather than with data attributes. The proposed interaction is performed through directly sketching lines over the visualization. Using this technique, users can draw lines over selected data points, and the system forms the axes that represent a nonlinear, weighted combination of multidimensional attributes. In this paper, we describe our techniques in three areas: 1) the design space of sketching methods for eliciting users' nonlinear domain knowledge; 2) the underlying model that translates users' input, extracts patterns behind the selected data points, and results in nonlinear axes reflecting users' complex intent; and 3) the interactive visualization for viewing, assessing, and reconstructing the newly formed, nonlinear axes.

  9. A preliminary study of reliability of impedance measurement to detect iatrogenic initial pedicle perforation (in the porcine model).

    PubMed

    Bolger, Ciaran; Carozzo, C; Roger, T; McEvoy, Linda; Nagaria, Jabir; Vanacker, Gerard; Bourlion, Maurice

    2006-03-01

    Accidental perforation of the vertebral pedicle wall is a well-known complication associated with standard approach of pedicle screw insertion. Depending on detection criteria, more than 20% of screws are reported misplaced. Serious clinical consequences, from dysesthesia to paraplegia, although not common, may result from these misplaced screws. Many techniques have been described to address this issue such as somatosensory evoked potentials, electromyography, surgical navigation, etc. Each of these techniques presents advantages and drawbacks, none is simple and ergonomic. A new drilling tool was evaluated which allows for instant detection of pedicle perforation by emission of variable beeps. This new device is based on two original principles: the device is integrated in the drilling or screwing tool, the technology allows real-time detection of perforation through two independent parameters, impedance variation and evoked muscular contractions. A preliminary animal study was conducted to assess the safety and efficacy of this system based upon electrical conductivity. A total of 168 manual pedicle drillings followed by insertion of implants were performed in 11 young porcine lumbar and thoracic spines. The presence or absence of perforation detection, which defines the reliability of the device, was correlated with necropsic examination of the spines. Using this protocol the device demonstrated 100% positive predictive value, 96% negative predictive value, 100% specificity, and 97% sensitivity. Of 168 drillings there were three (1.79%) false-negatives, leading to a minor effraction, cranially in the intervertebral disks, nine (5.36%) screw threads breaching the vertebral cortex when inserting screws, although preparation of the holes did not indicate any perforation, 34 (36%) breaches detected by the instrument and not detected by the surgeon. These results confirm that the impedance variation detection capability of this device offers a simple and effective

  10. Triple axis and spins spectrometers

    SciTech Connect

    Trevino, S.F.

    1993-01-01

    In the paper are described the triple axis and spin polarized inelastic neutron scattering (SPINS) spectrometers which are installed at the NIST Cold Neutron Research Facility (CNRF). The general principle of operation of these two instruments is described in sufficient detail to allow the reader to make an informed decision as to their usefulness for his needs. However, it is the intention of the staff at the CNRF to provide the expert resources for their efficient use in any given situation. Thus, the work is not intended as a user manual but rather as a guide into the range of applicability of the two instruments.

  11. A Novel Patient-Specific Drill Guide Template for Pedicle Screw Insertion into the Subaxial Cervical Spine Utilizing Stereolithographic Modelling: An In Vitro Study

    PubMed Central

    Delgado, Giorgio De Guzman; Grozman, Samuel Arsenio Munoz

    2017-01-01

    Study Design Cadaveric study. Purpose The purpose of this study was to assess the accuracy and feasibility of cervical pedicle screw (CPS) insertion into the subaxial cervical spine placed using a patient-specific drill guide template constructed from a stereolithographic model. Overview of Literature CPS fixation is an invaluable tool for posterior cervical fixation because of its biomechanical advantages. The major drawback is its narrow corridor that allows very little clearance for neural and vascular injuries. Methods Fifty subaxial pedicles of the cervical vertebrae from five cadavers were scanned into thin slices using computed tomography (CT). Digital imaging and communications in medicine images of the cadaver spine were digitally processed and printed to scale as a three-dimensional (3D) model. Drill guide templates were manually moulded over the 3D-printed models incorporating pins inserted in the pedicles. The drill guide templates were used for precise placement of the drill holes in the pedicles of cadaveric specimens for pedicle screw fixation. Results The instrumented cadaveric spines were subjected to CT to assess the accuracy of our pedicle placement by an external observer. Our patient-specific drill guide template had an accuracy of 94%. Conclusions The use of a patient-specific drill guide constructed using stereolithography improved the accuracy of CPS placement in a cadaveric model. PMID:28243363

  12. Decisive factor in increase of loading at adjacent segments after lumbar fusion: operative technique, pedicle screws, or fusion itself: biomechanical analysis using finite element

    NASA Astrophysics Data System (ADS)

    Park, Joon-Hee; Kim, Ho-Joong; Kang, Kyoung-Tak; Kim, Ka-Yeon; Chun, Heoung-Jae; Moon, Seong-Hwan; Lee, Hwan-Mo

    2009-12-01

    The aim of this study is to investigate the change in biomechanical milieu following removal of pedicle screws or removal of spinous process with posterior ligament complex in instrumented single level lumbar arthrodesis. We developed and validated a finite element model (FEM) of the intact lumbar spine (L2-4). Four scenarios of L3-4 lumbar fusion were simulated: posterolateral fusion (PLF) at L3-4 using pedicle screw system with preservation of PLC (Pp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system with preservation of PLC (Pp WoP), L3-4 using pedicle screw system without preservation PLC (Sp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system without preservation of PLC (Sp WoP). For these models, we investigated the range of motion and maximal Von mises stress of disc in all segments under various moments. All fusion models demonstrated increase in range of motion at adjacent segments compared to the intact model.For the four fusion models, the WiP model s P had the largest increase in range of motion at each adjacent segment. This study demonstrated that removal of pedicle screw system and preservation of PLC after complete lumbar spinal fusion could reduce the stress of adjacent segments synergistically and might have beneficial effects in preventing ASD.

  13. Decisive factor in increase of loading at adjacent segments after lumbar fusion: operative technique, pedicle screws, or fusion itself: biomechanical analysis using finite element

    NASA Astrophysics Data System (ADS)

    Park, Joon-Hee; Kim, Ho-Joong; Kang, Kyoung-Tak; Kim, Ka-yeon; Chun, Heoung-Jae; Moon, Seong-Hwan; Lee, Hwan-Mo

    2010-03-01

    The aim of this study is to investigate the change in biomechanical milieu following removal of pedicle screws or removal of spinous process with posterior ligament complex in instrumented single level lumbar arthrodesis. We developed and validated a finite element model (FEM) of the intact lumbar spine (L2-4). Four scenarios of L3-4 lumbar fusion were simulated: posterolateral fusion (PLF) at L3-4 using pedicle screw system with preservation of PLC (Pp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system with preservation of PLC (Pp WoP), L3-4 using pedicle screw system without preservation PLC (Sp WiP), L3-4 lumbar posterolateral fusion state after removal of pedicle screw system without preservation of PLC (Sp WoP). For these models, we investigated the range of motion and maximal Von mises stress of disc in all segments under various moments. All fusion models demonstrated increase in range of motion at adjacent segments compared to the intact model.For the four fusion models, the WiP model s P had the largest increase in range of motion at each adjacent segment. This study demonstrated that removal of pedicle screw system and preservation of PLC after complete lumbar spinal fusion could reduce the stress of adjacent segments synergistically and might have beneficial effects in preventing ASD.

  14. Flexible helical-axis stellarator

    DOEpatents

    Harris, Jeffrey H.; Hender, Timothy C.; Carreras, Benjamin A.; Cantrell, Jack L.; Morris, Robert N.

    1988-01-01

    An 1=1 helical winding which spirals about a conventional planar, circular central conductor of a helical-axis stellarator adds a significant degree of flexibility by making it possible to control the rotational transform profile and shear of the magnetic fields confining the plasma in a helical-axis stellarator. The toroidal central conductor links a plurality of toroidal field coils which are separately disposed to follow a helical path around the central conductor in phase with the helical path of the 1=1 winding. This coil configuration produces bean-shaped magnetic flux surfaces which rotate around the central circular conductor in the same manner as the toroidal field generating coils. The additional 1=1 winding provides flexible control of the magnetic field generated by the central conductor to prevent the formation of low-order resonances in the rotational transform profile which can produce break-up of the equilibrium magnetic surfaces. Further, this additional winding can deepen the magnetic well which together with the flexible control provides increased stability.

  15. Stress and the HPA Axis

    PubMed Central

    Stephens, Mary Ann C.; Wand, Gary

    2012-01-01

    Stress has long been suggested to be an important correlate of uncontrolled drinking and relapse. An important hormonal response system to stress—the hypothalamic–pituitary–adrenal (HPA) axis—may be involved in this process, particularly stress hormones known as glucocorticoids and primarily cortisol. The actions of this hormone system normally are tightly regulated to ensure that the body can respond quickly to stressful events and return to a normal state just as rapidly. The main determinants of HPA axis activity are genetic background, early-life environment, and current life stress. Alterations in HPA axis regulation are associated with problematic alcohol use and dependence; however, the nature of this dysregulation appears to vary with respect to stage of alcohol dependence. Much of this research has focused specifically on the role of cortisol in the risk for, development of, and relapse to chronic alcohol use. These studies found that cortisol can interact with the brain’s reward system, which may contribute to alcohol’s reinforcing effects. Cortisol also can influence a person’s cognitive processes, promoting habit-based learning, which may contribute to habit formation and risk of relapse. Finally, cortisol levels during abstinence may be useful clinical indicators of relapse vulnerability in alcohol-dependent people. PMID:23584113

  16. Gut microbiota-bone axis.

    PubMed

    Villa, Christopher R; Ward, Wendy E; Comelli, Elena M

    2017-05-24

    The gut microbiota (GM) is an important regulator of body homeostasis, including intestinal and extra-intestinal effects. This review focuses on the GM-bone axis, which we define as the effect of the gut-associated microbial community or the molecules they synthesize, on bone health. While research in this field is limited, findings from preclinical studies support that gut microbes positively impact bone mineral density and strength parameters. Moreover, administration of beneficial bacteria (probiotics) in preclinical models has demonstrated higher bone mineralization and greater bone strength. The preferential bacterial genus that has shown these beneficial effects in bone is Lactobacillus and thus lactobacilli are among the best candidates for future clinical intervention trials. However, their effectiveness is dependent on stage of development, as early life constitutes an important time for impacting bone health, perhaps via modulation of the GM. In addition, sex-specific difference also impacts the efficacy of the probiotics. Although auspicious, many questions regarding the GM-bone axis require consideration of potential mechanisms; sex-specific efficacy; effective dose of probiotics; and timing and duration of treatment.

  17. Cortical bone trajectory screws placement via pedicle or pedicle rib unit in the pediatric thoracic spine (T9-T12): A 2-dimensional multiplanar reconstruction study using computed tomography.

    PubMed

    Xuan, Jun; Chen, Jian; He, Hui; Jin, Hai-Ming; Zhang, Di; Wu, Yao-Sen; Tian, Nai-Feng; Wang, Xiang-Yang

    2017-02-01

    Thoracic cortical bone trajectory (CBT) screw fixation can maximize the thread contact with cortical bone, and it is 53.8% higher than that of the traditional pedicle screws. Moreover, it can also enable less tissue dissection and retraction for reduced muscle disruption.Eighty pediatric patients are divided into 4 age groups and their thoracic vertebrae are analyzed on computed tomography (CT) images. The maximal screw length, maximal screw diameter, screw diameter, and the cephalad angle are measured. The statistical analysis is performed using the Student's t-test and Pearson's correlation analysis.Maximal screw length increases from T9 to T12 and there are significant differences between girls and boys at T9, T10, T11, and T12 in majority of groups (P < 0.05). The maximal screw diameter and screw diameter increase from T9 to T12. The maximal screw diameter ranges from 6.27 mm to 10.20 mm, whereas the screw diameter ranges from 3.87 mm to 6.75 mm. Meanwhile, the maximum cephalad angle is 23.06° and the minimum is 13.11°. No statistically significant differences in the cephalad angle are found at all levels.Our study establishes the feasibility of 4.5 to 5.5 mm CBT screws fixation via pedicle or pedicle rib unit in the pediatric thoracic spine. The entry point of the pediatric thoracic CBT screws is 6 o'clock orientation of the pedicle. Findings of our study also provide insights into the screw insertion angle and screw size decision.

  18. Six axis force feedback input device

    NASA Technical Reports Server (NTRS)

    Ohm, Timothy (Inventor)

    1998-01-01

    The present invention is a low friction, low inertia, six-axis force feedback input device comprising an arm with double-jointed, tendon-driven revolute joints, a decoupled tendon-driven wrist, and a base with encoders and motors. The input device functions as a master robot manipulator of a microsurgical teleoperated robot system including a slave robot manipulator coupled to an amplifier chassis, which is coupled to a control chassis, which is coupled to a workstation with a graphical user interface. The amplifier chassis is coupled to the motors of the master robot manipulator and the control chassis is coupled to the encoders of the master robot manipulator. A force feedback can be applied to the input device and can be generated from the slave robot to enable a user to operate the slave robot via the input device without physically viewing the slave robot. Also, the force feedback can be generated from the workstation to represent fictitious forces to constrain the input device's control of the slave robot to be within imaginary predetermined boundaries.

  19. Light curves and spectra from off-axis gamma-ray bursts

    NASA Astrophysics Data System (ADS)

    Salafia, O. S.; Ghisellini, G.; Pescalli, A.; Ghirlanda, G.; Nappo, F.

    2016-10-01

    If gamma-ray burst prompt emission originates at a typical radius, and if material producing the emission moves at relativistic speed, then the variability of the resulting light curve depends on the viewing angle. This is due to the fact that the pulse evolution time-scale is Doppler contracted, while the pulse separation is not. For off-axis viewing angles θview ≳ θjet + Γ-1, the pulse broadening significantly smears out the light-curve variability. This is largely independent of geometry and emission processes. To explore a specific case, we set up a simple model of a single pulse under the assumption that the pulse rise and decay are dominated by the shell curvature effect. We show that such a pulse observed off-axis is (i) broader, (ii) softer and (iii) displays a different hardness-intensity correlation with respect to the same pulse seen on-axis. For each of these effects, we provide an intuitive physical explanation. We then show how a synthetic light curve made by a superposition of pulses changes with increasing viewing angle. We find that a highly variable light curve (as seen on-axis) becomes smooth and apparently single-pulsed (when seen off-axis) because of pulse overlap. To test the relevance of this fact, we estimate the fraction of off-axis gamma-ray bursts detectable by Swift as a function of redshift, finding that a sizeable fraction (between 10 per cent and 80 per cent) of nearby (z < 0.1) bursts are observed with θview ≳ θjet + Γ-1. Based on these results, we argue that low-luminosity gamma-ray bursts are consistent with being ordinary bursts seen off-axis.

  20. Functional latissimus dorsi island pedicle musculocutaneous flap to restore elbow flexion in replantation or revascularisation of above-elbow amputations.

    PubMed

    Parmaksizoglu, F; Beyzadeoglu, T

    2003-01-01

    Two total and one subtotal above-elbow amputations had replantation or revascularization for their severely damaged upper extremities followed by functional latissimus dorsi island pedicle musculocutaneous flap to restore elbow flexion. The mean follow-up was 68 months (range: 14 to 121 months). At final follow-up examinations, the patients had sufficient range-of-motion of their elbows with good strength. Restoring elbow function eliminates one of the most important limiting factors for above-elbow replantations. Functional latissimus dorsi island pedicle musculocutaneous flap is very reliable, has minimal donor-site morbidity and offers a wider choice when deciding about arm replantation in the upper arm region by providing a chance of restoring functions.

  1. Meaningful power grip recovery after salvage reconstruction of a median nerve avulsion injury with a pedicled vascularized ulnar nerve

    PubMed Central

    Van Slyke, Aaron C; Jansen, Leigh A; Hynes, Sally; Hicks, Jane; Bristol, Sean; Carr, Nicholas

    2015-01-01

    In cases of median nerve injury alongside an unsalvageable ulnar nerve, a vascularized ulnar nerve graft to reconstruct the median nerve is a viable option. While restoration of median nerve sensation is consistently reported, recovery of significant motor function is less frequently observed. The authors report a case involving a previously healthy man who sustained upper arm segmental median and ulnar nerve injuries and, after failure of sural nerve grafts, was treated with a pedicled vascularized ulnar nerve graft to restore median nerve function. Long-term follow-up showed near full fist, with 12 kg of grip strength, key pinch with 1.5 kg of strength and protective sensation in the median nerve distribution. The present case demonstrates that pedicled ulnar vascularized nerve grafts can provide significant improvements to median nerve sensory and motor function in a heavily scarred environment. PMID:26665144

  2. Diathermy testing: a novel method with electric knife stimulation to avoid nerve injuries during lumbar pedicle screw placement. Technical note.

    PubMed

    Yamazaki, Takashi; Matsudaira, Ko

    2007-05-01

    The purpose of this retrospective study was to demonstrate the utility of diathermy in avoiding nerve injuries due to misplacement of lumbar pedicle screws (PSs). The authors used diathermy to assess whether a screw deviated from the pedicle by observing synchronous leg movements caused by intermittently touching an electric knife to the pedicular instrument. Diathermy was performed in 259 cases in which 1301 PSs had been placed. Leg movements were observed in 36 cases, and the sensitivity of diathermy was 85.7%, with a specificity of 99.5%. No neurological complications associated with the placement of PSs were observed after adding diathermy testing to conventional methods. Diathermy testing may be a way to avoid nerve injuries during lumbar PS placement.

  3. GRB off-axis afterglows and the emission from the accompanying supernovae

    NASA Astrophysics Data System (ADS)

    Kathirgamaraju, Adithan; Barniol Duran, Rodolfo; Giannios, Dimitrios

    2016-09-01

    Gamma-ray burst (GRB) afterglows are likely produced in the shock that is driven as the GRB jet interacts with the external medium. Long-duration GRBs are also associated with powerful supernovae (SNe). We consider the optical and radio afterglows of long GRBs for both blasts viewed along the jet axis (`on-axis' afterglows) and misaligned observes (`off-axis' afterglows). Comparing the optical emission from the afterglow with that of the accompanying SN, using SN 1998bw as an archetype, we find that only a few per cent of afterglows viewed off-axis are brighter than the SN. For observable optical off-axis afterglows, the viewing angle is at most twice the half-opening angle of the GRB jet. Radio off-axis afterglows should be detected with upcoming radio surveys within a few hundred Mpc. We propose that these surveys will act as `radio triggers', and that dedicated radio facilities should follow-up these sources. Follow-ups can unveil the presence of the radio SN remnant, if present. In addition, they can probe the presence of a mildly relativistic component, either associated with the GRB jet or the SN ejecta, expected in these sources.

  4. Antler regrowth as a form of epimorphic regeneration in vertebrates - a comparative view.

    PubMed

    Kierdorf, Uwe; Kierdorf, Horst

    2012-01-01

    The annual regrowth of deer antlers is a unique case of extensive appendage regeneration in mammals. This review compares basic aspects of antler regeneration with epimorphic regeneration in other vertebrate taxa. The mesenchymal cells that build up the regenerating antler are not derived from dedifferentiated cells in the pedicle stump, but from the proliferation of cells of the pedicle periosteum; and based on different lines of evidence it has more recently been suggested that the pedicle periosteum contains stem cells that are periodically activated to produce a new antler. This constitutes a difference to urodele limb regeneration, where the blastema is (largely) formed from dedifferentiated cells. Antler regeneration involves healing of the large casting wound with no or only minor scarring, making the antler an interesting model for the control of scarring in mammals. Contrary to urodele limb regeneration, antler regrowth does not depend on a functional nerve supply. In our view, a comparative analysis of different regeneration phenomena, including antler regeneration, probably offers the best chance for achieving significant progress in regenerative medicine.

  5. A demineralized calf vertebra model as an alternative to classic osteoporotic vertebra models for pedicle screw pullout studies.

    PubMed

    Akbay, Atilla; Bozkurt, Gokhan; Ilgaz, Ozgur; Palaoglu, Selcuk; Akalan, Nejat; Benzel, Edward C

    2008-03-01

    Screws, clamps and other spinal instrumentation materials are tested using healthy animal and healthy human vertebrae, but the application of similar tests to an osteoporotic vertebra is generally neglected because of high costs and limited availability of high quality and consistent osteoporotic vertebrae. The objective of this study is to develop an in-vitro method to decrease the mineral content of an animal vertebra utilizing decalcifying chemical agents that alters the bone mineral density and some biomechanical properties to such an extent that they biomechanically mimic the osteoporotic spine. This study was performed on 24 fresh calf lumbar vertebrae. Twelve out of these 24 vertebrae were demineralized and the others served as control. A hole was opened in the pedicles of each vertebrae and the bone mineral density was measured. Each vertebra was then placed into a beher-glass filled with hydrochloric acid decalcifier solution. The decalcifier solution was introduced through the holes in the pedicles with an infusion pump. The vertebrae were then subjected to DEXA to measure post process BMD. Pedicle screws were introduced into both pedicles of each vertebrae and pullout testing was performed at a rate of 5 mm/min. The difference of BMD measurements between pre- and post-demineralizing process were also statistically significant (p < 0.001). The difference of pullout loads between pre- and post-demineralizing process were also statistically significant (p < 0.001). The acid demineralizing process may be useful for producing a vertebra that has some biomechanical properties that are consistent with osteopenia or osteoporosis in humans.

  6. Treatment of Unstable Posterior Pelvic Ring Fracture with Pedicle Screw-Rod Fixator Versus Locking Compression Plate: A Comparative Study

    PubMed Central

    Bi, Chun; Wang, Qiugen; Nagelli, Christopher; Wu, Jianhong; Wang, Qian; Wang, Jiandong

    2016-01-01

    Background The aim of this study was to assess the clinical results of treatment for unstable posterior pelvic fractures using a pedicle screw-rod fixator compared to use of a locking compression plate. Material/Methods A retrospective study was performed between June 2010 and May 2014 and the data were collected from 46 patients with unstable posterior pelvic ring fractures. All patients were treated using either a pedicle screw-rod fixator (study group, 24 patients) or locking compression plate (control group, 22 patients). In these patients, causes of injury included traffic accidents (n=27), fall from height (n=12), and crushing accidents (n=7). The quality of reduction and radiological grading were assessed. Clinical assessments included the operation time, times of X-ray exposures, bleeding volume during operation, incision length, and Majeed postoperative functional evaluation. Results No iatrogenic neurovascular injuries occurred during the operations in these 2 groups. The average follow-up time was 24.5 months. All fractures were healed. The significant differences (P<0.05) between the 2 groups were operation duration, size of incision, and intraoperative bleeding volume. Statistically significant differences in the Majeed postoperative functional evaluation and times of X-ray exposures were not found between the 2 groups. Conclusions Similar clinical effects were achieved in treating the posterior pelvic ring fractures using the pedicle screw-rod fixator and the locking compression plate. However, the pedicle screw-rod fixator has the advantages of smaller incision, shorter duration of the operation, and less bleeding volume compared to using the locking compression plate. PMID:27748355

  7. Comparative Analysis of Interval, Skipped, and Key-vertebral Pedicle Screw Strategies for Correction in Patients With Lenke Type 1 Adolescent Idiopathic Scoliosis

    PubMed Central

    Wang, Fei; Xu, Xi-Ming; Lu, Yanghu; Wei, Xian-Zhao; Zhu, Xiao-Dong; Li, Ming

    2016-01-01

    Abstract Pedicle screw constructs have become the mainstay for surgical correction in patients with spinal deformities. To reduce or avoid the risk of pedicle screw-based complications and to decrease the costs associated with pedicle screw instrumentation, some authors have introduced interval, skipped, and key-vertebral pedicle screw strategies for correction. However, there have been no comparisons of outcomes among these 3 pedicle screw-placement strategies. The aim of this study was to compare the correlative clinical outcomes of posterior correction and fusion with pedicle screw fixation using these 3 surgical strategies. Fifty-six consecutive patients with Lenke type 1 adolescent idiopathic scoliosis were included in this study. Twenty patients were treated with the interval pedicle screw strategy (IPSS), 20 with the skipped pedicle screw strategy (SPSS), and 16 with the key-vertebral pedicle screw strategy (KVPSS). Coronal and sagittal radiographs were analyzed before surgery, at 1 week after surgery, and at the last follow-up after surgery. There were no significant differences among the 3 groups regarding preoperative radiographic parameters. No significant difference was found between the IPSS and SPSS groups in correction of the main thoracic curve (70.8% vs 70.0%; P = 0.524). However, there were statistically significant differences between the IPSS and KVPSS groups (70.8% vs 64.9%) and between the SPSS and KVPSS groups (70.0% vs 64.9%) in correction of the main thoracic curve (P < 0.001 for both). Additionally, there were no significant differences among the 3 strategies for sagittal parameters at the immediate postoperative and last postoperative follow-up periods, though there were significant differences in the Cobb angle between the preoperative and immediate postoperative periods among the 3 groups, but not between the immediate postoperative and last follow-up periods. The amount of hospital charges in the SPSS group was significantly

  8. Biomechanical Comparison of Spinal Fusion Methods Using Interspinous Process Compressor and Pedicle Screw Fixation System Based on Finite Element Method

    PubMed Central

    Choi, Jisoo; Kim, Sohee

    2016-01-01

    Objective To investigate the biomechanical effects of a newly proposed Interspinous Process Compressor (IPC) and compare with pedicle screw fixation at surgical and adjacent levels of lumbar spine. Methods A three dimensional finite element model of intact lumbar spine was constructed and two spinal fusion models using pedicle screw fixation system and a new type of interspinous devices, IPC, were developed. The biomechanical effects such as range of motion (ROM) and facet contact force were analyzed at surgical level (L3/4) and adjacent levels (L2/3, L4/5). In addition, the stress in adjacent intervertebral discs (D2, D4) was investigated. Results The entire results show biomechanical parameters such as ROM, facet contact force, and stress in adjacent intervertebral discs were similar between PLIF and IPC models in all motions based on the assumption that the implants were perfectly fused with the spine. Conclusion The newly proposed fusion device, IPC, had similar fusion effect at surgical level, and biomechanical effects at adjacent levels were also similar with those of pedicle screw fixation system. However, for clinical applications, real fusion effect between spinous process and hooks, duration of fusion, and influence on spinous process need to be investigated through clinical study. PMID:26962413

  9. Improving fixation strength of pedicle screw by microarc oxidation treatment: an experimental study of osteoporotic spine in sheep.

    PubMed

    Shi, Lei; Wang, Ling; Zhang, Yang; Guo, Zheng; Wu, Zi-xiang; Liu, Da; Gao, Ming-xuan; Chen, Huan; Fu, Suo-chao; Lei, Wei

    2012-08-01

    Failure of fixation caused by loosening of pedicle screws in osteoporosis is a problem in spinal surgery. We compared the in vivo fixation strength between pedicle screws treated with microarc oxidation (MAO) and untreated screws in an osteoporotic model of ovariectomized sheep. The MAO treated and untreated screws were placed in lumbar vertebral bodies. After 3 months of implantation, biomechanical tests, micro-CT analysis, and histological observations were conducted to examine the performance of the two groups. At time 0, no significant difference was found between the two groups in biomechanical tests (p > 0.05); 3 months later, higher pull-out strength and load with less displacement were detected in the MAO-treated group (p < 0.05). Micro-CT analysis showed that the tissue mineral density, bone volume fraction, trabecular thickness, and trabecular number in the MAO-treated group were all higher than those in untreated group (p < 0.05), and trabecular spacing was smaller (p < 0.05). Histologically, the bone-implant interface in the MAO-treated group was better than that in untreated group (p < 0.05). In conclusion, pedicle screws with a bioactive surface treated by MAO can improve screw fixation strength in osteoporotic spines in sheep.

  10. The Use of Percutaneous Lumbar Fixation Screws for Bilateral Pedicle Fractures with an Associated Dislocation of a Lumbar Disc Prosthesis

    PubMed Central

    Harrison, William D.; Harrison, David J.

    2013-01-01

    Study Design. Case report. Objective. To identify a safe technique for salvage surgery following complications of total disc replacement. Summary of Background Data. Lumbar total disc replacement (TDR) is considered by some as the gold standard for discogenic back pain. Revision techniques for TDR and their complications are in their infancy. This case describes a successful method of fixation for this complex presentation. Methods and Results. A 48-year-old male with lumbar degenerative disc disease and no comorbidities. Approximately two weeks postoperatively for a TDR, the patient represented with acute severe back pain and the TDR polyethylene inlay was identified as dislocated anteriorly. Subsequent revision surgery failed immediately as the polyethylene inlay redislocated intraoperatively. Further radiology identified bilateral pedicle fractures, previously unseen on the plain films. The salvage fusion of L5/S1 reutilized the anterior approach with an interbody fusion cage and bone graft. The patient was then turned intraoperatively and redraped. The percutaneous pedicle screws were used to fix L5 to the sacral body via the paracoccygeal corridor. Conclusion. The robust locking screw in the percutaneous screw allowed a complete fixation of the pedicle fractures. At 3-year followup, the patient has an excellent result and has returned to playing golf. PMID:24294533

  11. Reconstruction of extensive abdominal wall defect using an eccentric perforator-based pedicled anterolateral thigh flap: a case report.

    PubMed

    Jang, Joonchul; Jeong, Seong-Ho; Han, Seung-Kyu; Kim, Woo-Kyung

    2013-09-01

    Reconstruction of extensive abdominal wall defects is a challenge for reconstructive surgeons. In this report, a case of reconstruction of a large abdominal wall defect using an eccentric perforator-based pedicled anterolateral thigh (ALT) flap is presented. A 30-year-old man presented with recurrent desmoid-type fibromatosis in the abdominal wall. The recurrent tumor was radically excised, and the en bloc excision resulted in a full-thickness, large abdominal wall defect (25 cm × 20 cm). An eccentric perforator-based pedicled ALT flap, including wide fascial extension, was transferred to the abdominal defect; fascial portions were sutured to the remnant abdominal fascia. Plication of the fascia along the sutured portion was performed to relieve the skin tension between the flap and the marginal skin of the abdominal defect. Eight months after surgery, the reconstructed abdomen had an acceptable esthetic appearance without tumor recurrence or hernia. The use of an eccentric perforator-based pedicled ALT flap may be an alternative method for the reconstruction of extensive abdominal wall defects.

  12. “Two-step” technique with OsiriX™ to evaluate feasibility of C2 pedicle for surgical fixation

    PubMed Central

    Marques, Luis Miguel Sousa; d’Almeida, Gonçalo Neto; Cabral, José

    2016-01-01

    Background: Surgical treatment of craniovertebral junction pathology has evolved considerably in recent decades with the implementation of short atlanto-axial fixation techniques, notwhithstanding increasing neurovascular risks. Also, there is strong evidence that fixation of C2 anatomical pedicle has the best biomechanical profile of the entire cervical spine. However, it is often difficult and misleading, to evaluate anatomical bony and vascular anomalies using the three orthogonal planes (axial, coronal, and sagittal) of CT. Objectives: The authors describe an innovative and simple technique to evaluate the feasibility of C2 pedicle for surgical screw fixation using preoperative planning with the free DICOM (Digital Imaging and Communications in Medicine) software OsiriX™. Materials and Methods: The authors report the applicatin of this novel technique in 5 cases (3 traumatic, 1 Os Odontoideum, and 1 complex congenital malformation) collected from our general case series of the Department in the last 5 years. Results: In this proof of concept study, the pre-operative analysis with the two-step tecnique was detrimental for choosing the surgical tecnique. Detailed post-operative analysis confirmed correct position of C2 screws without cortical breach. There were no complications or mortality reported. Conclusion: This two-step technique is an easy and reliable way to determine the feasibility of C2 pedicle for surgical fixation. The detailed tridimensional radiological preoperative evaluation of craniovertebral junction anatomy is critical to the sucess and safety of this surgeries, and can avoid, to certain degree, expensive intra-operative tridimensional imaging facilities. PMID:27217652

  13. The pedicle screw-rod system is an acceptable method of reconstructive surgery after resection of sacroiliac joint tumours

    PubMed Central

    Zhou, Yi-Jun; Yunus, Akbar; Tian, Zheng; Chen, Jiang-Tao; Wang, Chong; Xu, Lei-Lei

    2016-01-01

    Hemipelvic resections for primary bone tumours require reconstruction to restore weight bearing along anatomic axes. However, reconstruction of the pelvic arch remains a major surgical challenge because of the high rate of associated complications. We used the pedicle screw-rod system to reconstruct the pelvis, and the purpose of this investigation was to assess the oncology, functional outcome and complication rate following this procedure. The purpose of this study was to investigate the operative indications and technique of the pedicle screw-rod system in reconstruction of the stability of the sacroiliac joint after resection of sacroiliac joint tumours. The average MSTS (Musculoskeletal Tumour Society) score was 26.5 at either three months after surgery or at the latest follow-up. Seven patients had surgery-related complications, including wound dehiscence in one, infection in two, local necrosis in four (including infection in two), sciatic nerve palsy in one and pubic symphysis subluxation in one. There was no screw loosening or deep vein thrombosis occurring in this series. Using a pedicle screw-rod after resection of a sacroiliac joint tumour is an acceptable method of pelvic reconstruction because of its reduced risk of complications and satisfactory functional outcome, as well as its feasibility of reconstruction for type IV pelvis tumour resection without elaborate preoperative customisation. Level of evidence: Level IV, therapeutic study. PMID:27095944

  14. 3. AERIAL VIEW OF THE MALL BETWEEN TWELFTH STREET AND ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    3. AERIAL VIEW OF THE MALL BETWEEN TWELFTH STREET AND THE WASHINGTON MONUMENT, LOOKING NORTH UP THE 14TH STREET AXIS FROM OVER THE WASHINGTON CHANNEL. - National Mall & Monument Grounds, Washington, District of Columbia, DC

  15. SUMMER VIEW LOOKING SOUTHWEST FROM A POINT FURTHER NORTHWARD ALONG ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    SUMMER VIEW LOOKING SOUTHWEST FROM A POINT FURTHER NORTHWARD ALONG THE PRINCIPAL AXIS THROUGH SECTION F THAN THAT IN HALS NO. PA-5-53 - Woodlands Cemetery, 4000 Woodlands Avenue, Philadelphia, Philadelphia County, PA

  16. 1. AERIAL VIEW OF LAFAYETTE SQUARE, THE WHITE HOUSE GROUNDS, ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. AERIAL VIEW OF LAFAYETTE SQUARE, THE WHITE HOUSE GROUNDS, THE ELLIPSE, AND MONUMENT GROUNDS, LOOKING SOUTH ALONG THE 16TH STREET AXIS. - White House Grounds & Ellipse, Washington, District of Columbia, DC

  17. DARHT Axis-I Diode Simulations II: Geometrical Scaling

    SciTech Connect

    Ekdahl, Carl A. Jr.

    2012-06-14

    Flash radiography of large hydrodynamic experiments driven by high explosives is a venerable diagnostic technique in use at many laboratories. Many of the largest hydrodynamic experiments study mockups of nuclear weapons, and are often called hydrotests for short. The dual-axis radiography for hydrodynamic testing (DARHT) facility uses two electron linear-induction accelerators (LIA) to produce the radiographic source spots for perpendicular views of a hydrotest. The first of these LIAs produces a single pulse, with a fixed {approx}60-ns pulsewidth. The second axis LIA produces as many as four pulses within 1.6-{micro}s, with variable pulsewidths and separation. There are a wide variety of hydrotest geometries, each with a unique radiographic requirement, so there is a need to adjust the radiographic dose for the best images. This can be accomplished on the second axis by simply adjusting the pulsewidths, but is more problematic on the first axis. Changing the beam energy or introducing radiation attenuation also changes the spectrum, which is undesirable. Moreover, using radiation attenuation introduces significant blur, increasing the effective spot size. The dose can also be adjusted by changing the beam kinetic energy. This is a very sensitive method, because the dose scales as the {approx}2.8 power of the energy, but it would require retuning the accelerator. This leaves manipulating the beam current as the best means for adjusting the dose, and one way to do this is to change the size of the cathode. This method has been proposed, and is being tested. This article describes simulations undertaken to develop scaling laws for use as design tools in changing the Axis-1 beam current by changing the cathode size.

  18. Cost analysis in oral cavity and oropharyngeal reconstructions with microvascular and pedicled flaps.

    PubMed

    Deganello, A; Gitti, G; Parrinello, G; Muratori, E; Larotonda, G; Gallo, O

    2013-12-01

    Reconstructive surgery of the head and neck region has undergone tremendous advancement over the past three decades, and the success rate of free tissue transfers has risen to greater than 95%. It must always be considered that not all patients are ideal candidates for free flap reconstruction, and also that not every defect strictly requires a free flap transfer to achieve good functional results. At our institution, free flap reconstruction is first choice, although we use pedicled alternative flaps for most weak patients suffering from severe comorbidities, and for pretreated patients presenting a second primary or a recurrent cancer. From July 2006 to May 2010, 54 consecutive patients underwent soft tissue reconstruction of oral cavity and oropharyngeal defects. We divided the cohort in three groups: Group 1 (G1): 16 patients in good general conditions that received free radial forearm flap reconstruction; Group 2 (G2): 18 high-risk patients that received a reconstruction with infrahyoid flap; Group 3 (G3): 20 patients that received temporal flap (10 cases) or pectoral flap (10 cases) reconstruction. We must highlight that pedicled alternative flaps were used in elderly, unfavourable and weak patients, where usually the medical costs tend to rise rather than decrease. We compared the healthcare costs of the three groups, calculating real costs in each group from review of medical records and operating room registers, and calculating the corresponding DRG system reimbursement. For real costs, we found a statistically significant difference among groups: in G1 the average total cost per patient was € 22,924, in G2 it was € 18,037 and in G3 was € 19,872 (p = 0.043). The amount of the refund, based on the DRG system, was € 7,650 per patient, independently of the type of surgery. Our analysis shows that the use of alternative non-microvascular techniques, in high-risk patients, is functionally and oncologically sound, and can even produce a cost savings. In

  19. [Possible applications of pedicled vascularized bone transplants of the distal radius].

    PubMed

    Sauerbier, M; Bishop, A T

    2001-11-01

    Reverse-flow pedicle vascularized bone grafts (VBGs) from the distal radius may be used for the surgical treatment of carpal fracture nonunions and avascular necrosis. Such grafts remain viable with quantifiable blood flow as demonstrated in a recent canine experiment. In this paper, the vascular anatomy of the distal radius is demonstrated and the surgical technique of VBG harvest is described. Our indications and results for treatment of scaphoid nonunion and Kienböck's disease are discussed and compared with the current literature. Fifteen patients with scaphoid nonunion and nine patients with Kienböck's disease stage IIIa were treated by reverse-flow pedicled VBG. Range of motion and grip strength were measured postoperatively and compared to the contralateral hand in all patients. An outcome questionnaire was used to measure patient's satisfaction and ADL's in the patients with Kienböck's disease. The radiologic diagnostic was performed with conventional X-rays, trispiral tomograms and MRI. In the scaphoid nonunion group, all patients were male, with an average age of 27.6 years. Five patients had prior attempts of autogenous bone grafting which failed. Six patients had a radiographic suggestion of proximal fragment avascular necrosis. All scaphoids healed. Time to union was 11.1 weeks on average. Average follow-up was 36.2 months. Pain relief, range of motion and grip strength were very promising. The treatment of Kienböck's disease was also promising in nine patients. Mean patient age was 31 years, and follow-up averaged 32 months. Six patients had complete pain relief, and three had occasional pain. Grip strength reached 86% of the contralateral side (a 25% improvement from preoperative values). Postoperative MRI demonstrated progressive revascularization with time. The results of treating scaphoid nonunions are promising. The use of vascularized bone graft facilitates rapid, reliable union of established scaphoid nonunion, even with proximal location

  20. Evaluating Accuracy of Free-hand Pedicle Screw Insertion in Adolescent Idiopathic Scoliosis Using Postoperative Multi-Slice Computed Tomography Scan

    PubMed Central

    Etemadifar, Mohammadreza; Jamalaldini, Mohammadhossein

    2017-01-01

    Background: Pedicle screw instrumentation has many advantages for correction of adolescent idiopathic scoliosis (AIS) deformity including better correction and fewer late complications. On the other hand, screw insertion in AIS is challenging. Intraoperative fluoroscopy or navigation techniques are expensive, time-consuming, and exposed to high radiation. Free-hand technique relies on the surgeon's experience and locating the pedicle entry point with anatomical landmarks. There are few studies that evaluated pedicle screw position accuracy with postoperative multi-slice computed tomography scan. Materials and Methods: We prospectively considered 38 consecutive AIS cases, who underwent corrective surgery with all pedicle screw technique. All the screws were inserted with free-hand technique using anatomic landmarks as a guide for an entry site. We divided pedicle penetration in medial, lateral, inferior, superior, and anterior vertebral body as Grades 0–4, that Grade 0 is fully contained within the pedicle, Grade 1 (<2 mm), Grade 2 (2.1–4 mm), Grade 3 (4.1–6 mm), and Grade 4 (>6 mm). Results: A total of 720 screws were inserted, of which 623 screws (86.5%) were perfect and 97 screws (13.5%) were misplaced. Of those which were misplaced, 39 screws (40.2%) were medial and 58 (59.8%) were lateral, which shows that the prevalence of lateral misplacement was more in comparison to medial misplacement. However, in all misplaced cases, the deviation of the screw was <2 mm (Grade 1). There was no misplacement in the inferior and superior. Conclusion: Pedicle screw insertion in AIS with the free-hand technique is a safe and reliable method. PMID:28349022

  1. Biomechanical Analysis of Fusion Segment Rigidity Upon Stress at Both the Fusion and Adjacent Segments: A Comparison between Unilateral and Bilateral Pedicle Screw Fixation

    PubMed Central

    Kim, Ho-Joong; Kang, Kyoung-Tak; Chang, Bong-Soon; Lee, Choon-Ki; Kim, Jang-Woo

    2014-01-01

    Purpose The purpose of this study was to investigate the effects of unilateral pedicle screw fixation on the fusion segment and the superior adjacent segment after one segment lumbar fusion using validated finite element models. Materials and Methods Four L3-4 fusion models were simulated according to the extent of decompression and the method of pedicle screws fixation in L3-4 lumbar fusion. These models included hemi-laminectomy with bilateral pedicle screw fixation in the L3-4 segment (BF-HL model), total laminectomy with bilateral pedicle screw fixation (BF-TL model), hemi-laminectomy with unilateral pedicle screw fixation (UF-HL model), and total laminectomy with unilateral pedicle screw fixation (UF-TL model). In each scenario, intradiscal pressures, annulus stress, and range of motion at the L2-3 and L3-4 segments were analyzed under flexion, extension, lateral bending, and torsional moments. Results Under four pure moments, the unilateral fixation leads to a reduction in increment of range of motion at the adjacent segment, but larger motions were noted at the fusion segment (L3-4) in the unilateral fixation (UF-HL and UF-TL) models when compared to bilateral fixation. The maximal von Mises stress showed similar patterns to range of motion at both superior adjacent L2-3 segments and fusion segment. Conclusion The current study suggests that unilateral pedicle screw fixation seems to be unable to afford sufficient biomechanical stability in case of bilateral total laminectomy. Conversely, in the case of hemi-laminectomy, unilateral fixation could be an alternative option, which also has potential benefit to reduce the stress of the adjacent segment. PMID:25048501

  2. Element concentrations and element ratios in antler and pedicle bone of yearling red deer (Cervus elaphus) stags-a quantitative X-ray fluorescence study.

    PubMed

    Kierdorf, Uwe; Stoffels, Dieter; Kierdorf, Horst

    2014-12-01

    The present study compared the concentrations of different elements (Ca, P, Mg, Sr, Ba, K, S, Zn, Mn) as well as Ca/P, Ca/Mg, Sr/Ca, and Ba/Ca ratios in hard antler and pedicle bone of yearling red deer stags (n = 11). Pedicles showed higher concentrations of calcium and phosphorus and a higher Ca/Mg ratio than antlers, while antlers exhibited higher concentrations of potassium, sulfur, and manganese as well as higher Ca/P, Sr/Ca, and Ba/Ca ratios. The findings indicate that antlers are less mineralized and show less maturation of their bone mineral than pedicles. Antlers also showed a higher intrasample variation of mineralization than pedicles, which can be related to the shorter life span of the (deciduous) antlers compared to the (permanent) pedicles. It is suggested that antler bone formation is stopped before the theoretically possible degree of mineralization and mineral maturation is reached, resulting in antler biomechanical properties (high bending strength and work to fracture) that are well suited for their role in intraspecific fighting. It is further suggested that the differences in Sr/Ca and Ba/Ca ratios of antlers and pedicles are related to the dietary shift from milk to vegetation in combination with an increasing intestinal discrimination against Sr and Ba with age, resulting in a less marked difference in these ratios than would be expected based on the dietary shift alone. The findings of our study underscore the suitability of antlers and pedicles as models of bone mineralization and the influence of different animal-related and/or external factors on this process.

  3. Accuracy of Free Hand Pedicle Screw Installation in the Thoracic and Lumbar Spine by a Young Surgeon: An Analysis of the First Consecutive 306 Screws Using Computed Tomography

    PubMed Central

    Lee, Chang-Hyun; Kim, Yongjung J; Kim, Ki-Jeong; Jahng, Tae-Ahn; Kim, Hyun-Jib

    2014-01-01

    Study Design A retrospective cross-sectional study. Purpose The purpose of this study is to evaluate the accuracy and safety of free-hand pedicle screw insertion performed by a young surgeon. Overview of Literature Few articles exist regarding the safety of the free-hand technique without inspection by an experienced spine surgeon. Methods The index surgeon has performed spinal surgery for 2 years by himself. He performed fluoroscopy-assisted pedicle screw installation for his first year. Since then, he has used the free-hand technique. We retrospectively reviewed the records of all consecutive patients undergoing pedicle screw installation using the free-hand technique without fluoroscopy in the thoracic or lumbar spine by the index surgeon. Incidence and extent of cortical breach by misplaced pedicle screw was determined by a review of postoperative computed tomography (CT) images. Results A total of 36 patients received 306 free-hand placed pedicle screws in the thoracic or lumbar spine. A total of 12 screws (3.9%) were identified as breaching the pedicle in 9 patients. Upper thoracic spine was the most frequent location of screw breach (10.8%). Lateral breach (2.3%) was more frequent than any other direction. Screw breach on the right side (9 patients) was more common than that on the left side (3 patients) (p<0.01). Conclusions An analysis by CT scan shows that young spine surgeons who have trained under the supervision of an experienced surgeon can safely place free-hand pedicle screws with an acceptable breach rate through repetitive confirmatory steps. PMID:24967036

  4. Axis perpendicularity measuring method using vision

    NASA Astrophysics Data System (ADS)

    Lee, Chang-Woo; Song, Jun-Yeob; Ha, Tae-Ho

    2008-11-01

    Perpendicularity measurement is very important in machine assembly and calibration. Axis perpendicularity error often contributes much more to the total error than the linear positioning and straightness errors. This paper presents two new non-contact methods for measuring axis perpendicularity using vision system. In general a perpendicular master and a dial gauge are used to measure the axis perpendicularity. We can obtain the axis perpendicularity by measuring differences from the master. Therefore, its accuracy depends on the accuracy of perpendicular master. The accuracy of the perpendicular master is therefore extremely important and it is impossible that the accuracy of a perpendicularity measurement is superior to the accuracy of the perpendicular master. This paper proposes two new methods that can measure axis perpendicularity without using a perpendicular master. Absolute axis perpendicularity measurement can be achieved by vision system. The feasibility of our developed measurement methods are confirmed by several experimental results.

  5. Known-component 3D-2D registration for quality assurance of spine surgery pedicle screw placement

    PubMed Central

    Uneri, A; De Silva, T; Stayman, JW; Kleinszig, G; Vogt, S; Khanna, AJ; Gokaslan, ZL; Wolinsky, J-P; Siewerdsen, JH

    2015-01-01

    Purpose A 3D-2D image registration method is presented that exploits knowledge of interventional devices (e.g., K-wires or spine screws – referred to as “known components”) to extend the functionality of intraoperative radiography/fluoroscopy by providing quantitative measurement and quality assurance (QA) of the surgical product. Methods The known-component registration (KC-Reg) algorithm uses robust 3D-2D registration combined with 3D component models of surgical devices known to be present in intraoperative 2D radiographs. Component models were investigated that vary in fidelity from simple parametric models (e.g., approximation of a screw as a simple cylinder, referred to as “parametrically-known” component [pKC] registration) to precise models based on device-specific CAD drawings (referred to as “exactly-known” component [eKC] registration). 3D-2D registration from three intraoperative radiographs was solved using the covariance matrix adaptation evolution strategy (CMA-ES) to maximize image-gradient similarity, relating device placement relative to 3D preoperative CT of the patient. Spine phantom and cadaver studies were conducted to evaluate registration accuracy and demonstrate QA of the surgical product by verification of the type of devices delivered and conformance within the “acceptance window” of the spinal pedicle. Results Pedicle screws were successfully registered to radiographs acquired from a mobile C-arm, providing TRE 1–4 mm and <5° using simple parametric (pKC) models, further improved to <1 mm and <1° using eKC registration. Using advanced pKC models, screws that did not match the device models specified in the surgical plan were detected with an accuracy of >99%. Visualization of registered devices relative to surgical planning and the pedicle acceptance window provided potentially valuable QA of the surgical product and reliable detection of pedicle screw breach. Conclusions 3D-2D registration combined with 3D models

  6. Known-component 3D-2D registration for quality assurance of spine surgery pedicle screw placement.

    PubMed

    Uneri, A; De Silva, T; Stayman, J W; Kleinszig, G; Vogt, S; Khanna, A J; Gokaslan, Z L; Wolinsky, J-P; Siewerdsen, J H

    2015-10-21

    A 3D-2D image registration method is presented that exploits knowledge of interventional devices (e.g. K-wires or spine screws-referred to as 'known components') to extend the functionality of intraoperative radiography/fluoroscopy by providing quantitative measurement and quality assurance (QA) of the surgical product. The known-component registration (KC-Reg) algorithm uses robust 3D-2D registration combined with 3D component models of surgical devices known to be present in intraoperative 2D radiographs. Component models were investigated that vary in fidelity from simple parametric models (e.g. approximation of a screw as a simple cylinder, referred to as 'parametrically-known' component [pKC] registration) to precise models based on device-specific CAD drawings (referred to as 'exactly-known' component [eKC] registration). 3D-2D registration from three intraoperative radiographs was solved using the covariance matrix adaptation evolution strategy (CMA-ES) to maximize image-gradient similarity, relating device placement relative to 3D preoperative CT of the patient. Spine phantom and cadaver studies were conducted to evaluate registration accuracy and demonstrate QA of the surgical product by verification of the type of devices delivered and conformance within the 'acceptance window' of the spinal pedicle. Pedicle screws were successfully registered to radiographs acquired from a mobile C-arm, providing TRE 1-4 mm and  <5° using simple parametric (pKC) models, further improved to  <1 mm and  <1° using eKC registration. Using advanced pKC models, screws that did not match the device models specified in the surgical plan were detected with an accuracy of  >99%. Visualization of registered devices relative to surgical planning and the pedicle acceptance window provided potentially valuable QA of the surgical product and reliable detection of pedicle screw breach. 3D-2D registration combined with 3D models of known surgical devices offers a

  7. Known-component 3D-2D registration for quality assurance of spine surgery pedicle screw placement

    NASA Astrophysics Data System (ADS)

    Uneri, A.; De Silva, T.; Stayman, J. W.; Kleinszig, G.; Vogt, S.; Khanna, A. J.; Gokaslan, Z. L.; Wolinsky, J.-P.; Siewerdsen, J. H.

    2015-10-01

    A 3D-2D image registration method is presented that exploits knowledge of interventional devices (e.g. K-wires or spine screws—referred to as ‘known components’) to extend the functionality of intraoperative radiography/fluoroscopy by providing quantitative measurement and quality assurance (QA) of the surgical product. The known-component registration (KC-Reg) algorithm uses robust 3D-2D registration combined with 3D component models of surgical devices known to be present in intraoperative 2D radiographs. Component models were investigated that vary in fidelity from simple parametric models (e.g. approximation of a screw as a simple cylinder, referred to as ‘parametrically-known’ component [pKC] registration) to precise models based on device-specific CAD drawings (referred to as ‘exactly-known’ component [eKC] registration). 3D-2D registration from three intraoperative radiographs was solved using the covariance matrix adaptation evolution strategy (CMA-ES) to maximize image-gradient similarity, relating device placement relative to 3D preoperative CT of the patient. Spine phantom and cadaver studies were conducted to evaluate registration accuracy and demonstrate QA of the surgical product by verification of the type of devices delivered and conformance within the ‘acceptance window’ of the spinal pedicle. Pedicle screws were successfully registered to radiographs acquired from a mobile C-arm, providing TRE 1-4 mm and  <5° using simple parametric (pKC) models, further improved to  <1 mm and  <1° using eKC registration. Using advanced pKC models, screws that did not match the device models specified in the surgical plan were detected with an accuracy of  >99%. Visualization of registered devices relative to surgical planning and the pedicle acceptance window provided potentially valuable QA of the surgical product and reliable detection of pedicle screw breach. 3D-2D registration combined with 3D models of known surgical

  8. Antenna Axis Offset Estimation from VLBI

    NASA Technical Reports Server (NTRS)

    Kurdubov, Sergey; Skurikhina, Elena

    2010-01-01

    The antenna axis offsets were estimated from global solutions and single sessions. We have built a set of global solutions from R1 and R4 sessions and from the sets of sessions between SVETLOE repairs. We compared our estimates with local survey data for the stations of the QUASAR network. Svetloe station axis offset values have changed after repairs. For non-global networks, the axis offset value of a single station can significantly affect the EOP estimations.

  9. Principles of the prolactin/vasoinhibin axis

    PubMed Central

    Bertsch, Thomas; Bollheimer, Cornelius; Rios-Barrera, Daniel; Pearce, Christy F.; Hüfner, Michael; Martínez de la Escalera, Gonzalo; Clapp, Carmen

    2015-01-01

    The hormonal family of vasoinhibins, which derive from the anterior pituitary hormone prolactin, are known for their inhibiting effects on blood vessel growth, vasopermeability, and vasodilation. As pleiotropic hormones, vasoinhibins act in multiple target organs and tissues. The generation, secretion, and regulation of vasoinhibins are embedded into the organizational principle of an axis, which integrates the hypothalamus, the pituitary, and the target tissue microenvironment. This axis is designated as the prolactin/vasoinhibin axis. Disturbances of the prolactin/vasoinhibin axis are associated with the pathogenesis of retinal and cardiac diseases and with diseases occurring during pregnancy. New phylogenetical, physiological, and clinical implications are discussed. PMID:26310939

  10. Discomfort criteria for single-axis vibrations

    NASA Technical Reports Server (NTRS)

    Dempsey, T. K.; Leatherwood, J. D.; Clevenson, S. A.

    1979-01-01

    Experimental investigations were conducted to determine the fundamental relationships governing human subjective discomfort response to single-axis vibrations. The axes investigated were vertical, lateral, longitudinal, roll, and pitch, and the vibrations used were both sinusoidal and random in nature. Results of these investigations provided the basis for: (1) development of a scale of passenger discomfort that is common to all axes of vibration; and (2) generation of discomfort criteria for each axis of each axis and for both types of vibration. Furthermore, empirical equations describing discomfort responses within each axis of vibration are included.

  11. Helical axis stellarator with noninterlocking planar coils

    DOEpatents

    Reiman, Allan; Boozer, Allen H.

    1987-01-01

    A helical axis stellarator using only noninterlocking planar, non-circular coils, generates magnetic fields having a magnetic well and large rotational transform with resultant large equilibrium beta.

  12. PERPENDICULAR DOUBLE-PLATE FIXATION WITH LOCKING SYSTEM FOR ACROMION PEDICLE FRACTURE

    PubMed Central

    Zhu, Junkun; Pan, Zhijun; Zheng, Rongzong; Lan, Shuhua

    2016-01-01

    Objective : To describe the surgical technique and preliminary clinical outcomes in a series of open reduction internal fixation of basal acromion process fractures applying a double-plating technique. Methods : Nine consecutive patients, mean age 33.4 years old (range, 23-61 years old) with unilateral acromion fracture (Type 3 AO/OTA) with more than 1cm displacement who underwent fixation utilizing a locked double-plating technique, were evaluated on average at 7.8 months (range, 3-15 months) for outcomes related to pain, shoulder function, and surgical complications. Results : Eight patients recovered with complete radiographic union and favorable shoulder function. One case failed to be fully evaluated for more than 3 months follow-up. The overall scores of Constant, Shoulder Pain and Disability Index (SPADI) and DASH for the eight patients reviewed were 91.9± 6.31, 3.11± 3.79 and 5.2± 6.35, respectively. No post-operative infection or surgical hardware irritation was identified at final follow-up of these eight patients. Conclusion : While more evidence is needed to justify its advantages over traditional implants, perpendicular double-plate with a locking system may be indicated for acromion pedicle fracture treatment, since it performed well for fracture healing and joint function rehabilitation. Level of Evidence IV, Therapeutic Study. PMID:26981047

  13. The pedicled latissimus dorsi flap in head and neck reconstruction: an old method revisited.

    PubMed

    Wilkman, Tommy; Suominen, Sinikka; Back, Leif; Vuola, Jyrki; Lassus, Patrik

    2014-03-01

    In head and neck cancer patients with significant comorbidities, the reconstructive options are limited, and there is a need for a safe alternative for microvascular flaps without compromising flap size. During the study period, 331 head and neck cancer patients were reconstructed with microvascular tissue flaps. Ten patients requiring large resections were considered to have high risks for long surgery and to be poor candidates for free tissue transfer and thus were reconstructed with a subpectorally tunneled pedicled latissimus dorsi (SP-LD) flap. The flap was raised simultaneously with the tumor resection and tunneled to the head and neck region. The flap was used for reconstruction of oral, mandibular, pharyngeal, or neck defects. Median follow-up was 3.6 years. Median duration of surgery was 7 hours and 17 minutes, and total hospital stay was 20 days. During the follow-up, four patients died of their disease and one from another cause (median of 329 days). We were able to perform large tumor resections with a curative intent and reconstruct major defects in high-risk head and neck cancer patients with a SP-LD flap. It possesses many of the characteristics of a free flap with the benefits of a shorter operation time and less perioperative risk.

  14. Vertebroplasty plus short segment pedicle screw fixation in a burst fracture model in cadaveric spines.

    PubMed

    Grossbach, Andrew J; Viljoen, Stephanus V; Hitchon, Patrick W; DeVries Watson, Nicole A; Grosland, Nicole M; Torner, James

    2015-05-01

    The current project investigates the role of vertebroplasty in supplementing short segment (SS) posterior instrumentation, only one level above and below a fracture. In the treatment of thoracolumbar burst fractures, long segment (LS) posterior instrumentation two levels above and below the fracture level has been used. In our study, burst fractures were produced at L1 in eight fresh frozen human cadaveric spines. The spines were then tested in three conditions: 1) intact, 2) after LS (T11-L3), 3) SS (T12-L2) instrumentation with pedicle screws and rods, and 4) short segment instrumentation plus cement augmentation of the fracture level (SSC). LS instrumentation was found to significantly reduce the motion at the instrumented level (T12-L2) as well as the levels immediately adjacent in flexion, extension and lateral bending. Similarly, SSC augmentation was found to significantly reduce the motion compared to intact at T12-L2 but still maintained the adjacent level motion. However, SS instrumentation alone did not significantly reduce the motion at T12-L2 except for left lateral bending. While LS instrumentation remains the most stable construct, SS instrumentation augmented with vertebroplasty at the fracture level increases rigidity in flexion, extension and right lateral bending beyond SS instrumentation alone.

  15. Position and complications of pedicle screw insertion with or without image-navigation techniques in the thoracolumbar spine: a meta-analysis of comparative studies.

    PubMed

    Tang, Jinshan; Zhu, Ziqiang; Sui, Tao; Kong, Dechao; Cao, Xiaojian

    2014-05-01

    Computer-navigated pedicle screw insertion is applied to the thoracic and lumbar spine to attain high insertion accuracy and a low rate of screw-related complications. However, some in vivo and in vitro studies have shown that no advantages are gained with the use of navigation techniques compared to conventional techniques. Additionally, inconsistent conclusions have been drawn in various studies due to different population characteristics and methods used to assess the accuracy of screw placement. Moreover, it is not clear whether pedicle screw insertion with navigation techniques decreases the incidence of screw-related complications. Therefore, this study was sought to perform a meta-analysis of all available prospective evidence regarding pedicle screw insertion with or without navigation techniques in human thoracic and lumbar spine. We considered in vivo comparative studies that assessed the results of pedicle screw placement with or without navigation techniques. PubMed, Ovid MEDLINE and EMBASE databases were searched. Three published randomized controlled trials (RCTs) and nine retrospective comparative studies met the inclusion criteria. These studies included a total of 732 patients in whom 4,953 screws were inserted. In conclusion, accuracy of the position of grade I, II, III and IV screws and complication rate related to pedicle screw placement were significantly increased when navigation techniques were used in comparison to conventional techniques. Future research in this area should include RCTs with well-planned methodology to limit bias and report on validated, patient-based outcome measures.

  16. Reconstruction of an infected recurrent ventral hernia after a mesh repair using a pedicled tensor fascia lata flap: report of two cases.

    PubMed

    Hayami, Shinya; Hotta, Tsukasa; Takifuji, Katsunari; Iwahashi, Makoto; Mitani, Yasuyuki; Yamaue, Hiroki

    2009-01-01

    Recently, the use of prosthetic mesh has revolutionized the repair of ventral hernias. However, the occurrence of infection related with the use of this prosthesis remains an important complication, which may result in occurrence of fistula formation of the skin or intestine, sepsis, or reoccurrence of ventral hernia. This report presents two cases where a pedicled musculocutaneous flap using the tensor fascia lata (pedicled TFL flap) was effective as a treatment for an infectious large abdominal hernia, and reviews the previous literature. Two Japanese men aged 61 and 78 years old underwent a ventral hernia repair using Composix Kugel mesh. They both developed a wound infection with methicillin-resistant Staphylococcus aureus. Conservative therapy was not successful and the defect in the abdominal wall of two patients measured 12 x 21 cm and 7 x 10 cm in length, respectively. Reoperations were performed by removing the infectious mesh and then reconstructing the abdominal wall with the bilateral and left-side pedicled TFL flaps, respectively. No recurrence of the ventral hernia has been recognized for 50 months and 7 months after reoperation, respectively. A review of previous studies showed that no patients treated with a pedicled TFL flap experienced a recurrent hernia. Therefore, the pedicled TFL flap was considered to be effective for infectious large abdominal recurrent hernia.

  17. Normalized Point Source Sensitivity for Off-Axis Optical Performance Evaluation of the Thirty Meter Telescope

    NASA Technical Reports Server (NTRS)

    Seo, Byoung-Joon; Nissly, Carl; Troy, Mitchell; Angeli, George

    2010-01-01

    The Normalized Point Source Sensitivity (PSSN) has previously been defined and analyzed as an On-Axis seeing-limited telescope performance metric. In this paper, we expand the scope of the PSSN definition to include Off-Axis field of view (FoV) points and apply this generalized metric for performance evaluation of the Thirty Meter Telescope (TMT). We first propose various possible choices for the PSSN definition and select one as our baseline. We show that our baseline metric has useful properties including the multiplicative feature even when considering Off-Axis FoV points, which has proven to be useful for optimizing the telescope error budget. Various TMT optical errors are considered for the performance evaluation including segment alignment and phasing, segment surface figures, temperature, and gravity, whose On-Axis PSSN values have previously been published by our group.

  18. Photographic simulation of off-axis blurring due to chromatic aberration in spectacle lenses.

    PubMed

    Doroslovački, Pavle; Guyton, David L

    2015-02-01

    Spectacle lens materials of high refractive index (nd) tend to have high chromatic dispersion (low Abbé number [V]), which may contribute to visual blurring with oblique viewing. A patient who noted off-axis blurring with new high-refractive-index spectacle lenses prompted us to do a photographic simulation of the off-axis aberrations in 3 readily available spectacle lens materials, CR-39 (nd = 1.50), polyurethane (nd = 1.60), and polycarbonate (nd = 1.59). Both chromatic and monochromatic aberrations were found to cause off-axis image degradation. Chromatic aberration was more prominent in the higher-index materials (especially polycarbonate), whereas the lower-index CR-39 had more astigmatism of oblique incidence. It is important to consider off-axis aberrations when a patient complains of otherwise unexplained blurred vision with a new pair of spectacle lenses, especially given the increasing promotion of high-refractive-index materials with high chromatic dispersion.

  19. Identification of kinematic errors of five-axis machine tool trunnion axis from finished test piece

    NASA Astrophysics Data System (ADS)

    Zhang, Ya; Fu, Jianzhong; Chen, Zichen

    2014-09-01

    Compared with the traditional non-cutting measurement, machining tests can more accurately reflect the kinematic errors of five-axis machine tools in the actual machining process for the users. However, measurement and calculation of the machining tests in the literature are quite difficult and time-consuming. A new method of the machining tests for the trunnion axis of five-axis machine tool is proposed. Firstly, a simple mathematical model of the cradle-type five-axis machine tool was established by optimizing the coordinate system settings based on robot kinematics. Then, the machining tests based on error-sensitive directions were proposed to identify the kinematic errors of the trunnion axis of cradle-type five-axis machine tool. By adopting the error-sensitive vectors in the matrix calculation, the functional relationship equations between the machining errors of the test piece in the error-sensitive directions and the kinematic errors of C-axis and A-axis of five-axis machine tool rotary table was established based on the model of the kinematic errors. According to our previous work, the kinematic errors of C-axis can be treated as the known quantities, and the kinematic errors of A-axis can be obtained from the equations. This method was tested in Mikron UCP600 vertical machining center. The machining errors in the error-sensitive directions can be obtained by CMM inspection from the finished test piece to identify the kinematic errors of five-axis machine tool trunnion axis. Experimental results demonstrated that the proposed method can reduce the complexity, cost, and the time consumed substantially, and has a wider applicability. This paper proposes a new method of the machining tests for the trunnion axis of five-axis machine tool.

  20. One-stage posterior C2 and C3 pedicle screw fixation or combined anterior C2-C3 fusion for the treatment of unstable hangman's fracture.

    PubMed

    Liu, Jingchen; Li, Ye; Wu, Yuntao

    2013-03-01

    The present study aimed to evaluate the effect of using one-stage posterior C2 and C3 pedicle screw fixation or combined anterior C2-C3 fusion in the treatment of unstable hangman's fracture. A total of 13 patients with unstable hangman's fractures underwent C2 and C3 pedicle screw fixation, lamina interbody fusion or combined anterior C2-C3 fusion and imaging examinations to evaluate the fracture fixation and healing condition at three days and three months following surgery. Postoperative X-ray and computed tomography (CT) results showed high fracture reduction, good internal fixation position and reliable fracture fixation. The three-month postoperative CT showed good vertebral fracture healing. C2 and C3 pedicle screw fixation has a good curative effect in the treatment of unstable hangman's fracture. The direct fixation of the fracture enables early ambulation by the patients.

  1. Analysis of nodal aberration properties in off-axis freeform system design.

    PubMed

    Shi, Haodong; Jiang, Huilin; Zhang, Xin; Wang, Chao; Liu, Tao

    2016-08-20

    Freeform surfaces have the advantage of balancing off-axis aberration. In this paper, based on the framework of nodal aberration theory (NAT) applied to the coaxial system, the third-order astigmatism and coma wave aberration expressions of an off-axis system with Zernike polynomial surfaces are derived. The relationship between the off-axis and surface shape acting on the nodal distributions is revealed. The nodal aberration properties of the off-axis freeform system are analyzed and validated by using full-field displays (FFDs). It has been demonstrated that adding Zernike terms, up to nine, to the off-axis system modifies the nodal locations, but the field dependence of the third-order aberration does not change. On this basis, an off-axis two-mirror freeform system with 500 mm effective focal length (EFL) and 300 mm entrance pupil diameter (EPD) working in long-wave infrared is designed. The field constant aberrations induced by surface tilting are corrected by selecting specific Zernike terms. The design results show that the nodes of third-order astigmatism and coma move back into the field of view (FOV). The modulation transfer function (MTF) curves are above 0.4 at 20 line pairs per millimeter (lp/mm) which meets the infrared reconnaissance requirement. This work provides essential insight and guidance for aberration correction in off-axis freeform system design.

  2. A dual-axis approach to understanding neuroendocrine development

    PubMed Central

    Shirtcliff, Elizabeth A; Dismukes, Andrew R.; Marceau, Kristine P.; Ruttle, Paula; Simmons, Julian; Han, Georges

    2015-01-01

    This paper on ‘a dual-axis approach to understanding neuroendocrine development’ sets out to introduce a series of paper about a novel perspective regarding stress and sex hormones, or what the authors within this special issue term ‘coupling’ of hypothalamic-pituitary-adrenal and –gonadal axes. This view postulates that these axes do not necessarily operate in opposition, but can operate together as evidenced empirically as a positive within-person association between stress hormones like cortisol or sex hormones like testosterone. A wealth of papers within the special issue demonstrate positive coupling across acute, diurnal, basal, and longitudinal timeframes and across several different types of contexts. Reviews were meant to challenge whether this was physiologically plausible. Consistently, sophisticated statistical models were utilized in order to show a template for how to model positive coupling and to ensure that coupling was a within-person phenomenon. We cautiously considered positive coupling until the consistency of observing positive coupling was robust enough for us to consider challenging the prevailing oppositional view of these axes. We do so to acknowledge that there are contexts, moments and stages in which the function of these axes should work together: for example when contexts are both stressful and challenging or at developmental stages (like adolescence) in which the youth must grow up despite the storm and stress of youth. We hope that by putting forward a functional dual-axis approach, the field will be able to consider when and how a dual-axis approach is useful. PMID:26220016

  3. Feasibility of microvascular head and neck reconstruction in the setting of calcified arteriosclerosis of the vascular pedicle.

    PubMed

    Lee, Matthew K; Blackwell, Keith E; Kim, Brandon; Nabili, Vishad

    2013-03-01

    OBJECTIVE To report outcomes in free flap reconstructive surgery in the setting of calcified arteriosclerosis affecting the flap pedicle. DESIGN Retrospective review, including a detailed analysis of medical records, histopathologic findings, and a comprehensive review of the literature. METHODS A total of 1329 consecutive microvascular free tissue transfers were performed by 2 reconstructive surgeons at a university-affiliated tertiary care medical center from January 1, 1996, through December 31, 2011. Clinical notes, operative notes, and pathology reports were systematically reviewed to identify 44 patients (3%) with calcified arteriosclerosis involving the flap vascular pedicle. A comprehensive medical record review was performed for the included patients, detailing patient-related characteristics, flap survival, and incidence of perioperative complications. RESULTS A history of arteriosclerosis was identified preoperatively in 18 patients (41%). Eight patients (18%) were specifically recognized clinically and histologically to have a variant of arteriosclerosis known as Mönckeberg medial calcific sclerosis. In total, fibula osteocutaneous free flap was performed in 30 patients, radial forearm in 8 patients, rectus abdominus in 3 patients, latissimus dorsi in 2 patients, and parascapular in 1 patient. Perioperative complications occurred in 17 patients (39%), with the most common being pulmonary (14%) and cardiac (9%). Patient follow-up ranged from 3 to 137 months, with a mean postoperative follow-up of 21 months. The mean length of hospital stay was 12 days. There was a 0% incidence of total flap failure and a 7% incidence of partial flap necrosis. CONCLUSION Although technically challenging, successful microvascular free flap reconstruction can be achieved despite the presence of vascular calcifications affecting the flap vascular pedicle.

  4. A Universal Pedicle Screw and V-Rod System for Lumbar Isthmic Spondylolysis: A Retrospective Analysis of 21 Cases

    PubMed Central

    Chen, Xiong-sheng; Zhou, Sheng-yuan; Jia, Lian-shun; Gu, Xiao-min; Fang, Lei; Zhu, Wei

    2013-01-01

    Objective To investigate the surgical outcome of a universal pedicle screw-V rod system and isthmic bone grafting for isthmic spondylolysis. Methods Twenty-four patients with isthmic spondylolysis at L5 and grade 0–I spondylolisthesis (Meyerding classification) received isthmic bone graft and stabilization using the universal pedicle screw-V rod system. Back pain was evaluated using the visual analog scale (VAS) and time to bone healing, improvement in spondylolisthesis and intervertebral space height at L5/S1 and L4/L5 were assessed. Results Twenty-one patients were followed up for 24 months and included in the analysis. Back pain was markedly improved at 3 months postoperatively with a statistical difference in VAS scores compared with preoperative VAS scores (P<0.001). The VAS scores were 0 to 3 at 6 months postoperatively in all patients and no back pain was reported in all patients except 2 patients who complained of back pain after prolonged sitting. X-ray examination showed a bone graft healing time of 3 to 12 months. Grade I spondylolisthesis improved to grade 0 in 4 patients and no noticeable change was observed in the remaining 17 cases. The intervertebral space height at L5/S1 was statistically increased (P<0.05) while no statistically significant change was seen at L4/L5. There was no statistically significant difference in the ROM of the intervertebral disks of L5/S1 and L4/5 before and after surgery. Conclusions The universal pedicle screw-V rod system and isthmic bone grafting directly repairs isthmic spondylolysis and reduces back pain, prevents anterior displacement of the diseased segment and maintains intervertebral space height, thus offering a promising alternative to current approaches for isthmic spondylolysis. PMID:23691090

  5. The outcome of pedicle screw instrumentation removal for ongoing low back pain following posterolateral lumbar fusion

    PubMed Central

    Brumby-Rendell, Oscar P.; McDonald, Ben; Fisher, Tom; Tsimiklis, Christovalantis; Yoon, Wai Weng; Osti, Orso L.

    2015-01-01

    Background Our aim was to determine whether patients derived benefit from removal of pedicle screw instrumentation for axial pain without other cause using our surgical technique and patient selection. A secondary aim was to investigate factors that were associated with poorer outcomes for this procedure as well as complication rate in this cohort. Methods Theater records from a single spinal surgeon’s practice were reviewed to identify patients that had undergone lumbar fusion for discogenic back pain with subsequent pedicle screw instrumentation removal (Expedium, DePuy Synthes) in the preceding 3 years with a minimum of 18 months follow-up. Inclusion criteria were persisting midline axial back pain with computed tomography (CT)−confirmed solid fusion with non-radicular symptoms and nil other potential causes found, e.g., infection. Case note review along with pre- and post-operative Oswestry disability index (ODI) questionnaires and visual analog scores (VAS) were assessed for all patients. Surgical technique included re-use of previous midline posterior incision and the Wiltse approach with removal of implants, confirmation of a solid fusion mass, washout and bone grafting of removal sites. Results From 50 consecutive patients who underwent removal of posterolateral instrumentation for an index elective lumbar fusion for discogenic back pain, 34 patients were identified that met the criteria with a mean follow-up of 25 months (range, 18-36 months). The VAS and ODI improved in 22/34 (65%) of participants. The mean cohort VAS score was 6.6 pre-surgery and 4.3 post-surgery (P=0.04). Preoperative and postoperative mean Oswestry disability scores were 64 and 41, respectively (P=0.05). There was a statistically significant difference in the proportion of patients with poorer compared to satisfactory outcomes with regards to compensable status, preoperative grade II opioid use and shorter time between fusion and removal procedure. Complications were one

  6. Knee joint reconstruction after hemiarticular resection using pedicled patella and vascularized fibular graft.

    PubMed

    El-Gammal, Tarek A; El-Sayed, Amr; Kotb, Mohamed M; Saleh, Waleed Riad; Ragheb, Yasser Farouk

    2010-11-01

    Between 1999 and 2005, seven patients had resection of tumors around the knee joint that involved half of the articular surface of the femoral or tibial side. Average age of the patients was 28 years (range, 14-40). Tumor pathology was giant cell tumor in four patients, osteoblastoma in two, and benign fibrous histocytoma in one patient. Two patients had recurrent tumors. The tumor was located in the distal femur in five patients and in the proximal tibia in the remaining two. The ipsilateral patella pedicled on the infrapatellar fat pad was used to substitute the resected articular surface and a vascularized fibula osteoseptocutaneous flap was used to reconstruct the metaphyseal defect. Average follow-up period was 6.5 years (range, 3.5-10 years). All flaps survived. Average time to bone union was 3.5 months (range, 3-4 months), and average time to full weight-bearing was 5 months (range, 4-6 months). No radiological signs of avascular necrosis of the patella were observed in any patient. Two patients required secondary procedures for correction of instability. One patient had local recurrence. At final follow-up, the median range of knee motion was from 10° to 100°. The average Knee Society Score (KSS) was 76 points (range; 50-85 points), and the average KSS functional score was 76.6 points (range, 70-90 points). In conclusion, the procedure is a reliable option for after resection of tumors that involve half the articular surface of the femur or the tibia.

  7. Subsidence of metal interbody cage after posterior lumbar interbody fusion with pedicle screw fixation.

    PubMed

    Tokuhashi, Yasuaki; Ajiro, Yasumitsu; Umezawa, Natsuki

    2009-04-01

    Posterior lumbar interbody fusion is considered to be an excellent fusion procedure to stabilize anterior support, correct alignment in the sagittal and coronal plane, and achieve foraminal decompression by lifting the disk height. The metal interbody cage in posterior lumbar interbody fusion is thought to be useful to prevent collapse of the graft bone and to correct and maintain disk height; however, some studies have noted a gradual decrease of disk height due to cage subsidence. Therefore, to investigate the significance of cage subsidence, 86 disk levels radiographically confirmed to have good union in 66 patients with posterior lumbar interbody fusion combined with pedicle screw fixation and a single metal cage for degenerative lumbar disease were retrospectively evaluated. The follow-up period ranged from 3 years to 10 years 3 months, with a mean of 7 years 9 months. Cage subsidence often showed a gradual increase over time. At final follow-up, subsidence averaged 4.0 mm on the cranial surface and 2.7 mm on the caudal surface. Although the average increase of disk height was 3.2 mm immediately postoperatively, the final disk height decreased by 4.2 mm on average from that time. The degree of cage subsidence and decrease of disk height were not correlated with the final clinical results. Subsidence was not correlated with bone mineral density in the vertebral body, body weight, or site of the insertion. On the other hand, the wedge shape of the cage and the thickness of the resected endplate had a significant influence on cage subsidence.

  8. Design of Off-Axis PIAACMC Mirrors

    NASA Technical Reports Server (NTRS)

    Pluzhnik, Eugene; Guyon, Olivier; Belikov, Ruslan; Kern, Brian; Bendek, Eduardo

    2015-01-01

    The Phase-Induced Amplitude Apodization Complex Mask Coronagraph (PIAACMC) provides an efficient way to control diffraction propagation effects caused by the central obstruction/segmented mirrors of the telescope. PIAACMC can be optimized in a way that takes into account both chromatic diffraction effects caused by the telescope obstructed aperture and tip/tilt sensitivity of the coronagraph. As a result, unlike classic PIAA, the PIAACMC mirror shapes are often slightly asymmetric even for an on-axis configuration and require more care in calculating off-axis shapes when an off-axis configuration is preferred. A method to design off-axis PIAA mirror shapes given an on-axis mirror design is presented. The algorithm is based on geometrical ray tracing and is able to calculate off-axis PIAA mirror shapes for an arbitrary geometry of the input and output beams. The method is demonstrated using the third generation PIAACMC design for WFIRST-AFTA (Wide Field Infrared Survey Telescope-Astrophysics Focused Telescope Assets) telescope. Geometrical optics design issues related to the off-axis diffraction propagation effects are also discussed.

  9. A New Electromagnetic Navigation System for Pedicle Screws Placement: A Human Cadaver Study at the Lumbar Spine

    PubMed Central

    Hahn, Patrick; Oezdemir, Semih; Komp, Martin; Giannakopoulos, Athanasios; Heikenfeld, Roderich; Kasch, Richard; Merk, Harry; Godolias, Georgios; Ruetten, Sebastian

    2015-01-01

    Introduction Technical developments for improving the safety and accuracy of pedicle screw placement play an increasingly important role in spine surgery. In addition to the standard techniques of free-hand placement and fluoroscopic navigation, the rate of complications is reduced by 3D fluoroscopy, cone-beam CT, intraoperative CT/MRI, and various other navigation techniques. Another important aspect that should be emphasized is the reduction of intraoperative radiation exposure for personnel and patient. The aim of this study was to investigate the accuracy of a new navigation system for the spine based on an electromagnetic field. Material and Method Twenty pedicle screws were placed in the lumbar spine of human cadavers using EMF navigation. Navigation was based on data from a preoperative thin-slice CT scan. The cadavers were positioned on a special field generator and the system was matched using a patient tracker on the spinous process. Navigation was conducted using especially developed instruments that can be tracked in the electromagnetic field. Another thin-slice CT scan was made postoperatively to assess the result. The evaluation included the position of the screws in the direction of trajectory and any injury to the surrounding cortical bone. The results were classified in 5 groups: grade 1: ideal screw position in the center of the pedicle with no cortical bone injury; grade 2: acceptable screw position, cortical bone injury with cortical penetration ≤ 2 mm; grade 3: cortical bone injury with cortical penetration 2,1-4 mm, grad 4: cortical bone injury with cortical penetration 4,1-6 mm, grade 5: cortical bone injury with cortical penetration >6 mm. Results The initial evaluation of the system showed good accuracy for the lumbar spine (65% grade 1, 20% grade 2, 15% grade 3, 0% grade 4, 0% grade 5). A comparison of the initial results with other navigation techniques in literature (CT navigation, 2D fluoroscopic navigation) shows that the accuracy of

  10. Finite element analysis of Stryker Xia pedicle screw in artificial bone samples with and without supplemental cement augmentation.

    PubMed

    Pfeiffer, Ferris M; Choma, Theodore J; Kueny, Rebecca

    2015-01-01

    A validated, using in vitro biomechanical testing, finite element model was used to evaluate the affects of (1) cement augmentation and (2) an intact posterior cortex in osteoporotic bone. The presence of augmentation and/or a posterior cortical cortex increased the stabilization of the pedicle screw 2-5 fold. Placement of cement influenced failure load and toggle; with distal placement having the largest increase in failure load and decrease in cephalad-caudad toggle. The presence of posterior cortex caused a decrease in the amount of toggle, a proximal shift of the center of rotation and an increase in the maximum failure force.

  11. Prevalence of High-Riding Vertebral Artery and Morphometry of C2 Pedicles Using a Novel Computed Tomography Reconstruction Technique

    PubMed Central

    Wajanavisit, Wiwat; Fuangfa, Praman; Chanplakorn, Pongsthorn; Kraiwattanapong, Chaiwat; Jaovisidha, Supaneewan

    2016-01-01

    Study Design Cross-sectional, matched-pair comparative study. Purpose To determine whether a thin-sliced pedicular-oriented computed tomography (TPCT) scan reconstructed from an existing conventional computed tomography (CCT) scan is more accurate for identifying vertebral artery groove (VAG) anomalies than CCT. Overview of Literature Posterior atlantoaxial transarticular screw fixation and C2 pedicle screws can cause vertebral artery (VA) injury. Two anatomic variations of VAG anomalies are associated with VA injury: a high-riding VA (HRVA) and a narrow pedicle of the C2 vertebra. CCT scan is a reliable method used to evaluate VAG anomalies; however, its accuracy level remains debatable. Literature comparing the prevalence of C2 VAG anomalies between CCT and TPCT is limited. Methods A total of 200 computed tomography scans of the upper cervical spine obtained between January 2008 and December 2011 were evaluated for C2 VAG anomalies (HRVA and narrow pedicular width) using CCT and TPCT. The prevalence of C2 VAG anomalies was compared using these two different measurement methods via a McNemar's test. Results Of the 200 patients studied, 23 HRVA (6.01%; 95% confidence interval [CI], 3.61%–8.39%) were detected with CCT, whereas 66 HRVA (16.54%; 95% CI, 12.85%–20.23%) were detected with TPCT (p<0.001). Sixty-two narrow pedicles (15.58%; 95% CI, 11.99%–19.15%) were detected with CCT, whereas 90 narrow pedicles (22.83%; 95% CI, 18.58%–26.87%) were detected with TPCT (p<0.001). Conclusions VAG anomalies are commonly observed. A preoperative evaluation using TPCT reconstructed from an existing CCT revealed a significantly higher prevalence of C2 VAG anomalies than did CCT and showed comparable prevalence to previously published studies using more sophisticated and higher risk techniques. Therefore, we propose TPCT as an alternative preoperative evaluation for C2 screw placement and trajectory planning. PMID:27994792

  12. The UK National Flap Registry (UKNFR): A National Database for all pedicled and free flaps in the UK.

    PubMed

    Hazari, Anita; Walton, Peter

    2015-12-01

    The UK National Flap Registry (UKNFR) is a cross-speciality National Clinical Audit with participation by the British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS), British Association of Head and Neck Oncologists (BAHNO), British Association of Oral and Maxillofacial Surgeons (BAOMS) and Association of Breast Surgery (ABS). The aim of UKNFR is to collect information about all major pedicled and free flap operations carried out in the UK and through that, assess the quality of care we provide for patients. This audit will allow appropriate comparison of clinical performance with national standards and provide useful data on changing trends. Participation in audit is integral to appraisal and revalidation in the UK.

  13. Reconstruction of Abdominal Wall Defects Using a Pedicled Anterolateral Thigh Flap including the Vastus Lateralis Muscle: A Report of Two Cases

    PubMed Central

    Fujioka, Masaki; Ishiyama, Satoko

    2016-01-01

    The purpose of abdominal wall reconstruction is to prevent hernias and protect the abdominal viscera. In cases involving full-thickness defects of the rectus abdominis muscle, the muscle layer should be repaired. We present 2 cases in which full-thickness lower rectus abdominis muscle defects were reconstructed using vastus lateralis-anterolateral thigh flaps. The pedicled vastus lateralis-anterolateral thigh flap provides skin, fascia, and muscle tissue. Furthermore, it has a long neurovascular pedicle and can reach up to the periumbilical area and cover large defects. We consider that this muscle flap is a good option for repairing full-thickness lower abdominal defects. PMID:28074168

  14. Impact of pedicle-lengthening osteotomy on spinal canal volume and neural foramen size in three types of lumbar spinal stenosis

    PubMed Central

    Li, P.; Qian, L.; Wu, W. D.; Wu, C. F.

    2016-01-01

    Objectives Pedicle-lengthening osteotomy is a novel surgery for lumbar spinal stenosis (LSS), which achieves substantial enlargement of the spinal canal by expansion of the bilateral pedicle osteotomy sites. Few studies have evaluated the impact of this new surgery on spinal canal volume (SCV) and neural foramen dimension (NFD) in three different types of LSS patients. Methods CT scans were performed on 36 LSS patients (12 central canal stenosis (CCS), 12 lateral recess stenosis (LRS), and 12 foraminal stenosis (FS)) at L4-L5, and on 12 normal (control) subjects. Mimics 14.01 workstation was used to reconstruct 3D models of the L4-L5 vertebrae and discs. SCV and NFD were measured after 1 mm, 2 mm, 3 mm, 4 mm, or 5 mm pedicle-lengthening osteotomies at L4 and/or L5. One-way analysis of variance was used to examine between-group differences. Results In the intact state, SVC and NFD were significantly larger in the control group compared with the LSS groups (P<0.05). After lengthening at L4, the percentage increase in SCV (per millimetre) was LRS>CCS>FS>Control. After lengthening at L5 and L4-L5, the percentage increase in SCV (per millimetre) was LRS>FS>CCS>Control. After lengthening at L4 and L4-L5, the percentage increase in NFD (per millimetre) was FS>CCS>LRS>Control. After lengthening at L5, the percentage increase in NFD (per millimetre) was CCS>LRS>control>FS. Conclusions LRS patients are the most suitable candidates for treatment with pedicle-lengthening osteotomy. Lengthening L4 pedicles produced larger percentage increases in NFD than lengthening L5 pedicles (p < 0.05). Lengthening L4 pedicles may be the most effective option for relieving foraminal compression in LSS patients. Cite this article: P. Li, L. Qian, W. D. Wu, C. F. Wu, J. Ouyang. Impact of pedicle-lengthening osteotomy on spinal canal volume and neural foramen size in three types of lumbar spinal stenosis. Bone Joint Res 2016;5:239–246. DOI: 10.1302/2046-3758.56.2000469. PMID:27340140

  15. Vertical axis wind turbine. Final report

    SciTech Connect

    Hollrock, R.H.

    1983-06-01

    The work reported consisted of the fabrication and whirl testing of a vertical axis wind turbine. Problems are reported in blade fabrication and balancing. It is planned to provide speed control with a water agitator. (LEW)

  16. Vertical Axis Wind Turbine Foundation parameter study

    SciTech Connect

    Lodde, P.F.

    1980-07-01

    The dynamic failure criterion governing the dimensions of prototype Vertical Axis Wind Turbine Foundations is treated as a variable parameter. The resulting change in foundation dimensions and costs is examined.

  17. Off-axis illumination of lithography tool

    NASA Astrophysics Data System (ADS)

    Xing, Han; Lin, Li; Bin, Ma

    2013-12-01

    Lithography tool is a necessary part for LSI and VLSI. The illumination system design is an important part in the lithography optical system design. Off-axis illumination technology is an effective way to reducing resolution of lithography. The paper introduction the basic components of lithography tool, the principle of off-axis illumination reducing the resolution of lithography and focus on the two implementations of OAI technology, finally point out advantages and disadvantage of the two implementations.

  18. Electrical-Discharge Machining With Additional Axis

    NASA Technical Reports Server (NTRS)

    Malinzak, Roger M.; Booth, Gary N.

    1991-01-01

    Proposed electrical-discharge-machining (EDM) apparatus uses moveable vertical wire as electrode. Wire positionable horizontally along one axis as it slides vertically past workpiece. Workpiece indexed in rotation about horizontal axis. Because of symmetry of parts, process used to make two such parts at a time by defining boundary between them. Advantages: cost of material reduced, imparts less residual stress to workpiece, and less time spent machining each part when parts produced in such symmetrical pairs.

  19. Giant-cell granuloma of the axis.

    PubMed

    González-Martínez, Emilio; Santamarta, David; Lomas-García, Jesús; Ibáñez-Plágaro, F Javier; Fernández-Fernández, J Javier; Ariño, Teresa Ribas; García-Cosamalón, José

    2012-02-01

    Giant-cell granuloma is a benign and nonneoplastic lesion with an expansive and locally destructive behavior. It typically involves the mandible and the maxilla. Only 1 case arising from the odontoid process of the axis has been reported previously. The authors report on a 64-year-old man with a giant-cell granuloma of the axis. They review this uncommon entity, emphasizing the complexity of differentiating between this lesion and other giant-cell tumors.

  20. Sex differences in the HPA axis.

    PubMed

    Goel, Nirupa; Workman, Joanna L; Lee, Tiffany T; Innala, Leyla; Viau, Victor

    2014-07-01

    The hypothalamic-pituitary-adrenal (HPA) axis is a major component of the systems that respond to stress, by coordinating the neuroendocrine and autonomic responses. Tightly controlled regulation of HPA responses is critical for maintaining mental and physical health, as hyper- and hypo-activity have been linked to disease states. A long history of research has revealed sex differences in numerous components of the HPA stress system and its responses, which may partially form the basis for sex disparities in disease development. Despite this, many studies use male subjects exclusively, while fewer reports involve females or provide direct sex comparisons. The purpose of this article is to present sex comparisons in the functional and molecular aspects of the HPA axis, through various phases of activity, including basal, acute stress, and chronic stress conditions. The HPA axis in females initiates more rapidly and produces a greater output of stress hormones. This review focuses on the interactions between the gonadal hormone system and the HPA axis as the key mediators of these sex differences, whereby androgens increase and estrogens decrease HPA activity in adulthood. In addition to the effects of gonadal hormones on the adult response, morphological impacts of hormone exposure during development are also involved in mediating sex differences. Additional systems impinging on the HPA axis that contribute to sex differences include the monoamine neurotransmitters norepinephrine and serotonin. Diverse signals originating from the brain and periphery are integrated to determine the level of HPA axis activity, and these signals are, in many cases, sex-specific.

  1. [Variants in using the tubed pedicle in restorative operations on the face and the organs of the oral cavity].

    PubMed

    Arzhantsev, P Z; Gorbulenko, V B; Nikitin, A A; Spiridonova, N Z

    1995-01-01

    This article is based on 83 histories (89% male, 11% female) of patients who were operated for penetrating or superficial maxillofacial defects and deformations. 293 step-by-step operations were conducted using the bucket-handle graft in combination with nearest tissues. Age of patients: from 18 to 65. The Filatov-Gillies tubed pedicle was used as a carrier for hair-covering chin grafts which were implanted into de-epidermized zones during the formation of eyebrows in supraorbital areas. Bucket-handle graft was also used for reconstruction of lips, including vermillion border. The article contains the history and a photo of a woman who was operated for basaloma of nose and upper lip. After the destruction of a new growth by cryogenic method the plasty of upper lip and vermillion border was carried out with the help of one Filatov-Gillies tubed pedicle. The healing of wounds have proceeded without complications in 93.9 +/- 1.4% of cases. In 2 patients a partial necrosis of graft took place. One graft was removed. The divergence of stitches was marked in 15 (18%) of patients. Nevertheless it did not influence upon the outcome of reconstructive treatment.

  2. Multiobjective optimization design of spinal pedicle screws using neural networks and genetic algorithm: mathematical models and mechanical validation.

    PubMed

    Amaritsakul, Yongyut; Chao, Ching-Kong; Lin, Jinn

    2013-01-01

    Short-segment instrumentation for spine fractures is threatened by relatively high failure rates. Failure of the spinal pedicle screws including breakage and loosening may jeopardize the fixation integrity and lead to treatment failure. Two important design objectives, bending strength and pullout strength, may conflict with each other and warrant a multiobjective optimization study. In the present study using the three-dimensional finite element (FE) analytical results based on an L25 orthogonal array, bending and pullout objective functions were developed by an artificial neural network (ANN) algorithm, and the trade-off solutions known as Pareto optima were explored by a genetic algorithm (GA). The results showed that the knee solutions of the Pareto fronts with both high bending and pullout strength ranged from 92% to 94% of their maxima, respectively. In mechanical validation, the results of mathematical analyses were closely related to those of experimental tests with a correlation coefficient of -0.91 for bending and 0.93 for pullout (P < 0.01 for both). The optimal design had significantly higher fatigue life (P < 0.01) and comparable pullout strength as compared with commercial screws. Multiobjective optimization study of spinal pedicle screws using the hybrid of ANN and GA could achieve an ideal with high bending and pullout performances simultaneously.

  3. Usefulness of a first transferred free flap vascular pedicle for secondary microvascular reconstruction in the head and neck.

    PubMed

    Nakayama, Bin; Kamei, Yuzuru; Toriyama, Kazuhiro; Hyodo, Ikuo; Hasegawa, Yasuhisa; Torii, Shuhei

    2002-04-01

    The authors found that a previously transferred free flap vascular pedicle, distal to the first microvascular anastomosis, can be used as a recipient vessel for an additional free flap transfer. Free flap transfers were performed by using the standard procedure in patients with head and neck cancer. The mean age of the patients was 62 years. Five patients were men and three were women. A second free flap was transferred for secondary primary head and neck cancer in two cases, facial deformity in two cases, osteomyelitis of the skull in two cases, recurrent cancer in one case, and exposure of a mandibular reconstruction plate in one case. The interval between the two operations was from 4 months to 12 years (median, 21 months). All secondary free flaps were performed successfully. In two cases, the external jugular vein proximal to the previously anastomosed site was used for venous drainage. In another case, additional venous anastomosis was performed for flap congestion. It became clear that a previously transferred free flap vascular pedicle could be used as a recipient vessel for microvascular anastomosis. This is an excellent procedure for additional free flap transfers.

  4. Breast reconstruction with single-pedicle TRAM flap in breast cancer patients with low midline abdominal scar

    PubMed Central

    Wu, Jun-Dong; Huang, Wen-He; Qiu, Si-Qi; He, Li-Fang; Guo, Cui-Ping; Zhang, Yong-Qu; Zhang, Fan; Zhang, Guo-Jun

    2016-01-01

    Breast reconstruction with transverse rectus abdominis myocutaneous (TRAM) flap is challenging in patients with low midline abdominal scar. In this study, we aimed to investigate the clinical feasibility of immediate breast reconstruction using single-pedicle TRAM (SP-TRAM) flaps in patients with low midline abdominal scar. There were 4 strict selection criteria: 1) presence at least 3 perforators on the pedicle side; 2) perforators with regional average flow velocity of >20 cm/s; 3) upper edge of the abdominal scar at least 4 cm from the umbilicus; and 4) scar age >1 year. Eight breast cancer patients with low midline abdominal scar (scar group) and 20 without (control group) underwent immediate breast reconstruction with SP-TRAM flaps consisting of zone I and III and zone II tissues. Flap complications, donor-site complications, and cosmetic results were compared between the two groups. All flaps survived and both groups presented similar flap and donor site complications, including fat necrosis, seroma, hematoma, infection, delayed wound healing, and abdominal hernia, and patients in both groups had similar aesthetic results (p > 0.05). Thus, the study demonstrated that breast reconstruction using SP-TRAM flap was a safe approach in carefully selected patients with low midline abdominal scar. PMID:27406872

  5. Free and pedicled flaps for reconstruction of the weightbearing sole of the foot: a comparative analysis of functional results.

    PubMed

    Struckmann, Victoria; Hirche, Christoph; Struckmann, Folkart; Kolios, Leila; Lehnhardt, Marcus; Kneser, Ulrich; Daigeler, Adrien

    2014-01-01

    Reconstruction of the weightbearing sole of the foot is complex and requires soft tissue that is resistant to weight, pressure, and shear stress. Despite a variety of flap types and techniques, it is still challenging to meet these demands. The present retrospective study included 21 patients after reconstruction of plantar tissue defects from 2001 to 2011. The outcome was evaluated using the lower extremity functional scale, Weber score, pedobarography, assessment of shifting, and sensory recovery. The patients' quality of life was documented using the SF-36 questionnaire. Plantar reconstruction was performed using 12 free and 9 pedicled flaps. No differences in functional results were observed between the flap types, despite a better sense of temperature in the adipocutaneous flaps. The extent of flap shifting was independent of the flap type and did not correlate with the functional results. Pedobarography showed a tendency for increased peak pressure and prolonged contact time in the reconstructed weightbearing plantar areas compared with the sound feet and a control group. The present study found no relevant differences in the functional results between different flap types and free or pedicled techniques. Flap selection should be based on the individual requirements and availability of donor sites.

  6. Minimally invasive transforaminal lumbar interbody fusion with unilateral pedicle screw fixation: comparison between primary and revision surgery.

    PubMed

    Kang, Moo Sung; Park, Jeong Yoon; Kim, Kyung Hyun; Kuh, Sung Uk; Chin, Dong Kyu; Kim, Keun Su; Cho, Yong Eun

    2014-01-01

    Minimally invasive surgery with a transforaminal lumbar interbody fusion (MIS TLIF) is an important minimally invasive fusion technique for the lumbar spine. Lumbar spine reoperation is challenging and is thought to have greater complication risks. The purpose of this study was to compare MIS TLIF with unilateral screw fixation perioperative results between primary and revision surgeries. This was a prospective study that included 46 patients who underwent MIS TLIF with unilateral pedicle screw. The patients were divided into two groups, primary and revision MIS TLIF, to compare perioperative results and complications. The two groups were similar in age, sex, and level of operation, and were not significantly different in the length of follow-up or clinical results. Although dural tears were more common with the revision group (primary 1; revision 4), operation time, blood loss, total perioperative complication, and fusion rates were not significantly different between the two groups. Both groups showed substantial improvements in VAS and ODI scores one year after surgical treatment. Revision MIS TLIF performed by an experienced surgeon does not necessarily increase the risk of perioperative complication compared with primary surgery. MIS TLIF with unilateral pedicle screw fixation is a valuable option for revision lumbar surgery.

  7. AB191. Laparoscopic subcutaneous transposition of a pedicled adrenal for ACTH-independent bilateral macronodular adrenal hyperplasia

    PubMed Central

    Zhang, Weixing; Zhang, Tianbiao

    2016-01-01

    Objective Bilateral adrenalectomy or unilateral adrenalectomy and contralateral partial adrenalectomy are indicated for the treatment of ACTH-independent macronodular adrenal hyperplasia. Independent of the surgical procedure, the prognosis is poor. This paper discusses a new treatment method and its efficacy for treating nodular adrenal hyperplasia. Methods We performed a retrospective review of the medical records of 12 patients operated on between January 2008 and October 2014 at the First Affiliated Hospital of Zhengzhou University. All patients were treated by laparoscopic subcutaneous transposition of a pedicled adrenal. We performed postoperative monitoring of patients including clinical symptoms and 24-hour levels of serum free and urinary free cortisol. Results All twelve patients were pathologically confirmed to have nodular adrenal hyperplasia, and were followed for an average of 45.5 months (range, 24–60 months). The clinical symptoms of all patients disappeared, and the 24-hour plasma free cortisol and urinary free cortisol levels were within the normal range. Conclusions Laparoscopic subcutaneous transposition of a pedicled adrenal is a new and effective method for treating bilateral macronodular adrenal hyperplasia, and can achieve long-term remission of Cushing’s syndrome.

  8. Pedicle screw-based posterior dynamic stabilisation of the lumbar spine: in vitro cadaver investigation and a finite element study.

    PubMed

    Oktenoglu, T; Erbulut, D U; Kiapour, A; Ozer, A F; Lazoglu, I; Kaner, T; Sasani, M; Goel, V K

    2015-08-01

    Pedicle screw-based dynamic constructs either benefit from a dynamic (flexible) interconnecting rod or a dynamic (hinged) screw. Both types of systems have been reported in the literature. However, reports where the dynamic system is composed of two dynamic components, i.e. a dynamic (hinged) screw and a dynamic rod, are sparse. In this study, the biomechanical characteristics of a novel pedicle screw-based dynamic stabilisation system were investigated and compared with equivalent rigid and semi-rigid systems using in vitro testing and finite element modelling analysis. All stabilisation systems restored stability after decompression. A significant decrease in the range of motion was observed for the rigid system in all loadings. In the semi-rigid construct the range of motion was significantly less than the intact in extension, lateral bending and axial rotation loadings. There were no significant differences in motion between the intact spine and the spine treated with the dynamic system (P>0.05). The peak stress in screws was decreased when the stabilisation construct was equipped with dynamic rod and/or dynamic screws.

  9. Vaginal reconstruction with pedicled vertical deep inferior epigastric perforator flap (diep) after pelvic exenteration. A consecutive case series.

    PubMed

    Ferron, Gwénael; Gangloff, Dimitri; Querleu, Denis; Frigenza, Melanie; Torrent, Juan Jose; Picaud, Laetitia; Gladieff, Laurence; Delannes, Martine; Mery, Eliane; Boulet, Berenice; Balague, Gisele; Martinez, Alejandra

    2015-09-01

    Vaginal reconstruction after pelvic exenteration (PE) represents a challenge for the oncologic surgeon. Since the introduction of perforator flaps, using pedicled vertical DIEP (deep inferior epigastric perforator) flap allows to reduce the donor site complication rate. From November 2012 to December 2014, 27 PEs were performed in our institution. 13 patients who underwent PE with vaginal reconstruction and programmed DIEP procedure for gynecologic malignancies were registered. Nine patients underwent PE for recurrent disease and four for primary treatment. Six of the 13 patients have a preoperative fistula. Anterior PE was performed in 10 patients, and total PE in 3 patients. A vertical DIEP flap was performed in 10 patients using one or two medial perforators. The reasons for abortion of vertical DIEP flap procedure were: failure to localizing perforator vessels in two cases, and unavailability of plastic surgeon in one case. A vertical fascia-sparring rectus abdominis myocutaneous flap was then harvested. Median length of surgery was 335min, and 60min for DIEP harvesting and vaginal reconstruction. No flap necrosis occurred. One patient in the VRAM (vertical rectus abdominis myocutaneous) group experienced a late incisional hernia and one patient in the DIEP flap group required revision for vaginal stenosis. In our experience, DIEP flap represents our preferred choice of flap for circumferential vaginal reconstruction after PE. To achieve a high reproducibility, the technically demanding pedicled vertical DIEP flap has to be harvested by a trained surgeon, after strict evaluation of the preoperative imaging with identification and localization of perforator vessels.

  10. Pedicle Temporalis Fascial Flap with Axial Scalp Flap Obviates Need of Free Flap in Extensive Scalp Wound

    PubMed Central

    Khainga, S. O.

    2017-01-01

    Extensive scalp defect with exposed bone is best reconstructed with flaps. Majority of these wounds are now routinely reconstructed with free flaps in many centers. Free flaps however require lengthy operative time and may not be available to all patients, where possible less extensive options should thus be encouraged. A sixty-eight-year-old patient presented to us with a Marjolin's ulcer on the vertex of the scalp. After wide local excision a defect of about 17 cm and 12 cm was left. The defect was successfully covered with a combination of an ipsilateral pedicle temporalis fascial flap and an axial supraorbital scalp flap with good outcome. In conclusion wide defects of the scalp can be fully covered with a combination of local flaps. The axial scalp flap and the pedicle temporalis fascial flap where applicable provide an easy and less demanding option in covering such wounds. These flaps are reliable with good blood supply and have got less donor side morbidity. PMID:28194294

  11. Tuning the DARHT Axis-II linear induction accelerator focusing

    SciTech Connect

    Ekdahl, Carl A.

    2012-04-24

    Flash radiography of large hydrodynamic experiments driven by high explosives is a well-known diagnostic technique in use at many laboratories, and the Dual-Axis Radiography for Hydrodynamic Testing (DARHT) facility at Los Alamos produces flash radiographs of large hydrodynamic experiments. Two linear induction accelerators (LIAs) make the bremsstrahlung radiographic source spots for orthogonal views of each test. The 2-kA, 20-MeV Axis-I LIA creates a single 60-ns radiography pulse. The 1.7-kA, 16.5-MeV Axis-II LIA creates up to four radiography pulses by kicking them out of a longer pulse that has a 1.6-{mu}s flattop. The Axis-II injector, LIA, kicker, and downstream transport (DST) to the bremsstrahlung converter are described. Adjusting the magnetic focusing and steering elements to optimize the electron-beam transport through an LIA is often called 'tuning.' As in all high-current LIAs, the focusing field is designed to be as close to that of the ideal continuous solenoid as physically possible. In ideal continuous solenoidal transport a smoothly varying beam size can easily be found for which radial forces balance, and the beam is said to be 'matched' to the focusing field. A 'mismatched' beam exhibits unwanted oscillations in size, which are a source of free energy that contributes to emittance growth. This is undesirable, because in the absence of beam-target effects, the radiographic spot size is proportional to the emittance. Tuning the Axis-II LIA is done in two steps. First, the solenoidal focusing elements are set to values designed to provide a matched beam with little or no envelope oscillations, and little or no beam-breakup (BBU) instability growth. Then, steering elements are adjusted to minimize the motion of the centroid of a well-centered beam at the LIA exit. This article only describes the design of the tune for the focusing solenoids. The DARHT Axis-II LIA was required to be re-tuned after installing an accelerator cell to replace a failed

  12. Geometrical theory of aberrations near the axis in classical off-axis reflecting telescopes.

    PubMed

    Chang, Seunghyuk; Prata, Aluizio

    2005-11-01

    A geometrical theory of aberrations for the vicinity of the focus of arbitrary off-axis sections of conic mirrors is derived. It is shown that an off-axis conic mirror introduces linear astigmatism in the image. However, in classical two-mirror telescopes this aberration can be eliminated by tilting the secondary parent mirror axis. It is also shown that the practical geometrical-optics performance of a classical off-axis two-mirror telescope with no linear astigmatism is equivalent to the performance of an on-axis system, proving that both systems have identical third-order coma. To demonstrate the applicability of the theory developed in a practical system, a fast (i.e., f/2), compact, obstruction-free classical off-axis Cassegrain telescope is designed.

  13. Actuator assembly including a single axis of rotation locking member

    DOEpatents

    Quitmeyer, James N.; Benson, Dwayne M.; Geck, Kellan P.

    2009-12-08

    An actuator assembly including an actuator housing assembly and a single axis of rotation locking member fixedly attached to a portion of the actuator housing assembly and an external mounting structure. The single axis of rotation locking member restricting rotational movement of the actuator housing assembly about at least one axis. The single axis of rotation locking member is coupled at a first end to the actuator housing assembly about a Y axis and at a 90.degree. angle to an X and Z axis providing rotation of the actuator housing assembly about the Y axis. The single axis of rotation locking member is coupled at a second end to a mounting structure, and more particularly a mounting pin, about an X axis and at a 90.degree. angle to a Y and Z axis providing rotation of the actuator housing assembly about the X axis. The actuator assembly is thereby restricted from rotation about the Z axis.

  14. Posterior fusion only for thoracic adolescent idiopathic scoliosis of more than 80°: pedicle screws versus hybrid instrumentation

    PubMed Central

    Bakaloudis, Georgios; Lolli, Francesco; Vommaro, Francesco; Martikos, Konstantinos; Parisini, Patrizio

    2008-01-01

    The treatment of thoracic adolescent idiopathic scoliosis (AIS) of more than 80° traditionally consisted of a combined procedure, an anterior release performed through an open thoracotomy followed by a posterior fusion. Recently, some studies have reassessed the role of posterior fusion only as treatment for severe thoracic AIS; the correction rate of the thoracic curves was comparable to most series of combined anterior and posterior surgery, with shorter surgery time and without the negative effect on pulmonary function of anterior transthoracic exposure. Compared with other studies published so far on the use of posterior fusion alone for severe thoracic AIS, the present study examines a larger group of patients (52 cases) reviewed at a longer follow-up (average 6.7 years, range 4.5–8.5 years). The aim of the study was to evaluate the clinical and radiographic outcome of surgical treatment for severe thoracic (>80°) AIS treated with posterior spinal fusion alone, and compare comprehensively the results of posterior fusion with a hybrid construct (proximal hooks and distal pedicle screws) versus a pedicle screw instrumentation. All patients (n = 52) with main thoracic AIS curves greater than 80° (Lenke type 1, 2, 3, and 4), surgically treated between 1996 and 2000 at one institution, by posterior spinal fusion either with hybrid instrumentation (PSF–H group; n = 27 patients), or with pedicle screw-only construct (PSF–S group; n = 25 patients) were reviewed. There were no differences between the two groups in terms of age, Risser’s sign, Cobb preoperative main thoracic (MT) curve magnitude (PSF–H: 92° vs. PSF–S: 88°), or flexibility on bending films (PSF–H: 27% vs. PSF–S: 25%). Statistical analysis was performed using the t test (paired and unpaired), Wilcoxon test for non-parametric paired analysis, and the Mann–Whitney test for non-parametric unpaired analysis. At the last follow-up, the PSF–S group, when compared to the PSF

  15. Zograscopic viewing

    PubMed Central

    Koenderink, Jan; Wijntjes, Maarten; van Doorn, Andrea

    2013-01-01

    The “zograscope” is a “visual aid” (commonly known as “optical machine” in the 18th century) invented in the mid-18th century, and in general use until the early 20th century. It was intended to view single pictures (thus not stereographic pairs) with both eyes. The optics approximately eliminates the physiological cues (binocular disparity, vergence, accommodation, movement parallax, and image blur) that might indicate the flatness of the picture surface. The spatial structure of pictorial space is due to the remaining pictorial cues. As a consequence, many (or perhaps most) observers are aware of a heightened “plasticity” of the pictorial content for zograscopic as compared with natural viewing. We discuss the optics of the zograscope in some detail. Such an analysis is not available in the literature, whereas common “explanations” of the apparatus are evidently nonsensical. We constructed a zograscope, using modern parts, and present psychophysical data on its performance. PMID:23799196

  16. Periosteal ossification of the vascular pedicle after reconstruction of continuity defects of the mandible and the maxilla with fibular free flaps: a retrospective study.

    PubMed

    Karagozoglu, K H; Winters, H A H; Forouzanfar, T; Schulten, E A J M

    2013-12-01

    Periosteal ossification of the vascular pedicle of a fibular free flap after reconstruction of mandibular and maxillary continuity defects has been thought to be rare. The purpose of this study was to evaluate its incidence and contributory factors to its development.

  17. Freehand Thoracic Pedicle Screw Placement: Review of Existing Strategies and a Step-by-Step Guide Using Uniform Landmarks for All Levels

    PubMed Central

    Baaj, Ali A

    2016-01-01

    Pedicle screw fixation in the thoracic spine presents certain challenges due to the critical regional neurovascular anatomy as well as the narrow pedicular corridor that typically exists. With increased awareness of the dangers of intraoperative radiation, the ability to place pedicle screws with anatomic landmarks alone is paramount. In this study, we reviewed the literature from 1990 to 2015 for studies that included freehand pedicle screw placement in the thoracic spine with special emphasis on entry points and the trajectories of the screws. We excluded studies that used fluoroscopy guidance, navigation techniques, cadaveric and biomechanical articles, case reports, and experimental studies on animals. The search retrieved 40 articles, and after careful selection, seven articles were analyzed. Over 8,000 screws were placed in the different studies. The mean accuracy for placement of the thoracic screws was 93.3%. However, there is little consensus between studies in entry points, sagittal, and axial trajectories of the screws. We complete this review by presenting our step-by-step technique for the placement of freehand pedicle screws in the thoracic spine. PMID:27014535

  18. The use of computer-assisted surgery as an educational tool for the training of orthopedic surgery residents in pedicle screw placement: a pilot study and survey among orthopedic residents

    PubMed Central

    Aoude, Ahmed; Alhamzah, Hamzah; Fortin, Maryse; Jarzem, Peter; Ouellet, Jean; Weber, Michael H.

    2016-01-01

    Background The training of orthopedic residents in adequate pedicle screw placement is very important. We sought to investigate orthopedic residents’ perspectives on the use of computer-assisted surgery (CAS) in a training trial. Methods Orthopedic residents were randomly assigned to independently place a screw using the free-hand technique and the CAS technique on 1 of 3 cadavers (Cobb angles 5º, 15º and 67º) at randomly selected thoracolumbar vertebral levels. All residents were blinded to their colleagues’ pedicle screw placements and were asked to complete a short questionnaire at the end of the session to evaluate their experience with CAS. We obtained CT images for each cadaver to assess pedicle screw placement accuracy and classified placement as A) screw completely in pedicle, B) screw < 2 mm outside pedicle, C) screw 2–4 mm outside pedicle, or D) screw > 4 mm outside pedicle. Results Twenty-four orthopedic residents participated in this trial study. In total, 65% preferred using the free-hand technique in an educational setting even though most (60%) said that CAS is safer. The main reason for free-hand technique preference was the difficult technical aspects encountered with CAS. In addition, accuracy of pedicle screw placement in this trial showed that 5 screws were classified as A or B (safe zone) and 19 as grade C or D (unsafe zone) using the free-hand technique compared with 15 and 9, respectively, using CAS (p = 0.008). Conclusion Orthopedic residents perceived CAS as safe and demonstrated improved accuracy in pedicle screw placement in a single setting. However, the residents preferred the free-hand technique in an educational stetting owing to the difficult technical aspects of CAS. PMID:28234614

  19. POGAL B-Axis Motor Test

    SciTech Connect

    Hale, L C; Wulff, T A

    2004-06-28

    The Aerotech model S-180-69-A, a brushless DC motor of slotless design, was selected as the B-axis drive for the Precision Optical Grinder and Lathe (POGAL). It is common knowledge that a slotless motor will have effectively no magnetic cogging and much less torque ripple than a traditional slot-type motor. It is logical to believe that the radial and axial forces generated between the rotor and stator would also be smaller for a slotless design. This is important when a frameless motor is directly coupled to the axis, as these forces directly influence the axis and affect its error motion. It is the purpose of this test to determine the radial and axial forces generated by the Aerotech motor and to estimate their effect on the error motion of the axis using a mathematical model of the hydrostatic bearing being designed for POGAL. The test results combined with a mathematical model of the POGAL B axis indicate that the directly coupled Aerotech motor will be quite acceptable. In the radial direction, the residual motor force, after subtracting out the one-cycle force, could cause sub nanometer level error motion at the tool point. The axial direction is not in a sensitive direction for turning.

  20. Accuracy of Pedicle Screw Placement in Scoliosis Surgery: A Comparison between Conventional Computed Tomography-Based and O-Arm-Based Navigation Techniques

    PubMed Central

    Akazawa, Tsutomu; Sakuma, Tsuyoshi; Koyama, Kayo; Nemoto, Tetsuharu; Nawata, Kento; Yamazaki, Atsuro; Minami, Shohei

    2014-01-01

    Study Design Retrospective study. Purpose We compared the accuracy of O-arm-based navigation with computed tomography (CT)-based navigation in scoliotic surgery. Overview of Literature No previous reports comparing the results of O-arm-based navigation with conventional CT-based navigation in scoliotic surgery have been published. Methods A total of 222 pedicle screws were implanted in 29 patients using CT-based navigation (group C) and 416 screws were implanted in 32 patients using O-arm-based navigation (group O). Postoperative CT was performed to assess the screw accuracy, using the established Neo classification (grade 0: no perforation, grade 1: perforation <2 mm, grade 2: perforation ≥2 and <4, and grade 3: perforation ≥4 mm). Results In group C, 188 (84.7%) of the 222 pedicle screw placements were categorized as grade 0, 23 (10.4%) were grade 1, 11 (5.0%) were grade 2, and 0 were grade 3. In group O, 351 (84.4%) of the 416 pedicle screw placements were categorized as grade 0, 52 (12.5%) were grade 1, 13 (3.1%) were grade 2, and 0 were grade 3. Statistical analysis showed no significant difference in the prevalence of grade 2.3 perforations between groups C and O. The time to position one screw, including registration, was 10.9±3.2 minutes in group C, but was significantly decreased to 5.4±1.1 minutes in group O. Conclusions O-arm-based navigation facilitates pedicle screw insertion as accurately as conventional CT-based navigation. The use of O-arm-based navigation successfully reduced the time, demonstrating advantages in the safety and accuracy of pedicle screw placement for scoliotic surgery. PMID:24967047

  1. Aeroelastically coupled blades for vertical axis wind turbines

    DOEpatents

    Paquette, Joshua; Barone, Matthew F.

    2016-02-23

    Various technologies described herein pertain to a vertical axis wind turbine blade configured to rotate about a rotation axis. The vertical axis wind turbine blade includes at least an attachment segment, a rear swept segment, and optionally, a forward swept segment. The attachment segment is contiguous with the forward swept segment, and the forward swept segment is contiguous with the rear swept segment. The attachment segment includes a first portion of a centroid axis, the forward swept segment includes a second portion of the centroid axis, and the rear swept segment includes a third portion of the centroid axis. The second portion of the centroid axis is angularly displaced ahead of the first portion of the centroid axis and the third portion of the centroid axis is angularly displaced behind the first portion of the centroid axis in the direction of rotation about the rotation axis.

  2. Modular off-axis solar concentrator

    DOEpatents

    Plesniak, Adam P; Hall, John C

    2015-01-27

    A solar concentrator including a housing defining a vertical axis and including a receiving wall connected to a reflecting wall to define an internal volume and an opening into the internal volume, wherein the reflecting wall defines at least one primary optical element, and wherein at least a portion of the reflecting wall includes a layer of reflective material, the housing further including a cover connected to the receiving wall and the reflecting wall to seal the opening, and at least one receiver mounted on the receiving wall such that a vertical axis of the receiver is disposed at a non-zero angle relative to the vertical axis of the housing, the receiver including at least one photovoltaic cell.

  3. Enclosed, off-axis solar concentrator

    SciTech Connect

    Benitez, Pablo; Grip, Robert E; Minano, Juan C; Narayanan, Authi A; Plesniak, Adam; Schwartz, Joel A

    2013-11-26

    A solar concentrator including a housing having receiving wall, a reflecting wall and at least two end walls, the receiving, reflecting and end walls defining a three-dimensional volume having an inlet, wherein a vertical axis of the housing is generally perpendicular to the inlet, a receiver mounted on the receiving wall of the housing, the receiver including at least one photovoltaic cell, wherein a vertical axis of the receiver is disposed at a non-zero angle relative to the vertical axis of the housing, at least one clip disposed on the reflecting wall an optical element received within the three-dimensional volume, the optical element including at least one tab, the tab being engaged by the clip to align the optical element with the receiver, and a window received over the inlet to enclose the housing.

  4. Stability of vertical and horizontal axis Levitrons

    NASA Astrophysics Data System (ADS)

    Michaelis, M. M.; Taylor, D. B.

    2015-11-01

    The stability of the new horizontal axis Levitron3 is compared with that of the vertical axis device. The rotation frequency ranges are similar because they are determined by the same precessional micro-trap, for which some theory is given. But the macro-trap of the horizontal axis system gives it far greater mechanical stability. Field-line studies allow this to be more easily visualized. The greater stability allows for educational experiments which could only be contemplated with the old Levitron: driven precession and nutation and motion along the field lines. These experiments illustrate some very fundamental space dynamics and several other topics. The enhanced stability may also lead to electro-mechanical applications.

  5. Solar rotating magnetic dipole?. [around axis perpendicular to rotation axis of the sun

    NASA Technical Reports Server (NTRS)

    Antonucci, E.

    1974-01-01

    A magnetic dipole rotating around an axis perpendicular to the rotation axis of the sun can account for the characteristics of the surface large-scale solar magnetic fields through the solar cycle. The polarity patterns of the interplanetary magnetic field, predictable from this model, agree with the observed interplanetary magnetic sector structure.

  6. A users guide to HPA axis research.

    PubMed

    Spencer, Robert L; Deak, Terrence

    2016-11-18

    Glucocorticoid hormones (cortisol and corticosterone - CORT) are the effector hormones of the hypothalamic-pituitary-adrenal (HPA) axis neuroendocrine system. CORT is a systemic intercellular signal whose level predictably varies with time of day and dynamically increases with environmental and psychological stressors. This hormonal signal is utilized by virtually every cell and physiological system of the body to optimize performance according to circadian, environmental and physiological demands. Disturbances in normal HPA axis activity profiles are associated with a wide variety of physiological and mental health disorders. Despite numerous studies to date that have identified molecular, cellular and systems-level glucocorticoid actions, new glucocorticoid actions and clinical status associations continue to be revealed at a brisk pace in the scientific literature. However, the breadth of investigators working in this area poses distinct challenges in ensuring common practices across investigators, and a full appreciation for the complexity of a system that is often reduced to a single dependent measure. This Users Guide is intended to provide a fundamental overview of conceptual, technical and practical knowledge that will assist individuals who engage in and evaluate HPA axis research. We begin with examination of the anatomical and hormonal components of the HPA axis and their physiological range of operation. We then examine strategies and best practices for systematic manipulation and accurate measurement of HPA axis activity. We feature use of experimental methods that will assist with better understanding of CORT's physiological actions, especially as those actions impact subsequent brain function. This research approach is instrumental for determining the mechanisms by which alterations of HPA axis function may contribute to pathophysiology.

  7. Open dorsal vertebroplasty of the axis.

    PubMed

    Guerre, Pascal; Kröber, Markus

    2011-05-01

    Vertebroplasty of the axis is always a challenging procedure. We report the case of a young, HIV-positive patient suffering from an osteolytic metastasis of the axis. An open dorsal vertebroplasty was performed. A leakage of the cement formed a new cortical bone of the massa lateralis of C2, and stabilized the C1-C2 articulation by an arthrodesis-like effect. Durable pain relief and stabilization were obtained. The location of the cement, although atypical, had all desired effects of a conventional vertebroplasty. The intra-articular injection of cement into the facets for stabilization and pain relief could be considered in the future.

  8. Isodynamic axisymmetric equilibrium near the magnetic axis

    SciTech Connect

    Arsenin, V. V.

    2013-08-15

    Plasma equilibrium near the magnetic axis of an axisymmetric toroidal magnetic confinement system is described in orthogonal flux coordinates. For the case of a constant current density in the vicinity of the axis and magnetic surfaces with nearly circular cross sections, expressions for the poloidal and toroidal magnetic field components are obtained in these coordinates by using expansion in the reciprocal of the aspect ratio. These expressions allow one to easily derive relationships between quantities in an isodynamic equilibrium, in which the absolute value of the magnetic field is constant along the magnetic surface (Palumbo’s configuration)

  9. Isodynamic axisymmetric equilibrium near the magnetic axis

    NASA Astrophysics Data System (ADS)

    Arsenin, V. V.

    2013-08-01

    Plasma equilibrium near the magnetic axis of an axisymmetric toroidal magnetic confinement system is described in orthogonal flux coordinates. For the case of a constant current density in the vicinity of the axis and magnetic surfaces with nearly circular cross sections, expressions for the poloidal and toroidal magnetic field components are obtained in these coordinates by using expansion in the reciprocal of the aspect ratio. These expressions allow one to easily derive relationships between quantities in an isodynamic equilibrium, in which the absolute value of the magnetic field is constant along the magnetic surface (Palumbo's configuration).

  10. THE ENERGY-REDOX AXIS IN AGING AND AGE-RELATED NEURODEGENERATION

    PubMed Central

    Yap, Li-Peng; Garcia, Jerome V.; Han, Derick; Cadenas, Enrique

    2009-01-01

    Decrease in mitochondrial energy-transducing capacity is a feature of the aging process that accompanies redox alterations, such as increased generation of mitochondrial oxidants, altered GSH status, and increased protein oxidation. The decrease in mitochondrial energy-transducing capacity and altered redox status should be viewed as a concerted process that embodies the mitochondrial energy – redox axis and is linked through various mechanisms including: (a) an inter-convertible reducing equivalents pool (i.e., NAD(P)+/NAD(P)H) and (b) redox-mediated protein post-translational modifications involved in energy metabolism. The energy–redox axis provides the rationale for therapeutic approaches targeted to each or both component(s) of the axis that effectively preserves or improve mitochondrial function and that have implications for aging and age-related neurodegenerative disorders. PMID:19716388

  11. Periosteum as a lateral pedicle graft for the treatment of single tooth root recession: A novel approach.

    PubMed

    Kumar, Avadhesh; Kaushal, Shalini; Verma, Neelu; Chandra, Deepti

    2016-01-01

    The treatment of gingival recession defects is indicated for esthetic and functional reasons to reduce root sensitivity, to remove muscle pull, to create or augment keratinized tissue, and to prevent disease progression. The presence of sufficient amount of periosteum adjacent to gingival recession defects makes it a suitable graft. The adult human periosteum is a highly vascular connective tissue with immense regenerative potential. It contains fibroblasts, osteogenic progenitor cells, and stem cells as a result of which it has the ability to differentiate into fibroblast, osteoblast, chondrocytes, adipocytes, and skeletal myocytes. The tissue provided by these cells includes cementum with periodontal ligament fibers and bone. Therefore, in the present case, periosteum has been used as a lateral pedicle graft for the coverage of the single tooth gingival recession (mandibular central incisor). The procedure is justified by the evidence that periosteum is capable of proliferation and osteogenesis after injury.

  12. Treatment of Periradicular Bone Defect by Periosteal Pedicle Graft as a Barrier Membrane and Demineralized Freeze-Dried Bone Allograft

    PubMed Central

    Saxena, Anurag

    2017-01-01

    The purpose of this case report is to describe the usefulness of Periosteal Pedicle Graft (PPG) as a barrier membrane and Demineralized Freeze-Dried Bone Allograft (DFDBA) for bone regeneration in periradicular bone defect. A patient with intraoral discharging sinus due to carious exposed pulp involvement was treated by PPG and DFDBA. Clinical and radiological evaluations were done immediately prior to surgery, three months, six months and one year after surgery. Patient was treated using split-thickness flap, PPG, apicoectomy, defect fill with DFDBA and lateral displacement along with suturing of the PPG prior to suturing the flap, in order to close the communication between the oral and the periapical surroundings through sinus tract opening. After one year, successful healing of periradicular bone defect was achieved. Thus, PPG as a barrier membrane and DFDBA have been shown to have the potential to stimulate bone formation when used in periradicular bone defect. PMID:28274066

  13. Abdominal wall reconstruction after resection of an enterocutaneous fistula with an island pedicled anterolateral thigh perforator flap. Case report.

    PubMed

    Ali, F; Safawi, E B; Zakaria, Z; Basiron, N

    2013-01-01

    Entero-cutaneous fistula resulting from a locally invasive large bowel carcinoma is a difficult surgical challenge. En-bloc resection of the involved organs and the entero-cutaneous fistula tract with a healthy tissue margin will result in a composite abdominal wall defect that requires closure. Reconstructive surgical options include primary closure, components separation and the use of local, regional or free flaps with or without prosthetic mesh. We report a case of an abdominal enterocutaneous fistula secondary to a locally invasive sigmoid carcinoma, which was reconstructed with a pedicled antero-lateral thigh perforator (ALT) flap. To our knowledge, this is the first case of a malignant entero-cutaneous fistula, which was reconstructed with an ALT flap.

  14. Horizontal Axis Levitron--A Physics Demonstration

    ERIC Educational Resources Information Center

    Michaelis, Max M.

    2014-01-01

    After a brief history of the Levitron, the first horizontal axis Levitron is reported. Because it is easy to operate, it lends itself to educational physics experiments and analogies. Precession and nutation are visualized by reflecting the beam from a laser pointer off the "spignet". Precession is fundamental to nuclear magnetic…

  15. Tennis Rackets and the Parallel Axis Theorem

    ERIC Educational Resources Information Center

    Christie, Derek

    2014-01-01

    This simple experiment uses an unusual graph straightening exercise to confirm the parallel axis theorem for an irregular object. Along the way, it estimates experimental values for g and the moment of inertia of a tennis racket. We use Excel to find a 95% confidence interval for the true values.

  16. Comparison of Surgical Outcomes Between Short-Segment Open and Percutaneous Pedicle Screw Fixation Techniques for Thoracolumbar Fractures

    PubMed Central

    Fu, Zhiguo; Zhang, Xi; Shi, Yaohua; Dong, Qirong

    2016-01-01

    Background This study aimed to compare the surgical outcomes between open pedicle screw fixation (OPSF) and percutaneous pedicle screw fixation (PPSF) for the treatment of thoracolumbar fractures, which has received scant research attention to date. Material/Methods Eight-four patients with acute and subacute thoracolumbar fractures who were treated with SSPSF from January 2013 to June 2014 at the Changzhou Hospital of Traditional Chinese Medicine (Changzhou, China) were retrospectively reviewed. The patients were divided into 4 groups: the OPSF with 4 basic screws (OPSF-4) group, the OPSF with 4 basic and 2 additional screws (OPSF-6) group, the PPSF with 4 basic screws (PPSF-4) group, and the PPSF with 4 basic and 2 additional screws (PPSF-6) group. The intraoperative, immediate postoperative, and over 1-year follow-up outcomes were evaluated and compared among these groups. Results Blood loss in the PPSF-4 group and the PPSF-6 group was significantly less than in the OPSF-4 group and the OPSF-6 group (P<0.05). The OPSF-6 group exhibited significantly higher immediate postoperative correction percentage of anterior column height of fractured vertebra than the other 3 groups (P<0.05), and higher correction of sagittal regional Cobb angle and kyphotic angle of injured vertebra than in the PPSF-4 and -6 groups (P<0.05). In addition, there was no significant difference in the correction loss of percentage of anterior column height, and loss of sagittal Cobb angle and kyphotic angle of fractured vertebrae at final follow-up among the 4 groups (P>0.05). Conclusions OPSF with 6 screws had an advantage in the correction of injured vertebral height and kyphosis, and PPSF reduced the intraoperative blood loss of patients. PMID:27602557

  17. Multiplexed off-axis interferometric phase microscopy for dynamic cell measurements

    NASA Astrophysics Data System (ADS)

    Shaked, Natan T.; Girshovitz, Pinhas; Frenklach, Irena

    2015-03-01

    We present a new approach of optically multiplexing several off-axis interferograms on the same digital camera, each of which encodes a different field of view of the sample. Since the fringes of these interferograms are in different directions, as obtained experimentally by the optical system, we are able to double or even triple the amount of information that can be acquired in a single camera exposure, with the same number of camera pixels, while sharing the camera dynamic range. We show that this method can partially solve the problem of limited off-axis interferometric field of view due to low-coherence illumination. Our experimental demonstrations include quantitative phase imaging of microscopic diatom shells, fast swimming sperm cells and microorganisms, and contracting cardiomyocytes.

  18. New Two-Domain TN/LCD With Identical, Symmetrical and + or - 80 degs Viewing Cone in Left, Right, Up and Down Viewing Zones

    DTIC Science & Technology

    2000-07-01

    to -640) for CR=5, and 900 (+27 to -540) for CR=10. The viewing angle can be improved by Nitto C-plate with a vertically oriented optical axis and...vertical viewing zone with a viewing cone of 860 (±430) for CR=5, and 680 (±340) for CR=10. The viewing angle can be improved by Nitto C-plate with a

  19. LOFT. Containment and service building (TAN650). Section through east/west axis ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    LOFT. Containment and service building (TAN-650). Section through east/west axis of building as viewed from the north. Shows steel ladder to top of dome, gable roof of borated water tank enclosure, pumice block siding of pre-amp tower, metal siding of duct enclosure. Kaiser engineers 6413-11-STEP/LOFT-650-A-6. Date: October 1964. INEEL index code no. 036-650-00-486-122218 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  20. LOFT. Containment and service building (TAN650). Section through east/west axis ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    LOFT. Containment and service building (TAN-650). Section through east/west axis of building as viewed from the south. Shows basement and grade levels of containment building, connection to control room on west side, air filter vaults, and duct enclosure for air exhaust system. Kaiser engineers 6413-11-STEP/LOFT-650-A-4. Date: October 1964. INEEL index code no. 036-650-00-486-122216 - Idaho National Engineering Laboratory, Test Area North, Scoville, Butte County, ID

  1. Targeting Sphingosine-1-Phosphate Axis in Obesity-Promoted Breast Cancer

    DTIC Science & Technology

    2015-05-01

    2011; 20: 454-63. 5. Pierobon M, Frankenfeld CL. Obesity as a risk factor for triple-negative breast cancers : a systematic review and meta-analysis...AWARD NUMBER: W81XWH-14-1-0071 TITLE: Targeting Sphingosine-1-Phosphate Axis in Obesity-Promoted Breast Cancer PRINCIPAL INVESTIGATOR...0704-0188 Public reporting burden for this collection of infoonation is esttmated to average 1 hour per response, including the time for reViewing

  2. AXIS: an instrument for imaging Compton radiographs using the Advanced Radiography Capability on the NIF.

    PubMed

    Hall, G N; Izumi, N; Tommasini, R; Carpenter, A C; Palmer, N E; Zacharias, R; Felker, B; Holder, J P; Allen, F V; Bell, P M; Bradley, D; Montesanti, R; Landen, O L

    2014-11-01

    Compton radiography is an important diagnostic for Inertial Confinement Fusion (ICF), as it provides a means to measure the density and asymmetries of the DT fuel in an ICF capsule near the time of peak compression. The AXIS instrument (ARC (Advanced Radiography Capability) X-ray Imaging System) is a gated detector in development for the National Ignition Facility (NIF), and will initially be capable of recording two Compton radiographs during a single NIF shot. The principal reason for the development of AXIS is the requirement for significantly improved detection quantum efficiency (DQE) at high x-ray energies. AXIS will be the detector for Compton radiography driven by the ARC laser, which will be used to produce Bremsstrahlung X-ray backlighter sources over the range of 50 keV-200 keV for this purpose. It is expected that AXIS will be capable of recording these high-energy x-rays with a DQE several times greater than other X-ray cameras at NIF, as well as providing a much larger field of view of the imploded capsule. AXIS will therefore provide an image with larger signal-to-noise that will allow the density and distribution of the compressed DT fuel to be measured with significantly greater accuracy as ICF experiments are tuned for ignition.

  3. AXIS: An instrument for imaging Compton radiographs using the Advanced Radiography Capability on the NIF

    SciTech Connect

    Hall, G. N. Izumi, N.; Tommasini, R.; Carpenter, A. C.; Palmer, N. E.; Zacharias, R.; Felker, B.; Holder, J. P.; Allen, F. V.; Bell, P. M.; Bradley, D.; Montesanti, R.; Landen, O. L.

    2014-11-15

    Compton radiography is an important diagnostic for Inertial Confinement Fusion (ICF), as it provides a means to measure the density and asymmetries of the DT fuel in an ICF capsule near the time of peak compression. The AXIS instrument (ARC (Advanced Radiography Capability) X-ray Imaging System) is a gated detector in development for the National Ignition Facility (NIF), and will initially be capable of recording two Compton radiographs during a single NIF shot. The principal reason for the development of AXIS is the requirement for significantly improved detection quantum efficiency (DQE) at high x-ray energies. AXIS will be the detector for Compton radiography driven by the ARC laser, which will be used to produce Bremsstrahlung X-ray backlighter sources over the range of 50 keV–200 keV for this purpose. It is expected that AXIS will be capable of recording these high-energy x-rays with a DQE several times greater than other X-ray cameras at NIF, as well as providing a much larger field of view of the imploded capsule. AXIS will therefore provide an image with larger signal-to-noise that will allow the density and distribution of the compressed DT fuel to be measured with significantly greater accuracy as ICF experiments are tuned for ignition.

  4. The brain-pituitary-gonad axis in male teleosts, with special emphasis on flatfish (Pleuronectiformes).

    PubMed

    Weltzien, Finn-Arne; Andersson, Eva; Andersen, Øivind; Shalchian-Tabrizi, Kamran; Norberg, Birgitta

    2004-03-01

    The key component regulating vertebrate puberty and sexual maturation is the endocrine system primarily effectuated along the brain-pituitary-gonad (BPG) axis. By far most investigations on the teleost BPG axis have been performed on salmonids, carps, catfish and eels. Accordingly, earlier reviews on the BPG axis in teleosts have focused on these species, and mainly on females (e.g. 'Fish Physiology, vol. IXA. Reproduction (1983) pp. 97'; 'Proceedings of the Fourth International Symposium on the Reproductive Physiology of Fish. FishSymp91, Sheffield, UK, 1991, pp. 2'; 'Curr. Top. Dev. Biol. 30 (1995) pp. 103'; 'Rev. Fish Biol. Fish. 7 (1997) pp. 173'; 'Proceedings of the Sixth International Symposium on the Reproductive Physiology of Fish. John Grieg A/S, Bergen, Norway, 2000, pp. 211'). However, in recent years new data have emerged on the BPG axis in flatfish, especially at the level of the brain and pituitary. The evolutionarily advanced flatfishes are important model species both from an evolutionary point of view and also because many are candidates for aquaculture. The scope of this paper is to review the present status on the male teleost BPG axis, with an emphasis on flatfish. In doing so, we will first discuss the present understanding of the individual constituents of the axis in the best studied teleost models, and thereafter discuss available data on flatfish. Of the three constituents of the BPG axis, we will focus especially on the pituitary and gonadotropins. In addition to reviewing recent information on flatfish, we present some entirely new information on the phylogeny and molecular structure of teleost gonadotropins.

  5. Mortality of a captive axis deer (Axis axis) and a llama (Lama glama) due to ingestion of Wedelia glauca.

    PubMed

    Giannitti, Federico; Margineda, Carlos A; Cid, María S; Diab, Santiago S; Weber, Natalia; Rodríguez, Alejandro; Campero, Carlos M; Odriozola, Ernesto R

    2012-11-01

    The current study describes a naturally occurring cluster of cases of Wedelia glauca intoxication. Seven of 14 axis deer (Axis axis) and 1 of 8 llamas (Lama glama) in a zoo of Buenos Aires province, Argentina, died suddenly after ingestion of a new batch of alfalfa (Medicago sativa) hay bales contaminated with the hepatotoxic plant W. glauca. Necropsies of 1 deer and 1 llama were performed. Pathological findings in both animals included severe diffuse acute centrilobular hepatocellular necrosis and hemorrhage, and clear yellowish translucent gelatinous edema on the wall of the gall bladder and the serosa of the choledochoduodenal junction. Fragments of W. glauca plants were identified in the hay based on the botanical characteristics of the leaves. Samples of gastric contents were examined by microhistological analysis, which identified epidermal fragments of W. glauca based on the presence of characteristic uniseriate glandular hairs (trichomes), confirming recent ingestion of W. glauca in both cases. The fragments were quantified and represented 5% of all examined vegetal fragments in the deer and 10% in the llama.

  6. Environmental stressors and epigenetic control of the hypothalamic-pituitary-adrenal-axis (HPA-axis)

    PubMed Central

    Lee, Richard; Sawa, Akira

    2015-01-01

    In this review, we provide a brief summary of several key studies that broaden our understanding of stress and its epigenetic control of the hypothalamic-pituitary-adrenal axis (HPA)-axis function and behavior. Clinical and animal studies suggest a link among exposure to stress, dysregulation of the HPA-axis, and susceptibility to neuropsychiatric illnesses. Recent studies have supported the notion that exposure to glucocorticoids and stress in various forms, duration, and intensity during different periods of development leads to long-lasting maladaptive HPA-axis response in the brain. They demonstrate that this maladaptive response is comprised of persistent epigenetic changes in the function of HPA-axis-associated genes that govern homeostatic levels of glucocorticoids. Stressors and/or disruption of glucocorticoid dynamics also target genes such as brain-derived neurotrophic factor (BDNF) and tyrosine hydroxylase (TH) that are important for neuronal function and behavior. While a definitive role for epigenetic mechanisms remains unclear, these emerging studies implicate glucocorticoid signaling and its ability to alter the epigenetic landscape as one of the key mechanisms that alter the function of the HPA-axis and its associated cascades. We also suggest some of the requisite studies and techniques that are important, such as additional candidate gene approaches, genome-wide epigenomic screens, and innovative functional and behavioral studies in order to further explore and define the relationship between epigenetics and HPA-axis biology. Additional studies examining stress-induced epigenetic changes of HPA-axis genes, aided by innovative techniques and methodologies are needed to advance our understanding of this relationship and lead to better preventive, diagnostic, and corrective measures. PMID:25427939

  7. Full-field point-by-point direct design method of off-axis aspheric imaging systems.

    PubMed

    Gong, Tongtong; Jin, Guofan; Zhu, Jun

    2016-12-26

    It is of urgent need to develop a point-by-point design method for off-axis aspheric systems in full field and full aperture. So a general full-field point-by-point method for off-axis aspheric systems is presented in this paper, in which light rays from different field angles and aperture coordinates are considered. Surface fitting is included during the point calculations, rather than after all the points are calculated. Data point calculations and aspheric surface fitting are repeated continuously to calculate an unknown aspheric surface. Both coordinate and surface normal deviations are considered. As an example, an aspheric off-axis three-mirror reflective system is designed to operate at F/2.4 with a 100-mm entrance pupil diameter and a 3° × 6° off-axis field of view. This method can also be used to design co-axial aspheric systems and novel systems with new structures.

  8. Aircraft body-axis rotation measurement system

    NASA Technical Reports Server (NTRS)

    Cowdin, K. T. (Inventor)

    1983-01-01

    A two gyro four gimbal attitude sensing system having gimbal lock avoidance is provided with continuous azimuth information, rather than roll information, relative to the magnetic cardinal headings while in near vertical attitudes to allow recovery from vertical on a desired heading. The system is comprised of a means for stabilizing an outer roll gimbal that is common to a vertical gyro and a directional gyro with respect to the aircraft platform which is being angularly displaced about an axis substantially parallel to the outer roll gyro axis. A means is also provided for producing a signal indicative of the magnitude of such displacement as an indication of aircraft heading. Additional means are provided to cause stabilization of the outer roll gimbal whenever the pitch angle of the aircraft passes through a threshold prior to entering vertical flight and destabilization of the outer roll gimbal upon passing through the threshold when departing vertical flight.

  9. Multi-Axis Accelerometer Calibration System

    NASA Technical Reports Server (NTRS)

    Finley, Tom; Parker, Peter

    2010-01-01

    A low-cost, portable, and simplified system has been developed that is suitable for in-situ calibration and/or evaluation of multi-axis inertial measurement instruments. This system overcomes facility restrictions and maintains or improves the calibration quality for users of accelerometer-based instruments with applications in avionics, experimental wind tunnel research, and force balance calibration applications. The apparatus quickly and easily positions a multi-axis accelerometer system into a precisely known orientation suitable for in-situ quality checks and calibration. In addition, the system incorporates powerful and sophisticated statistical methods, known as response surface methodology and statistical quality control. These methods improve calibration quality, reduce calibration time, and allow for increased calibration frequency, which enables the monitoring of instrument stability over time.

  10. High payload six-axis load sensor

    DOEpatents

    Jansen, John F.; Lind, Randall F.

    2003-01-01

    A repairable high-payload six-axis load sensor includes a table, a base, and at least three shear-pin load transducers removably mounted between the table and the base. Removable mounting permits easy replacement of damaged shear pins. Preferably, the shear-pin load transducers are responsive to shear forces imparted along the two axes perpendicular to an axis of minimum sensitivity characteristic of the transducer. Responsive to an applied shear force, each shear-pin load transducer can produce an electrical signal proportional to the reaction force. The load sensor can further include a structure for receiving the proportional electrical signals and computing the applied load corresponding to the proportional electrical signals. The computed load can be expressed in terms of a three-dimensional XYZ Cartesian coordinate system.

  11. Two-axis joint assembly and method

    NASA Technical Reports Server (NTRS)

    Le, Thang D. (Inventor); Lewis, James L. (Inventor); Carroll, Monty B. (Inventor)

    2010-01-01

    In an embodiment, a two-axis joint that utilizes planar reactions to handle moments applied to the side of the joint thereby allowing the device to remain low profile and compact with minimal intrusion to the mounting surface of the two-axis joint. To handle larger moments, the diameter of the planar member can be increased without increasing the overall height of the joint assembly thereby retaining the low profile thereof. Upper and lower antifriction bearings may be positioned within a housing engage the planar member to reduce rotational friction. The upper and lower bearings and a hub which supports the planar member transfer forces produced by moments applied to the side of the joint so as to spread the forces over the area of the housing.

  12. Reconstruction of the Lower Abdominal Region Using Bilateral Pedicled Anterolateral Thigh Flaps Combined With Poly-Surgical Mesh: A Case Report.

    PubMed

    Zhou, Bo; Zhou, Xiao; Li, Zan; Chen, Ju-Ying; Peng, Xiao-Wei; Yang, Li-Chang; Lv, Chun-Liu

    2015-12-01

    The en-bloc resection of neoplasms on the abdominal wall often causes extensive defects that are difficult to manage. The anterolateral thigh (ALT) flap is a widely used flap in reconstructive surgery of defects. In this article, we present a case using bilateral pedicle anterolateral thigh flaps combined with a surgical polymesh to repair a large defect (22 cm × 18 cm) caused by dissection of a recurrent fibromatosis with good functional and aesthetic effects. There were no obvious morbidities or complications during a 6-month follow-up period.We conclude that the bilateral pedicle anterolateral thigh flap is a good choice for reconstruction of large lower abdominal wall defects. It can afford sufficient soft tissue coverage without obvious donor site morbidity.

  13. Pedicled full-thickness abdominal flap combined with skin grafting for the reconstruction of anterior chest wall defect following major electrical burn.

    PubMed

    Zhao, Jing-Chun; Xian, Chun-Jing; Yu, Jia-Ao; Shi, Kai

    2015-02-01

    Successful reconstruction of extensive anterior chest wall defect following major electrical burn represents a very challenging surgery. Herein we report the first case using pedicled full-thickness abdominal flap combined with skin grafting to treat this injury with severe infection and exposure of pericardium and ribs in a Chinese patient. Following the performance of chest debridement to remove necrotic and infected tissues and the injection of broad-spectrum antibiotics to reduce infection, a pedicled full-thickness abdominal flap was used to cover the exposed pericardium and ribs, and skin grafting from the right leg of the patient was done to cover the exposed vital tissues. The patient was followed up for a total of 3·5 years, and satisfactory cosmetic and functional outcomes were obtained without complications. This report provides an effective method for the surgeons who encounter similar cases where reconstruction of extensive anterior chest wall is required.

  14. Chimeric flaps pedicled with the lateral circumflex femoral artery for individualised reconstruction of through-and-through oral and maxillofacial defects.

    PubMed

    Gong, Zhao-jian; Zhang, Sheng; Wang, Kai; Tan, Hong-yu; Zhu, Zhao-fu; Liu, Jin-bing; Ren, Zhen-hu; He, Zhi-jing; Wu, Han-jiang

    2015-02-01

    Reconstruction of through-and-through oral and maxillofacial defects has always been difficult. We have evaluated the feasibility and reconstructive efficacy of chimeric flaps pedicled with the lateral circumflex femoral artery in the reconstruction of 41 through-and-through oral and maxillofacial defects after resections for cancer. There were 29 chimeric anterolateral thigh and anterolateral thigh flaps and 12 chimeric anterolateral thigh and anteromedial thigh flaps, the sizes of which ranged from 5×8 to 9×11 cm. The chimeric flaps provided separate flaps to reconstruct the intraoral mucosa and extraoral skin defects, and 40/41 of them survived. The appearance and function were satisfactory in all patients after the reconstruction. Chimeric flaps pedicled with the lateral circumflex femoral artery are a good choice for the reconstruction of through-and-through oral and maxillofacial defects.

  15. Prognosis of closure of large sinus membrane perforations using pedicled buccal fat pads and a resorbable collagen membrane: case series study

    PubMed Central

    Kim, Young-Kyun; Yun, Pil-Young; Oh, Ji-Su

    2014-01-01

    For large membrane perforations that develop during sinus-bone grafting, we performed repairs using a pedicled buccal fat pad and a resorbable collagen membrane simultaneously with the bone graft. This study included eight patients. Postoperative maxillary sinusitis developed in two patients, which we managed with incision and drainage, and antibiotics. Ultimately, six patients received 12 implants, three of which failed (75% success). Implant replacement was performed after the removal of the failed replacement, at which point the prosthetic treatment was considered complete. In all of the six cases that we were able to follow-up with, the sinus-bone graft was healing favorably. We observed that the sinus bone height decreased gradually with time. Based on these case series, we conclude that our procedure of repairing large sinus-membrane perforations with a pedicled buccal fat pad and a collagen membrane is a reliable technique. PMID:25247149

  16. Dysplastic dens of the axis: case report.

    PubMed

    Payer, M; Bijlenga, P; Delavelle, J

    2003-09-01

    In a patient injured in a bicycle accident, radiological evaluation of the cervical spine revealed an oblique orientation of a dysplastic dens of the axis, which, to our knowledge, has not been reported in the literature. There were no other bony or soft tissue anomalies and no associated instability. This case should draw attention to congenital anomalies of the cranio-cervical junction in trauma patients.

  17. Dynamics of the Lunar Spin Axis

    NASA Technical Reports Server (NTRS)

    Wisdom, Jack

    2006-01-01

    The evolution of the lunar spin axis is studied. Prior work has assumed that the inclination of the lunar orbit is constant and that the node regresses uniformly. This work takes into account the nonconstant inclination and nonuniform regression of the node as determined from averaged models of the motion of the lunar orbit. The resulting dynamics is considerably more rich, exhibiting additional resonances, period doubling and tripling, and chaos.

  18. Multivariable root loci on the real axis

    NASA Technical Reports Server (NTRS)

    Yagle, A. E.; Levy, B. C.

    1982-01-01

    Some methods for determining the number of branches of multivariable root loci which are located on the real axis at a given point are obtained by using frequency domain methods. An equation for the number of branches is given for the general case, and simpler results for the special cases when the transfer function G(s) has size 2 x 2, and when G(s) is symmetric, are also presented.

  19. Three-Axis Superconducting Gravity Gradiometer

    NASA Technical Reports Server (NTRS)

    Paik, Ho Jung

    1987-01-01

    Gravity gradients measured even on accelerating platforms. Three-axis superconducting gravity gradiometer based on flux quantization and Meissner effect in superconductors and employs superconducting quantum interference device as amplifier. Incorporates several magnetically levitated proof masses. Gradiometer design integrates accelerometers for operation in differential mode. Principal use in commercial instruments for measurement of Earth-gravity gradients in geo-physical surveying and exploration for oil.

  20. Determining the Stellar Spin Axis Orientation

    NASA Astrophysics Data System (ADS)

    Lesage, Anna-Lea; Wiedemann, Gunter

    2015-01-01

    We present an observing method that permits the determination of the absolute stellar spin axis position angle based on spectro-astrometric observations for slowly-rotating late-type stars. This method is complementary to current interferometric observations that determine the orientation of stellar spin axis for early-type fast-rotating stars. Spectro-astrometry enables us to study phenomena below the diffraction limit, at the milli-arcsecond scale. It relies on the wavelength dependent variations of the centroid position of a structured source in a long-slit spectrum. A rotating star has a slight tilt in its spectral lines, which induces a displacement of the photocentre's position. By monitoring the amplitude of the displacement for varying slit orientations, we can infer the absolute position angle of the stellar spin axis. Finally, we present first observational results on Aldebaran obtained with the Thüringer Landesternwarte high resolution spectrograph. We were able to retrieve Aldebaran's position angle with less than 10° errors.

  1. Three-axis superconducting gravity gradiometer

    SciTech Connect

    Paik, H.J.

    1989-06-27

    This patent describes a gradiometer having a sensitive axis for detecting a gravity gradient along the sensitive axis, comprising: a pair of accelerometers having respective sensitive axes; each accelerometer including a proof mass having a pair of hollowed out annular portions; each proof mass having at least one sensing coil arranged adjacent a bottom-side surface of the respective proof mass in one of the hollowed out portions and a levitation coil arranged adjacent a second bottom-side surface of the respective proof mass in the other hollowed out portion, at least one sensing coil and the levitation coil thus being located on the same side of the respective proof mass in relation to the direction of an external force exerted on the gradiometer thereby to compensate for temperature induced changes in magnetic field penetration into the respective proof mass; at least one first superconducting circuit in which the sensing coils of the accelerometers are interconnected and in which a first persistent current flows, the first circuit having an output indicative of a gravity gradient along the sensitive axis of the gradiometer.

  2. Flow-through anastomosis using a T-shaped vascular pedicle for gracilis functioning free muscle transplantation in brachial plexus injury

    PubMed Central

    Hou, Yi; Yang, Jiantao; Yang, Yi; Qin, Bengang; Fu, Guo; Li, Xiangming; Gu, Liqiang; Liu, Xiaolin; Zhu, Qingtang; Qi, Jian

    2015-01-01

    OBJECTIVE: In gracilis functioning free muscle transplantation, the limited caliber of the dominant vascular pedicle increases the complexity of the anastomosis and the risk of vascular compromise. The purpose of this study was to characterize the results of using a T-shaped vascular pedicle for flow-through anastomosis in gracilis functioning free muscle transplantation for brachial plexus injury. METHODS: The outcomes of patients with brachial plexus injury who received gracilis functioning free muscle transplantation with either conventional end-to-end anastomosis or flow-through anastomosis from 2005 to 2013 were retrospectively compared. In the flow-through group, the pedicle comprised a segment of the profunda femoris and the nutrient artery of the gracilis. The recipient artery was interposed by the T-shaped pedicle. RESULTS: A total of 46 patients received flow-through anastomosis, and 25 patients received conventional end-to-end anastomosis. The surgical time was similar between the groups. The diameter of the arterial anastomosis in the flow-through group was significantly larger than that in the end-to-end group (3.87 mm vs. 2.06 mm, respectively, p<0.001), and there were significantly fewer cases of vascular compromise in the flow-through group (2 [4.35%] vs. 6 [24%], respectively, p=0.019). All flaps in the flow-through group survived, whereas 2 in the end-to-end group failed. Minimal donor-site morbidity was noted in both groups. CONCLUSIONS: Flow-through anastomosis in gracilis functioning free muscle transplantation for brachial plexus injury can decrease the complexity of anastomosis, reduce the risk of flap loss, and allow for more variation in muscle placement. PMID:26247666

  3. Use of Latissimus Dorsi Pedicled Myocutaneous Flap for Reconstruction in the Chest Area of an 8-Month-Old Female Infant with Ectopia Cordis

    PubMed Central

    Dastagir, Khaled; Breymann, Thomas; Heckmann, Andreas; Horke, Alexander; Vogt, Peter Maria

    2014-01-01

    Ectopia cordis (EC) is characterized by a complete or partial malposition of the heart outside the thorax. Despite the interdisciplinary treatment, the repair of EC is still very difficult and offers new surgical challenges because of its complexity and various combinations with other anomalies. We report the successful outcome after using a pedicled latissimus dorsi flap in reconstructive surgery in the setting of chronic wound dehiscence in an 8-month-old female infant born with a thoracic EC and omphalocele. PMID:25798359

  4. Use of latissimus dorsi pedicled myocutaneous flap for reconstruction in the chest area of an 8-month-old female infant with ectopia cordis.

    PubMed

    Dastagir, Khaled; Breymann, Thomas; Heckmann, Andreas; Horke, Alexander; Vogt, Peter Maria

    2014-12-01

    Ectopia cordis (EC) is characterized by a complete or partial malposition of the heart outside the thorax. Despite the interdisciplinary treatment, the repair of EC is still very difficult and offers new surgical challenges because of its complexity and various combinations with other anomalies. We report the successful outcome after using a pedicled latissimus dorsi flap in reconstructive surgery in the setting of chronic wound dehiscence in an 8-month-old female infant born with a thoracic EC and omphalocele.

  5. Neuroanatomy and physiology of the avian hypothalamic/pituitary axis: clinical aspects.

    PubMed

    Ritchie, Midge

    2014-01-01

    This article describes the anatomy of the avian hypothalamic/pituitary axis, the hypothalamic-pituitary-thyroid axis, the hypothalamic-pituitary-adrenal axis, the hypothalamic-pituitary-gonadal axis, the somatotrophic axis, and neurohypophysis.

  6. The Pedicled Omental Flap Technique for Treating Extensive Defects or Soft-Tissue Infection of the Pelvic Area: A Report of 2 Cases.

    PubMed

    Hara, Yoshiaki; Matsumoto, Hisashi; Yokota, Hiroyuki; Kawai, Makoto; Yagi, Takanori; Saito, Nobuyuki; Yasumatsu, Hiroshi; Mashiko, Kazuki; Motomura, Tomokazu; Iida, Hiroaki

    2016-01-01

    Severe trauma injuries, such as open pelvic fractures and degloving injuries, have recently become salvageable. However, extensive soft-tissue defects often remain and can lead to disuse atrophy of the extremities, prolonged hospital stays, and numerous other problems. Such injuries can be easily and effectively treated by a general trauma surgeon performing the pedicled omental flap technique. We report on 2 highly diverse and complicated cases of soft-tissue defect that were both successfully treated with this technique. One case was an extensive right-sided defect of the pelvic soft-tissue in a 20-year-old woman. The other case was in a 55-year-old man who underwent emergency artificial vessel replacement surgery for a femoral artery tear with severe damage to the surrounding muscle. Although the surgery was successful, a methicillin-resistant Staphylococcus aureus infection developed around the artificial vessel 10 days after surgery. In both cases, the pedicled omental flap technique was successfully performed and yielded epithelization without serious infection and with the infection subsiding with wound-area healing. To our knowledge, the pedicled omental flap technique has rarely been used to treat severe trauma, and our results suggest its usefulness for both preventing infection in large wounds and healing infected wounds.

  7. Superior half of the sternoclavicular joint pedicled with the sternocleidomastoid muscle for reconstruction of the temporomandibular joint: a preliminary study with a simplified technique and expanded indications.

    PubMed

    Chen, M; Yang, C; Qiu, Y; He, D; Huang, D; Wei, W

    2015-06-01

    The sternoclavicular joint (SCJ) has similar anatomical and physical characteristics to the temporomandibular joint (TMJ). The purpose of this article is to introduce a modified technique for the pedicled SCJ and the expanded indications for its use. During the period June 2011 to June 2014, six TMJs were reconstructed using the superior half of the SCJ pedicled with the sternocleidomastoid muscle. The inclusion criteria were (1) poor vascularization jeopardizing a non-vascularized TMJ replacement, and/or (2) a large defect of both bone and soft tissue. The average follow-up period was 14.8 months (range 7-39 months). Fracture of the clavicle occurred in one patient (16.7%). No recurrence, graft resorption, or secondary deformity was found. Reconstruction of the TMJ using the superior half of the SCJ pedicled with the clavicle head of the sternocleidomastoid muscle and sternocleidomastoid branch of the superior thyroid artery benefited patients who had a poor blood supply and a medullary condition or who had a defect in both the condyle and surrounding soft tissue.

  8. Two levels above and one level below pedicle screw fixation for the treatment of unstable thoracolumbar fracture with partial or intact neurology

    PubMed Central

    Modi, Hitesh N; Chung, Kook Jin; Seo, Il Woo; Yoon, Hoi Soo; Hwang, Ji Hyo; Kim, Hong Kyun; Noh, Kyu Cheol; Yoo, Jung Han

    2009-01-01

    Background Treatment of unstable thoracolumbar fractures is controversial regarding short or long segment pedicle screw fixation. Although long level fixation is better, it can decrease one motion segment distally, thus increasing load to lower discs. Methods We retrospectively analyzed 31 unstable thoracolumbar fractures with partial or intact neurology. All patients were operated with posterior approach using pedicle screws fixed two levels above and one level below the fracture vertebra. No laminectomy, discectomy or decompression procedure was done. Posterior fusion was achieved in all. Post operative and at final follow-up radiological evaluation was done by measuring the correction and maintenance of kyphotic angle at thoracolumbar junction. Complications were also reported including implant failure. Results Average follow-up was 34 months. All patients had full recovery at final follow-up. Average kyphosis was improved from 26.7° to 4.1° postoperatively and to 6.3° at final follow-up. And mean pain scale was improved from 7.5 to 3.9 postoperatively and to 1.6 at final follow-up, All patients resumed their activity within six months. Only 4 (12%) complications were noted including only one hardware failure. Conclusion Two levels above and one level below pedicle screw fixation in unstable thoracolumbar burst fracture is useful to prevent progressive kyphosis and preserves one motion segment distally. PMID:19635134

  9. The Pedicled Buccal Fat Pad: Anatomical Study of the New Flap for Skull Base Defect Reconstruction After Endoscopic Endonasal Transpterygoid Surgery.

    PubMed

    Golbin, Denis A; Lasunin, Nikolay V; Cherekaev, Vasily A; Polev, Georgiy A

    2017-02-01

    Objectives To evaluate the efficacy and safety of using a buccal fat pad for endoscopic skull base defect reconstruction. Design Descriptive anatomical study with an illustrative case presentation. Setting Anatomical study was performed on 12 fresh human cadaver specimens with injected arteries (24 sides). Internal carotid artery was exposed in the coronal plane via the endoscopic transpterygoid approach. The pedicled buccal fat pad was used for reconstruction. Participants: 12 human cadaver head specimens; one patient operated using the proposed technique. Main outcome measures: Proximity of the buccal fat pad flap to the defect, compliance of the flap, comfort and safety of harvesting procedure, and compatibility with the Hadad-Bassagasteguy nasoseptal flap. Results: Harvesting procedure was performed using anterior transmaxillary corridor. The pedicled buccal fat pad flap can be used to pack the sphenoid sinus or cover the internal carotid artery from cavernous to upper parapharyngeal segment. Conclusion The buccal fat pad can be safely harvested through the same approach without external incisions and is compliant enough to conform to the skull base defect. The proposed pedicled flap can replace free abdominal fat in central skull base reconstruction. The volume of the buccal fat pad allows obliteration of the sphenoid sinus or upper parapharyngeal space.

  10. Failure by congestion of pedicled and free flaps for reconstruction of lower limbs after trauma: the role of negative-pressure wound therapy.

    PubMed

    Vaienti, L; Gazzola, R; Benanti, E; Leone, F; Marchesi, A; Parodi, P C; Riccio, M

    2013-09-01

    Lower limb reconstruction with pedicled or free flaps can be commonly compromised by venous insufficiency. This complication often leads to partial/complete flap necrosis and increases the risk of superinfection. Negative-pressure wound therapy (NPWT) is known to increase local blood flow, decrease edema, promote tissue granulation, and reduce the likelihood of soft tissue infection. This study aims to evaluate the effectiveness of NPWT in the treatment of congested pedicled and free flaps of the lower limb after reconstructions in lower limb traumas. A retrospective analysis was performed on four congested (pedicled and free) flaps on the lower limbs. NPWT was applied in all cases after partial flap debridement. NPWT was able to improve and resolve tissue edema and venous insufficiency, avoid further flap necrosis, and promote granulation. On NPWT removal, a split-thickness skin graft was applied on the wound, achieving complete and uneventful healing. NPWT is a useful instrument in managing flaps affected by venous insufficiency in lower limb reconstruction, although larger studies are necessary to better define the effectiveness and indications of NPWT in this setting.

  11. Cross-axis adaptation of torsional components in the yaw-axis vestibulo-ocular reflex

    NASA Technical Reports Server (NTRS)

    Trillenberg, P.; Shelhamer, M.; Roberts, D. C.; Zee, D. S.

    2003-01-01

    The three pairs of semicircular canals within the labyrinth are not perfectly aligned with the pulling directions of the six extraocular muscles. Therefore, for a given head movement, the vestibulo-ocular reflex (VOR) depends upon central neural mechanisms that couple the canals to the muscles with the appropriate functional gains in order to generate a response that rotates the eye the correct amount and around the correct axis. A consequence of these neural connections is a cross-axis adaptive capability, which can be stimulated experimentally when head rotation is around one axis and visual motion about another. From this visual-vestibular conflict the brain infers that the slow-phase eye movement is rotating around the wrong axis. We explored the capability of human cross-axis adaptation, using a short-term training paradigm, to determine if torsional eye movements could be elicited by yaw (horizontal) head rotation (where torsion is normally inappropriate). We applied yaw sinusoidal head rotation (+/-10 degrees, 0.33 Hz) and measured eye movement responses in the dark, and before and after adaptation. The adaptation paradigm lasted 45-60 min, and consisted of the identical head motion, coupled with a moving visual scene that required one of several types of eye movements: (1) torsion alone (-Roll); (2) horizontal/torsional, head right/CW torsion (Yaw-Roll); (3) horizontal/torsional, head right/CCW torsion (Yaw+Roll); (4) horizontal, vertical, torsional combined (Yaw+Pitch-Roll); and (5) horizontal and vertical together (Yaw+Pitch). The largest and most significant changes in torsional amplitude occurred in the Yaw-Roll and Yaw+Roll conditions. We conclude that short-term, cross-axis adaptation of torsion is possible but constrained by the complexity of the adaptation task: smaller torsional components are produced if more than one cross-coupling component is required. In contrast, vertical cross-axis components can be easily trained to occur with yaw head

  12. Effects of postural change on transesophageal echocardiography views and parameters in healthy dogs

    PubMed Central

    GOYA, Seijirow; WADA, Tomoki; SHIMADA, Kazumi; HIRAO, Daiki; FUKUSHIMA, Ryuji; YAMAGISHI, Norio; SHIMIZU, Miki; TANAKA, Ryou

    2016-01-01

    The purpose of the present study is to investigate the effect of postural change on transesophageal echocardiography (TEE) views and parameters of interest anesthesia monitoring in healthy dogs. Twelve Beagle dogs were anesthetized and randomly positioned in one of four postures: right lateral-recumbency, left lateral-recumbency, supine position and prone position. After examinations in one posture, the same examination was demonstrated in another posture and repeated in all postures. In each posture, several standard TEE views were demonstrated: longitudinal cranial-esophageal aorta long-axis-view, transverse middle-esophageal mitral valve long-axis-view and transgastric middle short-axis-view. Additionally, echocardiographic parameters were attempted to measure, and direct blood pressure monitoring was performed in each view. As a result, oriented views, except for transgastric middle short-axis-view, could be obtained in all postures. Stroke volume and peak early diastolic velocity of mitral inflow were lower in supine position compared with those in right and left lateral-recumbency. Heart rate (HR) and systemic vascular resistance were higher in supine position compared with those in right and left lateral-recumbency. Left ventricular pre-ejection period/left ventricular ejection time corrected and uncorrected by HR were higher in supine position compared with those in right and left lateral-recumbency. In conclusion, longitudinal cranial-esophageal aorta long-axis-view and transverse middle-esophageal mitral valve long-axis-view provide useful information of interest anesthesia monitoring, because of their views enable to certainly obtain TEE parameters in various postures. Furthermore, TEE parameters allow to detect the changes of preload, afterload and HR that occur in supine position dogs. PMID:27980234

  13. Effects of postural change on transesophageal echocardiography views and parameters in healthy dogs.

    PubMed

    Goya, Seijirow; Wada, Tomoki; Shimada, Kazumi; Hirao, Daiki; Fukushima, Ryuji; Yamagishi, Norio; Shimizu, Miki; Tanaka, Ryou

    2017-02-28

    The purpose of the present study is to investigate the effect of postural change on transesophageal echocardiography (TEE) views and parameters of interest anesthesia monitoring in healthy dogs. Twelve Beagle dogs were anesthetized and randomly positioned in one of four postures: right lateral-recumbency, left lateral-recumbency, supine position and prone position. After examinations in one posture, the same examination was demonstrated in another posture and repeated in all postures. In each posture, several standard TEE views were demonstrated: longitudinal cranial-esophageal aorta long-axis-view, transverse middle-esophageal mitral valve long-axis-view and transgastric middle short-axis-view. Additionally, echocardiographic parameters were attempted to measure, and direct blood pressure monitoring was performed in each view. As a result, oriented views, except for transgastric middle short-axis-view, could be obtained in all postures. Stroke volume and peak early diastolic velocity of mitral inflow were lower in supine position compared with those in right and left lateral-recumbency. Heart rate (HR) and systemic vascular resistance were higher in supine position compared with those in right and left lateral-recumbency. Left ventricular pre-ejection period/left ventricular ejection time corrected and uncorrected by HR were higher in supine position compared with those in right and left lateral-recumbency. In conclusion, longitudinal cranial-esophageal aorta long-axis-view and transverse middle-esophageal mitral valve long-axis-view provide useful information of interest anesthesia monitoring, because of their views enable to certainly obtain TEE parameters in various postures. Furthermore, TEE parameters allow to detect the changes of preload, afterload and HR that occur in supine position dogs.

  14. The optical axis optimization in measurement of decentration of lens

    NASA Astrophysics Data System (ADS)

    Wang, Yajing; Yang, Lin; Wang, Chunyu

    2013-09-01

    Measure of optical decentration plays an important role in inspection, installation and adjustment of optical system. This article describes optical measurement principle of decentration, analyzes the reason of the decentration measurement accuracy, and indicates the necessity of optimizing the optical axis. Finally, because of the error of the decentration optical axis fitting. A new method of optical axis optimization is put forward here. A mathematical model to find the best optical axis is established, which improved the optical performance of the system.

  15. Power optimal single-axis articulating strategies

    NASA Technical Reports Server (NTRS)

    Kumar, Renjith R.; Heck, Michael L.

    1991-01-01

    Power optimal single axis articulating PV array motion for Space Station Freedom is investigated. The motivation is to eliminate one of the articular joints to reduce Station costs. Optimal (maximum power) Beta tracking is addressed for local vertical local horizontal (LVLH) and non-LVLH attitudes. Effects of intra-array shadowing are also presented. Maximum power availability while Beta tracking is compared to full sun tracking and optimal alpha tracking. The results are quantified in orbital and yearly minimum, maximum, and average values of power availability.

  16. GRADIO three-axis electrostatic accelerometers

    NASA Technical Reports Server (NTRS)

    Bernard, A.

    1987-01-01

    Dedicated accelerometers for satellite gravity gradiometry (GRADIO project) are described. The design profits from experience acquired with the CACTUS accelerometer payload of the satellite CASTOR-D5B and studies of highly accurate accelerometers for inertial navigation. The principle of operation, based on a three-axis electrostatic suspension of a cubic proof mass, is well suited for the measurements of accelerations less than 0.0001 m/sec/sec. A resolution better than 10 to the minus 11th power m/sec/sec/sq root Hz is expected.

  17. Horizontal axis Levitron—a physics demonstration

    NASA Astrophysics Data System (ADS)

    Michaelis, Max M.

    2014-01-01

    After a brief history of the Levitron, the first horizontal axis Levitron is reported. Because it is easy to operate, it lends itself to educational physics experiments and analogies. Precession and nutation are visualized by reflecting the beam from a laser pointer off the ‘spignet’. Precession is fundamental to nuclear magnetic resonance, magnetic resonance imaging, particle traps and the movement of bodies in space. Longitudinal and lateral bounce behaviour is explained via ‘the principle of gentle superposition’ of two traps: the micro-precessional and the macro-trap. Theory is initiated. Scaling experiments are mentioned. Industrial applications might follow. Patent pending.

  18. Three-axis asymmetric radiation detector system

    DOEpatents

    Martini, Mario Pierangelo; Gedcke, Dale A.; Raudorf, Thomas W.; Sangsingkeow, Pat

    2000-01-01

    A three-axis radiation detection system whose inner and outer electrodes are shaped and positioned so that the shortest path between any point on the inner electrode and the outer electrode is a different length whereby the rise time of a pulse derived from a detected radiation event can uniquely define the azimuthal and radial position of that event, and the outer electrode is divided into a plurality of segments in the longitudinal axial direction for locating the axial location of a radiation detection event occurring in the diode.

  19. The Triple Axis and SPINS Spectrometers

    PubMed Central

    Trevino, S. F.

    1993-01-01

    In this paper are described the triple axis and spin polarized inelastic neutron scattering (SPINS) spectrometers which are installed at the NIST Cold Neutron Research Facility (CNRF). The general principle of operation of these two instruments is described in sufficient detail to allow the reader to make an informed decision as to their usefulness for his needs. However, it is the intention of the staff at the CNRF to provide the expert resources for their efficient use in any given situation. Thus, this work is not intended as a user manual but rather as a guide into the range of applicability of the two instruments. PMID:28053458

  20. The Triple Axis and SPINS Spectrometers.

    PubMed

    Trevino, S F

    1993-01-01

    In this paper are described the triple axis and spin polarized inelastic neutron scattering (SPINS) spectrometers which are installed at the NIST Cold Neutron Research Facility (CNRF). The general principle of operation of these two instruments is described in sufficient detail to allow the reader to make an informed decision as to their usefulness for his needs. However, it is the intention of the staff at the CNRF to provide the expert resources for their efficient use in any given situation. Thus, this work is not intended as a user manual but rather as a guide into the range of applicability of the two instruments.

  1. Single-axis gyroscopic motion with uncertain angular velocity about spin axis

    NASA Technical Reports Server (NTRS)

    Singh, S. N.

    1977-01-01

    A differential game approach is presented for studying the response of a gyro by treating the controlled angular velocity about the input axis as the evader, and the bounded but uncertain angular velocity about the spin axis as the pursuer. When the uncertain angular velocity about the spin axis desires to force the gyro to saturation a differential game problem with two terminal surfaces results, whereas when the evader desires to attain the equilibrium state the usual game with single terminal manifold arises. A barrier, delineating the capture zone (CZ) in which the gyro can attain saturation and the escape zone (EZ) in which the evader avoids saturation is obtained. The CZ is further delineated into two subregions such that the states in each subregion can be forced on a definite target manifold. The application of the game theoretic approach to Control Moment Gyro is briefly discussed.

  2. 23. Road view at Jim Camp Wash. Note Rainbow Museum ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    23. Road view at Jim Camp Wash. Note Rainbow Museum at rear. Road is on east-west axis here as original design of Rainbow Museum area. Long Logs Road to left foreground. Park Road to right foreground. Looking W. - Petrified Forest National Park Roads & Bridges, Holbrook, Navajo County, AZ

  3. VIEW LOOKING NORTHEAST FROM A POINT NEAR THE CIRCULAR DRIVE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    VIEW LOOKING NORTHEAST FROM A POINT NEAR THE CIRCULAR DRIVE ALONG THE PRINCIPAL AXIS THROUGH SECTION F. THOMAS U. WALTER PROVIDED THE WOODLANDS CEMETERY WITH A DESIGN FOR SECTION F’S LAYOUT IN 1846 - Woodlands Cemetery, 4000 Woodlands Avenue, Philadelphia, Philadelphia County, PA

  4. 10. Credit WCT. Photographic copy of photograph, view looking south ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    10. Credit WCT. Photographic copy of photograph, view looking south down axis of westernmost tunnel towards Test Stand 'A' from future site of Control and Recording Center Building 4221/E-22 (at junction of corrugated steel tunnel tubes). (JPL negative no. 384-1838-A, 9 March 1959) - Jet Propulsion Laboratory Edwards Facility, Test Stand A, Edwards Air Force Base, Boron, Kern County, CA

  5. Error Analysis and Experimental Study of a Bi-Planar Parallel Mechanism in a Pedicle Screw Robot System.

    PubMed

    Duan, Qingjuan; Du, Zhijiang; Yu, Hongjian; Wang, Yongfeng; Dong, Wei

    2016-11-30

    Due to the urgent need for high precision surgical equipment for minimally invasive spinal surgery, a novel robot-assistant system was developed for the accurate placement of pedicle screws in lumbar spinal surgeries. The structure of the robot was based on a macro-micro mechanism, which includes a serial mechanism (macro part) and a bi-planar 5R parallel mechanism (micro part). The macro part was used to achieve a large workspace, while the micro part was used to obtain high stiffness and accuracy. Based on the transfer function of dimension errors, the factors affecting the accuracy of the end effectors were analyzed. Then the manufacturing errors and joint angle error on the position-stance of the end effectors were investigated. Eventually, the mechanism of the strain energy produced by the deformation of linkage via forced assembly and displacements of the output point were calculated. The amount of the transfer errors was quantitatively analyzed by the simulation. Experimental tests show that the error of the bi-planar 5R mechanism can be controlled no more than 1 mm for translation and 1° for rotation, which satisfies the required absolute position accuracy of the robot.

  6. Radiological Evaluation of the Initial Fixation between Cortical Bone Trajectory and Conventional Pedicle Screw Technique for Lumbar Degenerative Spondylolisthesis

    PubMed Central

    Iwatsuki, Koichi; Ohnishi, Yu-Ichiro; Yoshimine, Toshiki

    2016-01-01

    Study Design Retrospective study. Purpose To compare initial fixation using the cortical bone trajectory (CBT) technique versus conventional pedicle screws (PS) in radiographs of postsurgical lumbar degenerative spondylolisthesis. Overview of Literature Few reports have documented the holding strength of CBT technique for spondylolisthesis cases. Methods From October 2009 to June 2014, 21 cases of degenerative spondylolisthesis were surgically treated in our institution. Ten were treated with conventional PS technique and 11 of with CBT technique. Mean lumbar lordosis and percent slippage were evaluated preoperatively, immediately after surgery, and 6 months and 1 year postoperatively using radiographs. We also investigated percent loss of slip reduction. Results There were statistically significant differences between preoperative percent slippage and postoperative slippage in both PS and CBT procedures over 1 year, and both techniques showed good slip reduction. On the other hand, lumbar lordosis did not change significantly in either the PS or CBT groups over 1 year. Conclusions CBT technique showed similarly good initial fixation compared with the PS procedure in the treatment of lumbar degenerative spondylolisthesis. PMID:27114765

  7. Error Analysis and Experimental Study of a Bi-Planar Parallel Mechanism in a Pedicle Screw Robot System

    PubMed Central

    Duan, Qingjuan; Du, Zhijiang; Yu, Hongjian; Wang, Yongfeng; Dong, Wei

    2016-01-01

    Due to the urgent need for high precision surgical equipment for minimally invasive spinal surgery, a novel robot-assistant system was developed for the accurate placement of pedicle screws in lumbar spinal surgeries. The structure of the robot was based on a macro-micro mechanism, which includes a serial mechanism (macro part) and a bi-planar 5R parallel mechanism (micro part). The macro part was used to achieve a large workspace, while the micro part was used to obtain high stiffness and accuracy. Based on the transfer function of dimension errors, the factors affecting the accuracy of the end effectors were analyzed. Then the manufacturing errors and joint angle error on the position-stance of the end effectors were investigated. Eventually, the mechanism of the strain energy produced by the deformation of linkage via forced assembly and displacements of the output point were calculated. The amount of the transfer errors was quantitatively analyzed by the simulation. Experimental tests show that the error of the bi-planar 5R mechanism can be controlled no more than 1 mm for translation and 1° for rotation, which satisfies the required absolute position accuracy of the robot. PMID:27916869

  8. Computer navigation-assisted spinal fusion with segmental pedicle screw instrumentation for scoliosis with Rett syndrome: a case report.

    PubMed

    Tanaka, Masato; Nakanishi, Kazuo; Sugimoto, Yoshihisa; Misawa, Haruo; Takigawa, Tomoyuki; Nishida, Keiichiro; Ozaki, Toshifumi

    2009-12-01

    Scoliosis is a common clinical manifestation of Rett syndrome, a neurodevelopmental disorder that almost exclusively affects females. The spinal curve in patients with Rett syndrome is typically a long C curve of a neuromuscular type. As the onset of the scoliosis is very early and shows rapid progression, early surgical intervention has been recommended to prevent a life-threatening collapsing spine syndrome. However, there are high perioperative risks in Rett syndrome patients who undergo spinal surgery, such as neurological compromise and respiratory dysfunction due to rigid spinal curve. We herein report the surgical result of treating severe rapid progressive thoracic scoliosis in a 16-year-old girl with Rett syndrome. Posterior segmental pedicle screw fixation was performed from T1 to L3 using a computer-assisted technique. Post-operative radiography demonstrated a good correction of the curve in both the sagittal and coronal alignment. There were no postoperative complications such as neurological compromise. The patient had maintained satisfactory spinal balance as of the 3-year follow-up examination.

  9. Interpositional Gap Arthroplasty by Versatile Pedicled Temporalis Myofascial Flap in the Management of Temporomandibular Joint Ankylosis- A Case Series Study

    PubMed Central

    Aneja, Vikas; Bansal, Anupam; Kumawat, Vinod; Kaur, Jasleen; Shaikh, Ahemer Arif

    2016-01-01

    Temporomandibular Joint (TMJ) ankylosis is a situation in which the mandibular condyle is fused to the glenoid fossa by bone or fibrous tissue. The management of TMJ ankylosis has a complicated chore and it is challenging for the maxillofacial surgeon because of technical hitches and high rate of re-ankylosis. Interpositional gap arthroplasty is one of the modalities for its management. A range of inter-positional materials have been used to avert recurrence after gap arthroplasty in TMJ ankylosis. The aim of this series was to evaluate the effectiveness of the temporomyofacial flap in the treatment of TMJ ankylosis as an interpositional gap arthroplasty. A total of 10 cases with unilateral TMJ ankylosis were treated by interpositional gap arthroplasty by pedicled temporalis myofacial flap and evaluated with a follow-up of 6 months to 5 years (Mean 3.3 years) for the functional stability of TMJ. All the patients were successfully treated. There were no signs of recurrence in any patients up to last follow up visit. The result showed that temporalis myofascial flap is a preferable choice for inter-positional gap arthroplasty which proves its versatility as an inter-positional material. PMID:27891496

  10. Non-Pedicled Buccal Fat Pad Grafts to Treatment for Class I and II Gingival Recessions: A Clinical Trial.

    PubMed

    Deliberador, Tatiana Miranda; Trevisani, Claudia Tenório; Storrer, Carmen Lucia Mueller; Santos, Felipe Rychuv; Zielak, João César; de Souza Filho, Celso Bernardo; Alfredo, Edson; Giovanini, Allan Fernando

    2015-01-01

    The aim of this study was to analyze the transplant efficiency of non-pedicled buccal fat pad graft (BFPG) for the treatment of Miller Class I or II gingival recessions (GRs) and to compare these results with those of subepithelial connective tissue graft (SCTG), which is considered the gold standard. Twelve patients with Miller Class I or II (≥2 mm) bilateral recessions in maxillary premolars or canines were selected. Recessions were randomly assigned to receive SCTG or BFPG. The clinical parameters evaluated at baseline and at 1, 3, and 6 months postoperatively included gingival index, plaque index, probing depth, GR, clinical attachment level, width of keratinized tissue, thickness of keratinized tissue and gingival margin to the acrylic guide. None of the evaluated clinical parameters differed significantly between the groups. At all evaluated postoperative time-points, both groups exhibited statistically significant differences in GR and gingival margin to the acrylic guide compared to baseline. Six months after surgery, the mean percentages of root coverage were 67.5% and 87.5% in the BFPG and SCTG groups respectively. In both groups, complete root coverage was observed in 50% of cases 6 months after surgery. The results presented herein indicate that the use of BFPG transplant has clinical similarities with SCTG and both may be considered as clinically successful methods for treating Miller Class I and II GRs.

  11. Giant cell reparative granuloma of the axis.

    PubMed

    Bayar, Mehmet Akif; Erdem, Yavuz; Gokcek, Cevdet; Koktekir, Ender; Kilic, Celal; Yasitli, Ugur; Tekiner, Ayhan

    2009-10-01

    Giant cell reparative granuloma (GCRG) is a rare, benign fibroosseous lesion. It typically arises in the mandible and maxilla, and less frequently in the skull bones. We report a case of GCRG of the axis, which is the first to be reported in the literature. A 35-year-old man was admitted to our clinic with the complaint of pain at his neck. There was no neurological deficit. CT and MRI showed a lesion destructing the body of the axis. Biopsy specimens were taken through the transoral-transpharyngeal route. Histopathological diagnosis was GCRG. The lesion was removed subtotally by the same route. We filled the tumor cavity with a bone graft and the patient was discharged with a halo brace without any neurological deficits. The follow-up CT revealed one year after the surgery showed sclerosis at the tumor site. The etiopathogenesis of GCRG is still controversial and the differential diagnosis, especially from giant cell tumor of bone is quite difficult. The treatment of choice for these lesions is complete surgical removal. Some authors recommend radiotherapy if total removal fails.

  12. Rapid 2-axis scanning lidar prototype

    NASA Astrophysics Data System (ADS)

    Hartsell, Daryl; LaRocque, Paul E.; Tripp, Jeffrey

    2016-10-01

    The rapid 2-axis scanning lidar prototype was developed to demonstrate high-precision single-pixel linear-mode lidar performance. The lidar system is a combined integration of components from various commercial products allowing for future customization and performance enhancements. The intent of the prototype scanner is to demonstrate current stateof- the-art high-speed linear scanning technologies. The system consists of two pieces: the sensor head and control unit. The senor head can be installed up to 4 m from the control box and houses the lidar scanning components and a small RGB camera. The control unit houses the power supplies and ranging electronics necessary for operating the electronics housed inside the sensor head. This paper will discuss the benefits of a 2-axis scanning linear-mode lidar system, such as range performance and a userselectable FOV. Other features include real-time processing of 3D image frames consisting of up to 200,000 points per frame.

  13. Computational modeling of the amphibian thyroid axis ...

    EPA Pesticide Factsheets

    In vitro screening of chemicals for bioactivity together with computational modeling are beginning to replace animal toxicity testing in support of chemical risk assessment. To facilitate this transition, an amphibian thyroid axis model has been developed to describe thyroid homeostasis during Xenopus laevis pro-metamorphosis. The model simulates the dynamic relationships of normal thyroid biology throughout this critical period of amphibian development and includes molecular initiating events (MIEs) for thyroid axis disruption to allow in silico simulations of hormone levels following chemical perturbations. One MIE that has been formally described using the adverse outcome pathway (AOP) framework is thyroperoxidase (TPO) inhibition. The goal of this study was to refine the model parameters and validate model predictions by generating dose-response and time-course biochemical data following exposure to three TPO inhibitors, methimazole, 6-propylthiouracil and 2-mercaptobenzothiazole. Key model variables including gland and blood thyroid hormone (TH) levels were compared to empirical values measured in biological samples at 2, 4, 7 and 10 days following initiation of exposure at Nieuwkoop and Faber (NF) stage 54 (onset of pro-metamorphosis). The secondary objective of these studies was to relate depleted blood TH levels to delayed metamorphosis, the adverse apical outcome. Delayed metamorphosis was evaluated by continuing exposure with a subset of larvae until a

  14. Methamphetamine and the hypothalamic-pituitary-adrenal axis

    PubMed Central

    Zuloaga, Damian G.; Jacobskind, Jason S.; Raber, Jacob

    2015-01-01

    Psychostimulants such as methamphetamine (MA) induce significant alterations in the function of the hypothalamic-pituitary-adrenal (HPA) axis. These changes in HPA axis function are associated with altered stress-related behaviors and might contribute to addictive processes such as relapse. In this mini-review we discuss acute and chronic effects of MA (adult and developmental exposure) on the HPA axis, including effects on HPA axis associated genes/proteins, brain regions, and behaviors such as anxiety and depression. A better understanding of the mechanisms through which MA affects the HPA axis may lead to more effective treatment strategies for MA addiction. PMID:26074755

  15. The surgical learning curve and accuracy of minimally invasive lumbar pedicle screw placement using CT based computer-assisted navigation plus continuous electromyography monitoring – a retrospective review of 627 screws in 150 patients

    PubMed Central

    McMillen, Jason

    2014-01-01

    Objective This study retrospectively assessed the accuracy of placement of lumbar pedicle screws placed by a single surgeon using a minimally-invasive, intra-operative CT-based computer navigated technique in combination with continuous electromyography (EMG) monitoring. The rates of incorrectly positioned screws were reviewed in the context of the surgeon's experience and learning curve. Methods Data was retrospectively reviewed from all consecutive minimally invasive lumbar fusions performed by the primary author over a period of over 4 years from April 2008 until October 2012. All cases that had utilized computer-assisted intra-operative CT-based image guidance and continuous EMG monitoring to guide percutaneous pedicle screw placement were analysed for the rates of malposition of the pedicle screws. Pedicle screw malposition was defined as having occurred if the screw trajectory was adjusted intraoperatively due to positive EMG responses, or due to breach of the pedicle cortex by more than 2mm on intraoperative CT imaging performed at the end of the instrumentation procedure. Further analysis of the data was undertaken to determine if the rates of malposition changed with the surgeon's experience with the technique. Results Six hundred and twenty-seven pedicle screws were placed in one hundred and fifty patients. The overall rate of intraoperative malposition and subsequent adjustment of pedicle screw placement was 3.8% (24 of 627 screws). Screw malposition was detected by intraoperative CT imaging. Warning of potential screw misplacement was provided by use of the EMG monitoring. With increased experience with the technique, rates of intraoperative pedicle screw malposition were found to decrease from 5.1% of screws in the first fifty patients, to 2.0% in the last 50 patients. Only one screw was suboptimally placed at the end of surgery, which did not result in a neurological deficit. Conclusion The use of CT-based computer-assisted navigation in combination

  16. Distribution of Io's volcanoes: Possible influence on spin axis

    NASA Astrophysics Data System (ADS)

    Stoddard, Paul R.; Jurdy, Donna M.

    2002-05-01

    We examine the potential effect of volcano distribution on the orientation of Io's spin axis. Volcanoes dominate Io's surface and the massive outpourings documented in short intervals could cause instability in Io's rotation and a corresponding reorientation of its spin axis. Currently, the volcanoes and mountains exhibit a complementary distribution, with the maximum principal axis for the set of 351 volcanoes close to the position of the rotation axis. In addition, a delicate balance results from the near equivalence of the magnitudes of the maximum and intermediate eigenvalues. Assuming an otherwise homogeneous body, a changing mass distribution on its surface could control the location of the spin axis. In our models, changing the location of as few as three volcanoes is sufficient to cause dramatic shifts of the principal axis positions, and hence the spin axis orientation. This result, although somewhat diminished, still prevails even when a strong influence of Io's tidal bulge is included in the model.

  17. Variation of the Kuroshio axis in the East China Sea

    NASA Astrophysics Data System (ADS)

    Min, Hong Sik

    2016-04-01

    Fluctuations of the Kuroshio axis in the East China Sea and their relations to variations of temperature and sea surface height are investigated using HYCOM data. Prominent fluctuations of the Kuroshio axis are shown in the east of Taiwan, northeast of Taiwan, and southwest of Kyushu. Local changes of temperature associated with the fluctuations of the Kuroshio axis at the three regions show dipole-like structures, cooling (warming) on the immediate onshore (offshore) side of Kuroshio axis when the Kuroshio axis is located offshore. The dipole-like structures are also shown in changes of sea surface height, but their centers are not located along the Kuroshio axis but on the offshore side of the Kuroshio axis.

  18. Characteristics of the somatotropic axis in insulin dependent diabetes mellitus.

    PubMed

    Mercado, M; Baumann, G

    1995-01-01

    Growth hormone (GH) plays an important role in glucose homeostasis in both healthy subjects and patients with diabetes. Patients with poorly controlled insulin-dependent diabetes mellitus (IDDM) have high basal and integrated serum GH concentrations, as well as an enhanced GH response to several secretagogues. Yet, these patients have impaired generation of insulin-like growth factor-I (IGF-I). These abnormalities tend to return to normal as an adequate metabolic control is achieved. In view of this hormonal profile, IDDM has been considered a state of relative GH resistance. Studies in experimental animals with streptozotocin-induced diabetes have shown a decreased binding of radiolabeled GH to liver membranes. More recently, adults and children with IDDM have been found to have low levels of the high affinity growth hormone binding protein (GHBP), which represents the extracellular portion of the GH receptor, and is thought to reflect GH receptor tissue concentrations. The abnormalities in the GH/IGF-I axis have been implicated in the worsening of metabolic control that occurs in some patients, as well as in the development of microvascular complications, particularly retinopathy.

  19. Selenium and thyroid hormone axis in critical ill states: an overview of conflicting view points.

    PubMed

    Gärtner, Roland

    2009-01-01

    In critical ill states the plasma selenium levels are low and inversely correlated with the severity and outcome of the disease. The plasma selenium levels indicate the amount of circulating selenoproteins and selenoenzymes. These are important for the maintenance of the redox system, modulating the immune system and also for thyroid hormone metabolism. Not only all three deiodinases (D1-3) are selenoenzymes, but within the thyroid gland there are several other selenoenzymes, which are important for the maintenance of normal thyroid function. In critical ill states also triodothyronine (T3) is low and reverse T3 elevated, and also TSH and thyroxin (T4) are low, correlating like low plasma selenium with the severity of the disease. Subsequently, several intervention trials had been performed to evaluate whether an adjuvant selenium supplementation might attenuate the course of the disease and improve outcome. The selenium supplementation improved outcome and even reduced mortality in some but not all prospective randomized trials. A few prospective randomized intervention trials with selenium supplementation had also been performed to evaluate the hypothesis, whether low selenium is the cause of low-T3-syndrome, however, with conflicting results and no clear evidence that low D1 activity is due to the selenium deficiency in critical illness. Because D1 catalyses the conversion of T4 to T3 and also the clearance of reverse T3, low D1 activity would sufficiently explain low plasma T3 and elevated reverse T3. It had been, however, clearly shown that cytokines are responsible for the inhibition of D1 activity, but D2 and D3 are even higher during acute inflammation in critically ill patients. One of the most important effects of selenium on the immune system seems to be the reduction of cytokine release and therefore an indirect connection between low selenium and low D1 activity has to be postulated and not a lower D1 activity due to lower availability of selenium for the D1 expression.

  20. AXIS: A Computer’s Eye View of an X-Ray

    DTIC Science & Technology

    1981-01-01

    accomplish this, the process of film reading is being automated. X-ray radiographs of actual shell are being analyzed and from this analysis computer ... algorithms are being developed to characterize both the digital image of the shell and anomalous points on the shell image. The system will be installed

  1. Two-photon three-axis digital scanned light-sheet microscopy (2P3A-DSLM)

    NASA Astrophysics Data System (ADS)

    Zong, Weijian; Zhao, Jia; Chen, Xuanyang; Lin, Yuan; Ren, Huixia; Zhang, Yunfeng; Fan, Ming; Zhou, Zhuan; Cheng, Heping; Sun, Yujie; Chen, Liangyi

    2014-09-01

    In this presentation we report a new 3D scanned DSLM. The system combined 1) two-photon excitation, 2) scanning along the illumination axis (x-axis) using tunable acoustic gradient lens (TAG) to stretch the Rayleigh range [5], 3) scanning vertically to the illumination axis (y-axis) by one galvo mirror to create light sheet. 4) scanning along Z-axis to do fast 3D imaging by another galvo mirror. The image plane was kept aligned with the fast z-axis scanned light sheet plane by an electric tunable lens (ETL) as described in ref. 6. The light sheet can be tailored to any shape between 50×50 μm2 and more than 500×500 μm2 with constant thickness limited by diffraction and fast imaging rates limited by the detector. The tailorable illumination area allows multi-scale field of view (FOV), and is consequently capable of imaging cells, tissue and live animals in one setup.

  2. Spin Squeezing: Transforming One-Axis Twisting into Two-Axis Twisting

    SciTech Connect

    Liu, Y. C.; Jin, G. R.; Xu, Z. F.; You, L.

    2011-07-01

    Squeezed spin states possess unique quantum correlation or entanglement and are significantly promising for advancing quantum information processing and quantum metrology. In recent back-to-back publications [C. Gross et al., Nature (London) 464, 1165 (2010) and Max F. Riedel et al., Nature (London) 464, 1170 (2010)], reduced spin fluctuations are observed leading to spin squeezing at -8.2 and -2.5 dB, respectively, in two-component atomic condensates exhibiting one-axis-twisting interactions. The noise reduction limit for the one-axis twisting scales as {proportional_to}1/N{sup 2/3}, which for a condensate with N{approx}10{sup 3} atoms is about 100 times below the standard quantum limit. We present a scheme using repeated Rabi pulses capable of transforming the one-axis-twisting spin squeezing into the two-axis-twisting type, leading to Heisenberg limited noise reduction {proportional_to}1/N or an extra tenfold improvement for N{approx}10{sup 3}.

  3. Digital Images and the Z-Axis

    ERIC Educational Resources Information Center

    Cross, Judie

    2010-01-01

    This article argues that while a semiotic analysis of composition in the screen, page and image has significant heuristic value, this would be further enhanced were it also to take into account surface and depth. It is argued that these two aspects of composition are critical for successful reading/viewing of images, and especially for digital…

  4. Interferometric phase microscopy using slightly-off-axis reflective point diffraction interferometer

    NASA Astrophysics Data System (ADS)

    Bai, Hongyi; Zhong, Zhi; Shan, Mingguang; Liu, Lei; Guo, Lili; Zhang, Yabin

    2017-03-01

    An interferometric phase microscopy (IPM) is proposed using slightly-off-axis reflective point diffraction interferometry for quantitative phase imaging. A retro-reflector consisting two mirrors is used to generate an angle between the object beam and reference beam, and a 45° tilted polarizing beam splitter is used to split the horizontal and vertical components of the both beams. Two carrier interferograms with π/2 phase-shift can be acquired in one shot, and the phase distribution of a thin specimen can be retrieved using a fast reconstruction method. The new IPM without loss in the utilization of the input-plane field of view combines the real time and optimizing detector bandwidth measurement benefit associated with slightly-off-axis method, high stability associated with common path geometry, and simplicity in terms of procedure and setup. Experiments are carried out on both static and dynamic specimens to demonstrate the validity and stability of the proposed method.

  5. Stability analyses of a vertical axis automatic washing machine without balancer

    NASA Astrophysics Data System (ADS)

    Chen, Hai-Wei; Zhang, Qiu-Ju

    2010-05-01

    This paper analyzes the nonlinear vibration characteristics associated with the spin drying process of a vertical axis automatic washing machine without any balancer. At first, damping properties born with the machine's suspension system are discussed and a mathematical model involving tangential damping forces is built. Based on a rotating coordinate transformation, this model is then converted to an autonomous form for stability analyses. The continuation and bifurcation software AUTO [1] is applied and a Hopf bifurcation phenomenon is observed from a one-parameter bifurcation diagram. Based on several two-parameter bifurcation diagrams, several parameters affecting the Hopf bifurcation are then discussed. At last, bifurcation results are validated by time responses of the autonomous system. For a further view of the spin drying process, simulations of the non-autonomous system are also provided. This paper provides a new insight into the spin drying process of the vertical axis automatic washing machine.

  6. Two-axis tracking solar collector mechanism

    DOEpatents

    Johnson, K.C.

    1992-12-08

    This invention is a novel solar tracking mechanism incorporating a number of practical features that give it superior environmental resilience and exceptional tracking accuracy. The mechanism comprises a lightweight space-frame assembly supporting an array of point-focus Fresnel lenses in a two-axis tracking structure. The system is enclosed under a glass cover which isolates it from environmental exposure and enhances tracking accuracy by eliminating wind loading. Tracking accuracy is also enhanced by the system's broad-based tracking support. The system's primary intended application would be to focus highly concentrated sunlight into optical fibers for transmission to core building illumination zones, and the system may also have potential for photovoltaic or photothermal solar energy conversion. 16 figs.

  7. Large, horizontal-axis wind turbines

    NASA Technical Reports Server (NTRS)

    Linscott, B. S.; Perkins, P.; Dennett, J. T.

    1984-01-01

    Development of the technology for safe, reliable, environmentally acceptable large wind turbines that have the potential to generate a significant amount of electricity at costs competitive with conventional electric generating systems are presented. In addition, these large wind turbines must be fully compatible with electric utility operations and interface requirements. There are several ongoing large wind system development projects and applied research efforts directed toward meeting the technology requirements for utility applications. Detailed information on these projects is provided. The Mod-O research facility and current applied research effort in aerodynamics, structural dynamics and aeroelasticity, composite and hybrid composite materials, and multiple system interaction are described. A chronology of component research and technology development for large, horizontal axis wind turbines is presented. Wind characteristics, wind turbine economics, and the impact of wind turbines on the environment are reported. The need for continued wind turbine research and technology development is explored. Over 40 references are sited and a bibliography is included.

  8. Vertical-Axis Wind Turbine Mesh Generator

    SciTech Connect

    2014-01-24

    VAWTGen is a mesh generator for creating a finite element beam mesh of arbitrary vertical-axis wind turbines (VAWT). The software accepts input files specifying tower and blade structural and aerodynamic descriptions and constructs a VAWT using a minimal set of inputs. VAWTs with an arbitrary number of blades can be constructed with or without a central tower. Strut connections between the tower and blades can be specified in an arbitrary manner. The software also facilitates specifying arbitrary joints between structural components and concentrated structural tenns (mass and stiffness). The output files which describe the VAWT configuration are intended to be used with the Offshore Wind ENergy Simulation (OWENS) Toolkit software for structural dynamics analysis of VAWTs. Furthermore, VAWTGen is useful for visualizing output from the OWENS analysis software.

  9. The somatotropic axis and longevity in mice

    PubMed Central

    2015-01-01

    The somatotropic signaling pathway has been implicated in aging and longevity studies in mice and other species. The physiology and lifespans of a variety of mutant mice, both spontaneous and genetically engineered, have contributed to our current understanding of the role of growth hormone and insulin-like growth factor I on aging-related processes. Several other mice discovered to live longer than their wild-type control counterparts also exhibit differences in growth factor levels; however, the complex nature of the phenotypic changes in these animals may also impact lifespan. The somatotropic axis impacts several pathways that dictate insulin sensitivity, nutrient sensing, mitochondrial function, and stress resistance as well as others that are thought to be involved in lifespan regulation. PMID:26219867

  10. Two-axis tracking solar collector mechanism

    DOEpatents

    Johnson, Kenneth C.

    1990-01-01

    This invention is a novel solar tracking mechanism incorporating a number of practical features that give it superior environmental resilience and exceptional tracking accuracy. The mechanism comprises a lightweight space-frame assembly supporting an array of point-focus Fresnel lenses in a two-axis tracking structure. The system is enclosed under a glass cover which isolates it from environmental exposure and enhances tracking accuracy by eliminating wind loading. Tracking accuracy is also enhanced by the system's broad-based tracking support. The system's primary intended application would be to focus highly concentrated sunlight into optical fibers for transmission to core building illumination zones, and the system may also have potential for photovoltaic or photothermal solar energy conversion.

  11. Two-axis tracking solar collector mechanism

    DOEpatents

    Johnson, Kenneth C.

    1992-01-01

    This invention is a novel solar tracking mechanism incorporating a number of practical features that give it superior environmental resilience and exceptional tracking accuracy. The mechanism comprises a lightweight space-frame assembly supporting an array of point-focus Fresnel lenses in a two-axis tracking structure. The system is enclosed under a glass cover which isolates it from environmental exposure and enhances tracking accuracy by eliminating wind loading. Tracking accuracy is also enhanced by the system's broad-based tracking support. The system's primary intended application would be to focus highly concentrated sunlight into optical fibers for transmission to core building illumination zones, and the system may also have potential for photovoltaic or photothermal solar energy conversion.

  12. Vertical axis wind turbine control strategy

    SciTech Connect

    McNerney, G.M.

    1981-08-01

    Early expensive in automatic operation of the Sandia 17-m vertical axis research wind turbine (VAWT) has demonstrated the need for a systematic study of control algorithms. To this end, a computer model has been developed that uses actual wind time series and turbine performance data to calculate the power produced by the Sandia 17-m VAWT operating in automatic control. The model has been used to investigate the influence of starting algorithms on annual energy production. The results indicate that, depending on turbine and local wind characteristics, a bad choice of a control algorithm can significantly reduce overall energy production. The model can be used to select control algorithms and threshold parameters that maximize long-term energy production. An attempt has been made to generalize these results from local site and turbine characteristics to obtain general guidelines for control algorithm design.

  13. Hydrothermal Cooling Within the Lau Integrated Study Site: No Evidence for Off-axis Discharge

    NASA Astrophysics Data System (ADS)

    Baker, E. T.; Resing, J. A.; Martinez, F.; Walker, S. L.; Buck, N.; Edwards, M. H.; Nakamura, K.

    2008-12-01

    Decades of intensive hydrothermal surveying, overwhelmingly concentrated within hundreds of meters of the axes of ridge crests, has supported the view that discrete fluid discharge is predominantly concentrated in this same region. This simple view, however, conflicts with emerging evidence for a crustal high-temperature, low-velocity volume (LVV) that extends 2-3 km beyond the ridge crest and generates strongly focused hydrothermal cooling along its off-axis vertical boundaries. In March/April 2008, we used high-resolution sampling of near-bottom waters along 175 km of the hydrothermally active Valu Fa Ridge (VFR) and Eastern Lau Spreading Center (ELSC) to comprehensively test the hypothesis that hydrothermal discharge is predominantly near-axis. Our sampling array included a suite of Miniature Autonomous Plume Recorders (temperature, light scattering, oxidation-reduction potential (ORP)) attached above (to a nominal altitude of 400 m) and below the deep-towed IMI120 sonar, plus CTDs and sensors at the bottom of the string (50 m) and on the clump weight (120 m). The ELSC between 19.9° and 21°S (spreading ~80 mm/yr) grades from a broad, flat valley in the north to a shallow high in the south. Ten survey lines at 1 km spacing were centered on the axis, plus five interleaved lines around the axial high of the ABE vent field (1300 km of track). The VFR from 21.9° to 22.4°S (~50 mm/yr) is a sharp ridge that deepens ~200 m within 1 km of the axis. Seven survey lines were run at 0.7 km spacing, plus two shorter lines adjacent to a broad overlapping spreading center (390 km). CTD tows and casts supplemented the IMI120 surveys. The surveys detected emissions from the several known on-axis vent fields, and also identified a substantial unexplored field near 20.65°S, ~10 km north of the ABE field. In neither survey area, however, did we detect evidence of high-temperature discharge beyond the near-axis (±1 km) zone. Because off-axis discharge may be largely low

  14. Elimination of off-axis light leakage in a homogeneously aligned liquid crystal cell

    NASA Astrophysics Data System (ADS)

    Oh, Seung-Won; Park, Byung Wok; Yoon, Tae-Hoon

    2015-03-01

    Among various liquid crystal display modes, the in-plane switching mode exhibits the widest viewing angle because the liquid crystals are homogeneously-aligned initially and rotate within a plane parallel to the substrates when an in-plane field is applied. However, further improvement is still needed for viewing high-quality dark images from the bisector direction of the crossed polarizers. Several compensation schemes have been proposed to eliminate the off-axis light leakage in a homogeneously-aligned liquid crystal cell. Although a 100:1 iso-contrast contour at an wavelength of 550 nm can cover the entire viewing cone, light leakage at other wavelengths still remains very severe. In this paper we introduce achromatic optical compensation methods using uniaxial films to eliminate the off-axis light leakage at the dark state in homogeneously-aligned liquid crystal cell.Uniaxial films with different dispersion characteristics are used so that they can compensate one another to achieve achromatic optical compensation. The retardation values are optimized through numerical research with the aid of the Poincaré sphere.

  15. Postoperative quality-of-life assessment in patients with spine metastases treated with long-segment pedicle-screw fixation.

    PubMed

    Bernard, Florian; Lemée, Jean-Michel; Lucas, Olivier; Menei, Philippe

    2017-03-24

    OBJECTIVE In recent decades, progress in the medical management of cancer has been significant, resulting in considerable extension of survival for patients with metastatic disease. This has, in turn, led to increased attention to the optimal surgical management of bone lesions, including metastases to the spine. In addition, there has been a shift in focus toward improving quality of life and reducing hospital stay for these patients, and many minimally invasive techniques have been introduced with the aim of reducing the morbidity associated with more traditional open approaches. The goal of this study was to assess the efficacy of long-segment percutaneous pedicle screw stabilization for the treatment of instability associated with thoracolumbar spine metastases in neurologically intact patients. METHODS This study was a retrospective review of data from a prospective database. The authors analyzed cases in which long-segment percutaneous pedicle screw fixation was performed for the palliative treatment of thoracolumbar spinal instability due to spinal metastases in neurologically intact patients. All of the patients included in the study underwent surgery between January 2014 and May 2015 at the authors' institution. Postoperative radiation therapy was planned within 10 days following the stabilization in all cases. Clinical and radiological follow-up assessments were planned for 3 days, 3 weeks, 6 weeks, 3 months, 6 months, and 1 year after surgery. Outcome was assessed by means of standard postoperative evaluation and oncological and spinal quality of life measures (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0 [EORTC QLQ-C30] and Oswestry Disability Index [ODI], respectively). Moreover, 5 patients were given an activity monitoring device for recording the distance walked daily; preoperative and postoperative daily distances were compared. RESULTS Data from 17 cases were analyzed. There were no

  16. Occam Paradox? A Variation of Tapia Syndrome and an Unreported Complication of Guidewire-Assisted Pedicle Screw Insertion

    PubMed Central

    Emohare, Osa; Peterson, Erik; Slinkard, Nathaniel; Janus, Seth; Morgan, Robert

    2013-01-01

    Study Design Case report. Clinical Question The clinical aim is to report on a previously unknown association between guidewire-assisted pedicle screw insertion and neuropraxia of the recurrent laryngeal nerve (RLN), and how this may overlap with the signs of Tapia syndrome; we also report our approach to the clinical management of this patient. Methods A 17-year-old male patient with idiopathic scoliosis experienced Tapia syndrome after posterior instrumentation and arthrodesis at the level of T1–L1. After extubation, the patient had a hoarse voice and difficulty in swallowing. Imaging showed a breach in the cortex of the anterior body of T1 corresponding to the RLN on the right. Results Otolaryngological examination noted right vocal fold immobility, decreased sensation of the endolarynx, and pooling of secretions on flexible laryngoscopy that indicated right-sided cranial nerve X injury and left-sided tongue deviation. Aspiration during a modified barium swallow prompted insertion of a percutaneous endoscopic gastrostomy tube before the patient was sent home. On postoperative day 20, a barium swallow demonstrated reduced aspiration, and the patient reported complete resolution of symptoms. The feeding tube was removed, and the patient resumed a normal diet 1 month later. Tapia syndrome, or persistent unilateral laryngeal and hypoglossal paralysis, is an uncommon neuropraxia, which has previously not been observed in association with a breached vertebral body at T1 along the course of the RLN. Conclusion Tapia syndrome should be a differential diagnostic consideration whenever these symptoms persist postoperatively and spine surgeons should be aware of this as a potential complication of guidewires in spinal instrumentation. PMID:24436711

  17. Fixation Strength of Caudal Pedicle Screws after Posterior Lumbar Interbody Fusion with the Modified Cortical Bone Trajectory Screw Method

    PubMed Central

    Miwa, Toshitada; Yamashita, Tomoya; Kuroda, Yusuke; Ohwada, Tetsuo

    2016-01-01

    Study Design Clinical case series. Purpose In the posterior lumbar interbody fusion (PLIF) procedure in our institute, the cephalad screw trajectory follows a mediolateral and caudocephalad directed path according to the original cortical bone trajectory (CBT) method. However, the starting point of the caudal screw is at the medial border of the pedicle on an articular surface of the superior articular process, and the trajectory takes a mediolateral path parallel to the cephalad endplate. The incidence of caudal screw loosening after PLIF with this modified CBT screw method was investigated, and significant risk factors for caudal screw loosening were evaluated. Overview of Literature A biomechanical study of this modified caudal screw trajectory using the finite element method reported about a 20% increase in uniaxial yield pullout load compared with the traditional trajectory. However, there has been no clinical study concerning the fixation strength of this modified caudal screw trajectory. Methods The subjects were 193 consecutive patients who underwent single-level PLIF with modified CBT screw fixation. Caudal screw loosening was checked in computed tomography at 6 months after surgery, and screw loosening was defined as a radiolucency of 1 mm or more at the bone-screw interface. Results The incidence of caudal screw loosening after lumbosacral PLIF (46.2%) was significantly higher than that after floating PLIF (6.0%). No significant differences in sex, brand of the instruments, and diameter and length of the caudal screw were evident between patients with and without caudal screw loosening. Patients with caudal screw loosening were significantly older at the time of surgery than patients without caudal screw loosening. Conclusions Fixation strength of the caudal screw after floating PLIF with this modified CBT screw technique was sufficiently acceptable. Fixation strength after the lumbosacral procedure was not. PMID:27559442

  18. Double Back Cut in Post-mastectomy Breast Skin (Fish-Shaped Skin Paddle) in Delayed Pedicled TRAM Flap Breast Reconstruction.

    PubMed

    Berezovsky, Alexander Bogdanov; Pagkalos, Vasileios A; Shoham, Yaron; Krieger, Yuval; Silberstein, Eldad

    2015-08-01

    Breast reconstruction has become standard of care for female patients with breast cancer. The transverse rectus abdominis musculo-cutaneous flap (TRAMf) is the most common method of immediate or delayed autologous breast reconstruction following mastectomy. We share our experience with modified, double back cut of post-mastectomy skin in delayed pedicled TRAMf breast reconstruction, resulting in fish-shaped skin paddle. This sort of back cut is a simple, reliable way to obtain a natural, esthetically pleasant breast mound with inconspicuous hidden scars.

  19. Split-thickness flap with a semicircular punched-ridge pedicled periosteal flap for implant restoration in highly atrophic patients: a technical note.

    PubMed

    Seemann, Rudolf; Perisanidis, Christos; Traxler, Hannes; Ewers, Rolf

    2014-01-01

    Attached gingiva is a crucial aspect of healthy peri-implant tissue. Severely atrophied jaws have minimal quantities of attached gingiva. Any surgical procedure bears the potential risk of further loss of attached gingiva. The split-thickness flap described here provides excellent access. Using a biopsy punch, the periosteum is easily cut in semicircular fashion on the labial surface of the bone so that it remains pedicled on the lingual or palatal ridge. The split-thickness flap permits fixation of the gingival flap to the periosteum. The periosteal flap is closed with sutures to achieve soft tissue closure over the implants even in case of simultaneous vestibuloplasty.

  20. Comparison of Radiation Exposure in Lumbar Pedicle Screw Placement With Fluoroscopy Vs Computer-Assisted Image Guidance With Intraoperative Three-Dimensional Imaging

    PubMed Central

    Smith, Harvey E; Welsch, Matthew D; Sasso, Rick C; Vaccaro, Alexander R

    2008-01-01

    Background/Objective: Little is known about the long-term effects of chronic exposure to ionizing radiation. Studies have shown that spine surgeons may be exposed to significantly more radiation than that observed in surgery on the appendicular skeleton. Computer-assisted image guidance systems have been shown in preliminary studies to enable accurate instrumentation of the spine. Computer-assisted image guidance systems may have significant application to the surgical management of spinal trauma and deformity. The objective of this study was to compare C-arm fluoroscopy and computer-assisted image guidance in terms of radiation exposure to the operative surgeon when placing pedicle screw-rod constructs in cadaver specimens. Methods: Twelve single-level (2 contiguous vertebral bodies) lumbar pedicle screw-rod constructs (48 screws) in 4 fresh cadavers were placed using standard C-arm fluoroscopy and computer-assisted image guidance (Stealth Station with Iso-C3D). Pedicle screw-rod constructs were placed at L1–L2, L3–L4, and L5–S1 in 4 fresh cadaver specimens. Imaging was alternated between C-arm fluoroscopy and computer-assisted image guidance with StealthStation Iso-C3D. Radiation exposure was measured using ring and badge dosimeters to monitor the thyroid, torso, and index finger. Postprocedure CT scans were obtained to judge accuracy of screw placement. Results: Mean radiation exposure to the torso was 4.33 ± 2.66 mRem for procedures performed with standard fluoroscopy and 0.33 ± 0.82 mRem for procedures performed with computer-assisted image guidance. This difference was statistically significant (P = 0.012). Radiation exposure to the index finger and thyroid was negligible for all procedures. The accuracy of screw placement was similar for both techniques. Conclusions: Computer-assisted image guidance systems allow for the safe and accurate placement of pedicle screw-rod constructs with a significant reduction in exposure to ionizing radiation to the

  1. Exploring point-cloud features from partial body views for gender classification

    NASA Astrophysics Data System (ADS)

    Fouts, Aaron; McCoppin, Ryan; Rizki, Mateen; Tamburino, Louis; Mendoza-Schrock, Olga

    2012-06-01

    In this paper we extend a previous exploration of histogram features extracted from 3D point cloud images of human subjects for gender discrimination. Feature extraction used a collection of concentric cylinders to define volumes for counting 3D points. The histogram features are characterized by a rotational axis and a selected set of volumes derived from the concentric cylinders. The point cloud images are drawn from the CAESAR anthropometric database provided by the Air Force Research Laboratory (AFRL) Human Effectiveness Directorate and SAE International. This database contains approximately 4400 high resolution LIDAR whole body scans of carefully posed human subjects. Success from our previous investigation was based on extracting features from full body coverage which required integration of multiple camera images. With the full body coverage, the central vertical body axis and orientation are readily obtainable; however, this is not the case with a one camera view providing less than one half body coverage. Assuming that the subjects are upright, we need to determine or estimate the position of the vertical axis and the orientation of the body about this axis relative to the camera. In past experiments the vertical axis was located through the center of mass of torso points projected on the ground plane and the body orientation derived using principle component analysis. In a natural extension of our previous work to partial body views, the absence of rotational invariance about the cylindrical axis greatly increases the difficulty for gender classification. Even the problem of estimating the axis is no longer simple. We describe some simple feasibility experiments that use partial image histograms. Here, the cylindrical axis is assumed to be known. We also discuss experiments with full body images that explore the sensitivity of classification accuracy relative to displacements of the cylindrical axis. Our initial results provide the basis for further

  2. Sensitivity to cross-axis oscillations in a single-axis nuclear gyroscope

    SciTech Connect

    Shaw, G.L.

    1984-07-01

    Nuclear gyro development efforts are intended to provide a low cost, high reliability alternative to conventional mechanical gyroscopes. Cross-axis rates, oscillating at the Larmor frequency, are presently noted to be able to cause a degradation in the SNR of nuclear magnetic resonance gyros. This effect has been demonstrated for a single-species, unpumped device, and may give rise to related problems in the dual-species, continuously pumped devices as well. 9 references.

  3. A comparison of on-axis and off-axis heliostat alignment strategies

    SciTech Connect

    Jones, S.A.

    1996-03-01

    Heliostat installation and alignment costs will be an important element in future solar power tower projects. The predicted annual performances of on- and-off axis strategies are compared for 95 m{sup 2} flat-glass heliostats and an external, molten-salt receiver. Actual approaches to heliostat alignment that have been used in the past are briefly discussed, and relative strengths and limitations are noted. The optimal approach can vary with the application.

  4. Earth viewing with a shuttleborne experiment pointing mount

    NASA Technical Reports Server (NTRS)

    Iwens, R. P.; Mayo, R. A.; Spector, V. A.; Van Vooren, R. H.

    1978-01-01

    The article considers the attitude determination and the control problems of the shuttleborne earth-viewing pointing mounts (EPMs). Per-axis pointing performance requirements are identified for troposphere/stratosphere pollution, tropical storm research, and urban air pollution. Ephemeris error contributions to earth pointing are discussed and candidate attitude reference systems are described. Primary interfaces between the orbiter flight control system, Spacelab, pallet-mounted EPM, and control subsystems are outlined. A block diagram is given of the EPM-mounted stellar-inertial attitude reference system. The system's performance is evaluated on the basis of the inertial sensor and a three-axis covariance analysis.

  5. Growth Hormone-Insulin-Like Growth Factor Axis, Thyroid Axis, Prolactin, and Exercise.

    PubMed

    Hackney, Anthony C; Davis, Hope C; Lane, Amy R

    2016-01-01

    This chapter addresses what is known about the endocrine system components growth hormone (GH)-insulin-like growth factor (IGF) axis, thyroid axis, and prolactin relative to exercise and exercise training. Each one of these hormone axes contributes to the maintenance of homeostasis in the body through impact on a multitude of physiological systems. The homeostatic disruption of exercise causes differing responses in each hormone axis. GH levels increase with sufficient stimulation, and IGFs are released in response to GH from the anterior pituitary providing multiple roles including anabolic properties. Changes in the thyroid hormones T3 and T4 vary greatly with exercise, from increases/decreases to no change in levels across different exercise types, intensities and durations. These ambiguous findings could be due to numerous confounding factors (e.g. nutrition status) within the research. Prolactin increases proportionally to the intensity of the exercise. The magnitude may be augmented with extended durations; conflicting findings have been reported with resistance training. While the responses to exercise vary, it appears there may be overall adaptive and regenerative impacts on the body into recovery by these hormones through immune and tissue inflammatory responses/mediations. Nonetheless, well-designed exercise research studies are still needed on each of these hormones, especially thyroid hormones and prolactin.

  6. Analytical computation of the off-axis effective area of grazing incidence X-ray mirrors

    NASA Astrophysics Data System (ADS)

    Spiga, D.; Cotroneo, V.; Basso, S.; Conconi, P.

    2009-10-01

    Aims: Focusing mirrors for X-ray telescopes in grazing incidence, introduced in the 70s, are characterized in terms of their performance by their imaging quality and effective area, which in turn determines their sensitivity. Even though the on-axis effective area is assumed in general to characterize the collecting power of an X-ray optic, the telescope capability of imaging extended X-ray sources is also determined by the variation in its effective area with the off-axis angle. The effective area, in general, decreases as the X-ray source moves off-axis, causing a loss of sensitivity in the peripheral regions of the telescope's field of view. Methods: The complex task of designing optics for future X-ray telescopes entails detailed computations of both imaging quality and effective area on- and off-axis. Because of their apparent complexity, both aspects have been, so far, treated by using ray-tracing routines aimed at simulating the interaction of X-ray photons with the reflecting surfaces of a given focusing system. Although this approach has been widely exploited and proven to be effective, it would also be attractive to regard the same problem from an analytical viewpoint, to assess an optical design of an X-ray optical module with a simpler calculation than a ray-tracing routine. This would also improve the efficiency of optimization tasks when designing the X-ray optical modules. In this paper, we thereby focused on developing analytical solutions to compute the off-axis effective area of double-reflection X-ray mirrors. Results: We have developed useful analytical formulae for the off-axis effective area of a double-reflection mirror in the double cone approximation, requiring only an integration and the standard routines to calculate the X-ray coating reflectivity for a given incidence angle. The computation is easily applicable also to Wolter-I mirrors (such as those of NeXT, NuSTAR, HEXIT-SAT, IXO) and the approximation improves as the f-number of the

  7. Multi-domain vertical alignment of nematic liquid crystals for reduced off-axis gamma shift

    NASA Astrophysics Data System (ADS)

    Yoon, Tae-Hoon; Park, Byung Wok; Kim, Ki-Han; Kim, Hoon; Shin, Ki-Chul; Kim, Hee Seop

    2013-03-01

    Several liquid crystal (LC) modes, such as twisted nematic, vertical alignment (VA), and in-plane switching, have been in competition with each other in the LC display market. Among them, the VA mode has been widely used because of the high contrast ratio. Since the LC molecules are aligned perpendicular to the substrate in the initial state, an excellent dark state can be obtained at normal viewing direction. However, effective phase retardation of LC layer at oblique viewing direction differs greatly from that at normal viewing direction. Thus, gamma distortion phenomenon occurs at oblique view direction. To reduce the gamma shift in the VA mode at oblique viewing direction, multi-domain VA modes were proposed. Although gamma shifts of these modes are smaller than that of the single domain VA mode, the problems still remain. Recently, several technologies for 8-domain alignment have been proposed to decrease the gamma shift at off-axis. However, additional driving circuits are required to realize the eight-domain structure. In this paper we report technologies for the multi-domain VA mode with no additional driving circuits. By using the proposed technologies, we can obtain the dual threshold voltage in each sub-pixel to realize the multi-domain VA mode with no decrease of contrast ratio.

  8. Effective solidity in vertical axis wind turbines

    NASA Astrophysics Data System (ADS)

    Parker, Colin M.; Leftwich, Megan C.

    2016-11-01

    The flow surrounding vertical axis wind turbines (VAWTs) is investigated using particle imaging velocimetry (PIV). This is done in a low-speed wind tunnel with a scale model that closely matches geometric and dynamic properties tip-speed ratio and Reynolds number of a full size turbine. Previous results have shown a strong dependance on the tip-speed ratio on the wake structure of the spinning turbine. However, it is not clear whether this is a speed or solidity effect. To determine this, we have measured the wakes of three turbines with different chord-to-diameter ratios, and a solid cylinder. The flow is visualized at the horizontal mid-plane as well as the vertical mid-plane behind the turbine. The results are both ensemble averaged and phase averaged by syncing the PIV system with the rotation of the turbine. By keeping the Reynolds number constant with both chord and diameter, we can determine how each effects the wake structure. As these parameters are varied there are distinct changes in the mean flow of the wake. Additionally, by looking at the vorticity in the phase averaged profiles we can see structural changes to the overall wake pattern.

  9. Yaw dynamics of horizontal axis wind turbines

    SciTech Connect

    Hansen, A.C. )

    1992-05-01

    Designers of a horizontal axis wind turbine yaw mechanism are faced with a difficult decision. They know that if they elect to use a yaw- controlled rotor then the system will suffer increased initial cost and increased inherent maintenance and reliability problems. On the other hand, if they elect to allow the rotor to freely yaw they known they will have to account for unknown and random, though bounded, yaw rates. They will have a higher-risk design to trade-off against the potential for cost savings and reliability improvement. The risk of a yaw-free system could be minimized if methods were available for analyzing and understanding yaw behavior. The complexity of yaw behavior has, until recently, discouraged engineers from developing a complete yaw analysis method. The objectives of this work are to (1) provide a fundamental understanding of free-yaw mechanics and the design concepts most effective at eliminating yaw problems, and (2) provide tested design tools and guidelines for use by free-yaw wind systems manufacturers. The emphasis is on developing practical and sufficiently accurate design methods.

  10. Control system for a vertical axis windmill

    DOEpatents

    Brulle, Robert V.

    1983-10-18

    A vertical axis windmill having a rotating structure is provided with a series of articulated vertical blades whose positions are controlled to maintain a constant RPM for the rotating structure, when wind speed is sufficient. A microprocessor controller is used to process information on wind speed, wind direction and RPM of the rotating structure to develop an electrical signal for establishing blade position. The preferred embodiment of the invention, when connected to a utility grid, is designed to generate 40 kilowatts of power when exposed to a 20 mile per hour wind. The control system for the windmill includes electrical blade actuators that modulate the blades of the rotating structure. Blade modulation controls the blade angle of attack, which in turn controls the RPM of the rotor. In the preferred embodiment, the microprocessor controller provides the operation logic and control functions. A wind speed sensor provides inputs to start or stop the windmill, and a wind direction sensor is used to keep the blade flip region at 90.degree. and 270.degree. to the wind. The control system is designed to maintain constant rotor RPM when wind speed is between 10 and 40 miles per hour.

  11. Gut/brain axis and the microbiota.

    PubMed

    Mayer, Emeran A; Tillisch, Kirsten; Gupta, Arpana

    2015-03-02

    Tremendous progress has been made in characterizing the bidirectional interactions between the central nervous system, the enteric nervous system, and the gastrointestinal tract. A series of provocative preclinical studies have suggested a prominent role for the gut microbiota in these gut-brain interactions. Based on studies using rodents raised in a germ-free environment, the gut microbiota appears to influence the development of emotional behavior, stress- and pain-modulation systems, and brain neurotransmitter systems. Additionally, microbiota perturbations by probiotics and antibiotics exert modulatory effects on some of these measures in adult animals. Current evidence suggests that multiple mechanisms, including endocrine and neurocrine pathways, may be involved in gut microbiota-to-brain signaling and that the brain can in turn alter microbial composition and behavior via the autonomic nervous system. Limited information is available on how these findings may translate to healthy humans or to disease states involving the brain or the gut/brain axis. Future research needs to focus on confirming that the rodent findings are translatable to human physiology and to diseases such as irritable bowel syndrome, autism, anxiety, depression, and Parkinson's disease.

  12. Microbiota and the gut-brain axis.

    PubMed

    Bienenstock, John; Kunze, Wolfgang; Forsythe, Paul

    2015-08-01

    Changes in gut microbiota can modulate the peripheral and central nervous systems, resulting in altered brain functioning, and suggesting the existence of a microbiota gut-brain axis. Diet can also change the profile of gut microbiota and, thereby, behavior. Effects of bacteria on the nervous system cannot be disassociated from effects on the immune system since the two are in constant bidirectional communication. While the composition of the gut microbiota varies greatly among individuals, alterations to the balance and content of common gut microbes may affect the production of molecules such as neurotransmitters, e.g., gamma amino butyric acid, and the products of fermentation, e.g., the short chain fatty acids butyrate, propionate, and acetate. Short chain fatty acids, which are pleomorphic, especially butyrate, positively influence host metabolism by promoting glucose and energy homeostasis, regulating immune responses and epithelial cell growth, and promoting the functioning of the central and peripheral nervous systems. In the future, the composition, diversity, and function of specific probiotics, coupled with similar, more detailed knowledge about gut microbiota, will potentially help in developing more effective diet- and drug-based therapies.

  13. Three-axis particle impact probe

    SciTech Connect

    Fasching, G.E.; Smith, N.S. Jr.; Utt, C.E.

    1991-04-02

    Three-axis particle impact probes detect particle impact vectors along x-, y-, and z-axes by means of a head mounted on the outer end of a shaft that is flexibly mounted in silicone rubber at the top of a housing so as to enable motion imparted to the head upon impact to be transmitted to a grounded electrode secured to the shaft within the housing. Excitable electrodes are mounted in the housing in a fixed position, spaced apart from the ground electrode and forming, with the ground electrode, capacitor pairs. Movement of the ground electrode results in changes in capacitance, and these differences in capacitance are used for measurement or derivation of momentum vectors along each of the three axes. In one embodiment, the ground electrode is mounted at the base of the shaft and is secured to a silicone rubber layer at the top of the housing, providing for cantilevered movement. In another embodiment, the shaft is mounted at its mid point in a flexible bushing so that it undergoes pivotal movement around that point.

  14. Three-axis particle impact probe

    DOEpatents

    Fasching, George E.; Smith, Jr., Nelson S.; Utt, Carroll E.

    1992-01-01

    Three-axis particle impact probes detect particle impact vectors along x-, y-, and z-axes by spherical probe head mounted on the outer end of a shaft that is flexibly mounted in silicone rubber at the top of a housing so as to enable motion imparted to the head upon impact to be transmitted to a grounded electrode secured to the shaft within the housing. Excitable electrodes are mounted in the housing in a fixed position, spaced apart from the ground electrode and forming, with the ground electrode, capacitor pairs. Movement of the ground electrode results in changes in capacitance, and these difference in capacitance are used for measurement or derivation of momentum vectors along each of the three axes. In one embodiment, the ground electrode is mounted at the base of the shaft and is secured to a silicone rubber layer at the top of the housing, providing for cantilevered movement. In another embodiment, the shaft is mounted at its mid point in a flexible bushing so that it undergoes pivotal movement around that point.

  15. Gut/brain axis and the microbiota

    PubMed Central

    Mayer, Emeran A.; Tillisch, Kirsten; Gupta, Arpana

    2015-01-01

    Tremendous progress has been made in characterizing the bidirectional interactions between the central nervous system, the enteric nervous system, and the gastrointestinal tract. A series of provocative preclinical studies have suggested a prominent role for the gut microbiota in these gut-brain interactions. Based on studies using rodents raised in a germ-free environment, the gut microbiota appears to influence the development of emotional behavior, stress- and pain-modulation systems, and brain neurotransmitter systems. Additionally, microbiota perturbations by probiotics and antibiotics exert modulatory effects on some of these measures in adult animals. Current evidence suggests that multiple mechanisms, including endocrine and neurocrine pathways, may be involved in gut microbiota–to–brain signaling and that the brain can in turn alter microbial composition and behavior via the autonomic nervous system. Limited information is available on how these findings may translate to healthy humans or to disease states involving the brain or the gut/brain axis. Future research needs to focus on confirming that the rodent findings are translatable to human physiology and to diseases such as irritable bowel syndrome, autism, anxiety, depression, and Parkinson’s disease. PMID:25689247

  16. Circadian genes, the stress axis, and alcoholism.

    PubMed

    Sarkar, Dipak K

    2012-01-01

    The body's internal system to control the daily rhythm of the body's functions (i.e., the circadian system), the body's stress response, and the body's neurobiology are highly interconnected. Thus, the rhythm of the circadian system impacts alcohol use patterns; at the same time, alcohol drinking also can alter circadian functions. The sensitivity of the circadian system to alcohol may result from alcohol's effects on the expression of several of the clock genes that regulate circadian function. The stress response system involves the hypothalamus and pituitary gland in the brain and the adrenal glands, as well as the hormones they secrete, including corticotrophin-releasing hormone, adrenocorticotrophic hormone, and glucocorticoids. It is controlled by brain-signaling molecules, including endogenous opioids such as β-endorphin. Alcohol consumption influences the activity of this system and vice versa. Finally, interactions exist between the circadian system, the hypothalamic-pituitary-adrenal axis, and alcohol consumption. Thus, it seems that certain clock genes may control functions of the stress response system and that these interactions are affected by alcohol.

  17. Mini-open pedicle subtraction osteotomy as a treatment for severe adult spinal deformities: case series with initial clinical and radiographic outcomes.

    PubMed

    Wang, Michael Y; Bordon, Gerd

    2016-05-01

    OBJECTIVE Pedicle subtraction osteotomy (PSO) is a powerful but high-risk surgical technique for destabilizing the spine for deformity correction in both the sagittal and coronal planes. Numerous reports have demonstrated the benefits of this technique for realigning the spine in a physiological posture; however, the open surgical technique is associated with a high complication rate. In this report the authors review data obtained in a series of patients who underwent PSO through a less invasive approach. METHODS Sixteen patients with severe coronal- and/or sagittal-plane deformities were treated in this series. Conservative measures had failed in all cases and patients had undergone a single-level PSO or extended PSO at L-2 or L-3. Fixation was accomplished using percutaneous instrumentation and interbody or facet joint fusions were used at the remaining levels. None of the procedures were aborted or converted to a traditional open procedure. Standard clinical and radiographic measures were used to assess patient outcomes. RESULTS Mean age was 68.8 years and mean follow-up duration was 17.7 months. An average of 7.6 levels were fused, and 50% of the patients had bilateral iliac screw fixation, with all constructs crossing both the thoracolumbar and lumbosacral junctions. Operative time averaged 356 ± 50 minutes and there was a mean blood loss of 843 ± 339 ml. The leg visual analog scale score improved from a mean of 5.7 ± 2.7 to one of 1.3 ± 1.6, and the back visual analog scale score improved from a mean of 8.6 ± 1.3 to one of 2.4 ± 2.1. The Oswestry Disability Index score improved from a mean of 50.1 ± 14.4 to 16.4 ± 12.7, representing a mean reduction of 36.0 ± 16.9 points. The SF-36 physical component summary score changed from a mean of 43.4 ± 2.6 to one of 47.0 ± 4.3, and the SF-36 mental component summary score changed from a mean of 46.7 ± 3.6 to 46.30 ± 3.0. Coronal alignment improved from a mean of 27.9 ± 43.6 mm to 16.0 ± 17.2 mm. The

  18. Pediatric Arm Reconstruction after Shot-gun Injury Using Peroneal Free-flap and Pedicled Latissimus Dorsi Muscle Flap: Late Follow-up

    PubMed Central

    Ortiz-Dominguez, Abel

    2016-01-01

    Summary: A 15-year-old patient harmed himself upon firing a shotgun that he was carrying when he slipped and fell, causing a destructive wound in the right arm with a medial entry hole and a posterolateral exit hole. The biceps, coracobrachialis, triceps, deltoids, skin cover, and humerus were injured; however, the blood vessels and major nerves of the area were surprisingly not affected. The residual skin muscle defect after debridements was 16 × 5 cm medially and posteriorly, and the bone loss was 7 cm. The wound was reconstructed during a single surgery with a free fibula flap and a pedicled flap of latissimus dorsi. Ten years after surgery, the patient presents neither functional deficit of the injured limb (shoulder, arm, forearm, and hand) nor sequelae in the donor areas; he performs his daily activities without any limitations. This case confirms that the use of free bone flaps and pedicled muscle flaps in pediatric patients can provide excellent long-term results. PMID:27622112

  19. Minimally Invasive Unilateral vs. Bilateral Pedicle Screw Fixation and Lumbar Interbody Fusion in Treatment of Multi-Segment Lumbar Degenerative Disorders

    PubMed Central

    Liu, Xiaoyang; Li, Guangrun; Wang, Jiefeng; Zhang, Heqing

    2015-01-01

    Background The choice for instrumentation with minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) in treatment of degenerative lumbar disorders (DLD) remains controversial. The goal of this study was to investigate clinical outcomes in consecutive patients with multi-segment DLD treated with unilateral pedicle screw (UPS) vs. bilateral pedicle screw (BPS) instrumented TLIF. Material/Methods Eighty-four consecutive patients who had multi-level MIS-TLIF were retrospectively reviewed. All data were collected to compare the clinical outcomes between the 2 groups. Results Both groups showed similar clinical function scores in VAS and ODI. The two groups differed significantly in operative time (P<0.001), blood loss (P<0.001), and fusion rate (P=0.043), respectively. Conclusions This study demonstrated similar clinical outcomes between UPS fixation and BPS procedure after MIS-TLIF for multi-level DLD. Moreover, UPS technique was superior in operative time and blood loss, but represented lower fusion rate than the BPS construct did. PMID:26603050

  20. Spin-stabilized magnetic levitation without vertical axis of rotation

    DOEpatents

    Romero, Louis; Christenson, Todd; Aaronson, Gene

    2009-06-09

    The symmetry properties of a magnetic levitation arrangement are exploited to produce spin-stabilized magnetic levitation without aligning the rotational axis of the rotor with the direction of the force of gravity. The rotation of the rotor stabilizes perturbations directed parallel to the rotational axis.

  1. Axis: Generating Explanations at Scale with Learnersourcing and Machine Learning

    ERIC Educational Resources Information Center

    Williams, Joseph Jay; Kim, Juho; Rafferty, Anna; Heffernan, Neil; Maldonado, Samuel; Gajos, Krzysztof Z.; Lasecki, Walter S.; Heffernan, Neil

    2016-01-01

    While explanations may help people learn by providing information about why an answer is correct, many problems on online platforms lack high-quality explanations. This paper presents AXIS (Adaptive eXplanation Improvement System), a system for obtaining explanations. AXIS asks learners to generate, revise, and evaluate explanations as they solve…

  2. The design of the central-axis reflector (ZAS).

    NASA Astrophysics Data System (ADS)

    Hügenell, H.

    1988-10-01

    The central-axis reflector (ZAS), the design principle which is presented in the paper is a segmented-mirror telescope. The inventions relate mainly to the optical system and to the tracking apparatus. A large number of small individual mirror bodies, ground off-axis (hexagonal/polygonal) produce one primary mirror with closed circular aperture when joined together.

  3. Extending the Principal Axis Theorem to Fields Other than R.

    ERIC Educational Resources Information Center

    Friedberg, Stephen H.

    1990-01-01

    That the principal axis theorem does not extend to any finite field is demonstrated. Presented are four examples that illustrate the difficulty in extending the principal axis theorem to fields other than the field of real numbers. Included are a theorem and proof that uses only a simple counting argument. (KR)

  4. Optical design of off-axis Cassegrain telescope using freeform surface at the secondary mirror

    NASA Astrophysics Data System (ADS)

    Gautam, Suryakant; Gupta, Amit; Singh, Ganga Sharan

    2015-02-01

    Freeform surfaces enable imaginative optics by providing abundant degrees of freedom for an optical designer as compared to spherical surfaces. An off-axis two-mirror-based telescope design is presented, in which the primary mirror is a concave prolate spheroid and the secondary mirror is freeform surface-based. The off-axis configuration is employed here for removing the central obscuration problem which otherwise limits the central maxima in the point spread function. In this proposed design, an extended X-Y polynomial is used as a surface descriptor for the off-axis segment of the secondary mirror. The coefficients of this extended polynomial are directly related to the Seidel aberrations, and are thus optimized here for a better control of asymmetric optical aberrations at various field points. For this design, the aperture stop is located 500 mm before the primary mirror and the entrance pupil diameter is kept as 80 mm. The effective focal length is 439 mm and covers a full field of view of 2 deg. The image quality obtained here is near diffraction limited which can be inferred from metrics such as the spot diagram and modulation transfer function.

  5. HPA-axis hormone modulation of stress response circuitry activity in women with remitted major depression.

    PubMed

    Holsen, L M; Lancaster, K; Klibanski, A; Whitfield-Gabrieli, S; Cherkerzian, S; Buka, S; Goldstein, J M

    2013-10-10

    Decades of clinical and basic research indicate significant links between altered hypothalamic-pituitary-adrenal (HPA)-axis hormone dynamics and major depressive disorder (MDD). Recent neuroimaging studies of MDD highlight abnormalities in stress response circuitry regions which play a role in the regulation of the HPA-axes. However, there is a dearth of research examining these systems in parallel, especially as related to potential trait characteristics. The current study addresses this gap by investigating neural responses to a mild visual stress challenge with real-time assessment of adrenal hormones in women with MDD in remission and controls. Fifteen women with recurrent MDD in remission (rMDD) and 15 healthy control women were scanned on a 3T Siemens MR scanner while viewing neutral and negative (stress-evoking) stimuli. Blood samples were obtained before, during, and after scanning for the measurement of HPA-axis hormone levels. Compared to controls, rMDD women demonstrated higher anxiety ratings, increased cortisol levels, and hyperactivation in the amygdala and hippocampus, p<0.05, family-wise error (FWE)-corrected in response to the stress challenge. Among rMDD women, amygdala activation was negatively related to cortisol changes and positively associated with the duration of remission. Findings presented here provide evidence for differential effects of altered HPA-axis hormone dynamics on hyperactivity in stress response circuitry regions elicited by a well-validated stress paradigm in women with recurrent MDD in remission.

  6. Micro-vision servo control of a multi-axis alignment system for optical fiber assembly

    NASA Astrophysics Data System (ADS)

    Chen, Weihai; Yu, Fei; Qu, Jianliang; Chen, Wenjie; Zhang, Jianbin

    2017-04-01

    This paper describes a novel optical fiber assembly system featuring a multi-axis alignment function based on micro-vision feedback control. It consists of an active parallel alignment mechanism, a passive compensation mechanism, a micro-gripper and a micro-vision servo control system. The active parallel alignment part is a parallelogram-based design with remote-center-of-motion (RCM) function to achieve precise rotation without fatal lateral motion. The passive mechanism, with five degrees of freedom (5-DOF), is used to implement passive compensation for multi-axis errors. A specially designed 1-DOF micro-gripper mounted onto the active parallel alignment platform is adopted to grasp and rotate the optical fiber. A micro-vision system equipped with two charge-coupled device (CCD) cameras is introduced to observe the small field of view and obtain multi-axis errors for servo feedback control. The two CCD cameras are installed in an orthogonal arrangement—thus the errors can be easily measured via the captured images. Meanwhile, a series of tracking and measurement algorithms based on specific features of the target objects are developed. Details of the force and displacement sensor information acquisition in the assembly experiment are also provided. An experiment demonstrates the validity of the proposed visual algorithm by achieving the task of eliminating errors and inserting an optical fiber to the U-groove accurately.

  7. Fast imaging with inelastically scattered electrons by off-axis chromatic confocal electron microscopy.

    PubMed

    Zheng, Changlin; Zhu, Ye; Lazar, Sorin; Etheridge, Joanne

    2014-04-25

    We introduce off-axis chromatic scanning confocal electron microscopy, a technique for fast mapping of inelastically scattered electrons in a scanning transmission electron microscope without a spectrometer. The off-axis confocal mode enables the inelastically scattered electrons to be chromatically dispersed both parallel and perpendicular to the optic axis. This enables electrons with different energy losses to be separated and detected in the image plane, enabling efficient energy filtering in a confocal mode with an integrating detector. We describe the experimental configuration and demonstrate the method with nanoscale core-loss chemical mapping of silver (M4,5) in an aluminium-silver alloy and atomic scale imaging of the low intensity core-loss La (M4,5@840  eV) signal in LaB6. Scan rates up to 2 orders of magnitude faster than conventional methods were used, enabling a corresponding reduction in radiation dose and increase in the field of view. If coupled with the enhanced depth and lateral resolution of the incoherent confocal configuration, this offers an approach for nanoscale three-dimensional chemical mapping.

  8. Leaf and inflorescence axis anatomy of Brazilian species of Rapateoideae (Rapateaceae, Poales).

    PubMed

    Daltin, Ângela L; Oriani, Aline; Scatena, Vera L

    2015-03-01

    The anatomy of leaves and inflorescence axes of Spathanthus (2 spp.), Rapatea (2 spp.), Cephalostemon (1 sp.), and Duckea (1 sp.) (Rapateoideae, Rapateaceae) was studied to identify useful characters for taxonomy. The cross-section shape of inflorescence axis differentiates the genera, while the cross-section shape and structure of leaf midrib has a specific value. The following characteristics are exclusive of Spathanthus: silica cells randomly distributed in the leaf epidermis; plicate chlorenchyma in the leaf blade; presence of fiber bundles in the mesophyll and in the inflorescence axis parenchyma. Spathanthus is also distinguished by the number, type and distribution of vascular bundles in the inflorescence axis. The genus Rapatea is characterized by the presence of stomata and silica cells only on the abaxial epidermis of the leaves and chlorenchyma composed of arm cells in the leaf blade. Characteristics with diagnostic value for Cephalostemon riedelianus are: leaf epidermal cells with straight to slightly sinuous walls in frontal view, inflorescence axes presenting a defined cortex, fiber bundles facing the larger vascular bundles and a fistulous pith. The anatomical characteristics of the leaves and inflorescence axes thus proved to be of taxonomic value in generic and specific levels. They are also useful to differentiate Rapateoideae from other subfamilies of Rapateaceae.

  9. Immunology, signal transduction, and behavior in hypothalamic-pituitary-adrenal axis-related genetic mouse models.

    PubMed

    Silberstein, Susana; Vogl, Annette M; Bonfiglio, Juán José; Wurst, Wolfgang; Holsboer, Florian; Arzt, Eduardo; Deussing, Jan M; Refojo, Damián

    2009-02-01

    A classical view of the neuroendocrine-immune network assumes bidirectional interactions where pro-inflammatory cytokines influence hypothalamic-pituitary-adrenal (HPA) axis-derived hormones that subsequently affect cytokines in a permanently servo-controlled circle. Nevertheless, this picture has been continuously evolving over the last years as a result of the discovery of redundant expression and extended functions of many of the molecules implicated. Thus, cytokines are not only expressed in cells of the immune system but also in the central nervous system, and many hormones present at hypothalamic-pituitary level are also functionally expressed in the brain as well as in other peripheral organs, including immune cells. Because of this intermingled network of molecules redundantly expressed, the elucidation of the unique roles of HPA axis-related molecules at every level of complexity is one of the major challenges in the field. Genetic engineering in the mouse offers the most convincing method for dissecting in vivo the specific roles of distinct molecules acting in complex networks. Thus, various immunological, behavioral, and signal transduction studies performed with different HPA axis-related mutant mouse lines to delineate the roles of beta-endorphin, the type 1 receptor of corticotropin-releasing hormone (CRHR1), and its ligand CRH will be discussed here.

  10. Effect of viewing angle on visual detection in liquid crystal displays

    NASA Astrophysics Data System (ADS)

    Badano, Aldo; Gallas, Brandon D.; Myers, Kyle J.; Burgess, Arthur E.

    2003-05-01

    Display devices for medical diagnostic workstations should have a diffuse emission with apparent luminance independent of viewing angle. Such displays are called Lambertian, or they obey Lambert's law. Actual display devices are never truly Lambertian; the luminance of a pixel depends on the viewing angle. In active-matrix liquid crystal displays (AMLCD), the departure from the Lambertian profile depends on the gray level and complex pixel designs having multiple domains, in-plain switching or vertically-aligned technology. Our previous measurements established that the largest deviation from the desired Lambertian distribution occurs in the low luminance range for the diagonal viewing direction. Our purpose in this work is to determine the effect that non-uniform changes of the angular emission have on the detection of low-contrast signals in noisy backgrounds. We used a sequential two-alternative forced choice (2AFC) approach with test images displayed at the center of the screen. The observer location was fixed at different viewing angles: on-axis and off-axis. The results are expressed in terms of percent-correct for each observer and for each experimental condition (viewing angle and luminance). Our results show that for the test images used in this experiment with human observers, the changes in detectability between on-axis and off-axis viewing are smaller than the observer variability. Model observers are consistent with these results but also indicate that different background and signal levels can lead to meaningful performance differences between on-axis and off-axis viewing.

  11. Accretion Rate: An Axis Of Agn Unification

    NASA Astrophysics Data System (ADS)

    Trump, Jonathan R.; Impey, C. D.; Kelly, B. C.

    2011-01-01

    We show how accretion rate governs the physical properties of broad-line, narrow-line, and lineless active galactic nuclei (AGNs). We avoid the systematic errors plaguing previous studies of AGN accretion rate by using accurate accretion luminosities from well-sampled multiwavelength SEDs from the Cosmic Evolution Survey (COSMOS), and accurate black hole masses derived from virial scaling relations (for broad-line AGNs) or host-AGN relations (for narrow-line and lineless AGNs). In general, broad emission lines are present only at the highest accretion rates (L/L_Edd>0.01), and these rapidly accreting AGNs are observed as broad-line AGNs or possibly as obscured narrow-line AGNs. Narrow-line and lineless AGNs at lower specific accretion rates (L/L_Edd<0.01) are unobscured and yet lack a broad line region. The disappearance of the broad emission lines is caused by an expanding radiatively inefficient accretion flow (RIAF) at the inner radius of the accretion disk. The presence of the RIAF also drives L/L_Edd<0.01 narrow-line and lineless AGNs to be 10-100 times more radio-luminous than broad-line AGNs, since the unbound nature of the RIAF means it is easier to form a radio outflow. The IR torus signature also tends to become weaker or disappear from L/L_Edd<0.01 AGNs, although there may be additional mid-IR synchrotron emission associated with the RIAF. Together these results suggest that specific accretion rate is an important physical "axis" of AGN unification, described by a simple model.

  12. Turbulence in vertical axis wind turbine canopies

    NASA Astrophysics Data System (ADS)

    Kinzel, Matthias; Araya, Daniel B.; Dabiri, John O.

    2015-11-01

    Experimental results from three different full scale arrays of vertical-axis wind turbines (VAWTs) under natural wind conditions are presented. The wind velocities throughout the turbine arrays are measured using a portable meteorological tower with seven, vertically staggered, three-component ultrasonic anemometers. The power output of each turbine is recorded simultaneously. The comparison between the horizontal and vertical energy transport for the different turbine array sizes shows the importance of vertical transport for large array configurations. Quadrant-hole analysis is employed to gain a better understanding of the vertical energy transport at the top of the VAWT arrays. The results show a striking similarity between the flows in the VAWT arrays and the adjustment region of canopies. Namely, an increase in ejections and sweeps and decrease in inward and outward interactions occur inside the turbine array. Ejections are the strongest contributor, which is in agreement with the literature on evolving and sparse canopy flows. The influence of the turbine array size on the power output of the downstream turbines is examined by comparing a streamwise row of four single turbines with square arrays of nine turbine pairs. The results suggest that a new boundary layer forms on top of the larger turbine arrays as the flow adjusts to the new roughness length. This increases the turbulent energy transport over the whole planform area of the turbine array. By contrast, for the four single turbines, the vertical energy transport due to turbulent fluctuations is only increased in the near wake of the turbines. These findings add to the knowledge of energy transport in turbine arrays and therefore the optimization of the turbine spacing in wind farms.

  13. Method for spinning up a three-axis controlled spacecraft

    NASA Technical Reports Server (NTRS)

    Vorlicek, Preston L. (Inventor)

    1988-01-01

    A three-axis controlled spacecraft (1), typically a satellite, is spun up about its roll axis (20) prior to firing a motor (2), i.e., a perigee kick motor, to achieve the requisite degree of angular momentum stiffness. Thrusters (21) for imparting rotation about the roll axis (20) are activated in open-loop fashion, typically at less than full duty cycle. Cross-axis torques induced by this rotational motion are compensated for by means of closed control loops for each of the pitch and yaw axes (30, 40, respectively). Each closed control loop combines a prebias torque (72) with torques (75, 74) representative of position and rate feedback information, respectively. A deadband (52) within each closed control loop can be widened during the spinup, to conserve fuel. Position feedback information (75) in each of the control loops is disabled upon saturation of the gyroscope associated with the roll axis (20).

  14. DARHT status and preparations for dual-axis hydrotesting (u)

    SciTech Connect

    Bowman, David W

    2010-01-01

    The status of the DARHT facility, including a history of events that have taken place since the end of the DARHT Second Axis Refurbishment Project, is discussed. Technical and operational enhancements that have been made will be addressed, and recent technical challenges, such as the RF noise in the kicker region, are discussed. Historical data on reliability of the second axis is discussed, as well as operational changes made to enhance reliability. In addition, the path forward for integrating the second axis into overall DARHT operations in preparation for a hydrotest is addressed. Timing integration tests are accompanied by a series of tests to evaluate neutron contamination and cross-axis scatter, with attempts being made to provide adequate shielding to minimize the effects of neutrons and cross-beam scatter. The discussion includes results of the testing performed to-date, and concludes with a discussion of the path forward for dual-axis hydrotesting at DARHT.

  15. Marker-free dual-axis tilt series alignment

    PubMed Central

    Winkler, Hanspeter; Taylor, Kenneth A.

    2013-01-01

    Dual-axis tilt series in electron tomography are collected by successively tilting the object about two approximately orthogonal tilt axes. Here we report on the extension of marker-free image registration based on cross-correlation techniques to dual-axis tilt series. A simultaneous geometry refinement yields accurate parameters for the computati on of the final reconstruction. Both, image registration and 3D-reconstruction operate on the combined data from the paired single axis series rather than computing individual single axis tomograms followed by a separate combination step. We show that with simultaneous registration and reconstruction of dual-axis tilt series, tomograms with higher resolution are obtained than by merging separately computed tomograms. PMID:23435123

  16. Core decompression or quadratus femoris muscle pedicle bone grafting for nontraumatic osteonecrosis of the femoral head: A randomized control study

    PubMed Central

    Li, Deqiang; Li, Ming; Liu, Peilai; Zhang, Yuankai; Ma, Liang; Xu, Fei

    2016-01-01

    Background: The traditional management for osteonecrosis of the femoral head (ONFH) includes core decompression (CD) and quadratus femoris muscle pedicle bone graft (QF-MPBG). The aim of this study was to investigate the effects of CD and QF-MPBG on the patients with nontraumatic ONFH in an early stage. Materials and Methods: 39 patients (47 hips) with ONFH in an early stage (Ficat Stage I or II) were randomly divided into two groups according to random number table method. One group was treated with CD and cancellous bone grafting. Another group was treated QF-MPBG with cancellous bone grafting. The hip function was evaluated using Harris hip score (HHS). The repair of the femoral head was estimated through X-ray, computed tomography (CT), or magnetic resonance imaging (MRI). The surgical time and intraoperative blood loss was calculated. Results: All patients were followed for an average 2.5 years (range from 1.5 to 4 years). Two hips in CD group progressed into stage 3 and three hips in QF-MPBG group processed into stage 3. No patient accepted the THA at the last followup. The HHSs significantly increased in both groups after surgery (P < 0.05). No statistical differences were found between CD and QF-MPBG groups in postoperative HHSs at last followup (P > 0.05). X-ray and CT showed that the femoral head did not progress to collapse after operation in both groups. In addition, MRI showed that the edema signals decreased. However, the surgical time was longer in QF-MPBG group than that in CD group (P < 0.05). The intraoperative blood loss was more in QF-MPBG than that in CD group (P < 0.05). Conclusion: The CD with bone graft could relieve hip pain, improve hip function with much lesser surgical trauma compared to QF-MPBG. Hence, the CD with bone graft should be generally used for the treatment of patients with an early stage (Ficat Stage I or II) ONFH. PMID:27904218

  17. Childhood stressful events, HPA axis and anxiety disorders.

    PubMed

    Faravelli, Carlo; Lo Sauro, Carolina; Godini, Lucia; Lelli, Lorenzo; Benni, Laura; Pietrini, Francesco; Lazzeretti, Lisa; Talamba, Gabriela Alina; Fioravanti, Giulia; Ricca, Valdo

    2012-02-22

    Anxiety disorders are among the most common of all mental disorders and their pathogenesis is a major topic in psychiatry, both for prevention and treatment. Early stressful life events and alterations of hypothalamic pituitary adrenal (HPA) axis function seem to have a significant role in the onset of anxiety. Existing data appear to support the mediating effect of the HPA axis between childhood traumata and posttraumatic stress disorder. Findings on the HPA axis activity at baseline and after stimuli in panic disordered patients are inconclusive, even if stressful life events may have a triggering function in the development of this disorder. Data on the relationship between stress, HPA axis functioning and obsessive-compulsive disorder (OCD) are scarce and discordant, but an increased activity of the HPA axis is reported in OCD patients. Moreover, normal basal cortisol levels and hyper-responsiveness of the adrenal cortex during a psychosocial stressor are observed in social phobics. Finally, abnormal HPA axis activity has also been observed in generalized anxiety disordered patients. While several hypothesis have attempted to explain these findings over time, currently the most widely accepted theory is that early stressful life events may provoke alterations of the stress response and thus of the HPA axis, that can endure during adulthood, predisposing individuals to develop psychopathology. All theories are reviewed and the authors conclude that childhood life events and HPA abnormalities may be specifically and transnosographically related to all anxiety disorders, as well as, more broadly, to all psychiatric disorders.

  18. Off-axis illumination direct-to-digital holography

    DOEpatents

    Thomas, Clarence E.; Price, Jeffery R.; Voelkl, Edgar; Hanson, Gregory R.

    2004-06-08

    Systems and methods are described for off-axis illumination direct-to-digital holography. A method of recording an off-axis illuminated spatially heterodyne hologram including spatially heterodyne fringes for Fourier analysis, includes: reflecting a reference beam from a reference mirror at a non-normal angle; reflecting an object beam from an object at an angle with respect to an optical axis defined by a focusing lens; focusing the reference beam and the object beam at a focal plane of a digital recorder to form the off-axis illuminated spatially heterodyne hologram including spatially heterodyne fringes for Fourier analysis; digitally recording the off-axis illuminated spatially heterodyne hologram including spatially heterodyne fringes for Fourier analysis; Fourier analyzing the recorded off-axis illuminated spatially heterodyne hologram including spatially heterodyne fringes by transforming axes of the recorded off-axis illuminated spatially heterodyne hologram including spatially heterodyne fringes in Fourier space to sit on top of a heterodyne carrier frequency defined as an angle between the reference beam and the object beam; applying a digital filter to cut off signals around an original origin; and then performing an inverse Fourier transform.

  19. Calibration method of absolute orientation of camera optical axis

    NASA Astrophysics Data System (ADS)

    Xu, Yong; Guo, Pengyu; Zhang, Xiaohu; Ding, Shaowen; Su, Ang; Li, Lichun

    2013-08-01

    Camera calibration is one of the most basic and important processes in optical measuring field. Generally, the objective of camera calibration is to estimate the internal and external parameters of object cameras, while the orientation error of optical axis is not included yet. Orientation error of optical axis is a important factor, which seriously affects measuring precision in high-precision measurement field, especially for those distant aerospace measurement in which object distance is much longer than focal length, that lead to magnifying the orientation errors to thousands times. In order to eliminate the influence of orientation error of camera optical axis, the imaging model of camera is analysed and established in this paper, and the calibration method is also introduced: Firstly, we analyse the reasons that cause optical axis error and its influence. Then, we find the model of optical axis orientation error and imaging model of camera basing on it's practical physical meaning. Furthermore, we derive the bundle adjustment algorithm which could compute the internal and external camera parameters and absolute orientation of camera optical axis simultaneously at high precision. In numeric simulation, we solve the camera parameters by using bundle adjustment optimization algorithm, then we correct the image points by calibration results according to the model of optical axis error, and the simulation result shows that our calibration model is reliable, effective and precise.

  20. Ion plateau transport near the tokamak magnetic axis

    SciTech Connect

    Shaing, K.C.; Hazeltine, R.D.

    1998-04-01

    Conventional neoclassical transport theory does not pertain near the magnetic axis, where orbital variation of the minor radius and the poloidal field markedly change the nature of guiding-center trajectories. Instead of the conventional tokamak banana-shaped trajectories, near-axis orbits, called potato orbits, are radially wider and lead to distinctive kinetic considerations. Here it is shown that there is a plateau regime for the near-axis case; the corresponding potato-plateau ion thermal conductivity is computed. {copyright} {ital 1998 American Institute of Physics.}

  1. Research of the micromechanical three-axis accelerometer

    NASA Astrophysics Data System (ADS)

    Konoplev, B.; Lysenko, I.; Ryndin, E.; Ezhova, O.; Bondarev, F.

    2016-12-01

    In the report the linear acceleration sensor design with three axis of sensitivity is researched. Parameterized geometry and finite element model for modal analysis are developed in the ANSYS program. Behavioral description of the study design is developed with language VHDL-AMS to simulate the sensor operation under the influence of linear acceleration along three axis of sensitivity. On the basis of research results three-axis device sensitivity, cross-sensitivity, duration transients are specified. As part of the work the experimental sensor prototypes are fabricated.

  2. VIEW in Review.

    ERIC Educational Resources Information Center

    Bonner, Don; Ellis, Sherrlyn

    Under the Vocational Education Amendments (1968) to the Vocational Education Act of 1963, innovative state-level projects entitled Vital Information for Education and Work (VIEW) have been implemented. VIEW was designed as a supplementary aid for counselors, teachers, and administrators to assist students in making occupational and career choices.…

  3. Taking the Long View

    ERIC Educational Resources Information Center

    Bennett, Robert B., Jr.

    2010-01-01

    Legal studies faculty need to take the long view in their academic and professional lives. Taking the long view would seem to be a cliched piece of advice, but too frequently legal studies faculty, like their students, get focused on meeting the next short-term hurdle--getting through the next class, grading the next stack of papers, making it…

  4. Optics for X-ray telescopes: analytical treatment of the off-axis effective area of mirrors in optical modules

    NASA Astrophysics Data System (ADS)

    Spiga, D.

    2011-05-01

    Context. Optical modules for X-ray telescopes comprise several double-reflection mirrors operating in grazing incidence. The concentration power of an optical module, which determines primarily the telescope's sensitivity, is in general expressed by its on-axis effective area as a function of the X-ray energy. Nevertheless, the effective area of X-ray mirrors in general decreases as the source moves off-axis, with a consequent loss of sensitivity. To make matters worse, the dense nesting of mirror shells in an optical module results in a mutual obstruction of their aperture when an astronomical source is off-axis, with a further effective area reduction. Aims: To ensure the performance of X-ray optics for new X-ray telescopes (like NuSTAR, NHXM, ASTRO-H, IXO), their design entails a detailed computation of the effective area over all the telescope's field of view. While the effective area of an X-ray mirror is easy to predict on-axis, the same task becomes more difficult for a source off-axis. It is therefore important to develop an appropriate formalism to reliably compute the off-axis effective area of a Wolter-I mirror, including the effect of obstructions. Methods: Most of collecting area simulation for X-ray optical modules has been so far performed along with numerical codes, involving ray-tracing routines, very effective but in general complex, difficult to handle, time consuming and affected by statistical errors. In contrast, in a previous paper we approached this problem from an analytical viewpoint, to the end of simplifying and speeding up the prediction of the off-axis effective area of unobstructed X-ray mirrors with any reflective coating, including multilayers. Results: In this work we extend the analytical results obtained: we show that the analytical formula for the off-axis effective area can be inverted, and we expose in detail a novel analytical treatment of mutual shell obstruction in densely nested mirror assemblies, which reduces the off-axis

  5. Design characteristics to reduce inadvertent cross-axis coupling during side stick handling of aircraft pitch and roll axis control

    NASA Astrophysics Data System (ADS)

    Cote, Marie-Eve

    Integrating a manual flight control inceptor with coupled axes such as the side stick within a flight deck creates challenges for the pilot to input a one-axis command without inadvertently inducing inputs in the opposite axis. The present paper studies three design features of the side stick and armrest setup believed to help reduce inadvertent cross-axis coupling occurrences. Design features address the aimed pilot population anthropometry (1.57m woman to 1.9m male) and their variability in upper segment measurements. Seven pilots of varying anthropometric sizes were asked to perform one-axis manoeuvres in pitch and roll for each setup configuration. To compare the setups both the duration and the definite integral of the unintended cross-axis input were processed and analyzed for each manoeuvre. Findings show that a short armrest reduces the occurrences of cross-axis input for the roll manoeuvre, whereas the side stick skew reduces inadvertent cross-axis coupling for the pitch manoeuvres.

  6. Improved Fine Sun Sensor Field of View Calibration

    NASA Technical Reports Server (NTRS)

    Sedlak, J.; Hashmall, J.

    2003-01-01

    The fine Sun sensor used on many spacecraft consists of two independent single-axis sensor heads, nominally mounted perpendicularly. These detect the Sun angle over a field of view typically of +32 deg. (There is a trade-off between accuracy and size of the field of view that allows for much latitude in any numbers quoted.) The nonlinear "transfer" function that maps the telemetered counts into observed angles consists of 9 adjustable parameters for each axis (1 8 total). An augmented transfer function has previously been reported that achieves a significant accuracy improvement across the entire field of view. That function expands the parameter set to 12 coefficients per axis (24 total) and includes cross terms combining counts from both axes. To make the best use of the Sun sensor for attitude determination, it must be calibrated after launch. However, the large number of parameters and the nonlinearity of the problem make this a challenging task. The purpose of this paper is to examine ways to improve convergence of the parameter search algorithm. In particular, experience has shown that the problem should be broken down into several steps, solving for a selected subset of the parameters at each step. This approach has now been incorporated as an option in the calibration utility.

  7. Distal pancreatectomy with celiac axis resection for pancreatic body and tail cancer invading celiac axis

    PubMed Central

    Ham, Hyemin; Kim, Sang Geol; Ha, Heontak; Choi, Young Yeon

    2015-01-01

    Purpose Pancreatic body/tail cancer often involves the celiac axis (CA) and it is regarded as an unresectable disease. To treat the disease, we employed distal pancreatectomy with en bloc celiac axis resection (DP-CAR) and reviewed our experiences. Methods We performed DP-CAR for seven patients with pancreatic body/tail cancer involving the CA. The indications of DP-CAR initially included tumors with definite invasion of CA and were later expanded to include borderline resectable disease. To determine the efficacy of DP-CAR, the clinico-pathological data of patients who underwent DP-CAR were compared to both distal pancreatectomy (DP) group and no resection (NR) group. Results The R0 resection rate was 71.4% and was not statistically different compared to DP group. The operative time (P = 0.018) and length of hospital stay (P = 0.022) were significantly longer in DP-CAR group but no significant difference was found in incidence of the postoperative pancreatic fistula compared to DP group. In DP-CAR group, focal hepatic infarction and transient hepatopathy occurred in 1 patient and 3 patients, respectively. No mortality occurred in DP-CAR group. The median survival time (MST) was not statistically different compared to DP group. However, the MST of DP-CAR group was significantly longer than that of NR group (P < 0.001). Conclusion In our experience, DP-CAR was safe and offered high R0 resection rate for patients with pancreatic body/tail cancer with involvement of CA. The effect on survival of DP-CAR is comparable to DP and better than that of NR. However, the benefits need to be verified by further studies in the future. PMID:26446424

  8. 5. LOOKING EAST ALONG AXIS OF BRIDGE. NOTE LARGE UNDEVELOPED ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    5. LOOKING EAST ALONG AXIS OF BRIDGE. NOTE LARGE UNDEVELOPED AREA IN FORMER CHANNEL OF RIVER (MOVED 1930). - St. Charles Air Line Bridge, Spanning South Branch of Chicago River, north of Sixteenth Street, Chicago, Cook County, IL

  9. Discrimination and the HPA axis: current evidence and future directions.

    PubMed

    Busse, David; Yim, Ilona S; Campos, Belinda; Marshburn, Christopher K

    2017-02-02

    Numerous studies suggest that discrimination is associated with poor physical and mental health outcomes. Whereas the cardiovascular system has been extensively studied as a potential pathway linking discrimination with disease, the role of the hypothalamic-pituitary-adrenal (HPA) axis remains understudied. We conducted a systematic review of research on discrimination and related constructs as predictors and correlates of HPA axis activity. Twenty seven studies (10 experimental, 17 observational) met inclusion criteria. Studies suggest that discrimination is associated with alterations in HPA axis activity and that the direction of this association depends on the timing and chronicity of the discrimination experience. There is also evidence of important modulating variables (race, socioeconomic status) and contextual confounders (emotional, situational) that warrant further study. Accounting for the HPA axis in addition to the cardiovascular system will contribute to a more comprehensive understanding of the biobehavioral pathways contributing to physical and mental health inequities related to discrimination.

  10. The axis of rotation of the ankle joint.

    PubMed

    Lundberg, A; Svensson, O K; Németh, G; Selvik, G

    1989-01-01

    The axis of the talo-crural joint was analysed by roentgen stereophotogrammetry in eight healthy volunteers. Examinations were performed at 10 degrees increments of flexion and pronation/supination of the foot as well as medial and lateral rotation of the leg. Results indicate that the talo-crural joint axis changes continuously throughout the range of movement. In dorsiflexion it tended to be oblique downward and laterally. In rotation of the leg, the axis took varying inclinations between horizontal and vertical. All axes in each subject lay close to the midpoint of a line between the tips of the malleoli. Our study indicates that the talo-crural joint axis may alter considerably during the arc of motion and differ significantly between individuals. This prompts caution in the use of hinge axes in orthoses and prostheses for the ankle.

  11. Determination of Elastic Twist in Horizontal Axis Wind Turbines (HAWTs)

    SciTech Connect

    Stoddard, F.; Nelson, V.; Starcher, K.; Andrews, B.

    2006-06-01

    This report presents the results of a project at the Alternative Energy Institute (AEI) which measured and calculated the elastic twist of three representative composite horizontal-axis blades: Carter 300, Gougeon ESI 54, and UTRC 8 kW.

  12. REGULATION OF THE THYROID AXIS IN DEVELOPING XENOPUS LAEVIS

    EPA Science Inventory

    The focus of the research presented here is the development of an in vitro pituitary gland culture system to test the effect of chemicals directly on the gland without influence of other parts of the HPT axis.

  13. Laser interferometric system for six-axis motion measurement

    SciTech Connect

    Zhang Zhipeng; Menq, C.-H.

    2007-08-15

    This article presents the development of a precision laser interferometric system, which is designed to achieve six-axis motion measurement for real-time applications. By combining the advantage of the interferometer with a retroreflector and that of the interferometer with a plane mirror reflector, the system is capable of simultaneously measuring large transverse motions along and large rotational motions about three orthogonal axes. Based on optical path analysis along with the designed kinematics of the system, a closed form relationship between the six-axis motion parameters of the object being measured and the readings of the six laser interferometers is established. It can be employed as a real-time motion sensor for various six-axis motion control stages. A prototype is implemented and integrated with a six-axis magnetic levitation stage to illustrate its resolution and measurement range.

  14. Development of a precision, six-axis laboratory dynamometer

    NASA Technical Reports Server (NTRS)

    Champagne, P. J.; Cordova, S. A.; Jacoby, M. S.; Lorell, K. R.

    1992-01-01

    This paper describes the design, fabrication, test, and operation of a unique six axis force/torque dynamometer The specimen table used to hold components under test is supported in a full six axis kinematic mount. Support struts fabricated from high strength steel with special integral two axis flexures link the specimen table to the load cell transducers. Realtime force/torque coordinate transform, root mean squared calculation, and data averaging, and color six axis display with controllable scaling are provided by a specially programmed desktop computer. The extensive structural analysis and design optimization required to obtain a stiff, well damped, lightweight structure is described in detail. Geometric optimization of the kinematic mount and fabrication details of the struts are also described.

  15. Improved Controller for a Three-Axis Piezoelectric Stage

    NASA Technical Reports Server (NTRS)

    Rao, Shanti; Palmer, Dean

    2009-01-01

    An improved closed-loop controller has been built for a three-axis piezoelectric positioning stage. The stage can be any of a number of commercially available or custom-made units that are used for precise three-axis positioning of optics in astronomical instruments and could be used for precise positioning in diverse fields of endeavor that include adaptive optics, fabrication of semiconductors, and nanotechnology.

  16. Critical Technology Assessment of Five Axis Simultaneous Control Machine Tools

    DTIC Science & Technology

    2009-07-01

    assessment, BIS specifically examined: • The application of Export Control Classification Numbers ( ECCN ) 2B001.b.2 and 2B001.c.2 controls and related...availability of certain five axis simultaneous control mills, mill/turns, and machining centers controlled by ECCN 2B001.b.2 (but not grinders controlled by... ECCN 2B001.c.2) exists to China and Taiwan, which both have an indigenous capability to produce five axis simultaneous control machine tools with

  17. Characterization of Magnetic Nanostructures Using Off-Axis Electron Holography

    NASA Astrophysics Data System (ADS)

    Zhang, Desai

    This dissertation research has involved microscopic characterization of magnetic nanostructures using off-axis electron holography and Lorentz microscopy. The nanostructures investigated have included Co nanoparticles (NPs), Au/Fe/GaAs shell/core nanowires (NWs), carbon spirals with magnetic cores, magnetic nanopillars, Ni-Zn-Co spinel ferrite and CoFe/Pd multilayers. The studies have confirmed the capability of holography to describe the behavior of magnetic structures at the nanoscale. The phase changes caused by the fringing fields of chains consisting of Co NPs were measured and calculated. The difference between chains with different numbers of Co NPs followed the trend indicated by calculations. Holography studies of Au/Fe/GaAs NWs grown on (110) GaAs substrates with rotationally non-uniform coating confirmed that Fe was present in the shell and that the shell behaved as a bar magnet. No fringing field was observed from NWs with cylindrical coating grown on (111)B GaAs substrates. The most likely explanation is that magnetic fields are confined within the shells and form closed loops. The multiple-magnetic-domain structure of iron carbide cores in carbon spirals was imaged using phase maps of the fringing fields. The strength and range of this fringing field was insufficient for manipulating the carbon spirals with an external applied magnetic field. No magnetism was revealed for CoPd/Fe/CoPd magnetic nanopillars. Degaussing and MFM scans ruled out the possibility that saturated magnetization and sample preparation had degraded the anisotropy, and the magnetism, respectively. The results suggested that these nanopillars were not suitable as candidates for prototypical bit information storage devices. Observations of Ni-Zn-Co spinel ferrite thin films in plan-view geometry indicated a multigrain magnetic domain structure and the magnetic fields were oriented in-plane only with no preferred magnetization distribution. This domain structure helps explain this

  18. Space camera optical axis pointing precision measurement system

    NASA Astrophysics Data System (ADS)

    Chen, Gang; Meng, Fanbo; Yang, Zijun; Guo, Yubo; Ye, Dong

    2016-01-01

    In order to realize the space camera which on satellite optical axis pointing precision measurement, a monocular vision measurement system based on object-image conjugate is established. In this system the algorithms such as object-image conjugate vision models and point by point calibration method are applied and have been verified. First, the space camera axis controller projects a laser beam to the standard screen for simulating the space camera's optical axis. The laser beam form a target point and has been captured by monocular vision camera. Then the two-dimensional coordinates of the target points on the screen are calculated by a new vision measurement model which based on a looking-up and matching table, the table has been generated by object-image conjugate algorithm through point by point calibration. Finally, compare the calculation of coordinates offered by measurement system with the theory of coordinate offered by optical axis controller, the optical axis pointing precision can be evaluated. Experimental results indicate that the absolute precision of measurement system up to 0.15mm in 2m×2m FOV. This measurement system overcome the nonlinear distortion near the edge of the FOV and can meet the requirement of space camera's optical axis high precision measurement and evaluation.

  19. Bi-pedicle nipple-sparing mastectomy (modified Letterman technique) and TIGR mesh-assisted immediate implant reconstruction, in a patient with Cowden syndrome

    PubMed Central

    2016-01-01

    Cowden syndrome, a rare genetic disorder estimated to occur in 1 in 200,000 live births and inherited as an autosomal dominant mutation in PTEN gene, is part of the PTEN hamartoma tumor syndrome. These patients are at risk of breast cancer, as well as cancers of the digestive tract, thyroid, uterus and ovaries. Often identified by their dentist due to characteristic papillomatosis in the gingival mucosa, they have an estimated lifetime risk of up to 81% of developing breast cancer. This article describes a relatively uncommon procedure of bi-pedicle nipple-sparing mastectomy, a modified Letterman technique, used in the setting of immediate implant based reconstruction in a patient with Cowden syndrome. PMID:27294038

  20. Comparison study of the pullout strength of conventional spinal pedicle screws and a novel design in full and backed-out insertions using mechanical tests.

    PubMed

    Amaritsakul, Yongyut; Chao, Ching-Kong; Lin, Jinn

    2014-03-01

    Recently, new pedicle screw designs have been developed. However, these designs' performances are still unclear, especially when backed out after insertion. The objective of this study was to investigate the performances of different screw designs when backed out from full insertion. Seven conventional designs of the pedicle screw and one novel design were inserted into polyurethane foam (0.32 g/cm(3)). All screws were first fully inserted (43 mm) and were backed out 360°. Axial pullout tests were performed and the reaction force was measured. The results showed that the conical screw of type 1 with a small inner diameter provided the highest pullout strength in both full insertion and backed-out insertion (2401.85 and 2169.82 N, respectively). However, this screw's pullout strength significantly decreased (9.7%) when backed out from full insertion. There was no significant difference between the conical screw of type 1 with a small inner diameter and double duo core screw (p > 0.01) in backed-out insertion. The cylindrical screw with a small diameter, dual inner core screw and double dual core screw also provided good results in both full insertion (2115.44, 2182.99 and 2226.93 N, respectively) and backed-out conditions (2065.80, 2014.28 and 1941.29 N, respectively). The increased pullout strength of the conical design could be due to the effect of bone compaction. However, the screw exhibited less consistent pullout strength when backed out when compared with the other designs. The conical screw should be inserted to the precise position without turning back, especially in osteoporosis patients. The dual inner core screw and double dual core screw could provide greater stability in both conditions. Care should be taken when using both the cylindrical screw with a small thread depth and the dual outer core screw.

  1. Successful Pedicled Anterolateral Thigh Flap Reconstruction for a Recurrent Ischial Pressure Ulcer: A Case With Multiple Recurrences Over a 7-year Follow-up.

    PubMed

    Wang, Chi-Yu; Shih, Yu-Jen; Chou, Chang-Yi; Chen, Tim-Mo; Chen, Shyi-Gen; Tzeng, Yuan-Sheng

    2015-06-01

    Ischial pressure ulcers are difficult ulcers to treat and have a low treatment success rate compared to sacral and trochanteric ulcers; regional flap failure further complicates the treatment. Reported here is a case of a 65-year-old man who experienced a spinal injury with paraplegia due to trauma 20 years ago. The patient experienced a recurrent ischial ulcer since 2007, and underwent several types of flap reconstruction with poor outcomes over a 7-year period. Therefore, the chosen intervention was a pedicled anterolateral thigh (pALT) fasciocutaneous flap reconstruction for the ischial ulcer via a subcutaneous route. Over the 10-month follow-up, the recurrent ischial ulcer healed without wound dehiscence. Island pALT reconstruction appears to be an alternative technique for treating recurrent ischial pressure ulcers. Though reconstruction of ischial ulcers via the pALT technique has been described previously, this may be the first case report to describe pALT flap in a patient with recurrent ischial ulcers after failed reconstructions using a gluteus maximus flap, V-Y advancement flap, and hatchet flap.Ischial pressure ulcers are difficult to treat and have a low treatment success rate1 compared to sacral and trochanteric ulcers. In addition, there are many different techniques that can be used to treat ischial pressure ulcers, including primary wound closure, gluteus maximus flaps, V-Y advancement flaps, or inferior gluteal artery perforator flaps. However, several experts have recently described using the pedicled anterolateral thigh (pALT) flap for reconstruction of recurrent ischial pressure ulcers.1,2 In the presented case, the authors followed a single patient with paraplegia with a recurrent ischial ulcer who had undergone several types of wound treatment over a 7-year period. The indurated ulcer was ultimately resolved by pALT reconstruction.

  2. Origin of the c-Axis Tilt Occurring During the Lateral Epitaxial Overgrowth of GaN

    NASA Astrophysics Data System (ADS)

    Kuan, T. S.; Inoki, C. K.; Zhang, R.; Gu, S.; Kuech, T. F.

    2001-03-01

    A large angle c-axis tilt has often been observed in GaN layers grown by lateral epitaxial overgrowth (LEO) through narrow windows defined on a seed layer. The c-axis tilt generates vertical tilt boundaries at the coalescence of growth facets. To investigate the defect mechanisms responsible for the onset of c-axis tilt, a series of GaN LEO samples was grown using the hydride vapor phase epitaxy (HVPE) technique and examined by transmission electron microscopy (TEM). Cross sectional TEM images indicate that as LEO proceeds from triangular-shaped ridges originally grown over the windows, all edge-type threading dislocations propagated from the seed layer bend into screw type and glide on the c plane. Plan-view TEM observations reveal further that to relax the twist/shear strain in the LEO regions, these screw dislocations collectively make another 90^o bend again, forming arrays of edge dislocations parallel to the mask edge. The number of dislocations in the arrays can account for the amount of crystal tilt observed. The c-axis tilt is thus a stress-driven phenomenon dictated by the growth window geometry, and is much less influenced by the growth parameters.

  3. Kepler Field of View

    NASA Video Gallery

    The Kepler mission will be looking continuously at over 100,000 stars in one region of the sky, in the Cygnus and Lyra constellations. The field of view is extremely large for an astronomical teles...

  4. A World View Sampler.

    ERIC Educational Resources Information Center

    Willard, Timothy; And Others

    1984-01-01

    An overview of topics discussed at the World View '84 conference, sponsored by the World Future Society, is provided. Topics include technology, the economy, the Third World, the environment, world order, and outer space. (RM)

  5. Plasma ionization frequency, edge-to-axis density ratio, and density on axis of a cylindrical gas discharge

    SciTech Connect

    Palacio Mizrahi, J. H.

    2014-06-15

    A rigorous derivation of expressions, starting from the governing equations, for the ionization frequency, edge-to-axis ratio of plasma density, plasma density at the axis, and radially averaged plasma density in a cylindrical gas discharge has been obtained. The derived expressions are simple and involve the relevant parameters of the discharge: Cylinder radius, axial current, and neutral gas pressure. The found expressions account for ion inertia, ion temperature, and changes in plasma ion collisionality.

  6. TOPOGRAPHIC VIEW THE STATE FORESTER'S COMPLEX, VIEW LOOKING SOUTH FROM ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    TOPOGRAPHIC VIEW THE STATE FORESTER'S COMPLEX, VIEW LOOKING SOUTH FROM STATE STREET, WITH THE NATIONAL REGISTER-LISTED OREGON STATE FORESTER'S OFFICE BUILDING TO THE LEFT OF VIEW. - Oregon State Forester's Office Complex, 2600 State Street, Salem, Marion, OR

  7. 33. VIEW LOOKING NORTHNORTHWEST AT THE DENNIS HOTEL (PARTIAL VIEW ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    33. VIEW LOOKING NORTH-NORTHWEST AT THE DENNIS HOTEL (PARTIAL VIEW OF THE BLENHEIM HOTEL) - Marlborough, Blenheim & Dennis Hotels (aerial views), Between Park Place, Michigan Avenue & Boardwalk, Atlantic City, Atlantic County, NJ

  8. 2. CONTEXTUAL VIEW OF WHITE ROCK ROAD, VIEW OF PROJECT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. CONTEXTUAL VIEW OF WHITE ROCK ROAD, VIEW OF PROJECT AREA LOOKING TOWARD ELEVATED INTERSECTION OF LATROBE ROAD; VIEW TO SOUTHWEST. - Placerville Road, White Rock Road between Clarksville & White Rock, El Dorado Hills, El Dorado County, CA

  9. 1. CONTEXTUAL VIEW OF WHITE ROCK ROAD, VIEW OF PROJECT ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. CONTEXTUAL VIEW OF WHITE ROCK ROAD, VIEW OF PROJECT AREA WITH INTERSECTION OF LATROBE ROAD SEEN IN UPPER LEFT; VIEW TO NORTHEAST. - Placerville Road, White Rock Road between Clarksville & White Rock, El Dorado Hills, El Dorado County, CA

  10. Is clinical measurement of anatomic axis of the femur adequate?

    PubMed

    Wu, Chi-Chuan

    2017-03-23

    Background and purpose - The accuracy of using clinical measurement from the anterior superior iliac spine (ASIS) to the center of the knee to determine an anatomic axis of the femur has rarely been studied. A radiographic technique with a full-length standing scanogram (FLSS) was used to assess the adequacy of the clinical measurement. Patients and methods - 100 consecutive young adult patients (mean age 34 (20-40) years) with chronic unilateral lower extremity injuries were studied. The pelvis and intact contralateral lower extremity images in the FLSS were selected for study. The angles between the tibial axis and the femoral shaft anatomic axis (S-AA), the piriformis anatomic axis (P-AA), the clinical anatomic axis (C-AA), and the mechanical axis (MA) were compared between sexes. Results - Only the S-AA and C-AA angles were statistically significantly different in the 100 patients (3.6° vs. 2.8°; p = 0.03). There was a strong correlation between S-AA, P-AA, and C-AA angles (r > 0.9). The average intersecting angle between MA and S-AA in the femur in the 100 patients was 5.5°, and it was 4.8° between MA and C-AA. Interpretation - Clinical measurement of an anatomic axis from the ASIS to the center of the knee may be an adequate and acceptable method to determine lower extremity alignment. The optimal inlet for antegrade femoral intramedullary nailing may be the lateral edge of the piriformis fossa.

  11. Achromatic optical compensation using dispersion of uniaxial films for elimination of off-axis light leakage in a liquid crystal cell.

    PubMed

    Oh, Seung-Won; Wok Park, Byung; Lee, Ji-Hoon; Yoon, Tae-Hoon

    2013-11-10

    We propose an achromatic optical-compensation method using uniaxial films to eliminate the off-axis light leakage at the dark state in a homogeneously aligned liquid crystal cell. Three uniaxial films with different dispersion characteristics are used so that they can compensate each other to achieve achromatic effective phase retardation at off-axis. The retardation values are optimized with the aid of the Poincaré sphere and through numerical research. A contrast ratio of higher than 2000∶1 is predicted over the entire ±60° viewing cone for a homogeneously aligned LC cell with zero pretilt angle.

  12. 4. DETAILED VIEW OF MAIN ENTRANCE ON SOUTHWEST FRONT. VIEW ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. DETAILED VIEW OF MAIN ENTRANCE ON SOUTHWEST FRONT. VIEW TO NORTHEAST. - Commercial & Industrial Buildings, Farley & Loetscher Manufacturing Company, Factory II, 750 White Street, Dubuque, Dubuque County, IA

  13. 4. PERSPECTIVE VIEW OF MAIN AND EAST ELEVATIONS, SHOWING VIEW ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    4. PERSPECTIVE VIEW OF MAIN AND EAST ELEVATIONS, SHOWING VIEW TOWARD CARPENTER'S HALL - Carpenters' Company, Front Store, 322 Chestnut Street & Carpenters' Court, Philadelphia, Philadelphia County, PA

  14. Detail view of upper southwest corner, showing representative view of ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    Detail view of upper southwest corner, showing representative view of cornice and window ornamentation - Hungarian Sick Benefit Societies Building, 1406-1418 State Street, Bridgeport, Fairfield County, CT

  15. Physiology of psychoneuroimmunology: a personal view.

    PubMed

    Besedovsky, Hugo O; Rey, Adriana Del

    2007-01-01

    This article offers a personal view on how the concept of the existence of a network of immune-neuro-endocrine interactions has evolved in the last 30 years. The main topic addressed is the relevance of the exchange of signals between the immune, endocrine and nervous systems for immunoregulation and brain functions. Particular emphasis is given to circuits involving immune cell products, the hypothalamus-pituitary-adrenal axis and the sympathetic nervous system. The operation of these circuits can affect immune functions and the course of inflammatory, autoimmune and infectious diseases. We also discuss increasing evidence that brain-born cytokines play an important role in brain physiology and in the integration of the immune-neuro-endocrine network.

  16. Overhead view of Pathfinder Landing Site

    NASA Technical Reports Server (NTRS)

    1997-01-01

    This image, prepared by Pathfinder scientists at NASA/ Ames Research Center, is a view of the landing site from above. Seen in the lower right is Mermaid dune, with its long axis oriented northwest-southeast and its steeper side, the presumed slipface, toward the southwest. Dunes like Mermaid, the depositional tails and erosional moats associated with rocks in the area, and the fluted and polished surfaces on several boulders at the landing site all indicate an effective wind that blows from the northeast to the southwest.

    Mars Pathfinder is the second in NASA's Discovery program of low-cost spacecraft with highly focused science goals. The Jet Propulsion Laboratory, Pasadena, CA, developed and manages the Mars Pathfinder mission for NASA's Office of Space Science, Washington, D.C. JPL is a division of the California Institute of Technology (Caltech).

  17. Diamond Machining of an Off-Axis Biconic Aspherical Mirror

    NASA Technical Reports Server (NTRS)

    Ohl, Raymond G.; Preuss, Werner; Sohn, Alex; MacKenty, John

    2009-01-01

    Two diamond-machining methods have been developed as part of an effort to design and fabricate an off-axis, biconic ellipsoidal, concave aluminum mirror for an infrared spectrometer at the Kitt Peak National Observatory. Beyond this initial application, the methods can be expected to enable satisfaction of requirements for future instrument mirrors having increasingly complex (including asymmetrical), precise shapes that, heretofore, could not readily be fabricated by diamond machining or, in some cases, could not be fabricated at all. In the initial application, the mirror is prescribed, in terms of Cartesian coordinates x and y, by aperture dimensions of 94 by 76 mm, placements of -2 mm off axis in x and 227 mm off axis in y, an x radius of curvature of 377 mm, a y radius of curvature of 407 mm, an x conic constant of 0.078, and a y conic constant of 0.127. The aspect ratio of the mirror blank is about 6. One common, "diamond machining" process uses single-point diamond turning (SPDT). However, it is impossible to generate the required off-axis, biconic ellipsoidal shape by conventional SPDT because (1) rotational symmetry is an essential element of conventional SPDT and (2) the present off-axis biconic mirror shape lacks rotational symmetry. Following conventional practice, it would be necessary to make this mirror from a glass blank by computer-controlled polishing, which costs more than diamond machining and yields a mirror that is more difficult to mount to a metal bench. One of the two present diamond machining methods involves the use of an SPDT machine equipped with a fast tool servo (FTS). The SPDT machine is programmed to follow the rotationally symmetric asphere that best fits the desired off-axis, biconic ellipsoidal surface. The FTS is actuated in synchronism with the rotation of the SPDT machine to generate the difference between the desired surface and the best-fit rotationally symmetric asphere. In order to minimize the required stroke of the FTS

  18. An optical-axis freezing stage for laser-scanning microscopy of broad ice-water interfaces.

    PubMed

    Neils, C M; Diller, K R

    2004-12-01

    This article presents a method to view a dynamic ice interface along the axis of ice growth using a laser-scanning microscope. A deep liquid volume is chilled from below so that ice growth is directed upward toward the microscope objective. The interface is made visible by rejection of fluorescent dye from the solid phase into the liquid. Images of the interface morphology in water with solutes of interest to cryobiology illustrate the imaging capability. These images are processed to quantify the lamellar structure of the ice interface. The optical-axis cryostage provides advantages over horizontal arrangements because (1) immersion objectives enhance, rather than disturb, the desired thermal gradient, and (2) features in the ice interface are not confined within a narrow capillary tube or microscope slide. This arrangement loses some of the thermal control found in planar freezing stages, and the dynamic, refractive interface presents challenges to confocal microscopy.

  19. Design of off-axis four-mirror optical system without obscuration based on free-form surface

    NASA Astrophysics Data System (ADS)

    Huang, Chenxu; Liu, Xin

    2015-11-01

    With the development of modern military technology, the requirements of airborne electro-optical search and tracking system are increasing on target detection and recognition. However, traditional off-axis three-mirror system couldn't meet the requirements for reducing weight and compacting size in some circumstances. Based on Seidel aberration theory, by restricting the aberration functions, the optical system could achieve initial construction parameters. During the designing process, decenters and tilts of mirrors were adjusted continuously to eliminate the obscurations. To balance off-axis aberration and increase angle of view, the free-form mirror was introduced into the optical system. Then an unobstructed optical system with effective focal length of 100 mm, FOV of 16°×16°, and relative aperture as F/7 is designed. The results show that the system structure is compact, with imaging qualities approaching diffraction limit.

  20. Magnetic axis alignment and the Poisson alignment reference system

    NASA Astrophysics Data System (ADS)

    Griffith, Lee V.; Schenz, Richard F.; Sommargren, Gary E.

    1989-01-01

    Three distinct metrological operations are necessary to align a free-electron laser (FEL): the magnetic axis must be located, a straight line reference (SLR) must be generated, and the magnetic axis must be related to the SLR. This paper begins with a review of the motivation for developing an alignment system that will assure better than 100 micrometer accuracy in the alignment of the magnetic axis throughout an FEL. The paper describes techniques for identifying the magnetic axis of solenoids, quadrupoles, and wiggler poles. Propagation of a laser beam is described to the extent of revealing sources of nonlinearity in the beam. Development and use of the Poisson line, a diffraction effect, is described in detail. Spheres in a large-diameter laser beam create Poisson lines and thus provide a necessary mechanism for gauging between the magnetic axis and the SLR. Procedures for installing FEL components and calibrating alignment fiducials to the magnetic axes of the components are also described. An error budget shows that the Poisson alignment reference system will make it possible to meet the alignment tolerances for an FEL.

  1. Mifepristone Accelerates HPA Axis Recovery in Secondary Adrenal Insufficiency.

    PubMed

    Cohan, Pejman

    2016-01-01

    Context. Transient secondary adrenal insufficiency (SAI) is an expected complication following successful adenomectomy of ACTH-secreting pituitary adenomas or unilateral adrenalectomy for cortisol-secreting adrenal adenomas. To date, no pharmacological therapy has been shown to hasten recovery of the hypothalamic-pituitary-adrenal (HPA) axis in this clinical scenario. Case Description. A 33-year-old woman underwent uncomplicated unilateral adrenalectomy for a 3.7 cm cortisol-secreting adrenal adenoma. Postoperatively, she developed SAI and was placed on hydrocortisone 15 mg/day, given in divided doses. In the ensuing six years, the patient's HPA axis failed to recover and she remained corticosteroid-dependent. Quarterly biochemical testing (after withholding hydrocortisone for 18 hours) consistently yielded undetectable serum cortisol and subnormal plasma ACTH levels. While she was on hydrocortisone 15 mg/day, mifepristone was initiated and gradually titrated to a maintenance dose of 600 mg/day after 5 months. Rapid recovery of the HPA axis was subsequently noted with ACTH rising into the supranormal range at 4 months followed by a subsequent rise in cortisol levels into the normal range. After 6 months, the dose of hydrocortisone and mifepristone was lowered and both were ultimately stopped after 8 months. The HPA axis remains normal after an additional 16 months of follow-up. Conclusion. Mifepristone successfully restored the HPA axis in a woman with prolonged secondary adrenal insufficiency (SAI) after adrenalectomy for Cushing's syndrome (CS).

  2. Alignment method of off-axis RC reflective optical system

    NASA Astrophysics Data System (ADS)

    Xue-min, Zhang; Xing, Song; Zhi-jun, Zhang; Hou, Xiao-hua

    2016-10-01

    Off-axis optical system has a wide application in space optics and remote detective area. The high surface shape accuracy can be ensured with the development of advanced manufacture technique. So the only condition which limits the wide application of off-axis optical system is how to realize the precise alignment of it. Based on a RC reflective optical system whose diameter is 400mm, the alignment method which combines the high resolution initial placement and computer-aided alignment is introduced. By designing a system which can measure the off-axis fabrication and off-axis angle precisely, the high resolution initial placement of off-axis mirror can be ensured with a measurement accuracy of +/-0.05mm and +/-10". The good initial placement can give a good initial state, so the computer-aided model can be converged well. The experiment shows that a system which has a good initial placement could have a good wave aberration of 0.04λ after three times iteration adjustment.

  3. Measurement of a part having a known axis misalignment

    SciTech Connect

    Castleton, R.

    1993-05-01

    It has been shown that undetected misalignment of the axis of a part can lead to unacceptable measurement errors. For this technical note, it is assumed that the axis misalignment has been determined, and that polar sweeps are used to measure the part. The proposed polar sweeps run vertically (ignoring the axis misalignment) between a plane that is parallel to the bottom datum surface of the part and a second such plane that is close to the pole of the part. No attempt is made to correct for axis misalignment by rotation of the part during the measurement sweeps. It is apparent that the distance traveled along the measurement sweep is more than the arc length representing the actual change in elevation in the part coordinate system. It is proposed that the measurement of the part on the vertical path be used as the measurement of the part on the base longitude line. This introduces an error, {delta}{theta}, in the sensitive direction that corresponds to the arc length B-S. It is shown that this error is not significant when the axis misalignment is small.

  4. Mifepristone Accelerates HPA Axis Recovery in Secondary Adrenal Insufficiency

    PubMed Central

    2016-01-01

    Context. Transient secondary adrenal insufficiency (SAI) is an expected complication following successful adenomectomy of ACTH-secreting pituitary adenomas or unilateral adrenalectomy for cortisol-secreting adrenal adenomas. To date, no pharmacological therapy has been shown to hasten recovery of the hypothalamic-pituitary-adrenal (HPA) axis in this clinical scenario. Case Description. A 33-year-old woman underwent uncomplicated unilateral adrenalectomy for a 3.7 cm cortisol-secreting adrenal adenoma. Postoperatively, she developed SAI and was placed on hydrocortisone 15 mg/day, given in divided doses. In the ensuing six years, the patient's HPA axis failed to recover and she remained corticosteroid-dependent. Quarterly biochemical testing (after withholding hydrocortisone for 18 hours) consistently yielded undetectable serum cortisol and subnormal plasma ACTH levels. While she was on hydrocortisone 15 mg/day, mifepristone was initiated and gradually titrated to a maintenance dose of 600 mg/day after 5 months. Rapid recovery of the HPA axis was subsequently noted with ACTH rising into the supranormal range at 4 months followed by a subsequent rise in cortisol levels into the normal range. After 6 months, the dose of hydrocortisone and mifepristone was lowered and both were ultimately stopped after 8 months. The HPA axis remains normal after an additional 16 months of follow-up. Conclusion. Mifepristone successfully restored the HPA axis in a woman with prolonged secondary adrenal insufficiency (SAI) after adrenalectomy for Cushing's syndrome (CS). PMID:27516913

  5. Semi-Major Axis Knowledge and GPS Orbit Determination

    NASA Technical Reports Server (NTRS)

    Carpenter, J. Russell; Schiesser, Emil R.; Bauer, F. (Technical Monitor)

    2000-01-01

    In recent years spacecraft designers have increasingly sought to use onboard Global Positioning System receivers for orbit determination. The superb positioning accuracy of GPS has tended to focus more attention on the system's capability to determine the spacecraft's location at a particular epoch than on accurate orbit determination, per se. The determination of orbit plane orientation and orbit shape to acceptable levels is less challenging than the determination of orbital period or semi-major axis. It is necessary to address semi-major axis mission requirements and the GPS receiver capability for orbital maneuver targeting and other operations that require trajectory prediction. Failure to determine semi-major axis accurately can result in a solution that may not be usable for targeting the execution of orbit adjustment and rendezvous maneuvers. Simple formulas, charts, and rules of thumb relating position, velocity, and semi-major axis are useful in design and analysis of GPS receivers for near circular orbit operations, including rendezvous and formation flying missions. Space Shuttle flights of a number of different GPS receivers, including a mix of unfiltered and filtered solution data and Standard and Precise Positioning, Service modes, have been accomplished. These results indicate that semi-major axis is often not determined very accurately, due to a poor velocity solution and a lack of proper filtering to provide good radial and speed error correlation.

  6. The Patient-Psychiatrist Relationship on the Axis of the Other and the Same.

    PubMed

    Schreiber, Gabriel; Avissar, Sofia; Jotkowitz, Alan; Halperin, Demian

    2016-12-14

    The patient-psychiatrist relationship is a cornerstone of psychiatric professionalism and ethics. We discuss this topic along the axis of the Other and the Same, concepts defined by continental philosophy. The self of Anglo-American philosophy is typically described in individualistic terms. Individualism, autonomy and ideal self are valorized within the current model of care. These characteristics belong to the Lacanian Imaginary Order, which is the core of narcissism. Patients may yearn for another model of interaction. For Levinas, ethics should not involve a search for perfectionism and accomplishment but responsibility toward others. Ethics is, according to him, rooted in the calling into question of one's Sameness by the other's Otherness. The question of hospitality and of the welcoming of Otherness is central to his thought. Derrida further asks whether hospitality is not an interruption of the self. Hospitality may thus become a fundamental way of re-thinking clinical practices. A relationship to the Other as an-other is characterized as of Euclidian-type, establishing borders between the self and the Other, whereas a relationship to the Other as same is characterized as of fractal-type, emphasizing similarities between self and other as same and obliterating boundaries. Winnicott's object-relating versus use of object and Buber's I-you and I-it relations are also examined along the axis of Sameness and Otherness. Since psychiatric clinical practice requires to our view adequate and adaptive to and fro movements along this axis, the two forms of relating to the Other are discussed both theoretically and through a clinical case presentation.

  7. Microbial genes, brain & behaviour - epigenetic regulation of the gut-brain axis.

    PubMed

    Stilling, R M; Dinan, T G; Cryan, J F

    2014-01-01

    To date, there is rapidly increasing evidence for host-microbe interaction at virtually all levels of complexity, ranging from direct cell-to-cell communication to extensive systemic signalling, and involving various organs and organ systems, including the central nervous system. As such, the discovery that differential microbial composition is associated with alterations in behaviour and cognition has significantly contributed to establishing the microbiota-gut-brain axis as an extension of the well-accepted gut-brain axis concept. Many efforts have been focused on delineating a role for this axis in health and disease, ranging from stress-related disorders such as depression, anxiety and irritable bowel syndrome to neurodevelopmental disorders such as autism. There is also a growing appreciation of the role of epigenetic mechanisms in shaping brain and behaviour. However, the role of epigenetics in informing host-microbe interactions has received little attention to date. This is despite the fact that there are many plausible routes of interaction between epigenetic mechanisms and the host-microbiota dialogue. From this new perspective we put forward novel, yet testable, hypotheses. Firstly, we suggest that gut-microbial products can affect chromatin plasticity within their host's brain that in turn leads to changes in neuronal transcription and eventually alters host behaviour. Secondly, we argue that the microbiota is an important mediator of gene-environment interactions. Finally, we reason that the microbiota itself may be viewed as an epigenetic entity. In conclusion, the fields of (neuro)epigenetics and microbiology are converging at many levels and more interdisciplinary studies are necessary to unravel the full range of this interaction.

  8. An FGF3-BMP Signaling Axis Regulates Caudal Neural Tube Closure, Neural Crest Specification and Anterior-Posterior Axis Extension.

    PubMed

    Anderson, Matthew J; Schimmang, Thomas; Lewandoski, Mark

    2016-05-01

    During vertebrate axis extension, adjacent tissue layers undergo profound morphological changes: within the neuroepithelium, neural tube closure and neural crest formation are occurring, while within the paraxial mesoderm somites are segmenting from the presomitic mesoderm (PSM). Little is known about the signals between these tissues that regulate their coordinated morphogenesis. Here, we analyze the posterior axis truncation of mouse Fgf3 null homozygotes and demonstrate that the earliest role of PSM-derived FGF3 is to regulate BMP signals in the adjacent neuroepithelium. FGF3 loss causes elevated BMP signals leading to increased neuroepithelium proliferation, delay in neural tube closure and premature neural crest specification. We demonstrate that elevated BMP4 depletes PSM progenitors in vitro, phenocopying the Fgf3 mutant, suggesting that excessive BMP signals cause the Fgf3 axis defect. To test this in vivo we increased BMP signaling in Fgf3 mutants by removing one copy of Noggin, which encodes a BMP antagonist. In such mutants, all parameters of the Fgf3 phenotype were exacerbated: neural tube closure delay, premature neural crest specification, and premature axis termination. Conversely, genetically decreasing BMP signaling in Fgf3 mutants, via loss of BMP receptor activity, alleviates morphological defects. Aberrant apoptosis is observed in the Fgf3 mutant tailbud. However, we demonstrate that cell death does not cause the Fgf3 phenotype: blocking apoptosis via deletion of pro-apoptotic genes surprisingly increases all Fgf3 defects including causing spina bifida. We demonstrate that this counterintuitive consequence of blocking apoptosis is caused by the increased survival of BMP-producing cells in the neuroepithelium. Thus, we show that FGF3 in the caudal vertebrate embryo regulates BMP signaling in the neuroepithelium, which in turn regulates neural tube closure, neural crest specification and axis termination. Uncovering this FGF3-BMP signaling axis is

  9. An FGF3-BMP Signaling Axis Regulates Caudal Neural Tube Closure, Neural Crest Specification and Anterior-Posterior Axis Extension

    PubMed Central

    Anderson, Matthew J.; Schimmang, Thomas; Lewandoski, Mark

    2016-01-01

    During vertebrate axis extension, adjacent tissue layers undergo profound morphological changes: within the neuroepithelium, neural tube closure and neural crest formation are occurring, while within the paraxial mesoderm somites are segmenting from the presomitic mesoderm (PSM). Little is known about the signals between these tissues that regulate their coordinated morphogenesis. Here, we analyze the posterior axis truncation of mouse Fgf3 null homozygotes and demonstrate that the earliest role of PSM-derived FGF3 is to regulate BMP signals in the adjacent neuroepithelium. FGF3 loss causes elevated BMP signals leading to increased neuroepithelium proliferation, delay in neural tube closure and premature neural crest specification. We demonstrate that elevated BMP4 depletes PSM progenitors in vitro, phenocopying the Fgf3 mutant, suggesting that excessive BMP signals cause the Fgf3 axis defect. To test this in vivo we increased BMP signaling in Fgf3 mutants by removing one copy of Noggin, which encodes a BMP antagonist. In such mutants, all parameters of the Fgf3 phenotype were exacerbated: neural tube closure delay, premature neural crest specification, and premature axis termination. Conversely, genetically decreasing BMP signaling in Fgf3 mutants, via loss of BMP receptor activity, alleviates morphological defects. Aberrant apoptosis is observed in the Fgf3 mutant tailbud. However, we demonstrate that cell death does not cause the Fgf3 phenotype: blocking apoptosis via deletion of pro-apoptotic genes surprisingly increases all Fgf3 defects including causing spina bifida. We demonstrate that this counterintuitive consequence of blocking apoptosis is caused by the increased survival of BMP-producing cells in the neuroepithelium. Thus, we show that FGF3 in the caudal vertebrate embryo regulates BMP signaling in the neuroepithelium, which in turn regulates neural tube closure, neural crest specification and axis termination. Uncovering this FGF3-BMP signaling axis is

  10. Charge rearrangement in magnetite: from magnetic field induced easy axis switching to femtoseconds electronic processes

    NASA Astrophysics Data System (ADS)

    Kąkol, Z.; Kozłowski, A.; Kołodziej, T.; Przewoźnik, J.

    2015-02-01

    Magnetite is the oldest magnet and the first material where the concept of a strong correlations driven metal-insulator transition was suggested and found at TV = 124 K in the so-called Verwey phase transformation. Recently, the structure below TV was solved revealing subtle electronic structure in the form of trimeron lattice that, according to yet another recent communication, may be switched within femtosecond range. In this review article, we argue that the same change of trimeron lattice can be achieved by a magnetic field, in the phenomenon called the easy axis switching. The results of many of our experiments show that although this process is best viewed by magnetization studies, it is also reflected in magnetostriction, causes some changes in electronic transport and can be observed microscopically by NMR that proved electronic order alteration. All those facts suggest that the axis switching process observed and studied by us is intimately linked with the fast change of electronic trimeron order mentioned above.

  11. Slightly off-axis holography with partially coherent illumination implemented into a standard microscope

    NASA Astrophysics Data System (ADS)

    Micó, Vicente; Picazo-Bueno, José Angel; Zalevsky, Zeev; Garcia, Javier; Ferreira, Carlos

    2016-04-01

    We have recently reported on a simple, low cost and highly stable way to convert a standard microscope into a holographic one [Opt. Express 22, 14929 (2014)]. The method, named as Spatially-Multiplexed Interferometric Microscopy (SMIM), proposes an off-axis holographic architecture implemented onto a regular (non-holographic) microscope with minimum modifications: the use of coherent illumination and a properly placed and selected onedimensional diffraction grating. In this contribution, we report on the implementation of partially (temporally reduced) coherent illumination in SMIM as a way to improve quantitative phase imaging. The use of low coherence sources forces the application of phase shifting algorithm instead of off-axis holographic recording to recover the sample's phase information but improves phase reconstruction due to coherence noise reduction. In addition, a less restrictive field of view limitation (1/2) is implemented in comparison with our previously reported scheme (1/3). The proposed modification is experimentally validated in a regular Olympus BX-60 upright microscope considering calibration samples (resolution test and microbeads) and for two different microscope objectives (10X and 20X).

  12. Effects of global warming on fish reproductive endocrine axis, with special emphasis in pejerrey Odontesthes bonariensis.

    PubMed

    Miranda, Leandro Andrés; Chalde, Tomás; Elisio, Mariano; Strüssmann, Carlos Augusto

    2013-10-01

    The ongoing of global warming trend has led to an increase in temperature of several water bodies. Reproduction in fish, compared with other physiological processes, only occurs in a bounded temperature range; therefore, small changes in water temperature could significantly affect this process. This review provides evidence that fish reproduction may be directly affected by further global warming and that abnormal high water temperature impairs the expression of important genes throughout the brain-pituitary-gonad axis. In all fishes studied, gonads seem to be the organ more readily damaged by heat treatments through the inhibition of the gene expression and subsequent synthesis of different gonadal steroidogenic enzymes. In view of the feedback role of sex steroids upon the synthesis and release of GnRH and GtHs in fish, it is possible that the inhibition observed at brain and pituitary levels in treated fish is consequence of the sharp decrease in plasma steroids levels. Results of in vitro studies on the inhibition of pejerrey gonad aromatase expression by high temperature corroborate that ovary functions are directly disrupted by high temperature independently of the brain-pituitary axis. For the reproductive responses obtained in laboratory fish studies, it is plausible to predict changes in the timing and magnitude of reproductive activity or even the total failure of spawning season may occur in warm years, reducing annual reproductive output and affecting future populations.

  13. Interaction between energy homeostasis and reproduction: central effects of leptin and ghrelin on the reproductive axis.

    PubMed

    Tena-Sempere, M

    2013-12-01

    Reproductive maturation and function are sensitive to the metabolic state of the organism and the magnitude of body fuel reserves; hence, conditions ranging from energy insufficiency to morbid obesity impact the timing of puberty and are frequently linked to fertility problems. This phenomenon is the result of the close interplay between a diversity of nutritional cues and metabolic signals (including hormones) with different elements of the so-called hypothalamic-pituitary-gonadal (HPG) axis. In this review, we will focus our attention on the 'reproductive' roles of 2 key metabolic hormones, namely, the adipose signal, leptin, and the gut hormone, ghrelin. These 2 factors, which have been proposed to operate as functional antagonists in the control of metabolism and energy homeostasis, are also provided with important, and in many cases opposite, roles in the regulation of puberty onset and gonadal function. We will provide herein an update view of the reproductive effects of leptin and ghrelin, with a major emphasis on the actions of these 2 key hormones upon the central elements of the HPG axis, including their putative effects on Kiss1 and other reproductive neuronal networks. This will help to understand the mechanisms whereby reproductive function is gated and dynamically regulated by metabolic signals at different key developmental stages, such as puberty and adulthood.

  14. Theoretical and experimental investigation of design for multioptical-axis freeform progressive addition lenses

    NASA Astrophysics Data System (ADS)

    Xiang, HuaZhong; Chen, JiaBi; Zhu, TianFen; Wei, YeFei; Fu, DongXiang

    2015-11-01

    A freeform progressive addition lens (PAL) provides a good solution to correct presbyopia and prevent juvenile myopia by distributing pupils' optical powers of distance zone, near zone, and intermediate zone and is more widely adopted in the present optometric study. However, there is still a lack of a single-optical-axis system for the design of a PAL. This paper focuses on the research for an approach for designing a freeform PAL. A multioptical-axis system based on real viewing conditions using the eyes is employed for the representation of the freeform surface. We filled small pupils in the intermediate zone as a progressive corridor and the distance- and near-vision portions were defined as the standard spherical surfaces delimited by quadratic curves. Three freeform PALs with a spherical surface as the front side and a freeform surface as the backside were designed. We demonstrate the fabrication and measurement technologies for the PAL surface using computer numerical control machine tools from Schneider Smart and a Visionix VM-2000 Lens Power Mapper. Surface power and astigmatic values were obtained. Preliminary results showed that the approach for the design and fabrication is helpful to advance the design procedure optimization and mass production of PALs in optometry.

  15. A novel three-axis cylindrical hohlraum designed for inertial confinement fusion ignition

    PubMed Central

    Kuang, Longyu; Li, Hang; Jing, Longfei; Lin, Zhiwei; Zhang, Lu; Li, Liling; Ding, Yongkun; Jiang, Shaoen; Liu, Jie; Zheng, Jian

    2016-01-01

    A novel ignition hohlraum for indirect-drive inertial confinement fusion is proposed, which is named three-axis cylindrical hohlraum (TACH). TACH is a kind of 6 laser entrance holes (LEHs) hohlraum, which is orthogonally jointed of three cylindrical hohlraums. Laser beams are injected through every entrance hole with the same incident angle of 55°. A view-factor simulation result shows that the time-varying drive asymmetry of TACH is less than 1.0% in the whole drive pulse period without any supplementary technology. Coupling efficiency of TACH is close to that of 6 LEHs spherical hohlraum with corresponding size. Its plasma-filling time is close to that of typical cylindrical ignition hohlraum. Its laser plasma interaction has as low backscattering as the outer cone of the cylindrical ignition hohlraum. Therefore, TACH combines most advantages of various hohlraums and has little predictable risk, providing an important competitive candidate for ignition hohlraum. PMID:27703250

  16. Alignment of fiducial marks in a tomographic tilt series with an unknown rotation axis

    NASA Astrophysics Data System (ADS)

    Levine, Zachary H.; Volkovitsky, Alex; Hung, Howard K.

    2007-06-01

    Alignment for tomography using a transmission electron microscopy frequently uses colloidal gold particles as fiducial reference marks. Typically, there is an implicit assumption that the tilt axis of the tomographic series is orthogonal to the beam direction. However, this may not be true, either intentionally, if a tilt-rotate stage is used, or unintentionally, because of mechanical errors in the rotation stage or the sample fixture. Here, we provide a computer code which takes as input a set of two-dimensional (2D) observations of fiducial reference marks at various tilt angles and the values of those tilt angles. It produces as output a three-dimensional model of the observations, 2D shifts for each view, and the tilt axis direction. Program summaryTitle of program: particleTilt Catalogue identifier: ADYW_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADYW_v1_0 Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Computers: IBM compatible desktop PC; SGI Octane Operating system: Red Hat WS 3 Linux (with 2.4.21-40.EL kernel); IRIX 6.5 IP30 Program language used: Fortran 90 No. of bits in a word: 32 No. of processors used: one Has the code been vectorized: no No. of lines in distributed program, including test data, etc.: 2397 No. of bytes in distributed program, including test data, etc.: 47 017 Distribution format: tar.gz Peripherals used: one Typical running time: 350 ms (larger included example, on 2.8 GHz 32-bit PC) Nature of problem: The program is used to assist the alignment step in tomography. The samples should be prepared with spherical particles (typically gold beads) which are observed in several views. (Not every particle need be observed in every view.) The program reports coordinates of a 3D model of the particles as well as the direction of the tilt axis as a point on the unit sphere. Method of solution: Our package minimizes an objective function whose free variables are a set of 3D model points and

  17. A novel three-axis cylindrical hohlraum designed for inertial confinement fusion ignition

    NASA Astrophysics Data System (ADS)

    Kuang, Longyu; Li, Hang; Jing, Longfei; Lin, Zhiwei; Zhang, Lu; Li, Liling; Ding, Yongkun; Jiang, Shaoen; Liu, Jie; Zheng, Jian

    2016-10-01

    A novel ignition hohlraum for indirect-drive inertial confinement fusion is proposed, which is named three-axis cylindrical hohlraum (TACH). TACH is a kind of 6 laser entrance holes (LEHs) hohlraum, which is orthogonally jointed of three cylindrical hohlraums. Laser beams are injected through every entrance hole with the same incident angle of 55°. A view-factor simulation result shows that the time-varying drive asymmetry of TACH is less than 1.0% in the whole drive pulse period without any supplementary technology. Coupling efficiency of TACH is close to that of 6 LEHs spherical hohlraum with corresponding size. Its plasma-filling time is close to that of typical cylindrical ignition hohlraum. Its laser plasma interaction has as low backscattering as the outer cone of the cylindrical ignition hohlraum. Therefore, TACH combines most advantages of various hohlraums and has little predictable risk, providing an important competitive candidate for ignition hohlraum.

  18. A novel three-axis cylindrical hohlraum designed for inertial confinement fusion ignition

    NASA Astrophysics Data System (ADS)

    Jiang, Shaoen; Kuang, Longyu; Li, Hang; Jing, Longfei; Lin, Zhiwei; Zhang, Lu; Li, Lilin; Ding, Yongkun; Zheng, Jian; Liu, Jie

    2016-10-01

    A novel ignition hohlraum for indirect-drive inertial confinement fusion is proposed, which is named as three-axis cylindrical hohlraum (TACH). TACH is a kind of 6 laser entrance holes (LEHs) hohlraum, which is made of three cylindrical hohlraums orthogonally jointed. Laser beams are injected through every entrance hole with the same incident angle of 55°. The view-factor simulation result shows that the time-varying drive asymmetry of TACH is no more than 1.0% in the whole drive pulse period without any supplementary technology such as beam phasing etc. Its coupling efficiency of TACH is close to that of 6 LEHs spherical hohlraum with corresponding size. Its plasma-filling time is close to typical cylindrical ignition hohlraum. Its laser plasma interaction has as low backscattering as the outer cone of the cylindrical ignition hohlraum. Therefore, the proposed hohlraum provides a competitive candidate for ignition hohlraum.

  19. Plasma Parking into Off-axis Storage Traps

    NASA Astrophysics Data System (ADS)

    Danielson, J. R.; Hurst, N. C.; Baker, C. J.; Surko, C. M.

    2015-11-01

    Advanced uses of positrons benefit by the development of efficient techniques for particle accumulation, storage and delivery. The multicell Penning-Malmberg trap is being developed as a way to obtain high-capacity antimatter traps. The multicell test structure at UCSD consists of multiple aligned storage cells, with one cell on the magnetic axis, and three off-axis. Described here are tests of the process by which plasma, first located in a large diameter master cell, is autoresonantly excited into a large amplitude diocotron mode and then transferred into off-axis cells. Through the use of bounce-average orbits and other manipulation techniques, the plasma position during transfer can be controlled precisely, and the plasma can be ``parked'' at any radial or azimuthal location within a storage cell. Other experiments in the test structure, including plasma lifetime studies and experiments with large space charge, will also be described.

  20. Microscope system with on axis programmable Fourier transform filtering

    NASA Astrophysics Data System (ADS)

    Martínez, José Luis; García-Martínez, Pascuala; Moreno, Ignacio

    2017-02-01

    We propose an on-axis microscope optical system to implement programmable optical Fourier transform image processing operations, taking advantage of phase and polarization modulation of a liquid crystal on silicon (LCOS) display. We use a Hamamatsu spatial light modulator (SLM), free of flickering, which therefore can be tuned to fully eliminate the zero order component of the encoded diffractive filter. This allows the realization of filtering operation on axis (as opposed to other systems in the literature that require operating off axis), therefore making use of the full space bandwidth provided by the SLM. The system is first demonstrated by implementing different optical processing operations based on phase-only blazed gratings such as phase contrast, band-pass filtering, or additive and substractive imaging. Then, a simple Differential interference contrast (DIC) imaging is obtained changing to a polarization modulation scheme, achieved simply by selecting a different incident state of polarization on the incident beam.